Issue 2017
Pathways

Pathways — the UBC Faculty of Medicine’s digital magazine — shares stories about learning, discovery and innovation that are making a difference in B.C. communities and around the world. Discover the impact of our global-leading health research and education.

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Mental Health & Addictions

Hope on the horizon

As a child, the image of flames engulfing her home — of her mother not being able to escape the thick, carbon smoke — tormented Andrea for years.

But the fire, visited over and over in her mind, was one that had never taken place.

“As a kid, I was always really anxious,” says Andrea. “I was worried about leaving the house, about a fire starting, about something happening to my mother.”

As a teenager, Andrea used substances to muffle her world, turned to self-harm to quiet the intensity of her emotions, and binged and purged to cope with her reality. She walked alone, she says, for a long time.

“I didn’t want anyone to know what I was thinking so I just focused on supressing my thoughts and feelings,” recalls Andrea. “But the older I got, the more severe my anxiety and depression became. Now I see that I was just in desperate need of help.”

Each day across British Columbia, families and communities are coping with mental illness, confronting substance use and addiction in their homes and on the streets, and grappling with the swift rise of overdose deaths.

Never before has B.C. seen a public health emergency of this magnitude.

Knowing the critical role that research and education can play in improving health and saving lives, the UBC Faculty of Medicine is asking, what can be done to transform care and build hope and promise for the future – for families, communities and individuals like Andrea?

Chapter 1 Shaping a new world

It wasn’t long after he started working as a child and adolescent psychiatrist at St. Paul’s Hospital and Covenant House in Vancouver that Steve Mathias realized he couldn’t help everyone.

It was a realization that would haunt and preoccupy him for years.

“I saw a lot of young people with mental health issues and problematic substance use coming through the doors at age 21 or 22.”— Dr. Steve Mathias

“I saw a lot of young people with mental health issues and problematic substance use coming through the doors at age 21 or 22 and, in a lot of cases, there was very little I could do for them over the long term,” says Dr. Mathias, a UBC graduate and clinical assistant professor in the Faculty of Medicine's Department of Psychiatry.

Many of his patients were living on the street, had dropped out of high school and had lost touch with family.

Steve Mathias and Skye Barbic Steve Mathias and Skye Barbic are working together to transform mental health research and services for youth and young adults.

The challenge, he recalls, was in changing the system — catching youth and young adults, like Andrea, before they were in crisis.

Today, after years of working to see more upstream interventions put in place, Dr. Mathias is serving as the Executive Director of Foundry, a new network of centres that offer integrated health and social services for youth and young adults across the province.

“They’re designed as a one-stop-shop,” he says. “Youth and young adults can walk into any Foundry location without an appointment and receive immediate access to mental health care, substance use care, primary care services, social services and peer support.”

But Dr. Mathias and his colleagues at Foundry are not just focused on delivering services. They are also working with Skye Barbic, an assistant professor in the Department of Occupational Science and Occupational Therapy at the UBC Faculty of Medicine, to build a culture of youth and family engagement in mental health research and clinical care.

“When we ask youth what it looks like to thrive in their communities, they start having whole conversations about getting work, getting better housing.”— Dr. Skye Barbic

Over the past several months, they’ve been speaking directly with youth and families to map out what health means to them.

“When we ask youth what it looks like to thrive in their communities, they start having whole conversations about getting work, getting better housing, or trying to have a more positive group of friends,” says Dr. Barbic.

While their research is still underway, Drs. Barbic and Mathias are already seeing the benefits of creating an environment where youth feel empowered to have their voices heard.

“Youth want to make a real contribution. Through this research we have a real opportunity to learn from them and ensure services are tailored to meet the full spectrum of their health needs.”

Chapter 2 Expanding the network of care providers

Loss is not something new for Evan Wood.

Over the years, as an addiction medicine physician, he’s witnessed countless individuals lose their jobs, their homes, their families and — in the most extreme cases — their lives.

The hardest days, he says, are spent listening to parents recount stories of the children they have lost to an overdose.

“In this line of business, there is no shortage of challenges, but also no shortage of motivators,” he says.

Dr. Wood, a professor of medicine and Canada Research Chair in Inner City Medicine at UBC's Faculty of Medicine is at the helm of the British Columbia Centre on Substance Use (BCCSU) — a newly-created provincial network of clinicians, educators and researchers strengthening the overall system of care for people struggling with problematic substance use and addiction.

“In this line of business, there is no shortage of challenges, but also no shortage of motivators.”— Dr. Evan Wood

As the founding director, Dr. Wood regularly meets with family support groups, people with addiction, individuals in recovery, as well as health care providers on the front lines to better inform research, training and clinical care efforts and priorities.

“We are bringing different groups together around shared goals and solutions,” he says. “By listening to each other, we’re starting to break down the silos to help accelerate addiction care and support for people in the years to come.”

But for Dr. Wood, combatting the rise of problematic substance use and addiction in B.C. over the long term will require building a larger network of care providers who are equipped with specialized skills in addiction medicine.

Evan Wood Evan Wood is leading efforts to accelerate care and support for people facing substance use and addictions.

Today, thanks to Dr. Wood’s efforts, the UBC Faculty of Medicine is working with BCCSU to lead the way — offering interdisciplinary fellowship opportunities in addiction medicine to a growing number of health care providers, including family doctors, like Leslie Lappalainen, who are at the onset of their career.

It’s this next generation of care providers who are beginning to make great strides in transforming addiction care in communities around the province, including B.C.’s Interior.

“No region is immune to this crisis,” says Dr. Lappalainen, a clinical instructor with the Faculty of Medicine who moved to Penticton after completing UBC’s enhanced skills training program in addiction medicine, followed by a one-year addiction medicine research fellowship.

“No region is immune to this crisis.”— Dr. Leslie Lappalainen

Like other past UBC trainees, Dr. Lappalainen is already putting her specialized skills to work, serving as the first Medical Lead for Addiction Medicine, Mental Health and Substance Use for Interior Health, as well as working closely with Dr. Wood and his team at BCCSU.

Leslie Lappalanien Leslie Lappalainen has travelled to communities across B.C.'s Interior to educate health care providers about the new provincial opioid treatment guidelines.

In fact, when she’s not supporting patients at an outreach clinic in Penticton, she can be found clocking miles on the open road. In the last several months, Dr. Lappalainen has been to Kelowna, Kamloops, Salmon Arm, Vernon, Cranbrook, Fernie, and Nelson to educate health care providers about new provincial opioid treatment guidelines.

“It’s critical that we empower health care professionals with the knowledge and tools they need to support people struggling with addiction,” she says.

Chapter 3 Promise for the future

Today, after seeking and receiving the counselling and help she needed, Andrea, now 26, says she is one of the lucky ones to have made it to the other side of her mental health challenges.

“As someone with lived experience, I think it’s so important to engage youth and their families. Youth are the future of our communities — we need to see, value, hear and respect their experiences and understand their needs,” she says.

It’s one of the reasons she’s now working at Foundry as the youth peer engagement coordinator.

“I have always wanted to contribute something meaningful and to help other people.”— Andrea

“I have always wanted to contribute something meaningful and to help other people,” says Andrea. “And now I have an opportunity to engage with youth and work towards them being seen for their strengths and abilities, as opposed to being viewed as just someone with mental health challenges.”

Andrea Dedicated to making a difference, Andrea is now working at Foundry as the youth peer engagement coordinator.

It’s the voices and courageous paths taken by those like Andrea that inform the work underway at the UBC Faculty of Medicine.

And while the journey ahead may be long, it’s the promise of a better tomorrow that continues to drive us.

It’s why those like Dr. Wood are scaling up addiction medicine expertise through education and training, it’s why passionate care providers, like Dr. Lappalainen, are urgently responding to the public health emergency, and it’s why Drs. Mathias and Barbic are connecting directly with youth and families to transform the future of care and bring hope to generations of British Columbians to come.

It will take working together — engaging a symphony of voices and putting the patient at the centre of everything we do — to continue charting new ground on the path to improved health, hope and promise.

Snapshots

Our faculty, staff, and students are on the path to hope and promise.

Discover snapshots of their stories.

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