What if a simple saliva test could tell a doctor precisely the right meds
your body needed to fight depression? What if science could prove
how dogs are able make breakthroughs in mental health treatment
where other approaches have failed?
And, what if we, as Canadians,
stopped blaming and shaming people with mental illness?
These questions are not hypothetical. They represent some of
the leading-edge research happening at institutions across Canada –
research that, in many cases, signals
a major shift in how mental health is
both studied and put into practice.
THE RIGHT DRUG FOR
THE RIGHT PERSON
The Centre for Addiction and
Mental Health (CAMH) is bringing the promise of personalized
medicine closer to reality with a
major study involving nearly
20,000 patients that could replace
the long and frustrating trial-and-error approach to prescribing drugs
with a scientifically proven diagnostic test.
At one test site north of Toronto,
doctors at the Thornhill Medical
Centre are using a saliva-based test
with 150 patients to predict which
of 19 commonly prescribed psychi-
atric medications work best, based
on each person’s unique genetic
make-up. Medications that work
well get a green light to prescribe
as directed. Those with a red light
are flagged for their poor efficacy or
side effects, while meds that fall in
the yellow zone may indicate that a
dosage is too low or too high.
“There are no biological mark-
ers to tell us how sick a person
with depression or schizophrenia
is, unlike there is for diseases like
cancer, heart disease and diabe-
tes,” says CAMH’s Dr. James Ken-
nedy, who is leading the IMPACT
(Individualized Medicine: Pharma-
cogenetic Assessment and Clinical
Treatment) study. “These tests will
enable doctors – for the first time
– to choose a medication based on
biochemical evidence specific to
Since 80% of psychiatric meds
are prescribed in primary care by
family doctors, and not psychia-
trists, Kennedy says it’s essential to
have a test that is easy to use.
“The real breakthrough part of
this project is being able to deliver
all this genetic information widely
to doctors in family practice. In a
couple of years we hope to have
it available to hundreds of doctors.
This has never been done before,”
In addition to improving patient
satisfaction and safety, the IMPACT
study could also help reduce health-care costs. One of the drawbacks
to trial and error prescribing is that
patients may have to try several different drugs and dosages to find one
that works, and that can take several
weeks or months.
“That first medication won’t
work well in thirty-five to fifty
percent of cases,” says Kennedy.
“That leaves patients frustrated and
at increased risk of suicide. It also
drives up health care costs.”
REDUCING THE STIGMA
OF MENTAL ILLNESS
Coming up with more effective
treatments for mental illness is only
half the solution. The bigger challenge, contends Dr. Heather Stuart
at Queen’s University, is reducing
the stigma that deters two-thirds
of Canadians with a mental illness
from seeking help.
The consequences of such stig-
matization are well known: trouble
staying in school, finding and keep-
ing a job and maintaining or estab-
lishing relationships. While there are
awareness programs to address this
issue, Stuart says most are based on
strongly held beliefs as opposed to
hard evidence. To fill this gap, she
is collecting scientific data on how
often such discrimination occurs, its
psycho-social effects and the best
ways to reduce discrimination in
homes, schools, workplaces and
even the health care system.
Her efforts received a major
boost last year when Bell
Canada donated $1 million to create the Bell Mental Health and
Anti-Stigma Research Chair – the
first academic position of its kind
in the world. Stuart is the inaugural
“My research looks at the prevalence and frequency of stigma from
the perspective of people who have
a mental illness and how that results
in prejudice, discrimination and
unequal life chances,” she says.
The end goal is to come up
with best practices and toolkits that
parents, schools and other organizations can use to fight the stigma
surrounding mental health.
“We now know that for these
programs to work the people who
have the illness and their family
members have to be front and centre in both planning and delivering
these programs,” says Stuart.
One of the biggest changes in
Canadian mental health research
over the past decade has been
the unprecedented level of support from corporate donors. Bell
Let’s Talk is a $50 million, multi-year program that promotes mental
health across Canada based on four
action pillars: anti-stigma, care and
access, research and workplace best
Bell’s investments on the
research side have included
a $10 million donation to the
Centre for Addiction and Mental
Health (CAMH), $2 million to the
Douglas Mental Health Univer-
sity Institute for the Douglas-Bell
Canada Brain Bank, and $1 million
to Queen’s University to estab-
lish the Bell Mental Health and
Anti-Stigma Research Chair.
Mary Deacon, Chair of the Bell
Let’s Talk mental health initiative,
says mental health was not high
on the list of priorities for corpo-
rate Canada a decade ago. The big
change, she believes, has been in
Canadians’ perceptions of mental
health. The result has been less
stigma and a better understanding
that mental illness is a brain disease
where investments and treatments
can have a profound effect.
“Mental illness is a serious, pervasive, underfunded, highly stigmatized and common health issue.
What has changed is that the conversation is no longer taking place
in the shadows. It is now talked
about at the dinner table, classroom
and boardroom,” says Deacon, who
worked as a fundraiser for 10 years
at the CAMH Foundation.
HOW KIDS SUFFER FROM
A PARENT’S TRAUMA
Reducing the stigma and discrimination too often associated with
mental illness begins with understanding its underlying causes.
Several studies have shown how
personal trauma can contribute to
depression, substance abuse and
other mental and physical illnesses.
Yet, until recently, there were few
studies that examined the effects of
psychological trauma on the chil-
dren and grandchildren of the per-
son initially victimized.
A team of neuroscientists at
Carleton University examined
this issue in the context of First
Nations adults forced to attend
Canada’s residential schools. For
second generation Aboriginals,
they found these traumatic events
had lasting neurochemical and hormonal effects that inhibited their
ability to cope with stress later in
life, increasing their vulnerability
to depression, post-traumatic stress
disorder and substance abuse, as
well as chronic conditions such as
heart disease, high blood pressure,
stroke and diabetes.
“Too often we end up blaming the victim because these events
happened so long ago,” says Dr.
Kimberly Matheson who collaborated on the study with Dr. Hymie
Anisman and Dr. Amy Bombay.
“But what this research demonstrates is that early life experiences
can sensitize the brain so that when
you encounter stressors later in life,
you are much more reactive.”
There is no one-size-fits-all intervention when it comes to treating
mental illnesses. Yet, in too many
Dr. Heather Stuart
Faculty of Health Sciences
Bell Canada Mental Health
and Anti-Stigma Research Chair
13-0557 Campaign Top 50 Research ad Heather Stuart_Layout 1 2013-10-17 2: 41 PM Page 1
Fresh thinking, new approaches and collaboration are
hallmarks of the Carleton experience.
The research advances in Neuroscience and Mental Health
at Carleton are changing lives – one person, one family and
one community at a time.
Learn more at neuroscience.carleton.ca
Painting by Jane Stewart
“ These tests will enable doctors –
for the first time – to choose a
medication based on biochemical evidence
specific to that patient. ”
Dr. James Kennedy
Centre for Addiction and Mental Health
“ Mental illness is a serious, pervasive, underfunded, highly stigmatized
and common health issue. What has changed is that
the conversation is no longer taking place in the shadows.
It is now talked about at the dinner table, classroom and boardroom. ”
Mary Deacon, Chair
Bell Let’s Talk
Canada Raises the Bar
for Mental Health Research
Continued on page 9