Mental Health Current Research
Partnering to Implement an Evidence-Based Intervention within Schools to Improve Child Mental HealthExamining the uptake of an evidence-based tool in typical school conditionsThis study will examine the processes and outcomes involved in implementing the Daily Report Card-Online, a positive behavioural support tool that helps teachers who work with children with disruptive behaviours and attention difficulties. There’s evidence that the Daily Report Card helps children to stay on track in the classroom when consultants provide direct support to teachers. This study will look at whether teachers can use an online tool with minimal support, more reflective of typical school realities. Funded by PolicyWise for Children and Families, the study will examine how this online tool is used and to what effect and whether it is ready for scale-up. The study is led by Dr. John McLennan and colleagues from Ohio University and the University of Calgary and will involve around 45 teachers in two Calgary school districts.UPDATE: Starts Fall 2017Contact info: Dr. John McLennanMapping Longitudinal Cross-Sector Service Use Patterns to Better Inform Service Reform: Children with Intellectual Disabilities and/or AutismStudy will chart service utilization maps to get a true picture of the care received across multiple providers.This study led by Dr. John McLennan will examine service links and discontinuities for children with intellectual disabilities and / or autism by surveys and interviews with parents and other stakeholder to examine what happens at multiple steps of their child’s care. Children with intellectual disabilities and autism spectrum disorder have complex needs and receive care from a variety of health, education and social services providers. Attempts to reform service delivery have been hampered by the lack of data examining how services are used. This study, funded by the Children’s Hospital Academic Medical Organization (CHAMO) / Academic Health Science Centre Alternative Funding Plan (AHSC AFP) Fund, will address the data gap by building service utilization maps that provide a better picture. The maps will be used to identify and illustrate problematic patterns and guide future investigations into their causes to inform service improvements.UPDATE: Starts Fall 2017Contact info: Dr. John McLennanOntario School Mental Health SurveyDr. John McLennan is a co-investigator in this study lead by a team at the Offord Centre for Child Studies at McMaster University. The study surveyed a large representative sample of students, teachers and principals from across Ontario to examine student mental health and well-being and the influence of schools. Within the larger study, Dr. McLennan is exploring patterns of classroom management strategies by teacher to improve student behaviour. The study is funded by the Canadian Institutes of Health Research. UPDATE: Analysis phaseWebpage: http://ontariochildhealthstudy.ca/Contact info: Dr. Kathy Georgiades
The Self-Harm and Resilience in Adolescence (SARA) Study Adolescent self-harm, such as cutting or suicide attempts, is a very serious mental health problem that occurs in roughly 16-18% of youth, with girls being up to four times more likely to self-harm than boys. It is unclear why many standard mental health treatments are not working as intended, but it is clear that we must invest in finding alternative solutions to this growing problem. CHEO researchers, led by Dr. Kathleen Pajer, are currently recruiting 120 girls between the ages of 14-18 for the SARA Study. The purpose of this study is to determine if adolescent girls with self-harming behaviours and/or suicidality have different stress responses, coping strategies or genetic expression compared to those without self-harm or suicidality. We are aiming to recruit 80 girls with self-harming behaviours and 40 girls without self-harming behaviours to complete questionnaires about their thoughts, emotions, behaviours, and childhood trauma, give saliva samples and one blood sample. Participants will be compensated for their time and effort for each stage that they participate in in the form of either a gift card to Chapters, Second Cup, Starbucks, or Amazon or volunteer credit hours. Parking passes can be provided for each study visit. If you are a girl between the ages of 14-18 and would like to participate in this study, please email us at firstname.lastname@example.org or call 613-737-7600 ext 4122.
Evaluating the impact of using telehealth to share knowledgeCHEO researchers led by Dr. Bill Gardner and Dr. Kathleen Pajer are evaluating the outcomes of 24 TeleECHO clinic sessions which aim to democratize specialist mental health knowledge and get primary care providers to learn by sharing case studies of children and adolescents with mental health problems. Project ECHO (Extension for Community Health Outcomes) Ontario Child and Youth Mental Health is solely funded by the Ontario Ministry of Health and Long-Term Care. The initiative aims to help clinicians in rural and remote communities across Ontario to provide better care to more children and youth. Remote regions with the highest demand for youth mental health services are often underserved: 18% of Ontarians live in rural areas where only 2% of the province’s child psychiatrists live. The study is evaluating how the first cohort of 35 family physicians, pediatricians and nurses within two local health integration networks – Champlain and North Simcoe Muskoka – applied and shared what they had learned, and whether the telehealth sessions had improved their knowledge and skills. The first cohort, which began in February 2017, will be followed up by second and third cohorts starting in Fall 2017. Clinicians interested in participating can find out more here.UPDATE: Cohort 1 completed on July 24, 2017 and data is being analyzed. Our 35 learning partners include physicians, psychiatrists & pediatricians (52%), nurse practitioners (17%), nurses (11%), other health professionals such as social workers, residents, psychologists (17%) and administrators (3%). We are hoping to conduct ethnographic interviews with the learning partners and will seek approval from the research ethics board. Cohort 2 started on September 7, 2017. There are currently 26 sites across 12 different LHINs with a total of 34 providers registered. Cohort 3 will begin January 2018.Contact info:Dr. Kathleen Pajer, email@example.comDr. William Gardner, firstname.lastname@example.orgJosée Blackburn, email@example.com
Cutting wait times for pediatric mental health care with CAPA (Choice and Partnership Approach)
Evaluating the impact of a program that takes a multi-pronged approach to tackling wait times and puts patients and their families at the centre of their treatment
For a year, the Young Minds Partnership, which is CHEO and The Royal Ottawa Mental Health Centre’s joint mental health program for youth, has been using a system created in the UK to cut wait times, known as the Choice and Partnership Approach (CAPA). The CAPA’s comprehensive approach to tackling wait times includes giving patients and their families more input over their care options and re-allocating staff to match patient demand. Between April 1, 2016 and June 30, 2017, a total of 726 new referrals were accepted and seen through CHEO’s Mental Health Outpatient CAPA program. The cohort consisted of 341 male and 385 female patients aged 3 to 17. The average referral-to-choice wait time was 52 days. The average choice-to-partnership wait time was 37 days. Eleven patients were referred directly to partnership with an average wait time of 45 days. Dr. Bill Gardner and Dr. Kathleen Pajer, who have previously led a CAPA evaluation study at the IWK Health Centre in Halifax, Nova Scotia, are evaluating the use of CAPA at CHEO. The study is also evaluating CAPA’s impact on wait times for first and second appointments, staffing requirements, the satisfaction and experience of patients, families, caregivers and care providers and cost-effectiveness. This study is funded by the University of Ottawa Brain and Mind Research Institute and Capitalize for Kids, a Toronto-based foundation.
UPDATE: In press for publication
Patient-Generated Goals in Mental Health Care: Better Outcomes?
Researchers believe that clinical care can be improved by engaging patients and families directly in planning the care process. Engagement efforts have included asking patients/families to provide information about whether they are getting better. But what does “getting better” mean? The merits of surveys, questionnaires, or rating scales have been widely discussed. Should they be disorder-specific or global? What should we do if patients have difficulty reading or understanding these instruments? Investigators in the UK have proposed a simple solution: ask the patients and families what their primary goal treatment goal is and track progress together on that goal (Goal-Based Outcomes or GBO). Although there has been some work to suggest that this is helpful, it has never been tested in a controlled way. This study will do a special type of randomized controlled trial to test whether GBO improves clinical care in child and youth mental health.
UPDATE: Randomized Controlled Trial being designed