COVID-19 brought much illness and loss, but with the pandemic came advancements in science and public health, including a more public discussion of mental health.
Research over the course of the pandemic indicates a surging demand for care. In September 2020, a cross-sectional survey led by academic researchers from the University of British Columbia (UBC) and the Canadian Mental Health Association (CMHA) in partnership with Maru/Matchbox revealed that 40 per cent of respondents reported a deterioration of their mental health since the onset of the pandemic. The number is even higher in Ontario, with 44 per cent of respondents reporting declines in their mental health.
There are not nearly enough care providers to address the need through traditional models. We need new ways of thinking, greater collaboration, funding, and a renewed focus on research and innovation. As one of Canada’s foremost mental health care, teaching, and research hospitals, The Royal offers our clients access, hope, and new possibilities through discovery.
Clinical Brain Research Centre
The Clinical Brain Research Centre (CBRC) at the University of Ottawa Institute of Mental Health (IMHR) at The Royal represents a way to dig into big questions in mental health while improving care. It brings together scientists, clinicians, educators, learners, volunteers, people with lived experience, integrating research technologies into the clinical workflow.
“The CBRC is transformational for The Royal and for the region,” says Dr. Florence Dzierszinski, president of the IMHR and vice president of research at The Royal. “By bringing research and care closer together, we can transform the future of mental health care.”
Through their participation in research, clients access cutting-edge technologies and promising treatments while contributing to our body of knowledge.
“We see better outcomes when research and care are integrated. It gives our clients hope,” says Katie Dinelle, manager of the Brain Imaging Centre. “We are excited about the work happening at the Clinical Brain Research Centre at The Royal and to see what the future holds.”
Neuromodulation with rTMS
In 2021, Dr. Sara Tremblay was one of three recipients of funding thanks to a $1.5 million anonymous donation through the Ottawa Community Foundation. Her focus is on repetitive transcranial magnetic stimulation (rTMS). rTMS is a type of neuromodulation that can directly stimulate dysfunctional brain circuits specific to a given mental illness. At the CBRC, we are combining rTMS with brain imaging to improve treatment targeting; each client’s treatment will be more personalized.
“Neuromodulation offers us a whole new way of looking at mental health treatment, where we can identify key circuits in the brain and effectively target them in a non-drug, non-invasive way,” says Tremblay. “Research in this area is leading to a better, more personalized standard of care for patients with depression and related mental health disorders, for whom traditional treatments haven’t worked.”
This innovative treatment has been shown to be effective for treatment-resistant depression, and has been approved by Health Canada. The treatment is not publicly funded in Ontario, making research streams the only potential access to this treatment for patients in the province.
Thanks to the significant donation to our foundation, Tremblay was able to increase the capacity of an rTMS clinical trial by doubling the number of clients that can receive rTMS treatment yearly. In the long term, this will also allow the implementation of different types of rTMS treatments for individuals with treatment-resistant depression as well as for individuals living with other mental health disorders such as post-traumatic stress disorder. Read more about the exciting research supported by this donation.
Esketamine clinic
The World Health Organization estimates that by the year 2030, depression will have the largest global burden of disease. One in six Canadians are diagnosed with depression at some point in their lives and up to one third of them will not respond to existing treatments.
In the Champlain region, an estimated 5,000 people meet criteria for treatment-resistant depression.
The discovery of the rapid antidepressant effects of ketamine has been hailed as the most important breakthrough in depression in the past half century and has been proven to be a life-changing – even life-saving – intervention for people with treatment-resistant depression.
Esketamine – a non-invasive nasal spray form of ketamine – is used together with an oral medication for clients with treatment-resistant depression.
In 2021, The Royal successfully launched a pilot esketamine clinic. The service is modeled on best practices in integrating patient care, research, education, and collaboration. Interdisciplinary expertise offers innovative, measurement-based, evidence-informed care that is fully integrated with research.
The goal now is to expand capacity and offer increased access to the clinic, develop additional research opportunities, and link the clinic to other available treatments and services at The Royal to maximize therapeutic outcomes and client satisfaction.
“Rapid-acting treatment strategies like esketamine offer clients access to specialized care,” says Dr. Jennifer Phillips, a scientist in the Mood Disorders Research Unit at the IMHR. “We hope to offer esketamine as part of a comprehensive treatment plan to provide clients with the opportunity to harness the rapid improvement in symptoms seen with esketamine to support their longer-term recovery from depression.”
