ROAR Canada stands for Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction.
ROAR CANADA is a five-year research study funded by Health Canada, focused on people being treated for severe concurrent disorders. Concurrent disorders are mental illness and substance use disorders that happen at the same time. Often, people with severe concurrent disorders only receive treatment for one of their conditions at a time. Currently, there are only a few places that provide integrated comprehensive treatment and recovery for severe concurrent disorders.
Dr. Christian Schütz, Principal Investigator, has teamed up with co-investigators Drs. Tonia Nicholls and
James MacKillop of McMaster University on this study, which focuses on these treatment centres:
M1 ward of St. Joseph's Healthcare Hamilton, an acute inpatient ward where people with severe concurrent disorders are stabilized and receive care before transitioning to other treatments.
Forensic Psychiatric Hospital, a facility that treats people who have been found not criminally responsible for a crime or unfit to stand trial due to a mental disorder.
Heartwood Centre for Women, an inpatient facility that provides integrated treatment for women (19+), including trans women, across British Columbia who struggle with severe substance use and mental health challenges.
By following clients (patients) from these treatment centres, we will learn more about people with severe concurrent disorders and about treatment outcomes.
We are interviewing clients four times:
- A baseline interview close to when they are admitted
- A second interview at discharge
- Two more interviews at one month after discharge and 6 months after discharge
Information from interviews will be complimented by chart reviews and administrative data from medical and legal services.
With 1,500 planned participants, we are assembling the largest-ever sample of people with severe concurrent disorders. This population is difficult to reach, and often left out of research studies. They are regularly excluded from mental health studies because of their substance use or from addiction studies because of their mental disorder diagnoses.
Participants are considered difficult to treat: they have been through other mental health treatment and other substance use treatment without persistent improvement.
By collecting data before, during, and after their stay, we can learn what treatment-as-usual looks like, how the M1 ward and Red Fish differ, and how these new integrated treatments change outcomes. In particular, our goal is to learn about overdose and relapse after discharge, and how to prevent them.
The study will provide much-needed information on this population and will allow us to explore subgroups, looking at differences based on things like sex, age, and whether participants live in urban or rural areas. We will also be able to look at factors that might improve or inhibit recovery, like participants' cognitive skills or their social support structure. We will look at a variety of outcomes such as emergency department utilization, continuity of care, continued use of medication, victimization, and police contacts.