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 Centre for Addictionand Mental Health |
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Research
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Health Systems Research and Consulting Unit: Research Annual Report 2003Section Head: Dr. Paula Goering Informing and improving systems of mental health and addiction service delivery -- this is the goal of the CAMH Health Systems Research and Consulting Unit (HSRCU), the base of the University of Toronto Department of Psychiatry's Health Systems Program. Our interdisciplinary team draws on the expertise of other jurisdictions, reviews current literature, interviews and consults with local stakeholders, analyzes data in existing administrative databases and gathers information through epidemiological and program evaluation studies. Our goal is to have research disseminated and translated into policy and practice. Our section head, Dr. Paula Goering, also
holds a CIHR/CHSRF (Canadian Health Services Research Foundation) health services chair; this supports knowledge transfer
and exchange activities and emphasizes training. We are affiliated with the Department of Health Policy, Management and Evaluation at the University of Toronto and have developed
a collaborative relationship with the Institute for Clinical Evaluative Studies. We had over 16 trainees supervised by scientists on the unit in the last year, three of whom won awards for the excellence of their work. Our summer studentship program has shown great success, attracting 80 applications this year for four positions. Three fellows have learned about health services research, as have graduate students from various disciplines. We are involved in two CIHR Training Centres that will provide stipends for trainees as well as opportunities to connect with broader networks. Our scientists are teaching several new university courses, and our unit offers an educational series for trainees and staff. Our knowledge and exchange activities are well-established; we have helped develop a knowledge transfer plan for best practices in concurrent disorders; organized a research education series for our policy partner; evaluated and disseminated the research transfer training series and worked with our provincial evaluation project to implement innovative communication strategies. A paper describing our relationship with the provincial policy branch has been accepted for publication. We are also developing a knowledge translation research program and a university course. Our consultation service is busy transferring knowledge and keeping research staff in touch with front-line service delivery issues and problems. We have added an evaluation component to all of our projects, which in the last year have included a review of Toronto's mental health court support services, an evaluation of a lead agency in northern Ontario and a study of use of inpatient services in southwestern Ontario. Community Mental Health Evaluation Initiative The HSRCU is the co-ordinating centre for a multi-site evaluation research project to advance understanding of the roles played by case management, assertive community treatment, crisis services and consumer and family initiatives. We are collecting common outcomes data on a cohort of over 600 people at baseline, nine and 18 months. The outcome protocol was designed to be brief and comprehensive; portions of it have been incorporated into other studies and monitoring initiatives. Projects are in the final stages of data collection and are now focusing on analyzing and interpreting results. We conducted a half-day plenary at the "Making Gains" conference in Fall 2003 to engage Ontario stakeholders in discussion
around the implications of the research for practice, programs and policy. Until recently, the availability of methadone treatment in Ontario and elsewhere in Canada has been restricted. In 1996, Ontario introduced a series of policy changes aimed at increasing the availability and uptake of methadone therapy. Using registry data from the College of Physicians and Surgeons of Ontario, we are assessing the five-year impact of these policy changes on the patient and physician populations. Between 1996 and 2001, the total number of methadone clients in treatment in Ontario increased substantially, from 1,595 to 7,787. Over this time period, the number of physicians prescribing methadone increased from 60 to 161. Drug and Alcohol Treatment Information System Drug and Alcohol Treatment Information System (DATIS) is a provincial information system that collects, summarizes and reports
information on the volume and characteristics of people being treated for alcohol, other drug and gambling problems in Ontario.
Unit staff help select performance measures within DATIS and analyse and interpret trends that are useful for planning, accountability
and research. In response to a request from the Ontario Roundtable on Appropriate Prescribing, we designed a study called Depression in the Workplace: Examining Antidepressant Use and Worker Characteristics and Their Associations with Disability. Three Canadian companies with national employee bases were recruited as project participants, representing over 65,000 workers. Results showed that approximately 58 per cent of employees who were receiving depression-related short-term disability benefits had made at least one antidepressant claim. mployees who did not use antidepressants typically reported significantly fewer symptoms at baseline on average than those who did use antidepressants. The results of this study represent an important first step in exploring the question of how antidepressants are used among workers who are most affected by depression and who use disability benefits. Comprehensive Assessment Projects This series of needs-based planning projects originated in Ontario's psychiatric hospitals and expanded into the community system. We used a consistent methodology to assess current and recommended levels of care for people who use mental health services and to determine how well care received matched the level of need. This series of needs-based planning projects is now completed; we created a database that merges results from projects across the province. There are about 42,000 clients of community mental health services and 13,000 clients of provincial psychiatric hospital services represented in this provincial database. Plans are under way to transfer the database to the Ontario Ministry of Health and Long-Term Care so researchers and planners can have full access to it. |
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Last updated: Aug 25, 2004 12:24 PM Published: Dec 09, 2009 8:17 PM ID#P5756 |