Introducing the BCMHA Survey
by Aarya Tamrakar and Kirsten Wesselow
Substance Use Treatment in British Columbia: Background
In 2020, reported deaths due to illicit drugs in British Columbia (BC) rose to 1,726 from 985 in 2019. The high levels of overdose and severe drug use issues indicates a need to develop an understanding of the factors leading to and factors which will help to improve the current situation. BC has a history of strong research and cutting-edge innovation, such as opening the world’s first methadone substitution program in 1959.
BCMHA Survey: What it is and why it’s important
Concurrent disorders (co-occurrence of mental health and substance use disorders) are the norm and not the exception in individuals suffering from substance use disorder, specifically severe substance use disorders. The Behavioral Reward Affect + Impulsivity Neuroscience Lab (BRAIN Lab) focuses on understanding the complexity of multiple disorders. At the Burnaby Centre for Mental Health and Addiction (BCMHA) we are completing a pilot study, “The Cross-Sectional Assessment of Substance Use Disorder, Mental Health and Quality of Life in Diverse Clinical Settings (BCMHA Survey),” to gather detailed information on patients and determine the feasibility of integrating larger studies into clinical practice, such as ROAR CANADA. Integrated treatment centres like BCMHA offer combined treatment efforts for individuals with severe concurrent disorders. BCMHA is unique since it offers integrated care from the same practitioners in one setting and provides the full range of evidence based mental health and substance use interventions in a coordinated manner, resulting in comprehensive consistent treatment and recovery.
A key aim of the BCMHA Survey is to describe and characterize clients at BCMHA and their trajectories to help pave the way for future research and treatment in addiction psychiatry. Data is already being used to inform planning for treatment infrastructure, such as the new Red Fish Healing Centre for Addiction and Mental Health that will be opening in Burnaby, BC.
How Are We Doing It?
Collecting reliable and relevant information on diverse aspects is a huge undertaking! So how do we do this?
We have selected standardized and novel self-report questionnaires for this study to assess participants’ behaviour, mental health, trauma history, substance use, use of health care services, and treatment outcomes. New questionnaires, such as the mobile phone technology survey (developed by Michael Krausz, one of our research partners), have been designed to examine the patients’ accessibility to new technologies (e.g. cell phones), which will help us assess the effectiveness of treatment interventions that require mobile devices.
These self-report questionnaires will then be supplemented by information from participants’ medical charts at BCMHA. Chart information includes socio-demographic data, clinical diagnoses, substance use and medication history, and cognitive function. Using a combination of participants’ subjective self-report data, as well as objective diagnoses, substance use histories, and outcomes, we can gain a holistic understanding of their experiences that will help us guide future studies and treatments.
The Bigger Picture
We currently have 311 participants that have completed the study and have a target sample size of 380 participants. The ability to successfully recruit participants will in itself offer valuable information on recruitment considerations for future studies.
By conducting the BCMHA Survey, we are better able to plan for future studies and understand the experiences of individuals with concurrent disorders. At the B.R.A.I.N. Lab, we aim to contribute to the research and treatment approaches that can make a meaningful impact. We are looking forward to sharing our results and implementing positive changes in the care provided to those who need it most.
Above is a pie chart showing what information we ask for on our survey.
Introducing ROAR CANADA
by Aarya Tamrakar
ROAR CANADA. Sounds intense, doesn’t it?
In many ways, it is. Primarily because ROAR CANADA (Reduction of Overdose and Relapse - Concurrent Attention to Neuropsychiatric Ailments and Drug Abuse) is the largest study of its kind yet, with a target sample size of 1500 participants!
It aims to study individuals with concurrent disorders, a population that often gets overlooked in research, due to the perceived risk of their multiple conditions leading to muddied study results.
So, what is a concurrent disorder?
In the context of substance use research, “concurrent disorders” (also called “dual diagnoses”) mean that an individual has at least one substance use disorder and at least one other mental health disorder. These individuals are often excluded in research because the effects of one disorder can be difficult to isolate from the other. Consequently, this population is severely understudied while at the same time facing debilitating challenges in their functioning.
This is a significant problem; roughly 37% of people with an alcohol use disorder and 53% of people with other substance use disorders will have a concurrent mental health disorder at least once in their life.
With the ROAR CANADA study, we hope to better understand peoples’ experiences with integrated treatments for concurrent disorders and to evaluate existing practices at three facilities that offer multidisciplinary integrated treatment for concurrent disorders. We also plan to assess the risk factors predicting overdose and relapse after patients are discharged from treatment. The UBC BRAIN Lab has teamed up with Dr. Tonia Nicholls’ lab at UBC and Dr. James MacKillop’s lab at McMaster University to study this complex population. We will be compiling data from different sources to get a better understanding of the problems clients with concurrent disorders face. Our work is funded by Health Canada and is supported by the BC Provincial Health Service Authority.
We will be working with the following treatment centres:
- The Burnaby Center for Mental Health and Addiction (British Columbia) - a facility that provides integrated treatment for adults with severe concurrent disorders
- The Heartwood Centre for Women (British Columbia) - a residential facility for women who struggle with severe substance use and mental health challenges
- St. Joseph’s Healthcare Hospital (Ontario) - a premier research and teaching hospital.
ROAR CANADA is a longitudinal study – one that assesses its participants over time. We will interview each participant when they first arrive at their treatment centre, shortly before discharge into the community, one month post-discharge, and 6 months post-discharge. By interviewing them over time, we hope to gain a better understanding of their experiences as treatment progresses as well as their experiences once they have left the facilities at which they were being treated.
We will then access the participants’ medical history and their experiences with the correctional system, then link this data to the information we collected from the earlier parts of our study to inform our understanding of participants’ experiences during and after treatment. All information will be handled confidentially; the safety of our participants and non-identifiability of their data is, and always will be our top priority.
Once data collection and analysis is complete, we will share our results with health authorities across Canada in the hope of developing effective treatment for individuals with substance use and concurrent disorders. We hope that the knowledge gained through the ROAR CANADA project will inform the set-up of new integrated care centres, thus creating meaningful and necessary change in treatments for individuals with concurrent disorders. In other words, we aim to match the intensity of our study’s name with our commitment to improving the lives of individuals with concurrent disorders.
If you're excited about this study and would like to learn more about our research, click here!