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Core Researchers / Consultants
Paula Goering, Director
Brian Rush, Associate Director
Dale Butterill, Manager-Knowledge Transfer
John Cairney, Research Scientist
Carolyn Dewa, Health Economist/Education Coordinator
Janet Durbin, Research Scientist
William Gnam, Health Economist
Nora Jacobson, Research Scientist
Chris Koegl, Research Specialist
Elizabeth Lin, Research Scientist
Dianne Macfarlane, Senior Associate
Carol Strike, Research Scientist
Paula Goering [Director]
Current Position(s): |
Director, Health Systems Research and Consulting Unit, CAMH
Professor and Vice-Chair-Programs and Planning, Department of Psychiatry, University of Toronto with cross-appointments to Faculty of Nursing, Institute of Medical Science and the Department of Health Policy, Management and Evaluation
Health Services Chair, CHSRF/CIHR
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Degree(s): |
B.S.N (University of Kansas)
M.S.N (Yale University)
Ph.D (Medical Sciences, University of Toronto)
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Experience: |
Dr. Paula Goering is an experienced
clinician, educator, consultant and researcher. She oversees the work
of a core group of interdisciplinary investigators and students who study
mental health service delivery and actively participate in the dissemination
and utilisation of new knowledge. Under her leadership over the past decade,
HSRCU has bridged academic and policy worlds in the area of mental health
services. This leadership has been recently recognized through the award
of a CIHR/CHSRF Chair in Health Services Research and her appointment
to the Institute Advisory Board of the IHSPR, CIHR Institute. HSRCU projects
cover a wide range of applied research activities that include synthesis
of existing scientific information for policy and planning use, design
and conduct of investigations for specific providers and planners, and
education of stakeholders in both worlds.
Dr. Goering's research activities have focused on the improvement of mental
health service delivery, particularly for those with severe and persistent
mental illness. She has published over 90 articles in a wide range of
refereed journals and frequently presents scientific papers at international
meetings. She has studied the delivery of aftercare services to discharged
psychiatric patients, depression in married women, conducted a longitudinal
evaluation of case management programs, a follow-up study of supportive
housing residents and a needs assessment of homeless women. The Ontario
Mental Health Supplement and A Pathways into Homelessness study provided
epidemiological descriptions of community and shelter populations. Collaborations
with the Institute for Clinical Evaluative Sciences are focused on the
mental health component of service delivery.
She has worked with policy decision makers at both the federal and provincial levels.
In Ontario assistance has been provided through a series of working papers that have
helped to define the service models, systems and targets which underlie mental health
reform. This work has been cited extensively in the official provincial mental health
policy documents. She has recently directed comprehensive assessment projects in many
of the Ontario provincial psychiatric hospitals. A Best Practices in Mental Health Reform
project, conducted in collaboration with government and professional organisations
resulted in three documents that have been widely circulated nationally and internationally.
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Brian Rush [Associate Director]
Current Position(s): |
Associate Director, Health Systems Research and Consulting Unit, CAMH
Assistant Professor, Department of Psychiatry, University of Toronto
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Degree(s): |
B.A. (Wilfrid Laurier University);
M.A. (University of Western Ontario);
Ph.D. (University of Western Ontario)
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Experience: |
Dr. Rush has a background of addiction and community mental health services
and systems research, social/psychiatric epidemiology, evaluation and planning
of community prevention and health care systems, program and policy evaluation,
and community needs assessment.
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Dale Butterill [Manager-Knowledge Transfer]
Current Position(s): |
Manager, Knowledge Transfer, Health Systems Research and Consulting Unit, CAMH
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Degree(s): |
Hon.B.A. (Sociology, University of Toronto);
M.S.W. (Simmons College of Social Work, Boston);
M.P.A. (Queens University)
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Experience: |
Dale Butterill has extensive experience in hospital and community?based mental health services.
As the Manager of Knowledge Transfer Dale is responsible for developing knowledge transfer and
exchange plans and strategies within the HSRCU, CAMH, the Ministry of Health and other external
research organizations. She is the former Strategic Initiatives Coordinator at CAMH and was
involved the facilitation of the post-merger transition at the Centre for Addiction and Mental
Health. Prior to that, as the Coordinator of the Clarke Community Linkage Program, she was
responsible for facilitating linkages between the various disciplines and divisions of the
Institute and providers and consumers of mental health services. Previously, she was responsible
for the development, administration and management of the Day Treatment Program for patients with
psychiatric disabilities in the Continuing Care Division. Her special interests also include
system and program development for individuals with co?existing psychiatric and substance use
problems.
Ms. Butterill a former member of the Board of Directors of the Canadian Mental Health
Association, Ontario served as the editorial committee chair of Network Magazine. She is the
past President of the Canadian Mental Health Association ? Metropolitan Toronto Branch. She
has been a founding board member of several innovative mental health agencies including the
Community Resources Consultants of Toronto, Keith Whitney Homes, and Bayview Community
Services.
Ms. Butterill's current teaching responsibilities are the Faculties of Health Policy,
Management and Evaluation and Social Work, University of Toronto. She taught for many
years in the Human Services Counselor Program at George Brown College, the Case Management
certificate program at Humber College and was a field instructor for the Faculty of Social
work, University of Toronto.
She has written, and presented papers to a variety of professional groups on such topics
as crisis intervention, family treatment, multidisciplinary team work, the impact of the
consumer movement on professional practice, concurrent disorders, psychiatric disability
in the workplace, day treatment and knowledge transfer/exchange. Recent publications are
in the area of knowledge transfer and exchange.
Ms. Butterill has extensive consulting experience. As a senior consultant in the Unit
she has conducted several operational reviews of hospital mental health programs and
community mental health programs. She also co?conducted a province?wide survey of the
training needs of case managers, reporting on the mental health needs of Natives and
persons with dual disorders for the long?term mental health plan of the District Health
Council of Metropolitan Toronto.
Before joining the former Clarke Institute of Psychiatry, Ms Butterill worked as a
consultant to mental health services in Toronto where she initiated a coordinated system
of aftercare including supportive and cooperative housing for people with mental illness.
Her extensive clinical experience includes short and long?term treatment of individuals,
families and group therapy. In addition, she has a great deal of administrative and
management experience in the community mental health field. She was the Program Director
of a mental health clinic in downtown Toronto where she was responsible for all aspects
of the program including supervision of staff, program evaluation and liaison with the
community.
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John Cairney [Research Scientist]
Current Position(s): |
Research Scientist, Health Systems Research & Consulting Unit, CAMH
Assistant Professor, Department of Psychiatry, University of Toronto
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Degree(s): |
B.A. (Brock University, 1993)
M.A. (Queen's University, 1995)
Ph.D. (University of Western Ontario, 2002)
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Experience: |
John Cairney has a Ph.D. in Sociology from the University of Western Ontario. He has
completed post-doctoral training in psychiatric epidemiology at the Canadian Centre
for Studies of Children at Risk, Department of Psychiatry and Behavioural Neuroscience,
McMaster University under Dr. Dan Offord and Dr. Michael Boyle. His research interests
are, broadly, in the areas of psychiatric sociology, population health and epidemiology.
In particular, his research has explored the social and economic determinants of
psychological well-being including the influence of socioeconomic status on
self-reported health among older adults, the relationship between age and depression,
and the effect of age on gender differences in depression. His doctoral dissertation
(2002) was an examination of the combined impact of age and socioeconomic status on
stress, psychosocial resources and psychological distress.
More recently, his work has focused on issues related to mental health care use in
vulnerable and/or marginalized populations. Dr. Cairney has extensive experience
analyzing large, population-based health surveys including the 1994-95 National
Population Health Survey, 1991 General Social Survey, the National Longitudinal
Survey of Children and Youth, and the 1990 Ontario Mental Health Supplement. He
has published 19 articles in peer-reviewed journals and presented at more than
25 national and international scientific conferences.
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Carolyn Dewa [Health Economist / Education Coordinator]
Current Position(s): |
Health Economist/Research Scientist, Health Systems Research & Consulting Unit, CAMH
Assistant Professor, Department of Psychiatry, University of Toronto
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Degree(s): |
B.A. (Wellesley College, 1985)
M.P.H. (San Diego State University, 1987)
Ph.D. (Johns Hopkins University, 1998)
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Experience: |
Dr. Dewa is a health economist/mental health
services research scientist with the Health Systems Research Unit at the Clarke Site of the Centre for Addiction and Mental
Health. Her Ph.D. is in Health Economics and her M.P.H. is in Health Services Administration. She was also a Visiting
Fellow in the Department of Health Care Policy at Harvard Medical School.
Since joining the Consulting Group in 1998, Dr. Dewa has been involved in a multisite evaluation of community mental health
services in Ontario where her primary interest is in developing methods to study program costs and cost effectiveness.
She is also the lead on a project examining depression in the workplace - assessing adequacy of treatment and predicting
worker disability. Other activities include analyses looking at the differences in factors affecting the demand for mental
health services among service users in Canada and the U.S.
Prior to joining the Consulting Group, Dr. Dewa was a project director at the National Opinion Research Center's Drug Abuse
and Mental Health consulting group. There, she was involved in studies determining the prevalence of substance abuse and mental
illness in the U.S. population and their effects on aspects of daily life ranging from driving to employment.
Other areas of interest include the financing and organization of mental health services.
Dr. Dewa was involved in a three year Robert Wood Johnson funded U.S. project comparing and contrasting the methods states used
to organize their mental health systems and tracking the funding streams from the Federal down to the local governments.
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Janet Durbin [Research Scientist]
Current Position(s): |
Research Scientist, Health Systems Research and Consulting Unit, CAMH
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Degree(s): |
B.Sc. (University of Toronto);
M.A. (University of Toronto);
M.Sc. (University of Toronto);
Ph.D (University of Toronto, candidate)
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Experience: |
Ms. Durbin has worked extensively
in program planning and evaluation. Recently she participated in a Health
Canada project to define and discuss implementation of best practices
in mental health reform. The project involved a critical review of literature
on best practices, and a summary of program and system initiatives across
Canada that approximate best practices. Currently she is director and
co-investigator on the multisite component of a Community Mental Health
Evaluation Initiative which is evaluating a diverse group of community
mental health programs in Ontario. Past evaluation projects include developing
an evaluation framework for a community housing program, and evaluation
of a case management program based on an assertive outreach model.
Ms. Durbin has been involved in a number of planning projects related
to mental health reform. She provided technical support to the Metro Toronto
District Health Council during development of a system design plan for
mental health reform in Metro Toronto, and also to the Ontario Ministry
of Health for service planning in Mental Health Reform. Projects focused
on developing conceptual frameworks and targets for case management, crisis
intervention, residential support and psychogeriatric outreach services.
A planning project that she led for the Metro Toronto District Health
Council examined the mental health service needs of the diverse ethno/racial
communities of Metropolitan Toronto. Earlier, Ms. Durbin worked with colleagues
on a project to advise a large Toronto teaching hospital regarding cross-cultural
psychiatry services.
Another interest relates to developing tools and strategies for managing
mental health services. Ms. Durbin completed a project in patient classification
systems for the Joint Planning and Policy Committee (JPPC) of the Ontario
Hospital Association and Ministry of Health, and recently she assumed
a lead role in an evaluation of the relationship between a measure of
patient severity and length of stay in hospital. Currently Ms. Durbin
is co-investigator in a series of comprehensive assessment projects to
determine service and support requirements of current users of provincial
psychiatric hospitals. She sits on several Centre and Department of Psychiatry
committees concerned with monitoring delivery of care and patient outcomes.
Ms. Durbin presents regularly at professional meetings and has published
in academic journals. Topics of recent presentations include Program Evaluation
in a Changing Mental Health System; Conducting a Feasible and Meaningful
Program Evaluation - A Case Example; Patient Classification Systems in
Psychiatry - Problems and Issues; and Knowledge Transfer Through Consultation:
What Makes a Successful Partnership. Ms. Durbin sits on several community
committees focused on program review and evaluation.
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William Gnam [Health Economist]
Nora Jacobson, Research Scientist
Nora Jacobson [Research Scientist]
Current Position(s): |
Research Scientist, Health Systems Research and Consulting Unit, CAMH
Assistant Professor, Department of Psychiatry, University of Toronto
Assistant Professor, Department of Public Health Sciences, University of Toronto
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Degree(s): |
B.A. (Hampshire College);
M.A. (Johns Hopkins University);
Ph.D. (Johns Hopkins University School of Hygiene and Public Health)
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Experience: |
Nora Jacobson completed an NIMH-sponsored
postdoctoral fellowship in the Mental Health Services Research Training
Program at the University of Wisconsin-Madison. In 1997 she was the American
Sociological Associations Spivak Program Congressional Fellow, working
as a health policy fellow for Senator Edward M. Kennedy and the Senate
Labor Committee.
An interpretive social scientist, Dr. Jacobson uses qualitative methods
to study the ways in which social constructions of health and illness
affect the making of health policy and the delivery of health services.
Some of her current work, for example, examines how the concept of recovery
from mental illness has been constructed by different stakeholder groups
and how these constructions are made manifest in policy and practice.
She is the author of Cleavage: Technology, Controversy, and the Ironies
of the Man-Made Breast (Rutgers University Press 2000), a sociological
analysis of the history of silicone breast implants, and of In Recovery: Meaning and
the Making of Mental Health Policy (forthcoming 2004 from Vanderbilt University Press).
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Chris Koegl [Research Specialist]
Current Position(s): |
Research Specialist, Health Systems Research and Consulting Unit, CAMH
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Degree(s): |
B.Sc. (Psychology, University of Toronto);
M.A. (Criminology, University of Toronto);
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Experience: |
Trained as a social psychologist and criminologist, Chris Koegl joined the HSRCU team in 2000.
For the past three years he has worked extensively on the "Comprehensive Assessment Projects"
which continues to provide information about the service and support needs of persons with
serious mental illness in hospital- and community-based programs across the province of
Ontario. He is currently managing the master dataset, working collaboratively with
researchers, community stakeholders, and government representatives, to further program
development and mental health policy reform.
He is also a member of the Hospital Report Card Research Collaborative whose mandate is to
measure the performance of hospitals providing mental health services in Ontario. In this
regard, current topics of interest include adherence to best practice/guideline care in the
treatment of major depressive disorder and schizophrenia, measuring mental health outcomes
of hospitalized patients, and assessing the feasibility of implementing performance
monitoring systems.
Mr. Koegl has given presentations to academic, clinical, governmental, and community
stakeholder audiences. He has published articles and book chapters in the areas of youth
justice, risk of antisocial behaviour in children, and institutional violence. He is
currently completing an analysis of the master dataset which will result in the first
comprehensive empirical analysis of the adult mental health system in Ontario.
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Elizabeth Lin [Research Scientist]
Current Position(s): |
Research Scientist, Health Systems Research and Consulting Unit, CAMH
Assistant Professor, Department of Psychiatry, University of Toronto
Adjunct Scientist, Institute for Clinical and Evaluative Sciences
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Degree(s): |
B.A. (Harvard University)
M.S. (University of Louisville)
P.H.D. (University of Louisville)
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Experience: |
Dr. Lin's expertise is in using information from large-scale
population surveys or administrative databases to describe how people use mental health care and to
point out areas where service delivery might be improved. Before her arrival in Canada in
1989, she participated in a number of needs assessments projects using community survey data.
Since 1989, she has been involved with the Mental Health Supplement to the Ontario Health Survey, an
epidemiological survey of nearly 10,000 Ontario household residents which assessed their mental
health status and associated disability and health care use. More recently, she has also used
administrative data (e.g., fee-for-service and hospital datasets) to add to the picture of how
mental health care is used and delivered in Ontario. Her interest in assessing Ontario's health
care system has also led to international projects - including a comparison of the U.S. and
Ontario as well as a comparison of treated and untreated depressed individuals in Ontario, the
U.S., and the Netherlands.
Her research has also led to considerable experience in more technical and methodological
issues such as complex survey design, the assessment of psychiatric disorder and mental
health service use in a survey format, and the definition of mental health care in
administrative databases.
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Dianne Macfarlane [Senior Associate]
Current Position(s): |
Health Care Consultant/Senior Associate, Health Systems Research and Consulting Unit
Assistant Professor, Department of Psychiatry, University of Toronto
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Degree(s): |
B.A. (University of Toronto);
M.A. (Criminology, University of Toronto);
C.H.E. (Canadian College of Health Service Executives)
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Experience: |
Ms. Macfarlane is an experienced leader and senior manager in mental
health and long-term care who has worked both in Ontario and British Columbia. She has extensive knowledge
of the organization and delivery of services for the mentally ill and for the elderly.
Her experience and expertise in mental health include the design and support of consultation and planning
processes that involve consumers, family members and care providers, the management of complex projects to
"downsize" psychiatric institutions and "upsize" community mental health services and supports, and the
development of comprehensive functional plans for psychiatric hospitals undergoing redevelopment. She
appreciates the importance of effective linkages between community and hospital in serving the mentally
ill and has initiated a number of such partnership programs.
Ms. Macfarlane has strategic planning expertise, is knowledgeable about organizational design including
approaches to program management and continuous quality improvement, and is experienced in implementing
change management strategies to assist consumers and care providers through challenging transitions.
She has been involved in the development of mental health and health reform policy in two provinces.
She is also an experienced researcher, teacher and public speaker.
Her pre-health care work includes ten years as a university researcher in criminology and five years as
a high school teacher.
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Carol Strike [Research Scientist]
Current Position(s): |
Research Scientist, Health Systems Research and Consulting Unit, CAMH
Assistant Professor,
Department of Psychiatry,
Institute for Medical Sciences,
and Department of Public Health Sciences,
University of Toronto
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Degree(s): |
B.A. (Sociology, University of Waterloo);
M.Sc. (Epidemiology, University of Ottawa);
Ph.D. (Public Health Sciences, University of Toronto)
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Experience: |
Dr. Strike is a public health scientist
and health services researcher with the Health Systems Research Unit.
Using both qualitative and quantitative methods, her research focuses
on service delivery models for illicit drug users; harm reduction programs
for illicit drug users; methadone programs; relationships between providers
and clients; and service utilization patterns of vulnerable populations.
Current projects include examining the delivery and operation of low
threshold methadone programs and a profile of methadone recipients and
providers in Ontario. The focus of prior research has been on HIV risk
behaviour and prevention programs; violence and health; development
of behavioural surveillance programs; general population health status
studies. In addition, Dr. Strike assists community groups that serve
marginalized populations with program evaluation and planning.
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