CAMH leveraging simulation to address mental health and addiction care

The treatment of mental illness and addiction is an important issue in the Province of Ontario, directly or indirectly affecting one in five residents. The challenge may seem outright daunting, but one hospital—the Centre for Addiction and Mental Health (CAMH)—is creatively tackling this issue through simulation. In the process, CAMH is positioning itself as a leader in mental health training.
CAMH is scheduled to build its first simulation centre in 2020. The new simulation centre will help students and professionals learn and test new approaches to treating physical and mental illness using simulated patients in realistic scenarios. The project is part of a larger initiative, called the… style=”font-size: 13px; line-height: 1.6em;” target=”_blank”>Medical Psychiatry Alliance, which seeks to help up to 500,000 people who are either at risk of, or living with, both physical and mental illnesses. CAMH, along with The Government of Ontario, The Hospital for Sick Children, Trillium Health Partners, the University of Toronto and a private donor, are providing a total of $60 million in funds towards the Medical Psychiatry Alliance.
The CAMH simulation program in general is seen as a critical element of the Medical Psychiatric Alliance. The program enables:

The practice of the use of new screening and diagnostic tools exploring complexities of mental and physical symptomology and treatment;
Specialized clinical training for medical students and interprofessional teams;
Research exploring effective clinical and teaching practices;
Impact curriculum development and innovation at the medical school; and
Supporting innovative practices in the delivery of psychiatrics care at home.

“As far as we are aware, we will be building the first simulation centre and program worldwide focusing specifically on enhancing mental health and addiction care and education,” said Dr. Ivan Silver, Vice-President of Education at CAMH. “We expect that everyone involved in care delivery, including staff, students, faculty, clients and their families will benefit from this innovative learning modality.”
Working with SIM-one”>CAMH hired SIM-one in 2013 to conduct a needs analysis for the construction of a new simulation centre that will contain flexible and multi-purpose space, in a safe and welcoming learning environment. During this consulting work, SIM-one provided analysis and developed an initial strategy for developing the functional aspects for the simulation programs and centre, including identifying the initial approaches and services it will support.
“It was an exhilarating experience to bring a consultation team to support CAMH’s groundbreaking simulation program,” said Dr. Bruce Ballon, Director of Education, SIM-one. “CAMH’s simulation program will be interprofessional and inclusive of family and patients in its educational endeavours. With CAMH fully embracing the values of collaboration, communication and innovation, this program has great potential for international impact.”
SIM-one’s consulting service draws upon a vast network of Ontario simulation experts and educators. This service covers a variety of areas, including custom education and training, simulation centre/program custom design, simulation centre resource planning, and specialty areas, including neonatology simulation.
“We had a positive experience working with SIM-one, and were pleased with SIM-one’s ability to meet our tight deadlines,” said Dr. Latika Nirula, Director of Teaching Excellence and Innovation at CAMH. “We’re really appreciative of the team Bruce Ballon (SIM-one’s Director of Education) assembled, especially Agnes Ryzynski, who remains a valued connection for us as we embark in our planning process.””>Learn more about SIM-one’s Consulting Services >
A creative approach to simulation
While the addition of an interprofessional simulation centre is considered key in CAMH’s strategic plan to develop interprofessional learning spaces, the hospital sees simulation more broadly.
“Simulation as a learning modality is really important for us to explore as it promotes a culture of reflective practice,” said Dr. Nirula, who leads a diverse education team responsible for faculty development, knowledge exchange, innovative educational curriculum development, and simulation training. “Seeing objectively how we work with our clients within our interprofessional teams is an important step towards improved patient care. I see a real potential for simulation to improve the student experience at CAMH. Our students and faculty need to see what they are doing, both as learners and as educators. By having a culture where critical reflection and meaningful feedback are seen as essential elements in the learning process, we hope our students have an enhanced experience here.”
Even though CAMH currently lacks a brick-and-mortar sim centre, the hospital makes the most of its resources. For example, CAMH employs a distributed model that makes maximum use of in situ simulation through a number of video observation units integrated across a number of clinical areas within the hospital. The hospital is currently installing a video observation system (VOS) throughout its facilities. These units provide the ability to remotely observe, supervise and control sessions for the purpose of education, supervision and training, leading to advancements in client care, improvements in the quality of supervision and enhancements in interprofessional collaboration.
When constructed, CAMH’s simulation centre will act as a central hub to the distributed model of the video units in situ. Within the physical simulation centre, the hospital will provide a safe learning environment to mirror clinical settings (e.g., enable the practice of complex skills such as team-based code white responses, CPR, etc.) while also being highly flexible to configure the space to support the multitude of communication-based training programs.
Spreading its sim reach
CAMH has become much more active in the world of simulation. Last year, the hospital hosted its inaugural SIM Week, a weeklong event that featured Israeli simulationist” target=”_blank”>Dr. Amitai Ziv as the primary presenter. This successful event generated a lot of internal interest at CAMH on the role of simulation in quality patient care and safety. SIM Week-related events focused on consultations across a variety of areas, such as geriatrics psychiatry, Access CAMH, and interprofessional education (IPE), and were presented at different venues.
CAMH is also providing simulation-based training to external clients, including its Preventing and Managing Aggressive Behaviour (PMAB) program. The course features online modules, a 1-day intensive workshop, simulation scenarios and a debrief. Currently, CAMH doesn’t have the required internal space to accommodate this training for external groups, but the hospital anticipates some of this training will always occur in the workplace setting. The hospital says that having the flexibility to offer training both in the simulation centre and in situ depending on the need creates opportunity for enhancing the quality of this simulation-based program.
Dr. Silver is very excited about the future: “Learning through simulation provides unique and profound opportunities for all participants to be observed and to receive feedback on so many aspects of the important work that we do day to day with our clients and their families. I am confident that our new simulation training program, the use of distributed video observations rooms throughout our campus and the building of the simulation centre will revolutionize education and knowledge exchange at CAMH.”
For more information on CAMH Education, please visit” target=”_blank”>
About SIM-one
SIM-one—Ontario Simulation Network—is a not-for-profit organization that connects the simulation community, facilities, resources and services across the Province of Ontario. SIM-one advocates for and advances simulated learning in health professions education for the benefit of patient care and patient safety. Supported in part by the Ontario Ministry of Health and Long-Term Care (MOHLTC), SIM-one’s vision is to further position Ontario as the global leader in healthcare simulation.
For more information on SIM-one, including information on our news releases, please visit contact John Gilson at [email protected].

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