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September 24, 2019

Message from Dr. Peter Szatmari


It’s hard to believe that the Cundill Centre for Child and Youth Depression is half way through its 7-year funding period—a great time to pause and reflect on our successes and goals for the future. In June, we conducted the first evaluation of the Centre and found that we are almost 70% on target with our research goals and over 80% on target with our knowledge translation and exchange goals.


We have been successful in determining the best evidence-based practices for the assessment and treatment of depression and self-harm in children and adolescents, and we have developed two new interventions for depression and suicide prevention in adolescents. We have developed eight evidence-based tools to help clinicians in their practice—these will be available on the Cundill Centre website in the coming months. We have presented our work 44 times at the local, national and international levels. Over half of Cundill Scholars have a clinical background, which helps ensure that research questions and knowledge translation tools are relevant to clinicians. The Centre has 28 partnerships, 13 of which are international. These partnerships help us incorporate different perspectives in our work; leverage the expertise of others; and share our work broadly. We have conducted over 50 consultations with Local Advisory Panels (groups of youth, family members, service providers or decision makers) to inform our work.

We are proud of what we have accomplished so far, but know there is more to do to achieve our vision of better health outcomes for children and youth with depression. To help us get there, we are welcoming Dr. Stephanie Ameis, who will take on the role of Associate Director of the Cundill Centre. Dr. Ameis is a Clinician-Scientist in the Child and Youth Mental Health Collaborative at the Hospital for Sick Children and CAMH and an Associate Professor in the Department of Psychiatry at the University of Toronto. She will be working with me to help support our project scientists and trainees and to advance our knowledge translation activities. Learn more about Dr. Ameis in the “Meet Our Team” section below, and keep reading to learn about an evidence-based intervention for youth suicide prevention, our work with the Georgian Bay Family Health Team and more.

Dr. Peter Szatmari
Director, Cundill Centre


Project Updates


Depression Early Warning Study Receives CIHR Funding

The Depression Early Warning Study was recently awarded a $952,000 project grant from the Canadian Institutes of Health Research (CIHR). Cundill Scholars Drs. Marco Battaglia and John Strauss have organized a team of international experts from the National Institute of Mental Health, Vanderbilt University, the University of Bordeaux, the Bill and Melinda Gates Foundation and the University of Toronto Department of Electrical and Computer Engineering, and others, to investigate early relapse detection in youth depression, using digital technology.  

The project’s main aim is to develop and validate a computer prediction system for relapse and recurrence in youth depression. Secondary aims include: computerized prediction of when relapse/recurrence will happen and grouping patterns of illness and recovery over time.

The four-year study will enroll participants aged 12 to 21 with a history of depression. Mobile phone use is on the rise in youth and gives objective, nearly invisible research data collection. Several kinds of measures will be used, ranging from wearable actigraphs to speech analysis. Statistical computer programs will be used to develop new insights and support better understanding of the course of depression over time.

Scroll down to read key messages from the study team’s Speaker Series presentation earlier this year.


Evidence-Based Intervention for Youth Suicide Prevention

Suicide is the second leading cause of death among adolescents in Canada, and there is an urgent need for effective suicide prevention strategies for high-risk adolescents. Cundill Scholars Drs. Daphne Korczak and Yaron Finkelstein are testing a suicide prevention strategy in a clinical trial—a Canadian first.

Read More

CARIBOU Integrated Care Pathway for Adolescents with Depression Becomes Standard of Care

We are happy to announce that the CARIBOU Integrated Care Pathway for Adolescents with Depression has been approved as a standard of care at CAMH. 


CARIBOU started as a pilot study at the Cundill Centre and will now receive support from CAMH for organization-wide implementation, as well as integration into CAMH's electronic medical record system. The structured, multi-disciplinary care plan was created through the synthesis of evidence-based treatment recommendations, clinician input and input from youth—three elements that define the practice of evidence-based medicine. The pathway guides young people through a detailed plan that includes family education, group cognitive behavioural therapy and medication for some youth with more serious depression. By standardizing evidence-based care care for youth, it is hoped that treatment variability will decrease, and youth will achieve positive treatment outcomes.

Read More about caribou

Working with the Georgian Bay Family Health Team to Implement Clinical Practice Guidelines


Georgian Bay Family Health Team: Marta Borges, Tracy Poole, Erica Tucker, Dr. Rob Meeder, Kendra Listro, Dr. Karin Euler, Renira Narrandes (Cundill Centre Knowledge Translation), Susan Lalonde Rankin, Gaynor Edwards (July 2019)


We met with members of the Georgian Bay Family Health Team (GBFHT) in February to hear about the care and treatment of children and youth with depression in the South Georgian Bay region. We explored what was working well, where opportunities for improvement existed, and what practice guidelines and standards were being used currently. Dr. Szatmari presented an overview of clinical practice guidelines and discussed how they could be used to address service gaps in the treatment of depression. The #CundillatCAMH Decision Aid for the Treatment of Child and Youth Depression was offered as a tool that could help standardize and improve care.

We are now working with the GBFHT and the Provincial System Support Program at CAMH to implement the decision aid in the South Georgian Bay region and have been meeting monthly to contextualize the treatment pathway. Are you interested in learning more about the decision aid and how it can be implemented in your context? E-mail us: Cundill.Centre@camh.ca.


Cundill Centre Scientific Retreat


We held our first Cundill Centre Scientific Retreat on May 13. The retreat brought Cundill Scholars, Fellows, local Mentors, trainees and research staff together to discuss project progress; collaborate to solve project challenges; brainstorm ideas for new projects; and share experiences. Presenters were asked to explain how their work would impact public health and how they would use knowledge translation to ensure research findings would be taken up in practice. Feedback was positive; everyone who attended said they would do it again next year—so we will!


Cundill Centre Speaker Series


Digital Phenotyping for Early Relapse Detection in Youth Depression

Drs. John Strauss and Marco Battaglia presented preliminary results of the Depression Early Warning Study, which aims to use mobile and wearable technology to predict relapse in youth depression.


Drs. John Strauss (left) and Marco Battaglia (right)


Key Messages

  • The Depression Early Warning study uses wearable and mobile technology to examine the relationship between physical activity, sleep patterns, mood and behaviour in depressed youth.
  • Variation in one or more of these metrics may predict depression relapse. This information could be used to inform relapse prediction software agents for clinicians.
  • The methods seem promising; data collected in the next year or so will give us a better idea of what contributes to depression relapse; however, the development of relapse prediction software is still a long way away.

2019 Update on the Child and Youth Mental Health Collaborative

Dr. Szatmari presented on the key successes and future plans of the Child and Youth Mental Health Collaborative, a partnership between CAMH, SickKids and the Division of Child & Youth Mental Health at the University of Toronto.


Key Successes

  • Child and Youth Acute Care Collaborative
  • Health Partnership Table
  • Urban tele-psychiatry
  • Several multi-site clinical trials
  • The most sought after training program in the country

Future Plans

  • Build a better system across the GTA with academic partners, primary care and Ontario Health Teams
  • Support research productivity across sites
  • Standardize Urgent Care Clinics across the Division
  • Implement evidence-based medicine curriculum for PGY 1-3 residents

More Knowledge Sharing


We are happy to share our recent editorials and publications with you. Please contact us at Cundill.Centre@camh.ca if you have difficulty accessing the articles.



The Forest and the Trees: Evidence-Based Medicine in the Age of Information

A case study of a 15-year-old girl with moderate to severe depression is used to illustrate the benefits of clinical practice guidelines to child and adolescent psychiatrists, as well as the benefits of systematic reviews and meta-analyses, the limits of primary studies and evidence syntheses and other considerations for clinicians.

Digital Phenotyping with Mobile and Wearable Devices: Advanced Symptom Measurement in Child and Adolescent Depression

This article discusses the concept of digital phenotyping and its application towards improving child and adolescent depression. It describes passive and active forms of data collection via mobile phones and wearables, including mobile app-based Ecological Momentary Assessment.

Putting Practicality into “p”: Leveraging General Factor Models of Psychopathology in Clinical Intervention

This article discusses how advanced statistical modeling of mental illness symptom data can be effectively leveraged to provide valuable insight into mental illness clinical treatment. It describes how mental illness data collected on large numbers of individuals can be best analyzed to provide information that may be useful to improve the well-being and lived experience of individuals suffering from mental illnessess.



Improving outcome reporting in clinical trial reports and protocols: study protocol for the Instrument for reporting Planned Endpoints in Clinical Trials (InsPECT)

A scoping review of evidence-based interventions for adolescents with depression and suicide related behaviors in low and middle income countries

Nash-wo-Numa (childhood growth & development) study protocol: factors that impact linear growth in children 9 to 15 years of age in Matiari, Pakistan


Meet Our Team


Dr. Stephanie Ameis, Associate Director of the Cundill Centre

Dr. Ameis is a Clinician-Scientist in the Child and Youth Mental Health Collaborative at the Hospital for Sick Children and CAMH and an Associate Professor in the Department of Psychiatry at the University of Toronto.

Full Bio

What excites you about the field of child and youth depression?

  1. If we can make a difference in the prevention and treatment of depression in children and youth, we can have a huge impact on long term health in adulthood!
  2. I am excited to improve research and care for children and youth who have depression as well as other mental health diagnoses (e.g., autism spectrum disorders); these children and youth are often excluded from participating in depression research and even accessing treatment opportunities.

What are you most looking forward to in your new role as Associate Director of the Cundill Centre?
Mentoring young scientists and helping them to flourish and contribute to the field.

What’s the most interesting thing about you that’s not on your resume?
I love personal stories, and I love to be active, play and connect. These are major factors that drew me to psychiatry and to child and youth psychiatry, in particular.


Sharon Neufeld,
Cundill Fellow

Sharon Neufeld is a quantitative psychologist and research associate at the University of Cambridge. She will be starting a post-doctoral fellowship with the Cundill Centre to discern mechanisms of treatment action in the IMPACT trial, a randomized control trial of psychotherapies for depressed adolescents.

Full Bio

What excites you about the field of child and youth depression?
It’s exciting that there are multiple psychotherapies that have been shown to be equally effective in treating youth depression–which means we can target treatment based on young people’s individual needs. It’s also very encouraging that the services young people are receiving in the community are indeed effective in the real world, beyond the idealized randomized control trial. Now we need to keep working to ensure that young people get access to the treatment they deserve.

What’s the most interesting thing about you that’s not on your resume?
I love back country exploring (skiing, canoeing, hiking) and have shared the joy of music through conducting several community choirs.


Thanks for reading! We look forward to updating you soon.

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