Newfoundland and Labrador (NL) embarked on its e-mental health journey in 2010 when the Department of Health and Community Services began implementing e-mental health options on a small scale with a minimal budget. At that time, innovative services were explored, with calculated risks taken, that proved successful and allowed the province to grow its suite of e-mental health services incrementally.


In 2015, the All-Party Committee on Mental Health and Addictions was established to review the mental health and addiction system in NL. The All-Party Committee completed its review in 2017, and the Towards Recovery Action Plan was publicly released just a couple of months later. This Action Plan supported the further expansion of e-mental health services, and that same year, the Government of NL and Dr. Peter Cornish co-led the Mental Health Commission of Canada’s E-Mental Health Demonstration Project for stepped care. By 2020, the Provincial Stepped Care Model was finalized and with e-mental health integrated throughout the model, particularly in the lower intensity steps.


Taken together, NL’s current stepped care model has evolved to meet the needs of our provincial mental health and addiction system, our people, and our communities. It aims to provide the right service, in the right place, at the right time, by the right person. NL now has a suite of more than 15 e-mental health services and helps support other provinces and territories in growing and expanding e-mental health solutions.


What are three things that have made e-mental health successful in Newfoundland and Labrador?


  1. Dedicated resources: Newfoundland and Labrador invests over a million dollars in e-mental health annually. It also has five dedicated e-mental health positions across the province; four at the regional level and one provincial e-mental health manager. 
  2. Integration into the Provincial Mental Health and Addictions Stepped Care Model: E-mental health is incorporated into the three access points of the stepped care model, as well as in each step within the model. This allows people more choice in the type and way they receive services in NL.
  3. Community of Collaboration: Newfoundland and Labrador values lived voice, and incorporates lived and living experience into the development of all e-mental health solutions. NL also leverages the power of collaboration with mental health providers, community groups, local, national and international stakeholders, and other provinces and territories, where possible. These partnerships have enabled a comprehensive expansion of the provincial mental health and addictions website, Bridge the gapp, which is now being utilized by New Brunswick and Prince Edward Island. Content sharing has also occurred with Nova Scotia and other provinces.


What are the main challenges facing Newfoundland and Labrador with the expansion of e-mental health services?


  1. Ongoing communications: Through the development of the Provincial Stepped Care Model, NL recognizes the need for ongoing regular communication with providers and the public. There continues to be an overall lack of awareness of e-mental health services available, which impacts uptake of the programs in the province, and as a result, ongoing dedicated communications campaigns are needed to improve mental health literacy.
  2. Recruitment and retention: NL is experiencing recruitment and retention challenges across the mental health and addictions field. As a result, ongoing training and knowledge transfer is necessary for staff. Leveraging evidence-based e-mental health programming will also be necessary, as longer waitlists and gaps in services are evident in some areas.