Grant: Doctoral: Vanier Canada Graduate Scholarships

Mental illness and substance dependence are complex disorders that represent the interaction of multiple risk factors including family history, environmental circumstances, and life experiences. Socially deprived neighbourhoods with precariously-housed individuals are associated with debilitating mental illness. In Vancouver's Downtown Eastside neighbourhood, high rates of multimorbid physical, mental, and substance disorders demonstrate a considerable need for innovative health interventions and integrated prevention approaches. The positive deviance approach identifies behaviours and traits associated with improved health outcomes for individuals within a high-risk population. I intend to identify life course factors and ongoing behaviours that contribute to improved mental health trajectories in a socially marginalized population. By employing group-based trajectory analysis, I intend to elucidate clusters of individuals following distinct trajectories of psychotic and depressive symptom severity, social and occupational function, or neurocognition over the study period. Based on this analysis, I will determine unique features shared by individuals following a trajectory toward improved mental health outcomes (Improvers). We hypothesize, the Improvers group is characterized by less harmful drug consumption and regular primary care utilization. Through the proposed studies, we hope to better understand the trajectories of several mental health outcomes and resilience factors in a high-risk population. This study aims to enhance capacity of health and harm reduction programs in prioritizing treatment strategies to positively impact mental health outcomes. This approach may offer new avenues to develop sustainable, individualized, and effective health interventions in the Downtown Eastside and other complex, disadvantaged communities.