The City of Toronto is starting construction on Ossington Avenue on March 27 until the end of May 2023. During the duration of construction, Ossington Avenue from Argyle Street to Queen Street will be reduced to south bound only for vehicles.
At CAMH, hope is in our DNA. So when Tim Rankin approached Nicole Thomson about an idea that would potentially save lives, they understood the importance and the potential impact of the project they were undertaking.
“Tim approached me to collaborate on exploring innovative solutions to prevent suicide,” says Nicole, Senior Director of Quality Innovation, Patient Safety & Experience. “We wanted to ensure that any ideas that were generated would be aligned with the broader patient safety goals at CAMH. This is how suicide safety planning became the area of focus for our submission for CAMH Innovation Day.”
The idea: to create a mobile safety planning app for patients and smartphone users that would provide people experiencing suicidal thoughts with the tools and resources to help keep them safe. For Tim, this was a personal endeavor as much as it was a professional one.
“My wife has suffered from depression and anxiety for many years,” he says. “One night she made a suicide attempt – thankfully, she survived. Her psychiatrist advised that she create a safety plan to identify personal warning signs, coping strategies, etc. that she could reference to help avoid a crisis or guide her through one. This was a bit of a relief for me, but the plan was on paper and I feared she might not have it with her when she needed it most.”
The initial team included, Tim, Operations Manager with CAMH’s IMG department, who would manage and oversee the submission, Nicole, who would provide the quality, patient safety and academic perspective, and IT Specialist Gurpal Bubbra, who would build the app. They spent time deciding on what tools to include, how it would work, and considered a phased approach to its continued development.
“Tim was the real champion for this; he was fundamental to it all,” says Nicole. “We worked together to pitch the idea in its most basic form, with plans of ongoing development in several phases.”
“When we pitched it at the expo, there was really nothing at that point,” says Tim. “[My wife’s] suicide attempt was very fresh, and it helped me think about ideas that could make a difference.”
For Jill Sword, the app has been a life-saver. Literally.
“I’m not afraid to talk about suicide – it’s part of who I am and part of my history and recovery.”
As a former patient at the Clarke Institute and the Addiction Research Foundation – two of the precursors to CAMH – Jill has had years of first-hand insight into her own mental health. She now volunteers at CAMH’s ECT clinic and also assists in our Patient & Family Experience department, and was one of the beta testers of the app.
“I’ve been part of many crisis plans before – they were generally just sheets of paper that were often out of date, and they often change over the years. Trying to find that piece of paper was often difficult. This is the first time I’ve seen these tools as an app.”
Kylie Payne echoes those sentiments. As a patient who has been to CAMH three times, she’s had experience with crisis plans before, and acknowledges why they don’t always work.
“My experience at CAMH was great, and when you leave they come up with a treatment plan with what you’re supposed to do. The problem was that it’s on pieces of paper. When you get home, you’ve got a bunch of papers you’ll eventually put in a box with other documents. And when you need them the most, you just can’t go through hundreds of pieces of paper to find your crisis plan.”
For Jill and Kylie, having an easy-to-access app has been key to maintaining their mental health, and serves as a constant reminder to check in and update their safety plan.
“Your thinking process is not clear when you’re in crisis. I have a very hard time thinking when I’m in crisis,” says Jill. “When things are starting to go south, you can go in [the app] and it tells you things to do to make you feel better, or to distract you. They’re adapted to you, to suggest things you may want to do to distract yourself from suicide.”
“It’s an amazing idea and also brings back the idea of patient empowerment,” adds Kylie. “Sometimes you feel hopeless and lonely, your doctors are far away, and you’re in the zone. Having a little thing to remind you on your phone that you’re not feeling good, or that you are feeling good – it puts the ball in the patient’s court. Being able to check on yourself and to be reminded of ways to manage your own mental health is always a good thing.”
Hope for tomorrow
Over the course of the last year-and-a-half, the app has seen a lot of improvements and includes a robust set of tools and features, including mindfulness and relaxation tools, crisis resources and even a journal so that users can jot down their feelings. It’s evident that the app has been created with great care and foresight, and continues to evolve with the feedback that they receive from users.
“We initially planned to keep it more basic in phase one, but as we built it out, it grew and there was always more information to move it forward. And there are more great ideas to continue to move it further,” says Nicole.
“This whole app was done in-house; everything by CAMH staff. The project team consisted of myself, Gurpal, Nicole, and expanded to include colleagues Kimberly Hunter, Lydia Sequeira and Stephanie Carter. Content and feedback was also provided through several clinical experts, as well as Legal and Privacy teams. It was an all-round team effort,” says Tim.
The app has just been added to both the Google Play Store and the iOS App Store and it’s now free to download, giving a larger number of users access to this life-changing tool. But the team that developed the app are also keen to increase its profile among patients at CAMH.
“Suicide prevention is a quality and patient safety priority at CAMH. It’s a required organizational practice across the hospital and it’s embedded in our clinical processes,” adds Nicole.
Ultimately, the value of this app doesn’t lie in the number of downloads, or the amount of engagement it receives. Unlike many tech-based innovations, this app is less about technological advancement, and more about solving deeply-rooted human issues, and delivering a uniquely human concept: Hope.
And to Jill, this is the most important innovation of all. “I’ve fought suicide and I’m still alive after many attempts, and any tool I can use to give me hope to stay healthy – physically or mentally – is a tool that I will use. Speaking as a survivor, this is definitely worthwhile. If it gives one person hope and it saves lives, then it has succeeded.”