Award-winning researcher explores new pathways towards prevention

Dr. Tracie O. Afifi has spent much of her career so far making some truly terrible discoveries.

For years, the accomplished mental health researcher has pored over data and reports related to child maltreatment, and has learned of disturbing and violent cases of physical, sexual and emotional abuse and neglect involving children.

Time and again, her research has found that the impact of child maltreatment does not go away once affected individuals reach adulthood – but often translates, instead, into mental health disorders across the lifespan.

Though she has made many important contributions to the field of mental health, and continues to impact policy and guide national public health protocols through her work, Dr. Afifi admits that conducting research dedicated to understanding the scope of the problem of child maltreatment and its effects on mental health can be difficult (and at times, discouraging).

“It’s a hard area of research – you learn about all these terrible things that children should never have to experience,” she says.

“What really motivates me, though, is how resilient children are – and just knowing that my research might help one or two – or many – children to not experience abuse.”

That resiliency is what is driving Dr. Afifi’s latest, more hopeful research endeavour.

As the 2018 winner of the prestigious Royal-Mach-Gaensslen Prize for Mental Health Research, Dr. Afifi, an associate professor at the University of Manitoba and a research scientist at the Children’s Hospital Research Institute of Manitoba, plans to use her $100,000 award to help uncover new, innovative strategies for child abuse prevention and mental health interventions.

To do this, Dr. Afifi and her research team are working to put together an adolescent cohort, with the goal of understanding what factors in one’s life might lead an individual to be more resilient.

By learning from the individuals in the cohort who have experienced childhood maltreatment, but haven’t developed mental health disorders or other poor mental health outcomes, Dr. Afifi hopes to build programs and provide evidence-based recommendations to policy makers, community-based organizations and healthcare professionals to improve mental health outcomes for individuals who have experienced trauma.

“We’re trying to learn what is it in their lives that contributed to their resiliency, whether it is at the individual level, or within their family, in the school, or in the community -- what factors are contributing to better mental health outcomes for these people,” she says.

The cohort will be the first of its kind in the world to focus on adversity and mental health, and will collect data from adolescents 14-17 years of age, along with data from one of their parents (1,000 adolescents matched to 1,000 parents).

By linking survey data to administrative data housed at the Manitoba Centre for Health Policy on education, social services, housing, health and justice outcomes, Dr. Afifi hopes to better understand the reasons why a proportion of children who experience maltreatment are resilient to poor mental health outcomes.

“We want to, of course, prevent child abuse in the first place, but we also want to learn how to better intervene – so for those who have unfortunately experienced child maltreatment, how can we decrease the likelihood that that experience will lead to a mental disorder?”

Since the impact and trauma of child maltreatment can have an effect on one’s mental health across the lifespan, Dr. Afifi’s vision for this research cohort is a long-term one: Her plan is to go back to the participants every two years and re-survey them, to continue to track and understand their experiences, health and well-being, and fine-tune intervention strategies.

This, she says, is how winning The Royal-Mach-Gaensslen Prize for Mental Health Research will really have an impact on her research trajectory -- and on the lives of individuals across Canada who have experienced child maltreatment.

“If we can use this funding to continue to keep in touch with these people for as long as possible and understand their ongoing resiliency strategies, we can improve interventions and outcomes for those who are living with mental health disorders,” she said.

The Royal-Mach-Gaensslen Prize for Mental Health Research, established in 2015, celebrates early-career researchers in the area of mental health, and encourages them to continue their research in Canada.

The prestigious national prize, awarded jointly by the Mach-Gaensslen Foundation of Canada and The Royal’s Institute of Mental Health Research (IMHR), affiliated with the University of Ottawa, recognizes excellence in clinical research, innovative thinking, collaboration, imagination and originality – qualities that Dr. Zul Merali, former President & CEO of the IMHR, says that this year’s winner certainly embodies.

“The Prize rewards promising researchers who approach mental health in innovative ways,” says Dr. Merali.

"Dr. Afifi’s dedication to preventing child maltreatment and exploring new ways to intervene and improve mental health outcomes does not only make her a leading expert in her field – her research is also truly helping to improve lives." - Dr. Zul Merali, former IMHR President & CEO

While Dr. Afifi’s ongoing research holds the promise to help improve the lives of individuals living with mental health disorders, she hopes it will also continue to inform legislative and policy changes in Canada that could prevent child abuse from happening in the first place.

She has used her research on spanking and its correlation to later in life mental health disorders, for instance, to publicly advocate for changes to Section 43 of the Criminal Code of Canada that still allows for corporal punishment such as spanking to discipline children -- an act that has already been made illegal in 54 other countries.

With access and availability of mental health services continuing to be an ongoing barrier in Canada, Dr. Afifi believes that prevention of child maltreatment is the key to improving mental health at the population level.

“If we can actually prevent child abuse and neglect from happening, we will be able to save so many people from suffering from mental health problems across the lifespan,” she says.

“If you can save one child from experiencing child abuse, you’re changing his/her whole trajectory – you can truly transform their whole life.”