Annual Report 2008 - 2009

“Vision: To be the Leading Academic Department of Psychiatry in Canada, Internationally Recognized in Psychiatry, Addictions and Neuroscience”

University of British Columbia Faculty of Medicine Table of Contents

Head’s Letter 3 Schizophrenia 60 Our Vision, Mission and Strategic Plan 4 Institute of Mental Health 62 Faculty Organizational Structure 6 Education Department Administration 8 Postgraduate Education 68 Department Committees 15 Undergraduate Education 76 Associate Head Reports Reports Graduate Program in Neuroscience 79 Education 18 Continuing Medical Education & Professional Development 80 Research and International Affairs 19 Resident Research Education 81 Health Authorities 21 Public Education 81 Clinical Affairs 23 Research Day 82

Division and Program Reports Faculty (Geographic Full Time and Clinical) Division of Basic Neuroscience 25 Faculty List 84 Division of Clinical and Behavioural Neurosciences 34 Faculty Appointments and Promotions 87 Addictions Psychiatry Program 34 Faculty Salary Awards & Endowment Chairs 88 Child & Adolescent Psychiatry 38 Notable Faculty Awards, Accomplishments and Appointments 88 Consultation Liaison 39 Partners Cross Cultural Psychiatry 40 Island Medical Program – Psychiatry Program 90 Developmental Cognitive Neuroscience 42 Fraser Health Authority 92 Developmental Disorders 44 BC Mental Health and Addictions Research Institute / Eating Disorders 46 Provincial Health Services Authority (BCMHAS/PHSA) 94 Forensic Psychiatry 46 Lion’s Gate Hospital 95 General & ER Psychiatry 48 Providence Health Care 96 Geriatric Psychiatry 49 Richmond General Hospital 98 Mood & Anxiety Disorders 50 Riverview Hospital 100 Neuropsychiatry 51 Vancouver General Hospital and UBC Hospital 101 Psychotherapy 52 Fast Fact Sheet 102 Reproductive Mental Health 53 Sexual Medicine 58 Dr. Trevor Young, MD, helped us align and streamline the faculty organizational structure and more fully reflects the changing environment within UBC and the PhD, FRCPC province. I was able to appoint several Associate Heads which has been Professor & Head invaluable for all of us in the department. Ensuring strong leadership at the Institute for Mental Health has also been critical to our success over

the last several years. 2008 - 2009 We also spent time on a couple of other operational items including Head’s Letter undertaking a review of divisions and programs, crystallizing the Appointments, Promotion and Tenure Committee process and the It’s now three years since I’ve been at UBC which has been a development of a faculty salary award policy, the latter of which is used wonderful time with many changes, achievements, and adventures across the Faculty. together. Getting an annual report has taken a little while longer than I thought but I’m sure you will agree it was worth the wait. In my brief introduction, I cannot do justice to the outstanding, world- There are a few reports that you may note as missing in this annual class research conducted in our department. The success in grants and report. This was not by design and we hope that those of you who publications, detailed in the following pages, is truly a remarkable missed making a contribution to this report will consider being testament to the all. We’ve had wonderful support from donors— 3 acknowledged in Department annual reports in the future. particularly the unparalleled anonymous donation which allowed us to develop the Institute of Mental Health. Our education programs I took over from Athanasios Zis on November 15, 2006. Thanasis continue to thrive with full accreditation from the Royal College while did a remarkable job of building on a very strong department close to doubling the size of the program in the three years I’ve been making it even better. His tenure was highlighted with excellent here, including CaRMS-matched positions within regional health recruitment and the founding of the Institute of Mental Health with authorities. Our fellowship programs continue to thrive as does our an incredibly generous endowment fund. He undertook a strategic graduate program in neuroscience. planning process which laid the foundation of much of this work. Two major developments with our health authority partners continue I’d like to reflect on a few of these issues as an introduction to this to evolve. The first is the B.C. Mental Health and Addictions Research remarkable annual report which details some of the achievements of Institute Translational Research facility at the Oak Street campus. The this extraordinary department. When I first arrived, I was strongly second is our partnership with the UBC Division of Neurology and supported by many of you to update the strategic plan, this is the Brain Research Centre in the establishment of the Centre for Brain found on the next couple of pages. The plan has been a stimulating Health. document and something we work toward. I am happy to say we have met a number of these objectives and achievements which we Although there are many challenges on the horizon, increasing service developed together. demands, and expectations, I am delighted to take on these wonderful opportunities as we build together an even stronger department to be Next, you’ll see the updated faculty organizational structure. This the leading academic department of psychiatry in Canada which is followed an external review and input from many of you. The process internationally recognized in psychiatry, addictions and neuroscience. Strategic Plan 2008-2013

Vision Strategic Priorities

To be the leading academic Department of Psychiatry in Canada 1. Increase our commitment to clinical and basic research which is internationally recognized in Psychiatry, Addictions and 2. Enhance clinical care through translation of science into practice Neuroscience 3. Enhance our educational programs and build capacity to develop exceptional teachers 4. Build and grow our commitment to our community and our partners Mission 4 • Provide academic leadership and train outstanding clinicians, 1. Increase our commitment to clinical research teachers and clinician scientists • Develop an environment which encourages world class basic and clinical research 1. Establish a resident research stream and a clinician scientist training • Promote and support partnerships to improve teaching, research program opportunities and clinical care 2. Give priority to recruitment of clinician scientists for vacant • Create an environment that respects, values and recognizes chair, faculty and leadership positions faculty, staff and students 3. Mentor and develop clinical researchers among our junior faculty • Be a leader in the understanding and treatment of mental illness and addictions 4. Develop a research investigator stream for clinical faculty Strategic Plan 2008-2013

2. Ensure the quality of undergraduate and postgraduate teaching 2. Enhance clinical care through translation of in distributed sites science into practice 3. Focus on faculty development in the areas of teaching skills and educational scholarship 1. Build our outstanding Division of Basic Neuroscience with recruitment, retention, resources and space allocation 4. Develop opportunities for graduate training of clinical researchers 2. Enrich undergraduate and postgraduate curricula with new knowledge in neuroscience 4. Build and grow our commitment to our 3. Work to establish the Centre for Brain Health on the UBC community and partners campus 1. Continue to work with BC Mental Health and Addiction Services 4. Promote evidence based practice in all areas of patient care (BCMHAS) and regional health authorities on joint academic and 5 including addictions and special populations like children and clinical appointments and leadership roles the elderly 2. Become a leader in addictions and concurrent disorders 3. Focus our international collaborations with partners integral to 3. Enhance our educational programs and build our community, i.e. China and India capacity to develop exceptional teachers 4. Deliver training programs in community and cross-cultural settings 1. Increase the number of top ranked applicants to our residency and 5. Address the health of the urban poor with mental illness and fellowship programs addictions Faculty In the spring of 2008 a decision was individual stakeholders where we have received made at the Department level to review support to move forward with these changes. Organizational its organizational structure for divisions These changes were further reviewed and and programs to identify improvements discussed at the Full Department Faculty Structure that could be made that would be more Meeting in November 2008. supportive of the Department Vision, The significant changes made to the Mission and Strategic Priorities and would Department’s organizational structure include be aligned with the Royal College recognized reducing the number of divisions from 8 The significant changes programs and programs we expect to be recognized by the Royal College. Dr. Grady to 2 (Basic Neuroscience and Clinical & made to the Department’s Menielly (Head - UBC Department of Behavioural Neurosciences) and increasing organizational structure Medicine), Dr. Garth Warnock (Head - the number of programs from 10 to 15. 6 Department of Surgery) and Dr. Richard include reducing the This change resulted in several divisions Veith (Chair – Department of Psychiatry becoming programs (Addictions, Forensic and number of divisions from – University of Washington) were asked Geriatric), the addition of two new programs to undertake this review and to provide 8 to 2 (Basic Neuroscience (Consultation Liaison and Developmental their insight, input and recommendations. Disorders), and the merging of several similar and Clinical & Behavioural Their review included consulting with key programs (Mood and Anxiety; and General Neuroscience) and individuals in the current structure. and Emergency Psychiatry). increasing the number of Based upon feedback and recommendations from the reviewers, the Department The established programs (including those programs from 10 to 15. Executive Committee brought forward a that were previously divisions) continue to be proposal to make changes to the division and lead as before with Dr. Stephen Fitzpatrick program structure. This proposal was shared being appointed as the Program Director throughout the Department including being for Consultation Liaison and Dr. Robin reviewed and discussed at the Department Friedlander being appointed as the Program Advisory Committee as well as with other Director for Developmental Disorders. >>

Depatment Head

Dr. L. Trevor Young(1)(2)(3)

Associate Head Associate Head Associate Head Associate Head Institute of Mental Health Research & Education Clinical Affairs Health Authorities Dr. Anthony Phillips, International Affairs Founding Director Dr. Jon Fleming Dr. Martha Donnelly Dr. Patrick Smith Dr. Allan Young, Director Dr. Lakshmi Yatham

Education Program Basic Neuroscience Clinical and Behavioural Neuosciences Division Head

Dr. Steve Vincent Addictions Psychiatry Child & Adolescent Psychiatry Consultation Liaison Director Post-grad Ed. Program Director Program Director Program Director *Dr. Jon Fleming (4) Dr. Patrick Smith Dr. Jana-Lea Davidson Dr. Stephen Fitzpatrick

Cross Cultural Psychiatry Dev. Cognitive Neuroscience Developmental Disorders Director Undergrad Ed. Clinical Faculty Representative (elected) Program Director Program Director Program Director *Dr. Janette McMillan (5) Dr. Soma Ganesan Adele Diamond Dr. Robin Friedlander 7 Dr. Heather Robertson Eating Disorders Forensic Psychiatry General & ER Psychiatry Director Graduate Education Program Director Program Director Program Director Dr. Steve Vincent Vacant Dr. Roy O’Shaughnessy Dr. Mark Levy

Geriatric Psychiatry Mood & Anxiety Disorders Neuropsychiatry Director Resident Research Program Director Program Director Program Director Dr. William Honer Dr. Martha Donnelly Dr. Raymond Lam Dr. Trevor Hurwitz

Psychotherapy Reproductive Mental Health Sexual Medicine Director CME Faculty Dev. Program Director Program Director Program Director Dr. Caroline Goesselin Dr. William Piper Dr. Shaila Misri Dr. Rosemary Basson

Schizophrenia Director Public Education Program Director Dr. Harry Karlinsky Dr. William MacEwan

* Committees: (number denotes committee chair) HOSPITAL HEADS / MEDICAL DIRECTORS:

1) Executive Committee Children’ & Women’s Hospital...... Dr. Jana-Lea Davidson / Dr. L. Trevor Young (acting) 2) Advisory Committee Forensic Institute...... Dr. Johann Brink 3) Appointments, Promotions and Tenure Committee Lion’s Gate Hospital...... Dr. Lance Patrick (acting) 4) Post-graduate Education Committee Providence Health Care...... Dr. Richard Pico 5) Under-graduate Education Committee Prince George...... Dr. Brenda Griffiths 6) Clinical Faculty Appointments and Promotions - Dr. Maria Corral (Chair) Richmond Columbian Hospital...... Dr. Terry Isomura 7) Merit Committee - yearly (rotating) Vancouver Acute/Community...... Dr. Soma Ganesan / Dr. L. Trevor Young Victoria...... Dr. Richard Williams Department Administration

The Department Administration and support, management of Department Administration Staff group has evolved over the past allocated space at all sites and few years in a number of ways IT support for those on the mostly due to the medical school Department network. This Director, Administration Colleen Tinline expansion, funding allocations group work very closely together to support undergraduate to reduce duplication of effort, Manager, Human Resources Janie McCallum and post-graduate teaching, provide coverage for one another an increased clinical faculty and to ensure that all required Manager, Finance Vicky Yau membership, the decentralization administrative processes, etc. of additional administrative have been addressed and Administrative Assistant to 8 Kerry Hall responsibilities to the department managed in the most effective Dept Head from UBC central, significant and efficient manner across the Archana Harit, Kristy Song Administrative Office Staff new endowments received and various functions. and Eniko Wilkie a continued increase in working The Education Programs, Colin Bryant and with health authorities and other IT Support including Post-Graduate Allan Kwan partners in mutually beneficial Program, Undergraduate Manager, Postgraduate collaborations. Lynn Falconer Program and CME and the staff Education The central administration of the to manage these programs are Postgraduate Administrative Department is located within the located at the Diamond Health Luiza Shamkulova Detwiller Pavilion, UBC, Point Care Centre. This group is Support Grey Campus. This group is responsible for the organization Manager, Undergraduate Toi Leslie responsible for the departmental and delivery of the education Education administrative functions programs. These programs Undergraduate Administrative providing human resource are covered more fully in the Angela Wong & CME Support support , financial management education program reports. Committees and Projects Finance

We have representation on various committees, with other The administrative financial workload consists of coordinating the administrators and within the Faculty of Medicine(FoM) Dean’s effective & efficient day-to-day infrastructure for financial activities Office, to ensure that we have input and can provide feedback related in the Department; developing and producing budget projections to our specific department requirements, challenges and concerns and and forecasts for the various Departmental funds; preparing financial to provide assistance with problem resolution, system development, analyses and summary reports; orientating, training and advising UBC and/or policy, procedure and process development, review and department members and partners on financial matters, systems/tools implementation, etc. and documentation required to manage research funds and process Vicky Yau is a standing member of the FoM Finance Committee, financial transactions per established policies and procedures at UBC; Janie McCallum replaced Colleen Tinline on the FoM Human administering and ensuring financial policies and procedures are Resources Working Group. Colleen Tinline represents the Department adhered to; providing assistance in financial problem resolution and as the Senior Administrator for the Faculty of Medicine Administrator acting as the point of contact for UBC central units and Department meetings, sits on various Faculty of Medicine and University ad-hoc members and institutional partners. committees, working groups and interview/selection committees.

Janie McCallum joined Colleen Tinline on the Faculty of Medicine The 2008-2009 fiscal year has been difficult. The department received 9 STAR database development project team . STAR has replaced the a 5% ongoing budget reduction on the UBC Operating Budget. In former FoM database system known as CFAD which the Department addition more detailed information became available on the impact that used for the centralized administrative database functions (i.e. UBC the global economic downturn had on the eleven (11) endowments appointments for Department members). In addition to replacing the held in the department. The endowment values have decreased from administrative database functionality, STAR will also provide a web- $30 million to $26 million and the available income from those based CV module to allow faculty members to access and update their endowments has been reduced by one half (due to reduced returns on CV’s from anywhere they have access to the internet and will also allow lower market values and the requirement to make up for the principle faculty to upload to the Common CV. In addition, once faculty CV lost). We continue to work closely with the Dean’s Office on finding data has been entered and is available through STAR, this will allow solutions to address these financial issues. The impact of this financial the Department to produce a variety of reports for inclusion annual setback is something that will take a number of years to recover from. reports, to produce reports for Program Directors to prepare summaries for their various reporting needs and produce lists of publications, grants, teaching activities, etc.. We are looking forward to the full implementation of STAR so that we may enjoy the many benefits of this tool.

DEPARTMENT ADMINISTRATION * 2008-2009 Department of Psychiatry - By Fiscal Year

2008/2009 2009/2010

General Operating UBC $3,450,438 $3,338,711 APP/Sessional $228,889 $228,889 Overhead Endowment* (11) - FY 08/09 - Market Invome $999,223 $470,000 Value at 30 M Carryforward $1,455,940 $1,493,552 FY 09/10 - Market Value at 26 M Research** as at Oct 31, 2009 $19,846,829 $24,547,448 10 Fee-For-Services*** $1,886,304 $1,795,528

Specific Purpose Funds**** $3,779,374 $4,106,862

Total Funding $31,683,053 $35,980,990

* Endowments - Market at 26M a decrease of 4 million in compare to 2008-09 (30M). Endowment Income for 2009-10 Included 1.5 million carryforward. Actual endowment income allocation for FY 09-10 = approximately 470K

** Includes approximately $10 M carryforward from FY08-09 *** Includes approx 650K of carryforward from various fee for service funding **** Includes miscellaneous donation, start up funding, Ministry-Strategic Teaching Initiative Funding, Fellow funding & funding to meet other commitments... etc

Note: Data as at Oct 31, 2009; 2009/2010 estimated 11

DEPARTMENT ADMINISTRATION * 2008-2009 Human Resources Appointments

In August 2008, Mark Friesen, the Department HR Manager accepted Faculty (as of June 30, 2009) an offer at another UBC unit as their HR Manager and left Psychiatry. In November 2008, Janie McCallum was recruited to fill this critical Professors – 22 role in the Department Administration. Associate Professors – 6 The administrative HR workload consists of being the point of contact Assistant Professors – 11 for central UBC Human Resources, Faculty Relations and other UBC units as well as Department members and partners in other Clinical Professors – 39 institutions; facilitating and organizing all recruitment and employment related work for all employee groups including faculty and the various Clinical Associate Professors – 62 staff groups; providing advisory services and support as needed to Clinical Assistant Professors – 95 supervisors and staff on various employment issues; processing hourly payroll; facilitating and organizing the requirements for resignations, Clinical Instructors – 99 terminations and retirements; organizing clinical faculty reviews for Research Associates, Post Doctoral Fellows, Clinical Fellows – 39 12 re-appointment and promotion; organizing reviews for GFT faculty re-appointment, promotion and tenure; managing all department Total - 373 member files, etc.. This does not include Emeritus, Adjunct, Visitor and Honorary Appointments The number of members in the department continues to grow (approximately 20% per year) while the administrative staff to manage Students the additional workload related to increased members has remained constant and operating budgets have been decreased. In addition, There are approximately 90 active students appointments processed UBC Human Resources has been working to implement new electronic through the Department Administration office, some of whom systems which have improved some parts of the recruitment process for are students whose initial/primary appointments are through the staff positions but also have impacted the workload at the Department Neuroscience Graduate Program and Graduate Studies. level by decentralizing some of the processes and accountability to Departments. Staff

This has proved to be challenging and the Department’s administration We maintain an annual staff count of approximately 107 throughout the Dept team has worked hard to improve processes and systems to provide better service to department members and at the same time, increase - Approximately 60 of the 107 are new staff recruitments and hires each year efficiency to manage the increased workload within the resources - Of the 47 staff who continue for more than one year, approximately 35 of available. those are grant-funded position and re-appointed on a yearly basis Resulting Annual Workload (approximate): Department of Psychiatry

• 40 new clinical faculty appointments and promotions People Apr - 08 Oct - 08 May - 09 Oct - 09 • 143 clinical faculty re-appointments Full-Time Academic 34 38 39 39 (including those paid via payroll) Clinical 274 306 317 343 • 73 appointments or re-appointments for postdoctoral fellows, clinical research fellows, Research Associate 14 12 13 15 research associates and visitors Total Faculty 322 356C 369 397 • 90 student appointments and re-appointments Learners • 60 new staff appointments each year Residents 60 60 66 72 • 35 staff re-appointments each year 13 Clinical Fellows 4 3 3 5 • 90 appointments due to administrative changes (change in funding, reclassifications, Postdoctoral Fellows 26 28 32 24 changes in FTE, etc.) Graduate Students 100+ 100+ 100+ 100+ • 30 hourly employees (staff and student) – twice monthly payroll submissions Total Learners 188+ 191+ 205+ 201+ • 25 resignations and/or terminations Staff

Research Assistants 59 62 64 72

Management & Professional 16 16 16 16

Administrative Support - Secretarial & Clerical 17.5 17.5 17.5 17

Total Staff 92.5 95.5 97.5 105

Total # of People 604.5 642.5 671.5 703

DEPARTMENT ADMINISTRATIONDEPARTMENT ADMINISTRATION * 2008-2009 * 2008-2009 Information Technology (IT)

Unlike many other Departments in the Faculty of Medicine, the Department of Psychiatry does not receive any support from the Health Space Authority IT unit (infrastructure or otherwise) in the hospitals where it resides. The Department provides the required network hardware and The Department of Psychiatry has been allocated academic core department computer hardware for central department operations, space of approximately 58,000 square feet at a number of shared file storage, security, firewalls, client education, backups, client campus locations, including: direct desktop support, network peripherals (printers, copiers, etc.), set up of new computers, system configuration, inventory, shared software UBC Point Grey Campus licensing, website maintenance and support, planning etc.. Networking, e-mail and web hosting services are supplied by other UBC units, but - Detwiller Pavilion (within UBC Hospital) coordinated by the Department’s IT support team (Colin Bryant and - Purdy Pavilion (within UBC Hospital) Allan Kwan). - Koerner Pavilion The following items were the major project focus of IT in the Department in 2008/2009. 14 - Strangway Building (as of May 2007) Vancouver General Hospital Campus File Storage The Departmental file server originally went into service in October - Diamond Health Care Centre (as of November 2006) 2003, with a total storage space of 894Gb. That space was seen as both St. Paul’s Hospital Campus P: and U: drives by Department members. It used the Windows 2000 operating system. Historically, we have a 12 fold increase in files, every - St. Paul’s Hospital three years. Some of the relevant issues were: In addition, a number of faculty and researchers in the Department have space within the Brain Research Centre - • Desktop computers are not backed up and people are storing UBC Hospital and within BC Mental Health and Addictions important files on desktop computers, because of the lack of space Research Institute – Children and Women’s Hospital Site. on our file server. • Our shared server backup system (with Brain Research Centre, Magnetic Resonance Imaging, PET and some other departments) was inadequate and malfunctioning. The three largest users of the backup system had invested $20,000 in new backup software and needed to replace and/or upgrade backup hardware. They were looking for a contribution of several thousand dollars from us. • 962Gb (0.9Tb) were allotted to P: and U: drives, with our quota management software. This is more space than the drive array Department Committees actually had (894Gb) and some of our divisions were at or near their Executive Committee quotas. This committees membership includes those in key leadership roles • The drives were ¾ full. At this point the server’s performance within the department whose input is necessary for strategic planning. dropped off significantly. The purpose of this committee is to provide direction and input into • A failed PCI bus on our server motherboard is causing frequent strategic priorities for the department and input into actions required in file access delays, to the point that people sometimes think their achieving those priorities. computers are frozen. Dr. L. Trevor Young, Chair Dr. Martha Donnelly (Associate Head – Clinical Affairs) We reviewed our options and concluded that we should contract our Dr. Jonathan Fleming (Associate Head – Education) file storage to the UBC Storage Area Network (SAN), via a Faculty Dr. Patrick Smith (Associate Head – Health Authorities) of Medicine virtual server. We signed the contract with FoM at the Dr. Lakshmi Yatham (Associate Head – Research and International Affairs) start of April 2008. The server was first available to us in May 2008 Dr. Allan Young (Director – Institute of Mental Health) but, it took several more months to get access from subnets (Strangway Dr. Steve Vincent (Division Head – Basic Neuroscience) 15 Building and Diamond Health Care Centre), copy all of our files to Dr. Heather Robertson (Clinical Faculty Affairs Representative) the new system, do some testing (thanks to 17 volunteers) and make the Colleen Tinline (Director, Administration) switchover. Merit Committees Introduce a “Basic Desktop” computer model At the request of several Department members, we have introduced a The purpose of these committees is to review applications for merit cheaper desktop computer model, for those that only need to run basic and to provide a consolidated rank ordered list of recommendations for office software and access the internet. Our initial model is one of the merit to the Department Head. A57 series from Lenovo. Full Professors (to consider merit of Associate and Assistant Professors): Dr. Peter Reiner, Chair Enable Volume Shadow Copy Service Dr. Allan Young While daily backups are being made to files on P: and U: drives, the Dr. Brian MacVicar recovery process can take a few days. Our contract also allows FoM to charge us for recovery time. We have enabled the Windows Volume Assistant and Associate Professors (to consider merit of Professors): Shadow Copy Service on the SAN and configured it to save a copy of Dr. John Ogrodniczuk (Associate Professor) - Chair changed files twice each day. We have installed the VSS Client on all Dr. Weihong Song (Associate Professor) Windows XP computers (preinstalled on Windows Vista) so that clients Dr. Erin Michalak (Assistant Professor) can restore their own P: and U: drive files. Dr. Paul Pavlidis (Assistant Professor)

DEPARTMENT COMMITTEES * 2008-2009 Advisory Committee Appointments, Promotions & Tenure Committee

This committee ‘s membership includes the Executive Committee This committee ‘s membership includes the Department Head, members, Department Program Directors, a number of Hospital Associate Head – Education, Associate Head – Research and Heads/Medical Directors, Health Authority representatives, the International Affairs, Human Resources Manager, as well as Director of the Institute of Mental Health and the Director, representatives of each GFT faculty rank. It includes a higher Administration (UBC Psychiatry). The purpose of this committee proportion of full Professors to ensure the required voting quorums can is to share knowledge and provide input into key issues to improve be achieved. The purpose of this committee is to assess documentation education programs, research and clinical care. related to new appointments, re-appointments, promotion and tenure and to determine whether individual’s meet the criteria for Dr. L. Trevor Young, Chair Dr. Janette McMillan appointment, promotion and/or tenure and in the case of a new Dr. Rosemary Basson Dr. Shaila Misri appointment, whether the appointment in Psychiatry is appropriate (or Dr. Johann Brink Dr. Roy O’Shaughnessy if another department would be more appropriate). Dr. Jana-Lea Davidson Dr. Lance Patrick Dr. L. Trevor Young, Chair (non- Dr. Lynn Raymond Dr. Martha Donnelly Dr. Anthony Phillips voting) Dr. Allan Young Dr. Stephen Fitzpatrick 16 Dr. Richard Pico Dr. Jonathan Fleming, Associate Dr. Weihong Song Dr. Jonathan Fleming Dr. Bill Piper Head – Education (non-voting) Dr. Josie Geller Dr. Robin Friedlander Dr. Heather Robertson Dr. Jeremy Seamans Dr. Soma Ganesan Dr. Lakshmi Yatham, Associate Dr. Patrick Smith Dr. Ann Marie Craig Dr. Caroline Gosselin Head - Research & International Dr. Steve Vincent Dr. Kerry Jang Dr. Brenda Griffiths Affairs (non-voting) Dr. Rivian Weinerman Dr. Paul Pavlidis Dr. Bill Honer Dr. Bill Honer Dr. Richard Williams Janie McCallum (non-voting) Dr. Trevor Hurwitz Dr. Brian MacVicar Dr. Lakshmi Yatham Dr. Terry Isomura Dr. Allan Young Dr. Michael Krausz Dr. Sheldon Zipursky Dr. Raymond Lam Colleen Tinline Dr. Mark Levy Dr. Bill MacEwan Clinical Faculty Appointments and Promotions Committee Department IT Advisory Committee

This committee ‘s membership includes representatives of various The Department’s IT Advisory Committee is responsible to the clinical faculty ranks as well as the Associate Head – Clinical Affairs, the Department Executive Committee. The mandate of this committee Education Program Directors (UGE, PGE and CME), the Department is to advise on the Information Technology related issues for the Clinical Faculty Representative and two individuals appointment by Department of Psychiatry that support the Vision, Mission, Goals the Department Head. The purpose of this committee is to assess and other Strategies of the Department within the resources available documentation related to new appointments, re-appointments and through discussions, meetings, etc. by ensuring input from the various promotion to determine whether individual’s meet the criteria for employee and user group representatives in the Department. appointment, re-appointment and promotion and in the case of a new Colin Bryant , Systems Analyst/LAN Administrator, Chair appointment, whether the appointment in Psychiatry is appropriate (or Representatives: if another department would be more appropriate). Dr. Raymond Lam (Faculty, SPSS Net, Clinical Neuroscience) Dr. Maria Corral (Clinical Professor), Chair Dr. Bradley Vines (PDF, Clinical Neuroscience, Strangway bldg.) Dr. David Cohen (Clinical Instructor) Dr. Tim Murphy (Faculty, Basic Neuroscience) Dr. Colleen Northcott (Clinical Assistant Professor) Fiona Choi (Student, SPSS Net, Basic Neuroscience) Dr. Eugene Wang (Clinical Assistant Professor) Clara Hungr (on behalf of John Ogrodniczuk Faculty, Behavioral Science, 17 Dr. John Higenbottam (Clinical Associate Professor) Strangway bldg.) Dr. Johann Brink (Clinical Professor) Dr. Jon Fleming (Faculty, PGE, Diamond bldg., Macintosh user) Dr. Stacy Elliott (Clinical Professor) Heidi Erb (Staff, Basic Neuroscience) Dr. Riho Kalda (Clinical Professor) Dr. Edwin Tam (Clinical Faculty, Clinical Neuroscience) Dr. Emlene Murphy (Clinical Professor) Dr. Bob Stowe (Clinical Faculty, Macintosh user) Lynn Falconer (Staff, PGE, Diamond bldg.) Ex-Officio (non-voting members): Diane Parsons (Staff, Exchange user, Basic Neuroscience, Clinical Dr. Janette McMillan (Clinical Associate Professor), Director UGE Neuroscience) Dr. Jon Fleming (Associate Professor), Director PGE Colleen Tinline (Administration, Executive) Dr. Caroline Gosselin (Clinical Associate Professor), Director CME Dr. Heather Robertson (Clinical Assistant Professor), Clinical Faculty Affairs Representative, Janie McCallum (Human Resources Manager) Appointment by Department Head: Dr. John Ogrodniczuk (Assistant Professor) Dr. Mark Tapper (Clinical Associate Professor) Invited Attendee by Department Head Dr. Martha Donnelly (Assistant Professor) (non-voting) DEPARTMENT COMMITTEES * 2008-2009 Dr. Jonathan Fleming Associate Head Education ASSOCIATE Over 100 M.Sc. and Ph.D. students in the Graduate Program in Neuroscience, led by Dr. Steve Vincent, persist in their exemplar of HEAD successfully obtaining scholarships from CIHR, NSERC and a variety of other funding agencies. The Undergraduate Program, led by Dr Macmillan, continues to REPORTS meet the challenge of an expanded Undergraduate class by providing innovative educational opportunities for medical students through Integrated Clerkships, revamping how student’s skills are assessed “Providing excellent and increasing the effectiveness of our teachers through Faculty 18 training and learning development. The interest in Psychiatry developed by both the Undergraduate opportunities to program and the Public Education program led by Dr Karlinsky, 2 benefits our Postgraduate Program enormously and this year we had a increasing numbers of record number of applicants (91) for our 14 positions. The Research learners and Track, led by Dr Honer, was introduced this year and will enhance our program and the future of academic psychiatry. We hope to continue the public has been the to recruit two Residents to this track, each year. Interest in scholarly activity has grown throughout the Residency and will flourish further theme of this with the appointment of Dr. Lam as Associate Director – Scholarly year’s accomplishments Activities. in Education.” Under Dr. Gosselin’s leadership the CPD and PD program ran, in conjunction with the Department of Family practice, the 5th Hot Topics in Psychiatry and her committee will define the thrust of future CPD and PD activities within the Department. An important day of faculty development for teachers in all of our programs will run in the Fall.

ASSOCIATE HEAD REPORTS * 2008-2009 Teaching and the promotion of scholarly activity are essential Research Funding by Division components of any University Department. We are lucky that so many members of our Department value and enjoy this part of their working 5,000,000 life. In their turn, the learners appreciate the willingness of the Faculty 4,500,000 to share their expertise and their continued assistance in promoting 4,000,000 their careers in Neuroscience, Medicine and Psychiatry. 3,500,000

3,000,000 2,500,000 2,000,000

1,500,000 Dr. Lakshmi Yatham 1,000,000 500,000

Associate Head 0 2007/2008 2008/2009 2009/2010 Research and Basic Neuroscience Clinical & Behavioral Neuroscience 19 International Note: Data as at May 31, 2009, 2009/2010 estimated

Affairs Annual Departmental Research Day

The Academic year 2008-2009 has been a very productive year for the The Departmental Research day was held in June at the Pan Pacific department with the establishment of international collaborations and a Hotel and it was attended by 173 people. The format included both highly successful annual departmental research day. clinical and basic science research presentations by the trainees but the new feature this year included a brief overview of each research project Research Funding by the trainee’s supervisor and this was well received by all attendees as The Research funding in 2008/2009 decreased slightly from 2007/2008, the overview put the research in context. Another new feature included but is estimated to double from $4 million in 2008-2009 to $8 million presentations by faculty members who provided an overview of their for the year 2009-2010 with Clinical and Basic Neuroscience Divisions research program. Guest speaker Dr. Ken Shulman gave an outstanding holding $4 million each. The largest increase in funding is in the presentation on state of the art on “Dementia” research. There were peer reviewed grants. While the funding in the clinical Neuroscience also poster presentations by the trainees. The research day concluded Division doubled from $2 million to $4 million, the funding in the with a faculty appreciation dinner and presentation of awards to Basic Neuroscience Division increased by 5 fold to $4 million from the recognize contributions in research and other areas. The winners of year before (see figure below). these awards this year were as follows:

ASSOCIATE HEAD REPORTS * 2008-2009

Category Awards (Research Day Awards) – Presented by Lakshmi Yatham: • Tsung-Yi Li Award for Clinical Research – Ana Andreazza • McGeer Award for Basic Science – Regina Dalhaus • Zeldowicz Basic Science Poster Award – Fiona Choi • Zeldowicz Clinical Science Poster Award- Karine MacRitchie

Undergraduate Teaching Awards – presented by Janette McMillan: • Teaching Excellence Year 3 – Rachel Boulding • Teaching Excellence Year 3 – Betty Tang • Teaching Excellence Year 3 – Randall White • Teaching Excellence Year 4 – Roger Shick UBC Psychiatry Residents Association Annual Award for Teaching • Jay C. Cheng Memorial Prize – Ingrid McFee Excellence 20 • BCCH – Andrea Chapman Postgraduate Teaching Awards – presented by Andrea Chapman: • VGH – Robert Hewko - CanMed Award – • RCH – Chris Babbage • 1st place – Alan Bates • Natalia Abraham • SPH – Samantha Kelleher • 2nd place – Chris Robertson • Kathryn Wynn • RGH – Ingrid Sochting • 3rd place – Jennifer Wide - Resident Undergraduate • Victoria – Chris Blashko and Kiri Simms • 4th place – Mitesh Patel Teaching Award – Kyle Burns CME Award Postgraduate Teaching Awards – presented by Trevor Young: • Stacy Elliott • George Davidson Research Award - Jenny Rogers • Significant Contribution to Research – Alan Bates • Significant Contribution to the UBC Psychiatry Residency Program – Kam Athwal • Significant Leadership – Chris Robertson Dr. Patrick Smith Associate Head Health Authority

Overview:

Like in many jurisdictions around the globe, British Columbia has been engaged in dramatic health services restructuring over the past decade. In BC, health services have been divested from the provincial Photo of delegates at UBC Department of Psychiatry government to Health Authorities. Over recent years, there have been symposium on May 12, 2009 considerable changes in the way services are organized and delivered. For about the past 5 years, there have been 6 health authorities in BC; International Collaborative Agreements five of them serving defined geographic regions (Vancouver Coastal 21 Health Authority - VCH; Vancouver Island Health Authority – VIHA; UBC Network for International Collaborations on Research and Fraser Health Authority – FHA; Interior Health Authority – IHA; and Education (UBC-NICER) was established this year. Our collaborative Northern Health Authority – NHA) and a sixth, the Provincial Health partners included Seoul National University in Korea and Institute Services Authority – PHSA, providing access to province-wide services of Psychiatry in Sao Paolo, Brazil. The UBC Psychiatry Department and solutions. hosted a symposium meeting in Vancouver on May 12th to review While the broader health service system has been in a state of change, progress in our collaborative efforts. Additional invitees for this meeting mental health and addiction reform has also been active in BC. The included faculty members from Porto Alegre in Brazil and from Izmir fields of addiction and mental health, with different histories and Turkey as the department is currently exploring collaborative links with funding structures, emerged as separate service systems in BC. More these centers. recently, these two fields have come together with structural integration UBC has engaged in negotiations with the National Institute of Mental at the government and HA levels, but functional integration is still a Health and Neurosciences in Bangalore and Universities in China work in progress. In the mental health field, major attention and focus for further collaborative opportunities. To date, we have trained 3 in recent years has been on the Riverview Redevelopment Project, fellows from Brazil, and two residents from Korea and more residents which supports the development of tertiary bed capacity for each region and fellows are expected to visit our center in the future. There are of the province rather than the reliance on a provincial psychiatric also opportunities for UBC residents to take elective postgraduate hospital for such tertiary services. In the area of problematic substance psychiatry training at these centres. use and addiction, the recent focus has been on trying to achieve a

ASSOCIATE HEAD REPORTS * 2008-2009 balance between moving upstream to treat high-prevalence disorders Psychiatry and leadership roles in the Health Authorities across BC. (e.g., alcohol-related problems) and meeting the needs of those most Some examples of these include: Dr. Richard Pico as head of Psychiatry vulnerable with severe addictions (e.g., homeless, DTES). for Providence Health; Dr. Michael Krausz as Medical Director of the Burnaby Centre for Mental Health and Addiction; Dr. Johan Brink as Experiences from international jurisdictions undergoing such wide- Medical Director of Forensic Psychiatric Services; Dr. Jana Davidson as spread health system reform indicate that, it is critical to support Medical Director of BCMHAS Child and Adolescent Psychiatry; Dr. partnerships between academic institutions/academic health science Trevor Young as Vice President, Medicine for BCMHAS and as lead centres and decision makers in government/health system and in VCH mental health and addictions; Dr. Mark Lau as Director of community partners to ensure that critical decisions are based on the Cognitive Behavioural Therapy Capacity Development at BCMHAS; best evidence. It is often the case that, unless special attention is paid Dr. Lorne Korman as Research Director and Director of Youth to this issue, the expertise of clinicians and researchers is not leveraged Concurrent Disorders Network at BCMHAS where he is leading the and decisions are made unilaterally without the benefit of the wisdom development of a community of practice to support clinicians in the and experience of experts in the field. There is some evidence that this health authorities and the Ministry of Child and Family Development. problem has occurred in BC in recent years. In addition to these key cross-appointments, several UBC Department In an effort to foster these critical relationships and to leverage a of Psychiatry Faculty members have served in leadership positions stronger voice for UBC Department of Psychiatry, we have chosen, as within government, health authorities, and community partner one of our key strategic directions, to “Build and grow our commitment 22 organizations. to our community and partners”. One of the key areas of focus is to continue to work with all health authorities to support joint academic Some examples of these partnerships include: Dr. Mark Lau was and clinical appointments and leadership roles in the health authorities. recognized by the BC Psychological Association for his contribution It is also critical to ensure that the expertise of UBC Department of to the community and to the field of psychology - supporting the Psychiatry faculty members is leveraged and positioned to impact the Canadian Mental Health Association lead initiative “Bounce Back” in decisions made across the province regarding the development and developing CBT-Informed Peer Support; Dr. William Honer engaged delivery of mental health and addiction services in BC and in healthy with BC Schizophrenia Society to provide leadership to develop the public policy to support a population health approach based on the best Clozapine Protocol and EPI Standards for the province; Dr. Lorne evidence. Furthermore, our steadfast commitment to supporting our Korman was recognized for providing support to Community community partners in achieving shared goals is critical. organizations serving Deaf Community in developing psychotherapy capacity; Dr. Patrick Smith served as the Project Principal for BC’s 2008-2009 Milestones: 10-Year Plan to Address Mental Health and Substance Use and supported the development and implementation of the Community One of the critical priorities for the Department of Psychiatry is to Action Initiative (CAI) - representing the BC Alliance for Mental ensure that key leadership positions in the teaching hospitals and the Health and Addiction and the Aboriginal Community as they develop health authorities are held by experts who also have a cross-appointment their plan to invest $10 Million granted by the BC Ministry of Health in the department at UBC. Over the past few years, several joint to support community engagement for the 10-Year Plan; Dr. Shaohua appointments have been made between the UBC Department of Lu served as Chair for the Addiction Strategy Group of the BCMA Health Promotion Group and was the lead author for the policy paper, priorities and recommendations that will require strong leadership by “Stepping Forward: Improving Addiction Care in British Columbia”; members of the department. Drs. Michael Krausz, David Marsh, and Patrick Smith represented on

Expert Group (Chaired by Dr. Perry Kendall) of Victoria Mayor’s Task Force to develop health response to needs of homeless; Dr. Michael Krausz lead “Collaboration for Change” for Vancouver and has served as co-lead of the Homeless Research Initiative funded by the Mental Health Commission of Canada. Dr. Martha Donnelly Associate Head Another critical success over the past year has been the development and implementation of several provincial specialized networks. The goal of these networks is to support the implementation of best practices Clinical across all areas of BC and to ensure the decisions made about service development and delivery are informed by the leadership and expertise Affairs of lead clinicians and researchers. Each clinical network is either chaired or co-chaired by a faculty member from the UBC Department of Reports to: Head of Department Psychiatry; BC CBT Network – Dr. Mark Lau; BC Psychosis Network – Dr. William Honer; BC Neuropsychiatry Network - Dr. Trevor Attends: 23 Hurwitz; BC Tertiary Network – Dr. Paul Dagg; BC Substance Use 1. Executive Committee Meetings Network – Dr. Patrick Smith; BC Severe Addiction and Concurrent 2. Advisory Committee Meetings Disorders Network – Dr. Michael Krausz; BC Youth Concurrent Disorders Network – Dr. Lorne Korman. 3. Clinical Faculty Promotion Committee Meetings

Plans for the Future: Summary of Activities for 2008/09:

Supporting cross-appointments in leadership positions in all the Health 1. Made suggestion to have an elected clinical faculty member sit on the Authorities across the province with members of the UBC Department executive. of Psychiatry will continue to be a priority. Particular focus will be 2. placed on supporting stronger linkages with Health Authorities that Wrote a role description of program directors for the Department of have not historically had a strong UBC Department of Psychiatry Psychiatry, which included responsibilities of education, subspecialty presence (e.g., Fraser Health Authority, Interior Health Authority). fellowships, research communication and general issues. There is currently work underway to streamline and strengthen the 3. Worked with Dr. Lam to do a survey of clinical faculty research interests work of the BC clinical networks that are lead out of BCMHAS. It will within the department. There were 99 participants who practiced in all be critical for the UBC Department of Psychiatry to remain involved in leading this work. As the BC government unveils their 10-Year Plan to health authorities, but primarily the Vancouver Coastal. About half had Address Mental Health and Substance Use in BC, there will be many practiced more than 15-years. Almost all had found themselves asking ASSOCIATE HEAD REPORTS * 2008-2009 questions from clinical experience that they thought would benefit from being investigated in an appropriate research project and many listed examples of questions that they had had.

Several barriers to doing research as a clinical faculty member were identified, including protected time, income, the need for infrastructure support, a lack of knowledge about methodology, the need for DIVISION mentoring or working with a colleague. Approximately 60% were interested in learning more about research methodology, how to conduct systematic review and how to do quantitative research. About 50% AND were interested in learning more about how to read a paper or to do qualitative research.

The main methods for learning, which were endorsed, included a face-to- PROGRAM face course or mentored program. There was less interest in an Internet 24 course. If people were interested they seemed to think that about two half days a week for two-years might be an appropriate mentored time REPORTS frame.

73% of respondents believed that residents should be expected to complete an academic or research project during the residency. 42% 3 respondents said that they were already doing clinical research at the present time, albeit unfunded. This information will be used to help develop further supports for clinical research over the next years. Division “The mission of the of Basic Division is to understand the basic neurobiological Neuroscience mechanisms underlying Dr. Steven Vincent normal brain function Division Head and neuropsychiatric disease. ”

Division Description Summary of Activities, Milestones, etc. 25 The Division of Basic Neuroscience is an integral unit within Dr. Alaa El-Husseini died tragically December 23, 2007. Over the the Department of Psychiatry. The mission of the Division is to past year his laboratory has remained intact and his students, fellows understand the basic neurobiological mechanisms underlying normal and technicians have continued to work on some of the important brain function and neuropsychiatric disease. The Division has played research projects that Alaa pioneered. Key publications include a full a key role in the development of the interdisciplinary Graduate article in Nature describing the multitude of synaptic proteins which Program in Neuroscience, at UBC, and our faculty are heavily involved are regulated by the reversible process of palmitoylation. in graduate and postgraduate teaching in the neurosciences. The 1. Dahlhaus R, Hines RM, Eadie BD, Kannangara TS, Hines DJ, members of the Division are fully committed to working together with Brown CE, Christie BR El-Husseini A. Overexpression of the cell other members of the Department of Psychiatry to provide a unique adhesion protein neuroligin-1 induces learning deficits and impairs opportunity to examine novel drug targets and therapeutics aimed at synaptic plasticity by altering the ratio of excitation to inhibition in schizophrenia and depression, compulsive behaviours including drug the hippocampus. Hippocampus. 2009 May 12. [Epub ahead of addiction and neurodegenerative processes, including Alzheimer’s print]. disease, Huntington’s disease and stroke. A major strength of this 2. Huang K, Sanders S, Singaraja R, Orban P, Cijsouw T, Arstikaitis collaborative effort is our ability to examine these issues from the level P, Yanai A, Hayden MR, El-Husseini A. Neuronal palmitoyl acyl transferases exhibit distinct substrate specificity. FASEB J. 2009 of basic cellular and molecular mechanisms, to animal models, human Mar 19. [Epub ahead of print]. brain imaging, clinical trials and ethical concerns. Our strengths in 3. Kang R, Wan J, Arstikaitis P, Takahashi H, Huang K, Bailey AO, these areas are complemented by those of other investigators associated Thompson JX, Roth AF, Drisdel RC, Mastro R, Green WN, Yates with the Brain Research Centre. JR 3rd, Davis NG, El-Husseini A. Neural palmitoyl-proteomics

DIVISION & PROGRAM REPORTS * 2008-2009 reveals dynamic synaptic palmitoylation. Nature. 2008 Dec 18;456 An unbiased expression screen for synaptogenic proteins identifies (7224):904-9. the LRRTM protein family as synaptic organizers. Neuron 61:734- 4. Keith D, El-Husseini A. Excitation Control: Balancing PSD-95 749. Function at the Synapse. Front Mol Neurosci. 2008;1:4. Epub 2008 5. [highlighted by Brose, N. (2009) Synaptogenic proteins and Mar 28. synaptic organizers: “Many hands make light work”. Neuron 5. Krivosheya D, Tapia L, Levinson JN, Huang K, Kang Y, Hines 61:650-652. and by Faculty of 1000 http://www.f1000biology.com/ R, Ting AK, Craig AM,Mei L, Bamji SX, El-Husseini A. 2008. article/id/1158322] ErbB4-neuregulin signaling modulates synapse development and Synapse organizing function for the dendritic arborization through distinct mechanisms. J. Biol. Chem. schizophrenia-linked gene LRRTM1 283:32944-32956. 6. Hines RM, Wu L, Hines DJ, Steenland H, Mansour S, Dahlhaus Linhoff et al. (2009) performed a function- R, Singaraja RR, Cao X, Sammler E, Hormuzdi SG, Zhuo M, based discovery screen in a mammalian El-Husseini A. Synaptic imbalance, stereotypies, and impaired system for proteins that can instruct social interactions in mice with altered neuroligin 2 expression. J presynaptic differentiation and identified Neurosci. 2008 28(24):6055-67. the leucine-rich repeat transmembrane protein LRRTM1. The image shows Professor Ann Marie Craig holds the Canada Research Chair in LRRTM1-CFP in a COS cell (blue) 26 Neurobiology. In her research, she studies how nerve cells in the inducing clustering of synapsin (red) in brain make connections and modify connections with experience. This contacting axons at sites lacking contact year she was elected a Fellow of the Royal Society of Canada, for her with dendrites (green, MAP2). LRRTMs outstanding research in this field. Recent publications from her lab localize to glutamate postsynaptic sites, include: mediate postsynaptic differentiation, and LRRTM1-deficient mice exhibit altered 1. Krivosheya D, Tapia L, Levinson JN, Huang K, Kang Y, Hines distribution of synaptic components. R, Ting AK, Craig AM, Mei L, Bamji SX, El-Husseini A. 2008. ErbB4-neuregulin signaling modulates synapse development and These results provide a cellular basis for dendritic arborization through distinct mechanisms. J. Biol. Chem. the reported association of LRRTM1 with 283:32944-32956. handedness and schizophrenia. From the 2. Krivosheya D, Tapia L, Levinson JN, Huang K, Kang Y, Hines Laboratory of Professor A.M. Craig. Rose, J., Jin, S.X., Craig AM. 2009. Heterosynaptic molecular dynamics: Locally-induced propagating synaptic accumulation of Professor Brain MacVicar holds the Canada Research Chair in CaM kinase II. Neuron 61:351-358. Neuroscience. 3. [highlighted by Klassen, MP and Shen, K (2009) The curious case This has been a remarkably successful year for his research team, of a wandering kinase: CaMKII spreads the wealth. Neuron 61:331- 332. and by Faculty of 1000 http://www.f1000biology.com/article/ publishing an article in Nature, and papers in Science and Neuron id/1158816]. among other publications. The findings published in Nature will 4. Linhoff, MW, Lauren, J, Cassidy RM, Dobie FA, Takahashi H, have a major impact on our understanding of the control of cerebral Nygaard HB, Airaksinen MS, Strittmatter SM, Craig, AM. 2009. blood flow (cbf) in response to metabolic demand. This study showed that astrocytes regulate both the dilation and constriction of adjacent Rungta, Dustin J. Hines, Michael A. Beazely, John F. MacDonald arterioles via a complex response to metabolic changes. This will and Brian A. MacVicar (2008) Activation of Pannexin-1 illuminate potential pathways involved in pathological changes in cbf Hemichannels Augments Aberrant Bursting in the Hippocampus. Science 322(5907):1555-9. observed following stroke, SAH and vascular dementias. The finding 2. also provides new insight into the mechanisms of how the brain is Grant R. J. Gordon, Hyun Beom Choi, Ravi Rungta, Graham C. R. Ellis-Davies, Brian A. MacVicar (2008) Brain metabolism intrinsically capable of regulating is own blood supply, which is very dictates the polarity of astrocyte control over arterioles. Nature important for the interpretation of functional magnetic resonance 456(7223):745-9. imaging data, a technique that is widely used in humans to ascertain 3. Kisilevsky, A.E., Mulligan, S., Altier, C., Iftinca, M., Varela, D., brain function in both normal and pathological states. This work led Tai, C., Hamid, J., Hameed, S., MacVicar, B.A. & Zamponi, to successful funding in October 2008 by the Leducq Fondation for a G.W. (2008). D1 receptors physically interact with N-type calcium Transatlantic Network of Excellence, and Dr. MacVicar serves as the channel complexes to regulate channel trafficking and dendritic director of this $6M network with collaborators in London and Oxford calcium entry. Neuron 58, 557–570. UK, Paris, Copenhagen and Minneapolis. Invited talks April 2008 to March 2009 The Science paper describes a strange new channel in pyramidal neurons called a hemichannel that can be activated by NMDA receptor 1. Astrocytes couple cerebral blood flow changes to brain metabolism and neuronal activity” Invited lecture March 2009 at the stimulation leading to epilepsy-like discharges. This finding explains 11th Meeting of Hirosaki International Forum of Medical 27 the mechanisms underlying a commonly observed but neglected Science~Emerging Frontiers in Brain Research-Crossroads of secondary response that can be triggered by NMDA receptor activation. metabolic regulation, stress response and disease. The impact of this finding is still too early to know but activation of 2. “Brain Metabolic State Dictates the Polarity of Astrocyte Vascular hemichannels represents a novel form of neuronal communication and Control” Invited lecture at the Gordon Conference -Glial Biology: appears to be involved in neuronal damage during stroke. Functional Interactions Among Glia & Neurons Ventura California, March 2009. As the president of the Canadian Association for Neuroscience I Dr. 3. “Regulation of the neurovasculature unit by astrocytes” Invited MacVicar has established an annual Canadian Neuroscience meeting lecture at the American Epilepsy Meeting, Seattle Washington, Dec which was held in Toronto in 2007, Montreal 2008 (1200 attendees) 2008. and will be held in Vancouver in May 2009. He has been the chair or 4. Invited commentary and Chair at Gordon Conference “Cerebral co-chair for all of these meetings and created and chaired the national Blood Flow and Energy Metabolism”, Oxford UK Aug 2006. scientific program committee. He is also a member of the Institute 5. Astrocyte regulation of the cerebrovasculature” University of Advisory board, CIHR Institute for Neuroscience Mental Health and Copenhagen, April 2008. Addiction and a member of the Planning and Priorities Committee for 6. “How the brain controls its own blood flow”. Invited lecture at the Canadian Stroke Network (until 2009). the Allan Taylor Symposium Robarts Research Institute, London Ontario, Oct, 2008. Publications 7. “How the brain controls its own blood flow”. Invited lecture at the Form and Function in Ocular Disease symposium, Halifax, NS 1. Roger J. Thompson, Michael F. Jackson, Michelle Olah, Ravi Sept, 2008.

DIVISION & PROGRAM REPORTS * 2008-2009 8. Using two photon microscopy to image the dynamic control of provides insight into stroke damage and recovery in mice.” brain functions by astrocytes and microglia” 12th International 7. National Institute of Physiological Sci. Okazaki Japan Invited Conference on In Vivo Methods. Vancouver BC August 2008. symposium speaker, April 19th 2008 “In vivo imaging of synaptic 9. Astrocyte regulation of the cerebrovasculature” Plenary speaker at structure and blood flow provides insight into stroke damage and the Berlin Neuroscience Forum, June 2008. recovery in mice.” 10. Astrocyte regulation of the cerebrovasculature” Samuel Weiner 8. University of Calgary Invited talk. “In vivo imaging of synaptic Distinguished Lecturer, University of Manitoba, May 2008. structure and blood flow provides insight into stroke damage and 11. Astrocyte regulation of the cerebrovasculature” University of recovery in mice.” June 13th 2008. Copenhagen, April 2008 9. 3D Microscopy of Living Cells Course Lecturer, University of British Columbia, “Imaging fluorescence in brain slices and in Professor Tim Murphy received the award for the best oral vivo.” Course Lecturer. Invited lecturer June 19th, 2008. presentation at the Gordon Research Conference on Brain Metabolism 10. Gordon Research Conference on Brain Metabolism and Blood and Blood Flow. Proctor Academy New Hampshire August 19, 2008 Flow. Proctor Academy New Hampshire August 19, 2008 “The for his lecture on“The impact of cortical perfusion on synaptic activity impact of cortical perfusion on synaptic activity and sensory-evoked and sensory-evoked hemodynamic responses”. hemodynamic responses” (awarded best oral presentation for the conference). He presented a number of other invited lectures including: 11. Canadian Stroke Network Meeting Winnipeg “Insight into stroke 28 1. University of California Berkley Advanced Imaging Methods damage and recovery from imaging individual synapses and circuits Workshop 2008 Scheduled Invited Speaker “In vivo imaging of in mice in vivo.” Sept. 16th 2008 Canada. synaptic structure and blood flow provides insight into stroke 12. McGill University Montreal Neurological Institute Invited seminar. damage and recovery in mice” Jan. 17th 2008. “Insight into stroke damage and recovery from imaging individual 2. University of Saskatchewan 2008 Invited Seminar Speaker “In vivo synapses and circuits in mice in vivo.” November 4th 2008. imaging of synaptic structure and blood flow provides insight into 13. Johns Hopkins University Solomon Snyder Dept. of Neuroscience stroke damage and recovery in mice” Feb. 7th 2008. Invited seminar. “Insight into stroke damage and recovery 3. UBC Eye Care Centre seminar speaker. “Imaging plasticity in from imaging individual synapses and circuits in mice in vivo.” somatosensory synapses and circuits in response to stroke damage in November 6th 2008. living mice” February 19th 2008. 4. Invited speaker for Canadian Critical Care Conference. “In vivo imaging of synaptic structure and blood flow provides insight into Dr. Murphy’s laboratory also published a number of important stroke damage and recovery in mice.” Whistler BC Canada Feb 21st publications over the past year: 2008. 1. Brown C.E., and Murphy T.H. (2008) Livin’ on the Edge: Imaging 5. UBC Brain Research Centre 31st Annual B.C. Neuroscience Dendritic Spine Turnover in the Peri-Infarct Zone during Ischemic Academic Day Scheduled Invited Speaker “Advances in imaging Stroke and Recovery. The Neuroscientist 14:139-46 Review Article the synapse in vivo provides insight into stroke damage and repair” MOP49586. March 7th 2008. 2. Brown, CE, Wong, C., and Murphy, TH (2008) Rapid 6. University of California Los Angeles Invited seminar speaker, April Morphological Plasticity of Peri-infarct Dendritic Spines after Focal 9th 2008 “In vivo imaging of synaptic structure and blood flow Ischemic Stroke. Stroke 4:1286-1291. 3. Murphy T.H., Li P., Betts K., Liu, R. (2008) Two-photon imaging Re-mapping the somatosensory cortex brain after stroke: insight of stroke onset in vivo reveals that NMDA-receptor independent from imaging the synapse to network. The Neuroscientist. ischemic depolarization is the major cause of rapid reversible damage 11. Murphy, T.H. and Corbett D. (2009) Plasticity during stroke to dendrites and spines. J. Neurosci. 28:1756-1772. recovery: from synapse to behavior. In press Nat. Rev. Neurosci. 4. Arstikaitis P, Gauthier-Campbell C, Carolina Gutierrez Herrera Epub available. R, Huang K, Levinson JN, Murphy TH, Kilimann MW, Sala C, 12. Sigler A., Mohajerani M, and Murphy, T.H. (2009) “Imaging rapid Colicos MA, El-Husseini (2008) A.Paralemmin-1, a Modulator of re-distribution of sensory-evoked depolarization through existing Filopodia Induction Is Required for Spine Maturation.Mol Biol cortical pathways after targeted stroke in mice.” Proc. Natl Acad Cell. 19:2026-2038. Sci. track II. 106:11759-64 Edited by Michael M. Merzenich. 5. Sigler, A., Goroshkov, A., and Murphy, T.H. (2008) Hardware for targeting single brain arterioles for photothrombotic stroke on an upright microscope. J. of Neurosci Meth. 170:35-44 MOP49586. Professor Lynn Raymond is the Director of the UBC MD/PhD 6. Winship, I.R., and Murphy, T.H. (2008) In vivo calcium imaging Program. She also serves on the Residency Research Track Admissions reveals functional rewiring of single somatosensory neurons after Committee for the Department of Psychiatry. She is on the Executive stroke. J. Neurosci. 28:6592-6606 see comments in Research Committee of the Canadian Association of Neuroscience, a member Highlights Nature 454, 140 (10 July 2008) doi:10.1038/454140b; Published online 9 July 2008 Neuroscience: Rewiring the brain of the Scientific Grants Awards Committee of the Huntington’s http://www.nature.com/nature/journal/v454/n7201/full/454140b. Disears Society of America, and a member of the CIHR Grants Review html MOP49586. Committee for Pharmacology and Therapeutics. In June, 2009, she 29 7. Murphy T.H., Li P., Betts K., Liu, R. (2008) Two-photon imaging was Session Chair at the Gordon Research Conference of CAG Triplet of stroke onset in vivo reveals that NMDA-receptor independent Repeat Disorders. ischemic depolarization is the major cause of rapid reversible damage to dendrites and spines. J. Neurosci. 28:1756-1772 MOP49586 and Publications: HSFBC. 1. Fan J, Cowan CM, Zhang L, Hayden MR, Raymond LA. (2009) 8. Interaction of postsynaptic density protein-95 with N-methyl- Li, P. and Murphy, T.H. (2008) Two-photon imaging during D-aspartate receptors influences excitotoxicity in the YAC prolonged middle cerebral artery occlusion in mice reveals recovery mouse model of Huntington’s disease. Journal of Neuroscience, of dendritic structure following reperfusion. J. Neurosci. 28:11970- 29(35):10928-10938. 79 MOP49586. 2. Graham RK, Pouladi MA, Joshi P, Lu G, Deng Y, Wu N-P, 9. **Brown CE, Aminoltejari K., Erb H., Winship I. Murphy TH Figueroa BE, Metzler M, Andre VM, Slow EJ, Raymond L, (2009) In vivo voltage sensitive dye imaging in adult mice reveals Friedlander R, Levine MS, Leavitt BR, Hayden MR. (2009) that somatosensory maps lost to stroke are replaced over weeks by Differential susceptibility to excitotoxic stress in YAC128 mouse new structural and functional circuits with prolonged modes of models of HD between initiation and progression of disease. Journal activation within both the peri-infarct zone and distant sites. In of Neuroscience, 29(7):2193-2204. press J. Neurosci. 29(6):1719-34. contains our cover photo. 3. Fan MMY, Zhang H, Hayden MR, Pelech SL, Raymond LA. 10. Ayling O., Harrison TC, Boyd J.D., Goroshkov A., Murphy (2008) Protein expression profiling in cells co-expressing N-methyl- T.H. (2009) Automated light based mapping of motor cortex by D-aspartate receptors and mutant huntingtin: upregulation of activation of channelrhodopsin-2 transgenic mice. Epub Nature protective stress response pathway. Journal of Neurochemistry, Methods, 2009 MT1267511. Winship I.R., & Murphy TH (2009) 104:790-805.

DIVISION & PROGRAM REPORTS * 2008-2009 4. Sornarajah L, Vasuta O, Zhang L, Sutton C, Li B, El-Husseini A, 4. Role of altered NMDA receptor trafficking and signaling in Raymond LA. (2008) NMDA receptor desensitization regulated by Huntington disease, Department of Pharmacology, University of direct binding to PDZ1-2 domains of PSD-95. J of Neurophysiol, Alberta, Edmonton, AB, April 6, 2009. 99(6):3052-62. PMID: 18400955. 5. Role of PSD-95 family proteins in enhanced NMDA receptor- 5. Paulsen JS, Langbehn DR, Stout JC, Aylward E, Ross CA, Nance mediated function and toxicity in the YAC mouse model of M, Guttman M, Johnson S, MacDonald M, Beglinger LJ, Duff K, Huntington’s Disease, in session on Synaptic Signal Transduction Kayson E, Biglan K, Shoulson I, Oakes D, Hayden M. Predict-HD and Striatal Neurodegeneration in Huntington’s Disease, Winter Investigators and Coordinators of the Huntington Study Group. Conference on Brain Research, Alta, Utah, January 2008. (2008) Detection of Huntington’s disease decades before diagnosis: 6. Altered NMDA Receptor Trafficking and Signaling in Mouse the Predict-HD study. J Neurol Neurosurg Psychiatry, 79(8):874- Models of Huntington Disease, in session on The Many Faces 80. of Ionotropic Glutamate Receptors, Second Annual Canadian 6. Cowan CM, Fan MMY, Fan J, Shehadeh J, Zhang LYJ, Graham Neuroscience Meeting, Montreal, QB, May 2008. RK, Hayden MR, Raymond LA. (2008) Chronically elevated 7. Mechanisms of altered NMDA receptor-mediated calcium signaling calpain activity in YAC transgenic Huntington disease mouse in the YAC transgenic mouse model of Huntington’s disease, in model: Impact on NMDA receptor function and toxicity. J of Calcium Signaling and Disease, Annual Meeting of the Society of Neurosci, 28(48):12725-35. General Physiologists, Woods Hole, Mass, September 2008. 7. Dorsey ER, Beck CA, Adams M, Chadwick G, de Blieck EA, 8. Mechanisms of altered NMDA receptor-mediated calcium signaling McCallum C, Briner L, Deuel L, Clarke A, Stewart R, Shoulson in the YAC transgenic mouse model of Huntington’s disease, in 30 I. Huntington Study Group TREND-HD Investigators. (2008) Symposium on Plasticity and Neurological Disease, Second Annual Communicating clinical trial results to research participants. Arch Gladstone Institute Symposium, San Francisco, CA, October 2008. Neurol, 65(12):1590-5. 8. Huntington Study Group TREND-HD Investigators. (2008) Professor Peter Reiner is a founding member of the newly constituted Randomized controlled trial of ethyl-eicosapentaenoic acid in Huntington disease: the TREND-HD study. Arch Neurol, National Core for Neuroethics. He is a co-investigator on the MSFHR 65(12):1582-9. grant “Neuroethics for British Columbia”; as part of that grant, Dr. Reiner chaired a conference entitled “Neuroethics of Addition” in April 2009. Dr. Reiner also is the recipient of a CIHR grant entitled Invited Presentations “International Neuroethics: Enhancement, Drugs and Devices” which 1. Increased extrasynaptic NMDA receptor signaling in YAC mouse seeks to determine the views of clinicians to the prospect of prescribing model of Huntington disease, World Congress on Huntington’s cognitive enhancers to their patients. Disease, Vancouver, BC, September 15, 2009. 2. Role of altered NMDA receptor trafficking and signaling in Publications: Huntington disease, Department of Pharmacology, University of 1. Reiner PB, The rise of neuroessentialism. In: Oxford Handbook of Alberta, Edmonton, AB, April 6, 2009. Neuroethics, J. Illes & B. Sahakian, eds., (in press). 3. Role of altered NMDA receptor trafficking in Huntington disease, 2. Buchman DZ, Reiner PB, Stigma and Addiction: Being and in Synapses: Postsynaptic Mechanisms of Plasticity, NIH-sponsored Becoming, American J Bioethics 9:18-19 (2009). Conference at the Airlie Conference Centre, Warrenton, VA, March 8 – 10, 2009. 3. Reiner PB, Unintended Benefits arising from Cell-Based Interventions for Neurological Conditions. American J Bioethics, of Voltage-Gated Calcium Channels Attenuates Ethanol-Induced 9:51—52 (2009). Intoxication, Place Preference, Self-Administration and Relapse. 4. Murphy ER, Illes, J, Reiner PB, Neuroethics of Neuromarketing, J Journal of Neuroscience 28(45): 11712-11719. Consumer Behav 7: 293–302 (2008). 2. Tao, J, ME Hildebrand, P Liao, MC Liang, G Tan, S Li, TP SNUTCH, and TW Soong (2008) Activation of corticotropin- Dr. Terrance Snutch, FRSC holds the Canada Research Chair in releasing factor receptor 1 selectively inhibits Cav3.2 T-type calcium Biotechnology and Genomics – Neurobiology. In 2008 he was elected channels. Molecular Pharmacology 73: 1596-1609. “Recommended as a Fellow of the Canadian Academy of Health Sciences and was ranked Reading” - Faculty of 1000 – Biology Reports. in Top 1% scientists worldwide by Ion Channel Media Group (> 3. Zamponi, GW, ZP Feng, L Zhang, H Pajouhesh, Yanbing Ding, 10,000 scientists ranked). During the period Dr. Snutch continued to F Belardetti, H Pajouhesh, D Dolphin, LA Mitscher and TP sit as a founding editorial board member of the journal “Channels” and SNUTCH (2009) Scaffold-based design and synthesis of potent also became a founding member of the editorial board of “Frontiers in N-type calcium channel blockers. Bioorganic and Medicinal Chemistry Letters, inpress. Molecular Neuroscience”. 4. Hildebrand, ME, P Isope, E Garcia, A Feltz, T Schneider, J His recent list of invited talks, publications and issued patents include: Hescheler, M Kano, K Sakimura, S Dieudonne, TP SNUTCH (2009) Functional Coupling Between mGluR1 and Cav3.1 T-type Invited Talks: Calcium Channels Enhances Cerebellar Purkinje Cell Excitability and Local Signaling. Journal of Neuroscience 29:9668-9682. 1. Calcium Channels and Disease, Belo Horizonte, Brazil (keynote “Exceptional Reading” – Faculty of 1000 – Biology Reports 31 address). 5. Belardetti, F, E Tringham, C Eduljee, H Dong, A Hendricson, Y 2. American Pain Society Annual Scientific Meeting, Tampa, Florida Shimizu, DL Janke, D Parker, J Mezeyova, H Pajouhesh, RA Fraser, (invited symposia talk) SP Arneric, and TP SNUTCH (2009) A Fluorescence-based High 3. 2nd Annual Canadian Neuroscience Meeting, Montreal (plenary Throughput Screening Assay for the Identification of T-type Calcium address). Channel Blockers, Assay and Drug Development Technologies 7:266-280. 4. T-type Calcium Channels: from Discovery to Channelopathies, 25 years of Research, Kiev, Ukraine (invited symposia talk). 6. Belardetti F, S Ahn, K So, TP SNUTCH and AG Phillips (2009) Block of voltage-gated calcium channels stimulates dopamine release 5. Robarts Research Institute, London, Ontario. in rat mesocorticolimbic system. Neuropharmacology 56: 984-993. 6. Korea Institute of Science and Technology, Seoul, Korea (invited 7. Adams, PJ, E Garcia, LS David, KJ Mulatz, SD Spacey and TP symposia talk). SNUTCH (2009) Cav2.1 P/Q-type Calcium Channel Alternative 7. International Congress of Physiological Sciences, International Union Splicing Affects the Functional Impact of Familial Hemiplegic of Physiological Sciences, Kyoto, Japan (invited symposia talk). Migraine Mutations: Implications for Calcium Channelopathies. 8. IUPS Satellite Symposium on Ion Channels, Kyoto, Japan (invited Channels 3(2): 110-121. “Recommended Reading” - Faculty of symposia talk). 1000 – Biology Reports. 8. Tringham, E and TP SNUTCH (2009) Voltage-Gated N- type and Publications: T-type Calcium Channels and Excitability Disorders. In Structure, 1. Newton, PM, L Zeng, V Wang, J Connolly, MJ Wallace, CK Kim, Function and Modulation of Neuronal Voltage-Gated Ion Channels. HS Shin, F Belardetti, TP SNUTCH, RO Messing (2008) Block (Edited by VK Gribkoff and L Kaczmarek ). John Wiley & Sons,

DIVISION & PROGRAM REPORTS * 2008-2009 Inc. P. 35-66. papers (1 JEM, 1 FASEB J. 1 Stroke, 1 J Neurochem and 1 E. J. 9. SNUTCH, TP (2009) “Voltage-Gated Calcium Channels”. In: Neuroscience): Squire LR (ed.) New Encyclopedia of Neuroscience, vol 10, p. 427- 1. They reported that an epilepsy drug, valproic acid (VPA), could 441. Oxford: Academic Press. prevent neuritic plaque formation and improve cognitive memory 10. Zamponi, GW, RJ Lewis, SM Todorovic, SP Arneric, TP deficits in AD model mice. The finding was published in a SNUTCH (2009) Role of voltage calcium channels in ascending high impact journal (Journal of Experimental Medicine, 205, pain pathway. Brain Research Reviews 60(1):84-9. 2781-2789, 2008) (impact factor 16.5). The discovery received 11. Powell, KL, SM Cain, C Ng, S Sirdesai1, LS David, M Kyil, E worldwide news coverage including Daily Mail, Vancouver Sun, Garcia, JR Tyson, CA Reid, M Bahlo, SJ Foote, TP SNUTCH, TJ CTV, CityTV, etc. The report was profiled in Neurology Today. O’Brien (2009) A Cav3.2 T-type calcium channel point mutation The story will be also featured in the CIHR’s Parliamentary has splice variant-specific effects on function and segregates with Report. seizure expression in a polygenic rat model of absence epilepsy. 2. They found that the degradation of RCAN1 protein is mediated Journal of Neuroscience 29(2): 371-380. by both CMA and ubiquitin proteasome pathways (FASEB J. in press June 9, 2009). Issued Patents: 3. The Song lab has discovered that MIF gene expression is upregulated in stroke patients and stroke model animals, and 1. US Patent “Urea derivatives as calcium channel blockers” hypoxia signaling plays an important role in upregulation of MIF (# 7378420 issued May 27, 2008) expression under stroke (Stroke 40, 973-976, 2009). 32 Inventors: H Pajouhesh, H Pajouhesh, Y Ding and T Snutch. 4. Most recently the Song lab discovered that Sp1 regulates SNAP25 2. Mexico Patent “Calcium Channel Blockers” (#261258 issued Oct gene expression (J Neurochem, 2008) and a newly identified AD 10, 2008) Inventors: T Snutch, G Zamponi. acsdsoictaed protein TMP21 is degraded by UPS system (Eur. J. 3. US Patent “Nucleic acids encoding mammalian T-type calcium Neuroscience, 2008). channels” (#7501263 issued Mar 10, 2009) Inventors: T Snutch and DL Baillie. Dr. Song has been invited to present at several international conference as keynote speakers and to give talks at Novartis and 4. European Patent (Norway) “Partially Saturated Calcium Channel Blockers” (#326939 issued Mar 16, 2009) Inventors: T Snutch, G GSK companies. Served as Chair for CIHR-NSFC Aging Research Zamponi. Conference in August 2008. Session Chair for France-Quebec-Canada 5. US Patent “N-type calcium channel blockers” (#7507760 issued Workshop on AD Initiative in Montreal, February 2009, and Session Mar 24, 2009) Inventors: H Pajouhesh, H Pajouhesh, Y Ding, T Chair for EU-Canada Workshop on AD in Prague, March 2009. Snutch. He accepted an invitation to be a member of Editorial Board of a 6. US Patent “Diamine calcium channel blockers” (#7511077 issued prestigious high impact journal, Journal of Clinical Investigation Mar 31, 2009) Inventors: H Pajouhesh, H Pajouhesh, Y Ding, T (impact factor 16.5) in March 2009. He has also been appointed a Snutch, F Belardetti. handling editor for Journal of Neurochemistry, and a member of 7. US Patent “Nucleic acids encoding mammalian T-type calcium editorial board for Journal of Molecular Neuroscience. Dr. Weihong Song is the Director of the Townsend Alzheimer’s Appointed by President Stephen Toope as “Special Advisor to the Research Laboratories. His group has published several high impact President on China”, starting January 2009 PhD student Philip Ly received CIHR IA AgePlus award and NSERC 2. PI, NARSAD Young Investigator Awards 2008-2010, “Oxidative the prestigious Alexander Graham Bell Canada Graduate Scholarship. damage in bipolar disorder: Implications for mood stabilizing treatment”.

Professor Steven Vincent holds the Louise Brown Chair in Neuroscience, and serves as head of the Division. He also directs the Publications: Graduate Program in Neuroscience and the CIHR Strategic Training Program in Neurobiology and Behaviour at UBC. He is also a 1. Shao L, Cui J, Young LT and Wang JF (2008). The effect of member of the executive and advisory committees of the Department mood stabilizer lithium on expression and activity of glutathione s-transferase isoenzymes. Neuroscience, 151: 518-24. of Psychiatry. His research was supported by a grant from CIHR on 2. “Novel Target of Nitric Oxide Signaling”. This year he presented an Tseng M, Alda M, Xu L, Sun X, Wang JF, Grof P, Turecki G, Rouleau G, Young LT (2008). BDNF protein levels are decreased invited lecture at the Karolinska Institute in Stockholm, on Nitric in transformed lymphoblasts from lithium-responsive subjects with Oxide Neurons and Neurotransmission. bipolar disorder. J Psychiatry Neurosci, J Psychiatry Neurosci. 33:449-53. Publications: 3. Bakareb A, Shao L, Cui J, Young LT, Wang JF (2009) Mood 1. Vincent, S.R. Nitric Oxide Neurons and Neurotransmission. stabilizing drugs lamotrigine and olanzapine increase expression and Progress in Neurobiology, 2009, in press. activity of glutathione s-transferase in primary cultured rat cerebral 33 2. Lin, D.T.S., Fretier, P., Jiang, C., and Vincent, S.R. Nitric Oxide cortical cells. Neuroscience Letters 455: 70-73. Signaling via cGMP-stimulated phosphodiesterase in striatal 4. Wang JF, Shao L, Sun X and Young LT. Increased Oxidative Stress neurons. Synapse, 2009, in press. in Anterior Cingulate Cortex of Subjects with Bipolar Disorder. Bipolar disorders, In press. Dr. Jun-Feng Wang joined our Division in 2007 as an Assistant 5. Johnson SA, Wang JF, Sun X, McEwen BS, Chattarji S and Young Professor. The major accomplishments for his research group during LT. Lithium treatment prevents stress-induced dendritic remodeling this period is that we found increased oxidative damage in brain of in the rodent amygdale. Neuroscience, In press subjects with bipolar disorder. This was first to report that oxidative Invited Talk: damage presents in the central nerve system in this disease. This work will be published in Bipolar disorders. In addition he has renewed his 1. “How do mood stabilizers work? Focus on new molecular CIHR and NARSAD research grants. approaches”. UBC celebrate research week, March 7, 2009. The following is a list of grants received, publications and an invited Program Plans for the Future speech: The Division tragically lost one of our Faculty members, Dr. Alaa Grant received: El-Husseini, in December 2007. The major goal for the Division in the coming year is to recruit a new faculty member who can bring to 1. PI, CIHR 2009-2013 “Neuroprotective Effect of Mood Stabilizers: the Division the same enthusiasm and research excellence that Alaa the Role of the Major Brain Antioxidant Glutathione”. embodied.

DIVISION & PROGRAM REPORTS * 2008-2009 Division of Clinical and Behavioural Neurosciences Program Reports

Addictions Psychiatry Program Developmental Disorders Mood & Anxiety Disorders Child & Adolescent Psychiatry Eating Disorders Neuropsychiatry Consultation Liaison Forensic Psychiatry Psychotherapy Micrograph showing the prostaglandin Cross Cultural Psychiatry General & ER Psychiatry Reproductive Mental Health transporter in neurons. (Dr. MacVicar) Developmental Cognitive Neuroscience Geriatric Psychiatry Program Sexual Medicine Schizophrenia

34 Addictions “The UBC Psychiatry Program Department of Dr. Patrick Smith Psychiatry has set Program Director its sights to lead the Program Description country in the area of addictions and The Addiction Psychiatry Program was founded in 2006 with the Astrocytes along a cerebral blood vessel mandate to provide academic leadership and scholarship in the area (Dr. Macvicar) concurrent disorders, of addictions. The goal of the program is to support multidisciplinary training in all aspects of substance abuse and concurrent disorders. and we are well on This specialty area has recently been identified by the Royal College our way. ” of Physicians as a training priority, and it has been recognized that improvements are required across Canada. The UBC Department of Psychiatry has set its sights to lead the country in the area of addictions and concurrent disorders, and we are well on our way. To achieve Disorders Unit at UBC (Drs. Shaohua Lu and Heather Robertson); this goal, the priorities of the program are: 1) to lead the development Provincial Youth Concurrent Disorders Program (Drs. Shimi Kang, of much needed exemplary clinical services for individuals with Lorne Korman, Steve Mathias); Vancouver Inner City Youth Mental problematic substance use and concurrent disorders; 2) to provide Health and Addiction Program (Dr. Steve Mathias); Burnaby Centre high quality multidisciplinary education and training at undergraduate, for Mental Health and Addiction (Drs. Michael Krausz, David Marsh, graduate, postgraduate, and continuing education levels; 3) to promote Shaohua Lu, Patrick Smith); INSITE and other clinical services and support integrated research and scholarly work in the areas of supporting NAOMI (Dr. David Marsh); Dialectical Behaviour Therapy addiction and concurrent disorders; and 4) to lead the development for Youth and Young Adults (Dr. Lorne Korman); New clinical services and implementation of evidence-based policy and practice in the area of as recommended by Victoria Mayor’s Task Force (Drs. Michael Krausz, addiction and concurrent disorders. David Marsh, Patrick Smith); Continuum of Addiction Services in Northern Health Authority (Drs. Patrick Smith, David Brown, Rebecca Dempster). Program Summary of Activities To support the systematic development and implementation of high quality services for individuals with a range of substance use problems, Exemplary Clinical Services we developed the BC Substance Use Network (BC SUN). With representation from the UBC Addiction Psychiatry Program as well as BC has lagged behind other jurisdictions in providing high quality each of the six health authorities and the Ministry of Health Services 35 services for individuals with problematic substance use. Services to and Ministry of Healthy Living and Sport, the goal of the BC SUN support individuals in acute withdrawal or with chronic addiction have is to support the required system improvements. BC was the first been lacking across the province. Historically, the fields of mental province to secure funding from Health Canada’s Drug Treatment health and addiction have been separate across Canada, and the same is Funding Program ($1.2 Million per year for 5 years) to support the true in BC, with the services only becoming structurally integrated over implementation of the recommendations of the National Addiction the past few years. Functionally, the services are still separated in most Treatment Strategy – co lead by BC. areas of the province, and individuals with concurrent mental health and substance use concerns fall through the cracks. Since the founding High Quality Multidisciplinary Education and Training of the Addiction Psychiatry Program at UBC, faculty members have been active in establishing high quality clinical programs for individuals Faculty members are actively engaged in providing education and with substance use problems and concurrent disorders in all Health training at the undergraduate, graduate, postgraduate, and continuing Authorities (HA’s) in British Columbia. Over the past few years, the professional education levels. We know that a comprehensive most dramatic development of clinical services in BC has been in these understanding of addiction and experience in working with individuals specialty areas. These evidence-based clinical services are critical, not with a range of problems from substance use and abuse is required for only for the individuals who require their care, but also to support all graduates and residents of UBC Department of Psychiatry. The high quality multidisciplinary training and integrated clinical research. goal of our education and training program is to provide, through Some examples of new clinical services in this area include: Concurrent didactic curriculum and hands-on practical experience, exposure to the

DIVISION & PROGRAM REPORTS * 2008-2009 broad range of issues faced by a working psychiatrist. The program involved in presenting Grand Rounds on the area of Youth Concurrent has identified the basic training and education that all clinicians Disorders across the province and has provided CME training need to master as well as advanced training and education for those on Motivational Interviewing in Vancouver and at the American who wish to pursue Addiction Psychiatry as an area of specialization. Psychiatric Association. Because problematic substance use and addiction often occurs in the Integrated Research and Scholarly Work context of complex concurrent mental health problems, it is critical for the training experiences to be blended with other training (e.g., Research in addiction and concurrent disorders for the Addiction psychotherapy training, addiction issues for geriatric patients, substance Psychiatry Faculty has dramatically increased over the past few years. abuse and mood disorders). Since there has been an historic gap In just the last year, several faculty members have been involved in new in psychiatry training in the area of substance abuse and addiction, CIHR emerging team grants and in securing operational funding for continuing professional education is also a high priority for faculty their research. Faculty members have also contributed to the literature members. with over 20 peer-reviewed publications and book chapters in the areas of addiction and concurrent disorders in the last year. Some examples of training and education that Addiction Psychiatry faculty members have been involved in are: Dr. Heather Robertson, Some of the highlights from the past year include: Dr. Rael Lange who received certification with American Board of Addiction Medicine has had a very successful year in supporting his independent research 36 this year, and her colleagues on the very active teaching unit at UBC in the area of Alcohol Misuse and Neuropsychological Outcomes in Hospital teach an average of 3-4 medical students and 1-2 residents Traumatic Brain Injury. He received a one year operating grant from in concurrent disorders and addiction medicine; Dr. Lorne Korman CIHR last year to support this area of inquiry and this year received established a one-year course for UBC Psychiatry residents, psychology a 5 Year grant from CIHR for a longitudinal study ($854,630); Dr. interns, and BC Children’s Hospital Staff on Dialectical Behaviour Michael Kraus, the Leading Edge Endowment Fund (LEEF) Chair in Therapy and Cognitive Behaviour Therapy for Addictions and also Addiction Research has been very successful both in establishing his taught the PGY2 Psychotherapy Seminar on Dialectical Behaviour own program of research and in supporting and mentoring others. His Therapy. Dr. Korman has also been actively involved in providing 4 key areas of research focus on Clinical Epidemiology and Evaluation, continuing professional education across BC and nationally and Clinical Research, Translational Research and Transcultural Research. developed the Working With Anger – Part of the Specific Treatments Examples of his work range from studying the mental health among for Specific Populations APA Psychotherapy Video Series; Dr. Michael ER users from the Vancouver Downtown Eastside (DTES) to a First Krausz has been actively involved in teaching and training, including Nation Mental Health Survey with the goal to develop models of the development of the “Summer School for Addiction” through best practice in partnership with Assembly of First Nations and the the School of Population and Public Health; Dr. Patrick Smith has Kaiser Foundation. Dr. Krausz is also the co-investigator for the provided continuing education in the areas of addiction and concurrent Mental Health Commission Demonstration Project to study housing disorders across BC and nationally; Dr. Shimi Kang has been actively and support needs for people with mental illness and addiction; Dr. involved in teaching and training from the Overview of Addictions David Brown has been active in studying the heavy drinking of college for UBC Year 3 Medical Students, to PGY3-4 Concurrent Disorders students on university campuses and the alcohol and drug use of and Motivational Interviewing Workshop. She has also been highly adolescents through the adolescent school surveys. He has also lead the development of a research and design project to develop continuing British Columbia; Dr. Patrick Smith served as project principal for medical education materials for primary care responses to patients the development of BC’s 10-Year Plan to Address Mental Health and with potential alcohol problems – funded by the Canadian Centre Substance Use and as co-chair of the national working group sponsored on Substance Abuse; Dr. Patrick Smith is a co-investigator on a new by Health Canada and the Canadian Centre on Substance Abuse CIHR Emerging Team Grant, Optimizing the Health of Women (CCSA) for the development of A Systems Approach to Substance with Substance Use Issues and their Children ($1,499,515); Dr. David Use in Canada: Recommendations for a National Treatment Strategy. Marsh is involved in several ongoing projects including a CIHR funded Many other UBC Addiction Psychiatry faculty were also involved in the grant, An Evaluation of Long-Term Medical Outcomes Following Strategy’s development. Discontinuation of Methadone Maintenance Treatment and a Social Dr. David Brown led the development of the Tier Model that was Sciences and Humanities Research Council grant, Drug Normalization adapted for use by the National Strategy and Peter Coleridge lead and Stigma: Canada’s experience with cannabis and tobacco; Dr. the development of the Knowledge Exchange Model adopted by the Mark Lau remains actively involved in research in Cognitive Behaviour Strategy; As the new President for the Canadian Executive Council on Therapy and Mindfulness-based Cognitive Therapy and received CIHR Addiction (CECA), Dr. Patrick Smith was a member of the delegation funding for a 5 year study, Evaluating Cognitive Reactivity as a Causal representing Canada at the United Nations Committee on Narcotic Risk Factor of Depressive Relapse ($323,985). Drugs (UN-CND) where the international conventions regarding Evidence-based Policy and Practice supply and demand reduction are set; Drs. Michael Krausz, David Marsh, and Patrick Smith served as members of the Expert Advisory 37 The Addiction Psychiatry Program and its faculty are dedicated Committee of the Victoria Mayor’s Task Force on services for people to supporting evidence-based decision making through policy and who are homeless and have substance use problems; Dr. Michael Krausz practice. We are committed to a knowledge exchange model that served as Chair of the Vancouver’s Expert Advisory Committee for the supports the translation of evidence into practice across three domains: Collaboration for Change process based on the Victoria model; The 1) for clinicians in the field – to support implementation of best and BC Substance Use Network – co-chaired by Dr. Patrick Smith was promising practice; 2) for decision makers in government and the established to support best practice implementation across the province. health and social services – to support development of public and health policies that are based on evidence and support a population health Many faculty members are part of the BC SUN and there is also approach to reduce the harms associated with substance use; and 3) for an Addiction Psychiatry Reference Group to support the Network the broader community – to support the development and availability to ensure the voice of addiction psychiatry is integrated into service of evidence based information about substance use and related harms development and delivery. for clients, their families and the public. Highlighted Awards Faculty members have been active in these areas on the local, national, 1. Dr. Mark Lau received the Scientist-Practitioner Award from and international level over the past year. Some highlights include: the British Columbia Psychological Association in honour of his Dr. Shaohua Lu served as Chair for the Addiction Strategy Group contribution to the field. of the BCMA Health Promotion Group and was lead author for 2. Dr. Steve Mathias and his program – The Vancouver Inner City the Policy Paper, Stepping Forward: Improving Addiction Care in Youth Mental Health Program received the Providence Health Care

DIVISION & PROGRAM REPORTS * 2008-2009 Program Plans for the Future Child and Adolescent While the Addiction Psychiatry Program and its faculty will continue Psychiatry Program to be actively engaged in service development, multidisciplinary teaching and training, integrated research, and advancing evidence- Dr. Jana-Lea Davidson based policy and practice, three key priority areas of focus for the program for the next year will be: Program Director 1. to leverage the recent clinical service development as well as the expertise of the growing multidisciplinary faculty in Addiction Psychiatry to develop and implement a comprehensive curriculum and practicum training plan that identifies learning Program Description objectives for all residents as well as advanced objectives for residents who wish to specialize in Addiction Psychiatry The Child and Adolescent Psychiatry Program located at BC Children’s 2. to support the implementation of the BC 10-Year Plan. With Hospital is the specialized provincial referral centre for the mainland the roll-out of the BC 10-Year Plan to Address Mental Health of the province providing secondary, tertiary and provincial specialized and Substance Use, the Addiction Psychiatry Program will be focused on the priority areas that support recommendations mental health and addiction services through a number of sub-specialty 38 of the Plan. These include: development of the BC Centre outpatient clinics and four inpatient programs. for Severe Addiction and Complex Concurrent Disorders – The majority of medical students as well as psychiatry and paediatric lead by Dr. Michael Krausz; development of a continuum of withdrawal management services for youth and adults across the residents within the Faculty of Medicine at UBC receive their training province; development of standards for residential treatment in Child and Adolescent Psychiatry through our acclaimed teaching for problematic substance use in BC; development of capacity program. across the province in the areas of Cognitive Behaviour Therapy (CBT), Dialectical Behaviour Therapy (DBT), and Motivational Research strengths within the program include: psychotherapies Enhancement Therapy (MET); expanding the mental health/ for mood and anxiety disorders, ADHD, infant psychiatry, addiction system and primary care capacity to respond to the full neurodevelopmental disorders, eating disorders and metabolic effects of range of substance use problems. psychotropic medications 3. to support the implementation of the National Treatment Strategy. BC continues to lead the way in the implementation of the National Treatment Strategy. UBC Addiction Psychiatry faculty members will support the implementation across the Program Summary of Activities province through the activities of the BC Substance Abuse Network and nationally through the Drug Treatment Funding Program initiatives (e.g., Screening and Brief Intervention; 1. May 2009 saw the completion of a renewed five year strategic plan Change Management Approach to Best Practice Implementation) with the ambitious but attainable vision of the program being and the ongoing involvement with the National Treatment recognized provincially and nationally as a centre of excellence in Strategy Leadership Team. child and youth mental health and addiction services. 2. In September 2008 Vancouver hosted the Canadian Academy of Child and Adolescent Psychiatry Annual meeting with a number of Consultation clinical faculty from the Child and Adolescent Programs presenting. Liaison Program 3. Academic Grand Rounds were made available to regions throughout BC via telehealth. Dr. Stephen Fitzpatrick 4. Dr. Andrea Chapman received the 2009 Faculty of Medicine Clinical Faculty Award for Excellence in Teaching. Program Director 5. Dr. Pratibha Reebye (PI) received CIHR funding (2009) for “Assessment of Infant Massage as a Non-Pharmacological Program Description Intervention in Postpartum Depressed Mothers”. 6. Dr. Jana Davidson (Co-PI) received Lawson Foundation funding The Program of Consultation-Liaison Psychiatry is an Academic and (2008-2010) for “Why Weight: A Community-Based Diabetes Clinical Program created in 2007. The Program aims to promote Prevention and Education Program for Youth with Mental Illness”. excellence in teaching in Consultation-Liaison Psychiatry at both 7. RBC donated $2 million over ten years to support the development clinical and academic levels and to encourage research and participation of a “Healthy Living Initiative” for Children and Youth with mental health concerns. This will include development of a knowledge in other Department based activities. Most members are very active hub and web-based resources accessible to children, youth and their in the training of medical students and residents in various hospital families throughout BC. settings, i.e. ICU, CCU, Transplant Psychiatry, Cardiac Psychiatry. 39 8. Search for a Research Chair in Child and Adolescent Psychiatry is Many of our members have been recognized locally and nationally for underway with a number of exceptional candidates short-listed. their excellence in teaching and their contributions to this field. We are closely affiliated with and participate in the Canadian Academy of Psychosomatic Medicine. Program Plans for the Future Our Program members meet quarterly for an evening Journal Club or 1. Fill the Research Chair in Child and Adolescent Psychiatry by Special presentation. We encourage medical students and resident with December 2009. an interest in this sub-specialized area of Psychiatry to spend elective 2. Support the development of research within the program through time with us and we hope to be able to offer Fellowship Training initiation of a competitive small grants process for Clinical Faculty within the next short while. Our training sites include all the major within the program. UBC-affiliated teaching hospitals 3. Take a leadership role in the ongoing development of both the The C/L Program services at St. Paul’s, VGH, Richmond General and Undergraduate and Postgraduate Training programs in Child and Royal Columbian Hospitals provide hundreds of hours of teaching per Adolescent Psychiatry for the province. month to a long list of students including Med 3 and elective Med 4. Ensure that the fellowship program in Child and Adolescent 4 students, residents on rotation and electives, International Medical Psychiatry meets any new criteria associated with the Canadian Academy of Child & Adolescent Psychiatry’s submission to the Graduates in the UBC Family Practice Program, and Surgical and Royal College of Physicians and Surgeons of Canada to have Child Neurology residents. We have received multiple awards and recognition and Adolescent Psychiatry recognized as an accredited subspecialty. for this teaching from the students and University.

DIVISION & PROGRAM REPORTS * 2008-2009 Program Summary of Activities Cross Cultural Psychiatry Program 1. Program Dinner Meetings – Oct. 20, 2008, March, 2009. 2. Canadian Academy of Psychosomatic Medicine – sponsored Dr. Soma Ganesan Symposium:‘Challenges in Treated the Multiply Addicted, HIV, Hep C patient’ - Dr. Carole Richford, Dr. Stephen Fitzpatrick, Dr. Program Director Marie-Josie Brouillette ‘An Update on C/L Psychiatry: Practical Tips’ – Dr. Peter Chan, Dr. Susan Abbey, Dr. Looper, Dr. Rodin. 3. VGH Annual C/L retreat – Whistler, BC – June 13th, 2009. 4. Publication: BCMJ, June 2009 – Dr. Kyle Burns – ‘Delirium after Program Description Cardiac Surgery’, in conjunction with the SPH C/L service. The Cross Cultural Psychiatry Program focuses on the delivery of culturally sensitive, relevant, and responsible mental health services in Program Plans for the Future both community and hospital settings, as well as conducting research on the impact of Cross Cultural issues in the field of psychiatry. 40 1. Development and implementation of an HIV C/L Psychiatry Residency Elective at St. Paul’s Hospital under the supervision of Dr. Stephen Fitzpatrick and the SPH C/L service. Program Summary of Activities 2. Development and implementation of a UBC C/L Fellowship in various teaching hospitals. With each passing year there is increased interest in the Cross-Cultural Psychiatry Program (CPP) at the clinical, academic, and public levels. This past year (2008) was no exception, which saw the CPP continue to expand and improve its services and public presence. The program’s regular clinical activities continued with its elective rotation for the medical student internship at UBC and outside the province; elective rotations for Psychiatry Residents at UBC and other provinces; and short-term fellowships for Psychiatrists in Japan, Taiwan, China and Hong Kong. Members continue to actively teach medical students and residents at UBC. Knowledge translation at the public, patient, and academic levels is a priority for the CPP. On the public front, last year marked the 13th consecutive year of the annual Cross-Cultural Conference held at SFU Harbor Centre with over 250 participants from the fields of psychiatry, psychology, social work, education and patient support. The focus of staff, in participation with Mental Health Commission, drafted a new the conference was the role of spirituality in the recovery from mental cultural standard, in addition to reviewing existing programmes on illness. The program was also actively engaged in highlighting cultural cultural diversity. psychiatry through the local and national media. Research is a vital component of the CPP and 2008 saw projects Academically the program was involved in several presentations in devoted to the understudied phenomena of refugees, depression, PTSD, 2008. The largest of these was the World Psychiatry Association Cross- and substance abuse; the utility of Mindfulness Cognitive Behavioural Cultural Psychiatry conference held in Tokyo, Japan in October of Therapy in the treatment of depression; and use of PRN medications in 2008. The cross-cultural staff presentations were all well received. the treatment of concurrent disorder. Additional presentations about the CPP were made to visiting study groups of clinicians and administrators from Japan and Taiwan, as well as New Zealand. Locally, presentations were made at the UBC Program Plans for the Future Department of Psychiatry Academic Day, and at local health authorities such as Fraser, Providence, and Vancouver Coastal. The Cross Cultural Psychiatry Program will continue to focus on its The staff of the CPP has also been actively involved in the creation, growth at the patient, clinical, research and academic levels. editing, and publication of a new journal on cross-cultural psychiatry, Asian-Pacific Psychiatry, published by Wiley-Blackwell. Its 41 premiere issue is available online at:www3.interscience.wiley.com/ journal/122491012/home Clinically, the CPP continues to see over 5000 patients annually and provides service in over 11 languages. The programme has also expanded to include an additional case worker as well as two half- day psychiatrists. The introduction of a Mindfulness Based Cognitive Behavioural Therapy (MBCT) group was well received by community health counselors, therapists, who attended the group as trainees. These newly trained MBCT therapists will use their new skills to expand the number of MBCT groups in the programme. Last year also saw a change in the multicultural liaison mental health workers becoming part of the CCP under the administration of the VGH hospital programme. The CCP also introduced a new model of collaborative care between it and the native health clinics of in downtown Vancouver, Immigrant Service Society, and SUCCESS. In this new model, CCP psychiatrists provide direct services at participating facilities using staff counselors as co-therapists. The CCP

DIVISION & PROGRAM REPORTS * 2008-2009 Developmental “The next Brain Development and Cognitive Learning Conference will be July Neurosciences Program 16-20, 2010 in Vancouver. Dr. Adele Diamond To learn more about it see: Program Director http://www.interprofessional.ubc. ca/bdl.html.” Program Description

The Program in Developmental Cognitive Neuroscience integrates exciting scientific findings in neuroscience and child development developmental, cognitive, neuroscience and molecular genetic in ways that people working on the frontlines -- parents, teachers, approaches to examine fundamental questions about the development doctors, social workers, and others -- can understand, see the immediate of “executive functions” (cognitive control abilities such as selective relevance of, and USE. People come from all over BC, North America, 42 attention, working memory, inhibitory control, and cognitive and around the world. They say it is the best conference they have ever flexibility) that rely on the prefrontal cortex of the brain. attended. These abilities are critically important for success in all life’s aspects. The next Brain Development and Learning Conference will be July Dysfunction in these plays a major role in a great many psychiatric 16-20, 2010 in Vancouver. To learn more about it see: and developmental disorders. Executive function abilities include http://www.interprofessional.ubc.ca/bdl.html. being able to keep your attention focused, stay on task, complete what you start, exercise self-control, and creatively and flexibly switch perspectives (“think outside the box”). Program Summary of Activities Research studies examine the modulation of executive functions by genes and neurochemistry, their modulation by the environment Finding #1: (including detrimental environmental factors such as poverty and As reported in the journal, Science, we found marked benefits from an facilitative ones such as school programs), how they become derailed in early education program that emphasizes social pretend play and that disorders (as in ADHD or autism), effective treatments for preventing supports, trains, and challenges, executive functions in all activities or ameliorating such disorders, and educational implications. through the school day. Children in the program showed superior The Developmental Cognitive Neuroscience Program runs the executive functions and academic performance compared with their immensely popular biennial conference on “Brain Development and peers in classes where they spend less time playing and more time in Learning Conference: Making Sense of the Science” which presents direct academic instruction. Similar gains are not found when an isolated executive-function module is tacked onto a curriculum. This prefrontal dopamine levels. Men and women may need different study demonstrated that executive functions can be improved even dosages, and the appropriate dosage for women may vary by the phase in children only 4-5 years old, and that this can be done in regular of their menstrual cycle. classrooms, with regular teachers, without special equipment, at minimal cost. Many had doubted that executive functions could be Program Plans for the Future improved in children so young. This work has started to affect school curricula around the world. We plan to follow up on earlier findings. For example, while The Dalai Lama even asked Prof. Diamond how this early education previous research has shown the Tools of the Mind curriculum to be program (called ‘Tools of the Mind’) could be implemented in Tibetan of great value for at risk-children, at least in the short-term. We want schools in India. The research has been featured in shows on the CBC, to build on what has already been done to address the next important CTV, NPR, and PBS, and in articles in the New York Times, Chicago questions: Is Tools of the Mind beneficial for children across SES levels Tribune, and the Vancouver Sun. or just for children who start more behind? What are the mechanisms underlying how, when, and why effects are found? Are benefits from Finding #2: Tools of the Mind ephemeral or lasting? Might benefits from Tools We have been studying gender differences in the dopamine system in of the Mind even increase over time so that gains down the road are prefrontal cortex. Such differences have direct implications for the even greater than early on? By helping young children improve their 43 dosages of medications that affect the prefrontal dopamine system executive functions, might Tools of the Mind reduce the incidence or severity of disorders of executive functions, such as ADHD or conduct We have evidence of a gender difference in how a single nucleotide disorder, as we predict? polymorphism in the catechol-o-methyltransferase (COMT) gene that affects executive functions. While methionine at codon 158 of the We also hope to bring Tools of the Mind to BC. If it is helpful to COMT gene is more beneficial for executive functions in men, valine children, we would like to see the children where we are benefiting at codon 158 is more beneficial for executive functions in women, from it. especially during the midluteal phase of the menstrual cycle, when estrogen levels are high (Evans et al. 2009). COMT genotype exerts its effect on executive functions through COMT’s effect on dopamine in prefrontal cortex. It appears that during the point in the menstrual cycle when estrogen levels are high, estrogen down-regulates COMT enzymatic activity resulting in higher levels of dopamine in prefrontal cortex than during other times of the month and than in men If women have higher baseline levels of dopamine in prefrontal cortex, as our results suggest, that has implications for gender and menstrual- phase differences in the optimal dosages of medications that affect

DIVISION & PROGRAM REPORTS * 2008-2009 Developmental and adults with Autism Spectrum Disorders, Fetal Alcohol Spectrum Disorders and other genetic and metabolic syndromes. Disorders Program Why is this an area of importance for Psychiatrists and other Mental Dr. Robin Friedlander Health Professionals? Program Director Compared to the general population, individuals with developmental disability have a much higher rate of psychiatric disorders, yet are typically under diagnosed, misdiagnosed, and/or underserved. It is Program Description imperative that we aim to improve mental health outcomes for these individuals, their families, and caregivers.

In April, 2008, an independent Developmental Disorders ( DD) History: Program was established in the Dept. of Psychiatry at UBC; distinct In British Columbia, long-stay institutions for people with from both Child and Adolescent Psychiatry and Neuropsychiatry, but developmental disorders have been closed. In 1981, the government with components from both areas. The preliminary discussions around announced a commitment to the closures of all long stay institutions this Program, were hosted by Trevor Young ( Head of Psychiatry at 44 for people with developmental disabilities. The aim of the policy UBC) and attended by Trevor Hurwitz ( Director of Neuropsychiatry of deinstitutionalization was to provide services closer to home. Program), Jana Davidson ( Director of Child and Adolescent Tranquille, in the Interior of BC was closed in 1985 and over the next Psychiatry Program), Jon Fleming ( residency training director) and ten years, the institutions of Glendale and Woodlands were closed and Robin Friedlander ( currently Director of the DD Program). individuals moved to the community. Definition: With these closures, specific health and social care protocols were The term Developmental Disorders is an umbrella term, which refers developed between the Ministry of Health (now Ministry of Health to disorders of the developing nervous system , resulting in impaired Services) and the Ministry of Social Services. intellectual and/ or adaptive functioning. These Ministries created two community based programs , to support This refers to children, youth and adults who have significantly people with developmental disorders: greater difficulty than most people with intellectual and adaptive - Health Services for Community Living (HSCL) functioning and have had such difficulties from a very early age (or the developmental period prior to age 18). ‘Adaptive functioning’ means - Mental Health Support Teams (MHST). carrying out everyday activities such as communicating and interacting These programs are currently operated and managed by Health with others, managing money, doing household activities and attending Authorities. Health Services for Community Living provides to personal care. consultation in the areas of home nursing, physiotherapy and This definition of developmental disorder includes children, youth occupational therapy as well as nutrition and dental care. The Mental Health Support Teams provide assessment, treatment and consultation Services: No longer between a rock and a hard place. Inaugural for those individuals with developmental disorders and mental meeting of the Developmental Disorders Program, Vancouver, BC. health needs who need special attention through Mental Health and 2. 2008 ( Sep): Dua V. The Psychiatry of Autism. Health and Addiction Services. Wellbeing in Persons with Intellectual/ Developmental Disabilities Conference, Vancouver, BC. It is important to note that in BC, access to publicly funded 3. 2008 ( Sep): Specialized Services:Where we need them: Ontario, community services for individuals with Developmental Disorders, BC and Saskatchewan Morris S, Friedlander R, Thorpe L. Health is only available to those whose IQ is < 70 – 75 ; i.e. within the and Wellbeing in Persons with Intellectual/ Developmental Intellectual Disability range of functioning ( according to DSM IV Disabilities Conference, Vancouver, BC. criteria for Mental Retardation) 4. 2008 ( September). Thorpe l, Elliot D, Friedander R. Developmental Disabilities and Psychiatry: An Overview. CPA, Successful community living requires not just a linkage of community Vancouver, BC. residential and day supports, but also a health care system that is 5. 2008 ( March) Friedlander R, Byrne C, Ory N. Mental Health informed and responsive to the needs of this population. Over the last and Developmental Disabilities training, MCFD, Vancouver, BC. three decades, knowledge concerning the mental health needs of this population has increased significantly leading to a better understanding Selected Publications: of service needs and growing international consensus on key elements of 1. Tang B, Byrne C, Friedlander R, et al ( 2008). The Other Dual an adequate and responsive health service system. Diagnosis: Developmental Disability and Mental Health Disorders. 45 BC Medical Journal, 50 (6), 319 – 324. 2. Friedlander R, Johnston P (2009). Down Syndrome: When to Program Summary of Activities worry about Mental Health and what to do about it! A Guide for Parents and caregivers. NADD Press, NY. Academic teaching: 3. Byrne C, Hurley A, James R. ( 2007). Planning Guidelines for Mental Health and Addiction Services for Children, Youth and Postgraduate: Adults with Developmental Disability, BC Ministry of Health, 15 hours to PGY 3-4 as part of the Neuroscience seminars ( Drs Byrne Mental Health and Addiction Services website: www.healthservices. gov.bc.ca/mhd. and Friedlander). 28 hours of clinical supervision in DD to residents as part of their Advocacy: chronic care rotation ( Drs Friedlander, Tidmarsh, McKibbon, 1. 2008 Establishment of the Developmental Disorders Program, Riley, Tang, Gutteridge, Bains are all involved. UBC Dept. of Psychiatry. 2. 2008-2009: National Coalition on Dual Diagnosis ( chaired by Dr Tidmarsh has taken responsibility for ensuring the quality of the Susan Morris at CAMH); chronic care residents’ training. Contributed to the response to the Mental Health Commission Selected Presentations: of Canada document titled Towards Recovery and Wellbeing: A framework for a mental health strategy for Canada. 1. 2009 ( June). Pipher B. Developmental Disabilities Mental Health Contributed to the Advocacy Toolkit Documents, developed under

DIVISION & PROGRAM REPORTS * 2008-2009 the auspices of the National Coalition on Dual Diagnosis. Eating Disorders 3. 2007 – present: Chair of the Developmental Disabilities Section of the Canadian Psychiatric Association ( RF) Program

Program Plans for the Future Program Director Report Not Available Vacant for year of Training Implement model training for psychiatry residents in DD, according to report the new Royal College standards of accreditation. Offer a fellowship in DD. Forensic Psychiatry Linkage with family Practice and Undergraduate medical education re basic training in DD for medical practitioners. Program Clinical Service Dr. Roy O’Shaughnessy 46 The Academic Program needs to be linked with the clinical mental Program Director health service. 10 beds for this complex population ( 5 for adult and 5 for children and youth) are needed attached to UBC hospitals and designated for individuals with complex neurodevelopmental conditions. Program Description

The forensic program offers educational and research opportunities in the subspecialty area of forensic psychiatry. Forensic psychiatry as defined by the Canadian Academy of Psychiatry and Law encompasses interface issues between psychiatry and the law in which psychiatric knowledge, research, and opinion are applied to assist the courts in resolving legal disputes within legal contexts. Forensic psychiatry encompasses, but is not limited to, issues in criminal law such as assessing competency to stand trial and mental responsibility at the time of the offence as well as assisting the court in managing offenders with mental disorders at the pre-sentence and post-sentence phase. Civil forensic psychiatry encompasses the assessment of mental disorders suffered by persons who have sustained personal injuries, the evaluation of disability, claims for Workers’ Compensation, evaluations clinical electives within the forensic program. Currently a number of various competencies including capacity to enter into contract, of residents who have completed electives are negotiating for future manage financial affairs, and make a will as well as legal competency fellowship positions with the intent of making forensic psychiatry a to instruct counsel. In child and adolescent fields, forensic psychiatry significant part of their career plans. Within this last year we have also encompasses assessment of young offenders charged with criminal received applications and provided training to residents from other offence under the YCJA, assessments of parental capacity¸ assessment programs who have come to UBC for elective opportunities in forensic for child abuse and/or neglect, and assessments for child custody. psychiatry that are not offered in other institutions. The forensic program offers clinical placements in three separate sites. Dr. Johann Brink is the head of research in the forensic program and The Adult Forensic Hospital under the clinical direction of Dr. Brink is actively engaged in multiple research projects through the Forensic offers student and residency placements in the Forensic Hospital and Hospital. The focus of the research is primarily on risk assessment and outpatient services. These focus on assessments of mental state at the management of violent offenders. Dr. Brink has arranged collaborative time of offences, competency to stand trial, treatment of individuals ventures with colleagues in psychology at Simon Fraser University with mental disorders, and assistance in the management of violent as well as Dr. Chris Webster from Ontario. This past year has seen behaviour while on probation. The service also provides opportunity for an increase in interest from residents at UBC to have supervision in assessment and treatment of offenders in provincial penal institutions. conducting research in forensic psychiatry. Consideration is currently The Youth Forensic Psychiatric Services under the clinical direction of underway for possible development of a Master’s program within the Dr. Riar offers placements to assess and treat young offenders both in forensic program to assist the development of academic researchers 47 the inpatient unit and in the detention centre as well as in outpatient within forensic psychiatry. facilities around the province. They also offer specialized programs for the assessment and treatment of violent adolescents and adolescent sexual offenders. Civil forensic psychiatry under the direction of Dr. Program Plans for the Future O’Shaughnessy is located at the St. Paul’s Hospital medical legal clinic. Residents and students are offered the opportunity of assessing The program will continue to offer training opportunities for both individuals claiming psychological injury following personal injury as general residents as well as encouraging sub-specialization within the well as doing evaluations of competency and malpractice assessments. field of forensic psychiatry. With the recognition of forensic psychiatry as a sub-specialty by the Royal College of Physicians and Surgeons Program Summary of Activities there will be increased need for training opportunities and fellowship positions. The program is looking towards increasing the funding The forensic program primarily focuses on clinical teaching and opportunities to double the fellowship positions available. The program supervision within the three respective clinical placements. This will build on its existing strengths in clinical supervision and teaching past year we have completed the training of one fellow in forensic through the three clinical placements to ensure that all residents psychiatry, Dr. Muneza Shah, and have provided elective training graduating from the UBC program in psychiatry will receive optimal opportunities for many residents in all three clinical placement sites. training in dealing with psychiatric-legal interface issues common to In the last year we have seen a further increase in resident interest in psychiatric practice.

DIVISION & PROGRAM REPORTS * 2008-2009 General and Emergency Formal teaching to third year medical students includes an Introduction to Emergency Psychiatry given during their week long orientation Psychiatry Program to psychiatry and a series of lectures given to the first year psychiatry residents at the beginning of the academic year. Dr. Mark Levy This year, the Emergency Program has been fortunate to have a Program Director psychology fellow, Kelly Watt, who has a special interest in violence and mental illness. Her work, co-authored by Dr. J.M. Levy and Dr. S. Hart lead to presentations at Grand Rounds, Vancouver General Hospital (February 2009), and the annual conference of the American Program Description Psychology-Law Society, San Antonio, Texas (March 2009).

The members of the General and Emergency Psychiatry Program are general adult psychiatrists who practice in outpatient and inpatient Program Plans for the Future settings, concentrated in the Lower Mainland and Victoria, but also throughout the province. In addition to providing excellent clinical Future plans for the Program include the maintenance of clinical care to patients, the members of the Program teach medical students 48 standards and the standardization of clinical teaching across sites. A and residents research project looking at violence risk assessment practices and management at various sites is just getting off the ground. Program Summary of Activities

Clinical teaching is provided to third year and elective medical students. Elective medical students come from the UBC Medical School, other Canadian medical schools, and medical schools from outside of Canada. Psychiatric residents have been placed at mental health teams within the Greater Vancouver Mental Health System and at the following hospitals: Vancouver General Hospital, St. Paul’s Hospital, Royal Columbian Hospital, Richmond General Hospital, Victoria and Riverview Hospital. In addition to the provision of clinical teaching opportunities for medical students and psychiatric residents, the Emergency Program at Vancouver General Hospital, St. Paul’s Hospital and Richmond General Hospital have had family practice residents and emergency medicine residents doing rotations in the last year. Geriatric Psychiatry months of her two-year Geriatric Psychiatry Fellowship at VGH. Publications: There were 17 publications listed by our members this Program year. Dr. Martha Donnelly Program Director Program Plans for the Future

Next year we will start six-months mandatory postgraduate geriatric Program Description psychiatry rotations. Dr. Jenny Rogers will be doing a fellowship year in 2009/2010, In June 2009 there were 36 members of the program around the focusing her research interests on addictions and group therapy. province, 18 in Vancouver. The overall goal of the program is to Members of the program will be working with the CAGP on sub- provide excellent education in Geriatric Psychiatry throughout specialization and creation of an exam. undergraduate and postgraduate activities and to support research into improved care for seniors. A complete description of the program A new interdisciplinary educational module on Capacity Assessment activities from 2004 to 2009 can be found on the UBC Department of will be written considering the new legislation. 49 Psychiatry website. Other:

During 2008/2009 members participated in two retreats. There was also Program Summary of Activities major participation in the Alzheimer’s Disease Therapeutic Initiative, as well as an individual submission by the Program to the Ombudsmen Undergraduate: Members participate in teaching in all four years of Report on care, particularly in long term care facilities in B.C medical school, as well as acting as mentors for interested students. This year Dr. Peter Chan and Dr. Martha Donnelly participated in a review of geriatric curriculums within the Medical School to identify gaps. Postgraduate: There is a 13-week, three-hours per week course for RIII/IV’s in Geriatric Psychiatry on Thursdays. Members supervise residents in three-month mandatory geriatric rotations. CBT: Numerous local, provincial, national, as well as international presentations were made by members. For a complete list see departmental website. Fellowship: In 2008/2009 Dr. Julie Mc Nicoll from Laval spent five-

DIVISION & PROGRAM REPORTS * 2008-2009 Mood & Anxiety Program Summary of Activities Disorders Program The MDC celebrated unprecedented success in the Fall, 2008 research Dr. Raymond Lam grant competition from the Canadian Institutes of Health Research Program Director (CIHR). Jun-Feng Wang and Mark Lau each received a CIHR operating grant, while Mark Lau and Raymond Lam each received a CIHR Catalyst Grant in the Workplace Mental Health special competition - 4 of these grants were awarded across Canada, and they Program Description received the two in BC. Lakshmi Yatham and Raymond Lam each received a clinical trials grant from the CIHR Randomized Controlled Trials competition. The RCT competition is different from other CIHR The Mood and Anxiety Disorders Program consists of faculty members programs in that it encompasses clinical trials across all of medicine, not with clinical and research expertise in these conditions, which together specifically for psychiatry, and it has a two-stage application process so are the most common and most burdensome disorders in all of only very good applications are allowed to be entered. There were 12 medicine. While the members of the Program are scattered across the grants funded out of 59 applications, of which 3 were in mental health, province, much of the activity is focused within the Mood Disorders so to have two funded grants within the same program is extraordinary. 50 Centre (MDC), located at UBC Hospital within the Vancouver The total amount of CIHR funding from these 6 grants exceeded $3.2 Coastal Health Authority. million. The mission of the MDC is to improve treatment for people with The MDC has an enviable publication record; in 2008-2009 mood disorders by integrating cutting-edge clinical research, innovative the core MDC investigators published over 70 papers in peer- clinical programs and creative educational initiatives within an reviewed journals including the top-ranked psychiatric journals: internationally-recognized centre of excellence. Biological Psychiatry, British Journal of Psychiatry, Nature Genetics, The Mood and Anxiety Disorders Program is a research-intensive Neuropsychopharmacology, and Journal of Clinical Psychiatry. program, with most members engaging in clinical research that A number of faculty members in the Mood and Anxiety Disorders represent the spectrum of investigation from psychobiology to Program also published scholarly books this past year, including psychotherapy. Raymond Lam and Hiram Mok (Depression, Oxford University The faculty within the Program includes nationally and internationally Press), Steven Taylor (Clinician’s Guide to PTSD: A Cognitive- recognized experts in anxiety and mood disorders. Education is also a Behavioural Approach, Guilford Press; Current Perspectives on the priority for the Program, with activity at all levels of learners, including Anxiety Disorders: Implications for DSM-V, Springer Publishing), undergraduate medical students, residents and clinical fellows in Lakshmi Yatham (Bipolar Disorder: A Clinician’s Guide to Biological psychiatry; graduate students and postdoctoral fellows in psychology Treatments, Routledge) and Allan Young (Comprehensive Care of and neuroscience; and health professionals in continuing medical and Bipolar Disorder: A Textbook of Clinical Management, Informa health education. Healthcare). The following members received special commendation for their promoting this joint Program and this will be the focus of efforts in research, educational and clinical excellence: David Bond, Samuel near future. This is especially critical given the recent restructuring of Gershon Award for Junior Investigators (International Society for clinical services with Vancouver Coastal Health that led to the closing Bipolar Disorder), Mark Lau, Scientist-Practitioner Award (BC of the Anxiety Disorders Clinic at Vancouver General Hospital. Given Psychological Association), Wei-Yi Song, Year 3 Undergraduate its importance, redefining and re-establishing specialty clinical services Teaching Award (UBC Department of Psychiatry) and Lakshmi for anxiety disorders, as well as providing a clinical base for research, Yatham, Mogens Schou Award for Education and Advocacy will be of highest priority. Other important activities for the Mood (International Society for Bipolar Disorder) and the CCNP Gold and Anxiety Disorders Program include planning for the new Centre Medal (Canadian College of Neuropsychopharmacology). for Brain Health, and strengthening scholarly activity within the postgraduate and undergraduate medical education programs. Several members hold executive roles within the Department, including L. Trevor Young (Head, Department of Psychiatry), Lakshmi Yatham (Associate Head, Research and International Affairs), and Allan Young (Director, Institute of Mental Health). All of the members of the Neuropsychiatry Mood and Anxiety Disorders Program contribute to the educational Program mission of the department. Several members have leadership roles in education, including Adam Chodkiewicz (Site Leader, St. Paul’s Dr. Trevor Hurwitz Hospital), Raymond Lam (Director of Scholarly Activity), CV 51 Manjunath (Site Leader, Surrey Memorial Hospital), Erin Michalak Program Director (Postdoctoral Coordinator, Faculty of Medicine) and Wei-Yi Song (Psychiatry Leader, Island Medical Program). A sad note for the Program was the news that Peter D. McLean, Program Description Professor Emeritus in the Department of Psychiatry, passed away in November, 2008. He was an accomplished researcher and an The UBC department’s neuropsychiatry program is the academic inspirational leader and advocate for anxiety disorders research, component of the tertiary provincial BC neuropsychiatry program education and clinical services. Peter was instrumental in founding the consisting of UBC Hospital and Hillside Centre in Kamloops. The Anxiety Disorders Clinic at UBC Hospital. He was also a co-founder clinical program provides assessment and treatment of psychiatric and past president of the Anxiety Disorders Association of Canada. illness caused by non traumatic and traumatic brain injury, brain electrical malfunction and extrinsic toxic metabolic disturbances. Program Plans for the Future The program also provides services to patients with psychiatric illness that presents as neurological or physical disease (the somatoform disorders). The academic component is responsible for teaching clinical The recent administrative reorganization of the UBC Department of neurosciences in the postgraduate programs, training fellows, residents Psychiatry consolidated the Mood Disorders Program with the Anxiety and MSIs, providing academic presentations in local, national and Disorders Program. Unfortunately, there has been little activity in international meetings and runs a very successful weekly telerounds

DIVISION & PROGRAM REPORTS * 2008-2009 that broadcasts to up to 26 sites around the province and to one Psychotherapy extraprovincial site. The program engages in a limited amount of research and publications. Areas of interest include neuropsychology, Program neuroimaging, neurogenetics, neurometabolic disorders, the neuropsychiatry of multiple sclerosis, epilepsy, dementia, head trauma, Dr. William Piper vasculitis and movement disorders and the surgical treatments of Program Director depression (deep brain stimulation of the white matter adjacent to the subgenual gyrus and bilateral anterior capsulotomy). Program Description Program Summary of Activities The Psychotherapy Program is an academic program within the The program, supported by the department, has applied for Department of Psychiatry at UBC. Its academic and clinical faculty are accreditation with United Council for Neurologic Subspecialties in engaged in teaching, research, and clinical activities in many clinics, the subspecialty of Behavioral Neurology and Neuropsychiatry. To hospitals, and private offices in the greater Vancouver area. In addition, our knowledge we will the first program in Canada to achieve such a long distance teaching and supervision as well as multi-site research 52 recognition. Currently two of our faculty are certified by the UCNS in studies take place in many locations. the subspecialty of Behavioral Neurology and Neuropsychiatry.

Program Summary of Activities Program Plans for the Future Objectives: A major goal is to develop our research capacity. Promote excellence in teaching, research, and clinical practice. Promote a broad-based approach for different modalities, structures, and orientations. 1. Integrate psychotherapy with other treatments. 2. Distinguish basic and advanced standards of training. 3. Integrate research, teaching, and clinical practice. 4. Promote interdisciplinary collaboration.

New Activities During Current Year: 5. Onset of Consultation Group for psychotherapy supervisors. 6. Continuing education event on treatment of Borderline Personality Disorders. obsessive compulsive disorder (OCD), and psychosis. Patients need to 7. Videotape monitoring of group psychotherapy for resident training. be a BC resident and a referral from a physician or midwife is necessary 8. SSHRC grant to study affective processes in group therapies. to access our clinical services. Outpatient clinic hours are Monday to 9. Recruitment activities for the Chair in Psychotherapy. Friday from 9 a.m. to 4 p.m. We also provide consultations and training to health and community Program Plans for the Future providers across the province. In addition, we work in collaboration with other service providers to deliver quality care to our patients and their families. 1. Onset of resident training seminar on dialectical behavior therapy. Our program consists of psychiatrists, nurse clinicians, psychologists, 2. Finalization of recruitment for the Chair in Psychotherapy. nutritionists and other professionals serving women with psychiatric 3. Continuing education events on topics to be determined. disorders specifically related to their reproductive cycle: 4. Expand hospital training sites for the increasing number of residents. • Pregnancy 5. Increase the number of residents directly involved in research • Postpartum – up to one year after delivery activities. • Pregnancy loss or perinatal loss • Infertility 53 • Perimenopause/ Menopause – maxium 6 visits. Only patients 55 years or younger. Reproductive Mental • Pre-Pregnancy/ Medications Assessments Health Program • PMS Dr. Shaila Misri The Program sees between 3000 – 4000 outpatient women during pregnancy, postpartum, perimenopause, and PMDD. These are follow Program Director up visits and new referrals. We also have an inpatient consultation service that meets the needs of maternity patients at both hospital sites. Program Description The Reproductive Mental Health Program offers education and training opportunities. This multidisciplinary program offers teaching in: The Provincial Reproductive Mental Health Program is based at 1. Department of Medicine: Medical students, residents in psychiatry, BC Children and Women’s Health Centre and St. Paul’s Hospital elective (genetics, obstetrics, and family practice). in Vancouver, BC. We help women and their families dealing with 2. Department of Psychology: PhD and MA level students training emotional difficulties related to the reproductive cycle. Approximately under PhD level psychologists. 1 in 12 women will experience mental illness or an emotional disorder 3. Nursing students related to their reproductive cycle, including depression, panic attacks, 4. Social Work students

DIVISION & PROGRAM REPORTS * 2008-2009 In addition, our program is involved in numerous research projects in • Optimistic Thinking the field of reproductive mental health. Our focus is on contributing • Women and Anger: Coping with Difficult Feelings to the knowledge on optimal treatment options for perinatal women’s mental health and increasing the understanding on the effects of psychotropic medication in the perinatal period. We also collaborate with the Women’s Health Research Institute who is engaged in various Program Summary of Activities projects with the goal of better understanding mental health in the perinatal period. Here is a list of accomplishments (July 2008 – June 2009), divided by We maintain a website for the public and health professionals, outlining appropriate headings: all treatment options, and providing a variety of information and Publications resources on topics related to mental illness and emotional disorder 1. Raudzus J & Misri S. Managing Unipolar Depression in Pregnancy. related to the reproductive cycle. Our website can be accessed here: Curr Opin Psychiatry 2008; 22: 13-18. http://www.bcwomens.ca/Services/HealthServices/ 2. Misri S, Kendrick K. Perinatal Depression, Fetal Bonding, and ReproductiveMentalHealth/default.htm. We offer groups and Mother-Child Attachment: A review of the literature. Current workshops to our patients at no cost. A list of current workshops and Pediatric Reviews. 2008; 4(2): 66-70. 54 groups includes the following: Submitted Manuscript BC Women’s Hospital: 3. Misri S, Kendrick K, Oberlander TF, Tomfohr L, Zhang H, Grunau R. Antenatal depression and anxiety affect postpartum • Assertiveness Training parenting stress: A longitudinal, prospective study. • Coping with Depression: Self-Care Management Plan Manuscript in Preparation • Depression and Anxiety in Pregnancy Therapy Group 4. Misri S, Kendrick K, Milis L, Tomfohr L, Carter D, Ryan D, • Overcoming Emotional Eating Oberlander TF. The course of mood and anxiety disorders across 8 months: Indicators and risk factors. • Parenting Skills Group Book Chapters • Partner Information and Support Seminar • Partner Up and Self Care: A Workshop for Couples 5. Misri S, Joe K. (2008) Perinatal Mood Disorders. For inclusion in Perspectives on Perinatal Mood Disorders: A Comprehensive • Postpartum Depression and Anxiety Therapy Group Treatment Guide. • PMS Education Session Poster Presentations • Raising Your Self-Esteem Using CBT 6. Norris S, Joe K, Misri N, Oberlander T, & Misri S. Personality St. Paul’s Hospital: factors governing the antidepressant use in pregnancy and postpsrtum. Vancouver. July 2008. • Dealing with Difficult People 7. Misri S, Norris S, & Oberlander T. Adherence vs Decline of • Stress Management Antidepressant Medications in Pregnancy. Canad Psychiatric Assoc Mtg. Vancouver. September 6, 2008. 5. January 26, 2009. WHRI/CREST Team Public Education Night Presentation. UBC Robson Square. Vancouver, BC. 8. Misri S, Kendrick K, Oberlander F, Tomfohr L, & Zhang H. Antenatal depression and anxiety affect postpartum parenting stress: 6. February 11, 2009. Mother Baby Unit in BC. Journal Club, A longitudinal, prospective study. International Marcè Society Reproductive Mental Health Program. BC Women’s Hospital. Conference. Brisslin & Sydney, Australia. September 2008. Vancouver, BC. 9. Misri S. Cultural Factors Affecting Perinatal Depression. Canadian 7. March 6, 2009. Mood Disorders and Pregnancy and Postpartum. Psychiatrist Association Conference. Vancouver, B.C. September Rounds, BC Women’s Hospital. Vancouver, BC. 2008. 8. March 20, 2009. Adherence vs. Decline with Antidepressant 10. Misri S, Joe K. Antidepressant Medications in Pregnancy & Medication in Pregnancy. Grand Rounds, St. Paul’s Hospital. Postpartum: Adherence vs. Decline. Marce Scoiety. Sydney. October Vancouver, BC. 7-8, 2008. 9. April 2, 2009. Two poster presentations at World Psychiatry 11. Misri S, Joe K, & George M. Antidepressant Medications in Association Meeting. Florence, Italy. Pregnancy & Postpartum: Adherence vs. Decline. ANCIPS meeting 10. April 30, 2009. Desvenlafaxine in Perimenopausal Women. in Agra, India. January 8-11, 2009. Vancouver, BC. 12. Misri S, Kendrick K, Oberlander F, Tomfohr L, & Zhang H. 11. May 2, 2009. PMDD to Perimenopause: A Reproductive and Antenatal depression and anxiety affect postpartum parenting Emotional Continuum. Edmonton, AB. stress: A longitudinal, prospective study, and Norris S, Joe K, 12. May 17, 2009. Management of Psychiatric Disorders in Pregnant Misri N, & Misri S. Personality Factors Impacting Decisions to and Postpartum Mothers. APA course submission. San Francisco, 55 Decline or Adhere to Medication in Pregnant Depressed Women: California. A Prospective Study. World Psychiatric Association Conference. Florence. March 2009. 13. May 23, 2009. PMDD to Perimenopause: A Reproductive and Emotional Continuum. Calgary, AB. 14. Talks May 25, 2009. Treating the Depressed Patient towards Full Functionality; Eradication of Residual Symptoms. Vancouver, BC. Dr. Shaila Misri 15. May 28, 2009. Mood & Anxiety Disorders through the Reproductive Cycle. Vancouver, BC. 1. July 18, 2008. UBC Clinical Day presentation on Personality Factors Impacting Decisions to Decline or Adhere to Medication in 16. 16. May 30, 2009. Mood & Anxiety Disorders through the Pregnant Depressed Women: A Prospective Study. (Co-presenter: Reproductive Cycle. Saskatoon, SK. Dr. Sandhaya Norris). Vancouver, BC. Dr. Shimi Kang 2. August 29, 2008. MotherRisk Program presentation on Adherence vs. Decline: Antidepressant Medications in Pregnancy & 1. 2008. The American Psychiatric Association. Course Director – Postpartum. Toronto. Motivational Therapy for Concurrent Disorders. Washington, DC, 3. October 08, 2008. Grand Rounds Obstetrics & Gynecology USA. presentation on Psychopharmacology of Depression in Pregnant 2. 2008. Cracked But Not Broken Conference. Speaker – Women. Methamphetamine Use in Women. Vancouver, Canada. 4. January 10, 2009. ANCIPS meeting presentation on Bipolar in 3. 2008. The Canadian Psychiatric Association. Speaker- Fundamentals Pregnant & Postpartum Women. India. of Addiction Psychiatry Course. Vancouver, Canada.

DIVISION & PROGRAM REPORTS * 2008-2009 4. 2008. The Canadian Academy of Child and Adolescent Psychiatry. and active controlled phase II study of the efficacy and safety of Vancouver, Canada. quetiapine fumarate sustained release (Seroquel SR) as mono- 5. 2009. Canadian Forensic Psychiatry Conference. Speaker- therapy in the treatment of adult patients with major depressive Withdrawal Management. Vancouver, BC. disorder (MDD) (AMBER Study). Completed. 5. Co-investigator for: The MTHFR C677T polymorphism and Dr. Vivian Polack postpartum mental illness in at-risk women. CIHR funding 1. July 2008. Presentation on Reproductive Mental Health. For reference number 82750. Physicians. Burnaby, BC. 6. Co-investigator for: Fetal and Newborn Behaviour Following Prenatal Selective Serotonin Reuptake Inhibitor Exposure. CIHR Dr. Deirdre Ryank funding reference number MOP57837. 1. Nov 20/2008, MDA Meeting, Vancouver, Presented a talk titled: 7. Co-investigator for: A microanalytic description of newborn pain “Psychiatric Concerns in Pregnancy and Postpartum”. reactivity in healthy and at-risk born infants. CIHR funding reference number MOP-77769. 2. Jan 19/2009, St Paul’s Hospital, Family Practice Rounds, presented a talk titled: “Practical Interventions for Women with Depression in 8. Co-investigator for: The Vancouver Longitudinal Study of the Pregnancy and Postpartum”. Psychosocial Development of Children. 3. May 04/2009, VGH, Clinical Epidemiology Rounds, presented a Dr.Shimi Kang talk titled: “Overview of Perinatal Depression”. 1. University of British Columbia 56 4. May 17/2009, San Francisco, USA, American Psychiatric Conference Annual Meeting: Co-Presented a course:” Psychiatric 2. Simon Fraser University Illnesses in Pregnancy and Postpartum”. 3. Michael Smith Foundation for Health Sciences Research, Vancouver, BC Grants 4. Center for Applied Research in Mental Health and Addictions Dr. Shaila Misri 5. Post Doctoral Fellow in Health Services Research 1. Principle Investigator: BC Medical Services Foundation (Vancouver Program Initiatives with the Ministry of Health Foundation) Grant for the application: Factors Impacting Medication Refusal and Adherence in Pregnant Depressed Women: Dr. Shaila Misri Maternal and Newborn Outcomes. In Progress. 1. Perinatal Framework 2. Principle Investigator: An open label dose titration study of 2. Cognitive Behaviour Therapy Initiative Quetiapine XR in the treatment of postpartum depression in non- lactating women diagnosed with Bipolar Disorder (BD), Type II. Dr. Shimi Kang Investigator Intiated Study. Starting Spring 2008. 1. Family Physician Guide Project 3. Principle Investigator: Investigator initiated trial of Escitalopram for post-partum depression. An Open Label Study. Starting Spring Other Academic Achievements 2008. Dr. Shaila Misri 4. Principle Investigator: AstraZeneca Canada,: A Multi-centre, double-blind, randomized, parallel group, placebo-controlled 1. Advanced Training in MI, MINT (Motivational Interviewing Network of Trainers) membership and academic teaching via UBC. Other

Dr. Vivian Polack 1. Attended the launch of the perinatal depression framework for Our program developed a Perinatal Depression Framework for BC’s Fraser Health. Health Authorities, in partnership with the BC Ministry of Health, Dr. Deirdre Ryan Mental Health and Addictions Branch and Healthy Children, Women and Seniors Branch. Its purpose is to guide the development of a 1. Awards: In Nov, 2008, Dr. Ryan received a UBC Dept of Psychiatry Continuing Medical Education and Professional regionally appropriate strategy for addressing perinatal depression at Development Award for 2007 – 2008. the local level. This guide was published in July 2006 and can be found 2. Committee Work: Current involvement in developing Best Practices here: Guidelines for treating patients with Psychiatric Illnesses who are http://www.bcwomens.ca/NR/rdonlyres/483927DE-698E-42A7- pregnant and postpartum (2007/2009). 89E5-6E7080D6ABA9/18624/Perinatal_Brochure.pdf Dr. Sheila Patton We also developed a popular patient guide called ‘Self-Care Program for Women with Postpartum Depression and Anxiety’. This guide 1. Administrative Work: 2008 to present - Organize CME Rounds was created for women with postpartum depression, as well as their for the Perinatal Provincial Group - utilizing local and international speakers. health care providers who come in contact with these women and their 57 families. Specifically, causes, prevention, and different treatments of 2. 2008 to present - organize Reproductive Call Group at BCWH. postpartum depression are addressed, and women are provided with 3. Continuing Medical Education: 1. Dec 2008 - ABC Educational Primer for Clinicians. structured exercises to empower them to become active participants in their treatment and recovery. It is available for free at: 4. 2008 - Teaching Skills for Community Based Preceptors. http://www.bcwomens.ca/NR/rdonlyres/483927DE- 5. Oct 2008 - 59th Canadian Psychiatric Association Conference. 698E-42A7-89E5-6E7080D6ABA9/12518/ ReproductiveMentalHealthSelfCareGuide.pdf Our program has developed other publications both for public and Program Plans for the Future professional use such as the ‘Guide to Postpartum Blues and PPD’ (2006). This is a two-page guide which covers definitions, symptoms, myths/facts, and helpful resources. It can be found here: http:// 1. To have a comprehensive mother baby unit in British Columbia, www.bcwomens.ca/NR/rdonlyres/483927DE-698E-42A7-89E5- which will meet the needs of inpatient care for women with mood, 6E7080D6ABA9/30445/PostpartumDepressionPamphlet.pdf anxiety, and psychotic disorders. Their babies will be admitted at the same time, thus offering a supportive milieu for recovery of this Our care providers have thus far developed two easy to use perinatal population. depression worksheets, for women to fill out themselves and monitor 2. To offer residency training for psychiatry residents rotating through their progress over time. They are called ‘What Are the Common either St. Paul’s Hospital or Children’s Hospital. Symptoms of Perinatal Depression?’ and ‘Things I Can Work On’.

DIVISION & PROGRAM REPORTS * 2008-2009 They are available here: Sexual Medicine http://www.bcwomens.ca/Services/HealthServices/ ReproductiveMentalHealth/Publications/ Program perinataldepressionworksheets.htm. Dr. Rosemary Basson Compulsory Prenatal Screening Program Director In 2008, the Reproductive Mental Health Program, in partnership with the Ministry of Health, has instituted prenatal screening for depression Program Description in the province of British Columbia, occurring between 28-30 weeks gestation and six to eight weeks postpartum The program provides clinical service for patients with sexual dysfunction referred by their physicians from across the province. Our clinical research includes collaboration with the departments of OBGYN, urology, physical medicine and rehabilitation and neurology. We teach extensively at undergraduate, post-graduate, national and international CME courses. 58 • Members: Stacy Elliott, Ron Stevenson, Miriam Driscoll, Gail Knudson • Associates: Lori Brotto, Andre Krassioukov • Sexual health clinicians: Kate Mcbride, Marie Carlson, Shea Hocaloski, Lesley Houle and Christine Zarowski

Program Summary of Activities

We have welcomed Dr. Miriam Driscoll as a part-time colleague and slowly said good-bye to Dr. Oliver Robinow now residing in Victoria. Presentations July 2008- June 2009: 42 presentations were given at various national and international conferences including the 13th International Congress on Hormonal Steroids, Annual Scientific Meetings of the International Society for the Study of Women’s Sexual Health and the Society for Sex therapy and Research , the 3rd National Spinal Cord Injury Conference, the 16th Interurban Spinal Cord Injury Conference, and the Canadian Fertility and Andrology Society Meeting. Positions held: Dr Basson is co- chair of the 3rd International Consensus on Sexual Medicine – every 5 years 25 committees create Awards: Dr.Elliott received the UBC Department of Psychiatry evidence based assessment and management guidelines. Dr Brotto is Continuing Medical Education and Professional Development Award scientific chair for the International Society for the Study of Women’s for 2008 – 2009. Sexual Health. Dr Knudsen is president and founder of the Canadian Research: The CIHR funded study of total androgen activity in women Professional Association for Transgender Health and Secretary- with and without sexual dysfunction (collaborators Professor John Treasurer, World Professional Association for Transgender Health. Drs Petkau, UBC Department of Epidemiology and Professor Fernand Brotto, Basson and Knudson Knudsen are members/ consultants on Labrie, Laval University) is undergoing final analysis, the manuscript the APA DSM-V Workgroup on Sexual and Gender Identity Disorders to be submitted shortly. New grants this year include those from the for revised definitions of sexual disorders. Dr.Elliott serves on the Disabilities Health Research Network, Women’s Health Research Clinical Practice Guidelines for Sexuality after SCI (Paralyzed Veterans Institute, Hampton Research Fund and a William Fraser Rehabilitation Association) which are to be published January 2010 and is the current Grant. Our ongoing research includes: Chair of the the Canadian Male Sexual Health Council. (1) BC Medical Services Foundation: Outcome of combined CBT, mindfulness, education and sex therapy programs for women with Program Plans for the Future sexual desire and sexual arousal disorders and Participation of Sexual Medicine in the Center for Brain Health may (2) Outcome of similar holistic program for women with provoked allow further collaboration within the Department of Psychiatry. 59 vestibulodynia. We envisage collaborative research with MS, Movement disorders, (3) An adaptated program for women with childhood sexual abuse Mood and other aligned neurological/psychiatric disciplines. The (4) CIHR: Sensory substitution for functional recovery of sexual collaboration with ICORD and SCI Solutions continues, as does sensations in individuals with chronic spinal cord injury the active business plan for a Chair in Sexual Rehabilitation. The (5) Sympathomimetics (Prazocin) in ejaculation after SCI Men’s Health Initiative, directed by Larry Goldenberg at the Prostate (6) Abdominal electrical stimulation with penile vibrostimulation to Center, is inclusive now of a full time sexual health clinician. By produce ejaculation in men with SCI, collaborating with the Miami September 2009, 2 of the 4 pillars of Men’s Health (sexual medicine, Project and University of Texas. bone health, cardiac health and androgen status) will be in place with ( 7) Disabilities Health Research Network grant for manual for sexual Dr.Elliott directing the Sexual Assessment and Rehabilitation Clinic aids for persons with disability and impaired hand function. with Shannon Griffin, RN and collaborating with Dr.Richard Bebb Publications: Twenty one book chapters and twelve peer reviewed (endocrinology) for the Testosterone Assessment and Replacement journal publications this year include manuscripts in Expert Opinion in Clinic .. A public forum in mid Nov 2009 will address this new Pharmacology, International Journal of Impotence Research, Journal of initiative. Cross collaborations with Radiation Oncology (Dr.Elliott), Sexual Medicine, Primary Care Psychiatry, Health Psychology, Journal Gynecology/Oncology (Dr.Brotto/Basson) and Rehabilitation ( Sexual of Sex and Marital Therapy, Journal of Spinal Cord Medicine and Health Clinicians and PM& R specialists) are current and future Spinal Cord. combined clinical/research enterprises.

DIVISION & PROGRAM REPORTS * 2008-2009 Summary of program activities since the report of Schizophrenia 2003-2004 Program Highlights include 71 publications with a series on sexual medicine Dr. Bill MacEwan for The Lancet as well as a review of women’s sexual dysfunction in the New England Journal of Medicine. There were 116 CME and Program Director conference presentations from this program locally, nationally and internationally. Research included CIHR funded study of psychoeducational Program Description intervention in cervical cancer; MSFHR funded study on cervical cancer and sexuality; CIHR funded study of androgen activity and The Schizophrenia Program is a multi-site clinical and research women’s sexual function; CIHR funded study of sensory substitution program which strives to investigate the origins and clinical correlates for the functional recovery of sexual sensations in individuals with of psychosis so that they can be translated into best clinical practices SCI and a previous RHMIM funded proof of concept study of the through education of clinicians. Our program is involved in all same; RHMIM funded study of the prophylactic value of Prazosin components of this discovery, education and translation. in reducing autonomic dysreflexia produced by ejaculation in men 60 Discovery with SCI; Christopher Reeve Paralysis Foundation Community Research Project targeted toward understanding and improving The program’s discovery arm is lead by Dr. Bill Honer, the UBC Jack sexual dysfunction associated with SCI and an industry sponsored Bell Chair in Schizophrenia, and is comprised of basic science and independent medical grant for understanding asexuality. clinical research studies. The research programs center out of the Centre A full illustrated manual for sexual aids for persons with disability for Complex Disorders (CCD) in Vancouver. The general theme of and impaired hand function is now available on line at www.dhrn. our research is to look at psychosis from a wide perspective including ca as a result of a 2008 grant . We taught within DPAS, clinical skills, proteomics (Drs. Clare Beasley and Bill Honer, UBC), pharmacology FERGU, endocrine and metabolism and brain and behaviour blocks, (Drs. Ric Procychyn and Alasdair Barr, UBC), neuroimaging (Drs. created on line case management teaching for 3rd year and provided Donna Lang, Todd Woodward and Elton Ngan, UBC), genetics (Drs. clinical experience for 4th year Selectives, Residents from Obgyn, Jehannine Austin and Robert Holt, UBC), cognition (Dr. Al Thornton, Family Practice and Psychiatry as well as Fellowships to one family SFU), social psychology (Dr. Tania Lecomte, U of Montreal) and physician and two psychiatrists. clinical (Drs. Bill Honer, Geoff Smith and Bill MacEwan, UBC). Education Our educational activity is lead by Drs Austin, Honer and MacEwan. Dr. Austin coordinates the psychosis training for the UBC Medical School, Dr. Honer’s group at CCD direct Masters, Doctoral and postdoctoral students. Clinical training in early psychosis occurs at the Education Early Psychosis Program (EPI) in Fraser South (Dr. Bill MacEwan), Dr. Khanbhai appointed psychiatry undergraduate teaching coordinator inpatient treatment at St Paul’s Hospital (Dr. Irfan Khanbhai), and St. Paul’s Hospital Refractory Psychosis at Riverview Hospital (Drs. Sean Flynn and Chris Schenk) . Translation

Translation • 9th Annual Early Psychosis meeting, conference theme on the stigma of mental illness held at Surrey Arts Centre attended by 450 The translational component of our program is broad. Our goal is to delegates. help clinicians deal with the complexity of psychotic illnesses especially when these illnesses commonly interface with medical illnesses (HIV, • 7th Annual Clinical Neurosciences meeting, held at Wosk Centre for HCV), substance abuse and poverty. It includes clinical training Dialogue, attended by 150 delegates. programs in early psychosis intervention in Fraser Health, acute care • The Inner City Youth Mental Health team, an outreach project at psychosis at St Paul’s Hospital and refractory psychosis at Riverview St. Paul’s, awarded by SPH Foundation for its innovative work. Hospital. We also organize 2 annual mulidisciplinary conferences in early psychosis and clinical neurosciences. We also have monthly Program Plans for the Future and quarterly journal clubs in basic science and early psychosis topics. Our program is also activiely involved in health networks providing To expand our horizons in understanding psychosis, particularly in 61 leadership to the BC Mental Health and Addictions Research Network those individuals suffering from complex forms that are influenced by (Dr Honer) and membership in the BC Psychosis network. substance abuse, head injury, viral infection and cognitive impairment.

Program Summary of Activities

Discovery

Launch of the “Hotel Study”, a one year, follow-up study which aims to investigate 300 participants who suffer from mental illness, substance abuse, viral infection and reside in poverty in the Downtown Eastside area of Vancouver. Salary Awards: Four of our Assistant Professors have received competitive, peer-reviewed salary awards at BOTH the Provincial (Michael Smith Foundation) AND the federal level (Canadian Institutes of Health Research): Drs. Todd Woodward, Alasdair Barr, Jehannine Austin, and Clare Beasley.

DIVISION & PROGRAM REPORTS * 2008-2009 UBC “Today, over 90 Institute basic and clinical scientists have for Mental become Founding Health Fellows of the Dr. Allan Young Institute of Mental Director Health”

62 From the Director, Institute of Mental Health (IMH)

It is now over 200 years since the concept of psychiatry as a distinct Psychiatry, Psychotherapy and Geriatric Psychiatry is now on the medical speciality was articulated by Johannes Reil and the problems threshold of success. As the IMH builds on these successes within that face us in mental health remain as great as ever. One of our the department of psychiatry in the coming year, we will continue great tasks facing in psychiatry is to translate the advances of science to provide key leadership on mental health issues in Vancouver as a into practical benefits for the clinical, social, and political ways that steward of this vision for translational research in mental health. we address mental illness. This past year we have undertaken a range

of activities to this end. For example in the IMH Master-Class on Bipolar Disorder world authorities reviewed the staggering advances in Sincerely, understanding of the genetic roots of severe mental illness. The successful initiation of the Coast Capital Savings Depression Research Fund, which funded 2 senior and three junior research projects is an outstanding example of partnership with the local Allan Young community and one which we wish will long continue. These are just two ways the Institute of Mental Health has catalyzed the seeding and translation of promising new research in the field of mental health. Our recruitment drive for world class faculty for our Chairs in Child Introduction enhancing authentic happiness and physical well-being. This highly successful event, held at the Orpheum Theatre, featured presentations By 2020, brain disease will overtake heart disease and cancer as the by Allan Young, Director of the IMH, as well as: leading cause of death and disability in Canada. A recent World Health • Edward Diener, Alumni Professor of Psychology at the University of Organization report identifies depression as the second leading cause of Illinois the lifetime burden of disease; four other forms of mental ill health – • Sonja Lyubomirsky, Professor of Psychology at the University of including tobacco and alcohol addiction – round out the top ten. California Meanwhile, societal pressures have created new ghettos of vulnerable • Paul Ekman, Emeritus Professor at the University of San Francisco populations, including Vancouver’s Downtown Eastside and First • Michael Meaney, James McGill Professor of Medicine and Director Nations communities throughout BC. Responding to the needs of of the Program for the Study of Behaviour, Genes and Environment these communities requires not only improving our understanding at McGill University of the brain, but also improving brain health care delivery and our understanding of how addictions modify behaviour. • Dacher Keltner, Director of the Berkeley Social Interaction Laboratory and Co-Director for the Center for the Development of The Institute’s interdisciplinary vision spans the faculties of Medicine, Peace and well-Being Nursing, Education, Law and Arts, with the department of Psychiatry • Deepak Chopra, best-selling author, The Dream Healer: March playing the leadership role. This engagement has enabled the Institute 63 2008 of Mental Health to play a major role in the recruitment of outstanding scientists. The Institute played an active role in organizing a series of academic lectures held to complement the world premiere of The Dream Healer, Today, over 90 basic and clinical scientists have become Founding an opera based on Timothy Findley’s Pilgrim, which focuses on Carl Fellows of the Institute of Mental Health. The executive Advisory Jung’s time at the Burghölzli Clinic. Three lectures—The Stigma of Board is now convening in its third session. This document provides Living with Mental Ill Health; C.G. Jung: The Man and the Myth; a snapshot for the Board of the Institute’s recent and past activities and Compassionate Approaches to Mental Ill Health—were held at the inclusive of the colloquia, workshops, seminars and conferences that Chan Centre and were open to all. Professor Nancy Hermiston, who serve to encourage cross-fertilization of ideas. heads the voice and opera division at the School of Music and who directed the production, said, “It’s a fantastic collaboration. And I think this is what universities should be doing: leading the dialogue in these Partnership Programs kinds of issues.”

Happiness and Stress as Determinants of Mental Health: Conferences September 2006 IMH Founding Director Anthony Phillips moderated a discussion In April 2008, the Institute sponsored a three-day conference at the among the Dalai Lama and leading researchers on the topic of UBC Life Sciences Centre entitled Cracked but not Broken, which

DIVISION & PROGRAM REPORTS * 2008-2009 addressed the current crisis in methamphetamine addiction. The of research (e.g. new hypotheses, new techniques, new ideas) that are in conference, spearheaded by Professor Michael Krausz, BC LEEF Chair a pilot / feasibility state that will lead to significant external funding to in Addiction Research, brought together experts and stakeholders support the next step in an exciting new research direction. from various continents, cultures, and disciplines to share their Two levels of funding made available through the Coast Capital Savings unique experiences and solutions on stimulant abuse. Focusing on the Credit Union Fund are: particular vulnerabilities in youths, the conference examined questions pertaining to pregnancy and stimulant use, concurrent disorders, • Coast Capital Young Investigator Grants physical and mental illness associated with stimulant use, and the • Coast Capital Independent Investigator Grants best evidence-based pharmacological and psychosocial treatments for In 2008, the Coast Capital Savings Depression Research Fund adolescents. In August 2008, IMH Founding Director Anthony Phillips competition attracted sixteen grant applications in both the chaired the 12th international conference on in vivo methods, entitled Independent and Young Investigator categories. Monitoring Molecules in Neuroscience. The conference provided a platform to facilitate the development and refinement of methods for The deadline for applications to this new competition was December 1, the detection of chemicals in the brain. Historically, this meeting has 2008, and a review panel consisting of Heather Craig, Rennie Hoffman, been an important forum for such progress and for standardization of Professor Tony Phillips, Professor Allan Young, and Professor Trevor methodology. In addition, as the meeting has evolved, it has taken on Young, met on December 17th, 2008 to choose the successful grant 64 a substantial emphasis on state-of-the-art applications of neurochemical applications, which are as follows: techniques ranging from studies conducted in single cells to those in living humans. An IMH Master-Class in Bipolar Disorder was held in January 2009. An international faculty of leading research updated Grant PI / Co-investigator Project Title UBC researchers on the latest developments in the field. The meeting Allocated was entirely supported by an unrestricted educational grant from PI: Nichole Fairbrother, FPostpartum mood disorders: $12,000 AstraZeneca. Co-investigators: Patricia prevalence, co-morbidity and risk Janssen, Mark Lau factors Grant Winners PI: Raymond Lam, EXCITED (Extending Care using $54,000 Co-Investigators: Andrew Clarke, Internet Treatment for Employees with Erica Frank, Dorothy Shaw Depression) The Depression Research Fund is funded by Coast Capital Savings Credit Union annual golf tournament. Coast Capital Savings Credit PI: Bradley Vines, Treating depression in Parkinson’s $30,000 Union has raised funds through its annual golf tournament for the Co-investigator: Jon Stoessl disease with transcranial direct current benefit of depression research. stimulation

In association with the UBC Institute of Mental Health and the VGH PI: Joanne Weinberg The role of hypothalamic-pituitary- $54,000 & UBC Hospital Foundation, Coast Capital Savings Credit Union adrenal (HPA) axis dysregulation in the wishes to support new research ideas identified by investigators in causes and treatment of depression British Columbia. The intent of this competition is to fund new areas These successful applicants have been invited to participate in the • The polyvagal theory: insights into the neurobiology of psychiatric Coast Capital Savings Credit Union Charity Golf Tournament disorders and behavioural problems banquet on June 25th, 2009 to share their research objectives and • Issues in Native mental health and research challenges progress. Colloquia

Since the fall of 2006, the IMH has sponsored an annual series of Recruiting Outstanding Faculty talks by distinguished researchers in mental health at universities across North America. Many of the talks were co-sponsored by the Dr. Allan Young Brain Research Centre, the National Core for Neuroethics, and other departments in the UBC Faculty of Medicine. Director of the UBC Institute of Mental Health, Leading Edge Endowment Fund Chair in Depression Research and Professor in the To date, there have been 28 talks in the colloquia series. The diverse UBC Department of Psychiatry | Appointed November 2005. colloquia topics have included: “Mental health problems are so common that everyone has them • Mother Nature and Mother Nurture in Mothers’ depression and in their wider family,” says Dr. Young. “Whether it’s an elderly children’s antisocial behaviour relative with Alzheimer’s, a child with learning disabilities or 65 • Is there a biology of misfortune? Social position, biological someone experiencing depression—it’s there.” Dr. Young’s research sensitivity, and child mental health concentrates on the causes and treatment of severe mental disorder, • Unravelling the molecular, cellular and systems mechanisms of particularly clinical depression. Very interested in the causes of remote memory depression, he has directed much of his work to understanding how • Remembering, The Default Mode, and Alzheimer’s Disease environmental stresses contribute to depressive symptoms. He is also trying to develop new treatments that can help with these. • The plastic human brain: implications for translational neuroscience and education “What’s happening here at UBC is really exciting,” he says. “We • Neurotransmitter transporters: new insights into structure, have this magnificent endowment that has allowed the Institute of function, and pharmacology Mental Health to be established, we have a university with a very good tradition of high-class research, and we have support from local • Turning up the heat: inflammation as a mechanism linking chronic stakeholders, including the families of people who’ve suffered from stress, depression, and heart disease severe mental ill-health.” • The foundation of human numerical thinking: implications for Dr. Young received his MD and PhD from the University of understanding dyscalculia Edinburgh. Following postgraduate studies at the University of • Producing and perceiving vocal communication signals Edinburgh and the University of Oxford, he obtained his MRC • Mapping brain maturation and cognitive development during Psych in 1988 and FRCPsych in 2003. He came to UBC from the adolescence University of Newcastle upon Tyne.

DIVISION & PROGRAM REPORTS * 2008-2009 Dr. L. Trevor Young Dr. Judy Illes Professor and Head, UBC Department of Psychiatry Canada Research Chair in Neuroethics | Appointed in November 2006. Appointed in the Department of Medicine, March 2007. As an active clinician scientist in the area of bipolar disorder, Dr. Ever question the ethics or science behind advertising? Well, Young’s principal research interests include understanding the Professor Judy Illes does. In fact, Illes, Director of the National Core molecular basis of bipolar disorder and its treatment, and how to of Neuroethics at UBC, is exploring the ethical issues around neuro- apply these findings to the clinical setting. He is widely published marketing, an emerging field of marketing that uses neuroscience and well funded by peer-reviewed granting agencies in these areas. to get you hooked on the latest fad. “The field of neuroscience is His research is particularly focused in understanding the processes evolving at a rapid rate,” says Illes, who is also a Canada Research that lead to long-term changes in brain structure and function in Chair in Neuroethics. “Advances in scientific technologies can patients with bipolar disorder and how these changes can be targeted give us intimate details about the inner workings of our brain. by the neuro-protective effects of mood stabilizing drugs. Neuroethics considers the social, cultural, personal, and religious implications of these advances in neuroscience.” Dr. Young has led several large clinical programs for patients with mood disorders including the Mood Disorders Program at Hamilton Neuromarketing uses neuroscience to study the brain’s responses to Psychiatric Hospital, which received the American Psychiatric marketing stimuli. It aims to understand a consumer’s decision and 66 the part of the brain that influences that decision. Services Gold Achievement Award. In 2003 he was awarded the Douglas Utting Award for outstanding contributions in the field “There are three major ethical issues for consideration,” says Illes. of mood disorders. In 2006 he was appointed a Distinguished “First, we must protect parties who may be harmed or exploited by Fellow of the American Psychiatric Association and received the neuromarketing. Second, we must protect consumer autonomy if Canadian College of Neuropsychopharmacology Heinz Lehmann neuromarketing reaches a critical level of effectiveness, and third, we Award for outstanding contributions in the field of research in must protect scientific integrity.” Says Illes, “The particularly loose neuropsychopharmacology in Canada. restrictions surrounding studies for marketing purposes outside the academic sector are especially worrying.” Dr. Young received his medical degree at the University of Manitoba. This was followed by residency training at McGill Moreover, if new technologies are developed that fall outside the University and the University of Toronto where he also completed purview of regulatory authorities, even these protections may be lost. his PhD in Medical Sciences. He completed a Research Fellowship Subject protections should be equal to those required by academic at Johns Hopkins University in Maryland. His former roles include and medical research centres.” Physician-in-Chief, Executive Vice President Programs at the Centre (Excerpted from “Can brain science manipulate consumers?” by for Addiction and Mental Health, and Professor and Cameron Catherine Loiacono. UBC Reports, April 2009.) Wilson Chair in Depression Studies in the Department of Psychiatry at the University of Toronto. He currently holds an adjunct faculty member position at Rockefeller University in New York. Dr. Richard Pico Krausz brings his international expertise in concurrent disorders— the dual diagnosis of mental illness and drug addiction—to address Head of the Department of Psychiatry at St. Paul’s Hospital | Appointed in the mental health crisis in Vancouver’s Downtown Eastside. Krausz September 2007. believes in a holistic approach to treating concurrent disorders as well Richard Pico is also a Clinical Professor in the Department of Psychiatry as a collaborative effort among health authorities, universities and at UBC, and the Senior Advisor for Advanced Information Technology government. Widely recognized as a world authority on addiction and Clinical Transformation at the Provincial Health Services Authority. treatment, Krausz has dedicated his professional life to treating As a researcher, Pico was principal or co-principal investigator in studies substance abuse and mental illness. By the mid-1990’s he was of medication use in adolescent schizophrenia, military-induced stress leading one of the world’s largest addiction trials at the University responses in servicewomen, and neuroanatomical and neuropsychological of Hamburg. Krausz was instrumental in the implementation of the correlates of psychosis. Educated in California, Pico received a PhD in German Methadone Program and the European Cocaine Project. Neurobiology and MD from the University of California, Irvine. It was through this work that he recognized the profound need to address concurrent disorders holistically. He also found that improved He completed a residency in Psychiatric Medicine at Wilford Hall treatment led to crime reduction. Vancouver’s current situation Medical Center in San Antonio, Texas. Pico came to St. Paul’s reminds Krausz of the open drug scenes that existed in Europe in the Hospital following five years as the Chief Medical and Technology 1980s and 1990s. He believes Vancouver’s situation poses a greater Officer at Perot Systems Healthcare, Dallas, Texas. Prior to that, he challenge in that homelessness is compounded with substance abuse 67 was Vice President, Chief Medical Officer, and Head of Research and and mental illness. Development for NexxtHealth-Empire Blue Cross Blue Shield in New York. He has held academic positions at California State University, the “What you see is that a high percentage of individuals are mentally ill University of California, Los Angeles, Wilford Hall Medical Center, and have no place to live,” says Krausz. “This has also led to higher Mount Sinai Medical Center and School of Medicine, and New York mortality rates. In this population, persons are dying two decades University. earlier due to suicide, overdoses and HIV/AIDS.” In addition to many peer-reviewed reports, abstracts and book chapters, (Excerpted from “UBC Psychiatry Prof. to Help Lead Mental Health Pico is also the author of Consciousness in Four Dimensions: Biological Collaboration for Vancouver’s Downtown Eastside” in UBC Reports, Relativity and the Origins of Thought, published in 2002 by McGraw April 3rd, 2008.) Hill. “The establishment of the UBC Institute of Mental Health added a whole new dimension to the psychiatric research taking place here, Dr. Michael Krausz and was a long overdue recognition of the toll exacted by mental Leading Edge Endowment Fund Chair in Addiction Research | Appointed in illness and addictions. Their gift allowed us to delve into traditionally the Department of Psychiatry in February 2007. neglected areas, such as child and adolescent psychiatry, geriatric psychiatry and psychotherapy, and to pool resources and expertise in “If you are not investing in innovative strategies, you are not moving ways that stretch traditional academic boundaries.” forward in solving the pressing issues of today,” says Dr. Michael Krausz, UBC Professor of Psychiatry and a clinician at St. Paul’s Hospital. —L. Trevor Young

DIVISION & PROGRAM REPORTS * 2008-2009 Postgraduate Education Program Dr Jonathan Fleming Program Director

EDUCATION Program Description Postgraduate Education The Postgraduate Program in Psychiatry at the University of British 68 Undergraduate Education Graduate Program in Neuroscience Columbia is a fully accredited, five year training program that provides comprehensive instruction, training and supervision in the CanMEDS Continuing Medical Education and Professional Development roles as required by the Royal College of Physicians and Surgeons of Canada. Resident Research Public Education The Department of Psychiatry’s training program integrates clinical Research Day training and academic seminars that are shaped, monitored and changed as required by the Program Committee, chaired by the Program Director, Dr Jonathan Fleming. This committee has members from the major hospitals involved in the training program as well as representatives of various sub-disciplines such as Child, Geriatric and Forensic psychiatry. Residents, elected by their peers, and representing 4 each training year serve as full voting members, and they work with Dr Fleming and the Faculty committee members to monitor the current program and to facilitate its future growth and development. This year four new positions were added: A Director of Scholarly Activities, Dr Ray Lam, a faculty representative from the psychiatry Undergraduate Program, Dr Sam Kelleher; a Resident representative for the distributed sites and the Chair of the Family Advisory Council (ex officio). “We are very proud of this year’s PGY5 Residents who all passed their Royal College exams.”

Kyle Burns, Sam Iskander, Sam Kelleher , Sam Miremadi, and Lindsay Davis, Eve Cabalo Luiza Shamkulova

Clinical placements, in years PGY2 through PGY5 are made in a Dr Jenny Rogers mutually agreed upon fashion in an integrated network of general Dr Andrea Tuka hospitals and special training sites, which include the Vancouver Dr Monique Wong 69 Hospital sites at VGH and UBC, St. Paul’s Hospital, Royal Columbian This year we welcomed 14 new PGY1 Residents through the CaRMS Hospital, Richmond Hospital, BC Children’s and Women’s Health match and one transfer Resident from Internal Medicine that brought Centre, Forensic Psychiatric Hospital, Royal Jubilee Hospital in our total number of Residents for the 2008-2009 academic year to 66. Victoria, Prince George Regional Hospital and Vancouver Community Mental Health Services. Primary entry into the program remains There were a total of 91 applications this year through CaRMS. In through the CaRMS match. the past all UBC medical students applying for psychiatry residency positions were automatically granted interviews. This year the New Developments Selections Committee instituted a new policy to apply the vetting process equally among all applicants. This resulted in some UBC medical students, whose qualifying scores had fallen below the median, We are very proud of this year’s PGY5 Residents who all passed their being passed over for interviews. Royal College exams. The graduating class is: This was also the inaugural year for two new CaRMS tracks which will Dr Kyle Burns each take in one new Resident a year: Prince George and Research. Dr Eve Cabalo The Residents matched to Prince George will spend their first three Dr Lindsay Davis years in Prince George. Dr Candida Graham will oversee all Psychiatry Dr Patricia Frew Residents while they are in Prince George. Both Dr Graham and Lisa Dr Sam Iskander Lakusta, who is the Postgraduate Medical Education Coordinator for Dr Saman Miremadi Northern BC, were invaluable in setting up the first year in Prince EDUCATION REPORTS * 2008-2009 George. Dr William Honer will oversee the Research Track Resident. invited to come to Vancouver to give a talk to the Residents on the Research will be an integral part of the Resident’s training beginning in Mental Health Commission. Members of the Family Advisory Council their PGY1 year with a 1-month research elective. By their fifth year were also invited to encourage discussion from the perspective of both they will be spending four days per week doing research. The Resident providers and consumers of Mental Health services and to further may complete an MSc in Clinical Neuroscience by graduation, or may enhance the Residents’ advocacy role. switch to the PhD program and continue research training as a PGY6 The Residents hold monthly one-hour business meetings and an annual and PGY7 through the Royal College Clinical Investigator Program. all day business retreat in which they discuss the overall residency The CPA Annual Conference was held in Vancouver this year and training program. The findings from this retreat are discussed at the traditionally the local Residents organize a meeting for all Residents Program Committee meetings and frequently provide the basis for attending from across Canada. Drs Kelly Saran and Jesse Sidhu, both making improvements to the program. Under the leadership of the PGY4 Residents, organized and hosted a “Relish the Night” social Resident President and Chair of the business meetings, Dr Chris which turned out to be the most successful annual CPA Resident social Robertson, the Residents were able to produce a comprehensive on-call event ever with over 100 attendees. policy which covers all the major call sites and includes information on everything from where to get your hospital ID to how to handle Residents from our program served on two national committees: Dr an intoxicated patient. The Residents were also able to clarify and Grant Millar, as co-Chair on the COPE committee and Drs Jerome Lee write down the roles of the various Resident representatives. Monthly and Ryan Chan, as CPA members-in-training. 70 Chief Residents meetings were also initiated this year with the goal The Inaugural BC Resident Physician Recruitment Fair was held of improving cohesiveness and to come up with standardized Chief on October 16th. Dr. Kelly Saran, PGY4 Resident and a PAR-BC Resident guidelines. representative, played a critical role in coordinating the launch of There are several Resident/Faculty social events planned throughout the this Resident job fair. It was a great success with over 85 Residents year. The first of these events was the Welcome Reception for the new attending and with all involved feeling ready to build on its success by PGY1 & 2 Residents held on July 10, 2008. This is our most popular making it an annual event. event giving the new Residents an opportunity to meet their colleagues. Dr. Fleming organized an Advocacy Night on September 11, 2008. The annual Residents vs Staff soccer game is another well-attended The purpose was to bring together Residents and representatives from event drawing competitive players from both groups followed by a various advocacy groups in Vancouver. Forty-two Residents attended victory celebration held at a local pub. to hear speakers from organizations such as the Family Advisory The Residents also meet socially on a regular basis throughout the year. Committee; Mood Disorders Association and BC Schizophrenic These events are usually clustered around the beginning of the academic Society. The evening was a success and further opportunities for year when events are held to welcome the new Residents, the Christmas increasing advocacy and contact with the major stakeholders in mental holidays when one Resident will host a party for all the Residents and health was proposed. their families and in winter when the Residents go to Manning Park Dr Larry Goldbloom, Professor of Psychiatry at University of Toronto for their annual retreat. All of these events are funded by the program and Vice-Chair of the Mental Health Commission of Canada was and Residents at distant sites are reimbursed for their travel expenses if they wish to attend. This year the Residents have started a weekly get- together after their academic day on Thursdays, usually at a local pub or restaurant. This is the second year for the Journal Club’s new format. It was previously held during lunch hours and attendance was sporadic but last year the Residents decided to make it a dinner event and it has been a growing success ever since. Unfortunately space is limited and the organizing Residents sometimes have to place people on a waiting list as demand is so high.

Resident Education Steve Wiseman Ren Persaud & Jon Fleming

Clinical

The Royal College introduced new specialty training requirements for mandatory rotations in Consultation Liaison, Collaborative/Share Care psychiatry effective July 1, 2008. Residents who entered the program and Chronic Care as well as 6 months each of Selectives and Electives. 71 in 2007 or earlier will be grandfathered under the previous training Senior Residents are expected to assume a leadership role in the requirements. The 5-year residency is now split into a Junior Residency education and supervision of their junior colleagues. (PGY1-3) and a Senior Residency (PGY4-5). Another major change introduced by the Royal College is the addition The most significant changes were made at the PGY1 level where all of a concurrent and longitudinal training component. Residents are psychiatry programs across Canada were asked by the Royal College to required to see patients with severe and persistent psychotic and/or design a PGY1 year that places more emphasis on providing a broadly severe and persistent bipolar illness for no less than 2 hours per month based medical experience relevant to Psychiatry while maintaining for at least one year. core elements in Medicine, Pediatrics, Family Medicine, Neurology/ Dr Kathleen McGarvey was asked to help implement this new Neuroimaging and Emergency Medicine. It was necessary to drop some requirement and her recommendation, which was approved by the rotations such as Obstetrics/Gynecology and Intensive Care which Program committee, is that this be done in the PGY2 year and that has resulted in Residents who started in July 2008 and beyond being the Residents be given a half-day per week to fulfill this element of unable to qualify for a BC College general license in their PGY2 year. their residency. This longitudinal rotation was to be implemented by There is no change to the PGY2 year which will continue to be a full September 1st, 2009. year of General Adult Psychiatry, split evenly between the inpatient Academic and outpatient wards. The PGY3 year will consist of 6 months each of Child and Geriatric Psychiatry and the PGY4 and PGY5 years include The PGE curriculum is held for a full day every Thursday for the

EDUCATION REPORTS * 2008-2009 PGY2-4 Residents. The mornings consist of seminars on and Courses, which are spread out over 2 years, include Child Psychiatry introduction to psychiatry for the PGY1’s, core disorders, special (35 hrs); Schizophrenia (12 hrs); Anxiety Disorders (6 hrs); Mood syndromes, and neurosciences for the PGY2-4s, and capstone skills Disorders (7 hrs); Community Psychiatry (4 hrs); Cultural Psychiatry for the PGY5s. For the PGY2-4 Residents the afternoons consist of (4 hrs); Consultation-Liaison (10 hrs); Sleep Disorders (6 hrs); Sexual seminars and group supervision in psychotherapy. PGY1 Residents Disorders (8 hrs); Eating Disorders (6 hrs); Forensics (23 hrs); Geriatric come in once a month for their academic day. Psychiatry (34 hrs); Dissociative Disorders (2 hrs); Reproductive Psychiatry (6 hrs); Neuropsychiatry (46 hrs); Psychopharmacology (9 PGY1 hrs); Critical Appraisal; and Epidemiology and Research. The objectives of the monthly academic days are to introduce Residents to a variety of topics in psychiatry to facilitate interaction between PGY5 PGY1s and other Residents. The curriculum includes courses in Ethics The objective of this series of workshops is to prepare Residents for their and Psychiatry; Mental Health Legislation; Pharmaceutical Industry and first years in professional practice and include The do’s and don’ts of Psychiatry; Psychiatric Practice; Anthropology of Psychiatry; Critical RCPSC Mock Orals; Negotiating for a psychiatric position; How to appraisal of research results; Psychosis in DD; Medical conditions bill as a psychiatrist; Financial issues you need to be aware of for your related to Autism; Mental status examination; Neuroimaging; first year of practice; Establishing a private practice; Medical legal issues; Community Recourses; Introduction to Psychopharmacology; How Interacting with insurance companies; Clinical supervision; What to 72 to give a great Grand Rounds; How to teach MSIs in ER when you expect in your first year; and transitional issues. are on call; Cultural Psychiatry; First Nations Psychiatry; Psychiatric Interviewing; and Introduction to Neuroethics The Psychotherapy curriculum is delivered on Thursday afternoons in a modular format: PGY2 The PGY2 seminars are designed to provide Residents with an overview PGY2 of the major psychiatric disorders and to prepare Residents for their • General Skills and Supportive Psychotherapy on-call experiences. Courses include Emergency Psychiatry Orientation • Introduction to Psychodynamic Psychotherapy (60 hrs); Mood Disorders (16 hrs); Anxiety Disorders (16 hrs); Schizophrenia (12 hrs); Dementia and Delirium (12 hrs); Personality PGY3 Disorders (15 hrs); Substance Disorders (6 hrs); Somatoform Disorders (3 hrs); Ethics (11 hrs); Religion and Spirituality (6 hours) and; Clinical • Long-term Psychodynamic Psychotherapy Neuroethics (2 hours). • Brief Psychodynamic Psychotherapy PGY3 and PGY4 • Group Psychotherapy The learning objectives for the PGY3 and PGY4 Residents are to PGY4 provide Residents with in depth knowledge of major clinical syndromes and special areas in psychiatry including knowledge of normal versus • Cognitive-Behavioural Therapy (CBT) abnormal states; current research and trends and controversial issues. • Interpersonal Psychotherapy (IPT) Research Awards

This year we had three Residents present at the 24th Annual Research Five Residents received awards this year and were presented with Day on June 4, 2009: Dr Chris Robertson gave a talk on “Which plaques at the awards dinner following the Research Day presentations: depressive symptoms predict impairments in work performance?”; Dr Alan Bates presented “Four years of mistakes: An examination of error- Name Award processing in schizophrenia” and Dr Jennifer Wide spoke on the “Effect Dr. Kam Athwal (PGY2) Significant Contribution to the Residency Program of gender role socialization in the presentation and diagnoses of major Dr. Alan Bates (PGY1) CanMEDs Award depression”. Dr. Alan Bates (PGY1) Significant Contribution to Research In this past year, Dr Raymond Lam was appointed the Director Dr. Kyle Burns (PGY5) Postgraduate Psychotherapy Award of Scholarly Activities. His responsibility will be to promote the Dr. Kyle Burns (PGY5) Resident Undergraduate Teaching Award CanMEDS role of Scholar throughout the Residency and he will concentrate on subjects such as critical appraisal, evidence-based Dr. Chris Robertson (PGY4) Leadership Award medicine and research. He, and a small sub-committee, are working on Dr. Jenny Rogers (PGY5) George Davidson Research Award) a variety of issues - such as a standardized format for rounds and journal clubs and incentives to increase scholarly activity with the Residency. In previous years the Residents have voted as a group for one faculty member to receive the UBC Psychiatry Residents’ Association Annual 73 Dr William Honer will continue his excellent work in coordinating the Award for Teaching Excellence. However, this year they decided to Research Track and work closely with the Residents who are matched break off into separate committees, each representing one of the major to the track. The Research Track is recognized as being our best teaching sites, to present this award to seven Faculty members:: opportunity to “grow our own” researchers and junior Faculty. This track, in combination with the change in training requirements allowing Name Teaching Sites Residents to start subspecialization electives in their final year along Dr. Chris Babbage Royal Columbian with the development of Fellowships in Geriatrics, Child Psychiatry and Forensics will contribute greatly to the future development of academic Dr. Chris Blashko/Kiri Simms Victoria (tie) psychiatrists. Dr. Andrea Chapman BC Children’s & Women’s Health Centre The Residents have appointed a Resident research representative whose Dr. Robert Hewko VGH task it will be to encourage non-research track Residents to pursue this Dr. Samantha Kelleher St. Paul’s important aspect of psychiatry. Ms. Ingrid Sochting Richmond

EDUCATION REPORTS * 2008-2009 Concerns Program Plans for the Future

When the Royal College decided to change the final evaluation from Two new CaRMS tracks will be established in time for the 2010 a long-case examination and presentation to the more objective and match. Two Residents will match to the Vancouver Island Health standardized OSCEs, the Specialty Committee was concerned that the Authority and will spend their Junior Residency (PGY1-3) in Victoria. important skill of completing a comprehensive clinical examination, Four Residents will match to the new Fraser Valley/Royal Columbian formulating a case and presenting it would be diminished. Their track for their Junior Residency. Discussions are ongoing regarding a solution was to require the training programs to ensure that each possible track for Kelowna and it is hoped to have two positions based Resident completed and passed two such evaluations before going on in Kamloops in the 2011 academic year. to the final examinations. These evaluations, called STACERS, are The Chief Residents, under the leadership of Dr Chris Robertson, have recognized as being labour intensive, costly and unfortunately focus developed a standardized teaching program across the sites, which will the final year Residents on an examination that is anxiogenic and provide Residents with an opportunity to teach and provide the medical distracts then from other endeavors such as research or electives in their students with a standardized learning opportunity. final year. Dr Fleming has being working with COPE and the Royal College to develop a reliable method to test interview, formulation and As the Royal College implements sub-specialty programs in child, presentation skills throughout the Residency and it is hoped that the geriatric and forensic psychiatry we will need to develop Fellowship STACERS will soon be dropped. programs in these important areas. 74 An ongoing concern has been a lack of consideration and consultation In preparation for the Royal College Accreditation visit in 2013, our by hospital administrations when plans are made to change clinical program will undergo an internal review later this year. services that make up an essential component of the educational enterprise. This year the Anxiety Disorders Clinic was moved from UBC to the VGH site and eventually disbanded. This restructuring was done without consultation with the training program and has had RESIDENTS – July 1, 2008 to June 30, 2009 a significant impact on the delivery of our psychotherapy CBT module ABRAHAM, Natalia (PGY2) LAX, Stuart (PGY4) this year and eliminated a highly valued training site for our Residents. ADAM, Trudy (PGY3) LEE, Jerome (PGY4) An ongoing concern is the absence of adequate office space for our ANDERSON, Cameron (PGY3) LOVE, Maia (PGY1) Residents at some teaching sites. This will need to be a focus between ATHWAL, Kam (PGY2) LUCKHURST, Jessica (PGY2) the Program and the Health Authorities in the coming year and must be resolved before the next accreditation visit in 2013. BARLEY, Jennifer (PGY1) MACFADDEN, Megan (PGY3) BATES, Alan (PGY1) MENDOZA, Valentina (PGY3) Although our Department has been successful in distributing our BOROWSKA, Anna (PGY3) MILLAR, Grant (PGY4) Residents and increasing the entry class each year this growth (21 new BROST, Philip (PGY1) MIREMADI, Sam (PGY5) Residents will enter the PGY1 stream in 2010) may impact one of our core strengths – the cohesiveness within the program and the excellent BURNS, Kyle (PGY5) PATEL, Mitesh (PGY2) relationships between the Residents and the Faculty. BURNS, Kyle (PGY5) PHILLIPS, Michael (PGY2) BURRELL, Erin (PGY2) PROULX, Francois (PGY2) Postgraduate Program Committee BUZATU, Liliana (PGY3)) RAMIREZ, Saby (PGY3) D.r Jonathan Fleming Chair CABALO, Eve (PGY5) RIVERA, Karen (PGY2) CAMERON, Kristjana (PGY2)) ROBERTSON, Christopher (PGY4) Dr. Cam Anderson PGY3 Rep CASEY, Janel (PGY3)) ROGERS, Jenny (PGY5) Dr. Auby Axler Assoc Program Director – Psychotherapy CHAN, Ryan (PGY3) ROSENAUER, Helen (PGY3) Dr. Alan Bates PGY1 Rep CHEEK, Joanna (PGY2) SALIH, Tamara (PGY2) Dr. Andrea Chapman Assoc Program Director – Curriculum CHIN, Danielle (PGY1) SARAN, Kelly (PGY4) Dr. Caroline Choo Richmond/Geriatric CHOW, Matthew (PGY3) SHAWN, Ilana (PGY1) Dr. Stephen Fitzpatrick Consultation-Liaison DAVIS, Lindsay (PGY5)) SIDHU, Fulroop (PGY2) Dr. Peter Gibson VCMHS DONAHUE, Birgitta (PGY1) SIDHU, Jesse (PGY4) Dr. Caroline Gosselin Geriatrics DROUILLARD, Natalie (PGY1) SMITH, Karolina (PGY3) Dr. Alison Gregson PGY2 Rep ELLINGSEN, Emily (PGY4) TRUEMAN, Karen (PGY1) Dr. William Honer Director of Research FREW, Patricia (PGY5) TSANG, Nicole (PGY3) Dr. Trevor Hurwitz Neuropsychiatry 75 FRIZEN, Oxana (PGY1) TUKA, Andrea (PGY5) Dr. Harry Karlinsky RGH / PGE Exec GREGSON, Alison (PGY2) WAN, Dante (PGY1) Dr. Samantha Kelleher RCH / PGE Exec HARVEY, Layne (PGY1) WIDE, Jennifer (PGY3) HILLIER, Kortney (PGY2) WIEBE, Carl (PGY3) Dr. Stuart Lax PGY4 Rep IRANI, Kaizad (PGY2) WONG, Gloria (PGY1) Dr. Keith Marriage Child / PGE Exec ISHKANIAN, Ryan (PGY1) WONG, Monique (PGY5) Dr. Grant Millar COPE Rep ISKANDER, Sam (PGY5) WYNN, Kathryn (PGY1) Dr. Hiram Mok Assoc. Program Director – Evaluation JUNAID, Sara (PGY4) YEH, Jennifer (PGY3) Mrs. Joan Nazif Family Advisory committee (ex officio) KAPUR, Rishi (PGY1) YEH, Sophia (PGY4) KENNEDY, Andrea (PGY4) . Dr. Kiran Rabheru Riverview Dr. Chris Robertson Resident President Dr. Ladan Sadrehashemi VGH / PGE Exec Dr. Andrea Tuka PGY5 Rep Dr. Eugene Wang Forensics FPI Dr. Steve Wiseman SPH / PGE Exec

EDUCATION REPORTS * 2008-2009 and out-patient as well as on-call/Emergency duties. Students are Undergraduate assessed formatively during the rotation with six MiniCEXs (to be handed in) and a mid-rotation evaluation. The end-of-rotation Education summative assessments are the Clinical Assessments, the Clinical Reasoning Exam (CRE) and the National Board of Medical Examiners Program exam (NBME). Students must document their clinical learning Dr. Janette McMillan encounters in a “log” in the web-based system, one45. Program Director For students in the Integrated Clerkships in Chilliwack, Terrace and Fort St. John, the clinical learning is distributed throughout the year. Their assessments are the same as the above with the exception of the NBME Comprehensive Clinical Skills Exam being used instead of the Psychiatry-specific exam.

Program Description Program Summary of Activities 76 There are components taught by Department Faculty in all four years Child, Adolescent and Family Teaching Review of the medical school program. These include Communication Skills Dr. Ashley Miller and Dr. Muffy Greenaway were jointly appointed as in Year 1 and 4, Clinical Skills in Year 2, the Brain and Behaviour Child/Adolescent/Family Co-Directors in July 2008. On September Block in Year 2, the Core Clinical Clerkship in Year 3 and Senior 18, 2008 a half-day retreat was held to introduce the Directors to the Electives in Year 4. key CAF supervisors from Royal Columbian Hospital, Richmond The majority of Psychiatry teaching is focused on the Year 3 Clerkship. General Hospital, Chilliwack, Surrey Memorial Hospital, Northern Year 3 runs from September through August and at most sites, the Medical Program and the Island Medical Program and Terrace. We Psychiatry rotation is in six-week blocks. The first week in VFMP is reviewed the BCCH seminars and clinical skill learning. the “Academic Half-Day” seminars: Psychiatry Assessment, Emergency Recommendations included: Psychiatry, Anxiety and Sleep Disorders, Psychotic Disorders, Mood Disorders, Consultation Liaison, Personality Disorders, and Geriatric • recording or video-linking some of the new seminars; Psychiatry. Child/Adolescent/Family seminars for students at BCCH • resident teaching packages to be distributed to teachers; are distributed throughout the six weeks and will be available to be • and further discussion of capacity issues for September 2009. video-linked to all sites. The students are assigned to clinical learning at teaching hospitals for the subsequent weeks. For the IMP and Year 3 “Train the Trainers” Retreat NMP, seminars are tailored to the site needs and distributed through the six weeks. The clinical experiences are a balance of acute in-patient On March 27, 2009 a full-day retreat was held in Vancouver to review several key aspects of teaching and assessment. The participants were Medical School Expansion Site Leaders, Supervisors, Residents and administrative staff from 1. Southern Medical Program (Kelowna, Kamloops, Vernon) Vancouver Fraser Medical Program, Island Medical Program, Northern A successful pilot experience has developed into this being offered as Medical Program and the Southern Medical Program as well as a possible rotation for students. The SMP will have Year 3 students Chilliwack, Abbotsford and Terrace. of their own in 2012. The Plenary in the morning was focused on the End-of-Rotation 2. Terrace ICC Exams. In afternoon sessions, three groups rotated through each Three students successfully completed their year in Terrace. session on MiniCEX review, Case Writing and Feedback Review. The 3. Chilliwack ICC Administrators held a workshop on review and standardizing processes Because of a shift in staffing, students from the Chilliwack program completed half of their designated Psychiatry time in Abbotsford. as well as acquiring a better understanding of the Psychiatry UG 4. Peace Liard ICC Education Program. Four students will spent the year in Fort St. John (primarily) and Dawson Creek. PsychSIGN student interest group 5. Plus-32 In September 2009, the class expansion to 256 will start Year 3. The UG Education has continued to support this Psychiatry student This includes eight more students in the IMP and NMP and 16 in interest group throughout the year. On September 18, 2008, the UG the VFMP. 77 Education hosted the annual “Meet and Greet” dinner for Years 1-4 students to meet the faculty. This included an invitation to the “Frames of Mind” movie that evening. In April 2009, Dr. S. Kelleher and Dr. New Site Leaders G. Millar visited the Island Medical Program PsychSIGN group in Dr. Ashley Miller Child & Adolescent Program-Seminar Co-Director Victoria. In May 2009, the UGE Committee nominated a student to attend the annual PsychSIGN conference at the APA in San Francisco. Dr. Muffy Greenaway Child & Adolescent Program-Clinical Skills Co-Director It is hoped that the NMP students will start an interest group at Prince George. Dr. Colleen Froese Psychiatry Site Leader, Terrace Integrated Program Residents as teachers of medical students Discipline-Specific Site Leader at Kelowna General Hospital, Dr. Neil Hanon Residents are significant teachers of medical students in their clinical Southern Medical Program placements and on-call duties. Residents have played even more prominent roles in medical students’ education this year. There has Dr. Kathryn Fung Richmond General Hospital Discipline-Specific Site Leader been active participation in the UGEC meetings and retreats; two Interim St. Paul’s Hospital Discipline-Specific Site Leader while residents have done Education Electives under the supervision of Dr. Dr. Christopher Murray Dr. Adam Chodkiewicz is on leave Kelleher; residents have been involved in the seminar series delivery; have developed packages for teaching; and have assisted marking the Dr. Carolyn Jones Psychiatry Site Leader, Fort St. John Clinical Reasoning Exam.

EDUCATION REPORTS * 2008-2009 Year 3 Teaching Excellence Awards Dr. Anson Koo RCH UG DSSL Dr. James Fabian LGH UG DSSL Dr. Rachel Boulding Discipline Site Specific Leader, Northern Medical Program Dr. Kathryn Fung RGH UG DSSL Dr. Betty Tang Psychiatry Site Leader, Chilliwack Integrated Program Dr. C. Manjunath SMH UG DSSL Dr. Randall White SPH Supervisor Dr. Neil Hanon Kelowna UG DSSL Year 4 Teaching Excellence Award Dr. Betty Tang Chilliwack Integrated Program Psychiatry Team Leader Dr. Roger Shick SPH Supervisor Dr. Colleen Froese Terrace Integrated Program Psychiatry Team Leader Student Awards Dr. Carolyn Jones Ft. St. John Integrated Program Psychiatry Team Leader Dr. Cameron Anderson VFMP Resident Representative Julia Wong, class of 2009 Annette Hacking Memorial Award Dr. Jennifer Barley VFMP Resident Representative Ingrid McFee, class of 2009 Year 4 Academic Excellence Dr. Francois Proulx IMP Resident Representative Dr. Layne Harvey NMP Resident Representative UG Education Committee Carina Perel-Panar, Willough Jenkins, Cristina Aydin, Yr 4 Student Representatives: (1 vote) 78 The Psychiatry UG Education Committee continues to meet once per Kevin Wong month through the year with full participation by the members. The Jennifer Scott, UGE Committee Terms of Reference is reviewed at the beginning of Yr 3 Student Representatives: (1 vote) Kaivon Pakzad-Vaezi each academic year. Noah Alexander, Tia Liu Yr 2 Student Representatives Voting members 2008-2009 Dr. Janette McMillan Undergraduate Director and Chair Non-Voting/consulting members are Dr. Samantha Kelleher Year 3 Director Dr. Trevor Young Department Head Dr. Peter Chan Year 4 Director Dr. Jonathan Fleming Associate Head, Education Dr. Muffy Greenaway Co-Director Child & Adolescent Psychiatry Dr. Patrick Rowe NMP Site Clerkship Director Dr. Ashley Miller Co-Director Child & Adolescent Psychiatry Dr. Cherrie Tan-Dy IMP Site Clerkship Director Dr. Kerry Jang Brain and Behaviour Director Dr. Joan Fraser VFMP Site Clerkship Director Dr. Elton Ngan Clinical Skills Director Dr. Cheryl Holmes SMP Site Clerkship Director Dr. Andrzej Koczapski UBC UG Discipline-Specific Site Leader (DSSL) Dr. Becky Temple FSJ Integrated Program Clerkship Director Dr. Adam Chodkiewicz SPH UG DSSL (on leave) / Dr. Christopher Murray Toi Leslie UG Program Manager Dr. Wei Yi Song VGH UG DSSL Angela Wong Program Assistant Dr. Rachel Boulding NMP UG DSSL Stefanie Sladick BCCH Academic Secretary Lynne Fisher IMP Program Manager Yrs 3 & 4 Jennifer MacMillan IMP Assessment & Evaluation Coordinator Graduate Stephanie Goult IMP Program Assistant Program in Twylla Hamelin NMP Program Manger Yrs 3 & 4 Denise Marcotte NMP Program Assistant Neuroscience Leonor Blanche NMP Assessment & Evaluation Coordinator Dr. Steve Vincent Elaine Thomas SMP Program Manager Beverly Berg FSJ Program Manager Program Director Myra Hughes Chilliwack IC Program Assistant

Program Plans for the Future

• Curriculum evaluation and renewal Program Description • Development of capacity for expansion 79 • Faculty Development – co-hosting Day for Psychiatry Educators in The Graduate Program in Neuroscience through the Faculty of October Graduate Studies and the College for Interdisciplinary Studies, offers • Evaluation of Residents as Teachers a coordinated program of graduate studies leading to MSc and PhD degrees in Neuroscience. The objectives of the Program are to educate • Peer Evaluation of Faculty graduate students as neuroscientists with intensive experience in at least one area of research, and to ensure that students in the Program develop a broadly based knowledge of the neurosciences. The Program is administered by the Chairman of the Neuroscience Advisory Committee, and comprises over 100 faculty members representing 13 departments from the Faculties of Medicine, Science, and Arts at the University of British Columbia. Laboratory and teaching areas are located across the UBC campus, and at the affiliated teaching Hospitals, according to the teaching and research affiliations of the Neuroscience faculty members. The Program aims for flexibility so that the individual needs and background of each student can be accommodated as quickly as possible. The past year we have well over 100 M.Sc. and Ph.D. students in our program. Their award winning research spans the filed of neuroscience, from computational work, to cellular and molecular

EDUCATION REPORTS * 2008-2009 neurobiology, to systems neuroscience and clinical research, and the field of neuroethics. Our outstanding students have been highly Continuing successful in obtaining scholarships from CIHR, NSERC and a variety of other funding agencies. Medical Education and Program Summary of Activities Professional The administration of the program is carried out by Ms. Liz Wong in Development the Graduate Program Office in the Detwiller Pavilion. Her dedicated work has help guide hundereds of successful graduate students through Dr. Caroline Gosselin our program. Teaching of the core courses in the program, Cellular Program Director and Molecular Neuroscience (NRSC 500) and Systems Neuroscience (NRSC 501) is provided in 2NAB of Detwiller Pavilion. Many faculty Program Summary of Activities members in the Department participate in this important graduate teaching. In particular, Drs. Lynn Raymond, Tim Murphy, Brian • 5th Annual Hot Topics in Psychiatry was hosted together with the 80 MacVicar, Ann Marie Craig, Weihong Song, Jun-Feng Wang, Peter Department of Family Practice on January 30th at the Robson Square Reiner, Bill Honer and Jeremy Seamans serve as module leaders in these Media Centre. courses. • Dr. Andrew Krystal from Duke University delivered an all-day workshop for B.C.’s ECT Clinicians on February 19th at the Liu Institute for Global Issues • New CME & PD Committee was struck and held its first planning meeting on June 23rd

Program Plans for the Future

• A Needs Survey will be designed and conducted by the CME & PD committee in the summer of 2009 • A Day for Psychiatric Educators will be held Friday October 16th at the Delta Vancouver Airport for faculty of both Undergraduate and Postgraduate Education Programs. The focus of the day will be Evaluation. Guest speakers and UBC Faculty will address Assessment tools, delivering more useful feedback to students, and enhance examination writing skills. Resident Public Research Education Program Program Dr. Bill Honer Dr. Harry Karlinsky Program Director Program Director

Program Description Program Description

The UBC Department of Psychiatry is unique in offering dedicated The current focus of the Dept’s Public Education program is a mental slots in the Psychiatry Residency Training Program for research health film series called ‘Frames of Mind’. Its goal is to promote 81 track residents. The Research Track offers the opportunity to obtain community education of issues pertaining to mental health and illness. a Master’s degree as part of the residency training, which can be This ongoing series consists of a once-a-month evening screening of a followed with a PhD during fellowship training as part of the Clinician feature length dramatic film or documentary followed by an informal Investigator Training Program. Protected time for research is integrated presentation related to the mental health issue depicted in the film. within clinical training rotations, and through research electives. Speakers and panelists range from psychiatrists and other mental health professionals to representatives from mental health community- Program Summary of Activities based and nonprofit organizations, cinema experts and mental health consumers and their family members. A moderated discussion concludes The Research track was initiated in July, 2008 with the first resident, each evening, with full audience participation encouraged. Alan Bates, MD, PhD. Dr. Bates has initiated a research project on delirium, mentored by Dr. Alasdair Barr (Dept, of Anesthesia, Other aspects of the series - now in its eighth year - include its rotating Pharmacology & Therapeutics) and Dr. Honer. The Research Track co-sponsorship by relevant community advocacy organizations and recruited a second resident, Jennifer Li, MD, PhD to begin residency its ongoing evaluation by those who attend. To date, topics ranging training in July, 2009. from depression to schizophrenia to autism have now been successfully presented to over 8000 attendees. Program Plans for the Future Program Summary of Activities The goal is to continue to recruit one or two outstanding graduates in each year to the Research Track. Screenings take place at the Pacific Cinematheque, a downtown

EDUCATION REPORTS * 2008-2009 nonprofit theatre. A full summary of activities are available online at http://www.framesofmind.ca and on Facebook http://www.facebook.com/ 24th Annual pages/Frames-of-Mind/29383069289 . Department Program Plans for the Future Research Day and The series will continue in its current format for the coming year. Faculty

Other Dinner and Awards

‘Frames of Mind’ is the 2003 winner of the ‘Most Outstanding June 4, 2009 Continuing Education Activity in Psychiatry in Canada (awarded by the Canadian Psychiatric Association and the Council of Psychiatric Continuing Education). Its founder and Director, Dr Karlinsky The main objective of the Department’s Research Day is to showcase ([email protected]), has been awarded the 2006 UBC Faculty some of the research being conducted at UBC. The Research Day 82 of Medicine Award for Innovation in Continuing Medical Education provides an opportunity for faculty, residents, fellows, post-docs and award for his involvement with ‘Frames of Mind’. graduate students to present their research in the main program as oral presentations or as posters during the reception in the evening. This combined event provided an opportunity for those involved in research to share information on research being conducted in the department with clinicians and other researchers and to acknowledge all individuals in the department on their accomplishments over the past year. In addition, this year’s event was approved by UBC Division of Continuing Professional Develop as an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada. The Department’s Annual Research Day and Faculty Appreciation Dinner and Awards has been a combined event for the past two years. The Clinical Faculty Business Meeting is also coordinated to occur at this event. Research day started with registration and lunch followed by oral presentations in basic science and then oral presentations for clinical science. After a short break, the oral presentations continued with a number of faculty presentations, the plenary guest presentation from Dr. Ken Shulman, University of Toronto (“Early detection of dementia; Promises and Practicalities) and a tribute to Dr. Peter MacLean. The poster presentations immediately followed these speakers and presenters and the evening concluded with the Faculty Appreciation Dinner and Award presentations.

FACULTY 83 (GFT AND 5 CLINICAL) Faculty List June 30, 2009 Assistant Professors Koch, William J Dua, Vikram Austin, Jehannine Kopala, Lili C Fitzpatrick, Stephen Beasley, Clare Louise Leichner, Pierre Flynn, Sean Professors Donnelly, Martha (Joint appointment; Louie, Donald F Friedlander, Robin Clark, Campbell M Home Department - Family Practice) Marriage, Keith Jeffrey Gibson, Peter Craig, Ann Marie Fairbrother, Nichole Misri, Shaila Gibson, Ronald E Diamond, Adele Holt, Robert A Murphy, Emlene M Graham, Candida Rae Honer, William Michalak, Erin Myers, Michael Gruson, Valerie Iverson, Grant Loren Nicholls, Tonia Lee Noone, Joseph Hathaway, Lorraine Jang, Kerry L Pavlidis, Paul O’Shaughnessy, Roy Joseph Higenbottam, John A Krausz, Reinhard M Wald, Jaye Pico, Richard Michael Hoeschen, Lawrence Lam, Raymond Wang, Jun Feng Reebye, Pratibha N Irwin, David A.J. Rungta, Kamal Nayan MacVicar, Brian Woodward,Todd Jiwa, Abdulkarim M Sehon, Anthony Murphy, Timothy Ngan, Elton Kang, Arvind Sivertz, Kristin S Phillips, Anthony G Kang, Nirmal Clinical Professors Smith, Derryck H Piper, William E Kiraly, Stephen 84 Agbayewa, M Oluwafemi Steinberg, Paul Raymond, Lynn Kjernisted, Kevin Altman, Siemion Waring, Ted Reiner, Peter Bart Koczapski, Andrzej Snutch, Terrance (Joint appointment; Basson, Rosemary Weiss, Margaret Korman, Lorne Home Department - Zoology, Michael Braunstein, Ronald Edwin Williams, Richard Lau, Mark Smith Laboratories) Brink, Johann Zipursky, Sheldon Liang, Raymond A Taylor, Steven Buchanan, R Alan Clinical Associate Professors Locke, Jake Vincent, Steven R Choo, Caroline Lomax, Susan Yatham, Lakshmi N Corral, Maria R Anderson, Stephen D Young, Allan Hunter Elliott, Stacy Lorraine Baerg Hall, Elizabeth MacEwan, G William Young, Lionel Trevor Fast, Diane K Blank, Myles McMillan, Janette M Zis, Athanasios Ganesan, Soma Burgmann, Allan J.F. Mithani, Akber Carter, Diana Mok, Hiram Associate Professors Garland, Jane Gosselin, Caroline Chan, Peter Nixon, Mary Fleming, Jonathan Hewko, Robert Claman, Jeffrey M Northcott, Colleen Geller, Josie Holland, Roy Vincent Dagg, Paul O’Kane, Janine Ogrodniczuk, John Hurwitz, Trevor Davidson, Jana-Lea Patrick, Lance Seamans, Jeremy K Kalda, Riho Drance, Elisabeth J Rabheru, Kiran Song, Weihong Karlinsky, Harry Drysdale, Elaine Riar, Kulwant Robinow, R Oliver Cockhill, Leslie Manjunath, Chinnapalli Veeraiah Song, Wei-Yi Scamvougeras, Anton Cohen, David Jay Manley, Ronald Stuart Steinberg, Carolyn Rita Segal, Barry Michael Cooper, Michael C Maskall, Doug Straszak, Irena Shrikhande, Surish Dahi, Abi Mathew, Biju Taylor, Christine Smith, Patrick D. Erickson, Dave McGarvey, Kathleen Tesler-Mabe, Carlos Solomons, Kevin Fabian, James McIntosh, Diane Tham, Joseph Srikameswaran, Suja Fahy, Mellisa J McWatters, Dorothy Tomita, Todd Stevenson, Ronald Firstbrook, Peggy Meldrum, Lee Anne Wang, Eugene Stowe, Robert Friesen, Wesley Howard Miller, Robert Ward, Carol Lee Tam, Edwin Froese, Colleen Lynn Mirmiran, Jamaluddin Weiss, Jacqueline Tapper, Christopher Mark Geizer, Marie Myette, Larry Thomas Whelan, John W Wanis, Wahan Grabovac, Andrea Dagmar Patterson, Bruce Duncan White, Randall Francis Weideman, Rene Hall, Andrew Pawliuk, George Wilkins-Ho, Michael C F Weinerman, Rivian Harris, James Gerald Persaud, Rainer Wong, Angela Whittal, Maureen Leslie Hutnyk, David Piper, Emily Yaxley, David Wilt, Frances R Ingram, Diana Ruth Raina, Raj Ye, June 85 Wiseman, Stephen Kane, Barbara J Richford, Carole Young, Kay Wong, Allan Puy Gee Katta, Balaraju Robertson, Heather Clinical Instructors Zoffmann, Elisabeth Kaye, Valerie Rosin, Richard Abdel-Fattah, Mohamed Clinical Assistant Professors Kelleher, Samantha Ryan, Deirdre Knudson, Gail Schaffer, Nathan Ainsworth, Geoffrey Anderson, John Atkins, Mark H Koo, Anson Schenk, Christian Hans Axler, Auby Au, Raymond Tung Kope, Teresa Schertzer, Stephen Baril, Marie-Claire Babbage, Christopher A Koritar, Endre Laszlo Schwartz, Patricia T Berzen, Leon Baer, Susan Kosaka, Brenda Dale Setton-Markus, Judith Bhopal, Jaswant S. Barker, Linda Joan Bilsker, Daniel Kwan, Man Wai Shabbits, Michael Becker, Ellen Bond, David Lamba, Rakesh Sheldon, Leslie James Bloch, Maurice Bouffard, Rachelle Lange, Rael Sherwood, Megan Booth, Christopher Byrne, Caron Lee, Michael Shun Wai Sinai, Joanne Bosley, Lawrence A Chapman, Andrea J.M. Levin, Alexander Singh, Kulbir I Boulding, Rachel Chapman, Laura M Levy, J Mark Smith, Geoffrey N Bowering, Tricia Chernick, Grant Lisiak, Elena Smith, Jeanette Brandt, Edwin Lorne Chodkiewicz, Adam C Lu, Shao-Hua Sochting, Ingrid Breitman, Deanne

FACULTY * 2008-2009 Broadway, Lauren Kang, Gurmit Shimi Kaur Tang, Betty Klonoff, J. Campbell, Diane Paula Khanbhai, Irfan A Tarzwell, Robert Krell, R. Carlson, Marie Lazar, Gary Thibeault, Amy Lin, T.Y. Ceresney, Maureen N Lazar, Susan Thompson, Darren Marcus, A. Chauhan, Harpreet Marsh, Teresa To, Agnes Shuk Ling Maurice, William Collins, Nelson McBride, Kate Tomm, Bill George Parfitt, H. Corcoran, Megan McDonald, Daniel Vik, Astrid L Parkinson, R. Culo, Sandi Mehra, Atul Vincent, Merville Penfold, Susan D’Oyley, Heather Miller, Ashley Pauline Voutsilakos, Emorphea Fia Pulos, L. Dempster, Rebecca Miller, Debra Sheryl Ward,David Shulman, Ralph Donaldson, Heather Minnes, Yoram Wicholas, Leslie Stephenson, G. Driscoll, Miriam More, Susan Widajewicz, Witold Sung, Shan-Ching Woolf, L. Fedoroff, Ingrid Murray, Christopher Wisniewska, Anna B Flynn, Paula S Musacchio, Mafalda Wrixon, Katherine Frankland, Allan Narang, Satinder Pal Singh Yamamoto, Aiko Honorary Assistant Professor Arnold, Leslie 86 Freedman, Glen Ong, Larry Yuswack, Timothy J Freer, Janya Passmore, Michael Zarowski, Christine Ruth Frye, Charles R Patton, Sheila Adjunct Professor Lecomte, Tania Fung, Jonathan Phaterpekar, Hem Emeritus and Post-Retirement Furlong, Allan Polak, Vivian Noda, Fumitaka Appointees O’Hagan, Patricia Garbett, Sally E Preuss, Jennie Livesley, John Genge, Margot Rabin, David McGeer, Edith Postdoctoral Research Fellow Gould, Brent Randhawa, Ramandeep McGeer, Patrick Andreazza, Ana Greenaway, Masa’ilt Riley, Mark Peter Wada, Juhn Brown, Craig Griffin, Shannon Robichaud, Melisa Freeman, Roger Choi, Hyun Beom Griffiths, Brenda Lee Routledge, Robin Bezeredi, T. Cuttler, Carrie B Guan, Brian Sadrehashemi, Ladan Caird, W. Dahlhaus, Regina Gubanov, Alexander Scarth, Brian Crockett, D. Ferguson, Kyle Howard, Andrew Sharan, Richa Fibiger, C. Gawryluk, Jeremy William Isomura, Theresa K Shoja, Sheila Fine, Stewart Gillis, Jesse Jani, Aarti Shulman, Barbara Freedman, R.D. Gladding, Clare Melanie Janke, Paul Smith, David H Goresky, W. Gordon, Grant Jokhani, Krishna Veena Stern, Richard John Jilek, W. Hashioka, Sadayuki Jones, Russet Stevenson, Kevin William Jilek-Aall, L. Heidari Mohajerani, Majid Hyman, James Michael Faculty Appointments and Sheila Shoja Kang, Yun Hee David Smith Lapish, Christopher Court Promotions Kevin Stevenson Lee, Moonhee Bill G. Tomm Siddiqui, Tabrez Jamal July 1, 2008 – June 30, 2009 Amy Thibeault Sierocinski, Thomas Astrid Vik Strehlau, Verena H Anna Wiesniewska Appointed Clinical Instructor Tachikawa, Masanori Full-time Academic Faculty Takahashi, Hideto (July 1, 2008) Clinical Faculty – Promotions Tan, Hua Appointed Assistant Professor Mark Atkins Promoted to Clinical Professor Vines, Bradley William Nichole Fairbrother – January 1, 2009 Christopher Baggage Wang, Liang Christopher Booth Johann Brink Wu, Yili Promoted to Associate Professor Lawrence Bosley Caroline Gosselin Zhang, Xiaozhu Rachel Boulding Robert Holt – July 1, 2008 Promoted to Clinical Associate Deanne Breitman Elton Ngan – July 1, 2008 Professor Clinical Fellow Nelson Collins Jeremy Seamans – July 1, 2008 Jana Lee Davidson Kunz, Mauricio Paula Flynn 87 Vikram Dua Schuetz, Christian Georg Janya Freer Jake Locke Clinical Faculty - Jonathan Fung Mary Kaye Nixon Research Associate Appointments Sally Garbett Rivian Weinerman Ahn, Soyon Appointed Clinical Professor Masa’il Greenaway Maureen Whittal Chopra, Vikramjit S (July 1, 2008) Brian Guan Dias, Carine Roy Holland Alexander Gubanov Promoted to Clinical Assistant Gorelova, Natalia A Edward Waring Marcel Hediger Professor Guo, Jian-Ping Krishani V Jokhani James Fabian Lane, Carol Appointed Clinical Assistant Ashley Miller Andrea Chapman Milnerwood, Austen James Professor (July 1, 2008) Debra Miller David Cohen Qing, Hong Marie-Claire Barit Yoram Minnes Andrew Howard Schwab, Claudia Andrew Hall Susan More Anson Koo Shao, Li Diana Ingram Satinder P.S. Narang Lee Ann Meldrum Yokomaku, Daisaku Brenda Kosaka Larry Ong Sayed J Mirmiran Rakesh Lamba Vivian Polak Michael Shabbits Research Associate II Michael Lee Megan Roberts Christine Taylor Dalton, Gemma Louise Richard Rosin Robin Routledge Randall White Di Pietro, Nina Jaonne Sinai Richa Sharan June Ye

FACULTY * 2008-2009 Faculty Salary Award Holders Chairs and Professorships (as of June 30, 2009) (as of June 30, 2009) Leading Edge Endowment Fund (LEEF) – Chair in Depression Research Allan Young Michael Smith Foundation for Health Research (MSFHR) Salary Award Holders: Leading Edge Endowment Fund (LEEF)– Chair in Addictions Research Jehannine Austin Michael Krausz Clare Beasley Ann Marie Craig Jack Bell Chair in Schizophrenia Research Josie Geller William Honer Erin Michalak Tonia Nicholls Louise A. Brown Chair in Neuroscience Paul Pavlidis Steven Vincent Jeremy Seamans Wei Hong Song Brown and Family Professorship in Alzheimer Research Jaye Wald Wei Hong Song 88 Todd Woodward Canadian Institutes of Health Research (CIHR) Salary Award Notable Faculty Awards Holders: Accomplishments and Appointments Jehannine Austin Clare Beasley (as of June 30, 2009) Erin Michalak Jehannine Austin Peter Wall Institute Early Career Scholar Award Paul Pavlidis UBC Psychiatry Residents Association Award for Teaching Todd Woodward Chris Babbage Excellence at RCH UBC Department of Psychiatry, Undergraduate Teaching Award – Canada Research Chairs (CRC) Salary Award Holders: Rachel Boulding Teaching Excellence in Year 3 Education Ann-Marie Craig Faculty of Medicine, Clinical Faculty Award for Excellence in Adele Diamond Andrea Chapman Teaching; UBC Psychiatry Residents Association Award for Brian MacVicar Teaching Excellence at BCCH Jeremy Seamans UBC Killam Research Prize; Election as a Fellow of the Royal Terrance Snutch, Joint Appointment - Home Department - Zoology, Michael Smith Laboratories Ann Marie Craig Wei Hong Song Society of Canada Appointed as Vice Chair to the Specialty Committee on Psychiatry Erin Michalak Appointed as Postdoctoral Co-ordinator, Faculty of Medicine Paul Dagg for the Royal College of Physicians and Surgeons of Canada Tonia Nicholls MSFHR and BCMHAS establishment grants Faculty of Medicine, Distinguished Achievement Award for Colleen Northcott APA Fellow for service advocacy/education Adele Diamond Service to the University and Community; YWCA 2009 Woman of NSERC Discovery Grant; CIHR New Investigator Award; CFI/ Distinction Award for Technology, Science and Industry Paul Pavlidis BCKDF infrastructure grant Stacey Elliott UBC Department of Psychiatry, CME Award Appointed as Scientific Director of CIHR’s Institute of Stephen Fitzpatrick Appointed as Department Program Director, Consultation Liaison Neuroscience, Mental Health and Addiction; Faculty of Medicine Appointed as Department Program Director, Developmental Tony Phillips Distinguished Achievement Award for Outstanding Contributions Robin Friedlander Disorders by a Senior Faculty Member; CCNP Heinz Lehmann Award for Josie Geller BCMSF (Vancouver Foundation) research grantd outstanding contributions to neuropsychopharmacology UBC Psychiatry Residents Association Award for Teaching Peter Reiner CIHR operating grant Robert Hewko Excellence at VGH Heather Robertson Elected Clinical Faculty Affairs Representative for the Department Awarded the C.A. Roberts Award from the Canadian Psychiatric UBC Psychiatry Residents Association Award for Teaching Trevor Hurwitz Ingrid Sochting Association Excellence at RGH Faculty of Medicine, Distinguished Achievement Award for UBC Department of Psychiatry Undergraduate Teaching Award – Betty Tang Kerry Jang Service to the University and Community; Elected to Vancouver Teaching Excelling in Year 3 89 City Council Appointed as Beck Institute Scholar, Beck Institute for Cognitive Steve Taylor UBC Psychiatry Residents Association Award for Teaching Therapy and Research for 2008-2009 Samantha Kelleher Excellence at SPH Jaye Wald Worksafe BC funding award Appointed as Medical Director, Vancouver Coastal Health Complex UBC Department of Psychiatry, Gordon Shrum Award in Geriatric Michael Krausz Mental Health and Addiction Program and The Burnaby Centre David Ward Psychiatry Postgraduate training for Mental Health and Addiction UBC Department of Psychiatry Undergraduate Teaching Award – Appointed as the Department Director of Scholarly Activity for Randall White Ray Lam Teaching Excelling in Year 3 postgraduate education Faculty of Medicine, Distinguished Achievement Award for Rael Lange CIHR operating grant Todd Woodward Excellence in Clinical or Applied Research BC Psychological Association Scientist-Practitioner Award; 2009 CCNP Medal for meritorious career and for outstanding Mark Lau University of Toronto, Excellence in Continuing Medical Health Lakshmi Yatham contributions to neuropsychopharmacology; 2009 Mogens Shou Education Award Award for Education and Advocacy Brian MacVicar 5 year research network funding from the Leduc Foundation Appointed as Co-Chair, Vancouver Coastal Mental Health and Trevor Young Janette McMillan Elected to the Faculty of Medicine Nominating Committee Addictions Council

FACULTY * 2008-2009 Island Medical Program - Psychiatry Program

Academic Site Leader: Dr. Richard Williams

Undergraduate Leader: partner Dr. Wei-Yi Song reports Island Medical Program – Psychiatry Program Residency Leader: Northern Medical Program Dr. George Pawliuk 90 Fraser Health Authority BC Mental Health and Addiction Services/ Provincial Health Services Authority Lion’s Gate Hospital The Island Medical program continues to grow both in Providence Health Care number of medical students from Richmond General Hospital 24 to 32 and in clinical faculty “The Island medical Riverview Hospital who now total 19 with full Vancouver General Hospital and UBC Hospital approval and 14 in the process Program is now in its Brain Research Centre of application, as well as one fifth year of functioning, Child and Family Research Institute full time faculty. Dr. Nichole 6 Fairbrother joined the Island and graduated 25 MD’s Medical Program as Assistant Professor in the tenure track in in 2009. ” January 2009. She participates primarily in research, her specialized area being perinatal mental health with a focus on anxiety disorders, but she is also involved in the undergraduate program all actively involved in research and many are the recipients of external working as a tutor in the Doctor, Patient and Society module: in the funding. Drs. Shrikhande and Williams presented at CPA in 2008 residency program working with the R1s on 10 weeks of basic skills in and will again in August 2009. They both lectured abroad including CBT, and collaborates with Dr. Ingrid Sochting from UBC. in India, China, Thailand, Hong Kong, Korea and Taiwan. Drs. Rivian Weinerman and Helen Campbell have published on a quality The Island medical Program is now in its fifth year of functioning, and improvement initiative for depression and have received substantial graduated 25 MD’s in 2009. financial support for the mental health project working with family Dr. Wei-Yi Song remains the principal organizer and coordinator of physicians. Dr. Ian Musgrave continues to be a provincial leader in the clerkship experiences. We have 3 or 4 students at any one time, the provincial initiative in ACT and Dr. Williams works with the undertaking a 6-week clerkship rotation. Dr. Song has organized locally Provincial Psychosis Network and early psychosis programs. a very successful half-day seminar series each week for the 6 weeks of Our faculty continues to teach undergraduates, residents, and provide the clerkship. CME to psychiatrists and family physicians. Our faculty members are Dr. George Pawliuk continues to offer leadership in the R1 to R5 years. developing our own island residency program and faculty continue to This year he has provided strong support for the IMP to participate in publish, present research nationally and internationally, and work with the CARMs match, such that we will be offering 2 residency slots for UBC faculty on research projects. The participation from psychiatrists years 2-5. This match is due to strat in 2010. Dr. Michael Cooper is in the region in the IMP has been substantial. The Victoria based 91 now heading the unit of psycho-geriatrics and Dr. Jenny Preuss and residency program will be an exciting development. Dr. Rex Bowering the division of child and adolescent psychiatry on the island. Both programs have now been approved by UNC to offer mandatory residency positions. We initially envision residents will spend years 2 and 3 based in Victoria, but then may do electives in other sites on Vancouver Island or elsewhere including Vancouver. Dr. Kiri Simms and Dr. Chris Blashko received an award from the residents for the best teaching experience in R1 this year. Dr. Satish Shrikhande leads CME in Victoria and is responsible for an excellent monthly journal club, which residents participate in, and he organizes rounds twice a month. Last year residents gave a number of grand round presentations. Research continues to be an important area for the Island Medical Program and we are pleased to have Dr. Nichole Fairbrother join us this year in a newly funded full time research position. The schizophrenia program, mood disorder service, shared care, and USTAT services are

PARTNER REPORTS * 2008-2009 Department Description

Fraser Health Authority (http://www.fraserhealth.ca/Pages/default.aspx) has the largest and fastest growing population among regional health authorities in British Columbia, with 1.5 million people or one-third of the provincial population. Adult mental health and addictions needs are met by eight acute care hospitals, 12 community mental health centres, three tertiary care facilities, three community residential short stay and treatment Fraser Health psychiatric facilities, and long-term supported housing. Young adults are served by a 10 bed acute adolescent inpatient unit at Regional Surrey Memorial Hospital, a day treatment program, crisis response teams, community-based mental health teams, and an early psychosis Department of intervention program. The elderly are served by a tertiary geriatric specialized residential unit, 92 Psychiatry behavioural stabilization unit, nine community mental health teams, Dr. Terry Isomura and a shared care team. Medical Director, Medical education currently takes place at three sites within Fraser Mental Health & Health: Royal Columbian Hospital, Peace Arch Hospital and Surrey Memorial Hospital. Addictions Fraser Health Department Summary of Activities

Program Heads Royal Columbian Hospital Summary

Dr. Terry Isomura 1. Hired full-time Psychologist, Dr. Nicole Dorfan, to develop curriculum and lead training in Royal-College mandated rotation in Medical Director, Mental Health & Addictions. Fraser Health evidence-based psychotherapies, in particular, CBT group therapies. Dr. Ambrose Cheng 2. Implemented telepsychiatry pilot with Mission Mental Health Post Graduate Education Director, Fraser Health Centre, offering clinical service and academic training. 3. 3a. Training in general psychiatry (1-3 month rotation): Dr. Doug Maskall Psychiatry program PGY1s = 6 Child Psychiatry Physician Leader, Fraser Health Non-psychiatry program PGY1s = 19

Family Practice PGY2s = 7 community mental health centres, tertiary care facilities, and other UBC medical students = 18 mental health and addictions services within the Fraser Health 3b. Training in general adult psychiatry (12 month core rotation): Authority. Psychiatry PGY2s = 2 3c. Training in electives (variable length of rotation): Royal Columbian Hospital has a successful track record in PGY1, Psychiatry senior residents = 2 (consult-liaison psychiatry) PGY2, and senior resident training. The Fraser Health Authority has committed organizational support, solid infrastructure, and sound Peace Arch Hospital Summary program fundamentals for a full five-year regional residency training program. For the July ’08-June’09 time span, Peace Arch Hospital hosted a UBC PGY2 Psychiatry Resident (Dr. Jessica Luckhurst) for a six month Peace Arch Hospital will be hosting PGY 2 Family Practice residents for rotation (ending Oct ’09). month long psychiatry rotations (at the time of preparing this report, we have since had 3 residents). We look forward to assuming an active Surrey Memorial Hospital Summary teaching role in the new Fraser Health-distributed residency program, which begins in July 2010. In the last year, a University of Saskatchewan PGY4 psychiatry resident completed an elective rotation on the Adolescent Psychiatry Unit at Child Psychiatry: SMH Fraser Health looks forward to having more child psychiatry residents 93 Department Plans for the Future on the Surrey Memorial Hospital APU. We are working to establish an outpatient child psychiatry clinic at SMH, initially in neuropsychiatry There is tremendous potential to learn from a large and diverse and infant psychiatry, which will serve a teaching mandate. May population, breadth of conditions in mental health and addictions, and establish a formal outpatient teaching clinic at RCH for medical a community-oriented continuum of care (urban and rural). Strengths students and/or residents. of the program include individually supervised cognitive-behavioural group therapy training for depressive and anxiety disorders, shared care psychiatry, telepsychiatry, and openness to innovative models of clinical care and education. Adult Psychiatry:

In 2010, UBC is accepting 4 PGY1 Residents into a dedicated CaRMS track for the Fraser Health / Royal Columbian Hospital regional psy- chiatry residency program. PGY1 and PGY2 Residents will be trained at the Royal Columbian Hospital. PGY3 to PGY5 core and elective rotations will be developed and offered through a number of treatment settings, including hospitals,

PARTNER REPORTS * 2008-2009 and education activities. These activities are intended to support BC Mental Health advances in mental health and addictions services province-wide.

and Addictions Program Summary of Activities

Research Institute • BCMHARI has a total of 31 researchers • Five Michael Smith Foundation (MSF) Scholars and four CIHR (BCMHARI) New Investigators Dr. Trevor Young • Host of the BC Mental Health and Addictions Research Network Program Head (Michael Smith Foundation for Health Research) • BCMHARI researchers provided training and supervision to 55 http://www.bcmhas.ca/Research/default.htm trainees (post doctoral fellows, PhD’s, and masters trainees) November 2008 saw the opening of the Translational Research Hub of http://www.bcmhas.ca/Research/default.htm http://www. the BC Mental Health & Addictions Research Institute (BCMHARI) Funding Activity 2008’2009 in the new Translational Research Building on the campus of BC Research Grants $3,276,197 bcmhas.ca/Research/default.htm 94 Children’s Hospital and the BC Women’s Hospital and Health Centre. Salary Awards I$675,000 The BCMHARI operates under the auspices of BC Mental Health & Addiction Services (BCMHAS), an agency of the Provincial Health In FY 2008-09, researchers associated with BCMHARI were awarded a total of $3,951,197 in Services Authority (PHSA). research funding (grants and salary awards). The goal of BCMHARI is to bring together and strengthen existing mental health and addictions research capacity, and to build and enhance partnerships with health authorities, universities, researchers Department Plans for the Future and other individuals and agencies, within the province, nationally, and Continue to encourage greater collaboration and integration by internationally. Areas of research include both basic and translational bringing together teams of scientists studying basic science and clinical research, and fall within the four domains identified by the Canadian and population health research. Institutes of Health Research (CIHR): Biomedical, Clinical, Health Systems and Services, and Population and Public Health. Research Highlights Research occurs across all BCMHAS program areas: Adult Tertiary Psychiatry, Geriatric Psychiatry, Neuropsychiatry, Forensic Psychiatric Co-occurring Polysubstance Abuse, Psychosis and Viral Infection Services, Child and Adolescent Mental Health Services, and the (Hotel Study): Provincial Specialized Eating Disorders Program. Researchers, clinical staff, and physicians across BCMHAS are actively involved in research • Currently underway in Vancouver’s downtown eastside (DTES) where 300 subjects will be recruited who live in single room offence history regain personal and interpersonal success and refrain occupancy (SRO) hotels. from re-offending. • Examines the complex relationship between addiction, mental illness, • Study will inform risk management and treatment that merges with infectious disease, cognitive impairment, and how these factors the growing emphasis on positive psychology in the mental health impact effective treatment. field.

Metabolic Effects of Second-Generation Antipsychotics: • Results demonstrated that 21.5 per cent of youth treated with these medications had pre-diabetes or Type 2 diabetes compared to 7.5 Lions Gate per cent of youth who were not taking the drugs; and 57 per cent of youth on these antipsychotics were overweight or obese, compared to Hospital 23 per cent of youth not on these medications. • Led to a protocol and clinic being developed at BC Children’s to Dr. Lancelot Patrick , MD, FRCP(C) http://www.bcmhas.ca/Research/default.htmensure http://www. children are appropriately monitored for metabolic status. Head, Department of Psychiatry bcmhas.ca/Research/default.htm• Funded by CFRI, the Canadian Diabetes Association and an 95 unrestricted research grant from AstraZeneca Canada. Academic: Types of Interactions, Attitudes, Experiences and Feedback: When People Living with Severe Mental Illnesses Interact with the Police: • Lectured, presented a workshop and symposium on treatment of Borderline Personality Disorder for Kasr El-Ainy International • Examines the diversity of perceptions and interactions with police Psychiatry Conference, Cairo, Egypt, Feb 17-19, 2009. from the perspective of people with severe mental illness in British This presented my research findings on the efficacy of group Columbia. psychotherapy modalities for the borderline psychopathology. Also • Findings will be used to inform training curricula and practice presented this topic at LGH grand rounds. guidelines for police officers who interact with people who have • Member of the education committee, Department of psychiatry, of severe mental illness. VGH and UBCH. • Funded by the Mental Health Commission of Canada ($100K) • Organized and chaired the VGH and Community Mental Health services staff annual conference, April 24, 2009; a one-day event that has been at full capacity for the full range of hospital staff eight years Trajectories of Resiliency in Conditionally Discharged Forensic out of the past 10. This year we did “Hot Topics in Mental Health” Psychiatric Patients: which consisted of our top rated lectures and speakers over the last • Investigates how and why persons with a major mental illness and several years. • Attended Aboriginal Mental Health Conference Sept 24-25, 2009. municipally funded youth workers within the community centers • Member of the division of psychotherapy. and schools. • Member of the search committee for endowed chair in • Obtained seniors funding for enhanced community facility care but psychotherapy have been unable to recruit staff yet. • Member of department advisory committee. • Manage routine UBCH clinical functions • Recruited 3 psychiatric specialists, although still have significant Clinical service: (specific to Dr. Patrick) vacancies in Sea to Sky area, Powel River, and need enhancements in Teli-health for Northern communities like supporting Bella Bella’s • Head of the Department of Psychiatry, Lions Gate hospital and Hailika’as Heiltsuk Health Center or the Klemtu community that is Medical Director of Mental health and Addictions for the North even more isolated. Shore. • Created a LGH department advisory structure that engages a comprehensive range of community stakeholders. • Created a LGH multidisciplinary Quality Improvement committee with an independent chair. Providence 96 • Reorganized LGH inpatient service to an up-to-date structure. Health Care • Redeveloped LGH emergency service, including a rapid access psychiatric service accessible to outpatient referrals as well as the Dr. Richard Pico, MD, PhD emergency department (obtained private donor funding for capital costs). Head, Department of • Produced functional plan for a replacement psychiatry facility at Psychiatry LGH, approved by VCH, half of funding is available from private donors, awaiting matching government funds. The municipality and the local MLA’s have supported this plan, but the provincial treasury board has not yet ruled on the proposal. Department Description • The psychiatry facility initiative inspired the development of a The Department of Psychiatry at Providence Health Care (PHC) comprehensive LGH master plan that I contributed to. has a team of 50 full- and part-time Staff Psychiatrists, that provides • Clinical lead on Riverview replacement project, produced capital patient care in acute care, ambulatory, and residential care facilities plan for VCH tertiary care redevelopment, approved by VCH, of the one of the largest faith-based health care organizations in awaiting final government approval. Canada. The two major hospitals at PHC are St. Paul’s and Mount • Reorganized Child and Youth services on the North Shore, Saint Joseph’s. As part of PHC’s role as an Academic Health Science recruited new managers, redeployed health workers to complement Centre, the Department’s staff physicians provide a significant portion of the psychiatric education and training for British Columbia’s medical joined the C-L team at St. Paul’s Hospital. students and resident physicians. Eating Disorders. Samantha Kelleher was recruited to the role of The specialized psychiatric services provided by the Department include: Medical Director for the adult eating disorders program. A new Adult inpatient and outpatient care at St. Paul’s; Geriatric adult multidisciplinary, psychiatry-internal medicine, team was created to inpatient and outpatient care at Mount Saint Joseph’s; Consultation- manage the tertiary inpatient and outpatient services. Liaison; Adult Eating Disorders; Reproductive; Chronic Pain; and Chronic Pain. Medical Director, Roger Shick led a Medical-Legal services. multidisciplinary team that successful competed for $1M in Lower Mainland Integration and Innovation Funding. Department Summary of Activities Reproductive. Medical Director Shaila Misri and her team continued to enhance the local, national, and international reputation and research excellence for this psychiatric service (please General. The Department welcomes new staff members: Brett Broster, see separate report). Kyle Burns, Lindsay Davis, Eve Cabalo, and Emiko Moniwa. Education. Maria Corral has accepted the role of directing all educational activities in the Department. Dr. Corral has also taken an Department Plans for the Future important executive education role, as Director of Medical Education 97 for PHC. In the 2009 academic year, the PHC Department of Psychiatry is Inpatient. The Department is pleased to announce new medical looking forward to: directors: Diane Fredrikson and Leona Adams. They join Bill • Enhancing the acute inpatient care capacity at St. Paul’s MacEwen to manage patient care at St. Paul’s Hospital. Hospital Outpatient. Medical Director, Victor Banno led a team of physicians • Opening a general medical/psychiatric care unit for the most and nurses to design and open a new Acute Psychiatric Assessment complex acute care patients at St. Paul’s Hospital Clinic (APAC) in the outpatient service. The APAC serves to provide • Expanding community and outreach programs an important link in the continuum of care; allowing patients visiting the emergency room to obtain psychiatric follow-up care within hours. • Launching a new Department Website • Community and Outreach. Steven Mathias led a team that established Developing a vibrant research program at St. Paul’s and Mount a significant relationship with Covenant House to provide psychiatric Saint Joseph’s Hospitals services to Vancouver youth. Mellisa Fahy will provide psychiatric • Increase the awareness among the citizens of Vancouver of the leadership to a new ACT service in a cooperative agreement between the scope and depth of psychiatric services provided by the PHC Department and Rain City. Department. Consultation-Liaison. Stephen Fitzpatrick took the role of Director, UBC Program of Consultation-Liaision Psychiatry. Julia Raudzus

PARTNER REPORTS * 2008-2009 Richmond at multiple sites. The Dept. has developed its own website www.rhpsychiatry.com which General we are in the process of updating. Please refer to it for a list of our faculty. Hospital Clinical Programs Dr. Sheldon Zipursky, MD, PhD The clinical services provided by the Department of Psychiatry are Head & Medical Director extensive and work closely on a Best Practices model of delivery of care Mental Health and Addiction and include:

Inpatient Adult Community Program Department Description Outpatient Older Adult Program

Richmond Hospital is located in the City of Richmond and has a Emergency Care The Bridge House 98 catchment area of approximately 250,000 people. It is a community Community Based Services Psychological Services teaching hospital that is affiliated with the University of British Infant, Child, and Adolescent Addiction Service Columbia and the Faculty of Medicine. In addition to serving the Program Psychiatric Emergency Unit community in Richmond, the hospital also serves communities in parts of Delta, B.C. Please refer to our website for descriptions of our clinical programs The Department of Psychiatry is situated within the grounds of www.rhpsychiatry.com. Richmond Hospital. It is located 10 minutes from Vancouver’s International Airport and 20 minutes from Vancouver’s downtown Emergency Dept: #’s of psychiatric patients seen in emergency dept. =1112 core. Richmond Hospital serves a large multi-cultural population. The Dept of Psychiatry’s mission is to deliver the best quality of mental Outpatient service: #1167 patients were seen health and addiction care for the citizens it serves and to provide an excellent training site in psychiatry. The Department reflects values of Inpatient admissions: #831 honesty, fairness, and good stewardship. Total No. of patient visits to all programs: #32,009 ( excludes statistics The Dept. of Psychiatry is an integrated department such that all for our addiction programs) community and hospital programs in mental health and addiction are in one system. All physicians in those programs are part of the Medical students & Psychiatry Residents: # of medical students=19 | Department of Psychiatry. A significant number of our physicians work # of Psychiatry residents=10 Teaching Department Plans for the Future

Our Department’s teaching program has grown significantly over The department is increasing its focus on addictions and has developed the past few years with all staff required to maintain a UBC Faculty a program to support family physicians doing addictions. This is along Appointment. In terms of Post Grad activities, ten psychiatry residents with addiction consultative services to various community programs were trained at Richmond between July 1, 2008 to June 30, 2009; such as Richmond Addiction Service (RAS) and Turning Point. The specific teaching rotations included inpatient; outpatient; emergency Department has also developed a Drug and Alcohol Resource Team and consultation-liaison; infant, child and adolescent psychiatry; (DART) that provides addiction consultation throughout the hospital. geriatric; chronic care; as well as individual and group psychotherapy. Our goal is to develop a program whereby residents could receive The undergrad teaching program is also extremely active. There are 2 training in addiction psychiatry. clinical clerks at any one time at our site as well as a steady stream of Plans are to develop the child psychiatry program so that this site may medical students in a range of elective rotations. be an additional site for child psychiatry training. This year we have 1 Our department also undertakes two other relatively unique activities. fellow in Child Psychiatry. Each year a number of IMGs are provided with Clinical Trainee appointments. And twice a year, our department collaborates on public education evenings with a number of consumer advocacy organizations. Other 99 Our department also has an active continuing medical education and Overview of the Richmond Hospital Department over the past few faculty development program. This is not industry-supported but years: funded by our Dept’s educational fund. Activities include monthly grand rounds, journal clubs, quarterly faculty development evening The Department has grown significantly since 2004. The number of rounds well as an annual educational retreat - this past year the topic new members in the Department has grown from 8-35. Speciality was ‘Group Psychotherapy’ and was facilitated by Dr. Molyn Lescz Clinics, Addiction services and an Early Childhood/Infant Psychiatry from the University of Toronto. program were initiated. A new Psychiatric Emergency Unit was opened in 2009. Our challenges are to have adequate resources to Our staff is valued as teachers, and this past two years Drs. Ingrid meet the clinical needs. The Department recognizes the need for a Sochting (2008-2009) and Michael Shabbits (2007-2008) were awarded GeriPsych-GeriMed unit and is acknowledged in this hospital as a the UBC Psychiatry Association Annual Teaching Award for Teaching priority Excellence, Postgraduate Education. A number of members in the department have published articles in various journals and presented provincially, nationally and internationally.

PARTNER REPORTS * 2008-2009 Health’s Cypress Lodge which is currently under construction on the Riverview Riverview lands. The transfer is expected to take place in early 2010.

Hospital Department Plans for the Future Dr. Soma Ganesan, MD, FRCPC The original Riverview Redevelopment Project was part of the 1998 Programme Head Provincial Mental Health Plan and was targeted for completion in 2007. Challenges faced by several regional health authorities in the development of tertiary mental health beds caused significant delays and prompted MoHS in early 2009 to revisit the implementation Department Description model. In the spring of 2009 MoHS developed a framework for a single “master plan” that will ensure the timely and predictable completion Riverview Hospital provides specialized tertiary acute care, geriatric of the entire bed plan and the transfer of the remaining 215 Riverview adult care and rehabilitation services to BC adults living with a serious patients. A total of 402 beds remain to be developed. All regional health mental illness. Its focus is to improve the quality of life of adults authorities, PHSA and MoHS are participating in the planning, which and geriatric adults affected by persistent or severe mental illness is progressing well. 100 by providing excellent, specialized care for individuals with unique Our role continues to be the provision of expertise to ensure that the treatment challenges, and by increasing service capability with BC clinical and environmental needs of this patient population are met in through clinical service, education and research partnerships. the new care settings and the transfer of patients is completed using a client centered approach. Department Summary of Activities The Riverview Legacy Book project is well underway. The book is In June 2009 a very smooth and well managed transfer took place, scheduled for completion in December 2009 and will highlight, among with 25 tertiary rehab patients from the adult program at Riverview other things, the significant changes to psychiatric care throughout the transferring to the new Memorial Cottage in Langley. RVH staff history of the Riverview Hospital. members and physicians spent significant time developing and reviewing care plans as well as working with the individual patients and their families. Clinical staff reported that the patients responded positively and are adapting well. As a result of these transfers the Brookside unit was closed. An event was held for Riverview staff to mark the closure of the Brookside building and to celebrate Brookside’s rich history of psycho-social rehabilitation. The event was extremely well received and well attended. The next confirmed transfer will be 20 Riverview patients, to Fraser Columbia Hospital (UBCH), with continuing assessment, Vancouver reorganization, improvement and implementation of new and existing programmes. The primary goal of these programme changes is two fold: General faster access to, and improved quality in the delivery of mental health services, addictions services, and community mental health services. We Hospital would like to highlight some of the major initiatives and programme and UBC changes in the following paragraphs. The Neurostimulation Programme has recently created a new initiative in coordinating existing ECT programmes at VGH and UBCH. This Hospital coordination of programmes will streamline treatment for patients by Dr. Soma Ganesan, MD, FRCPC extending service support to meet unmet ECT demand. In addition, Programme Head the Neurostimulation Programme will open the first TMS clinic in the lower mainland. It will be run out of VGH and focus on the treatment of depression and related illnesses. The new Crisis Management Intervention Initiative (CMII) began in Department Description November of 2008 with the goal of serving patients and families in 101 need of immediate access to mental health intervention and services. Under the Crisis Intervention Programme (CIP) a broad spectrum of The VGH and UBCH Department of Psychiatry include 72 permanent services are provided including: counseling, medication management staff psychiatrists and 40 consultant psychiatrists. The programme and mobile outreach/home based assessment and treatment. Following provides inpatient treatment through the Psychiatric Assessment Unit, the success of this programme in the medical and surgical units, CIP Brief Intervention Unit, and the Concurrent Disorders unit with a has been expanded and aims to improve access for patients in all VCH total of 117 beds. Outpatient treatment includes Geriatric Psychiatry, and UBCH programmes. To date we have implemented the following Cross Cultural Psychiatry, and Neuropsychiatry. Residents to the changes: introduction of psychiatric triage at VGH Emergency programme follow a three, six months or one year rotations at various Department; introduction of case management leader at VGH and clinical programs. The programme also provides training for medical UBCH; creation of home-Based Treatment unit based at VGH Health students, family practice residents and residents of other specialty Centre. training programs doing elective rotations. Outpatient service has also undergone some revisions. The Anxiety Clinic based at UBCH was recently transferred to VGH and integrated Department Summary of Activities into the existing Outpatient Psychiatry Programme (OPP) in order to facilitate improved patient access and triage. Under OPP, the Anxiety This past year has seen rapid change in the programmes delivered Clinic will encompass four parts: cross-cultural facilitation, crisis by Vancouver General Hospital (VGH) and University of British management, depression and anxiety.

PARTNER REPORTS * 2008-2009 Department Plans for the Future

Within Vancouver Community Mental Health (VCMH) there have been several additions and improvements to the delivery of services. The first is the streamlining of patient flow through the creation of an older adult central intake process in combination with the Adult Mental Health Team. After a thorough review and evaluation, it was decided that the Westside Mental Health Team should be phased out and its resources distributed among the other mental health teams in order to meet the increased demand in other catchment areas. Finally, the existing UBCH Early Psychosis Intervention (EPI) Day Programme will be shifted into a new facility within Vancouver community in order to improve patient access and intake process. FAST

102 FACTS 7 (as of June 30, 2009) FAST FACTS Learners PEOPLE (as of June 30, 2009) Residents – 66 DIVISIONS AND PROGRAMS Faculty Undergraduate Program Students: Division of Basic Neuroscience Professors - 22 Y1 – 303 Division of Clinical and Behavioural Neuroscience Associate Professors - 6 Y2 – 263 Addictions Psychiatry Program Assistant Professors - 11 Y3 – 221 Y4 – 220 Child & Adolescent Psychiatry Total Full-time – 39 Consultation Liaison Total 1007 Cross Cultural Psychiatry Clinical Professors - 41 Graduate Students- 100+ Developmental Cognitive Neuroscience Clinical Associate Professors – 65 Developmental Disorders Clinical Assistant Professors – 114 FUNDING Eating Disorders Clinical Instructors – 123 Forensic Psychiatry Total Clinical Faculty – 343 Operating Funds General & ER Psychiatry Emeritus and Post-Retirement Appointees - 28 University General Purpose Operating - $3,450,438 Geriatric Psychiatry Program Honorary Assistant Professor – 1 Sessional Funding - $1,470,729 Mood & Anxiety Disorders Sessional Overhead - $228,889 Adjunct Professor – 3 103 Neuropsychiatry Post Doctoral Research Fellows – 25 Research Support Psychotherapy Clinical Fellows – 2 Faculty Salary Support Reproductive Mental Health Research Associates/Research Associate II - 13 Canada Research Chairs (CRC) – 6 Sexual Medicine Total Other – 72 Schizophrenia (One with home Department of Zoology) Education Programs Canadian Institute of Health Research (CIHR) Salary Award Postgraduate Education Staff Holders - 5 Undergraduate Education Research Assistants/Lab Managers – 73 Michael Smith Foundation (MSFHR) Salary Award Holders – 11 Neuroscience Graduate Program Administration/Management – 5 Chairs and Professorships – 5 Continuing Medical Education/Faculty Development IT - 2 Resident Research Administrative/Secretarial Support – 17.5 Public Education

FAST FACTS * 2008-2009 New Research Project Funding Vancouver General Hospital Campus (By Award Type) • Diamond Health Care Centre – 2069 sq ft Agreement - $250,804 • Echelon Building – 5082 sq ft Clinical Trial - $173,555 • Peer Review (CIHR & MSFHR) - $997,909 VGH Research Pavilion – 1953 sq ft General (including industry) – $1,369,892 St. Paul’s Hospital Campus Total - $2,892,160 • St. Paul’s Hospital – 6025 sq ft Other Funding Surrey Memorial Hospital Endowments • Surrey Memorial Hospital Income - $999,223 – 161 sq ft Carry Forward - $1,455,940 Total Space: 57,776 sq ft Total Research Funding - $19,846,829 (includes salary awards and carry forward from previous years) INFORMATION TECHNOLOGY SUPPORT #’s Specific Purpose Funding - $3,779,374 (includes Ministry of Health Clinical Teaching funds) • 104 130 computers Total Other Funding - $26,081,366 • 20 networked printers and various other personal printers SPACE • 4 servers AND network hubs/switches UBC Point Grey Campus • 5 network attached storage devices • Detwiller Pavilion (within UBC Hospital) • 3 date projectors – 36,341 sq ft • 185 login accounts and approximately 200 • Koerner Pavilion (within UBC Hospital) users – 638 sq ft • 1600 different software packages and • Strangway Building (4th Floor) utilities – 5507 sq ft • 281 viruses blocked by central antivirus software this year

105 UNIVERSITY OF BRITISH COLUMBIA

Faculty of Medicine Department of Psychiatry

Detwiller Pavilion 2255 Wesbrook Mall Vancouver, BC V6T 2A1

www.psychiatry.ubc.ca