Year: 2018

A public health emergency has been declared in British Columbia in response to the rising number of fentanyl-related overdose deaths. While numerous efforts are underway to coordinate and improve access to evidence-based addictions treatment and related services, it is crucial these efforts include a comprehensive and nuanced understanding of the impact of substance use problems on parents and families. Stigma, stress, caregiver burden, and current service limitations can affect people’s ability to access services and effective interventions to help them recover from addictions.

This project will support an emerging team of investigators, clinicians, and advocates passionate about reducing health and social inequities for and improving the care of families affected by substance use problems. Under a participatory research agenda, families, researchers, clinicians, service planners, and policy makers will be brought together for a three-day workshop to support the development of a pragmatic, rigorous evidence-base needed to enable this work. The main deliverable will be a sustainable “Learning Alliance”, made up of researchers and research users who will address challenges around effective policy and practice related to supporting families affected by substance use problems and develop momentum for subsequent activities. The knowledge this team’s research and learning alliance will generate would inform provincial efforts to improve the delivery of services to individuals struggling with addictions and the family members who support them.

The breadth and scope of this collaboration will be increased through synergy with an emerging five country collaboration focused on examining policy and practice on substance use and parenting in Canada, the UK, US, Ireland and Australia. This perspective, also supported through a learning alliance, will allow for knowledge exchange, provide a more nuanced understanding of the core governing principles and ethics of care in different contexts, and will catalyze efforts to generate the evidence-base needed to enable this work.

This project’s purpose is to hold a symposium followed by several advisory board meetings. The key objective is to bring health researchers and research users together to share ideas and plan for activities regarding Syrian mothers support and access to health care. This first step connects to a larger proposed longitudinal study application (MSFHR Health Professional-Investigator Program 2018) in planning research and building a strong foundation of trust and relationships within the community. The research team has been established and will complement the two funding opportunities. The proposed activities align with British Columbia’s health system priority areas of i) enhanced access to effective primary health care and; ii) mental health care.

Activities will focus on community engagement, a symposium (face to face event), and development of an advisory board consisting of key stakeholders and gatekeepers of the Syrian community. The advisory board promotes knowledge exchange about the aims of this research and to build dialogue about how the community might benefit from the research findings. Advisory board members will include Syrian mothers and members of the Syrian community, settlement workers, health care professionals, non-government organizations, and immigrant service representatives. As a point of entry, this research team has existing relationships with key stakeholders working at Bridge Clinic, Options Community Services and other immigration service centers already working with Syrian mothers and their families.

Anticipated outcomes are:

1. Develop a comprehensive community engagement plan.
2. Form an advisory board.
3. Provide important and foundational knowledge for future research opportunities with the Syrian population.
4. Give graduate research trainees invaluable experience in community development and engagement processes.

Borderline Personality Disorder (BPD) is a complex mental health condition associated with high rates of self-injury and suicidal behaviours. BPD is estimated to affect over 200,000 adults in BC. People with BPD experience challenges in accessing and engaging with mental health services due to high levels of stigma among mental health clinicians, frequent misunderstanding or misinformation about their diagnosis, inadequate access to evidence-based outpatient programs, and perceptions by clinicians and people with BPD that psychiatric care will not be effective. Together, these experiences often result in feelings of demoralization, hopelessness, and reluctance to engage with mental health services.

Peer support for people with mental health issues can improve their healthcare experiences and quality of life. However, a recent systematic review concludes that further research is needed to evaluate the effectiveness of peer support interventions. This project’s purpose is to bring together people with lived experience of BPD, mental health clinicians and decision-makers, and health researchers to lay the groundwork for a pilot trial to evaluate a peer support intervention for adults with BPD.

The activities will have three phases.

• Phase 1 will consist of reviewing and summarizing evidence for peer support interventions.
• Phase 2 will be gathering input on the needs and priorities of stakeholders to inform the peer support intervention.
• Phase 3 will be developing a research plan to assess the feasibility and effectiveness of the peer support intervention.

These activities will achieve four outcomes. They will:

1. Build research capacity in our team through training, co-development of the research plan, and collaborative grant writing.
2. Increase knowledge of community priorities and needs of people with BPD.
3. Create and summarize knowledge to guide decision-making around peer support interventions for people with BPD.
4. Instill hope in people with BPD that community input will guide care improvements.

Significant commitments from each of the stakeholder groups support the feasibility of this work. The patient-led approach ensures activities will reflect the priorities of people with BPD and their families. This work strongly aligns with the BC Health System Priority of improving care for people living with mental illness.