A leading-edge mental health therapy at the Centre for Addiction and Mental Health has big dark eyes, long black eyelashes and a furry white face. Meet Paro, the harp seal, a cuddly interactive robot that is changing the culture of care for people suffering with dementia and depression.

“Paro is a companion robot,” explains says Dr. Simon Davies, clinician, assistant professor and staff psychiatrist, who spearheaded the efforts to get the device for patient care at CAMH.

Davies had seen programs about Paro and its calming effect on patients with dementia, but experienced it hands-on last October at the Japan Foundation in Toronto.

“Having actually come across this interactive robot, I thought maybe this was an innovation we should have here at CAMH,” says Davies. He applied for a grant from the CAMH Foundation, which was accepted, and in March this year, the fluffy, 2.7-kilogram robotic seal arrived — the first in a Canadian hospital. A pilot program using Paro for in-patient therapy is now in full swing.

Pet therapy made more accessible

How is the cuddly harp seal used?

“It is designed to act like a real pet,” Davies explains. “We know pets are good for people. They improve people’s survival rates with certain illnesses, for instance.”

Indeed pet therapy is one of the treatments the hospital has used for years, but as Davies points out, it has limitations.

“A dog being a real dog only has a certain tolerance for being used for therapy, and it may only be one hour a week,” he says. “You can’t always make the dog do what you want it to do and not all people are comfortable with dogs.”

Plus, dogs used for pet therapy need specially trained handlers who may also have limited availability. “When you get the right dog with the right person, it’s great,” Davies says, “but it’s very resources-intensive.”

With the Paro robot, however, there are none of these issues.

“It will mimic the actions and responses of a real pet, but it can be used all day long and you don’t need any specially trained member of staff,” says Davies. Paro is designed with a variety of sensors that respond to sights, sounds and touch. It can also move like a real animal.

“It’s very endearing,” says Chris Bartha, executive director of CAMH’s underserved populations program. “It has a soft, fluffy coat, big black eyes and a sweet, expressive face. In the hands of clients, he is surprisingly responsive. He raises his head, opens and closes his eyes, moves his flippers. He’s like a cute, gentle animal.”

Making a positive connection

He’s also proving to be an effective form of therapy in CAMH’s geriatric program, where, according to Davies, about one-third of patients have depression and another third have some form of dementia — two areas where Paro is useful.

“With depression, if you get admitted to a hospital ward, it can be a lonely place without a lot of interesting things for you,” says Davies. “Giving people Paro reduces the loneliness and improves the environment. One person said it gave her something to care for that needs caring for.”

That sense of caring for something is key to helping bring people with depression.

“People with depression sometimes become very self-focused,” explains Davies. “We’ve found that the Paro can flip people into that caring role. So it does seem to help move people from a negative mindset into something more positive — even if it’s only transiently.”

As for patients with dementia, Paro provides a link back to more positive aspects of life, often promoting behaviours patients do automatically. Davies recalls one patient who had three cats.

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“As soon as you give him the Paro, he started treating it the way he treated his cats,” says Davies. “So it immediately took him into a behaviour that he was familiar with and sensible with. That would make him smile and I thought it was bringing him back to the good things in life.”

Another Paro benefit is that it seems to reduce wandering in patients with dementia. Davies suspects this is because the robot acts as a focus for them and holds their attention.

Bartha agrees: “There’s a real interaction that happens between the client and the seal,” she says. “He creates a really soothing, calming relationship with someone who might be agitated.”

Great tool for the clinical team

While the seal has proven popular with CAMH’s patients, he is just as popular with the clinical team.

“Paro is very practical because we can clean it, we can sanitize it, which is obviously important in a hospital environment,” says Bartha. “We can include in the structured program. It’s available to us on a very practical basis.”

Plus, Paro is fully rechargeable.

“The team has been absolutely delighted to have found a tool so elegant in its simplicity, but also has had such great response from the clients,” Bartha says. “It’s very gratifying for the team to see that.”

Tools like the Paro robot are in keeping with CAMH’s mandate to offer a holistic set of therapies to meet the needs of the organization’s patients.

“It’s a big part of our mandate, it’s a big part of our current strategic plan,” Bartha confirms. “We want to support innovation both in terms of traditional approaches with the use of medication and psychotherapy for the treatment of mental health concerns, but we also want to bring an innovative, holistic approach to the care and treatment of clients.”

And though Paro is still in a pilot phase, because the robot has worked so well, Bartha says, CAMH will be looking to see if it is just as effective outside of the hospital’s geriatric program.

“It’s been gratifying to see how beneficial Paro has been to the clients, but also how it’s been such a great piece of the work the staff is doing,” he says. “I think the team has really appreciated seeing clients perk up and feel better.”