Health
Potential targets for prevention and early detection of mental illness
A new study by the Centre for Addiction and Mental Health (CAMH), titled “Use of mental health services before a first diagnosis of mental illness”, JAMA Psychiatry, They found that approximately 75 per cent of Ontario youth with mental illness received mental health services at least once within the three years prior to their first diagnosis of a mental illness.
This retrospective cohort study, the largest of its kind, suggests that young people with a mental disorder were nearly four times more likely to have a history of mental health-related hospitalization, twice as likely to have a mental health-related emergency department visit, and more likely to have been previously diagnosed with a substance use disorder compared to young people diagnosed with a mood disorder.
“Our findings suggest that these factors – a history of mental health-related hospitalizations or emergency department visits, and a history of substance use disorder diagnoses – may indicate an increased risk of psychosis,” said Nicole Kozlov, PhD, co-director of CAMH's Slate Family Centre for Transition-Age Youth. “These results are remarkably consistent with jurisdictions outside of Canada and should guide further research into early detection and intervention of psychosis.”
As part of the study, researchers used health service utilization information and other relevant data held by ICES to examine the historical mental health care utilization of Ontarians aged 15-29 who were diagnosed with a mental disorder between April 1, 2012 and March 31, 2018. The research team identified more than 10,000 individuals who had a first diagnosis of a mental disorder and matched them to individuals who had been diagnosed with a mood disorder.
“People at risk for psychosis are 'hiding in plain sight,'” said Aristotle Voinskos, PhD, CAMH vice president for research and director of the Campbell Family Mental Health Institute. “These data provide a very different picture of who is at risk for psychosis and also suggest an opportunity for future investigation into whether effective treatment of prior medical conditions may alter risk of psychosis.”
The initial results of this study prompted CAMH to launch the Toronto Youth Cohort Study (TAY), a five-year study that will follow 1,500 children and young people receiving mental health services to examine their biology, education and cognition, social factors, and service utilization patterns to better understand who is at risk for mental illness and, most importantly, how to reduce that risk through early intervention.
This research is a key pillar of CAMH's new strategic plan. Go upstreamaims to position hospitals at the forefront in early detection of mental illness, prevention strategies and timely access to quality care.
CAMH is already a leader in both research and clinical care for young people with psychosis. Slate Family Center's unique integrated approach for transition-age youth translates the latest clinical and scientific evidence into better intervention and recovery strategies that make a real difference in young people's lives. The Slate Center includes an outpatient Early Psychosis Intervention Program, a Clinical High Risk Program and an inpatient Early Psychosis Unit, treating an average of more than 425 patients between the ages of 14 and 29 each month.
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