|
 Centre for Addictionand Mental Health |
|
|
|
Research
|
Centralized Assessment, Triage and Support ProgramSection Head ContactDr. Paul Kurdyak Research Objectives
Summary of ActivitiesThe CATS program is the clinical “front door” to CAMH with very busy clinical programs in the area of General Psychiatry. The main clinical activities are the Emergency Department, the CATS ambulatory program, and the CATS inpatient unit. The clinical sample is not selected; therefore, it is representative of the mental health needs of the entire CAMH population. As such, it provides an opportunity for exploring the determinants of community-based mental health needs and access. Access to treatment Many factors determine whether someone seeks treatment for mental illnesses. On September 21, 2005, CAMH went “smoke-free”. Overnight, the Emergency Department, along with the rest of the hospital, no longer permitted smoking within the hospital. From a public health perspective, imposing restrictions on smoking, as well as alternatives to smoking, is laudable given the burden of illness associated with smoking in a population with mental illness. However, policies can have both intended and unintended consequences. We were interested in determining whether the smoke-free policy would affect the likelihood that certain patient groups would use the Emergency Department after the ban was imposed. We were interested in whether the policy would force certain patients to choose to have the freedom to smoke over seeking treatment for their mental health issues. We also investigate treatment-related policy at the provincial level. In the past five years, there has been a high level of concern about the relationship between antidepressants and an elevated risk of suicide. While the association remains controversial, drug advisory agencies in three different countries, the United Kingdom Committee on the Safety of Medications, the United States Food and Drug Administration, and Health Canada, all published advisory warnings on the potential relationship between antidepressants and suicidal ideation. We studied the impact of the various warnings on antidepressant prescribing trends and found that the more specific the warning is, both in terms of antidepressant and patient population, the more likely the advisory will have an impact on physician prescribing behaviours. The interaction between chronic medical and mental illnesses There are many ways that medical and mental illnesses can interact. We have focused on cardiovascular illnesses and depression to explore the interaction of these two conditions in terms of mortality and health service utilization. The latter outcome is particularly interesting since it is unclear whether someone with cardiovascular illness and depression is more or less likely to receive treatment for cardiovascular illness than a patient with no depression. Investigating the interaction of mental and medical illnesses with respect to access to services allows for a more comprehensive view of our health care system than looking at barriers to treatment for a single diagnostic entity. This is a more realistic approach since comorbidity, whether psychiatric or medical, for individuals with mental illnesses is likely the norm rather than the exception. Research methodologies Research in the area of mental health epidemiology requires the use of survey-administered diagnostic instruments. As a result, missing data are frequently generated. Missing data in observational studies can produce estimates of population parameters that are biased. We are interested in missing data mechanisms and methodologies, such as multiple imputations, as ways to address the potential bias from the all-too-frequent problem of missing data. |
 Related Links |
Share|
Last updated: May 17, 2007 4:13 PM Published: Oct 26, 2009 4:07 PM ID#P29972 |