Thursday 30 October 2008

What is Knowledge Translation?

Knowledge translation (also known as KT) is one of those important things that has been going on since the dawn of time, but has now been given a name and a scientific grounding. Many things that we have learned have been from knowledge translation - someone who “knows” has taken that knowledge and put it into a format that helped us learn. This is great as long as the knowledge is correct.

But what happens if it is not?

We could learn something that will not be of maximal value to us and may even be unhelpful or harmful. So here is where the science of KT comes in. Over the last few years a methodology for doing KT has been developed and extensively tested. It consists of systematic and reproducible techniques of finding and evaluating all the available knowledge on any particular topic or issue. These techniques are necessary because all information out there is not of equal quality - some is better and some is much better than others. Some may be more likely to be correct and some more likely to be wrong. The techniques used to evaluate the information are very stringent and have been developed to try and ensure that when the information is synthesized the syntheses is more likely to be correct than not correct. So knowledge will have been translated from scientific studies into a common and more certain bundle of information.

Then the next step comes in — taking that bundle of information and putting it into a format that meets the needs of various users. Because what good is KT if it is not used by people to improve what they are doing and to better understand the world around them?

The Sun Life Chair group does both kinds of KT. We conduct systematic literature evaluations and critical analysis to provide the best available evidence on a variety of topics. For example, one recent topic was that of school-based programs designed to prevent suicide. Guess what we found — although there are many such programs (and I think that some people are making quite a bit of money by selling them) there is very shaky evidence that any are effective.

Indeed, we could not find one that clearly demonstrated it decreased suicide rates in young people! So this is very important information for people making health and education policy and for people who want to buy some of these programs. We think that it’s better to use those things that work instead of those things that do not work or that we do not know if they work or those things that may be harmful.

I recently filmed a video with Insider Medicine talking about knowledge translation. Check it out for more info.

Cheers - Dr. Stan Kutcher

Wednesday 22 October 2008

Teen Mental Health Blog - Our Mission

Teen Mental Health Blog is alive!

Our mission is to become the world’s premiere blog for child and youth mental health. Most of the entries will be written by me - Dr. Stan Kutcher. The blog be a place where people can come to get the latest news on youth mental health issues (policy, mental disorders, medications, school mental health, etc.)

This blog is part of teenmentalhealth.org a website dedicated to helping improve the mental health of youth by the effective translation and transfer of scientific knowledge. The website is a place where youth, parents, patients, educators, and health professionals can go to download resources and get information on youth mental health based on the best scientific evidence available.

 

Wednesday 8 October 2008

Facing mental illness: a 10-step plan for Nova Scotia

What does the face of a person with mental illness look like?

That question is at the heart of this year’s national anti-stigma campaign "Face Mental Illness," which is the theme of Mental Illness Awareness Week (Oct. 5-11). In Canada, one in five people is living with a mental illness. Mental disorders are some of the most disabling medical conditions, with about 70 per cent of them onsetting prior to age 25. They exact a huge negative impact on health, society and our economy. Yet a strong and persistent stigma prevents thousands of adults and youth from accessing and receiving the help they need to get well and say well.

While the scientific understanding and treatment of mental disorders and the awareness of the importance of mental health in all aspects of life have advanced considerably in the past decade, the public perception of people with mental illness has been much slower to change. A recent national survey conducted by the Canadian Medical Association found extremely high rates of stigma against those who suffer from mental disorders, permeating all aspects of Canadian society. This stigma is largely present in our social structures and institutions – including our health, social services, education and justice sectors.

Stigma is essentially the polite word for discrimination. There is no room in our caring society for discrimination against those living with mental illness. There is no reason for those living with mental illnesses to be denied adequate housing or equitable health care or to spend their lives in the shadows.

The recently established Mental Health Commission of Canada has announced that it will be addressing stigma against the mentally ill through a national strategy. However, Nova Scotians should not need to wait until a national strategy is unveiled to begin to address the complex issues that need our attention. We could start with these 10 steps to immediately begin to improve mental health and the care for those who suffer from mental disorders in this province:

1. Establish a consensus that promotion of mental health and recovery from mental disorders should be the framework for the development and delivery of mental health care across the province.

2. Establish a child and youth policy and plan that commit to providing equity in health access to all young people suffering from mental disorders.

3. Enhance funding for treatment of those with mental disorders, basing all interventions on best available scientific evidence.

4. Address youth needs as the cornerstone of mental health promotion and prevention activities. Focus these activities in schools and community organizations and link these to enhanced community based mental health care capacity for young people.

5. Support the creation and distribution of mental health literacy programs to enhance knowledge for the public, professionals and policy-makers alike.

6. Allocate a specific portion of the Nova Scotia Health Research Foundation funding for mental health research – especially in areas traditionally receiving little research support.

7. Establish innovative community-based and supported housing that meets the needs of the mentally ill – and link this to the development and delivery of peer support training for those who wish to obtain it.

8. Establish novel competency training programs to upgrade the mental health treatment skills of all health providers – so people with mental disorders can get their care from the same people who look after their diabetes, cancers and heart disease.

9. Establish youth engagement and intervention programs that will prevent young people from ending up in jails, and establish mental health courts for all offenders who are currently rotating through the legal system.

10. Accelerate the process of de-institutionalization of those who have mental disorders and ensure that sufficient acute and long-term care resources are available in usual health care locations instead of stand-alone mental health facilities – thus decreasing the stigma of receiving mental health care.

Societies are judged by how they treat their most vulnerable citizens. Nova Scotians are too good a people to continue ignoring the needs of our brothers and sisters, husbands and wives, friends and neighbours because they live with mental illness. It’s time we faced the issue and did ourselves proud.