Section Research Updates

Report on projects currently underway or in active planning and the report is arranged by subsection for clarity.

Acute Care

Examining Attitudes Towards Injectable Psychiatric Medications in Women Undergoing Acute Mental Healthcare.

• This mixed-methods study explores how cultural influences shape women's attitudes toward long-acting injectable (LAI) antipsychotic medications. By surveying and interviewing a diverse sample, with a focus on Black Canadian and African Nova Scotian women, the research aims to inform culturally competent healthcare practices for LAI medication acceptance.
• PI: Mutiat Sulyman
• Team: Muhammad Naqvi (Research Assistant), Jennifer Emesih (Trainee), Sanjana Sridharan (Sub-investigator), Candice Crocker (Sub-investigator), Matthew Knox (Sub-investigator)
• REB approval received, DPRF grant awarded, recruitment underway (and observations from this led to #4 below)

Impact on Length of Stay and Symptomatic Recovery of Seclusion Versus Chemical Restraint in an Inpatient Acute Care Unit.

• This study evaluates the use of coercive methods like seclusion and chemical restraint in psychiatric care within Central Zone, Nova Scotia Health. By analyzing patient outcomes, hospital stay duration, and policy impacts through chart reviews and interviews, the research aims to inform policy improvements and promote compassionate mental healthcare.
• PI: Sanjana Sridharan
• Team: Muhammad Naqvi (Research Assistant), Mutiat Sulyman (Sub-Investigator), Candice Crocker (Sub-Investigator), Ashwini More (Med student), Matthew Knox (Sub-Investigator), Niamh Campbell (Resident), Joseph Saunders (Resident), Julia LeBlanc (Med student)
• REB submitted January 16^th, 2025. Working on REB feedback, aiming for re-submission by end of March.

Day Hospital Service Delivery – Is a Multi-Level Approach to Care Effective in Preventing Re-admission and Improving Engagement to Continuing Mental Health Care?

• This QI project evaluated the effectiveness of NSH's acute care day hospital program, launched on April 1, 2022.
• Internal report under review internally.
• Entire Day Hospital team pitched in with this one.

Day Hospital Clozapine Use

• PI: Anthony Pianosi
• Team: Section leadership helping with design. Team not pinned down.
• Design phase started in Dec 2024. REB projected for submission start April 2025, further details to follow in time.

Gender and Sex Distribution in Acute Care Admissions

• PIs: Sanjana Sridharan & Candice Crocker
• Team: Joey Nosko (graduate student)
• QI application submitted; rapid review evidence synthesis begun (Joey Nosko independent study).
• Planned product is an internal report for QI and a manuscript for the rapid review. Full REB/project planned if bias found.

Use of Psychiatric In-Home Care

• Manuscript outlined with rapid review evidence synthesis and integrated case study as the plan for this publication.
• Literature searches developed.
• PI: Sanjana Sridharan
• Team: Muhammad Navqi (RA) and looking for learners to attach to this one.

Case study manuscript (new this month)

• Dr Sridharan in consultation with Neurology is preparing a case study on an unusual presentation of multiple sclerosis. Patient consent for this manuscript has been obtained.

Psychiatric Emergency Service

Assessing the Applicability of the SMART Medical Checklist in the Assessment of Psychiatric Patients in the Emergency Department: A Retrospective Cohort Chart Review  

• This retrospective cohort chart review examines the impact of the SMART medical clearance checklist on psychiatric emergency department assessments. By analyzing 1000–1500 patient charts from 2023, the study aims to determine whether the tool could reduce medical workups and emergency wait times, with findings potentially informing procedural improvements.
• PI: Shiloh Gossen
• Team: Muhammad Naqvi (Research Assistant), Michelle MacDonald (Sub-Investigator), Emma Hazelton-Povo (Sub-Investigator), Louise Moodie (Sub-Investigator)
• REB approved January 8^th, 2025
• Muhammad assisting residents with data extraction methods.

Race and Ethnicity as Moderators to Likelihood of Psychiatric Admission From ED

• PI: Shiloh Gossen or Michelle Macdonald
• Team: Qendresa Sahiti (Resident) & Renaj Forbes (Medical Student)
• Design in progress. First project consultation was Jan. 17, 2025.

Investigation of Outcomes after Thoracic Surgery for Malignancy in Patients with Severe and Persistent Mental Illness (SPMI)

• Shiloh Gossen is finalizing a manuscript based on a project from her residency and remains actively involved in the collaboration.

Consultation Liaison

Perinatal Mental Health Care

Attitudes, Beliefs, and Practices of Healthcare Providers Regarding Birth Plans and Mental Health, and Healthcare Providers' Perceptions of the Correlation Between the Two.

• This cross-sectional study examines healthcare providers' attitudes and practices regarding birth plans and maternal mental health in Saudi Arabia and Canada. Using an online survey distributed via REDCap and social platforms, the study aims to assess providers' perspectives, competency in mental health assessment, and alignment with patient needs to improve childbirth care standards.
• PI: Awateif Alsupiany (Fellow, Tania Tulipan supervising)
• Team: Muhammad Naqvi (Research Assistant), Candice Crocker (Sub-Investigator), Nicole Herschenhous (Supervising Investigator), Tanya Tulipan (Sub-Investigator)
• IWK REB approval received on January 29^th, 2025

Transition Hall

This one has had a few bumps but design discussions restarted in December and underway for project to measure efficacy of program. This will require REB as manuscript is stated aim. PI will be Curt Peters.

Neuropsychiatry

Systematic reviews:

• One systematic review and Meta-analysis: Still in the abstract screening phase.
• One other systematic review on neuropsychiatry and epilepsy: abstract screening done, approximately 20 full-text articles left to review.  Fellow also involved in this project.

Survey projects:

• Structures of Neuropsychiatric services in Canada –data collection, ongoing survey project.
• Neuropsychiatry day education module survey for effectiveness – pre-post survey, first draft of manuscript prepared.

Knowledge Translation

No new items this month. Items from previous months collected in a separate document for year end report.

Overview:

Pipeline established. Design phases take longer than desired currently. Have reached out to more individuals across the sections to recruit more “research reluctant or inexperienced” faculty. Key: Design phase, REB indicates REB review underway, Active all approvals from REB and project underway, Manuscripts indicates manuscripts being drafted or under review. Grant applications are grants currently held or awarded.  Knowledge translation is dissemination other than manuscripts such as presentations, reports etc.

 

Primary Care Project in CMHA

Investigators:

• PI: Dr. Greg MacMullin
• Others:  CMHA CALs, Aaron Keshen, Bill Bradley, David Gardner

Aim

• To measure the extent of primacy care activities being conducted by clinicians (psychiatrists, other MDs, nurses) in Community Mental Health and Addictions clinics.

Method

• Prospective study, ~500 patient encounters

Status

• REB returned with minimal edits requested, submitting revisions early next week.
• Testing data collection form in select clinics for ease of use in January.
• Creating training and recruitment package for participants.

Rehabilitation Project

Investigators

• Drs. Mahmoud Awara and Josh Green

Aim

• To assess psychiatric rehabilitation programming for patients with severe persistent mental illness (SPMI).

Method

• Mirror image study – health resource use before vs. after rehab
• Database study using NSHealth mental health and addictions data

Status

• Received departmental funding.
• In discussions with Patryk Simon, to confirm the work they would be assisting with in extracting data from databases. Awaiting response.

Complexity Assessment Project

Investigators

• Dr. Shannon MacDonald and Donalda Edgar, Dartmouth Community Mental Health and Addictions clinic 

Aim

• To develop and implement a novel complexity assessment tool to identify patients with more complex health care needs and coordinate their care with greater efficiency.

Method

• Tool development and testing
• Delphi 

Status

• Finalizing spreadsheet of measures/scales that capture the psychosocial information we are looking to capture, to determine what scales will be used.
• Sent request to scale author for permission of use.
• Scheduling follow up meeting for February to do first round of evaluations of measures.

Prazosin Shortage Case Series

Investigators

• PI: Dr. Sonia Detillieux, OSI
• Others: Dr. Rami Rudnick, Leigh Meldrum

Aim

• With a shortage of Prazosin (evidence-based medication for trauma related nightmares), OSI clinicians have been prescribing alternatives (doxazosin or terazosin) and getting similar positive reports from patients. Are interested in detailing this in a case series. 

Status

• Data extraction form finalized.
• Writing background portion on literature so far
• Created informed consent form to be distributed to eligible case series participants.
• Sonia and team underway with contacting eligible patients for consent, once contacted will submit for REB case series exemption.

BPD Clinic Research (Deborah Parker & Marie-Eve Couture)

Aim

• To restart research within this program, by first uploading paper data from 2019 to an electronic database and look into possible projects with this data.

Status

• Will be posting an ad soon to recruit undergraduate student volunteers to assist with data entry. Lucy will act as coordinator for this.
• Lucy completed the first session with data to familiarize. Will do a couple more sessions to get comfortable before recruiting students.

PCTEL CBT-i project (PCTEL team/Susan Jerrott)

Aim

• Review implementation process of PCTEL's CBT-i training with clinicians and effectiveness.

Status

• Finalizing project proposal for Susan to share with colleagues who have previously completed the CBT-i training.

Cognitive Remediation Group (Mairi Mcguire/Connections Sackville)

Aim

• Interested in looking at studying the relationship between participation in cognitive remediation therapy and functional rehabilitation.

Status

• Very early stages, team is looking at their specific research questions, and who would participate in this project. Will get back to us.

Diagnosis of ASD and ADHD Workshop (Sandra Murphy/Gina Kokoska of CMHA Cole Harbour)

Aim

• They have received funding to conduct a workshop on diagnosing ASD and ADHD, along with evidence-based treatments.

Status

• Lucy conducted a literature review for them on practices so far, prevalence, treatments, etc.
• Workshop presented to Cole Habour CMHA team by Sandra and Gina.

Additional Items

• Met with Dr. Jackie Kinley to discuss recruitment strategies for her staff survey.
• Meeting next week with Kait Sullivan from Connections Halifax to discuss possible research.
• Organizing a meeting with new community psychiatrists (Drs. Hashmi and Babalola) to introduce section research offerings.

The Research Assistant has been busy trying to determine the best way to capture the data that has been collected to date. We have narrowed down a platform to use for a robust, dedicated database (MS SQL Server) after carefully reviewing current options and considering things like partnerships NSHA already has and recommendations from the database management team. In the meantime, RedCap/MS Forms are being considered for data entry purposes.

We have begun entering the Dynamic Appraisal of Situational Aggression (DASA) data and we are to the point where we have a good flow for it. Two volunteers are assisting with data entry prospectively, allowing the research assistant to focus on entering retrospective data. We should hopefully have the most recent 30 days of scores for all patients in a few weeks and going forward.  

The purpose of capturing this data in this way will be to examine for changes prior to and after restructuring of the model of care. More assessment measures (e.g., DUNDRUM) will be added.              

Study of Cognitive Behaviour Therapy for Older Adults with Late-Life Depression

Investigators:

• PI: Dr. Keri-Leigh Cassidy
• Others: Amy Gough, Karen Cochrane, Mark Bosma, Gail Eskes, Marilyn Cipak, Luc Rivet

Funding: NS Health Research Fund

Aim

• To determine the efficacy of an enhanced form of Cognitive Behaviour Therapy for older adults with late-life depression as compared to being on the waitlist for treatment

Method

• Randomized controlled trial, target recruitment of n=50 patients

Status

• REB application and trial registration on clinicaltrials.gov in progress
• Completing edits on participant and therapist manuals by March
• Aiming to start recruitment in early Summer 2025

Capacity Assessment Simulation Project

Investigators

• Drs. Kathleen Singh, Mark Bosma, Cheryl Murphy
• Others: Mandy Esliger, Maia von Maltzahn, Cindy Shearer, Luc Rivet

Aim

• To develop simulation workshop to teach Geriatric Psychiatry and Geriatric Medicine residents capacity assessment in the domains of making financial and personal care decisions

Method

• Workshop consisting of simulated patients and adult children for residents to assess

Status

• Completed; Paper submitted at the end of 2024 as an Educational Case Report to Academic Psychiatry

Scoping Review of Hidden Curriculum in Medical Education

Investigators

• Drs. Kathleen Singh, Mark Bosma, Cheryl Murphy
• Others: Mae-Lin de Lange, Luc Rivet

Aim

• To review the hidden curriculum (ageism, stereotypes, discrimination, etc.) in caring for older adults that medical trainees may be exposed to at any level of training

Method

• Systematic scoping review

Status

• Currently screening papers and resolving conflicts on Covidence
• Completing review registration on Open Science Framework

Developing an Educational Package for Geriatric Nurses in an In-Patient Hospital Setting

• Principal Investigator: Dr. Meagan MacNeil
• Others:  Dr. Mark Bosma, Marilyn Cipak, Lucette Mornay

Aim

• To develop an education series for inpatient acute unit staff

Method

• Needs survey to staff to assess confidence and interest in relevant topics
• Develop education series
• Evaluate effectiveness

Status

• Needs survey completed
• Education series in progress

Comparing Referral Criteria of Geriatric Psychiatry Services across Canada

• Principal Investigator: Dr. Mackenzie Armstrong
  
• Others: Dr. Mark Bosma, Dr. Cheryl Murphy

Aim

• To summarize and compare current referral criteria for Geriatric Psychiatry services in academic health centres across Canada

Method

• Semi-structured survey of academic centres

Status

• Completed
• Presented at CAGP, Psychiatry Research Day

Integrated video simulation and role play: Exploring a novel faculty development approach to teach assessment and feedback skills.

• Principal Investigator: Dr. Mark Bosma
• Others:  Dr. Cheryl Murphy, Mandy Esliger

Aim

• To assess effectiveness of a novel educational intervention to teach faculty to provide effective feedback in a CBME environment

Method

• Multiple workshops/seminars with various medical specialties followed with data collected via focus groups

Status

• Completed
• Presented at ICAM, ICRE, and AAP
• In process of finalizing manuscript to submit for publication