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CAMH Stories Centre for Addiction
and Mental Health

Project Echo reaches out to Ontario's Aboriginal Communities

TORONTO, March 17, 2017 - Project ECHO, the internationally-acclaimed model for mental health care that came to CAMH a year ago, has now been expanded to several Aboriginal communities in Ontario.

ECHO Ontario First Nations, Inuit and Métis Wellness is a branch of ECHO Ontario Mental Health. Calling itself a “high speed internet connection for the health care system,” the Project ECHO model uses telemedicine technology to bring the best practices in complex mental health care to communities where access to specialized care for clients with complex needs is scarce or not available.

Here is how it works. Every two weeks, a multi-disciplinary team at CAMH that includes a psychiatrist, a neurologist, an addictions specialist, as well as Indigenous social workers and Elders, holds a video workshop with mental health professionals from Aboriginal communities across Ontario, known as “spokes” in the Project Echo model.

During each session, a case study of a client with a complex mental illness who is being treated at one of those spokes is presented by a clinician there to the CAMH team in Toronto. The Toronto team interacts with clinicians at the spokes via a giant video wall that allows them to see and hear the members of the Toronto team and each other. As the particulars of the case are presented and discussed, the CAMH team provides its collective feedback on the best and most current practices back to the clinician at that spoke.

“It can be very isolating to work in those communities and the knowledge sharing with ECHO can be very helpful,” says ECHO Ontario First Nations, Inuit and Métis Wellness Co-Chair Dr. Allison Crawford. “You don’t get specialists in such small communities. To be expected to manage every complex case on your own is a huge burden.”

Echo team meeting
The new program uses the same principles of the Project ECHO model and adapts it to the unique needs and cultural and spiritual practices of Ontario Aboriginal communities.

“As we know, our communities are all different,” says Indigenous Telemedicine Coordinator Jeff D’Hondt. “There is north, south, urban, rural, different nations, different languages, different beliefs. It’s hard to come up with one specific resource, but the advantage of ECHO is that we don’t have to do that because we can talk to each other all at once. So working together province-wide means we can address the issues province-wide.”

In addition to helping clinicians in Aboriginal communities deal with complex cases, the Project ECHO model also encourages those clinicians to share their unique experiences and practices to the Toronto team and the clinicians on the other spokes. 

“It’s not just about one group teaching another group,” Dr. Crawford says. “Everyone contributes and everyone teaches.”

CAMH Aboriginal Service Social Worker Walter Lindstone, also a member of the ECHO Ontario First Nations, Inuit and Métis Wellness team, saw that himself during the first session last week. There he presented a case study of one of his complex clients to the clinicians on the spokes. The purpose was to show the clinicians listening in how their own case studies should be presented at future sessions. But what surprised Lindstone was how useful their feedback was to his own work.

“It was amazing to see that range of knowledge at the table,” says Lindstone. “The people chiming in from the spokes gave me a tremendous number of recommendations that I would not have thought of-- it was very rewarding. I was in awe of how well it went and how many different aspects of learning were a part of it.”

The full ECHO Ontario First Nations, Inuit and Métis Wellness team includes:

  • Allison Crawford, Psychiatrist, Co-chair 
  • Renee Linklater, Co-chair
  • Diane Longboat, Elder and Senior Project Manager
  • Eva Serhal, Manager
  • Jeff D'Hondt, Aboriginal Telemental Health Coordinator
  • Walter Lindstone, Social Worker
  • Jonathan Bertram, Addiction Medicine Physician
  • Andrew Smith, Neurologist and Addictions Medicine
  • Amanda Arena, Research coordinator
  • Christine Mitchell, Project Coordinator
  • Julie Bull, Research Methods Specialist (Aboriginal Engagement and Outreach)
  • Maurey Nadarajah, Administrative Supervisor
  • Sharon Bailey and Terri Rodak, Librarians
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