They are an unlikely sales team.
Phil Upshall is a former lawyer who was active in the Conservative Party until his life spiralled out of control because of mental illness. He was disbarred and spent time in jail, but has become a passionate and effective advocate on mental health issues.
Zul Merali is a neuroscientist at the University of Ottawa and the Royal Ottawa Mental Health Centre. Together, the two friends made a pitch to the Conservative government for a new research network with 80 scientists working together on more effective approaches to help hundreds of thousands of Canadians suffering from depression.
Their success – the federal budget included $5-million to establish the Canadian Depression Research and Intervention Network – is the result of their hard work. But it is also a reflection of the Conservative government’s research priorities at a time when money is tight and mental health has emerged as an important issue. Ottawa is still considering how it will proceed with the ground-breaking national strategy for mental health released last month, but may favour collaborative initiatives like this one.
The funding will start once the omnibus budget bill becomes law, but the network also needs funds from other sources for research into more effective approaches to treating depression.
“The problem is you can have two people with depression who have no symptom overlap. Both get the same diagnosis and treatment. No wonder it frequently doesn’t work,” said Dr. Merali, president of the University of Ottawa Institute of Mental Health Research. “We need to understand who, with a particular profile, best responds to a type of medication or other intervention in a systematic way.”
The researchers involved in the network hope to do long-term epidemiological studies to identify different types of depression, based not only on symptoms but also on what is happening in a patient’s brain.
“What particular circuits in the brain are responsible for what particular symptoms? Then you could refine your treatment based on what you are seeing in the brain,” says Dr. Merali.
The network will also focus on two issues that the two men say came up repeatedly in conversations with cabinet ministers: youth suicide and post-traumatic stress disorder, or PTSD.
Suicide is the second leading cause of death in young people after motor vehicle accidents, said Mr. Upshall, who is national executive director of the Mood Disorders Society of Canada.
Post-traumatic stress disorder is also an important issue for the government, which has been criticized for not doing enough to help soldiers returning from Afghanistan. PTSD is an anxiety disorder, but is linked to depression, to addictions to alcohol or drugs, and to increased risk of suicide.
The Conservatives announced that the Mood Disorders Society of Canada will lead the development of the network in conjunction with the Mental Health Commission of Canada. Last month, it delivered a national strategy to fix the mental health system, which is underfunded and poorly co-ordinated and leaves many families feeling as if they have nowhere to turn.
Patrick Dion, vice-chair of the commission’s board of directors, said the funding for the depression research network is an encouraging sign of the government’s commitment to do more on mental health.
The network appealed to Conservative politicians because it will focus on quickly improving treatment for patients rather than on basic, curiosity-driven research that might pay off years down the road, Dr. Merali said.
Mr. Upshall stressed the role that patients will play in guiding the direction of the research. He understands the needs of patients and their families from his own experience with bipolar disorder in the early 1990s, when he attempted suicide, was convicted on fraud-related charges and jailed for eight months, declared bankruptcy and was divorced.
“Phil always brings us back to the patient. We want to make sure we always have that voice in whatever we do,” Dr. Merali said.
“This is not research that is going to sit on a shelf,” Mr. Upshall said. “It is going to change the way we treat and deal with people, not just in hospitals but in communities. The key word is intervention, to translate research into primary and secondary care for patients. ”