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Visual based on images from McGill University for the Advancement of Learning Volume II by Stanley Price, Memories and profiles of McGill University by MacKay L. Smith and the McGill Archives.

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In recent years, a new movement has emerged in the mental health field, as research evidence recognizes the importance of intervening early to maximize recovery and providing targeted services for youth in the critical age group of 12 to 25. This new model aims to change the way society thinks about the mental health of young people and to strengthen the mental health system. However, this poses a challenge to the traditional Western mental health system, which splits the population into two groups: children, anyone up to the age of 18, and adults, anyone who is between 18 to 65 years old.

Stories like that of Graham Boeckh, a young person who died of complications from medication in 1986, show the traditional model to be insufficient. Boeckh did not receive appropriate care for schizophrenia after he turned 18, as he no longer fit the range for the mental health program in which he had been participating. This case indicated the need for reform in order to better meet the mental health care needs of youth.

To discuss these issues, the International Association of Youth Mental Health (IAYMH) hosted its third International Youth Mental Health Conference in Montreal on October 8. This year’s theme was “Transformations: Next Generation Youth Mental Health,” and the conference aimed to initiate a global conversation on youth involvement in mental health care, to introduce research models emerging from the youth mental health field, and to focus on transitioning from traditional mental health services to the next generation of programs and services that will better serve young people.”

Craig Hodges, one of the organizers of the 2015 IAYMH conference said, “The goal [of the conference] is to promote the work that is occurring internationally around changing mental health services and systems to be more responsive to the mental health […] needs of young people, with young people at the forefront of this change.” Hodges noted that while the conference saw more countries on board this year, it is still in its “infancy” and must continue to solicit participation from a wider span of countries.

For the three days of the conference, delegates representing various disciplines from countries such as the UK, Australia, the U.S., and Canada gathered to discuss youth reform and mental health. The conference offered a variety of workshops, speeches, and presentations covering a plethora of topics from mental health stigma, the idea social media in suicide prevention, and research, to meaningful engagement of young people.
Each workshop took the full day, and during each of the workshops, delegates formed small groups to share ideas and brainstorm solutions to their specific challenges.

For example, Amanda Costa, a research project director at the Transitions Research and Training Center (RTC) of the University of Massachusetts Medical School, said at the Youth Engagement workshop, “[At RTC, we have] the College Annual Internship Program, [which involves] young adults from local universities to come work with us through the entire school semester for academic credit. [This helps them] learn about what it means to work in the mental health field as a partner, and then they can share their experience with other college students.”

Some of the students who attended the conference had a very positive experience. “Thursday’s Youth Engagement workshop was beautiful. I especially liked the speaker Ashley Tritt, who highlighted the importance of not tokenizing youth and keeping feedback anonymous,” Jimmy Tan, a McGill student who attended the conference told The Daily.

However, Karen Young, a University of Toronto Scarborough (UTSC) student, expressed that the content of the conference did not do enough to address intersectionality, and that there was not a fair representation of minority profiles. “For instance […] this year’s International Youth Mental Health Conference [had] only English-speaking countries represented at the plenary and keynote aspects,” Young told The Daily.

Indeed, as Young pointed out, the conversation about mental health needs to be inclusive to everyone, and the International Youth Mental Health conference was largely attended by English-speaking Commonwealth countries, with only a relatively small percentage of attendees being youth themselves.

The small turnout of youth was largely due to the high cost to attend, with the student concession price being just under $500 without the workshop, and over $500 including workshop participation. Youth who do not have student status and do not fulfill other criteria to receive the concession discount needed to pay the full price of around $900.
“So many diverse populations could not attend because of the hefty conference cost,” Tan told The Daily. Tan also mentioned that the conference had a lack of representation from high school policy makers – there was a disproportionate number of post-secondary personnel in comparison.

In the end, this conference was just one aspect of the broader global movement to include youth perspectives in mental health research and increase youth access to mental health services. This is crucial to the field of mental health care, where services to youth are gravely insufficient to meet the needs of young people. However, the conversation will have to include a variety of people, countries, cultures, and backgrounds to be representative of the diverse mental health needs of youth and successfully create solutions to this problem.

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In recent months, Ebola has been portrayed as a serious epidemic in West Africa. According to the presentation, the epidemic was declared last March, and the first cases were reported in Guinea. After this, the epidemic spread rapidly throughout Guinea and to the surrounding countries. Since then, the outbreak has affected Sierra Leone, Nigeria, and Liberia, and has killed more that 3,000 people, causing panic in West Africa and raising international concerns.

Lacombe addressed the Ebola scare created by media outlets, which have been exaggerating facts and spreading paranoia ever since the outbreak started. At the time, the healthcare system of the region was extremely weak, which is why doctors from Médecins Sans Frontières (MSF) had already been established and working in West Africa for some time. Lack of knowledge about the virus as well as misconceptions about its contagiousness led to widespread fear – the local media in Guinea even stated that contracting Ebola would result in certain death. “Fear and incomprehension led to patients not going to treatment centres, hence spreading the virus further, and causing cases of contact [to be] hidden, as well as the ostracization of the survivors,” said Lacombe.

While there is no cure for Ebola, according to the World Health Organization (WHO) the mortality rate of Ebola can vary between 25 and 90 per cent. Lacombe explained supportive treatments, such as maintaining oxygen status and blood pressure, making sure the patient is hydrated, and keeping their electrolytes balanced, can greatly increase the survival rate of the disease. This shows the essential need for treatment centres in affected regions.

The recent outbreak came as a shock to many as it occurred on a larger scale than previous ones. Addressing this shock, Lacombe stated that in addition to “fear of the disease, there are also cultural implications and operational implications.” Time reported that cultural practices that involve physical contact such as burial rituals largely account for the increase in cases of people contracting Ebola, as the virus is transmitted through contact with bodily fluids. In addition, there is a limited number of deployable medical teams. On this note, Lacombe also mentioned how the high turnover rate of international medical and logistical staff created a lack of institutional memory over time in dealing with the outbreak.

“We need to find new ways to communicate about the disease […] and to improve our understanding about it.” Realizing this, MSF has since changed its approach to the disease, tackling it as a social rather than a medical problem. The organization been meeting with local community leaders to provide them with information on Ebola, as well as increasing transparency by giving patients cell phones so they can communicate with concerned relatives. They have also filmed raw footage to show what happens in treatment centres, all in an effort to counter misinformation, false perceptions, and panic.

Yansouni spoke about the harm in taking too many medical precautions, and warned how the hysteria in trying to contain the spreading of Ebola is raising concerns about the preparedness and ability of the healthcare system here in Montreal. “A lot of the time more protection gives you either a false sense of security, or it displaces your attention to where you really need to be careful,” he said. For example, in the case of Ebola, taking the extra precaution of assuming it is airborne could lead to accidental transmission by bodily fluids, which is actually how the virus is transmitted.

The crux of the issue in Montreal lies in the worry that people from affected regions are at risk of having the disease and potentially spreading it. This belief has a significant effect on the way Montreal hospitals treat people from West Africa. In an overwhelming number of cases, the patients may not have Ebola, but may have something else like malaria or leukemia. But because of the recent West Africa outbreak of Ebola, anyone who has visited the region is automatically suspected of Ebola. Yansouni warns that a false assumption could lead doctors to inaccurately diagnose patients and recommends everyone take reasonable precautions.

Although it remains to be seen whether or not this recent Ebola outbreak will transmit to Canada, it has served as wake-up call to our healthcare system and sparked questions on how it deals with infectious diseases.

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“This is really the last stage of what has been an immensely long project, starting from the early 2000s and beating so many obstacles along the way [such as] lack of institutional support [and] lack of faculty support. It was really a big student push that catalyzed this.”

Claire Stewart-Kanigan, Arts Senator

After around a decade of advocacy and struggle, McGill finally approved the Indigenous Studies minor at a Senate meeting on February 19. The minor, which will start being offered in the 2014-15 academic year, will provide a chance for Indigenous and non-Indigenous students to learn about history, culture, and worldviews, and develop a broader understanding of contemporary issues. Student groups have supported the minor this year, such as when the Arts Undergraduate Society (AUS) passed a motion regarding support for an Indigenous Studies program, but this is not the only support it has garnered.

Since the early 2000s, advocates have been pressing for the establishment of an Indigenous Studies minor, but were constantly faced with hurdles, such as lack of support from both the University and the Faculty. Since many other universities around Canada have comparable programs, some established as early as 1969, the creation of this minor is a long-overdue step at McGill. The University is complicit in colonialism, which is still ongoing: investment in resource exploitation plans in Northern Quebec is one example. Proponents see this minor as a first step toward a better relationship with Indigenous people, whose rights are still abused by the government and many institutions to this day.

—Joelle Dahm

“It’s not about doing more with less. It’s about finding things we don’t need to do anymore.”

Christopher Manfredi, Dean of Arts

2013-14 saw continued debate over the People, Processes & Partnerships initiative, the Arts faculty plan that would restructure Leacock and adjacent Arts buildings in order to consolidate administrative positions within the faculty. The discussion began in 2012-13 when the faculty unveiled plans to create administrative “hubs” within the Leacock building, though it has since backed down from its proposal to turn the third floor of Leacock into a reception area. This year has seen a continuation of question-and-answer periods and presentations to AUS Council, coming on the heels of last year’s complaints that the faculty had not done enough to elicit feedback from the Arts community.

Critics of the plan, including students, faculty, and non-academic staff, have cited failed examples at other universities. They have also expressed doubt over the feasibility of increased workload for administrative staff, if they were to become responsible for several departments instead of a single department. The administration continues to cite the context of austerity and the Quebec provincial government’s imposed hiring freeze on administrative positions as reasons for moving ahead with the plan. As of November 2013, the plan includes creating two administrative hubs in the Leacock building.

The proposed changes to the departmental structure and organization within the Leacock building are set against the backdrop of parallel changes made at the Ferrier building and 688 Sherbrooke. The Department of East Asian Studies was moved out of its rowhouse on McTavish last summer to 688 Sherbrooke, and the Department of Jewish Studies is expected to follow suit by moving into the Leacock building.

—Anqi Zhang

“A diagnosis can have a major impact on the way one lives, and yet here we have groups of people who can’t access resources if they don’t fit into the proper category.”

Ethan Macdonald, Inclusive Mental Health Collective

The past decade has seen a dramatic major increase in students seeking help at the McGill Mental Health Services (MMHS), following the larger trend of increased mental health issues among university students. Attempts have been made in recent years to improve services at MMHS, with the implementation of non-medicinal anxiety treatment, mindfulness groups, and an eating disorder treatment program. Yet, MMHS’ shortage of staff and expedited care require additional funding and structural reconfiguration in order to address the needs of students who may require long-term care.

Moreover, both Mental Health and Counselling Services, which receive funding from Student Services, have recently suffered a loss of almost $500,000 as a result of the university-wide budget cut. These cuts have put additional strain on an already struggling system. As a result of this, a $20 registration fee for Mental Health and Counselling services was implemented in September 2013. It was removed later in the month after being brought forward to the Fee Advisory Committee in September, since the fee was not approved in a student referendum. Officials from the Mental Health Counselling Services, however, noted that this would not have an impact on the quality of mental health services within McGill.

This February, a new mental health policy focused on creating a mental health network of student resources was adopted by the SSMU Legislative Council. The adopted policy includes a five-year plan, which aims to hire a SSMU mental health coordinator, improve student-accessible resources on mental health, and increase awareness and advocacy of mental health on campus.

—Diana Kwon and Alice Shen

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This is mainly due to the limitations of approaches that introduce technology into the healthcare system, as pointed out in an article in Technology Innovation Management Review by Jeeshan Chowdhury, a researcher on health information systems. Specifically, large-scale applications, implemented by government or corporate organizations, require a long time to develop, and a large maintenance budget. An example of this is OACIS (Open Architecture Clinical Information System), an electronic health record system used by the McGill University Health Centre (MUHC) hospitals. Because these systems are often geared toward data collection, they do not serve the specific needs of health professionals for patient care and are often inconvenient to use. On the other hand, smaller applications initiated by software developers are more user-friendly and affordable in comparison, but they tend to focus more on self-help or fitness and wellness, and lack systematic testing. Therefore, during the implementation of these approaches, fundamental medical and clinical practices are often not addressed.

Between February 21 and 23, over 500 individuals gathered to participate in a healthcare-oriented hackathon that aimed to bridge the social and technical barriers among experts across the fields of medicine, technology, and design, to fulfill the growing need for innovation. The event was organized by Hacking Health Montreal in collaboration with HEC Montréal (École des Hautes Études Commerciales de Montréal) and Sainte-Justine’s Hospital, where the participants gathered for a focused and collaborative journey to develop working technological prototypes to target healthcare issues. According to Etienne Langace, one of this year’s organizers, this was in fact one of the biggest and most attended healthcare hackathons in the world.

During the event, teams pitched ideas and developed prototypes for demonstration, which were scored by a judging panel at the end of the weekend. Examples of prototypes ranged from cutting edge diagnostic tools for early autism to mobile-based applications for nurses to organize patient information.

The event provided a way to initiate team momentum by facilitating team communication, management, and business plan formulation. Although the organizers of Hacking Health attempted to promote team formation prior to the start of the event, the amount of time available to develop the projects was extremely limited, and insufficient to develop large-scale projects. In response to concerns about how impactful Hacking Health was, participants of one of the winning teams, “Justine Time,” told The Daily, “It was [a] great [place] to meet people, and get the team started […] but it’s really now that we are actually developing the product and thinking about long-term developments.”

“The crux is what happens after […] about half of the participants end up continuing their Hacking Health projects with their team after the event,” Lagace told The Daily. While Hacking Health events aim to be impactful on targeting healthcare issues, the reality sometimes falls short of what they claim to deliver. Considering the guidance and support that is required long after the weekend-long event is over, Hacking Health’s current lack of empirical data on the long-term impact to generate lasting entrepreneurship implies that a structured support system for the start-up teams is yet to be put in place.

Another problem that arises from bringing together experts of very specialized fields such as computer programming, design, and medicine, is that often there isn’t enough experience on managing the transition of the project into a business plan. This can potentially limit the start-up teams from obtaining meaningful economic returns.
Though hackathons hold irreplaceable value in bringing experts together, they still have a way to go to establish a structure for lasting impact.

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In an effort to improve the condition of those who suffer from PTSD, Alain Brunet, a professor in psychiatry at McGill, and many leading researchers in the field, have been investigating the use of the drug propranolol for treating and preventing PTSD.

According to the National Institute for Mental Health, PTSD is characterized by three categories of symptoms: re-experiencing (flashbacks, bad dreams, and frightening thoughts), avoidance (emotional, mental, and physical), and hyperarousal (insomnia, angry bursts, and tenseness).

Treatments for PTSD include psychological therapies, such as cognitive behavioural therapy and pharmacological intervention; however, many patients (around 40 to 50 per cent) do not respond to these standard treatments, urging novel treatment methods to be explored. Research over the past decade has identified propranolol as a promising drug to attenuate the emotional responses associated with memories of traumatic experiences.

Research over the past decade has identified propranolol as a promising drug to attenuate the emotional responses associated with memories of traumatic experiences.

Propranolol, a beta-adrenergic blocker that is commonly used to treat hypertension and anxiety disorder, utilizes its intrinsic property to block the binding of the hormones epinephrine and norepinephrine to the receptors in the brain. While there are many theories of how the drug works in the scientific literature, the precise mechanism of propranolol is not fully understood.

Both animal and clinical studies have shown that those administered with controlled doses of propranolol exhibit consistent decrease in emotional response to fearful memory recall. Brunet says, “As clinical psychologists, [we] ask whether the drug works, and we leave the how does it work question to the animal psychologists.” Recently, propranolol has been found to block a number of protein activities at the molecular level that ultimately prevent memory reconsolidation.

A common misconception of this drug is its non-selectivity for memory control; many question whether it suppresses more than just the targeted memories. In order to dispel such myths, Brunet’s lab designed a double blind study to assess the drug’s effect on patients’ factual and emotional memories. They dispensed propranolol to people with PTSD or a placebo once per week for six weeks, and discovered that individuals who were given propranolol retained their ability to describe the traumatic events taking place, but had little emotional reaction compared to those who were given placebo. In other words, their factual memories were not directly affected by the treatment. Furthermore, Brunet reported no other side effect of the drug from his patients. On the other hand, while the drug has no adverse effect on memory, further investigation needs to be done on its selectivity on emotion, including, but not limited to, reactions to traumatic events.

A common misconception of this drug is its non-selectivity for memory control; many question whether it suppresses more than just the targeted memories.

The emotion-suppressing effect of the drug may be fitting to the treatment of PTSD, but there are legal implications. As addressed in a paper published in the Journal of Law, Medicine & Ethics, the authors raise the concern that in cases of sexual assault, victims may lose validity in their testimonies due to their relative indifference to their experiences and thus be less convincing when presented as evidence in legal trials. Brunet defends these implications by comparing propranolol to other existing psychiatric treatments, including those that do not involve direct chemicals interventions in the patient’s brain, such as cognitive therapy.

Brunet explains that any treatment for PTSD is aimed at removing the patients’ burden of having the pathological reactions to past traumatic events, in order to restore patients to their mental and behavioural state prior to the trauma. Consequently, the medical objective of treatments does not preclude legal proceedings – as the objective facts are still present, one should not require patients to suffer just to fulfill certain emotional expectations in court.

The medical potential of propranolol extends beyond PTSD, and is presently being studied by many institutions other than McGill. For example, a research group at the University of Cambridge is investigating propranolol’s effectiveness in treating drug addiction. Though it is important to stay informed on one’s drug subscription, it is also important to distinguish myths from facts. It seems ironic that while Prozac abuse is so common in society, newer drugs like propranolol – arguably with greater medical value, and fewer side effects – are irrationally feared and thus overlooked.

The medical institution advances on scientific fact, not fear and lack of understanding. Brunet does not deny potential risks and concerns of propranolol – as mentioned, its effects are yet to be clarified, and there are certainly concerns about its abuse – but one does not stop at just any doubt. On the contrary, current debates on the drug are precisely why institutions exist: to discover truths, to dispel myths, and ultimately, to better lives. As is the case with all medication, only by understanding the exact nature of the drug can society tailor the production, distribution, and control procedures to balance the risks and benefits of propranolol.

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