From the CAMH newsroom
Trauma and experience of violence add to complexity of care for people with mental health, substance use problems
High rates of trauma and violence are experienced by people with mental health and substance use problems, adding to the complexity of their service needs, according to two studies by the Centre for Addiction and Mental Health (CAMH), conducted in collaboration with local partners in eight Ontario communities.
Yet there are innovative solutions to address these co-occurring issues – solutions often driven by community need, and led by local service providers.
At a two-day forum held October 28-29 in Toronto, community partners from across Ontario heard the combined results from these studies, which were conducted in each community out of CAMH’s mobile research lab, a custom-built 34-foot trailer that allows CAMH scientists to conduct multidisciplinary research in diverse communities across the province.
(From left) Dr. Kate Graham and Dr. Samantha Wells, outside CAMH's mobile lab
“The issue of violence among people with mental health and substance use problems has not been widely studied, but as our research shows, it’s a huge factor that needs to be addressed in treatment and recovery,” says Dr. Samantha Wells, Scientist in Social and Epidemiological Research at CAMH and study lead on the Researching Health in Ontario Communities project, funded by the Canadian Institutes of Health Research (CIHR).
Based on 1,831 survey results from residents of the eight communities, people who had experienced depression in the past year were three times more likely to report being victims or perpetrators of physical aggression than those without depression. Overall, 43 per cent of those with depression met the criteria for PTSD, compared with six per cent of those who did not experience depression.
A second CIHR-funded project, Five Views on a Journey, captured the perspectives of clients, family members, social service agencies and community members, and examined health services records.
“To understand the system of services for people with co-occurring problems at local and provincial levels, these multiple perspectives need to be considered,” says Dr. Kate Graham, Senior Scientist in Social and Epidemiological Research at CAMH, who led this study. “Especially important is the perspective of people with experiences getting help.”
Among 243 people interviewed who had received help for mental health or addictions problems, nearly 60 per cent had also experienced physical aggression, most often victimization. In addition, 54 per cent had encountered the police/justice system related to these problems. Many believed they could have avoided police contact if they had received help sooner.
Examples of collaborations and partnerships, described at the two-day meeting, showed how different sectors can respond to clients with multiple issues in a coordinated way.
Innovative solutions included Community Mobilization Sudbury, a partnership of over 20 services, including social service agencies, school boards and police, among others, which addresses acute risk situations. Recently, the partnership intervened to address a suicide pact involving multiple students and families at a local high school, noted Maureen McLelland, Associate Vice President, Clinical Transformation & Transitions, at Health Sciences North/Horizon Santé-Nord.
Community-led solutions have been developed to address the links between poverty and mental health. Christine Clark Lafleur, Executive Director of Port Cares in Port Colborne, described how her agency provides a “wrap around” service with access to help for health‑related needs including housing, crisis and advocacy, employment and education.
The forum also highlighted the importance of paying attention to the voices of consumers of mental health and addiction services to ensure recovery-oriented care that is appropriate and effective.
“It’s becoming apparent that we need to shift the way that mental health is seen by service providers,” said Shana Calixte, the Executive Director of Northern Initiative for Social Action. “We need to think about the whole person, meet people where they’re at, think about the fact that people need to be the directors of their own health care.”