Creating a new era in psychiatry
BOUNDLESSIMPACT
Creating a new era in psychiatry
The 21st century epidemic 4 Transforming the future of psychiatry 7 Preparing transformative leaders 9 Driving research and innovation 10 Responding to critical mental health challenges 12 Kim Moran’s story 16 Boundless potential 17 Funding priorities 18
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The 21st century epidemic eople with mental illness can expect P a lifespan shortened by 10 to 15 years. y 2020, depression will be the leading B cause of disability on the planet. I n North America, based on data from the United States, about six per cent or one in 17 suffer from a serious mental illness. t any one moment in Canada, 800,000 A children aged four to 17 experience mental disorders causing stress and impairment through to adulthood. Physical and mental illness co-occur 25 to 45 per cent of the time.
There is no longer any doubt that mental illness is one of the most prevalent chronic illnesses of our time. In Canada alone, one in five people will experience mental illness or addiction in their lifetime, contributing to approximately $28.8 billion being spent every year in public disability income support for people with mental illness1. According to the World Health Organization, Canada’s youth suicide rate is the third highest in the industrialized world. More than 70 per cent of adults living with mental illness trace first symptoms to the ages of 16–24, and 90 per cent of suicides are associated with mental disorder2. Gaps in our health care system are inadvertently adding to the suffering of those experiencing mental illness. However, a growing body of research highlighting the impact of mental illness, greater understanding of its physiological origins, and clearer evidence of its connection with physical health is cause for optimism. We now know that behavioural symptoms are the last indications to appear in mental illness. These findings underscore the potential for tremendous gains in human health to be found through new approaches to early detection and intervention. Just as deaths by leukemia and heart disease were reduced by 85 per cent and 63 per cent respectively over a 30-year period, largely through emphasis on early intervention3, we have the potential to greatly reduce the toll of mental illness for the patient, as well as his or her community of friends and family. As part of University of Toronto’s $2 billion Boundless Campaign, the Department of Psychiatry will lever this new knowledge and explore our boundless capacity to improve mental health for Canadians and citizens across the globe. Our department’s initiative is organized around three central pillars: preparing transformative leaders, driving research and innovation, and responding to critical mental health challenges. Through new and expanded commitments, we will ensure our students are given the knowledge, experience and skills needed to become leaders and innovators in an increasingly complex and global health care landscape. We will support the boundary-crossing research of our faculty and hospital partners. We will introduce multi-disciplinary approaches across mental health and medical care systems, at home and abroad, that allow for greatly improved care for those living with mental illness and addiction. We will provide our alumni, volunteers and donors with meaningful ways to connect with the issues they care about most and advance positive change through our education and research mission. With collective commitment, we will transform the future of psychiatry.
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4 Creating a New Era in Psychiatry
Aspiring Workforce Report 2012, commissioned by Mental Health Commission of Canada, 2Mental Disorders are brain disorders, 3Ibid
“The discovery, application and communication of knowledge will enable us to address the most critical mental health challenges of our time. At U of T’s Department of Psychiatry, our integrated approach to teaching will radically change how medical students and allied health professionals think about, and care for, individuals with mental illness.”
Trevor Young FRCPC (Psychiatry) ’88, MSc. ’89, PhD ’95 is Dean of Medicine at the University of Toronto and Senior Scientist at the Centre for Addiction and Mental Health. As an active clinician-scientist, Dr. Young’s principal research interest includes understanding the molecular basis of bipolar disorder and its treatment. Dean Young is the former Chair of the Department of Psychiatry.
“Psychiatry is a fascinating and rapidly evolving field! As a psychiatry resident at the University of Toronto, I work with and learn from world class clinicians and researchers who are expanding our understanding of mental illness and pioneering new treatments in psychotherapy, pharmacology, and neurostimulation. Most importantly, we are trained to be skilled and compassionate physicians who deliver comprehensive and individualized care to patients and their families."
Kathleen Sheehan FRCPC (Psychiatry) '15 is a fourth year resident in psychiatry. Prior to medical school, she was awarded her doctorate from the University of Oxford, where she studied as a Rhodes Scholar. Dr. Sheehan's principal clinical interest is in medical psychiatry.
Transforming the future of psychiatry
We are at a pivotal moment. Not since the origins of the field of psychiatry have there been such clear, untapped opportunities to advance human health. The public conversation around mental health is more open, informed and engaged than ever before. The future promises to be even brighter. What was once science fiction — treating neurological conditions through deepbrain stimulation and understanding the genetic basis of schizophrenia — now has the potential to become reality. This research will revolutionize our world. At the University of Toronto’s Department of Psychiatry, exciting collaborative research programs are underway that are expanding our understanding of the connection between mental illness and physical health. Our innovative education programs are preparing future health care leaders with the most current knowledge in mental health and addiction, and providing hands-on training at hospitals across our integrated network in the world-renowned health care cluster in downtown Toronto. Through collaboration with our peers and partners who share our goals of improved mental health, integrated health systems and broad dissemination of new knowledge, the Department of Psychiatry is equipping future psychiatrists with the information and skills needed to meet today’s mental health challenges head on. We embrace this responsibility with the confidence of a department that is part of one of the world’s top Faculties of Medicine and situated within Canada’s premier research university — the only university in this country to be consistently ranked among the global
elite. The Department of Psychiatry’s students and faculty are learning and teaching outside the classroom within 26 community sites across Ontario, including eight fully-affiliated teaching hospitals. Our faculty are leading researchers, clinicians, educators and medical practitioners, not only in psychiatry but many of its related disciplines including culture, community and health, family and community medicine, neuroscience, medical science, nursing, pharmacology, psychology, psychopathology, psychosomatic medicine, public health sciences and social work. We are a force for the growing integration between psychiatry and other areas of medicine, as well as a world leader in brain science. Through these novel collaborative frameworks and unique opportunities for student and faculty exchange, we are supplying the field of psychiatry with the leading researchers and practitioners who will promote dramatically improved patient outcomes. The option also exists to pursue both streams simultaneously through the department's Clinician-Scientist program, which fosters the ability to translate laboratory discoveries into proven therapies. Our $30 million campaign for the Department of Psychiatry will help the department to realize its tremendous potential. An integral part of the Faculty of Medicine’s $500 million campaign, the department has three distinct priorities: preparing transformative leaders, driving research and innovation, and responding to critical mental health challenges.
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“U of T’s Department of Psychiatry appealed to me because of the calibre of its faculty, access to worldrenowned researchers and innovative approach to psychiatric care. First as a resident, and now as a faculty member, I continue to be proud to be part of this great department.”
Sanjeev Sockalingam FRCPC (Psychiatry) ’08 is an Assistant Professor and the Director of Continuing Professional and Practice Development in the Department of Psychiatry, as well as Deputy Psychiatrist-in-Chief at Toronto General Hospital and Princess Margaret Hospital. Dr. Sockalingam’s principal research interest includes psychosocial issues in bariatric surgery and psychiatric care of patients with liver disease.
Preparing transformative leaders
In order to transform psychiatry, we must create transformative leaders. Our Department of Psychiatry offers the largest psychiatry training program in North America. Yet, Health Force Ontario is predicting an upcoming shortage of psychiatrists at the very time the need for their services will be near its peak. Achieving the level of education and expertise needed to become a psychiatrist is a necessarily long and rigorous path, requiring a degree, followed by completion of medical school and then specialization in psychiatry. This may be followed by a further sub-specialization, such as in geriatric or forensic psychiatry.
to attain this level of education while others may choose to pursue other areas of medicine that promise greater compensation and recognition. These obstacles mean that the potential in the field of psychiatry is being limited. Financial support for students through awards, scholarships and fellowships ensures the development of expertise and innovative thinking in psychiatric practice at a time when the field is rapidly evolving. Support from the community will cultivate greater interest in psychiatry as a profession, and ensure that more candidates are attracted to the department, which will result in improved access to quality psychiatric care.
Facing mounting fees and a commitment of approximately 12 years, it can be a challenge to attract even the most eager of the brightest minds. Many potential students simply do not have the financial resources necessary
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Driving research and innovation “Our vision is that one day genetic discoveries will lead to targeted treatments for mental illness in the way we now have targeted treatments for cancer.” Anne Bassett FRCPC (Psychiatry) ’87 is a professor in the Department of Psychiatry, Director of the Clinical Genetics Research Program at the Centre for Addiction and Mental Health and Director at the Dalglish Family Hearts and Minds Clinic at the Toronto General Hospital. Dr. Bassett is an internationally recognized expert in schizophrenia and multi-system genomic disorders.
The field of psychiatry is at a highly dynamic point in its evolution. Advances in psychopharmacology, brain science, and applications of psychosocial and psychotherapeutic interventions are transforming the theory, knowledge and practice of the discipline. At the same time, a better understanding of how mental health is shaped by genetics, psychosocial environment, molecular biology and brain systems remains to be investigated. In such a fluid environment, the Department of Psychiatry calls on the contributions of our top academic thinkers to further define its key role as a top centre of psychiatric learning—expanding the boundaries of knowledge and levering our educational and health networks to translate findings into practice. Primary paths by which the world’s leading minds arrive at the department are through Chairs and Early Career professorships. A Chair creates an entire ecosystem around him or herself, immediately elevating the University’s capacity in a field of study and attracting top students from around the world who want to learn and work alongside a renowned academic. A key fundraising priority for the
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department is to increase the number of Chairs in critical areas of inquiry, leading to discoveries that will improve psychiatric care. Supporting this research will lay the groundwork for the health discoveries and treatments of tomorrow and help us envision a day when far more people will recover from mental illness and addiction. The Department of Psychiatry, through its vast network, also has the ability to identify and nurture exceptionally talented young academics who represent the future in a particular field. In order to retain these up-and-coming top minds, the department seeks the community’s support to increase the number of Early Career professorships. These positions will continue to foster the innovation in teaching that carries so much promise for transformative change.
Responding to critical mental health challenges “If you have not experienced mental illness, the chances are you know a family member, friend, or colleague who has struggled with it. Support for the Department of Psychiatry means leveraging U of T’s vast network of collaborators to develop more innovative approaches to integrated and preventative care.” Paul Garfinkel FRCPC (Psychiatry) ’74, MSc. ’77 is a professor and Campaign Cabinet Chair in the Department of Psychiatry, as well as former President and Chief Executive Officer of the Centre for Addiction and Mental Health. Dr.Garfinkel is an Officer of the Order of Canada and an internationally-recognized expert in eating disorders.
Few organizations possess the resources and the influence to effect systemic change across the broad landscape of mental illness like University of Toronto’s Department of Psychiatry. Standing at the intersection between medical education, clinical care and cutting-edge research, the department has a unique understanding of the overarching challenges facing health systems and is an active partner in the University's global health strategy initiatives. The department is, therefore, ideally positioned to drive new approaches to solving the major health challenges of our day; not from the vantage point of a single discipline or institution but from the combined perspectives of institutions from across the health care spectrum. In those local and global relationships, between clinicians and researchers, between alumni and faculty, between the University and hospitals, we create a powerful network that influences and leads all aspects of psychiatric care. The department is leading a number of collaborative initiatives locally and internationally to respond to critical mental health challenges. One such project is the Kenya Integrated Intervention Model for Dialogue and Screening to Promote Children's Mental Well-being (KIDS). It is a partnership between
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the University of Toronto and the University of Nairobi to improve identification and care of children in Kenya with mental health issues. The Medical Psychiatry Alliance is a groundbreaking collaboration between the Centre for Addiction and Mental Health, the Hospital for Sick Children, Trillium Health Partners and the University of Toronto. Launched in 2014, the alliance will enable a new model of integrated care for those with combined medical and psychiatric illness. By participating in telehealth programs across the department’s teaching hospital sites, the department is also supporting the delivery of best-practices in addiction and mental health care through community partnerships across Ontario and beyond. Support from the community would allow the department to share knowledge and build capacity within new clinical and research partnerships, and provide greater educational opportunities for psychiatric students, inter-professional learners and community partners.
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In developing countries, mental health promotion, prevention of illness and access to care are significant problems. Early identification of children with learning disabilities, emotional problems and other conditions greatly improves the chances of receiving treatment. The University of Toronto and the University of Nairobi have partnered to address these issues through KIDS—the Kenya Integrated Intervention Model for Dialogue and Screening to Promote Children’s Mental Well-being. In the photo, a researcher is training parents to conduct mental health assessments of their children. More than 5,000 children in schools in rural areas will be reached through the program.
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Kim Moran’s story “Physical illness is a difficult time for patients and their families, challenging them emotionally as they try to come to terms with the disease and its treatment. At University of Toronto’s Department of Psychiatry, we train Consultation-Liaison psychiatrists to develop comprehensive medical and psychiatric approaches to coping that support the patients, their families and the treating teams.” Jonathan Hunter MD ’84, FRCPC (Psychiatry) ’90 is an Associate Professor and Head of the Division of Consultation-Liaison at the Department of Psychiatry, as well as head of Psychosocial Services at the Marvelle Koffler Breast Centre. Dr.Hunter’s principal research interest is the role of early life experience in adaptation to disease.
Lauren was eventually transferred to a treatment centre where she was diagnosed with Major Depressive Disorder. I was extremely distressed; I wanted my 11 year old daughter home, in the care of her loving and supportive family. The next four-and-a-half months were very hard on our family. We wanted her home. Instead, we were relegated to visiting Lauren one-on-one in the treatment centre. Staff escorted us for our visits into a room through one door and then out another. There was never any interaction with other kids. It perpetuated the stigma I knew was wrong — the notion that we should be ashamed of mental illness and those struggling with it. My 11-year-old daughter, Lauren, was a high performing student, competitive athlete and doing well socially until she said that she was sad in April 2011. Our journey to find the help we needed started with her pediatrician and turned into months of being bounced around from one institution to another. By summer, Lauren stopped eating and drinking in order to kill herself and was admitted to the local hospital. I can’t articulate fully the feeling of watching your child walking down a hall with a burly security guard to a locked-in facility.
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Lauren is 13 now and has integrated back into school. We take every day one at a time. As a parent who has had to navigate the complexities of our health care system with her child’s life at stake, I can say now more confidently than ever that it doesn’t have to be this way. The Department of Psychiatry at the University of Toronto is working hard to improve care for people like Lauren. These efforts include research showing that symptoms occur well before a breakdown occurs—findings that can trigger intervention and prevent a crisis from even occurring.
Boundless potential “If psychiatry is the youngest branch of medicine, psychiatry at U of T is a conspicuous prodigy with a brilliant future.” The Honourable Michael H. Wilson, P.C., C.C., B.Comm. '59 TRIN, D.S.L. '94 TRIN, LL.D. '05 is the 33rd Chancellor of the University of Toronto and an advocate for research and education tackling mental illness and addiction. He is shown speaking at the launch of the Department of Psychiatry’s faculty and staff campaign in September 2013.
We are on the cusp of dramatic change. The University of Toronto’s Department of Psychiatry is training the finest young people to become the world’s next generation of mental health professionals and academic leaders. Our faculty members are phenomenal educators and world-leading scientists who attract the best students, fellows and colleagues to our growing health network. Our community of supporters, alumni and philanthropists also play an integral role in our success; their ongoing support and advocacy help us to meet the demands of modern mental health education and research. Now is the time to invest in our collective future and in the people who will define it. Our campaign promise is to transform the future of psychiatry. If we are to lead change in this critical arena of human health, the window of opportunity is open now. We invite our community of supporters—faculty, friends and alumni—to help us to seize these opportunities. Through your generosity and involvement, we will realize our boundless potential.
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Funding priorities The Faculty of Medicine’s $500 million campaign is a cornerstone of the University’s unprecedented $2 billion Boundless campaign and the largest fundraising initiative for a medical school in Canadian history. The campaign builds on our strengths as one of the top medical schools in the world and helps catalyze our international leadership in biomedical research and education. Our contributions will improve the health of Canadians and people around the world. We make this promise because of the tireless devotion to excellence put forward by our remarkable students, faculty and staff members, and community of supporters led by our visionary philanthropists.
Driving Research and Innovation
Preparing Transformative Leaders
Responding to Critical Mental Health Challenges
$10 million
$7 million
$13 million
Chairs
Awards, scholarships and fellowships
Medical Psychiatry Alliance
Early Career professorships
Educational innovation
L ocal and international capacity building projects
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For more information, please contact: Gabrielle Duchesne Senior Development Officer Department of Psychiatry, Faculty of Medicine T: 416-978-7993 gabrielle.duchesne@utoronto.ca