- Taking advantage of newer technology and care approaches
- Revise delivery of care to better meet the goal of community integration
- Integrated mental health system that focuses on community integration
- Aligning research with clinical models that spans the continuum of care
- Identify and promptly deliver services that enhance quality of life for persons living with mental illness
- Evaluate the outcomes of new approaches to care through analysis of effectiveness, costs, ethics and policy
Early Intervention and Primary Care
The delivery of mental health services is often characterized by long waiting lists, and difficulty accessing services. In addition, when services are provided, there is often little continuity and co-ordination between the agencies and the professionals who are involved. This can be frustrating to those in need of such services and those who provide them. There is evidence that prompt delivery of psychiatric assessment and treatment, providing such services within a context of continuity of care over time, and co-ordination between primary care services, community services, and psychiatric treatment, leads to better outcomes.
One focus of this within mental health research at Lawson is the effectiveness of early intervention programs on treatment outcomes, particularly with reference to psychotic disorders (Prevention and Early Intervention Program for Psychoses – PEPP) and mood and anxiety disorders (First Episode Mood and Anxiety Program – FEMAP). Issues being investigated include methods of reducing treatment delay, the relationship between treatment delay and outcomes, and the identification of other malleable predictors of treatment outcome and the role of continuity of care in improving treatment outcomes. The basic pathophysiology and psychopathology of the early stages of these diseases is also being investigated.
Another research focus has been on the benefits of shared care models of service delivery, in which psychiatric specialists and primary care practitioners consult and co-operate in providing in improving service delivery and outcomes for those needing mental health services.
Emergency - Crisis and Acute Care
There are a variety of clinical research programs and activities aligned with the clinical services offered to children, adolescents and adults including seniors. Additionally, there are strong links between clinicians and the basic science and brain imaging researchers affiliated with Lawson and Western University.
Common to our child and adolescent, adult, and geriatric programs is research into better understanding and subsequently preventing suicide. Our research relating to emergency-crisis and acute care includes: risk and protective factors relating to suicide, development of clinical measures, and evaluating psychotherapeutic approaches with at risk populations. Similarly, all of our major programs are studying new models of health care delivery, involving enhanced use of inter-professional teams and shared mental health care.
Examples of more focused significant areas of research include that of pharmacologic and psychotherapeutic interventions in Mood, Anxiety, and Psychotic Disorders. We are also engaged in basic science research including strategies to better understand the genetics and brain receptors associated with Schizophrenia. Our participation in brain imaging research, with a particular focus on Mood Disorders, Post Traumatic Stress Disorder, and Schizophrenia connect the basic science world to applied research.
Psychiatric Rehabilitation and Tertiary Care
Psychiatric rehabilitation and tertiary mental health care research at Lawson aims to develop, study, disseminate, advance and promote assessments, interventions, and policies that facilitate recovery of people with serious mental illness. (Recovery is measured through the achievement of a personally meaningful life and valued social roles).
The theoretical framework is informed by disability studies, addressing the fit between people with serious mental illness and their physical and social environments. Our research encompasses a wide variety of methods, from conceptual and ethical analysis, to randomized controlled psychosocial trials to transformative (participatory action) research and beyond.
Community integration is the goal of all phases of identification, treatment, rehabilitation, and recovery in mental health care.
Research within community integration focuses in large part on social determinants of health, such as social support (including peer and family support), housing/homelessness, income/poverty, employment, education, and community systems or care. This area of research includes multiple community partners and participatory approaches to research.
Brain Imaging and Biology
Mental Health research at Lawson includes a brain imaging research component through the Department of Psychiatry at Western Ontario. Using non-invasive scanning technologies like MRI and MRS, this research focuses on the neural circuitry of mental illnesses, such as brain structures and activities. Through improved understanding, our research strives for new and improved treatment strategies for a variety of mental illnesses, including schizophrenia, dementia, depression, post-traumatic stress disorder (PTSD), and autism.
One area of research interest is emotional regulation, and the interactions between cognition and emotion in illnesses like depression and bipolar disorder. Other topics of investigation include biochemical alteration in schizophrenia, the use of transcranial magnetic stimulation in psychiatry, self-regulation in the context of stress, the neural circuitry of self-perception, and the intergenerational transmission of trauma in patients with complex PTSD.
A priority area that pulls together care across the continuum is the development of a SMART (Smart Mental health Assessment Research and Treatment) mental health system. The backbone of this approach is the Lawson Integrated Database (LIDB) which is a secure enterprise information management platform that collates and manages client health information collected from multiple community health and social service agencies and care providers. This research platform is developed alongside of London’s hospitals’ electronic client record (EPR) system, (behind the hospital firewall). Specific projects are working on tools that generally encourage self-assessment and use prompts and reminders related to care while supporting therapeutic relationships with care providers. Examples of innovations include using personal health records and internet browser tools, text messaging solutions, and technology focused on developing smart mental health homes. We are also exploring alternatives for data linkage such as iris scanning.
Division of Psychiatry
Lawson partners with the Department of Psychiatry at the Schulich School of Medicine & Dentistry, Western University, on a wide range of research studies in mental health. This work ranges from the level of molecule to that of populations, focusing on enhancing mental health and well-being from childhood and adolescence through adulthood and older adulthood.
Research in the Department of Psychiatry addresses a diversity of content areas including mood and anxiety disorders, personality and personality disorders, post-traumatic stress disorder, psychosis, and suicide prevention. The department has research expertise in community outreach and engagement, early intervention, clinical psychotherapy and medication trials, neuropsychiatry, mental health service delivery, educational research and knowledge translation.
Research by division:
- Division of Child and Adolescent Psychiatry
- Division of Forensic Psychiatry
- Division of General Adult Psychiatry
- Division of Geriatric Psychiatry
- Division of Neuropsychiatry
- Developmental Disabilities Division
In addition, strong collaboration occurs with other faculties such as Health Sciences, Social Sciences and Engineering.