Grant: Operating Grant - Priority Announcement: Institute of Gender and Health

Mental illness and substance abuse can lead to poor physical health such as cardiovascular disease, diabetes, cirrhosis of the liver and several forms of cancer; cumulative chronic health problems are associated with poor mental health and substance abuse. Mortality is higher among people with psychiatric problems relative to the general public and other comparison patient groups. Patients suffering from chronic pain may self-medicate and become addicted to drugs in an effort to cope. The primary objective of this research is to explore whether the presence of one of these condition creates an increased risk in the development of additional health problems, and if so, to understand the nature of multiple health problems among men and women. The spotlight here is on mental illness, substance abuse and ten high incidence/high prevalence chronic physical health conditions (e.g., cancer, hypertension). The study is timely since the Provincial Forum and the Mental Health Implementation Task Forces (2000/01) were mandated to examine the current process of delivery of mental health services in Ontario and to make recommendations for mental health care reform. One of the Task Force recommendations was to address current gaps in mental health services for those who have a dual diagnosis and/or concurrent disorder. Another concern identified was that mental health services and supports are not always accommodating to all people in terms of cultural, gender or special needs. The study will inform present clinical practice which is currently, not optimally designed to address multiple needs of patients with mental illness/addictions; time constraints often force physicians to address the most salient health problem (e.g., depression, anxiety, schizophrenia) so that preventive procedures are not delivered (e.g., pap tests, hypertension). This is the first study in Canada to inquire into this topic, and specifically to study co-morbidity from a gendered perspective