This month's brainbuzz™ includes new research conducted by CAMH on the effect of alcohol on gun-involved suicides; evidence that culturally adapted CBT is more effective for this population than traditional psychotherapy; and the launch of the 2023 womenmind™ Leadership Fund for CAMH women in science. Please reach out if you have
any questions or feedback.
Aristotle Voineskos VP Research, CAMH
Alcohol increases risk for gun-involved
suicide among Americans
CAMH-led study highlights need for targeted suicide prevention regarding alcohol use and access to guns
A CAMH-led study just published in the journal JAMA Network Open has found that the probability of using a gun as a means of suicide among Americans increases the more alcohol they drink.
The study looked at all suicides in a national surveillance system in the United States over a 17-year period for people 18 and older who had alcohol in their system at the time of death. It found that the more alcohol they drank, the greater the probability that they
would use a gun as the means of suicide, highlighting the need for suicide prevention initiatives and safety planning for people who drink and have access to guns.
Gun death has been the leading cause of suicide in the United States for decades and has been increasing in recent years to what is currently a 30-year high. More than 50 per cent of all suicides in America involve the use of a firearm. In Canada that figure is 16 per cent. Overall, the suicide rate in the United States is approximately fifty per cent higher than it is in Canada.
“There are significant differences between Canada and the United States in regards to gun ownership and access to guns, but this study does have important implications for Canada,” says lead author Dr. Shannon Lange, Independent Scientist at the Institute for Mental Health Policy Research at CAMH. “Responsible gun ownership is important wherever you live and that goes well beyond the harm you can potentially inflict on others, especially when alcohol is involved. People need to aware of the harm they can inflict on themselves. In fact, guns are used more often as a tool of self-harm rather than in self-defense.”
The study authors state that “means restriction” has long been a cornerstone of suicide prevention, but acknowledge that the political environment in the United States makes restriction of guns highly unlikely. They also elaborate on other targeted suicide prevention safety measures that could help reduce the number of gun-involved suicide deaths north and south of the border:
“There needs to be more education and awareness of the increased risk of suicide by any method when alcohol is involved, and especially for people with access to guns,” adds Dr. Lange.
CAMH shares new evidence-based tools and training to support mental health of Canadians of South Asian origin
New research provides evidence culturally adapted CBT is a more effective treatment for this population than traditional psychotherapy
Culturally adapted cognitive behavioural therapy (CaCBT) is a more effective treatment for people of South Asian origin experiencing depression and anxiety, and should be implemented countrywide.
This is a key conclusion from new research entitled Culturally Adapted Cognitive Behavioural Therapy for Canadians of South Asian Origins released today by the Centre for Addiction and Mental Health (CAMH) alongside
the Mental Health Commission of Canada (MHCC) and community partner organizations nationwide. Offered with the research report are training resources for mental health professionals of all backgrounds on how to implement the newly developed culturally adapted mental health treatment for South Asian people, as well as supplementary information for patients and mental health professionals.
There are 2.6 million people of South Asian origin in Canada, representing seven percent of the population and the country’s largest racialized group. This population has a higher rate of anxiety and mood disorders, but is also 85 per cent less likely to seek treatment due to many factors, including socioeconomic disparities, cultural differences and stigma.
When treating
depression and anxiety, many therapists will turn to cognitive behavioural therapy (CBT), an evidence-based psychological treatment that focuses on changing people’s negative thoughts and beliefs. However, CBT was developed in a Western context, and has proven to be not as effective with those of different backgrounds. In 2019, CAMH received funding from the Health Canada Health Care Policy Contribution Program to develop, test and evaluate new mental health supports for South Asian populations in Canada. CAMH also worked closely with partners MHCC, Moving Forward Family Services (Vancouver), Ottawa Newcomer Health Centre (Ottawa) and Punjabi Community Health Services (Greater Toronto Area) as part of this initiative.
“CBT
is the most popular form of evidence-based therapy that exists,” Principal Investigator Dr. Farooq Naeem, CAMH Clinician Scientist at the Campbell Family Mental Health Research Institute. “This new culturally adapted CBT also takes into account a person's cultural background and is modified to better fit the patient's beliefs, language, and cultural context. This study found that in terms of acceptance and effectiveness, culturally adapted CBT works even better for this population.”
As part of the study, researchers first met with various members of the South Asian community (including those
diagnosed with depression and anxiety, their families/caregivers, community leaders and more) to better understand beliefs, experiences and opinions about mental health, illness and treatment within that population. All the data was then used to create a new culturally adapted CBT protocol and training manual for therapists. In order to test the new approach, 146 participants of South Asian origin were randomly assigned to receive 8-12 sessions of standard or the specialized CaCBT. Finally, 29 therapists of various racial and ethnic backgrounds received the training and provided feedback on their experiences.
Participants who received CaCBT reported lower levels of mental illness symptoms and higher self-reported overall health than those receiving standard CBT. The number of mental health visits to a psychiatrist, psychologist and other
medical doctors was also significantly lower in the CaCBT group, indicating that expanding this therapy more widely in Canada could reduce strain on the healthcare system. The research team is currently seeking government funding for a national training program of clinicians in CaCBT based on the training created for this study.
“One of the important things about this work and the training available in CaCBT for the South Asian population—or indeed the Caribbean origin population through the CAMH Health Equity Department—is it signals to therapists that we cannot use simple one-size-fits-all treatments in a diverse country like Canada,” said Co-Principal Investigator Dr. Kwame McKenzie, Director of Health Equity at CAMH. “We sometimes need different interventions for different groups of people. Equity requires therapeutic flexibility.”
The researchers stress that CaCBT does not have to be administered by a therapist with the same cultural background as the patient to be effective. One participant in the study who had tried therapy in her native Pakistan without success found the CaCBT treatment she received from a non-South Asian therapist so beneficial that she continued to seek treatment from that therapist after the study period ended.
“CAMH was a pioneer in this work and now leads nationally and
internationally in the study and implementation of CaCBT among several populations,” added Dr. Naeem. “As a diverse country with an ongoing mental health crisis, we need options for care that honour people’s cultural values, beliefs and life experiences. We are proud to offer today proven, effective mental health care resources that can make a real impact for millions of people Canada-wide.”
On International Women's Day (March 8th), CAMH launched the 2023 womenmind™Leadership Fund for CAMH women in science to help mitigate inequities and support them in advancing in leadership roles.
womenmind is a community of philanthropists and thought leaders tackling the unique gender issues that underrepresented people face when it comes to their mental health. Inspired and empowered by their support of CAMH, members of the womenmind community connect with and learn from each other while driving change for women’s mental health and women in science.
At CAMH, our definition of women includes cisgender, transgender, and non-binary people.
Our Impact
The womenmind community exists to put the unique needs and experiences of women at the forefront of mental health research and care – prioritizing the narratives, bodies and minds of women.
In its first five years, womenmind will raise funds to recruit new female scientists and provide them with early career support, hold research and seed grant competitions, offer mentoring programs for women in science and host an annual global research symposium. These initiatives are all oriented around furthering women-centered research while promoting the careers of women in science.
Since launching in March 2020, the funds raised by the womenmind community have contributed to:
Hiring Dr. Daisy Singla, the first-ever womenmind-funded scientist at CAMH whose research focuses on closing the gender gap in mental health by improving access to talk therapies for women worldwide
Awarding Seed Funding to fuel the work of three scientists focused on important and under-researched areas of women's mental health
Developing a mentorship program for women scientists
Onboarding Dr. Liisa Galea as the inaugural womenmind Treliving Family Chair in Women’s Mental Health whose research examines the intersection of hormones, sex and stress on brain plasticity
CAMH thanks the womenmind philanthropic community for their dedicated support in strengthening our ambition for diversity and gender parity in leadership roles within CAMH.
Dr. Peter Szatmari from CAMH's Cundill Centre for Child and Youth Depression will join an Ontario Brain Institute panel discussion exploring current research and emerging discoveries that could lead to individualized treatment of brain disorders - register for the online event here https://twitter.com/OntarioBrain/status/1632788464285392898
