A mental illness prevention and early intervention program is coming to Pictou County, with funding from the Aberdeen Health Foundation.
Families Overcoming Risks and Building Opportunities for Wellbeing (FORBOW) has been operating in Halifax since 2013 as a program within the Dalhousie University. The aim of the study is to reduce the burden of mental illness on youth through early identification of risk and targeted prevention.
Dr. Rudolf Uher is a psychiatrist with Nova Scotia Health, Canadian Research Chair in Early Intervention in Psychiatry and Professor in the Department of Psychiatry at Dalhousie University. He has been Primary Investigator in the FORBOW study since it began and one of the physicians currently involved in the program. “We knew that mental illness tends to run in families and start early in life,” Dr. Uher explains about the development of the study. “We saw a big opportunity to prevent that from happening by helping young people, especially those coming from families where mental illness is present.”
Children in the general population show a one in ten chance of developing mental illness, says Dr. Uher. These odds increase to one in three when one parent has been diagnosed with a major mood or psychotic disorder, and further increase to one in two when both parents have a diagnosed mental illness. Despite the stark statistics, it may be possible to prevent the onset of mental illness in more than half of these cases.
“We started the FORBOW study ten years ago now and have developed it gradually over time. We have very strong indications that for young people who are likely to develop major forms of mental illness, like depression, bipolar disorder and psychosis, we can see it coming years in advance and have time to intervene. We’ve been working with families across Nova Scotia to develop ways to predict and prevent the onset of mental illness.” Dr. Uher was recognized in 2021 as one of the world’s most cited researchers, demonstrating the significant impact his work has in the field of mental health.
In 2021, the Aberdeen Health Foundation began funding transportation subsidies to enable Pictou County families to participate in the program in Halifax. Sixteen families from Pictou County have participated so far, including Kim and Peter Crawford and their two daughters Katie and Lauren.
“I am diagnosed with bipolar II disorder, which is the lesser extreme of the two bipolar disorders,” says Kim Crawford, when asked how she learned about FORBOW. “I was at an appointment with my psychiatrist about ten years ago and she explained what FORBOW was and that they were looking for families to be involved in the research project.”
Kim and her family joined without hesitation and have been active participants since then. “We saw it as a really positive thing from the beginning and we were excited to be a part of it. They pose questions that cause you to really look inward, toward yourself. We found that as the kids got older, they recognized what mental health was and understood it in ways that weren’t provided by the school system. My husband liked it because it gave him more insight into what goes on with me and my mental illness.”
While the FORBOW study has seen tremendous growth and success over the past decade, Dr. Uher believes the program can make an even greater impact outside of Halifax. “We have been finding that we can make a bigger difference in regions that are not as well-resourced,” says Dr. Uher. “Families from city areas have typically already experienced input from therapists or psychologists when we see them, whereas families from more rural regions often have not had any previous intervention. We know we see greater success with earlier intervention, and so we made a push to focus more on these regions. The Aberdeen Health Foundation approached us with an interest in launching a satellite site in Pictou County, which was a great fit. Not only were we able to receive financial support from the Foundation but we were able to secure an appropriate space in New Glasgow through Nova Scotia Health.”
The FORBOW Pictou County satellite location is set to open soon at 690 East River Road in New Glasgow, co-located with Mental Health and Addiction Services. The location aims to serve up to 100 families. “What we want to see within the first year or two is engagement,” says Dr. Uher. “We want to reach these young people and their families in a way that is representative, that is equitable, and in a more accessible way across the northern region of the province. In the longer term, we seek to build on these relationships and keep the young people and families within the study.”
When it comes to early interventions, there has been no issue with recruiting and retaining participants in the past says Dr. Uher. “We often contact FORBOW families and ask if their son or daughter would be interested in taking part in these coaching sessions and the vast majority not only say yes initially, but actually complete the program. We have an over 85% completion rate which really speaks to the need for the program and I think for us, it confirms that it’s set up well for young people and families to give them what they need.”
Dr. Pat Craig, Co-Chair of the Aberdeen Health Foundation’s Population Health committee, expressed pride in seeing the Foundation bring the program to the county. “Throughout my years practicing family medicine, I witnessed many, many times the devastating impact that serious mental illness can have on patients and their families. The idea that we can reduce these negative impacts and potentially prevent them altogether through early intervention is incredibly exciting. This program has the potential to directly and indirectly improve the lives of many Pictou County residents.”
The new location will focus on youth aged 9-24 and offer in-person and remote sessions. Families can become involved in the study via clinician referral or self-refer by visiting the FORBOW website, www.FORBOW.org. The program will also partner with the Chignecto-Central Regional Centre for Education to offer outreach to local schools.
As for Kim Crawford and her family, they are eager to continue participating in the program much closer to home. “As the kids got older, their lives became busier and it was harder for us to make it to Halifax for sessions,” says Kim. “The new location will be much more convenient for us, and I think having it here will definitely give people of Pictou County more knowledge and a better understanding of mental illness. I think we really needed the additional resources here in the community.”