CSP Alumni Profiles

Jonathan Lee

Degree(s): HBSc, MD

Program (Year): CSP Graduate Stream

Email: chiaho.lee@utoronto.ca

At the beginning of my psychiatric training I was lucky enough to be connected with Dr. Daskalakis who was an ideal supervisor and mentor and was instrumental in fostering my interest in research. I am interested in becoming a clinician-scientist to find ways to integrate brain stimulation methods to better understand and treat psychiatric disorders affecting children and adolescents. For the past two years I have explored brain plasticity in healthy adolescents using a paradigm known as paired-associative stimulation. I hope to create new brain stimulation-based treatments to advance the field of child and adolescent psychiatry.

Project Title: Repetitive transcranial magnetic (rTMS) in youth depression: Efficacy and targets of response

Supervisor(s): Dr. Jeff Daskalakis

Joshua Rosenblat

Degree(s): MD

Program (Year): CSP Graduate Stream

Email: joshua.rosenblat@utoronto.ca

Ever since elementary school, I have been extremely interested in science and ‘doing experiments.’  This interest has grown greatly over the years as I have had the opportunity to work in several labs throughout my undergraduate degree as well as during medical school.

My main field of interest currently is the interaction between mood disorders and medical comorbidities (more specifically, inflammatory and metabolic disorders).  Understanding the biological underpinnings of these interactions may lead to an improved understanding of the pathophysiology of mood disorders. This improved understanding may also allow for the discovery of novel therapeutic targets that may simultaneously treat mood disorders and medical comorbidities.

Project Title: Interactions between Mood Disorders and Medical Comorbidities

Supervisor: Dr. Roger S. McIntyre

Dr. Joshua Rosenblat on PubMed

June Lam

June Lam is a youth psychiatry fellow and a PhD student in Clinical Epidemiology & Health Care Research at the University of
Toronto. He has a clinical and research interest in working with underserved and marginalized populations, including with transgender
and gender diverse, homeless, and new immigrant populations. He is part of the Clinician Scientist Program (CSP), working on a
CIHR-funded qualitative study understanding the suicidal behaviour of Chinese and Chinese-Canadian women. His PhD thesis uses
mixed methods to study access to acute and post-discharge mental health care for transgender and gender diverse individuals.

Dr. June Lam on PubMed

Dr. June Lam on Research Gate

Katrina Hui

Katrina Hui is a psychiatry resident at the University of Toronto. Before completing medical school at McMaster University, she received a B.S. in Biology and a minor in Philosophy from Stanford University and an M.S. in Bioethics at Columbia University. She has published work in ethics, advocacy, and addictions, including in The Lancet and Psychopharmacology. She is currently a Clinician-Scientist-in-Training pursuing mixed methods mental health services research with a main research focus on implicit bias in medicine.

Supervisor(s): Dr. Juveria Zaheer

Dr. Katrina Hui on Research Gate

Dr. Katrina Hui on ORCID

Lucy Barker

Degree(s): MD

Program (Year): CSP Graduate Stream, (Fellow)

Email: lucy.barker@utoronto.ca

My research interests include women’s mental health, reproductive psychiatry, psychiatric services, and the social determinants of
mental health. I am in the Clinical Epidemiology and Health Care Research program through the Institute for Health Policy,
Management and Evaluation. My PhD thesis uses Ontario population-level data to explore the outcomes of postpartum women who
visit the emergency department for mental health care, and takes an intersectional feminist approach to understand gaps in care and
disparities for women experiencing multiple forms of marginalization. My goal is establish a research program that improves the design
and delivery of mental health services for marginalized women.

Project Title: Maternal postpartum psychiatric emergencies: applying an intersectional feminist framework to understand outcomes and
better identify groups of women whose care needs are not being met

Supervisor(s): Dr. Simone Vigod

Dr. Lucy Barker on PubMed

 

Paul Kudlow

Degree(s): MD, PhD

Program (Year): Clinician Scientist Program (2019)

Email: paul.kudlow@mail.utoronto.ca

Paul is currently completing his residency in psychiatry at the University of Toronto. Paul recently returned to residency from a 4-year leave of absence. In his leave, Paul launched and sold a technology business, TrendMD, as well as earned his PhD for research in the fields of bibliometrics, knowledge dissemination, and scholarly communication from the Institute of Medical Sciences at the University of Toronto. 

Project Title: Increasing the Reach, Usage, and Impact of Scholarly Content

Supervisor(s): Dr. Reinhart Reithmeier; Dr. Aviv Shachak 

Dr. Paul Kudlow on PubMed

Dr. Roland Jones identifies key factors and possible interventions

Many prisoners with mental illness end up back in prison after they’re released, and rates of mental illness are higher among inmates than the general population. Dr. Roland Jones and his team have identified risk factors that could provide the key to giving prisoners better support, preventing reincarceration, and vastly improving their quality of life. We spoke to Dr. Jones about his research and the impact it could have on how we treat prisoners with mental illness.

 

 

 

 

Which mental disorders are most prevalent among prisoners?

A portrait photo of Dr. Roland Jones
RJ: There are around 11 million people in prison on any given day worldwide, and more than 30 million people pass through prisons each year.  Even if the rate of mental illness among prisoners was the same as in the general population, this would translate to very large numbers of people with mental illness being incarcerated.  However, rates of mental illness are much higher among prisoners than in the general population.  Around 15% of prisoners have a serious mental illness.  Nearly 1 in every 25 has a diagnosis of a psychotic illness and more than 1 in 10 has major depression.  Substance use disorders are even more common, found in a quarter to a half of all prisoners. 

 

What motivated this research?

RJ: This research arose from work with the Forensic Early Intervention Service (FEIS) in two jails (one detaining men, the other women).  FEIS provides assessment and intervention for inmates who have mental illness and who are on remand.  We observed that many of the people seen by the service return to jail again after release, some very frequently, and we wanted to investigate how often this happens, and what social, clinical and demographic factors are associated with reincarceration.

 

What was the most important finding of this study, in your opinion?

RJ: In our study of over 4,700 prisoners who had major mental illness, nearly a quarter were reincarcerated within one year.  There was a small but significant number of people (around 7%) who were incarcerated 3 or more times within a year accounting for nearly 20% of all incarcerations.  Those who had a diagnosis of schizophrenia or bipolar disorder or who were homeless were among the most likely to be reincarcerated.  Those who used the street drugs crystal methamphetamine or crack were also significantly more likely to return to prison. Offences associated with reincarceration tended to be relatively minor, such as theft and failing to comply with conditions of release.

 

How does this change treatment services for prisoners with serious mental illnesses?

RJ: By identifying the factors that make those with mental illness in prison most at risk of returning to custody, we can find areas where more focussed treatment will make a major difference.  We identified several opportunities for effective interventions, including better treatment for those with schizophrenia and bipolar disorder, greater continuity between mental health services in jail and in the community, and providing treatment for those with substance use problems (particularly those using stimulants).  We also found that homelessness is a significant issue among prisoners with mental illness.  Without stable housing, access to community resources is fragmented.

 

Any next steps?

RJ: We are working to develop community services that will support those who are most at risk during transitional periods, while evaluating how effective this approach is.  We are also planning to evaluate whether focused interventions delivered before release will reduce the rate of reincarceration. In addition, people in the at-risk groups we study are often incarcerated for relatively minor offenses including crimes of poverty, offenses related to the use of illegal substances, or minor offenses against judicial orders. We believe alternatives to incarceration should be considered for these individuals.

 

What is the major take home message from your research?

RJ: Very large numbers of people with mental illness are incarcerated every year, and many fall into a pattern of frequent reincarceration. Investment in specific transition and community services and careful evaluation of their efficacy is required to address the challenges faced by people with serious mental illness who are released from jail to reduce reoffending.

Acknowledgements

The work was also carried out by Dr Sandy Simpson, Chief of Forensic Psychiatry, CAMH, Cory Gerritsen, Independent Scientist, CAMH, Madleina Manetsche, University Psychiatric Clinics, Basel, Switzerland, and assisted by all members of the Forensic Early Intervention Service, CAMH. 

Impact: Important Psychiatry Articles that Change Treatment

ImPACT Committee includes Krista Lanctôt, Alastair Flint, Meng-Chuan Lai and Simone Vigod.

Jones, R. M., Manetsch, M., Gerritsen, C., & Simpson, A. I. (2020). Patterns and Predictors of Reincarceration among Prisoners with Serious Mental Illness: A Cohort Study: Modèles et Prédicteurs de Réincarcération Chez les Prisonniers Souffrant de Maladie Mentale Grave : Une Étude de Cohorte. The Canadian Journal of Psychiatry, 070674372097082. doi:10.1177/0706743720970829

Simina Toma

Degree(s): MD

Program (Year): CSP Pregraduate Stream

Email: simina.toma@utoronto.ca

My research interest stemmed from longstanding intellectual curiosity and enthusiasm about finding new ways to approach problems.

With its clinical complexity, treatment challenges, and strong biological basis with undeniable psychological impact, Bipolar Disorder is one the most fascinating psychiatric illness, and the cause of intractable suffering. I intent to contribute to the understanding of its development and progression, which can lead to treatment targets for early intervention.

My current project is aiming to investigate the biological underpinnings of the different bipolar subtypes, with the goal to assess whether neuroanatomical factors support the clinical distinctions between BD-I, II and NOS, as well as the inclusion of BD-NOS in the bipolar spectrum.

Project Title: Neuroimaging in youth Bipolar subtypes

Supervisor(s): Dr. Ben Goldstein

Tanya Hauck

Dr. Tanya Hauck MD PhD FRCPC is completing the Bellwood Fellowship in addictions psychiatry and also currently completing a MSc degree in clinical epidemiology through the Institute of Health Policy, Management and Evaluation at the University of Toronto.  Her research interests include the clinical epidemiology of substance use disorders and their treatment, and the treatment of comorbid PTSD and substance use disorders.

Dr. Tanya Hauck on PubMed

Tyler Kaster

I’ve been passionate about research since my undergraduate degree in Medical Biophysics. Because of my background, I initially wanted to be a radiologist and therefore completed research in cardiac PET imaging. However, because of my clinical experiences I was drawn to psychiatry. Since starting my psychiatry residency I have been involved in brain stimulation research which allows me to leverage my biophysics training. In the future I hope to develop a career as a clinician scientist using brain stimulation as a technique to better understand and treat psychiatric illness.

Dr. Tyler Kaster on PubMed

Dr. Mark Sinyor examines the relationship between tweets and suicide rates

Can tweets with the right message about suicide help us save lives? When traditional media reports on people who have died by suicide, it can unfortunately lead to an increase in suicide rates. Dr. Mark Sinyor and his team have found that social media can have similar impacts. Now, they’re working to establish a better understanding of how we can communicate about suicide in ways that save lives, rather than endangering them.

What is the background that we should know about this suicide and social media?

A portrait photo of Dr. Mark Sinyor
MS: We know that traditional media reports about suicide are often associated with increases in suicide rates when they cover the deaths of individuals that their audience can relate to, such as celebrities. These increases are substantial. In the months following the death of Robin Williams, there was a 10% or greater increase in suicides in Canada, the United States, and Australia (the only three countries where this has been studied to date). That’s literally thousands of lives lost that likely would not have been if those reports hadn’t happened, and it emphasizes that we in the scientific community and journalists need to continue to work hard to ensure that suicide-related reporting does not cause harm. At the same time, there is increasing evidence that stories of survival and resilience in the context of suicidal crises can have the opposite effect and may reduce suicide deaths across the population.

What led you and your team to conduct this study?

MS: We’ve been working for a number of years now with journalists and social media platforms to improve the safety and scientific accuracy of suicide-related content. ​The specific content of media that we are exposed to really can have a dramatic effect on what we learn and how we behave. The question for this study is would we see this same relationship in widely disseminated social media posts?

What is the ​main message that you think the results convey?

MS: The study really aligns very closely with both the theory of social learning and contagion and what we know from studies of traditional media.  In essence, we saw that widely disseminated tweets about suicide death in general or of a local celebrity and tweets conveying hopeless messages were followed by more suicides. In contrast, tweets about hope, survival, and suicidal thinking without suicidal behavior were followed by fewer suicides. Educating people that they can survive and overcome suicidal crises may be one of the most powerful and under-used suicide prevention tools that we have. The message is quite clear that we need to do more to share stories of resilience across society.  We know that the overwhelming majority of people who contemplate suicide survive and go on to lead meaningful lives. We know that reaching out and receiving treatment can make an extraordinary difference. Suicide is never the only option.  That information is sadly often missing from our discourse. And we need to change that because it will save lives.

​Do you think that Twitter is a unique medium in regard to its influence on suicide rates, or would you anticipate that other social media platforms would result in similar effects?

MS: We studied Twitter largely for practical reasons. It is much easier to analyze a Tweet for content in a standardized way than, for example, a TikTok video. That said, we see the same patterns over and over again with different forms of media. Unless evidence unexpectedly emerges showing otherwise, I think it is reasonable to assume that the same overarching principles will apply to any media exposure including other social media platforms.

What do you think is most important for us to figure out next in this subject area?

MS: I think there are a few clear directions. First, this study really supports the importance of narrative in driving suicide and resilience contagion effects. Most work including media guidelines to date has really focused on the impact of piecemeal aspects of suicide information (e.g. we suggest not to include details of suicide methods and instead to include information on where to seek help). That is valuable but the importance of overarching narratives in our discourse and particularly the impact of stories of hope and survival has not received enough attention. We also need more translational research to understand how our efforts have changed discourse and in turn what impact that may have had on suicide rates. We need to understand more clearly how we can optimally translate what we know into meaningful change and fewer suicides. Both are areas of active research for our team.

Acknowledgements

Funded by the American Foundation for Suicide Prevention (AFSP).

Impact: Important Psychiatry Articles that Change Treatment

 

 

 

 

 

 

ImPACT Committee includes Krista Lanctôt, Alastair Flint, Meng-Chuan Lai and Simone Vigod.

Sinyor, M., Williams, M., Zaheer, R., Loureiro, R., Pirkis, J., Heisel, M. J., . . . Niederkrotenthaler, T. (2020). The association between Twitter content and suicide. Australian & New Zealand Journal of Psychiatry, 000486742096980. doi:10.1177/0004867420969805