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December 2022 As I reflect on the past year and the accomplishments of the scientists, trainees and research staff at CAMH's Campbell Family Mental Health Research Institute, there is much to be proud of! Please enjoy this month's issue of brainbuzz™ featuring highlights of digital innovations developed at CAMH, and the introduction of Dr. Liisa Galea as the inaugural Treliving Family Chair in Women’s Mental Health. Happy holidays and best wishes for 2023! Aristotle Voineskos 
CAMH embraces the future of digital healthDigital technologies have incredible power to support both clinicians and patients in mental health care, which is why CAMH continues to employ these tools to enhance and grow its programs and services. After celebrating Digital Health Week in November, CAMH is featuring digital innovations that CAMH has introduced in recent years, including a variety of apps for mental health. From first steps like the integrating the internal I-CARE clinical information system in 2014, to more recent innovations like the digital dashboards for at-a-glance patient summaries, CAMH continues to be a national and international leader in digital health. In fact, three years ago, CAMH was recognized as such by the world’s leading authority on electronic medical records management. When the COVID-19 pandemic began, virtual care appointments at CAMH grew from approximately 350 per month to almost 3,000 per month, an increase of over 750 per cent. It all adds up to rapid and profound change in the way mental health care is delivered at CAMH. “Pretty soon we aren’t even going to
be talking about digital health any more in the same way we don’t talk about digital banking,” says Dr. Gillian Strudwick, Independent Scientist and the head of CAMH’s digital mental health lab. “Virtual care and the use of apps and artificial intelligence decision-making will become as commonplace as they are in the rest of society.” 
Hope for the future of suicide preventionOne of CAMH's newest and most popular apps is the Hope by CAMH app for wellness and suicide prevention. As a CAMH-branded app, it is guided by the best clinical practices in the area of suicide prevention, however the inventor was actually an IT specialist at CAMH. Tim Rankin, whose wife had recently attempted suicide, submitted a winning proposal with the rest of his IT team at the CAMH Innovation Expo in 2019. Now in its fourth year, this annual CAMH event is a catalyst for innovative ideas that directly impact the patient and family care experience. By 2020, Hope by CAMH was a reality. Two years and over 10,000 downloads later, Hope by CAMH continues to develop new features inspired by patient and family co-designers like the “reasons for living” section where people can post a photo of a loved one. The Hope by CAMH app is already being used in some outpatient clinics and there are plans to embed it at the CAMH emergency department as well. “Safety plans work,” says CAMH psychiatrist Dr. David Gratzer. “Sometimes people just need a reminder of their strengths and reasons for living to stay alive.” “It’s a trusted app,” says Hope by CAMH researcher Dr. Lydia Sequeira. “Our research shows that most of the people who downloaded did so because of the CAMH name.” There are now plans to expand the reach of the Hope by CAMH internationally. CAMH recently entered into a partnership with the University of Toronto and Oxford University to develop the app further for use in clinical settings in Canada and the UK. The ultimate goal is to make it a global standard for suicide prevention and have it made available in multiple languages. “I’ve fought suicide and I’m still alive after many attempts, and any tool I can use to give me hope is a tool I will use,” says former CAMH patient Sarah Kimball. “Speaking as a survivor, this is definitely worthwhile.” 
Helping people with schizophrenia manage their own livesApp4Independence (A4i) was developed by CAMH Senior Scientist Dr. Sean Kidd and industry partner MEMOTEXT through a joint venture. This technology was designed for people with schizophrenia spectrum disorder to assist in all aspects of their clinical care and daily living. Among its many features are medication and appointment reminders, cognitive-behavioural therapy (CBT)-based prompts for people with schizophrenia spectrum disorder, a portal to connect patients to their care providers and a moderated peer-to-peer feed that fosters coping strategy sharing between people with lived and living experience. It even has an audio recording function to allow users to determine if any ambient noise they are hearing is real or a hallucination. Dr. Kidd says the moderated feed, which is constantly updated, helps keep patients engaged regularly with the app. “The feed makes the app alive and brings people back to it,” says Dr. Kidd. “For a range of reasons, many of the patients we see at the emergency department are not able to engage in their care and medication plans. We need other ways to connect because the consequences of not engaging can be devastating for patients, families and the system as a whole.” Working with American partners, Kidd has ambitious plans for A4i, including applying to the U.S. Food and Drug Administration to have it approved as a digital therapeutic, which would potentially enable clinicians to fully integrate the app into patient care plans, including being able to bill health care systems for time spent using the app in patient care. Dr. Kidd is also developing an app for opioid use disorder based on the same
technology and infrastructure used to build the A4i app incorporating co-design with persons in recovery and their supports. 
Helping Canadians kick nicotine dependenceSmoking cessation was CAMH’s first step into the world of virtual care way back in 2005 with its online STOP program pioneered by CAMH Senior Medical Consultant Dr. Peter Selby and his team, including Dr. Nadia Minian and collaborators at the University of Toronto. They saw early on the power of simple yet powerful prompts in the struggle against tobacco use disorder. The more recently released MyChangePlan app features personal reasons and motivations to quit and stay quit. “We knew way back that when we allowed people to upload pictures of loved ones, it reduced their cravings.” The app continues to evolve with making it more women-centred under the leadership of Dr. Osnat Melamed. Currently, 400 Ontarians per week use the STOP on the Net program to access free nicotine replacement therapy to quit smoking from anywhere in the province. Working closely with the CAMH Youth Engagement team, Independent Scientist Dr. Michael Chaiton has developed several free technologies to help youth and young adults manage their vaping habits:
“For the TikTok generation, we wanted to keep the apps really simple. That’s why co-designing these technologies with youth is so important. We can’t be talking down to them. We have to be honest and straightforward and treat youth as self-determinative individuals who are making their own choices. They don’t want to see a doctor, but one third of young people who vape do want to quit. Most of them just want some guidance and these apps help fill that gap.” Dr. Chaiton is currently developing an app for young people who use cannabis that will be similar in design as the vaping interventions. It all adds up to a digital health future where patients and families have more ways than ever to find mental health resources and supports that suit their individual needs. “Some of these apps will become more sophisticated over time,” adds Dr. Gratzer. “All of these digital health innovations are about moving away from a model of healthcare being something that is done to you towards something more tailored to you.” Have you used a CAMH-developed app or technology? Share your story via social media with the hashtag #DigitalCAMH. 
CAMH welcomes Dr. Liisa Galea,
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