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
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
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
Staff
Tharani Raveendran
Research Project Coordinator
About Tharani
Luxzonica Young
Administration
About Luxzonica
Trainees
Dr. Eduardo Gus
About Eduardo
Dr. Gus pursued fellowship training in adult and paediatric burns, pediatric plastic surgery, and breast reconstruction at the University of Toronto, which were followed by an appointment at the Victorian Adult Burns Service in Melbourne, Australia. He returned to the Division of Plastic, Reconstructive & Aesthetic Surgery in 2021 to join the Burn Program at SickKids. Dr. Gus’ clinical practice interest encompasses acute and reconstructive burn surgery, complex wounds, scar management, laser therapy, skin lesions, and breast conditions in the paediatric population. His research interest centres on understanding burn epidemiology and informing policies for burn injury prevention.
Emily Hamovitch
About Emily
Emily Hamovitch is a PhD candidate in the Institute of Health Policy, Management & Evaluation. Emily graduated with an MPH and MSW from New York University. Since then, she has held research and managerial positions within the child mental health system. As a Research Project Manager at the McSilver Institute for Poverty Policy and Research, she managed a multisite NIMH-funded study examining an intervention for children with oppositional defiant disorder (ODD). This project provided a much-needed evidence-based treatment for ODD while improving access for low-income children. Emily has disseminated findings from her graduate work and from these studies through numerous peer-reviewed publications, a book chapter and several conference presentations.
Upon her return to Toronto, Emily worked as the Manager of Implementation and Training at the Child Development Institute, where she managed the implementation of another evidence-based program for children with behavioral difficulties and supervised a team of consultants who worked with over 100 schools and agencies to implement the program globally. Emily has also held leadership and volunteer roles that center around helping children and youth. In her doctoral work, she will use a health equity lens to examine follow-up mental health services for children and youth that were reshaped by the pandemic. By examining multi-level barriers and facilitators to virtual care, as well as utilization patterns of children and youth, her research aims to inform the provision of mental health services in ways that will improve access and equity.
Hodan Mohamud
About Hodan
Hodan Mohamud is a medical student and a Comprehensive Research Experience for Medical Students (CREMS) Student in the Graduate Diploma in Health Research Program (GDipHR) at the Temerty Faculty of Medicine at the University of Toronto. She graduated with an Honours Bachelor of Science from the University of Toronto. Hodan is currently working on a project looking at the impact of language ability and immigration on the utilization of virtual mental health care by youth in Ontario. Her research interests include population health, health equity, knowledge translation, and evaluation.
Alumni
Dr. Etienne Archambault
About Etienne
Dr. Archambault is currently completing a Master’s degree in Health Services Research at the Institute of Health Policy, Management and Evaluation (IHPME) of the University of Toronto. His thesis research project on the mental health outcomes of childhood survivors of physical assault was funded by the National Foundation to End Child Abuse (EndCAN) in the United States. Dr. Archambault’s research interests center around the prevention of child maltreatment and its impact on children’s health and development.
Dr. Afua Asare
About Afua
Afua Asare is a Research Assistant Professor in the Department of Ophthalmology & Visual Sciences at the University of Utah School of Medicine. Her research focuses on facilitating the early identification of vision disorders to improve vision health outcomes in children, especially those most at risk for health disparities, through the development and implementation of evidence-based health information technology tools for primary care physicians at the point of care.
Dr. Alene Toulany
About Alene
Dr. Toulany co-leads the Adolescent Medicine Consultation Clinics and Service, which aims to improve access to specialized consultative adolescent health care services for youth with complex care needs. She also provides care to adolescents with obesity and other forms of eating disorders in STOMP.
Dr. Ayesha Siddiqua
About Ayesha
Ayesha is passionate about making evidence-based policy recommendations that are grounded in principles of equity, diversity, and inclusion (EDI). In her various professional roles, she strives to implement an EDI lens when conducting research and is committed to supporting the next generation of researchers in conducting research that will serve the needs of diverse communities.
Dr. Sarah Smith
About Sarah
Dr. Smith clinical interest is paediatric eating disorders. As a resident and fellow she has received further training in paediatric eating disorder psychotherapy and pharmacotherapy at several specialized, intensive, eating disorder programs in Ontario. Her research interests include paediatric eating disorder service delivery, specifically psychotherapeutic models of care, measurement-based care and predictors of treatment outcome. Her thesis work examines changes in the characteristics of child and adolescent eating disorder patients hospitalized in Ontario over time.
Glenda Babe
About Glenda
Glenda Babe is a PhD candidate in the Department of Sociology at Western University and an Epidemiologist at IC/ES McMaster. Glenda’s PhD dissertation aims to understand mental health outcomes of adult immigrants, with particular focus on the impact that socioeconomic characteristics, residential mobility, and neighborhoods have on immigrant mental health in comparison to Canadian born. Further, her PhD research examines time between mental health diagnosis and receipt of disability services. Glenda’s expertise is in quantitative analysis, predominantly with large administrative data from IC/ES and Statistics Canada.
Funding partners
Collaborators
Media
Print
- The Canadian Press-Broadcast News,Maan Alhmidi. Refugee children do not place significant demands on health care: Ontario study.
- The Toronto Star, Gilbert Ngabo. ‘These are still weapons’: What to learn from a rash of Toronto air gun case.
- The Globe and Mail. Canadian researchers find sharp increase in suicide attempts by children: study.
- National Global News. Immigrant, refugee youth end up in ER for mental health care more than others: study.
Connect with us
Administration: Luxzonica.young@sickkids.ca
Location
Peter Gilgan Centre for Research and Learning
The Hospital for Sick Children
686 Bay St., Toronto, ON M5G 0A4