2 - (SYM 1) Intake and Triage - The Intersection of Technology and Clinical Strategy

A stepped care program of this scale requires an ambitious and efficient intake, assessment, and enrollment strategy. Many thousands of clients need to be skillfully screened and directed to one of six different services (low and high intensity) and designated one of nine priority problems for treatment that reflects best practices and their own preferences at intake. Qualitative and quantitative (e.g., PHQ-9, GAD-7, problem-specific measures) information are gathered throughout the process to ensure appropriate clients enroll in the program, and at the most appropriate start point (e.g., at least 60% of clients start in a low intensity CBT service).

We present the intake strategy and outcome data from one hub, the Canadian Mental Health Association, York and South Simcoe, as an example of how technology has been used to better achieve the goals of intake.  

Between April 2024 and March 2025, over 4500 clients were automatically screened at the NLO using an online referral form. Eligibility criteria were used at this stage to direct appropriate clients to continue with the process and provide others with alternative resources.

The electronic background package used additional information collected from the client to determine the length of clinical intake and triage assessment (CITA) required using a smart logic. Approximately 75% of clients were offered a short 30-minute assessment and 25% were offered a long 60-minute assessment session. Clients waited a median of 23 days from referral form submission date to date of held assessment.

Finally, the assessment with a clinician integrated the client’s presenting symptoms, background, goals, and preferences for treatment, to determine overall program suitability, a main problem descriptor, and the most appropriate service start point. Seventy-six percent of clients were successfully enrolled to start in low intensity programs with the shortest wait times, which optimized the wait time for all clients. There were no appreciable differences in symptom scores for those starting in high (PHQ = 15, GAD-7 = 13) or low intensity programs (PHQ = 14, GAD-7 = 12). The most prevalent main problem descriptors were depression (35%) and generalized anxiety and worry (22%).

Approximately 93% of all clients assessed enrolled in the program, with the remainder receiving navigation to a more appropriate service, highlighting the success of the screening process. Next steps to further streamline and improve accessibility of the process are discussed.