Stades cliniques et soins échelonnés des troubles de santé mentale des jeunes : de la neurobiologie à l'évaluation des services

 

Jai Shah

Centre de recherche de l'IUSM Douglas

 

Domaine : neurosciences, santé mentale et toxicomanies

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2019-2020

Until now, mental health diagnoses and interventions have been organized around classic, fully-formed psychiatric disorders.  However, a more proactive mental health system would focus on identifying, preventing and treating mental illness during the developmental period when its earliest signs and symptoms emerge and evolve: adolescence and young adulthood.  This transformation, if it were to occur, would likely improve access to care precisely when it is weakest and most needed.

A reconfigured, developmentally aware mental health system would likely involve two key elements: 1) a reliable approach to staging mental illness severity that takes into account data beyond the immediate clinical presentation; 2) this would allow clinicians to select interventions that are likely to yield greatest benefit with the least amount of risk.  In other words, an improved understanding of stages of illness and the 'stepping' of interventions up and down according to stage would dramatically advance the field.

In order to achieve this, my program of research adopts approaches ranging from neurobiology to health services evaluation to improve youth mental health.  First, it aims to understand and improve clinical staging in severe mental illness – and specifically the earliest stages of schizophrenia and related psychoses.  Second, it undertakes multiple forms of evaluation of emerging models of stepped care for youth mental health settings.  These studies are possible through my key involvement in PEPP-Montréal, an internationally recognized clinical research infrastructure for early psychosis; and in ACCESS Open Minds, a major patient-oriented platform for youth mental service reform.