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Venture onto CAMH's Queen Street site, past the newly opened Crisis and Critical Care Building that serves as a gateway to emergency care at Canada's largest mental health hospital, and you'll find a small tent and a nondescript gym door. This unassuming threshold serves as the entrance to CAMH's COVID-19 Vaccine Clinic.

Housed in the Sandi and Jim Treliving Gymnasium, this modest-sized clinic recently celebrated a significant milestone of administering 20,000 COVID-19 vaccine doses. While small in size, it carries a big mandate – to ensure that those looking to get vaccinated for COVID-19 can do so in a barrier-free setting that is comfortable and accommodating.

Each year, CAMH treats over 35,000 inpatients and outpatients dealing with mental illness or addiction – some of whom have traumatic or anxiety-inducing experiences in clinical settings. At a time when vaccinations are the most effective intervention to get us out of the pandemic, this clinic is crucial to serving the population that CAMH supports.

 "CAMH's vaccine clinic has gone above and beyond to offer accommodations in the form of a low-stimulation, calm and non-judgmental environment," says Erin LeDrew, Vaccine Clinic Manager and Recreation Therapist.

"We've implemented one of the only evidence-based approaches to needle fear known as the CARD System (Comfort, Ask, Relax, Distract) method. From the time the patient first walks in until they check-out, our main goal is to listen and to accommodate as best we can."

This approach has led to the creation of specialty clinics meant to serve very specific populations. For example, early on in the vaccine rollout, CAMH held clinics for patients in the CAMH Adult Neurodevelopmental Service.

"We needed to do something to support this population," says Dr. Yona Lunsky, Director of the Azrieli Adult Neurodevelopmental Centre at CAMH. "We know from research conducted here and internationally that people with intellectual and developmental disabilities who contract COVID-19 are more than twice as likely to be hospitalized and to die than other adults."

Thanks to this initiative, over 40 CAMH outpatients and their caregivers received their shot early, ensuring they could protect themselves and their loved ones.

The clinic has also operated two fully booked clinic days for people with needlephobia and medical anxiety, and the demand for this type of service is a positive sign that the message is getting through.

"Attending a clinic requires making a purposeful decision – this can be hard for someone with a needle phobia or medical anxiety," says Dr. Renee Logan, Medical Director of Infection, Prevention and Control (IPAC) at CAMH.

"Many people express that their anxiety over the needle is what made them most hesitant to receive their vaccine," says Ledrew. The anxiety is around the fear of the needle itself, not the vaccine. Our staff have a great understanding of the types of barriers and concerns individuals with medical anxiety experience, and this allows staff to use their skills to provide support for a positive vaccine experience."

With a dedicated staff who recognize the barriers in place, it became apparent that their services needed to extend beyond the walls of the clinic to better serve the community, which led to community outreach at nearby Trinity Bellwoods park.

"What has really struck me doing outreach is that we have been missing people who are not making it through the front door," says Dr. Logan. "Some who don't have a family doctor or another trusted healthcare provider have very valid questions and concerns. We are often able to have a brief discussion on the street or in a park that can help folks make the choice to confidently get vaccinated. Outreach has also been a great way to facilitate the process for those who are not able to take a day off from work to attend a vaccine clinic. So many folks out there want the vaccine – reducing barriers and providing support can go a long way." Along with providing the COVID-19 vaccination, CAMH also partnered with UHN's Viral Hepatitis Care Network (VIRCAN) to provide voluntary Hepatitis-C screening to those in the vaccine aftercare area, and on at least one occasion, this collaboration may have saved someone's life .

The pandemic will continue to have lasting effects on the population, and we've barely scratched the surface of the mental health impact of COVID-19. But before we can venture into the future, our first step needs to be through the door and into the Vaccine Clinic.

CAMH is here to accommodate you.