Health Services

Substance dependence and mental illness frequently co-occur, presenting challenges to treatment providers and increasing the likelihood of suicide, drug overdose, and criminal justice involvement. Assessment and treatment of concurrent disorders (CD) have been identified by police, health professionals, and the Auditor General as urgent priorities in BC, and leadership in the treatment of CD is integral to the mandate of the Provincial Health Services Authority. 

In Canada, poor mental health among Indigenous youth is an ongoing issue. This leads to high rates of suicide, addiction, violence, chronic diseases and chronic pain. A potential reason for these challenges is historical trauma linked to government policies intended to eliminate Indigenous cultures, including residential schools, the 'sixties scoop' and the child welfare system.

Abortion is a common reproductive health procedure, with nearly one-third of women in Canada having had at least one abortion. However, abortion access is not equitable. Most abortions are surgical, and are provided in a small number of facilities located in BC’s largest cities. Some women, particularly those in rural or remote regions, experience significant wait times and must travel long distances to reach abortion services.

Human papillomaviruses (HPV) can lead to cervical cancer and other anogenital, head, and neck cancers in both women and men. A safe and effective vaccine against the most common types of HPV associated with cancer was introduced in 2008 into BC’s exemplary school immunization program. However, rates of HPV vaccine uptake have remained low, with less than 70% of eligible students receiving the vaccine each year.

British Columbia is facing an unprecedented and escalating opioid crisis, underscoring the urgent need for innovative science-driven solutions. There is critical implementation gap of evidence-based care for opioid use disorder (OUD), this research will seek to narrow this gap.

First, Dr. Socias will seek to advance the implementation of evidence-base treatments for OUD, by leading a series of ongoing and planned clinical trials evaluating innovative and promising models of care (e.g., take-home strategies) and alternate treatment options (e.g., slow-release oral morphine).

Stroke is a leading cause of death and disability in Canada, costing our economy $3.6 billion per year. More than 405,000 people are currently living with the effects of stroke. This number is expected to rise to 720,000 by 2038.

Dr. Hanley's research in women's reproductive health uses the large population-based datasets that already exist in British Columbia, and is driven by diverse training in population and public health, health services research, and economics.

Mental health and substance use (MHSU) disorders affect 1 in 4 Canadian youth. Of all age groups, young Canadians (ages 15 to 24) have the poorest access to health services. In response, British Columbia (BC) established a primary health initiative called 'Foundry' to promote and support early treatment for young people with MHSU disorders. Foundry is comprised of seven centres that provide integrated, coordinated health services for young people.

Today the greatest barrier to optimal health among persons living with HIV (PLWH) is antiretroviral (ART) adherence. The WelTel program uses weekly text-messages to improve ART adherence and HIV viral suppression among PLWH, but does not work for everyone. The literature states that personality traits and sense of purpose (dispositional traits) play a role in HIV-related outcomes. Measuring disposition is simple and rapid, and could be used to personalize adherence supports for clients with relative ease. 

Medications have transformed the lives of Canadians suffering from many debilitating conditions. However, medications may also cause harm. As medication use has increased, so has the incidence of adverse drug events (ADEs), harmful and unintended events related to medication use. Today, ADEs cause over 2 million emergency department visits across Canada each year, and are a leading cause of admissions. 

Preventing ADEs is not easy. Health care providers often unknowingly expose patients to the same or similar medications as ones that previously caused harm. For example: 

Cerebral venous thrombosis (CVT) is a rare type of stroke that can cause headaches, vision loss, weakness, seizures and coma. It is most common in young women and causes 1/3 of strokes that occur around pregnancy. Among those affected, up to 15% are left dead or disabled, 25% cannot return to work, and over half have lasting issues with energy, thinking or mood. 

Health information technology (HIT) safety is an important issue internationally. Clinician organizations (e.g. American Medical Association, Institute of Medicine) and health informatics organizations (e.g. Digital Health Canada) have made statements about HIT safety concerns and their implications.

This research will encompass several interconnected studies to develop a comprehensive strategy to improve HIT safety in Canada and internationally, to be conducted in a series of phases. 

Recent debates about palliative end-of-life (EOL) care and legalized assisted dying have stimulated new questions about EOL care for those living with dementia. However, when discussing preferences for EOL care, individuals with dementia are often excluded from the decision-making process, leaving decision making to family members and/or care providers. 

Early intervention therapy (EIT) programs for children with developmental challenges and disabilities have been shown to be highly beneficial for young children (0-5 years) in the wider Canadian population. However, EIT programs are consistently significantly under-utilized by Indigenous communities and families. Indigenous parents and community stakeholder perspectives on EIT are largely absent in current literature, and Indigenous communities are often not consulted on how these programs are delivered. 

Residential care aides (RCAs) provide the majority of hands-on care for individuals in long-term residential care (LTRC). Yet, as they are situated at the bottom of the workplace hierarchy, they receive little respect or recognition for their work. In BC, LTRC workers (mainly RCAs) have the highest rates of on-the-job injury; four times higher than the provincial average and twice as high as acute care workers, due primarily to overexertion and violent or aggressive acts from residents.