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People who come from low socioeconomic positions are more likely to struggle with substance use disorders, and that strikes me as incredibly unfair. Your life circumstances shouldn’t determine whether you are going to face these problems.
Jenna van Draanen began to see the connection between mental illness and substance use disorder during her work in Canada with homeless, mentally ill and substance use populations, as well as evaluating programs designed to address these issues. Now a third-year PhD student in the Fielding School’s Department of Community Health Sciences, van Draanen plans to study factors that determine the timing of the onset of a mental illness and substance use disorder in people who end up developing both – a condition referred to as co-occurring disorders or dual diagnosis.
“We don’t know much about why, for some of these individuals, the mental illness comes first, while in others the addiction comes first, and in still others the two occur at the same time,” van Draanen says. “But we do know that people who develop these co-occurring disorders really struggle, and have far worse outcomes than those who have only one of the two diagnoses.” By identifying predictors of the timing and sequencing for the onset of the disorders in the dual-diagnosis population, van Draanen hopes to pave the way toward more tailored prevention strategies. “When you look at some of the social determinants of substance use disorder and mental illness, it’s really profound,” van Draanen says. “People who come from low socioeconomic positions are more likely to struggle with substance use disorders, and that strikes me as incredibly unfair. Your life circumstances shouldn’t determine whether you are going to face these problems, or whether you will have access to treatment for them. I’m hoping my work can contribute to changing that.”
Sarah Waters, a first-year student in the Fielding School’s Executive MPH Program in Health Policy and Management, views the public health response to the substance use disorder population as an essential entryway to better health. “If we want people with a dependence problem to be able to live healthy and productive lives, we can’t tackle anything else until we take care of that one issue for them,” she says.
Waters travels to the Fielding School two weekends a month from Toronto, where for the last four years she has worked at the Centre for Addiction and Mental Health (CAMH) as a clinical researcher in geriatric neuropsychiatry. The program seeks to discover new approaches to enhance the effectiveness of treatment for mood and addiction disorders across the lifespan. Waters has already begun to gain knowledge that she intends to bring back to CAMH, with the promise of more to come. “One of the classes I will have the opportunity to take in the spring is on integrated health systems, which has direct relevance to the needs of my organization,” she says. Among Waters’ other interests: developing a checklist that would allow primary care providers to more efficiently and accurately screen patients to detect early concerns about substance use and dependence.
Waters has no regrets about her decision to make the unusual commute from Toronto to L.A. “This is such a stimulating academic environment, with supportive faculty and students, in a city with an ideal population for someone with my interests,” she says. “As soon as I arrived, I could see that all of these doors were opening for me, both at the school and in the community, to make a difference in addressing this important issue.”