Saunders Lab | SickKids

About us

The Saunders Lab is primarily focused on child health services research to create an evidence base to inform policy development. We use population-based linked health administrative and demographic datasets to investigate how health services and policy influence child health and contribute to inequities.

Research

Our lab is focused on three research areas:

Mental health system and primary care system measurement and performance

We have led and collaborated on a series of multi-year projects to provide measures of mental health system performance to help understand the shifting health-care needs of children and adolescents in Ontario. Our work, which includes measuring care integration across systems (primary and acute care sectors) and for children with co-occurring physical and mental health needs, the impact of COVID-19 and the widespread use of virtual care on health system performance has been a stimulus for discussion for practical solutions to optimize scarce resources related to mental health and primary care.

Health system access and outcomes, with a focus on immigrants and refugees

Canada has the second largest immigrant population in the world. Mental illness is common, affecting one in five individuals and rates of acute care use by youth for mental illness are rising. Our studies leveraged novel linkages of health, administrative and immigration data, and were among the first population-based studies – and the largest to date – to examine mental health outcomes and mental health system utilization by immigrants to Canada.

Collectively, several publications showed that immigrants have lower rates of use of both outpatient and acute care services for mental health compared with Canadian-born. Further, suicide and self-harm rates are lower in immigrants compared with Canadian born and there is substantial variability by region and country of origin, visa class and time since immigration. Our research showed methods used for self-injury are different between immigrants and non-immigrants including less frequent use of firearms to complete suicide.

In our work on mental health system accessibility, our studies demonstrated that immigrants primarily use the emergency department as a first point of contact for mental health concerns, without ever having accessed outpatient care (Saunders et al, CMAJ 2018). Ongoing grant funded work examines the role of religion and sex in suicide risk among immigrants to Canada. These findings provide critical insight for our understanding of care delivery needs and planning in these populations.

Injury epidemiology, with a focus on firearms

Injuries are the leading cause of death and disability in children and youth in high income countries. This work focuses on measuring sociodemographic risk factors for injury including immigration and marginalization related measures of unintentional and intentional injury risk that may be amenable to targeted injury prevention strategies.

View our publications on PubMed or Google Scholar

Our team

Principal Investigator

Dr. Natasha Saunders MD, M.Sc., FRCPC

Dr. Natasha Saunders is a Clinician-Investigator in the Division of Paediatric Medicine at The Hospital for Sick Children (SickKids) and a Senior Associate Scientist in Child Health Evaluative Sciences at the SickKids Research Institute. She is an Associate Professor of Paediatrics at the University of Toronto and a Health Services Researcher at IC/ES (formerly the Institute for Clinical Evaluative Sciences).

Dr. Saunders’ primary areas of clinical practice are general paediatric hospitalist medicine and outpatient consultant general paediatrics. She consults on a wide spectrum of acute and chronic childhood conditions requiring tertiary level assessment or management and has a clinical focus on children and adolescents with complex, often diagnostically challenging, co-occurring physical and mental health conditions. Saunders’ research interests include access to and quality of care for children and youth with a specific focus on injuries and mental health of children and youth, and primary care delivery and using large, linked health and administrative databases to understand health service delivery.

Appointments

Clinician-Investigator, Division of Paediatric Medicine, SickKids
Senior Associate Scientist, Child Health Evaluative Sciences Program, SickKids Research Institute
Adjunct Scientist, ICES
Associate Professor, Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto