Chair of the Board, HRI.
Executive Director of HRI.
From our leadership
We are delighted to present the Homewood Research Institute (HRI) 2022-2023 Annual Impact Report, which showcases our remarkable progress and achievements during the past year.
A key milestone this year was the launch of our strategic plan; a roadmap that will guide HRI’s direction over the next five years. This comprehensive plan reflects our commitment to innovation, excellence, and creating a world where no life is held back or cut short by mental illness and/or substance use issues.
Among the highlights from this fiscal year:
- HRI researchers successfully employed artificial intelligence to predict PTSD symptom severity and functional impairment.
- Almost 1,500 people registered for our HRI Talks webinars and the recordings were viewed more than 1,000 times on YouTube.
- We continue to work with our six partner sites in Ontario to implement progress and outcome monitoring systems.
- We welcomed seven collaborating clinicians and researchers, and five research trainees to our team.
As we reflect on these accomplishments, we are acutely aware of the complex work that lies ahead. Our dedication to advancing applied research in mental health and substance use health remains resolute. The future holds both opportunities and challenges, and we are prepared to address them with the same energy and ambition that has propelled us thus far.
With our focus on collaboration, discovery and translating new knowledge into practice, we continue to amplify our strengths and accelerate the real-world impact of our research in Canada and beyond.
With sincere gratitude,
Sidney Kennedy, MD, FRCPC, FCAHS, FRSC
Executive Director
Homewood Research Institute
Ronald P. Schlegel, OC, PhD, LLD, FCAHS
Board Chair and Director
Homewood Research Institute
research INNOVATION
HRI Researchers Unveil Machine Learning’s Potential to Predict PTSD Symptom Severity Providing New Opportunities for Personalized Treatment
Researchers report high accuracy when using AI to predict symptom severity and functional impairment in PTSD patients.
Groundbreaking work from a team of HRI researchers, including Drs. Margaret McKinnon, Ruth Lanius, Andrew Nicholson and PhD candidates Anna Park and James Mirabelli, has the potential to transform how Post-Traumatic Stress Disorder (PTSD) is understood and treated.
PTSD, a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event, has been difficult to diagnose.
“Relationships and interactions among PTSD symptoms are highly complex and understanding them is critical for effective treatment,” says Dr. Nicholson, Collaborating Scientist with HRI and Director of Clinical Research at the Atlas Institute for Veterans and Families within The Royal Ottawa Hospital. “We wanted to know if machine learning models are able to capture these complex, non-linear variables in a real-world sample.”
The team’s most recent study aimed to answer specific questions:
- Can we use machine learning models to predict PTSD symptom severity and functional impairment?
- How could we use artificial intelligence to predict how someone will respond to treatment?
“We were really blown away by the results,” Dr. Nicholson says. The accuracy scores of the machine learning models were very high when compared to classical statistical prediction methods. On a scale from 0-80, the machine learning model predicted a new patient’s symptom severity within around six points. As well, on a scale of 0-48, the model predicted within about five points the severity of a patient’s functional impairment.
The study was made possible with the unique access to data collected from Homewood Health between 2017 and 2019. “It was a great collaboration with Dr. Ruth Lanius’s group at Western University and Dr. Margaret McKinnon’s team at McMaster. HRI took care of the data management and transfer, including organizing and cleaning the data,” Dr. Nicholson says. “It’s been a large group effort – and the results are promising.”
The level of accuracy in this study allows the team to move forward with developing tools for tailored treatments that improve outcomes for patients based on their individual characteristics. It presents an opportunity to bring more personalized and effective care to those affected by this debilitating condition.
“This may also have implications for other personalized medicine approaches or treatments,” says Dr. Nicholson.
An Early Researcher Pioneering Predictive Models for PTSD Symptom Severity and Response to Treatment
Dedicated to neuroscience and psychiatric research, Dr. Nicholson’s areas of study incorporate a range of innovative technologies, most recently Artificial Intelligence (AI), or machine learning, in an effort to improve diagnosis time, tailor treatments, and significantly improve outcomes for people living with PTSD.
Dr. Nicholson’s relationship with HRI began in 2017. After completing his PhD in Neuroscience at the Schulich School of Medicine and Dentistry, Western University, Andrew began his first postdoctoral fellowship as a research trainee with HRI, working alongside Dr. Margaret McKinnon and Dr. Ruth Lanius. Andrew says his first post-doc, jointly funded by HRI, the FDC Foundation and Mitacs Elevate, was “a taking off point” for his career. He says, “I’m really grateful for the opportunities that have been provided to me from working with everyone here.”
During his first year with HRI, Andrew worked jointly on an innovative study using machine learning algorithms and co-authored a publication of the team’s findings about the accuracy of their work. Results of this study attracted media attention and served as a catalyst to continue further with this line of research.
Nicholson says future studies will look at different forms of therapy to find what’s working, why, and with whom, saying, “I think this research provides a lot of hope for clients regardless of the stage at which they access care.”
2023-2027 Strategic Plan: Driving Change to Improve Care
After a full year of collaboration, research and engagement with our stakeholders, we proudly launched our new strategic plan in January, 2023.
It builds on HRI’s ongoing research in the areas of substance use and trauma, and adds depression as a new focus area.
The plan highlights the gap in addressing treatment for people with concurrent substance use disorder and other mental illnesses or conditions.
Over the next five years, we will build on our strengths and extend our research to better understand how co-occurring conditions interact, and how we can improve outcomes through the delivery of enhanced treatments for people living with mental illness and/or substance use issues.
Publishing and Presenting Research Findings
At HRI, we are committed to turning applied research into solutions for the real world. Publishing and presenting our research findings allows researchers to share their knowledge, insights and innovations with the broader mental health and substance use health community. Knowledge translation is a fundamental aspect of our work.
Presentations at conferences and symposia in 2022-2023
Publications in academic journals in 2022-2023
Stakeholder presentations and public webinars in 2022-2023
seeding SYSTEMS-LEVEL CHANGE
Is Anyone Getting Better? How Measurement-Based Care Can Transform Care for Mental Health and Substance Use Health
Currently, there is no standardized system of tools or processes in Canada that measures how a person’s mental and substance use health changes over the course of inpatient treatment and beyond. How, then, do we know if anyone is getting better? This information gap hinders our ability to understand the real world effectiveness of treatment programs, leaving clinicians and service providers without clear data on which programs are creating positive changes – and for whom.
What is Measurement-Based Care?
Measurement-based care, also referred to as progress and outcome monitoring, involves regularly assessing a patient’s symptoms, progress and treatment outcomes using validated measurement tools. This data-driven approach helps healthcare providers make more informed decisions and provide more personalized care.
A standardized system could revolutionize the way we measure long-term patient outcomes across diverse treatment locations, settings and populations in Canada. Implementing measurement-based care could enable researchers and clinicians to gather and analyze data, allowing them to identify opportunities to improve specific interventions or program design and delivery. It would allow them to start answering the question, “Is anyone getting better?”
HRI has been collecting data on patients’ symptoms, progress and treatment outcomes of in-patient program attendees through the Recovery Journey Project since 2015. Researchers use questionnaires, online surveys, interviews and check-ins to gain insights into how people experience their lives during and after treatment. Participants were asked to report changes in their mental health, substance use, social and family relationships, and overall quality of life. The analysis of these data informed the development of an innovative model for progress and outcome monitoring system (POM). It was first implemented in the Addiction Medicine Program at Homewood Health Centre, and subsequently adapted and implemented across Homewood Health programs and services as Homewood Touchpoint.
Testing and Scaling the System
HRI leads a group of six partner sites in Ontario, including Homewood Health, to test the “real-world” implementation and delivery of these POM systems within different treatment settings. At these locations, both clinicians and patients will ideally have access to real-time data with accompanying visualizations, providing a helpful and tangible way to track progression toward wellness. Learning about how these POM systems are adapted and implemented within each of these unique settings will help inform future scale up efforts.
Regan Anderson, CEO of partner site Wayside House of Hamilton notes that, “The implementation of a progress and outcome monitoring system is a much-needed shift in the publicly funded system; away from quantitative reporting of how many people we serve and toward a true understanding of the impact of that service.”
Kim Baker, Director of Clinical Services at St. Leonard’s Community Services, a partner site in Brantford adds, “POM is a foundational step toward significant system quality improvement efforts. The knowledge gained through the initial implementation efforts will inform scale up of outcome monitoring across bed-based services, but also within other levels of care.”
Systems-Level Change: Data-Driven Evolution of Mental Health Systems
The ultimate goal is to develop a rigorous and reliable system of tools and processes that can be adapted and scaled to any in-patient treatment context in Canada. The data collected through this system will provide valuable insights into opportunities for improving current treatments and identifying key points in time when people may need more support after completing their program.
“It’s a community of practice, really, where we learn from each other’s experiences implementing these systems across organizations with very different resources, structures and client bases. The model is iterative, innovative and impactful,” says Dr. Jean Costello, Director of Research and Evaluation at HRI.
With 1 in 3 Canadians facing mental health challenges at some point in their lives, it is crucial to improve post-treatment monitoring for mental health and substance use health. By collecting and analyzing standardized data, we can better understand patient outcomes and make informed decisions to elevate the quality of care and after-care.
We are grateful to KPMG Waterloo, the KPMG Foundation and to CCSA for their generous support of this work.
Healthcare Salute: Mobilizing Knowledge in Support of Canadian Healthcare Providers Impacted by the COVID-19 Pandemic
Healthcare Salute is an ongoing monitoring and knowledge mobilization initiative to support the needs of healthcare providers impacted by the COVID-19 pandemic.
Led by Dr. Margaret McKinnon, Homewood Chair in Mental Health and Trauma, the Healthcare Salute website was launched in early 2023. It provides mental health and wellness resources for public safety personnel and healthcare workers in Canada.
Visit the Healthcare Salute website to learn more.
Powering Progress in Mental Health and Substance Use Health
HRI Talks are free public events aimed at powering progress in mental health and substance use health. They are held virtually, enabling people from across the world to participate in important conversations about mental health, substance use health and the value of science in finding solutions to these public health crises.
We had almost 1,500 people register for our HRI Talks this year. That means our audience grew by 26% in just one year. People joined us from all over the world, including the United Kingdom, India, Brazil, Norway, Singapore and New Zealand.
We are grateful for the support of our HRI Talks sponsors: CIBC, KPMG and the Otsuka-Lundbeck Alliance.
Watch our 2022-2023 HRI Talks on this page or explore the full series on our YouTube channel.
Subscribe now so you don’t miss any of our events.
Number of HRI Talks views on YouTube in 2022-2023
Percentage of attendees who reported they learned valuable or helpful knowledge at an HRI Talk
Number of countries from which our audience joined an HRI Talk in 2022-2023
training the next generation
Building the Future of Applied Research in Mental Health and Substance Use Health, One Trainee At A Time
We work to ensure the growth and sustainability of practice-based research in Canada.
Advancements in the field of mental health and substance use health are crucial in addressing the global burden of mental illness and substance use issues. As understanding of the complexities surrounding these issues deepens, the need for dedicated, well-trained researchers becomes paramount. Building the future of applied research in mental health and substance use health is about more than developing novel treatments and tools; it’s about nurturing the next generation of researchers who will drive advancements forward.
HRI trainees are registered students or postdoctoral fellows at academic institutions across Canada. They work alongside senior or collaborating scientists to bring forward fresh perspectives and novel ideas from their disciplines. Our established researchers and clinicians, who are leaders in their respective fields, guide trainees through the intricacies of research design and ethics, data analysis and interpretation, and, ultimately, knowledge translation.
Emily Levitt, an HRI trainee and PhD candidate in Research and Clinical Training at McMaster University, says, “Working with HRI was one of the best things that’s ever happened to me. I feel extremely lucky to have been given the opportunity. Clinical psychology is such a difficult program to get into, and I had so much support, and so many amazing learning experiences. I feel very, very lucky to have had that support.”
One of HRI’s unique features is our national mandate to facilitate partnership and knowledge exchange between experts and knowledge holders with diverse perspectives– researchers, policymakers, people with lived experience and community organizations. This provides our trainees with the opportunity to collaborate with stakeholders from across Canada and beyond, giving them access to a broad range of expertise.
Trainees also learn the importance of applying the principles of equity, diversity and inclusion in their research and, more broadly, in their careers. It is vital that the next generation be equipped with cultural competence to provide effective, respectful, and equitable care that values the diverse backgrounds and needs of their clients. The future of applied research in mental health and substance use health is bright and promising, driven by the passion and dedication of trainees and researchers. Through their relentless pursuit of knowledge and innovation, we can build a world where wellness is prioritized, and evidence-based interventions pave the way for mental health and substance use health for all.
New HRI Research Trainees 2022-2023
Each year, HRI hosts a number of students and post-doctoral fellows from across Canada through our trainee program. We were thrilled to welcome five new HRI Trainees in 2022-2023:
Andrea D’Alessandro-Lowe
PhD Student at McMaster University, ON
Understanding Moral Injury in Public Safety Personnel and Health Care Workers
Supported by: Horne Family Memorial Fellowship
Amanda Joseph
PhD Student at University of Victoria, BC
Analyzing Research on Internet-Based Cognitive Behavioural Therapy (iCBT) in the Treatment of Substance Use Disorders
Supported by: Mitacs Accelerate and Mental Health Research Canada
Ashley Williams
Postdoctoral Fellow at McMaster University, ON
Examining the Efficacy of Equine Assisted Learning for Public Safety Personnel with PTSD
Supported by: Mitacs Elevate and AllOne Foundation
Kiran Punia
PhD Student at McMaster University, ON
Research in psychometric scale validation
for PHQ-9 and GAD-7 diagnostic tools
Supported by: CIHR Canada Graduate Scholarships – Masters Award
Brian Bird
Postdoctoral Fellow at McMaster University, ON
Research in psychometric scale validation for PCL-5 diagnostic tool
Supported by: CIHR Postdoctoral Fellowship
Working with HRI was one of the best things that’s ever happened to me. I feel extremely lucky to have been given the opportunity. Clinical psychology is such a difficult program to get into, and I had so much support, and so many amazing learning experiences. I feel very, very lucky to have had that support.
– Emily Levitt, HRI Trainee and PhD candidate in Research and Clinical Training at McMaster University
DONOR CHANGEMAKERS
“We Don’t Want This to Happen to Anyone Else”: How One Family’s Tragedy is Leading to Improved Mental Health Supports for Veterans and Public Safety Personnel
Rob Horne and his family raised over $40,000 in two years to fund new research into post-traumatic stress injury (PTSI) and moral injury in public safety personnel and Veterans.
In 2018, the Horne family suffered the catastrophic loss of a family member. Paul Horne was a decorated military veteran who served in Bosnia, and a highly respected Detective Inspector with the Ontario Provincial Police. He died by suicide after living with post-traumatic stress injury (PTSI) that had developed as a result of on-the-job trauma.
Rob Horne, now a retired municipal leader, recalls the ethos of his youngest brother: “Paul was all about getting people out of undesirable situations and then trying to help them get back on track in life.” Paul’s sense of purpose inspired Rob and his family to create something that would resonate far beyond their loss.
The Horne Family Memorial Fellowship
In 2019, Rob Horne received a serendipitous call from a professional acquaintance of many years. It was Rob Schlegel, a member of the founding family of HRI. The two shared their concerns about the gaps in mental health care and the urgency required to address them. The conversation quickly evolved, and the Horne family concluded that a partnership with HRI would be a perfect fit for the work they wanted to do.
“Like many people, I had no idea that Canada is a world leader in mental health research. It was outside of my field of vision. When I learned about the incredible work happening at HRI, I wanted to get involved. I knew there was a role for me. Call it serendipity, but sometimes opportunities pop up in the least expected places,” Rob said.
In 2021, Rob and his family launched the Horne Family Memorial Fellowship. It supports exceptional graduate students who, working alongside Dr. Margaret McKinnon, Homewood Chair in Mental Health and Trauma, are dedicated to advancing research and treatment for people with PTSI. Dr. McKinnon and her team conduct research and develop treatment interventions for front-line workers who have experienced trauma, particularly military members, veterans, public safety personnel and health care professionals.
Earlier this year, the fellowship reached a major milestone. It funded its first research trainee, Andrea D’Alessandro-Lowe, a clinical psychology PhD student at McMaster University. “For our family, supporting a talented early career researcher in this discipline means so much. It reflects my brother’s values and his existence in life, which was to help others.”
This was a major step toward the broader impact the Horne family is aiming for: transforming a deeply personal loss into real progress toward new strategies and solutions for treating PTSI.
“Our family wants to help prevent this from happening to people like Paul. The loss to their families, and to society, is unspeakable. It cannot continue,” says Rob.
Why Research?
Before losing Paul, Rob hadn’t considered the often-overshadowed role of research in mental healthcare. As Rob points out, without understanding the underlying causes of mental illness and the treatments that can address them, advances will not be made.
Now Rob channels his time and energy into raising awareness of, and funding for, research at HRI. Why? Because, as he explains, “Research is the backbone of effective treatments, yet it’s underfunded and under-represented in conversations about improving mental health care in Canada.”
He believes that research has the potential to transform care for those who desperately need it, and funding of that strategic, applied research holds the key to deeper understanding and novel treatments that are more effective.
Fostering the Future
Rob’s dedication to mental health research is both personal and profound. It goes beyond charity – it’s a mission fueled by his family’s two intertwined goals: to honour the memory of Paul and to illuminate a neglected yet critical aspect of mental health care – research.
The Horne Family Memorial Fellowship is making a significant impact and its influence is growing. As Rob continues his mission, he gives a face to illnesses like PTSI to let others know they are not alone, while reframing the narrative from one of loss to hope.
Our Donors
We are deeply thankful to all our supporters who champion our vision: No life held back or cut short by mental illness or substance use issues. Your invaluable contributions enable us to conduct vital research and bring about positive change in the field of mental health and substance use health in Canada.
* Denotes multi-year project funding.
Our Financials
Statement of Operations and Changes in Net Assets
Year ended March 31, 2023, with comparative information for 2022.
| Revenue | 2023 | 2022 |
|---|---|---|
| Donations and grant funding | $1,865,283 | $2,294,462 |
| Investment income (loss) | ($33,472) | $78,133 |
| Total revenue | $1,831,811 | $2,372,595 |
| Expenses | 2023 | 2022 |
|---|---|---|
| Salaries and benefits | $765,469 | $952,113 |
| Purchased services | $797,159 | $934, 083 |
| Supplies and other | $155,190 | $256,491 |
| Total expenses | $1,717,818 | $2,142,687 |
| Change in Assets | 2023 | 2022 |
|---|---|---|
| Excess of revenue over expenses | $113,993 | $229,908 |
| Net assets, beginning of year | $999,379 | $769,471 |
| Net assets, end of year | $1,113,372 | $999,379 |
Thank You
Thank you to HRI staff, board members, trainees and our collaborators for your continued support of HRI. We are grateful for your expertise, dedication and partnership as we continue to advance our vision: No life held back or cut short by mental illness or substance use issues.