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.


The three research areas of The Saunders Lab include:

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.

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.

Injuries are the leading cause of death and disability in children and youth in high income countries. This work focuses on measuring socio-demographic 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.

As part of our injury research, we discovered unintentional and assault-related firearm injuries occur three times daily in Canadian youth and 13% of suicide deaths are by firearm. Since beginning this work in 2017, we have led several publications on firearm epidemiology. Results have provided a comprehensive picture of firearm injuries critical to informing injury prevention strategies to improve firearm safety for youth. Through this research, we have been able to describe, at a population level, the burden of firearm injuries in Ontario, Canada and understand the impact of legislative changes on rates of firearm injuries.

View our publications on PubMed and Google Scholar

Our team

Natasha Saunders

Principal Investigator

SickKids ICES IHPME Twitter

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


Tharani Raveendran

Tharani Raveendran

Research Project Coordinator

Luxzonica Young

Luxzonica Young



Eduardo Gus

Dr. Eduardo Gus

Emily Hamovitch

Emily Hamovitch

Hodan Mohamud

Hodan Mohamud


Etienne Archambault

Dr. Etienne Archambault 

Afua Asare

Dr. Afua Asare

Alene Toulany

Dr. Alene Toulany

Ayesha Siddiqua

Dr. Ayesha Siddiqua 

Sarah Smith

Dr. Sarah Smith

Hodan Mohamud

Glenda Babe

Funding partners

SickKids Foundation
Ontario Ministry of Health
Canadian Institutes of Health Reseach
SickKids Dept of Pediatrics
Centre for Addiction and Mental Health