Stepping up to COVID-19: Examining a virtual mental health stepped care approach to addressing needs of at-risk children and families

COVID-19 has necessitated unprecedented quarantine policies that have caused increased stress and uncertainty among Canadian families. At a time when most research is focused on the virus itself, the importance of rapid action in providing and evaluating targeted virtual family mental health interventions for high-risk groups is also paramount. Families with children with pre-existing neurodevelopmental disorders that can influence emotional and behaviour regulation (e.g. ADHD, Autism) are at enormous risk for heightened strain and deterioration, due to disruptions in routine, decreases in external social support, and multiple demands on parents. Providing opportunities for mental health support to these families is essential, with options that are flexible and matched to the family's needs. The current study will evaluate an adapted stepped-care model of an evidenced-based virtual mental health parent intervention (I-InTERACT-North; PI:Williams), an already active SickKids clinical research program with a strong record of success in virtual service delivery predating COVID-19. Stepped care models offer effective treatment and tailor treatment intensity and level of therapist involvement to families' needs. For this proposal, I-InTERACT-North is partnering with the Province of Ontario Neurodevelopmental Disorders (POND) Network (Co-PI: Anagnostou), a large well characterized diverse cohort of children and youth across Ontario with neurodevelopmental conditions impacting mental health. Recruitment will target children ages 3-9 years across four centers in Ontario (Holland Bloorview Kids Rehabilitation Hospital, SickKids, University of Western Ontario, Queen's University). Overall, the purpose of this project is to evaluate implementation of the stepped-care intervention, providing steps to match family need, in effort to mitigate further mental health risk and family dysfunction and inform program scalability during and beyond the immediate crisis.