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Child and Youth Mental Health Research Unit
Child and Youth Mental Health Research Unit

Research

The Child and Youth Mental Health Research Unit (CYMHRU) has five broad objectives for knowledge exchange and research initiatives:

  • To improve the capacity, effectiveness, and efficiency of services for children, youth and families at the hospital and community level
  • To build community commitment and capacity to support the success of children and youth
  • To provide evidence for strong and effective policies and programs to support children, youth, and their families
  • To improve our understanding of implementation of evidence across multiple contexts
  • To improve qualitative methods

We have listed some of the projects that illustrate our research and knowledge transfer initiatives.

Core Research Activities

Implementation of Evidence in Practice Settings

Evidence-Based Classroom Instruction

Adjunct Research Activities

Access to Mental Health Care in Rural Communities

Arts-Based Research

Family Mental Health

First Episode Psychosis

Mental Health Promotion and Intervention Research

Prevention and Treatment of Eating Disorders

Professional Development Intervention Research: Mental Health and Healthy Weights

Research with Young People

 

Access to Mental Health Care in Rural Communities: Paediatric Telepsychiatry and Use of Technologies in Mental Health Service Delivery 

Dr. Katherine Boydell's program of research in paediatric telepsychiatry and access to rural mental health care (Goering, Boydell & Pignatiello, 2008; Pignatiello, Boydell, Teshima et al. 2008, 2011; Pignatiello, Teshima, Boydell et al., 2011) is based on the exchange and linkage conceptual Knowledge-to-Action (KTA) framework. This model identifies two broad activities: knowledge creation and knowledge action. Rigorous evaluation and theory-grounded research have contributed to the credibility and viability of the telepsychiatry program and have impacted both the internal program and broader provincial and international initiatives. 

Internally, each of the research phases produced findings that were extensively disseminated and then used to change or modify the practice of the program. Internationally, many emerging programs in the United Kingdom, Australia and the United States are looking to emulate the model, based on evidence emerging from our research program. More recent work involves production of a policy ready paper on the use of technology in mental health service delivery to children and youth (Boydell et al., 2013) and receipt of a grant to explore Technology Enabled Knowledge Translation. 

Dr. Boydell is also currently conducting research to test a mobile phone application for individuals with mood disorders and gaming technology for youth experiencing psychosis.

For more information, please contact Dr. Katherine Boydell at katherine.boydell@sickkids.ca.

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Arts-Based Research

Dr. Katherine Boydell's program of research uses arts-based qualitative methods to create and disseminate research and to translate knowledge beyond academia (Boydell, Gladstone, Volpe et al., 2012; Romano, Boydell & McCay, 2011; Caine & Boydell, 2010; Boydell, 2011a, 2011b). 

Her arts-based research grants focus on exploring the arts as a knowledge translation strategy. For example, one project (CIHR funded) focuses on using dance to share empirical findings from qualitative research on early psychosis. This work resulted in many peer-reviewed publications, a CIHR-KT casebook, a book on early psychosis, media coverage on CBC radio and in The Toronto Star, short listed at an international film festival at a conference on early psychosis, invited presentations internationally, and invited to secondary schools for Mental Health Awareness Week, to name a few. This work and the resulting response created momentum and a desire to further explore the potential for using the arts to both create and share research information.

 A particular area of focus in this work is on the unique ethical challenges of using the arts as a knowledge translation strategy. As a result, Dr. Boydell has received peer-reviewed awards to bring together a diverse range of scholars and artists and have published articles and a book chapter on the subject (Boydell et al., 2012, Gladstone et al., 2012; Cox & Boydell, 2014). Dr. Boydell and colleagues (Boydell et al., 2012) published a scoping review on arts-based health research, which identified the dearth of critical research in this arena. 

In response to this gap, Dr. Boydell received eight CIHR grants as PI to explore use of the arts (visual art, photography, digital storytelling) with youth experiencing early psychosis. She is also currently involved in a large SSHRC funded (2.5 million) grant to study the arts as a mechanism of social change. She has currently drafted a manuscript for submission to a peer-reviewed journal on the unique ethical challenges of engaging community partners in arts for social change projects.

For more information, contact Dr. Katherine Boydell at katherine.boydell@sickkids.ca.

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Implementation of Evidence in Practice Settings

Implementation science is the process of systematically investigating the methods used for increasing the uptake and use of evidence-based practices into routine clinical practice across a range of contexts. Often used interchangeably with terms “knowledge translation” and “dissemination”, implementation science differs from the previous two terms given its focus on evaluating the processes and methods by which evidence-based practices are integrated within, applied or used a practice setting.  

Although effective implementation of evidence-based practices is essential for improving health and well-being, the Institute of Medicine noted a substantial gap between care that could be delivered if it were informed by scientific knowledge, and the care that is delivered. Some estimate it takes approximately 17 years for only 14% of research to make its way down the "leaky pipeline" into clinical practice. Given rising needs and costs, determining how to maximize societal benefit from the research knowledge we generate is imperative.

This program of research explores how best to implement evidence into practice settings, across a range of contexts including child and youth mental health, health, education, and global health.  Several projects are underway in collaboration with SickKids investigators, national, and international investigators.  

For more information, please contact Dr. Melanie Barwick at melanie.barwick@sickkids.ca.

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Evidence-Based Classroom Instruction

Dr. Solomon is interested in how developmental science can inform classroom instruction. Her current work is focused primarily on evaluating different approaches to mathematics instruction. Mathematical competence has considerable long-term implications for individuals and for society. Dr. Solomon’s research examines the impact of mathematical input on academic functioning as well as on variables that may mediate academic outcomes such as attention and anxiety. Most of her research takes place in the community, with teachers and students in real classrooms. As such, it stands to inform and to impact student growth in mathematics provincially, nationally and beyond. Related work investigates interventions to help improve numeracy in long-term patient populations.

A secondary line of research evaluates the impact of different curricula on the development of self-regulation, key to successful school entry, in the early school years. Results stand to inform policy and practice regarding programming in full-day Kindergarten (FDK) in Ontario.

Dr. Solomon’s work constitutes the first RCT research in Education in Canada since the 1950s. She shares her work with the scientific community as well as with various stakeholders in Education. She is committed to translating her reaching findings to help make effective, evidence-based instruction accessible to the broader education community.

For more information, please contact Dr. Tracy Solomon at tracy.solomon@sickkids.ca.

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Family Mental Health

“I think the mother needs support, and you both also need support. And it would be nice if that support like ended up joining all of you at some point, so it wasn’t just constantly looking at each of you separately.” (Alex, 16 yrs., digital storytelling participant)

Recent (under) estimates tell us that 12.1 % (570,000) of all Canadian children under 12 have a parent with a mental illness, such as depression, bipolar disorder or schizophrenia.  A new policy and practice focus on the parenting roles of individuals with mental illnesses is beginning to emerge worldwide. However, in this complex and under- serviced area, little is known about how young people manage the challenges of everyday life as they go to school and work and live in their own communities; what they think about the support and services they (and their families) do receive, and how they would like to be supported if we could do things better in practice.  

Evidence from a new program of research with young people living in families where a parent has a mental illness is linked to an emerging community of practice in Canada to enhance family (mental) health outcomes, drawing on international partnerships with scholars from the United Kingdom, Australia, Europe and the United States to support the whole family.

For more information, please contact Dr. Brenda Gladstone at brenda.gladstone@sickkids.ca.

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First Episode Psychosis

At least two per cent of adolescents in Canada suffer from psychosis, often a precursor to schizophrenia. First episode psychosis is a critical period for intervention to prevent further impairments and a critical time to instigate optimal, integrated bio-psycho-social interventions. However, many youth with psychosis do not seek help. Family and friends fail to comprehend the enormity of changes occurring and psychosis is often overlooked or misdiagnosed, leading to significant delays between symptom onset and treatment initiation. This duration of untreated psychosis is critical, given the strong relationship between length of untreated psychosis and poor clinical and social outcomes. 

Dr. Katherine Boydell's research focuses on exploring pathways to mental health care and improving knowledge of who seeks help, how they find appropriate help, how willing and/or informed health care gatekeepers are, and identifying obstacles to care and effective ways to inform a community. Knowledge translation is critical to the research program, as we know that for research findings to make their way into policy/practice, it is necessary to share research with decision-makers and practitioners in ways that are accessible to them. Thus, research activities include attention to disseminating research in multiple formats to key stakeholders (academic, decision-maker, practitioner, consumer, general public) at all stages from process to outcome.

Dr. Boydell's  work with youth experiencing psychosis focuses on understanding reasons for long delays in help-seeking (Boydell, Volpe, Gladstone et al., 2012; Boydell, Jackson & Strauss, 2012; Boydell, Gladstone, Goering et al., 2012; Addington, Epstein, Liu et al., 2011; Boydell, Stasiulis, Volpe et al, 2010; Boydell, Addington, Gladstone et al., 2008a; Boydell, Addington, Gladstone et al., 2008b; Gladstone, Volpe & Boydell, 2007; Boydell, Gladstone & Volpe, 2006). Her group's studies utilize a sociological help-seeking model, The Network Episode Model, to highlight the complexity of the pathway process, and to empirically test and extend this model to focus on young people (Boydell, Volpe, Gladstone et al., 2013). Dr. Boydell's program of research in early psychosis is characterized methodologically by use of arts-based research methods in both the creation and dissemination of research knowledge (see qualitative arts-based health research). 

Dr. Boydell hosted an international symposium on The Utilization of Qualitative Research in Early Psychosis, which led to publication of an edited book (Boydell & Ferguson, 2012). This primary arena of research in first episode psychosis is related to my research endeavors in rural and remote mental health namely, a program of research in paediatric telepsychiatry. These two areas are intimately intertwined by overlapping themes including pathways to care, use of new technologies, a focus on qualitative inquiry, and innovative knowledge translation and exchange strategies.

For more information please contact Dr. Katherine Boydell at katherine.boydell@sickkids.ca

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Mental Health Promotion and Intervention Research

As a Clinician Scientist and Psychologist within the Child and Youth Mental Health Research Unit, Dr. McVey is involved in the development, implementation, and evaluation of mental health promotion and prevention programming designed to foster protective factors and reduce risk for eating disorders, substance abuse and related mental health concerns among youth.  There is a pressing need for evidence-based practices to guide prevention in a way that meaningfully addresses the root causes that drive these problems during adolescence.

With CIHR mid-career award and funding, McVey developed, revised, and tested a mental health intervention, Girl Talk, aimed at promoting protective factors and reducing risk for eating disorders for middle school females. Girl Talk is a school-based prevention model that is peer group based, led by public health professionals trained by McVey, and focused on individual skill building.  The purpose of the Girl Talk intervention is to 1) Intervene when young females are closer to the entry level of risk e,g., the transition into adolescence; 2) Teach them healthy coping behaviours a. offered in groups to foster peer and school connectedness and b. adult-led by qualified mental health experts to reduce the likelihood of negative consequences such as peer contagion effects, or transmission of weight biases to students, and 3) Foster supportive environmental factors with the goal of decreasing the likelihood that students will turn to unhealthy coping behaviours including those associated with negative health outcomes.

Effectiveness trials have revealed its success in reducing risk for eating problems among middle school girls. An immediate next step is to adapt and test its effectiveness and perceived impact on high school females and broaden the outcome indicators beyond eating disorder risk alone and determine the impact of Girl Talk on additional mental health symptoms such as mood, anxiety and substance misuse; as well examine whether the intervention effects are mediated through changes in self-worth, internalization of the media ideal, perceived stress, coping skills, peer and school connectedness. A pilot study underway this year with Grade 9 females provides a practical lens on how to carry out this intervention research during mandatory Health & Physical Education class.
                                    
In addition to Girl Talk, McVey has designed, implemented, and evaluated through randomized controlled trials a series of prevention programs aimed at children, youth, and young adults, as well as adults who mentor them.  The cycle of intervention research carried out by McVey includes efficacy trials (does the intervention work?), effectiveness trials (does the intervention work in real life settings?), implementation research (what are the barriers to sustainability?) and translational research (translation of findings into policy).  This has led to the creation of practical resources including 1) EveryBODY is A Somebody: A resource designed to promote positive body image and self-esteem, 2) The Student Body (http://thestudentbody.aboutkidshealth.ca) an online training and curriculum for elementary school, 3) Healthy Schools-Healthy Kids Ontario, a comprehensive school health approach to preventing eating problems, and 4) Bodysense (www.bodysense.ca), a program to promote positive body image in female athletes, parents and coaches. Coordination of prevention research and knowledge translation activities has been potentiated by McVey’s active membership in various coalitions and through her delivery of many face‐to‐face, community‐based prevention workshops across Ontario.

For more information contact Dr. Gail McVey at gail.mcvey@sickkids.ca.

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Prevention and Treatment of Eating Disorders

Sharing our expertise in the prevention and treatment of eating disorders with a network of service providers, with children in the schools, and globally through the World Wide Web

Approximately one in four Canadian adolescent girls report symptoms of an eating disorders. Eating disorders, considered serious and life threatening, can occur in children as young as nine years of age and can impact on the physical, emotional, and social lives of children and their families. This serious disorder requires specialized treatment and prevention approaches.

An innovative community based training program, led by Dr. Gail McVey in partnership with the Eating Disorders Programs at Sick Kids and University Health Network, has standardized the treatment approach developed in these hospitals and others across Ontario. This has resulted in the creation of a provincial network to ensure that children, youth, and adults receive specialized medical and mental health services closer to home. Other work in partnership with Public Health units across Ontario has seen the development of an innovative peer-group program called Girl Talk and a school-based ecological prevention program that promote positive body image and self-esteem among school age children, and has important implications for school board policies relating to nutrition in the schools, “weight and shape teasing,” and the availability of physical activity for children regardless of shape and size. Throughout the cycle of prevention research attention is given to professional development activities geared at sensitizing adult influencers about the role they play in shaping children’s body image.   McVey’s mental health promotion research and professional development activities have been extended to the sport and university/college settings.  The all-girls group is being modified and evaluated for the high school setting to determine its impact in reducing the risk for eating disorders, substance abuse and related mental health concerns among female youth.

To increase the impact of our work in this area, we are sharing what we know globally through a Web-based training program that seeks to translate knowledge about best practices in the prevention of disordered eating to teachers and public health practitioners across Canada and beyond.

For more information, please contact Dr. Gail McVey at gail.mcvey@sickkids.ca.

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Professional Development Intervention Research: Mental Health and Healthy Weights

Dr. McVey is leading a professional development intervention research program designed to scale up the delivery of evidence-based prevention of weight related disorders among public health professionals. Specifically, McVey in partnership with public health professionals has developed and evaluated a professional development model designed to help public health practitioners integrate mental health promotion and weight bias awareness into their daily healthy weight promotion practice. Given the pervasiveness of weight bias among health professionals and educators and its direct influence on discourses about weight, nutrition, and physical activity, McVey with collaborators from public health developed and piloted with CIHR funding a professional development workshop geared at reducing the dangerous body shaming attitudes of adult professionals (McVey, Walker, Beyers, Harrison, Russell-Mayhew, & Simkins, 2013). The workshop was also designed to empower professionals with knowledge on how to address weight-related problems using a mental health framework, and on how to carry out evidence-based programming that is peer group/processed based. This professional development workshop has been shown to help reduce weight biased attitudes among public health professionals and increase their understanding of how to leverage mental health promotion to prevent weight related issues.  

McVey has hosted three national/international symposia with stakeholders from research, practice and policy from the fields of eating disorders and obesity (healthy eating/healthy weights) with the goal of seeking common ground to promote health.  Outcomes stemming from these knowledge exchange forums include the development of collaborative research agendas, an edited volume entitled Prevention of eating-related and weight related disorders: Collaborative research, advocacy and policy change. Waterloo, ON: Wilfrid Laurier University Press by McVey, Levine, Piran and Ferguson (2012), and the creation of a National Prevention Strategy Group in Weight Related Disorders led by McVey that meets bi-monthly to discuss ways to integrate the prevention of eating disorder and obesity and ways to incorporate mental health into healthy weight public health planning.

For more information please contact Dr. Gail McVey at gail.mcvey@sickkids.ca.

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Research with Young People

Using innovative research methods Dr. Gladstone brings young people's voices into current debates about their health and social care needs, building on prior help-seeking research in early intervention and prevention of mental health difficulties with young people at risk of or experiencing psychosis. Her current project, (Co) Producing Help-Seeking Narratives with Children of Parents with Mental Illnesses, uses arts-based qualitative and participatory approaches to study young people’s help-seeking experiences across home, school, primary care and hospital settings.  An important objective of this research is to examine how young people acquire further competencies and skills through guided participation and active and meaningful engagement with others in an integrated knowledge creation and translation process.

For more information, please contact Dr. Brenda Gladstone at brenda.gladstone@sickkids.ca.

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