May 1, 2016
New ways of thinking about mental health
Researchers at the University of Calgary are working on finding strengths-based, empowering approaches to postpartum depression, Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).
Mental health affects us all. One in five Canadians will experience a mental illness over the course of their lives and all of us know someone – a friend, neighbour, family member or colleague – who has experienced a mental illness or disorder. It can strike anyone, regardless of age, gender, education or income. Seventy per cent of mental disorders first appear before the age of 18 and half even younger, before the age of 14. As many as 20 per cent of children may have a diagnosable mental illness, yet only a fraction of them will get the support they need.
Researchers at the University of Calgary are exploring a number of facets of mental health, many of them through the Mathison Centre for Mental Health Research & Education. “The research covers a pretty broad range and that’s part of our strength,” says Dr. Paul Arnold, the director of the Mathison Centre, which promotes research and education on early identification, treatment and prevention of mental disorders. “It ranges from genetic research, to the study of workplace depression, to looking at how we take the information that's being produced and put it into practice.”
Moms helping moms with postpartum depression
Postpartum depression can start during a woman’s pregnancy or at any time up to a year after the baby is born. Women feel isolated, ashamed and completely overwhelmed, which can make caring for their infants seem like too much to bear. When a mom is depressed, she is less likely to interact with her baby, which can also hinder the child’s development.
But research by University of Calgary professor Nicole Letourneau and Dr. Cindy-Lee Dennis, of the University of Toronto, is leading to a simple, practical and effective way to treat women with postpartum depression.
In a two-and-a-half year Canadian study, women with postpartum depression were matched with other mothers who had recovered from the condition. The recovered moms, called “peer mentors,” were given one or two days of training before talking to the depressed moms every week for twelve weeks. After only six or seven phone calls, 92 per cent of the women who were paired with another mom were no longer depressed. After the program ended, most women – more than 88 per cent – were no longer depressed. Many women felt better after only four weeks of phone calls.
After only six or seven phone calls, 92 per cent of the women who were paired with another mom were no longer depressed.
“Social support is an amazing thing for mental health problems,” says Letourneau, who is also Palix/ACHF Chair in Parent-Infant Mental Health in the Faculty of Nursing and a member of the Alberta Children’s Hospital Research Institute. “If you have somebody in your life who can talk to you about the symptoms and understand what you’re going through and can offer hope, that will make the difference. The women who were the peer mentors were well. They were that light at the end of the tunnel.”
Letourneau's earlier research found that women with postpartum depression are reluctant to tell people they aren’t feeling well. “There’s a huge stigma around it when you’re a mom and depressed,” she says. “For them, it was the same thing as saying ‘I’m a terrible mother. I can’t do this. I am failing,’ so they just didn’t tell anybody.”
But talking to women who have been through it and recovered, and understand what they're going through, is a powerful way to help moms with postpartum depression, says Letourneau. “They don’t have to find the words to explain how they feel. They’ve got someone who already knows. So it’s that instant kind of rapport they can get, and this person represents hope to them. And this person doesn’t judge them.”
Letourneau says that in the study, depressed mothers also didn’t have to pack up the baby (and other children) and leave the house to find help. They could talk to someone from the privacy and comfort of their own home. “Not having to go see a health provider, not having to leave the home when she has no energy, not having to go to a public place or clinic, where people are only there for mental health needs – it was just easy, non-stigmatizing and supportive, and it worked.”
The project worked so well that Innovate Calgary, the technology-transfer and business-incubation centre for the University of Calgary, is in the process of commercializing this research by working with Sykes, a company that delivers phone-based support programs, to reach women across Canada. “This support system provides a much-needed resource for women who are suffering from postpartum depression,” says Nima Najand, intellectual property manager at Innovate Calgary. “What stands out for this innovation is the societal impact it provides with its practical and beneficial solution to a worldwide problem.”
For women with postpartum depression, anti-depressants work only about half the time. Letourneau’s peer mentor program was far more effective. “What made the difference was the social support they received,” she says. “It got the incidence of depression in mothers in the study from 100 per cent down to eight.”
Things to remember:
- Talk to someone. Reach out to a friend, family member or health care professional for social support.
- Seek help. Don’t just try to ignore postpartum or any other kind of depression. It’s not going to go away on its own.
- Look for the light at the end of the tunnel. There are people who have recovered from postpartum depression who can be a beacon of hope. If you know someone like that, reach out to them.
Helping children with ADHD succeed
Researchers at the University of Calgary are getting a much better understanding of what children with Attention Deficit Hyperactivity Disorder (ADHD) need in order to succeed in the classroom, the community, and even the home.
“ADHD kids are seen in a negative light,” says Emma Climie, a registered psychologist, assistant professor, and lead researcher of the Carlson Family Research Award in ADHD in the School and Applied Child Psychology program in the Werklund School of Education.
“Teachers see their classes at the beginning of the year and think ‘I’ve got this one and this one and this one,’ and they’re gearing themselves up for a tough year,” Climie says. “But one of the things that is really important is taking a strengths-based approach to working with kids and understanding what they do well.”
“When parents work together, we see behavioural concerns at a lower level.”
Climie says that focusing on what children with ADHD can do and supporting them in areas where they’re having difficulties will help them build coping strategies, overcome challenges and build the resilience they need to succeed. Every child has “islands of competence” that can be connected. But first, a parent has to really understand their child’s ADHD so they are equipped to advocate for their child at home, in the community or at school.
“There is a lack of knowledge and a stigma that’s prevalent with ADHD and it can be very limiting,” says Climie. “Parents need information so they can share it with teachers and other people, so they have an understanding of what the disorder is, what it looks like and how they can best support their child.”
Connection is crucial
Having a connection with another adult is important to building resiliency in children, says Climie. “I talk a lot about having good social support," she says. "Having a community and a network of people to collaborate with and encouraging kids to develop important relationships with other adults in their lives, not just the parents but maybe a teacher or an aunt or uncle, is important.
“Obviously, mom and dad play a very important role but it’s important to have somebody else that they can confide in or they feel they have someone else they can go to. Sometimes kids don’t want to tell mom and dad everything that’s going on but they might be more willing to tell an aunt or grandma or a family friend.”
Climie has also found it makes a difference when children have strong relationships with their fathers. Moms are often the primary caregiver, but there are benefits when dads spend time with the kids, have open communication and help more around the house. “Moms see more stress and often take on more of the disciplinary behavior, and that’s challenging with ADHD,” Climie says. “When parents work together, we see behavioural concerns at a lower level.”
“Dr. Climie’s research can help to educate people about the ‘other side’ of ADHD, and perhaps be integrated into treatment and education programs for ADHD children,” says Emma Hoblak, an undergraduate honours student in psychology who is completing her honours thesis with Climie in the Strengths in ADHD research lab. “Often these kids are seen as being disruptive and hard to manage but it's important to note that they are often just as intelligent as children without ADHD and can be very creative.”
Things to remember:
- Seek out information about ADHD. You need information to share with teachers and advocate for your child. Check the eBook to find some resources.
- Play to your child’s strengths. Understand their areas of strength and what they do well as well as their needs.
- Encourage connection with family and other adults. Children with ADHD benefit from having close relationships with their fathers as well as other adults.
Autism spectrum disorder: The journey
Researchers at the University of Calgary are delving into autism spectrum disorder (ASD) to help people with this disability from the beginning of their lives right through to adulthood. The developmental disability affects one in every 68 children.
Suzanne Curtin is an associate professor in the Department of Psychology, in the Faculty of Arts, whose research begins with babies. “The idea is that if you can identify kids who are at risk of something, then you can hopefully get the supports they need earlier on, so they are then able to succeed,” she says.
Curtin is researching early signs and differences in infants who have an older sibling diagnosed with ASD, as these children have “elevated risks” of being diagnosed with ASD, or a language or cognitive problem. She follows infants from four months until three years of age, at which point you can get a “more stable” diagnosis for ASD.
Curtin has to wait for the children to grow up for final results to her research, but she is finding that by 12 months, children with an older sibling with ASD are not “attending to” sound patterns the same way as other children, resulting in the one-year-olds having a smaller vocabulary.
“We’re hoping we’ll be able to use this information to ultimately get a better sense of some of the underlying behaviours for ASD and use it to identify them earlier,” Curtin says. “The first three years are important building blocks of development, so the earlier you can identify potential problems or atypical behaviour, the earlier you can start to get interventions in place and give extra supports for these kids.”
Things to remember:
- Knowledge of risks. If you have a child diagnosed with ASD, their younger siblings have “elevated risks” of being diagnosed with ASD.
- Watch for certain behaviours. Behaviours such as a child not responding to their name, unable to disengage from a particular activity, upset by certain noises or textures or not producing any words by 16-24 months may indicate that the child is at risk of ASD. Don’t hesitate to contact your family doctor or pediatrician.
ASD is a marathon, not a sprint
It’s important to remember that Autism Spectrum Disorder (ASD) extends well beyond the early years. “The misnomer has been that autism is a childhood disability,” says David Nicholas, associate professor in the Faculty of Social Work at UCalgary. “It’s often identified in childhood and we expend substantial resources and focus – rightfully – on early intervention, but we can’t lose sight that this is a lifetime disability. Ensuring continued support wisely builds on that important investment in earlier years.”
Among his research programs, Nicholas looks at the impact ASD has on families. “As people move toward adulthood there is an expectation that youth will become independent and develop agency and separate from family,” he says. “Parents or other caregivers are often engaged with the support of that individual relative to their disability for the entirety of their lives.”
The community plays a crucial role helping provide holistic solutions and “wraparound” support for both the individual and their family and caregivers.
As children with ASD grow into adults, they face enormous challenges. John Seigner’s son, Anders, 24, has severe autism and is non-verbal. “All families have their share of challenges,” says Seigner. “Funding dries up and there’s the issue of what happens when the family is gone and who will take care of the kids. It’s challenging and it’s worrisome.” Seigner works with other ASD families to network, exchange ideas and give each other support.
Raising children with ASD is “a marathon over a lifetime, not a sprint,” says Nicholas. The community plays a crucial role helping provide holistic solutions and “wraparound” support for both the individual and their family and caregivers. “It’s critical to think about ways to enhance quality of life and to increase community engagement so that people aren’t isolated,” he says.
And then there’s the labour market. People with ASD are vastly underrepresented in the workplace, yet they can be “loyal fastidious employees” with many skills that can be put to work. “There is an issue of transition into adulthood and employment or vocation,” says Nicholas. Challenges in the workplace could be met with technologies such as personal assist devices that prompt workers or modifying lights or other aspects of the workplace to assist with sensory issues. Job coaching and supporting employers to understand autism could help create jobs for people with ASD.
Things to remember:
- ASD is more than a childhood disorder. People with ASD and their families need support across their lifespans.
- Seek support. Find other families in your community, who have a loved one with ASD, to share ideas and provide mutual support.
- Work with community and potential employers. People with ASD can often be productive employees, with relatively few modifications in the workplace required.
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ABOUT OUR EXPERTS
Dr, Nicole Letourneau, PhD, is professor and Norlien/ACHF Chair in Parent-Infant Mental Health at the University of Calgary’s Faculty of Nursing. Her areas of research include parenting and child development in the context of teen motherhood, family violence, substance abuse, interventions for mothers, fathers, and infants exposed to postpartum depression, and origins of fetal programming of infant stress reactivity associated with exposure to maternal depression in utero. Learn more about Nicole's work here.
Dr. Emma Climie, PhD, is assistant professor at the University of Calgary’s Werklund School of Education. Her research interests focus on a strengths-based understanding of children with ADHD and their families. She is interested in better understanding factors that allow children with ADHD to be successful at home, at school, and with their peers. Find more detail on Emma's work here.
Dr. Suzanne Curtin, PhD is associate professor at the University of Calgary’s Faculty of Arts. The goal of her research is to understand how early speech perception and word learning contributes to the acquisition of a phonetically driven phonological system. Her research focuses on speech perception abilities in both typically and atypically developing infants with a special focus on infants who are at heightened risk for ASD. Find a listing of Suzanne's academic papers here.
Dr. David Nicholas, PhD, is associate professor at the University of Calgary’s Faculty of Social Work. He is a leader in nurturing capacity building, addressing vocational issues in ASD, and building partnerships in Canada and internationally. Much of his current research focuses on seeking more equitable opportunities for obtaining and retaining employment for persons with ASD. Find a listing of David's academic papers here.