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LONDON, ON- A team at Lawson Health Research Institute are looking to improve mental health treatments and resources for patients who have experienced a stroke. The team will recruit 100 stroke patients to assess whether the completion of a guided therapy program can improve mental health and quality of life.

Strokes affect approximately 400,000 Canadians each year and can be debilitating. They can negatively affect a person’s cognition and mobility, and severely impact mental health and wellbeing.

“More than sixty per cent of patients experience depression after stroke,” says Dr. Robert Teasell, Lawson Scientist and Physiatrist at St. Joseph’s Health Care London’s Parkwood Institute. “Having a stroke itself makes people more vulnerable and makes people feel their lives have changed negatively.”

During stroke rehabilitation, patients are typically offered mental health treatments, but the research team say it is post rehabilitation that stroke patients tend to experience worsening depression.

“Publicly funded allied health care services are available at inpatient and outpatient care; however, psychology is often limited across the rehabilitation continuum from acute to community care,” says Dr. Swati Mehta, Lawson Scientist. “We are looking at how we can provide a program that is cost effective to help those who have these barriers to access mental health services.”

The study will examine the use of cognitive behavioral therapy (CBT), which is an evidence based psychological intervention that aims to provide people with increased coping ability and self-efficacy. Participants will complete a 10-week guided program with specific targeted lessons, tailored to the needs of those post stroke, delivered virtually through a trained clinician. They will then complete a questionnaire to see if there have been any improvements to self-efficacy and emotional wellbeing.

“We have found this form of therapy (CBT) has been very effective and feasible for spinal cord injury patients with mild traumatic brain injury and we want to see how a modified version could potentially help those with stroke and depression,” says Randy Upper, Clinical Research Associate at Lawson.

If CBT is proven effective through this study, Dr. Mehta hopes it will encourage similar programming that would be available to stroke patients after rehab.

“We are hoping we can connect with community organizations and work with them to implement this program in a service delivery model that would be easily accessible for stroke patients living in the community.”

Recruitment for this study is currently underway, those interested in taking part can email Dr. Swati Mehta at: @email
 

LONDON - In a study published in MDPI Journal, a team of researchers at Lawson Health Research Institute have shown that the use of technology may assist in better outcomes for those living with both mental health and physical disorders.

Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson, and her team embarked on a pilot study that used smart home monitoring solutions to assist those living with both a mental health disorder and other health challenges. The purpose of this pilot study was to see if technology could improve overall lifestyle and wellbeing.
 
“We began our research by using hospital prototype apartments – apartment style care spaces within hospital settings – that were equipped with smart home technology solutions such as a screen device, activity trackers, weigh scales and medication dispensers,” says Dr. Forchuk who is also the Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery at St. Joseph’s Health care London. “Once we tested it in a hospital setting, we wanted to find a way to take this idea out into the community in different kinds of housing and living situations to see if it would be beneficial.”

The research team partnered with the Canadian Mental Health Association (CMHA) and the London and Middlesex Community Housing (LMCH) to work together to retrofit the homes of the 13 study participants.

“We worked together with the participants and their care providers to choose what combination of  technology they felt would be best for them,” says Dr. Forchuk. “No matter their health condition each participant wanted to be more active and independent, with the goal of staying out of hospital.”

All smart devices were connected to the Lawson Integrated Database, which is a database that can securely collect data from multiple sources such as health devices. This allowed care providers to send reminders to participants, while also tracking usage and results.

“The key benefits we noted was that study participants started to live healthier lives,” says Jonathan Serrato, Lawson Research Associate. “Participants logged going for walks and exercising more often, as well as making healthier food choices. Those who used the medication dispensers did not miss a single dose. The touch screen devices also allowed participants to easily communicate with care providers and support networks, and access more resources.”

Following the pilot study, the research team also published a subsequent paper, as a ‘how-to guide’ for utilizing smart home technology interventions as a health care tool.

“This paper is a helpful resource that outlines implications and considerations when it comes to smart home technologies,” adds Serrato. “There are many areas we touch upon such as security, privacy and feasibility as well as hardware and software information for those who would like to take on their own similar type of smart home technology project.”

LONDON, ON- The COVID-19 pandemic has taken a toll on social connections, emotional health and well-being, especially for older adults.  A new study through Lawson Health Research Institute will examine whether online/virtual ‘meaning-centered’ groups can help promote social connections and reduce risk for psychological distress.

Online meaning-centered groups are a promising approach developed by a research team led by Dr. Marnin Heisel, a Lawson Scientist, Clinical Psychologist at London Health Sciences Centre and Professor at the Schulich School of Medicine and Dentistry at Western University.

In his previous research, which began in-person and pivoted online during the pandemic, Dr. Heisel found that Meaning-Centered Groups helped men transitioning into retirement, a time when there is often a struggle with issues of identity, purpose and lost social connections.

“We found that people really enjoyed the camaraderie, they supported one another and many of them started getting involved in community activities, including outreach activities of their own and volunteering,” says Dr. Heisel.

Now, Dr. Heisel and his colleagues are looking to recruit participants from one of the populations hardest hit by the mental health impacts of the pandemic – older adults, who have become even more socially isolated.

“A lot of my research is focused on suicide prevention in older adults and I realized over time that one of the best ways of doing that is not waiting until people have to come for a psychologist or psychiatrist’s help, but rather to intervene much earlier and help people find those things that make life worth living,” notes Dr. Heisel.

The sessions will be 75 to 90 minutes and convened online once a week for eight weeks. The hope is to include approximately 10 people per group, with multiple groups underway at the same time.

“The meetings will focus on supporting one another, trying to build and enhance psychological resiliency, focusing on finding meaning in creative outlets, in relationships and other experiences,” explains Dr. Heisel. “They will also focus on attitudes towards challenges in life including adversities, the pandemic, being socially isolated, and also positive experiences.”

Dr. Heisel says he recognizes that the virtual format can be a challenge for some, but his team will help participants to both access and successfully use the technology.

Recruitment for the study is underway. Those interested in participating or who have friends or loved ones who might be interested can contact Dr. Heisel at Marnin.Heisel@lhsc.on.ca or view the study website at https://meaningfulgroups.com/groups for details.

Funding for the study is being provided by the Centre for Aging and Brain Health Innovation at the Baycrest Centre and the Canadian government.
 

LONDON, ONTARIO - Lawson Health Research Institute and the Centre of Excellence on Post-Traumatic Stress Disorder (PTSD) are partnering with a population at high risk of mental illness – Canadian Veterans and spouses of Canadian Veterans – to study how they have been impacted by the COVID-19 pandemic. Through online surveys, the project will hear directly from Veterans and their spouses to assess the pandemic’s effects on their wellbeing over time. The team hopes results can be used by health care workers and policymakers to support Veterans and their families during both the current pandemic and future public health emergencies. 

“With concerns about COVID-19 infection and drastic changes to everyday life, the pandemic is taking a toll on the health of Canadians,” explains Dr. Don Richardson, Lawson Associate Scientist and Director of the MacDonald Franklin Operational Stress Injury (OSI) Research Centre. “And it may be particularly distressing for those vulnerable to mental illness.”

Population studies show that Canadian Veterans are at double the risk of mental illness when compared to the rest of the population. They experience higher rates of depression, anxiety and loneliness. Spouses of Canadian Veterans are also at higher risk of distress, sometimes undertaking significant caregiving responsibilities that lead to less independence.  

“It’s currently unknown how the pandemic will impact Veterans and their spouses, but it could result in particularly serious outcomes,” says Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre. “We want to hear from all Canadian Veterans and their spouses, whether they’re doing well or not and whether they’re seeking care or not.”

The study aims to recruit 1,000 Canadian Veterans and 250 spouses of Canadian Veterans.  Participants will complete online surveys, available in both English and French, once every three months for a total of 18 months. They will be asked questions about their psychological, social, family-related and physical wellbeing, and any relevant changes to their lifestyle and health care treatment. 

“Veterans who regularly access health care services could encounter significant changes, including a move to virtual care appointments. This could lead to increased caregiving responsibilities for spouses,” says Dr. Nazarov. “Given the uncertainty surrounding the pandemic, these changes may persist well into the future, mandating a thorough assessment of patient satisfaction and treatment outcomes.”
 
The team hopes results can be used to support the wellness of Veterans and their families during public health emergencies. This includes providing health care professionals and policymakers with information to guide emergency preparedness policies and health care delivery models. They hope results can also be used to recognize early signs of distress in order to target with early interventions.

“We are seeking to understand the impact of COVID-19 on Veterans and their families to identify if this global pandemic is leading to psychological distress or triggering historical traumas,” says Dr. Patrick Smith, CEO of the Centre of Excellence on Post-Traumatic Stress Disorder. “The Centre’s primary goal is to increase Canadian expertise related to military and Veteran mental health, suicide prevention and substance use disorders. This study can help us understand if the pandemic is having debilitating and life-altering effects, and help us address a potential mental health crisis.”  

Interested Canadian Veterans and spouses of Canadian Veterans can learn more about the study at www.veteransurvey.ca.

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LONDON, ON – Transitional aged youth in Middlesex County now have access to a free transportation resource to access mental health services. Called the County Transport initiative, it will help youth ages 16 to 25 in Lucan, Parkhill, Exeter and Strathroy-Caradoc get the mental health care they need, when they need it.  

County Transport is being coordinated by MINDS of London-Middlesex, a program of Lawson Health Research Institute, in partnership with the Canadian Mental Health Association (CMHA) of Elgin-Middlesex, Star Taxi and Middlesex County through the Lucan and Parkhill Libraries.  

“Through our collaborative work, we’ve heard from many youth that transportation is a barrier for them when trying to access mental health services when in crisis. Youth in rural areas find this very challenging since most services are not close to their location,” says Romaisa Pervez, Research Assistant at MINDS of London-Middlesex.  

MINDS, a Mental Health INcubator for Disruptive Solution, is a social innovation lab with a mission to address the complexity of the mental health care system. Youth with lived experience, community members and researchers work together to understand and help those living with mental health challenges in London-Middlesex by designing, piloting and testing innovative solutions developed locally.  

“We do not have the exact numbers of Transitional Aged Youth (TAY) living in rural Middlesex who would benefit from access to the County Transport Initiative, but we know that mental health services in rural communities are limited and that access to the services available in larger city centres is challenging due to transportation difficulties,” explains Cathy Burghardt-Jesson, Warden for Middlesex County. “Transportation from Middlesex to London, where the majority of mental health resources are located, is underdeveloped as there are limited bus routes and schedules. This leaves little in the way of affordable transit options for TAY in crisis.”  

Youth in crisis who connect with CMHA’s Reach Out 24/7 line at www.reachout247.ca or by phone at 519-433-2023 will be supported and assessed by the Crisis Line staff. If it is determined that a visit to the London Crisis Centre is needed, the CMHA Crisis worker will ensure a smooth transition from the Crisis Line to the Star Taxi Service. The youth will be provided with free transportation to and from CMHA’s Mental Health and Addictions Crisis Centre located at 648 Huron Street.  

To ensure the safety and wellbeing of the youth accessing this service, Star Taxi drivers have received training developed by CMHA regarding mental health and crisis de-escalation, as well as suicide prevention training by Living Works. 

Funding for the initiative has been provided by St. Joseph’s Health Care Foundation and the generous support of individual donors in the community. 

“With additional funding, the initiative could be scaled up to reach as many youth as possible in Middlesex County and beyond. We want to see all youth in rural areas who want to access mental health services able to do so, by removing the barriers of location and transportation,” adds Pervez. They will be collecting information regarding use of the transportation service and youth experience to refine and improve the initiative.  

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