In the days leading up to New Directions for Adolescents and Young Adults with Depression, the second conference held by CAMH’s Cundill Centre for Child and Youth Depression, Director Dr. Peter Szatmari considers the promising future of advances in the treatment of child and youth depression – and how the Cundill Centre at CAMH is helping us get there.
What is the Cundill Centre working on?
The Cundill Centre’s focus is very much on developing new interventions that prevent the onset of depression; new screening tools to identify kids earlier; and, for those that are depressed, interventions that get them better quicker and keep them well for longer periods of time.
Is this approach truly new?
Yes – other research centres are often more interested in basic mechanism, brain circuits and genetics, drug trials, family history, and the role of biomarkers. Those approaches are certainly valuable, but they’re long-term investments. They’re high risk. You may find a new drug for depression that’s fantastic, but it’s going to take years and years to develop and do clinical trials. The Cundill Centre wants to have a big impact in a short period of time, and that involves focusing on screening, prevention and treatment.
What’s your focus over the next few years?
People in North America don’t really know what the best treatment is for adolescent depression.
We’ve identified these best practices through a systematic review and we want to get that decision aid out to the people who need it.
We’re answering other questions, too, around adverse side-effect associated with treatment. We’re measuring outcomes and using a stepped-care approach that will lead to better outcomes for kids.
We also have three screening projects, including for First Nations youth, and for children with cancer, who are at a high risk of developing depression. For young people who present to the emergency department with self-harm, we’ve taken the best elements of existing interventions and packaged them together in one coherent treatment, which we’re testing.
And we’re giving youth a voice in our projects through CAMH’s Youth Engagement Initiative. By making meaningful contributions to this work, young people are ensuring treatments meet their needs.
What do you imagine when you dream big?
I have worked with kids a long time, and I sometimes despair over the kinds of services that kids with serious mental illness receive. It’s a dog’s breakfast out there with kids getting unproven treatments, particularly for depression. In my dreams, we’ll reduce the number of interventions kids receive to only those that are evidence-based, effective and efficient, and we’ll make sure as many kids as possible are getting these proven treatments rather than just the current “flavour of the month.”
What are you most looking forward to?
I’m excited to be part of a movement to kick start the field of child and youth depression. One of the discouraging things is that very little has happened in the field for 40 years. With no new psychotherapies, medications or intervention, a lot of really smart young clinicians and scientists have left the field or have not been interested in it to begin with. I truly hope – and believe – that the Cundill Centre will be a magnet that will pull together the best, brightest and most energetic young people to excite them about the possibilities of making a difference. In this way, we’ll get the field moving again, so we can make advances with a much bigger impact.