Mental Health

Women

Subheadline

“The current road towards pandemic recovery needs to consider these at-risk populations. If not, there could be dire long-term consequences for the current generation and ones to come”

Two new studies supported by the Institute for Pandemics – a University of Toronto institutional strategic initiative – show that the non-pharmaceutical public health measures implemented during the COVID-19 pandemic were associated with increased mental health visits for mothers with young children, young women and adolescent girls.

As governments around the world imposed public health measures to reduce viral transmission, including stay-at-home orders, travel restrictions, and school closures, experts raised concerns about the potential lasting impact on the mental health of individuals, especially those belonging to vulnerable and at-risk populations.

In particular, mothers with young children faced obstacles related to parenting and caregiving, while young women and adolescent girls experienced major disruptions to school, social and daily routines.

The new studies – which built on previous research showing the COVID-19 pandemic had a larger impact on the mental health of men compared to women – aimed to examine how these pandemic-related non-pharmaceutical interventions have impacted the mental health of these groups.

“This work raises concerns about how to contain and address this issue,” says Geoffrey Anderson, a professor at the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation (IHPME) and lead of the pandemic recovery theme at the Institute for Pandemics.

“The current road towards pandemic recovery needs to consider these at-risk populations. If not, there could be dire long-term consequences for the current generation and ones to come.”

The research team also included: John Moin, a former post-doctoral researcher funded by the Institute for Pandemics; Shauna Brail, an associate professor at �Թϱ�� Mississauga who directs the Institute for Management & Innovation; and Simone Vigod, head of the department of psychiatry at Women’s College Hospital and a professor in the department of psychiatry in the Temerty Faculty of Medicine.

Both studies compared rates of doctor visits for mental health care in the pre-pandemic period from March 2016 to March 2020 to rates during the pandemic from April 2020 to November 2021.

The first, published in the Canadian Medical Association Journal (CMAJ) Open, found a rapid increase in doctor visits by mothers of young children for mental health care during the pandemic compared to the pre-pandemic period, with most of the care for mood, anxiety, depressive disorders and alcohol and substance abuse.

In the second study, published in the British Medical Journal (BMJ) Open, the team found an increase in doctor visits for adolescent girls and women aged 14 to 24 for mental health care largely driven by care for mood, anxiety and depressive disorders. Additionally, there was an increase in hospital visits for eating disorders for adolescent girls and women aged 14 to 19. There was no increase in doctor visits or hospitalizations for boys or young men.

Both studies show that the implementation of public health measures during the pandemic was associated with increased usage of mental health services among mothers of young children, young women and adolescent girls, and point to potential lessons for future public health crises.

“Our research raises concerns about the mental health impacts of public health measures on vulnerable women,” says Anderson. “We need to address these impacts as key part of any effective and equitable pandemic recovery strategy and we need to pay more attention to these consequences in future public health crises”.

"We saw the rapid and ongoing application of non-pharmaceutical interventions as public health measures throughout the pandemic,” says Moin, who was the lead author of both studies. “We also now know that they were associated with abrupt and prolonged changes in the utilization of mental health services. This association should be considered for future public health planning and strategy.”

Renzo Calderon, another post-doctoral fellow funded by the Institute for Pandemics, is leading a team that is further exploring this observed trend.

Despite nearly four years having passed since the beginning of the restrictions, the pandemic continues to alter the landscape of mental health. Hence, the researchers’ focus is not solely on exploring the overarching trends but also on better understanding if there are specific socio-demographic groups of women who were particularly affected.

Preliminary results indicate that the demand for mental health services around specific issues such as eating disorders and substance abuse, especially among young women, has not yet diminished.

Such a targeted approach aims to uncover nuanced insights into how the COVID-19 pandemic exacerbated these problems and lead to more effective interventions.

�Թϱ�� undergraduate students explore the use of AI to treat speech disfluency

rahul.kalvapalle — Mon, 26 Feb 2024 14:00:00 +0000

�Թϱ�� undergraduate students explore the use of AI to treat speech disfluency

rahul.kalvapalle Mon, 02/26/2024 - 09:00

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Assistant Professor Michael Guerzhoy, top left, meets virtually with a team of undergraduate students who are developing a reinforcement learning-based system to help clinicians predict medication outcomes and adjust dosage accordingly (image courtesy of Michael Guerzhoy)

Selah Katona

Topic

Faculty of Applied Science & Engineering

Mechanical & Industrial Engineering

Undergraduate Students

Artificial intelligence, including machine learning systems, could help mental health clinicians optimize treatments for speech disfluency, or interruptions in the regular flow of speech.

Michael Guerzhoy, an assistant professor, teaching stream, in the division of engineering science and the department of mechanical and industrial engineering in the University of Toronto’s Faculty of Applied Science & Engineering, and a team of undergraduate students are developing a “reinforcement-learning-based” system that uses machine-learning algorithms to help clinicians predict medication outcomes and adjust dosage accordingly.

By contrast, many clinicians currently adjust medications based on expensive and sparse observations, making it difficult to identify if a specific drug is working optimally. That’s because patients respond to medication differently and its effects can be subtle or only visible over a long period of time. The effects can also be difficult to distinguish from other factors affecting patient behaviours.

Guerzhoy says complex symptoms like speech disfluency – characterized by chronic and repeated problems with continuous speech – can be particularly challenging to treat.

“Studies show that there is a correlation between mental health conditions like anxiety and depression and speech disfluency,” he says. “I believe that patient care can be substantially improved in situations where low-cost frequent observations are possible through making use of reinforcement learning systems to help prescribe and adjust medications.”

The team outlined their research in a recent paper presented at the Machine Learning for Cognitive and Mental Health Workshop at the Conference of the Association for the Advancement of Artificial Intelligence.

The first component of the system features a module that detects and evaluates speech disfluency on a large data set. The second is a reinforcement learning algorithm that automatically sources and recommends medication combinations. To support the two modules, the team built a plausible patient-simulation system.

Guerzhoy compared this system to the idea of a computer playing chess. “We all know that computers are excellent at playing chess,” he says. “Our hope is that these computer-based reinforcement learning models will help clinicians become sort of chess grandmasters in their field.”

By exploring the potential of automating and fine-tuning medication regimes for patients, the team hopes to provide a pathway to improve the way we treat mental health. Harnessing AI to pick up on small changes in behaviour in more frequent increments would give clinicians another tool in their toolkit, says Guerzhoy, especially since the high cost of sessions is a significant factor in a patient’s treatment.

Guerzhoy emphasized the crucial role played by the team of undergraduate students, which included: Michael Akzam, Micol Altomare, Lauren Altomare, Nimit Amikumar Bhanshali, Kaison Cheung, Jiacheng Chen, Andreas Constas, Pavlos Constas, Vhea He, Aditya Khan, Asad Khan, Heraa Murqi, Matthew Honorio Oliveira, Youssef Rachad, Vikram Rawal and Najma Sultani – all undergraduate students at �Թϱ�� – and Carrie Chen from Cornell University.

“Having such a large team of undergraduate students involved that are passionate about the research was essential.”

Could psychedelics be used to help manage athletes' mental health?

Christopher.Sorensen — Mon, 21 Aug 2023 18:43:24 +0000

Could psychedelics be used to help manage athletes' mental health?

Christopher.Sorensen Mon, 08/21/2023 - 14:43

Cutline

(photo by Peartree Photography/Getty Images)

Jelena Damjanovic

Topic

Temerty Faculty of Medicine

Sinai Health

Faculty of Kinesiology & Physical Education

Sports

Subheadline

David Lawrence, who works with the Toronto Blue Jays, says he's always on the lookout for emerging research in the field

Why do people who take DMT, a powerful psychedelic drug, feel a strong sense of familiarity about places, things or entities that are not a part of waking life?

David Lawrence, a medical director at the David L. MacIntosh Clinic at the University of Toronto’s Faculty of Kinesiology & Physical Education and assistant professor in the department of community and family medicine in the Temerty Faculty of Medicine, sought to shed light on the puzzling phenomenon in a recent study published in the Journal of Psychoactive Drugs.

It found the sense of familiarity was not linked to prior psychedelic use.

David Lawrence (supplied image)

The assistant medical director at the Dovigi Orthopedic and Sports Medicine Clinic at Mount Sinai Hospital and lead primary care physician for the Toronto Blue Jays, Lawrence says the study is just one element of his broader research interest into using psychedelics to treat mental health conditions experienced by athletes.

“This particular study focuses on one subjective feature of the DMT experience, but the bigger picture is that psychedelics have shown great promise in managing mental health conditions for which athletes are at particular risk,” he says.

KPE writer Jelena Damjanovic recently caught up with Lawrence to find out more about the current research into psychedelics and mental health and why he thinks athletes could be uniquely positioned to benefit from it.

How did your interest in psychedelics in the service of athlete mental health come about?

Over the years, I've had the privilege of working closely with numerous athletes who grapple with various mental health challenges. For them, the stakes are high. Their mental well-being directly affects not only their quality of life but also their performance, resilience and overall career trajectories.

In my goal to provide the most effective care, I've always been on the lookout for emerging research within the field of mental health.

The resurgence of academic and clinical interest into the therapeutic potential of psychedelics sparked my interest for any generalizability to my patient population. There are concrete clinical trials and reputable studies suggesting that substances like psilocybin, which is the active ingredient in magic mushrooms, LSD or MDMA – in conjunction with psychotherapy – might hold promise in treating a range of mental health disorders, from depression and PTSD to anxiety.

This burgeoning field of research sparked a myriad of questions for me. Could psychedelics provide a therapeutic avenue that was previously unexplored for athletes? Could they help in addressing the unique mental strains athletes face? And, more broadly, how could they be safely integrated into a comprehensive mental health management strategy?

Are there any unique considerations in this area of research?

Firstly, it's paramount to understand the legal and research landscape surrounding psychedelics. As of now, many of these substances remain illegal in numerous jurisdictions. Furthermore, an essential aspect of any potential psychedelic therapy is the environment – both physical and mental – in which these substances are administered, known as the “set and setting.” Current research protocols emphasize the importance of a controlled setting, typically facilitated by skilled professionals who can guide the experience, particularly for larger doses. Moreover, post-session integration, where individuals process and make sense of their experiences, is crucial to achieve lasting positive outcomes.

How prevalent are mental health disorders among athletes?

There are various estimates. However, a recent meta-analysis suggests the prevalence of mental health symptoms and conditions ranges from 20 to 35 per cent in elite athletic populations, which is significant.

What kinds of stressors are athletes commonly exposed to?

There a number of recognized unique stressors encountered by athletic populations, including: performance and personal issues such as injuries, finances and career transitions; leadership and personnel issues such as spectators, media, governing bodies, coaches and support staff; logistic and environmental issues such as travel, selection, accommodation and physical safety; and cultural and team issues such as teammates behaviour, goals, cultural norms and team support.

What role can psychedelics play in the management of mental health disorders for which athletes are at particular risk?

Athletes often grapple with disorders like depression and anxiety – pressures that can be amplified by the unique demands of their profession. In some sports, notably, there's a prevalence of disordered eating patterns. These conditions are very challenging to manage. Intriguingly, there are preliminary reports suggesting that psilocybin may hold promise in the treatment of disordered eating conditions like anorexia.

Additionally, there are some research groups exploring the use of certain psychedelics like DMT for the treatment of acquired brain injury. In sport medicine and at the David L. MacIntosh Clinic, we pride ourselves on being leaders in the management of concussion, which is a form of brain injury. Most concussions resolve over a period of weeks. However, a proportion of individuals experience a prolonged and protracted recovery – often complicated by mood and other mental health symptoms. Addressing these persistent post-concussion symptoms remains challenging, presenting a possible avenue for future studies involving psychedelics.

What also intrigues me about psychedelics is their purported ability to foster deep introspection, cognitive flexibility, and lasting shifts in perception and beliefs – qualities that could be profoundly beneficial for athletes navigating the immense pressures and existential questions often associated with their careers.

Navi virtual assistant expands to incorporate more �Թϱ�� resources

ksoobria — Tue, 15 Aug 2023 17:19:45 +0000

Navi virtual assistant expands to incorporate more �Թϱ�� resources ksoobria Tue, 08/15/2023 - 13:19

In August 2023, Navi is widening its scope to offer even more assistance to students, staff, faculty and librarians across the University of Toronto’s three campuses.

The virtual assistant, originally implemented to help students access mental health resources on campus and in the community, is expanding to incorporate general �Թϱ�� resources into its offerings, through the same easy-to-use chat interface.

“Navi has become a critical tool in helping students find mental health resources,” says Sandy Welsh, Vice Provost, Students. “And now we have an opportunity to enhance the service it’s providing. Allowing Navi to guide users to general, tri-campus resources helps Navi become a more robust tool that serves the �Թϱ�� community on an even larger scale.”

While Navi’s commitment to connecting users with mental health supports remains, the tool will now include other on-campus resources such as study supports, finding community, how to connect with a registrar and more. The automated assistant uses a chat format, so users can communicate in full sentences instead of entering keywords. Typing phrases like “I’m having trouble sleeping” or “I want to learn how to take better notes” allows Navi to recognize what users need and quickly link to appropriate resources.

And it’s not just for students, says Welsh.

“Navi is incredibly helpful for faculty and staff, staff, faculty and librarians as well. When a student or colleague asks for assistance, we don’t need to have all the answers – we can use a tool that directs us to the appropriate resources. Navi can help us all become more familiar with the incredible programs and services offered across the University.”

Welsh encourages all staff, faculty and librarians faculty to include the Navi widget on �Թϱ�� webpages, and for student-facing staff, in their email signatures.

As always, information shared with Navi is completely anonymous and users are reminded that the resources and supports provided do not replace workshops or one-to-one conversations with experts.

To access the tool, visit uoft.me/navi.

Navi virtual assistant expands to incorporate more �Թϱ�� resources

Tool will now include on-campus resources such as study supports, finding community, registrarial information and more

(photo by Johnny Guatto)

Communications Staff

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Can AI deliver therapy? �Թϱ�� PhD candidate examines the pros and cons

Christopher.Sorensen — Fri, 28 Jul 2023 20:00:38 +0000

Can AI deliver therapy? �Թϱ�� PhD candidate examines the pros and cons

Christopher.Sorensen Fri, 07/28/2023 - 16:00

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(photo by Igor Kutyaev/Getty Images)

Sean McNeely

Topic

The Institute for the History and Philosophy of Science and Technology

Artificial Intelligence

Faculty of Arts & Science

Graduate Students

Factor-Inwentash Faculty of Social Work

Earlier this year, the U.S.-based National Eating Disorder Association shut down its AI-powered chatbot after it provided unsafe advice to people seeking help.

The chatbot, called “Tessa,” instructed people with eating disorders to greatly reduce their daily calorie intake, according to complaints.

“The chatbot was suggesting callers try things that gave them eating disorders in the first place,” says Rachel Katz, a PhD candidate with the Faculty of Arts & Science’s Institute for the History & Philosophy of Science & Technology.

Her research focuses on bioethics, as well as the philosophy of medicine and psychiatry – including an interest in AI ethics.

Katz is in the early stages of her doctoral research that examines the pros and cons of AI-facilitated psychotherapy, specifically AI-delivered therapy that doesn’t involve a clinician at any point.

Her work received coverage from major news outlets this summer, following her research presentation at the Congress 2023 gathering of the Canadian Society for the History and Philosophy of Science at York University in May.

Rachel Katz believes AI-delivered psychotherapy can be a useful tool in certain situations(photo courtesy of Rachel Katz)

“There are several ways that AI has come to be part of psychotherapy,” Katz says. “I'm focusing on the patient interaction aspect. I’m looking at apps ... that don't require interaction with a human therapist.

“I'm not against the use of AI therapy chatbots – they are a useful tool, but they need to be understood and regulated properly before they spin out of control. Currently, we don't have sufficient rules and guidelines for the kinds of things these chatbots could be useful for.”

Katz believes the difference between an AI chatbot and a human therapist is trust, as opposed to reliance.

“When we have a good relationship with a human therapist, we've formed a trust-based relationship built on goodwill and vulnerability,” she says.

Conversely, Katz describes the reliant relationship with AI therapy as “talking to an affectionate wall.”

“You can have this supportive, helpful experience working with an AI therapist,” Katz says. “There's no vulnerability, but you can rely on it to be there.”

But she notes there is something fundamentally different about human-to-human relationships – and part of that comes from the fact that a therapist can make mistakes.

“You may have a great working relationship with a therapist, and then they suggest something that doesn't work for you,” Katz says. “Or they may say, ‘Here's how I've interpreted what you've told me,’ and you correct them.”

That could become problematic with misdiagnosing or mistreating a mental health concern.

“But part of that ability to mess up represents that ‘special human element’ that I’m exploring – and it’s one of the things that makes [us] trust someone in general,” she says. “That's something you completely lose out on with an AI therapist.”

That element of vulnerability can flow both ways – a human therapist can make themselves vulnerable by offering insights into their personal lives, which can also strengthen a bond with a patient.

Katz plans to further investigate what makes that human relationship special – something she feels she hasn’t fully uncovered yet.

“That’s the big philosophical question underpinning the whole project,” she says.

Katz also questions whether AI chatbots are effective when dealing with crises. For example, chatbots are not considered very effective when assisting someone who is suicidal.

“They will just direct you to call 911 or some other kind of emergency service,” Katz says. “That's not always a good solution for people who may be very distressed.”

Despite the challenges, Katz believes AI has some advantages.

For example, crisis lines are often staffed by volunteers, and such work can take a heavy emotional toll.

“You could argue that turning those call systems into AI saves the emotional burden from volunteers,” Katz says.

Distance and accessibility could also be a factor – if a person living remotely has to drive hours for an appointment, AI might be a more convenient option.

“Or if you're someone who works strange hours – say you work a night shift and need to see a therapist – that's also a difficult situation that might be better suited to AI,” Katz says.

But AI’s biggest appeal may be the fact that it’s impersonal.

Some people – particularly those who have never taken part in therapy before – may feel more at ease chatting to AI rather than a person when it comes to sharing their problems and issues.

“I was teaching a class and asked my students, ‘How would you feel about having a therapist?’ A shocking number of them said they were keen on first talking to an AI therapist,” Katz says.

“They were nervous about the idea of expressing difficult emotions to another human. They preferred having something that could listen but was incapable of human judgment. Ideally, a therapist is non-judgmental, but someone who's seeking out a resource for the first time may not be aware of that.”

As Katz continues her research, she does see AI-based psychotherapy working well in certain situations – with the proper guidelines and disclaimers.

“Ultimately, I want to advocate for patient choice,” she says. “I wouldn't want to deny a patient their ability to make the choice for what intervention they feel will make the most sense for them. If the type of therapy or the method of delivery of therapy doesn't work for the patient, the treatment is not going to be effective.”

As she delves deeper into the subject, Katz sees real-world applications for her work.

“The goal is to do some philosophical investigating and hopefully come up with some answers that are philosophically interesting and can also help inform policy development in this area.”

Two �Թϱ�� faculties join forces to boost mental and physical health of local seniors

siddiq22 — Fri, 28 Jul 2023 16:45:47 +0000

Two �Թϱ�� faculties join forces to boost mental and physical health of local seniors

siddiq22 Fri, 07/28/2023 - 12:45

Cutline

Participants in the Work it Out, Talk it Out program, jointly created and run by �Թϱ�� social work and kinesiology professors and students, stretch in their chairs at the Jane/Finch Centre (photo courtesy Work it Out, Talk it Out)

Topic

Faculty of Kinesiology & Physical Education

Subheadline

Factor-Inwentash Faculty of Social Work and Faculty of Kinesiology & Physical Education partner with community centre

Two University of Toronto faculties are teaming up on a new pilot project that aims to improve the physical and mental health of local seniors through a combination of exercise and talk therapy.

Partnering with the Jane/Finch Centre in northwest Toronto – a multi-service community centre focusing on poverty reduction – the Factor-Inwentash Faculty of Social Work and the Faculty of Kinesiology & Physical Education developed the Talk It Out, Work It Out program for the centre’s clients, particularly seniors.

Graduate students from each faculty also contributed to the program’s curriculum.

Kinesiology students focused on the “Work It Out” section of the program, where participants do some basic exercise before moving on to the “Talk It Out” part, where trained Master of Social Work students shepherd the clients into small groups so they can share their thoughts and concerns to the degree and depth they choose.

Over seven 1.5-hour sessions, the participants’ anxieties are soothed and their comfort level rises through the combination of physical stress release and expert peer support.

Catherine Sabiston and Lin Fang

“We planned it this way so that seniors could first get activated through exercise,” says Lin Fang, associate professor of social work and Factor-Inwentash Chair in Children’s Mental Health at the Factor-Inwentash Faculty of Social Work.

“Later on, as seniors were used to the Talk It Out section and needed more time for it, we switched it around so that they could have time to speak first. The program was designed to be fully integrated.”

The Talk It Out program was inspired by the growing mental health crisis during the pandemic, which hit marginalized communities hard.

Social work students were trained to provide free counselling sessions online or by phone, but Fang knew some seniors would remain resistant to the idea of counselling – even if it was free.

So she joined forces with Catherine Sabiston, a professor of exercise and sport psychology at the Faculty of Kinesiology & Physical Education who holds a Canada Research Chair in physical activity and mental health. Sabiston had led a similar initiative called MoveU.HappyU – an exercise and mental-health coaching program overseen by KPE students from her lab to help �Թϱ�� students.

Both sets of graduate students partnered on adapting their programming to meet the needs of the senior clients Fang had in mind.

They’ve since seen real progress during the sessions at the Jane/Finch Centre, where many of the seniors initially lamented the lack of social support in their lives. Not only do they now have the support of the Talk It Out, Work It Out facilitators, but participants have been coming together themselves – making new walking buddies and friendships beyond the sessions.

“That’s the best part of ‘talking it out,’” says Jane/Finch Centre program worker Sandra Anderson.

“Everyone has a story. Your story reflects what you’re going through, but I can identify with it, too. By talking, we’ve helped each other make it through another day.”

Read the full story at the Faculty of Kinesiology & Physical Education

Read the full story at the Factor-Inwentash Faculty of Social Work

New name for �Թϱ�� 24/7 mental health program

ksoobria — Tue, 25 Jul 2023 15:45:04 +0000

New name for �Թϱ�� 24/7 mental health program ksoobria Tue, 07/25/2023 - 11:45

This summer, the �Թϱ�� My Student Support Program (�Թϱ�� MySSP) app is getting a fresh design and updating its name to �Թϱ�� Telus Health Student Support.

The program offers students access to free mental health and well-being support through the app, real-time chat function and phone consultations.

While the look and name have changed, the service remains the same.

“�Թϱ�� Telus Student Support continues to provide students with a safe space that is both confidential and personal,” says Sandy Welsh, Vice Provost, Students. “Support is available 24 hours a day, seven days a week in over 146 languages. It’s a critical tool in promoting the well-being of our community.”

Video and phone counselling appointments are available by calling 1-844-451-9700. Students located outside Canada or the United States can call 001-416-380-6578. To avoid long-distance charges, students can either make a collect call or phone over WiFi. Staff and faculty can also use the app to access live support for students in crisis.

After downloading the free app, students are asked to update their profile and allow push notifications so that they can stay in touch with their care. Students who already have the app will see an automatic change in its name and appearance on July 31, 2023.

Privacy is always top priority, and any information provided over chat, video or phone remains completely confidential.

More information can be found at uoft.me/THSS.

New name for �Թϱ�� 24/7 mental health program

Mental Health

Communications Staff

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Researchers examine mental health and well-being of Canada’s unpaid caregivers

siddiq22 — Fri, 21 Jul 2023 18:00:11 +0000

Researchers examine mental health and well-being of Canada’s unpaid caregivers

siddiq22 Fri, 07/21/2023 - 14:00

Cutline

(photo by Patricia Kovac/iStockphoto)

Rebecca Biason

Topic

Canadian Institutes of Health Research

Aging

Lawrence S. Bloomberg Faculty of Nursing