Client Outcomes and Quality of Care at a Mental Health Clinic Run By a School of Social Work: A Preliminary Analysis

Background:

Talk It Out Clinic (TIOC) emerged from a social work school's response to the escalating mental health inequities during the pandemic and remains steadfast as the public transitions through the pandemic. TIOC offers free short-term counseling services facilitated by supervised MSW students as part of their field practicum, accessible through a secure online platform or phone. Operated from trauma-informed and anti-racist perspectives, TIOC aims to provide vital mental health support to residents aged 16 and above in the Greater Toronto Area, particularly those facing multiple barriers to health and equity, along with individuals identifying as Black or belonging to other racialized communities. This study examines: 1) the preliminary mental health outcomes of clients who completed services at TIOC; and 2) TIOC’s virtual service quality.

Methods:

We conducted a chart review of clients completed services from September 2022 to January 2024 and anlayzed the data collected from an anonymous post-service survey that assesses TIOC service quality. Client mental health outcomes are measured by PHQ-2 and GAD-2 that were assessed at the intake and termination. Service quality was measured by the adapted Virtual Client Experience Survey (VCES; Serhal et al., 2020; Cronbach alpha=.93), a 17-item Likert scale that assesses domains of virtual behavioral health care quality, including client-centered, effectiveness, efficiency, timeliness and access to care, safety, and equity. Paired t-tests to evaluate the mental health outcomes and descriptive statistics to examine the virtual service quality and service utilization.

Results:

A total of 68 clients received an intake at TIOC during the evaluation period (66.2% female, 4.4% non-binary; mean age=32.62 [SD=13.05] years; 75% self-identified as Black or other racialized groups). The top reasons for referral include anxiety (70.6%), stress (61.8%), and depression (55.9%). Thirty-seven clients (54.4%) successfully completed services, and their PHQ-2 scores have decreased from intake (M=3.39, SD=1.76) to termination (M=1.68; SD=1.58), t(31)=4.4, p<.0001, and GAD-2 scores from intake (M= 4.10, SD=1.83) to termination (M=2.52, SD=1.73), t(31)=3.60, p<.001. VCE results show that 94.7% agreed that it was easy to access the services at TIOC, the wait time was reasonable, and they were treated with respect by their counselor. All clients agreed that they felt comfortable during the appointment, there was an adequate amount of time allotted for the appointment, they were able to follow their counsellor’s recommendations, and they were satisfied with the services overall.

Implications:

The evaluation results indicate that individuals who received mental health counseling from supervised MSW students exhibit lower levels of anxiety and depressive symptoms. Moreover, they express satisfaction with the accessibility, safety, and client-centered approach of the services provided at TIOC. While the sample is relatively small, the preliminary findings suggest that a school-operated mental health counseling service can deliver effective and high-quality care.