Barriers and Facilitators to the Use of E-Health by Older Adults: a Scoping Review

Responding to the increasing challenges to mental health equity, Talk It Out Counseling Clinic (the Clinic), an innovative, public-facing counselling service, was established at the University of Toronto during the pandemic. Operating on the principles of anti-oppression and trauma-informed care, the Clinic trains Master of Social Work students to deliver mental health counselling to populations encountering multiple barriers to mental health equity through phone or video. Guided by a quality improvement framework, this study used chart reviews to examine the demographic characteristics, initial mental health status and service utilisation of clients (N = 116) who completed services at the Clinic during its inaugural year. Three-quarters of the clients identified as Black or other racialised individuals, and over 70 per cent rated their general mental health as poor or fair. Nearly 80 per cent of clients referred to the Clinic proceeded to an intake, amongst whom 69.6 per cent successfully completed the services. Warm handoff was associated with service engagement, whilist men and older clients were more likely to terminate the services prematurely. The study underscores the mental health needs of communities confronting multiple challenges and illuminates the processes conducive to client engagement and service delivery within an innovative, school-run mental health clinic.In response to the urgent need for accessible mental health counselling services during the coronavirus disease 2019 (COVID-19) pandemic, Talk It Out Counseling Clinic (the Clinic) was established to serve communities facing multiple challenges. Master of Social Work students were trained to provide services to clients referred by agency partners, such as homeless shelters, community centres and community health centres, that had existing relationships with the clients they serve. All clients were assigned to a student within a week of receiving the referral. The results show that over 75 per cent of the clients at the Clinic are racialised (e.g. Black, Latino and Asian), and the Clinic effectively engage the clients through its warm handoff process. Amongst clients who proceeded to intake, approximately 70 per cent successfully completed the counselling services. Notably, men and older clients were more likely to drop out of services. These results provide a snapshot of an innovative social work field practice model, and render valuable insight for ongoing service improvement efforts.