Where we started

In 2017 we set out to bridge the gap between primary care and community-based mental health services with the publication of Paving the path to connected care. Based on recommendations from this policy paper, we then launched our Primary care pathways demonstration project, working with several communities across Ontario to: 

• Create community advisory groups to promote communication between providers from different care settings. 
• Support providers to work together to create integrated care pathways for their communities. 
• Help providers integrate a standardized tool – the HEADS-ED – into their pathways.

Where we are now

The pandemic posed many challenges but also brought about new priorities and opportunities that allowed our primary care pathways project to evolve and spin off into several related ongoing projects. We’ve now completed two validation studies for the HEADS-ED Under 6 and continue work to mobilize the tool across Ontario (and beyond).

See HEADS-ED pathways projects below, to learn more about current and upcoming projects.

Where we are headed

Our dedicated research team remains focused on advancing pathways work using HEADS-ED. Upcoming projects include: 

Emergency department and community mental health pathways

In Renfrew County, we are working with local emergency departments, the mental health crisis team (housed at Pembroke Regional Hospital) and the Phoenix Centre to evaluate an ongoing pathway to mental health and substance use care using the HEADS-ED. The pathway was implemented in spring 2023. 

HEADS-ED is also being used within a Canada-wide randomized controlled trial and three Ontario emergency departments: 

• London Health Sciences 
• McMaster Children’s Hospital 
• SickKids 

Primary care and community mental health pathways 

Launched in 2023, the MyDAWN pathway aims to improve the mental health and wellness of children and young people aged 6- to 17-years-old. We’re now working with members of the Georgian Bay Family Health Team, New Path, Waypoint Centre, Cundill Centre CAMH and the South Georgian Ontario Health Team to develop a framework to evaluate the pathway. We want to understand the barriers and facilitators to using the pathway and related screening tools such as HEADS-ED. 

Pathways for children under 6

We collaborated with Children First to pilot the HEADS-ED Under 6 with their intake workers in 2019. As an initial validation study, we were looking at the usefulness of the tool to conduct a quick mental health scan, identify levels of need and help guide clinical decision making. Our findings showed that the tool is easy to use and helpful for guiding care to programs of varying intensity. We’re now expanding upon this work to determine how the tool is being used within primary care and EarlyON centres. 

Read our paper about the pilot from Infant Mental Health Journal 

Coordinated access and navigation pathways

1Call1Click.ca is a transformational initiative of the Kids Come First Health Team in eastern Ontario. Launched in 2021, the goal is to establish guidelines for coordinated access and navigation services, generate best practices and serve as a model for other regions in the province by using valid and reliable tools, clearly defined care pathways and a stepped care approach. To that end, 1Call1Click Intake workers use HEADS-ED and HEADS-ED Under 6 to help select appropriate mental health, substance use and addictions care for children and young people.  

We’re collaborating to: 

• Examine and validate the HEADS-ED and HEADS-ED Under 6 screening tools to guide level of care in decision making. 
• Measure equity and access of care by comparing client data with regional census data. 
• Forecast monthly intake volume and clinical needs. 
• Learn about intake workers’ experiences with the program.  

Read the full 1Call1Click report

Read our paper about the feasibility of using the HEADS-ED Under 6

Brief service pathway

One Stop Talk is a provincial initiative that provides immediate, brief and low-level clinical access to children, young people and families, and helps guide those who require ongoing support to the appropriate mental health services and addictions care. 

We’re collaborating to: 

• Evaluate client, system and program metrics. 
• Explore how HEADS-ED can help clinicians identify needs and direct clients to appropriate services.