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Jun 2021

Virtual Care for Youth and Young Adult Mood Disorders (Anxiety and Depression) During COVID-19


Youth’s self-rating of mental health has dropped by approximately 20% during the COVID-19 pandemic. This resource will guide primary care providers on how to adapt usual practices for managing youth and young adults with anxiety and depression during the pandemic. 

It supplements the CEP’s Youth Mental Health Tool (2017).

Please note, the following resource was developed in the context of the COVID-19 pandemic, when necessity required deviation from existing evidence-based guidelines as in-person visits were significantly limited. Certain frameworks and guidance within the resource are applicable only to the "crisis care" needs during the COVID-19 pandemic and should be reviewed with this consideration in mind. Established Clinical Practice Guidelines are the authoritative source for evidence-based care.

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About the tool

This resource has been developed to guide family physicians and primary care nurse practitioners to adapt usual practices for managing youth and young adults with anxiety and depression during COVID-19.  Using a familiar framework, the HEEADSSS guide was adapted to support assessment of youth and young adults' wellness and needs during the COVID-19 pandemic. This resource allows family physicians and primary care practitioners to capture the specific needs of their patients while supporting more comprehensive documentation.  This resource has been divided into the following sections:

  • How to conduct virtual visits and when to see patients in-person
  • Tips for providing care during COVID-19
  • HEEADSSSS during COVID-19

The Management of Youth and Young Adult Mood Disorders (Anxiety and Depression) During COVID-19 Resource was developed using a modified version of the Centre for Effective Practice’s integrated knowledge translation approach. The CEP ensures that primary care providers are engaged throughout the resource development process. Clinical leadership was provided by Dr. Anna Holland, along with a clinical working group and an advisory committee.

This resource was developed by the Centre for Effective Practice and University of Toronto's Department of Family and Community Medicine with support from the Ontario College of Family Physicians, Nurse Practitioners' Association of Ontario, Association of Family Health Teams of Ontario, Ontario Medical Association Section for General and Family Practice, eHealth Centre of Excellence, Ontario MD and Ontario Health (OTN).

Clinical leads

  • Anna Holland

    MD CCFP (AM)

    Dr. Anna Holland is a family physician in West Toronto practicing comprehensive care including procedures, homevisits, and palliative care. Dr. Holland is also a specialist in Addiction Medicine in both an inpatient and outpatient capacity. She is a Lecturer at the University of Toronto’s DFCM where she teaches medical students, residents and fellows. She advocates for her patients needs and through this supports health care system transformation to support them.

Clinical working group

The following clinical working group of providers helped with the development of the resource:

  • Mia Biondi PhD, NP-PHC
  • Payal Agarwal MD, CCFP,  BASC
  • Patricia Windrim MD, CCFP, MHS
  • Rebekah Neckoway MD, CCFP

Advisory committee

Feedback was also provided by a committee of advisors:

  • Noah Ivers, MD, PhD
  • Tara Kiran, MD, MSc, CCFP, FCFP
  • Daniel Pepe, MD, CCFP
  • Sarah Newbery MD, CCFP, FCFP, FRRMS
  • Nicole Nitti, MD, CCFP(EM), FCFP
  • Anna Holland MD, CCFP (AM)
  • Mia Biondi PhD, NP-PHC
  • Jennifer Young, MD, FCFP-EM (Ontario College of Family Physicians)
  • Kevin Samson MD (Association of Family Health Teams of Ontario)
  • Danika Voisin (eHealth Centre of Excellence)
  • Laurie Poole RN, MHSA (Ontario Health, OTN)
  • Reza Talebi MD, MSc (OntarioMD)
  • Chandi Chandrasena MD (OntarioMD)
  • Karine Baser (Ontario Health)
  • Maurine Parzen RN, PhD (Patient Representative)

Conflict of interest

Clinical leads received compensation for their role. 

Clinical working group members received an honorarium for their participation.

Focus group and usability participants received a small token of appreciation (e.g. gift certificate).

Expert Reviewers

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