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Introducing: Talk it Out — a new online clinic supporting marginalized communities hit hard by COVID-19

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Run by Master of Social Work students, FIFSW’s new online clinic addresses the increased need for counselling services in Toronto

This spring, U of T social work student Mechelle Thomas is providing weekly online counselling to a young man who would otherwise be on long waiting lists for mental health services. He has no privacy at home and does not want his family to know that he is seeking counselling, so he speaks to Thomas from a bench in a park near his apartment.

This unique connection is part of the new Talk it Out clinic, a partnership between the Factor-Inwentash Faculty of Social Work and several community agencies. The clinic offers free online or phone counselling to GTA residents who have been disproportionately affected by COVID-19, particularly young people who are Black and racialized. Students in the Master of Social Work (MSW) program deliver the counselling as part of their practicum, under the supervision of professional staff and faculty members.

“I wanted to be part of this clinic because of its priority populations,” says Thomas, a second-year MSW student in the Faculty’s Indigenous Trauma and Resiliency field of study. Having worked as a community health nurse for over a decade, she was inspired to return to school for social work after years of seeing many clients and families struggle with mental health issues without access to adequate support. “The Talk it Out clinic is reaching those individuals,” she says.

Photo of Lin Fang

Associate Professor Lin Fang

The idea for the clinic came to social work professor Lin Fang, founding director of Talk It Out Clinic, in the early months of the pandemic. “I and many of my colleagues were feeling paralyzed and powerless, and we started thinking about how the faculty could help,” says Fang, whose research focuses on mental health in racialized communities. “It quickly became clear that marginalized populations were experiencing the most negative impacts from COVID-19, including mental health concerns. At the same time, our students were having trouble finding practicum placements because of pandemic restrictions.”

Fang recognized the mutual benefits of bringing those two groups together: COVID-affected community members would receive timely access to mental health services, while social work students would gain much-needed experiential learning opportunities. The Dean, Faculty and FIFSW Alumni Association quickly threw their support behind the initiative and the advancement office secured a major lead gift from Janis Rotman, in addition to support from CIBC and the Telus Community Foundation.

“FIFSW’s innovative faculty and dedicated students are helping meet an urgent need for increased mental health support through the Faculty’s new online clinic,” says Rotman. “I am delighted to support this initiative and the Factor-Inwentash Faculty, which is doing amazing work in communities and touching lives.”

One of the first challenges, says Fang, was finding a way to engage the target communities. She began consulting community health centres in neighbourhoods with large Black and racialized populations. “We discovered that many of these centres had clients on waiting lists for mental health care,” says Fang. “Creating a program to bridge this gap fit perfectly within the faculty’s mission of increasing our community impact through training and service.”

The community health centres were receptive to the idea of referring clients to the new clinic, but wanted to ensure that centre staff would remain closely connected to the clinic team. Another priority area was easing the transition to counselling for clients.

Basma Hakem, a Youth Wellbeing Worker at Jane Finch Community and Family Centre, says many of her clients have little to no experience with therapy, especially with an unknown provider outside their neighbourhood. “Affordability is a big issue, and so is the challenge of taking time off work to travel to an office. Stigma around mental health is also a barrier in some racialized communities.”

For these reasons, Hakem says it’s vital for counsellors to foster trust from day one. To do this, the clinic team developed a “warm handoff” approach, where a community centre staff member attends the first online meeting with their client. “We act as a middle person who introduces the client to the counsellor and the therapy process,” she says. “The goal is to make the client feel as comfortable as possible, because we already have a relationship with them. It’s a way of saying, ‘You trust me, and I’m telling you that you can trust this person.”

Talk it Out clinic manager Sylvia Delgado

Sylvia Delgado (MSW 2019), a trauma counsellor at Black Creek Community Health Centre, a graduate of the Faculty’s Indigenous Trauma and Resiliency field of study and the inaugural clinic manager at Talk it Out, ensures the community partners remain firmly in the loop after the first session. She schedules regular check-ins where the counsellors and faculty supervisors share non-confidential information about clients’ progress. “We also work together as a team when clients have finished their counselling to make sure there’s a safety net of services in place at the referring community centre.”

In addition to the Jane Finch Community and Family Centre, the community partners include Black Creek Community Health Centre, Parkdale Queen West Community Health Centre, TAIBU Community Health Centre, and Unison Health and Community Services. Delgado is currently in discussion with other potential partners, but counselling capacity is still limited. To date, 33 clients have been referred to the six student counsellors.

The clinic uses a brief therapy model, which involves six to eight sessions designed for people who are experiencing mild to moderate distress. “These are the individuals who have been falling through the cracks in the system more than ever during the pandemic,” says Professor Fang. “There tend to be more services available for people with serious mental illness, but we’re seeing a steep increase in those experiencing isolation, anxiety and depression.”

Before the clinic launched in March, students received comprehensive education and hands-on training – such as simulations on the online counselling platform – to prepare them for handling these issues and others, ranging from family conflict and peer bullying to policy and racial distress trauma. They also had to become deeply familiar with the centres and clients they would be serving through research and interviews.

For non-racialized students with no prior community experience, this is a crucial step, says Delgado. She shares her knowledge of intergenerational trauma and anti-Black racism based on over a decade working in child welfare in racialized communities. “It is imperative that social work students gain the skills and knowledge of working from an anti-Black racist lens when working within these communities,” says Delgado. “I believe that this placement offers them this level of reflection.”

Both Thomas and Delgado hope that more Black and racialized students will choose to be part of the clinic in the future. “What I hear from my clients is that it feels good to be in the space we’ve provided, where they can talk to somebody who looks like them,” says Thomas.

Clients have also said the online or phone format is more accessible than in-person counselling because it eliminates travel time and expenses. “So far the feedback from clients has been very positive,” says Hakem of the Jane Finch centre. “They love the fact that they’ve been able to access services so quickly. Demand is already increasing through word-of-mouth.”

Dexter Voisin, Dean of the Factor-Inwentash Faculty says the free online clinic is among the first of its kind for a faculty of social work in North America. “The COVID-19 pandemic has shown us that telemental health is creating access to mental health services for persons who have been falling through the cracks, hesitant or unable to access traditional in person services,” he says. “There is increasing demand for this mode of delivey, and it is exciting that our students can be trained to be effective telemental health service providers.”

To assess the clinic’s success, PhD students in social work are collecting data on clients’ mental health before and after counselling. The long-term goal, says Professor Fang, is to create a model that could be replicated by other social work faculties. “We’re starting out small, but we want to be part of a much bigger rethinking of mental health care service delivery. The demand is only going to increase post-pandemic, and we need to be creative in building access for the people who need it most.”

By Megan Easton


Donations to the Talk it Out online clinic, can be made via the University of Toronto’s website.

> Click here to make a donation.