What 52 school-based mental health professionals across Alberta told us about implementing digital mental health tools
A peer-reviewed study published in JMIR Mental Health (2024) surfaces what gets in the way — and what genuinely helps — when an evidence-based eMH platform is introduced into secondary schools across Canada.
Youth mental health services in Canada are under sustained pressure. Waitlists extend for months. School counsellors and psychologists are absorbing increasingly complex caseloads, often without adequate supervisory support or shared clinical infrastructure. Into this context, electronic mental health (eMH) tools are being deployed — not as replacements for clinical relationships, but as structured supports intended to extend and deepen them.
A qualitative study published in JMIR Mental Health (Dimitropoulos et al., 2024) asked a straightforward question: what do the mental health professionals working directly with young people actually think about implementing this kind of platform in schools? The answers are instructive for anyone planning eMH deployment in Canadian health services.
What the research examined
Researchers from the University of Calgary and Alberta Health Services, collaborating with the Brain and Mind Centre at the University of Sydney, conducted eight focus groups with 52 school-based stakeholders across 11 school divisions in Alberta. Participants included psychologists, counsellors, social workers, teachers, and administrators representing 21 schools — urban, rural, Catholic, Francophone, and alternative outreach settings.
The platform under review was Innowell, a configurable web-based measurement-based care (MBC) tool developed out of the Brain and Mind Centre. It uses a multi-domain assessment framework — spanning psychological distress, suicidal thoughts and behaviours (STB), social connectedness, everyday function, and more — to support collaborative care planning between clinicians and clients. Crucially, this was a pre-implementation study. The aim was to surface realistic barriers and facilitators before rollout, not after.
Four barriers that emerged with clarity
Individual capacity and literacy. Participants raised practical concerns about whether Innowell’s comprehensive 20-domain intake assessment was suitable for all young people — particularly those who were already acutely symptomatic, had limited literacy, or presented with attention difficulties. The concern was not about the platform’s clinical validity but about contextual fit: completing Innowell’s structured biopsychosocial questionnaire may not be appropriate for a client in acute distress. Practitioners wanted clearer guidance on how to stage or adapt assessment entry points for different presentations.
Parental consent and confidentiality. Many young people access school-based mental health support precisely because they want to manage that access independently of their families. Any implementation requiring parental consent to activate Innowell risks deterring the clients most likely to benefit. School staff were not opposed to the platform — they were asking for system-level policies on consent that could be applied consistently across school divisions before they could proceed with confidence.
Technology access and infrastructure inequity. Rural and remote communities across Alberta face real connectivity gaps. Several participants described students without reliable Wi-Fi or personal devices — a straightforward barrier that no feature of Innowell’s design can compensate for without a parallel infrastructure response.
Service capacity to respond to identified need. Perhaps the most clinically significant barrier raised: what happens when Innowell’s systematic measurement uncovers more need than the service has capacity to address? Structured MBC raises the floor on clinical visibility — a benefit — but only where there is adequate resource to follow through. Participants were not opposed to better assessment. They were concerned about identifying acute need, including suicidal thoughts and behaviours flagged through Innowell’s automated escalation pathway, that they lacked the capacity to respond to in a timely way.
Four facilitators participants described
Strengthening the therapeutic relationship through shared data. Multiple participants anticipated that Innowell’s shared longitudinal view — client and clinician seeing the same domain data across Health Cards and Health History together — would make sessions more focused and clinically productive. The platform creates a common reference point, a shared language, and an explicit basis for collaborative decision-making. This was consistently described as one of Innowell’s most clinically useful features.
Youth empowerment and engagement between sessions. The ability to track one’s own health profile across Innowell’s domains, access vetted apps and resources through the platform independently, and see measurable change over time was viewed as developmentally appropriate for the young adult population. Several participants anticipated this would strengthen self-management capacity and increase engagement with clinical services more broadly.
Cross-service coordination. Innowell’s measurement framework could serve as a shared reference for communication between school-based clinicians, community providers, and specialist services — reducing the fragmented, siloed communication that currently impedes continuity of care. Participants saw this as a genuine system-level opportunity, particularly given the platform’s capacity to compare client needs across services and geographic regions.
School staff flexibility as an implementation asset. Participants actively generated solutions to the barriers they identified — using school devices for students without their own, adapting Innowell’s assessment schedule to fit existing clinical workflows. The researchers noted this problem-solving orientation as a meaningful organisational facilitator and a realistic basis for sustained implementation.
What this means for implementation planning
The study’s recommendations are specific. Clear system-level policies on parental consent and student confidentiality are needed before implementation, not during it. Training must address competencies for responding to STB disclosures that may emerge through structured assessment — not just platform navigation. And implementation sequencing must consider what can be removed or combined from existing workflows to avoid increasing administrative burden on already stretched practitioners.
For clinical leads and health system planners considering eMH deployment in schools or community youth services, this research offers something practically useful: a grounded account of what practitioners need to support implementation — not just what the platform can demonstrate in a trial context.
About the research
Dimitropoulos G, Bassi EM, Bright KS, et al. Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders. JMIR Ment Health 2024;11:e49099. Read the full open-access paper →
The Innowell platform was developed by the Brain and Mind Centre at the University of Sydney and is currently deployed across mental health services in Australia and Canada.
Disclaimer: This blog is intended for informational purposes only and may reference related resources for additional context. For more detailed or official guidance, please refer this document.
