Research

At Wellstream, our interdisciplinary team conducts research aimed at addressing knowledge gaps to improve mental health and reduce substance use harms for children, youth and their communities. Our research and related partnerships build trusted connections across communities, professionals and governments creating direct pathways for influence and impact.

“You kind of blame it on the alcohol, but…”: A discourse analysis of alcohol use and sexual consent among young men in Vancouver, Canada

Health | 2023

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or “non-ideal” contexts, including sex involving alcohol.

Overlapping pandemic- and climate-related worry: Prevalence and association with mental health outcomes in a Canadian sample

Journal of Mental Health and Climate Change | 2023 | Health

Evidence on the population-level mental health impacts of COVID-19 are beginning to amass;

Intersecting transitions among 2S/LGBTQ+ youth experiencing homelessness: A scoping review

Children and Youth Services Review | 2024 | Health

Two-Spirit, lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (2S/LGBTQ+) youth under 30 years of age are inequitably impacted by homelessness.

Parent psychological distress and parent child relationships two years into the COVID-19 pandemic: Results from a Canadian cross-sectional study

PLoS One | 2023 | Health

Mental health impacts of the COVID-19 pandemic have not been felt equally within populations. 

How an emergency department is organized to provide opioid specific harm reduction and facilitators and barriers to harm reduction implementation: A systems perspective.

Harm Reduction Journal | 2023 | Health

The intersection of dual public health emergencies—the COVID-19 pandemic and the drug toxicity crisis—has led to an urgent need for acute care based harm reduction for unregulated opioid use.

Food-related worry and food bank use during the COVID-19 pandemic in Canada: Results from a nationally representative multi-round study.

BMC Public Health | 2023 | Health

Early in the COVID-19 pandemic, nearly one in five adults in Canada worried about having enough food to meet their household’s needs.

Engaging families and parent advocates in research on substance use and drug policy reform: Guiding principles from a Canadian community-academic partnership.

Drug and Alcohol Review | 2023 | Health

Canada is in the midst of a public health emergency in drug poisoning (overdose) deaths. In this context parents, and especially mothers, of those who have died from drug poisoning have mobilised to advocate for urgent responses and drug policy reforms.

Differentiating the role of alcohol in young men’s use of substances with sex: A qualitative study.

Harm Reduction Journal | 2023 | Health

Alcohol consumption is common among young men and occurs in many contexts.

Women’s experiences in injectable opioid agonist treatment programs in Vancouver, Canada.

International Journal of Drug Policy | 2023 | Health

Alcohol consumption is common among young men and occurs in many contexts.

Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada.

Digital Health | 2023 | Health

Alcohol consumption is common among young men and occurs in many contexts.

Advancing socioecological mental health promotion intervention: A mixed methods exploration of Phase 1 Agenda Gap findings.

Frontiers in Public Health | 2023 | Health

Protecting and promoting the mental health of youth under 30 years of age is a priority, globally.

Moderation of the association between COVID-19-related income loss and depression by receipt of financial support: Repeated cross-sectional surveys of young adults in Canada and France (2020-2021)

Population Health | 2023 | Health

To mitigate the adverse effects of the COVID-19 pandemic on financial resources, governments and family/friends mobilized financial support interventions (e.g., emergency aid funds) and assistance.

Anchoring to life: A Photovoice study of resiliencies among sexual and gender minority women post-suicide attempt.

Qualitative Research in Health | 2023 | Health

Lesbian, bisexual, trans, queer, and other sexual and gender minority (SGM) women are at high risk of suicide.

Adolescent substance use treatment and care: Troubling assumptions about autonomy and (in)capacity to consent.

Journal of Adolescent Health | 2023 | Health

British Columbia (BC), Canada, is an epicenter of North America’s overdose crisis.

Emotional response patterns, mental health, and structural vulnerability during the COVID-19 pandemic in Canada: A latent class analysis.

BMC Public Health | 2023 | Health

The COVID-19 pandemic has contributed to increases in negative emotions such as fear, worry, and loneliness, as well as changes in positive emotions, including calmness and hopefulness. 

Enhancing nurses’ capacity to provide concurrent mental health and substance use disorder care: A quasi experimental intervention study.

Nurse Education Today | 2023 | Health

Patients experiencing concurrent disorders (i.e., co-occurring mental health and substance use disorders) are prevalent in mental health settings and their health and social outcomes are often poor. 

Young adults’ mental health and unmet service needs in the context of the COVID-19 pandemic across Canada and France.

Community Mental Health Journal | 2023 | Health

While young adults experienced mental health challenges during the COVID-19 pandemic, little is known about how their mental health needs were subsequently met through access to mental health services (MHS).

Mental health inequities amid the COVID-19 pandemic: Findings from three rounds of a cross-sectional monitoring survey of Canadian adults.

International Journal of Public Health | 2022 | Health

Adverse mental health impacts of the COVID-19 pandemic are well documented; however, there remains limited data detailing trends in mental health at different points in time and across population sub-groups most impacted.

Using photovoice to understand experiences of opioid use among sexual and gender minority youth.

Culture, Health & Sexuality | 2022 | Health

In Canada, sexual and gender minority youth use opioids at disproportionately high rates. Yet, little is known about the distinct contexts of opioid use within this group, challenging capacity to develop well founded policy and practice supports.

Connectedness in the time of COVID-19: Reddit as a source of support for coping with suicidal thinking.

Qualitative Research in Health | 2022 | Health

The COVID-19 pandemic is adversely impacting suicidality at a population level, with consequences resulting from a variety of pandemic-driven disruptions, including social activities and connectedness.

Widening mental health and substance use inequities among sexual and gender minority populations: Findings from a repeated cross-sectional monitoring survey during the COVID-19 pandemic.

Psychiatry Research | 2022 | Health

This paper examines the mental health and substance use impacts of the COVID-19 pandemic among sexual and gender minority (SGM) populations as compared to non-SGM populations, and identifies risk factors for mental health and substance use impacts among SGM groups.

Correlates of suicidal ideation related to the COVID-19 pandemic: Repeated cross-sectional nationally representative Canadian data.

Population Health | 2022 | Health

With significant levels of mental distress reported by populations, globally, the magnitude of suicidal ideation during and beyond the COVID-19 pandemic is a central concern. 

Increases in alcohol and cannabis use associated with deteriorating mental health among LGBTQ2+ adults in the context of COVID-19: Findings from a repeated cross-sectional study in Canada, 2020-2021.

International Journal of Environmental Research and Public Health | 2021 | Health

Lesbian, gay, bisexual, trans, other queer, and Two-Spirit (LGBTQ2+) people are particularly at risk for the psycho-social consequences of the COVID-19 pandemic, though population-tailored research within this context remains limited.

Impacts of the COVID-19 pandemic on family mental health in Canada: Findings from a multi-round cross-sectional study.

International Journal of Environmental Research and Public Health | 2021 | Health

Pandemic-related disruptions, including school, child care, and workplace closures, financial stressors, and relationship challenges, present unique risks to families’ mental health. 

Cannabis Education Resources for Parents: An Environmental Scan and Critical Content Analysis in the Context of Legalization.

Drugs Education, Prevention and Policy | 2021 | Health

Cannabis was recently legalized for adult use in Canada and many American states. In this context, there is a pressing need for educational resources – aimed at youth and their parents/caregivers – to reduce potential harm.

“I’m not your reality show”: Perspectives of bereaved mothers’ engagement with the news media to advance drug policy reform.

Social Science and Medicine | 2021 | Health

North America’s overdose crisis is one of the most urgent public health issues of our time and parents bereaved from substance use are a prominent voice within the news media.

Reddit users’ experiences of suicidal thoughts during the COVID-19 pandemic: A qualitative analysis of r/Covid19_support posts.

Frontiers in Public Health | 2021 | Health

The COVID-19 pandemic is having considerable impacts on population-level mental health, with research illustrating an increased prevalence in suicidal thoughts due to pandemic stressors.

Enhancing Conceptual Clarity of Self-Care for Nursing Students: A Scoping Review is about to be published in Nurse Education in Practice

Nurse Education in Practice | 2021 | Health

The COVID-19 pandemic is having considerable impacts on population-level mental health, with research illustrating an increased prevalence in suicidal thoughts due to pandemic stressors.

Examining associations between food worry and mental health during the early months of the COVID-19 pandemic in Canada.

Canadian Journal of Public Health | 2021 | Health

Little is known about the association between mental health and diminished food worry during the COVID-19 pandemic. 

“It’s a bit of a double-edged sword”: Motivation and personal impact of bereaved mothers’ advocacy for drug policy reform.

Qualitative Health Research | 2021 | Health

North America’s overdose crisis is an urgent public health issue that has resulted in thousands of deaths. As the crisis began to take hold across Canada in 2016, bereaved parents, mainly mothers, emerged as vocal advocates for drug policy reform and harm reduction, using their stories to challenge the stigma of drug-related death.

Information and Communication Technologies in Commercial Sex Work: A Double-Edged Sword for Occupational Health and Safety

Social Sciences | 2021 | Health

Over the previous decade, there has been a notable shift within sex work marketplaces, with many aspects of the work now facilitated via the internet.

Examining the impacts of the COVID-19 pandemic on family mental health in Canada.

BMJ Open | 2021 | Health

In the first wave of the COVID-19 pandemic, social isolation, school/child care closures and employment instability have created unprecedented conditions for families raising children at home.

Associations between periods of COVID-19 quarantine and mental health in Canada

Psychiatry Research | 2021 | Health

Since the onset of the COVID-19 pandemic, many jurisdictions, including Canada, have made use of public health measures such as COVID-19 quarantine to reduce the transmission of the virus.

Involuntary stabilization care of youth who overdose: A call for evidence- and ethics-informed substance use policy.

Canadian Journal of Public Health | 2021 | Health

As is the case across Canada, the province of British Columbia is in the midst of an opioid overdose crisis. In response to the devastating impacts of this crisis on youth (under 19 years of age), the provincial government is considering amending the Mental Health Act to allow for involuntary, hospital-based stabilization care of youth following an overdose.

A portrait of the early and differential mental health impacts of the COVID-19 pandemic in Canada: Findings from the first wave of a nationally representative cross-sectional survey.

Preventative Medicine | 2021 | Health

Evidence on the population-level mental health impacts of COVID-19 are beginning to amass; however, to date, there are significant gaps in our understandings of whose mental health is most impacted, how the pandemic is contributing to widening mental health inequities, and the coping strategies being used to sustain mental health.

Bereaved mothers’ engagement in drug policy reform: A multisite qualitative analysis.

International Journal of Drug Policy | 2021 | Health

Globally, a tainted drug supply is claiming the lives of tens of thousands of people who use drugs and current measures are not quelling this crisis.

Use of asynchronous virtual mental health resources for COVID-19 related stress among the general population in Canada: Findings from a nationally representative cross-sectional survey.

International Journal of Drug Policy | 2020 | Health

The COVID-19 pandemic has resulted in profound mental health impacts among the general population worldwide. 

Assessing the impacts of the Agenda Gap intervention for youth mental health promotion through policy engagement: A study protocol

International Journal of Mental Health Systems | 2020 | Health

Mental health challenges are a leading health concern for youth globally, requiring a comprehensive approach incorporating promotion, prevention and treatment within a healthy public policy framework.

Addressing ethical issues in studying men’s traumatic stress.

International Journal of Men’s Social and Community Health | 2020 | Health

Like many human experiences, traumatic stress is highly gendered. Over the past several decades, a substantial number of empirical studies have explored ethical issues in traumatic stress research.

Leveraging nurses to improve care for inpatients with concurrent disorders: A scoping review

Journal of Dual Diagnosis | 2020 | Health

Several challenges have been identified for patients with concurrent disorders and the providers that care for them, contributing to a pressing need for interventions to improve outcomes, particularly within inpatient mental health settings.

“Am I gonna get in trouble for acknowledging my will to be safe?”: Identifying the experiences of young sexual minority men and substance use in the context of an opioid overdose crisis.

Harm Reduction Journal | 2020 | Health

North America and other parts of the globe are in the midst of a public health emergency related to opioid overdoses and a highly contaminated illicit drug supply.

Undergraduate students’ reflections on mental health nursing following practicum experience

Journal of Clinical Nursing | 2021 | Health

To explore a cohort of mental health nurses’ views and experiences in developing and applying critical appraisal of research skills to identify helping and hindering factors.

Exploring the implications of a self-care assignment to foster undergraduate nursing student mental health: Findings from a survey research study.

Nurse Education Today | 2021 | Health

Nursing students experience numerous personal, academic, and practice-related stressors, impacting their mental health. Nursing programs often contribute to student stress and should incorporate strategies to support students’ mental health. 

Equipping youth for meaningful policy engagement: An environmental scan.

International Journal of Health Promotion | 2020 | Health

To better address the mental health and substance use crises facing youth globally, a comprehensive approach, inclusive of mental health promotion is needed. A key component of mental health promotion is policy intervention to address the social and structural determinants of health.

“You can’t chain a dog to a porch”: A multisite qualitative analysis of youth narratives of parental approaches to substance use

Harm Reduction Journal | 2019 | Health

Reducing harms of youth substance use is a global priority, with parents identified as a key target for efforts to mitigate these harms. Much of the research informing parental responses to youth substance use are grounded in abstinence and critiqued as ineffective and unresponsive to youth contexts.

How the study of networks informs knowledge translation and implementation: A scoping review.

Harm Reduction Journal | 2019 | Health

To date, implementation science has focused largely on identifying the individual and organizational barriers, processes, and outcomes of knowledge translation (KT) (including implementation efforts).

Understanding the mental health and recovery needs of Canadian youth with mental health disorders: A Strategy for Patient-Oriented Research (SPOR) collaboration.

International Journal of Mental Health Systems | 2019 | Health

While considerable progress is being made to understand the health and self-management needs of youth with mental health disorders, little attention has focused on the mental health and recovery needs that the youth themselves identify—this despite a national priority to incorporate patient-oriented research into the development and assessment of mental health services.

Disrupting assumptions of risky play in the context of structural marginalization: A community engagement project in a Canadian inner-city neighbourhood.

Health and Place | 2019 | Health

Play is a complex, taken-for-granted activity that is often assumed to be universal in how it is conceptualized and experienced. In a global context, play has been identified as a human right for all children (UNICEF, 2006).

Unpacking Social Isolation in Men’s Suicidality

Qualitative Health Research | 2019 | Health

Social isolation has featured as a significant and oftentimes all-encompassing risk factor for male suicide, yet, as an explanatory mechanism, it has not been unpacked in terms of what it constitutes in everyday life.

‘Parents are the best prevention’? Troubling assumptions in cannabis policy discourses in the context of legalization in Canada.

International Journal of Drug Policy | 2019 | Health

Canada has announced that it will legalize cannabis on October 17, 2018, and as a result of this impending drug law reform the need to develop prevention resources and drug education – in schools, in public health, and for parents – has emerged as a public concern and a policy priority.

Power and resistance: Nursing students’ experiences of navigating mental health practicums.

Advances in Nursing Science | 2018 | Health

Mental health challenges are a leading health issue, and while nurses should be well positioned to provide care to this client population, nurses are not adequately prepared for this role during their education.

A guide to Multi-Site qualitative analysis

Qualitative Health Research | 2018 | Health

The aims of multisite qualitative research, originally developed within the case study tradition, are to produce findings that are reflective of context, while also holding broader applicability across settings.

Assessing the impacts and outcomes of youth driven mental health promotion: A mixed-methods assessment of the social networking action for resilience study.

Journal of Adolescence | 2018 | Health

Mental health challenges are the leading health issue facing youth globally. To better respond to this health challenge, experts advocate for a population health approach inclusive of mental health promotion; yet this area remains underdeveloped.

Setting the legal age for access to cannabis in Canada: Bridging neuroscience, policy and prevention.

Neuropsychopharmacology Reviews | 2017 | Health

The United States and Canada are both engaged in cannabis policy reforms with a number of US states legalizing or decriminalizing use, possession, cultivation, and sale, and the Federal Government of Canada poised to legalize cannabis in 2018. 

Photovoice ethics: Critical reflections from men’s mental health research.

Qualitative Health Research | 2017 | Health

As photovoice continues to grow as a method for researching health and illness, there is a need for rigorous discussions about ethical considerations. In this article, we discuss three key ethical issues arising from a recent photovoice study investigating men’s depression and suicide. 

Developing Harm Reduction in the context of youth substance use: Insights from a multi-site qualitative analysis of young people’s harm minimization strategies.

Harm Reduction | 2017 | Health

Youth substance use programming and educational strategies are frequently informed by prevention approaches that emphasize abstinence goals, which often do not resonate with youth in their lack of acknowledgment of young people’s social context and how young people perceive positive effects of substance use.

Injury, Interiority and Isolation in Men’s Suicidality.

American Journal of Men’s Health | 2017 | Health

Men’s high suicide rates have been linked to individual risk factors including history of being abused as a child, single marital status, and financial difficulties. While it has also been suggested that the normative influences of hegemonic masculinities are implicated in men’s suicide, the gendered experiences of male suicidality are poorly understood.

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice

Nursing Inquiry | 2017 | Health

The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm.

Unpacking young people’s narratives about their aspirations: A Bourdieusian perspective.

International Journal of Child, Youth and Family Studies | 2016 | Health

Drawing from Bourdieu’s theories on habitus, capital, and field, this article explores the complex relationship between social context and youth’s aspirations and perceptions of the future.

Strengthening Population Health Interventions: Developing the CollaboraKTion Framework for Community-Based Knowledge Translation.

Health Research Policy and Systems | 2016 | Health

Drawing from Bourdieu’s theories on habitus, capital, and field, this article explores the complex relationship between social context and youth’s aspirations and perceptions of the future.

Sustaining organizational culture change in health systems

Journal of Health Organization and Management | 2016 | Health

The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues.

Understanding adolescent narratives about “bullying” through an intersectional lens: Implications for youth mental health intervention.

Youth & Society | 2016 | Health

This article is based on findings from a qualitative study with 27 adolescents in northern British Columbia, Canada. Our aim was to explore youths’ perspectives on the sources of emotional distress in their lives and how these are connected to peer-based aggression and victimization within their community.

Divided and disconnected—An examination of youths’ experiences with emotional distress within the context of their everyday lives. 

Youth & Society | 2015 | Health

This paper is based on a qualitative study conducted in a rural community in British Columbia, Canada. Ethnographic methods were used to: (1) to bring youth voice to the literature on emotional distress; and (2) to capture the ways in which context shapes young peoples’ experiences of emotional distress within their everyday lives. 

Implications for understanding and addressing mental health and illness.

Nursing Inquiry | 2014 | Health

While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development.

A narrative review of recent developments in knowledge translation and implications for mental health care providers.

The Canadian Journal of Psychiatry | 2014 | Health

Attention to knowledge translation (KT) has increased in the health care field in an effort to improve uptake and implementation of potentially beneficial knowledge. We provide an overview of the current state of KT literature and discuss the relevance of KT for health care professionals working in mental health.

The influences of health beliefs and identity on adolescent marijuana and tobacco co-use.

Qualitative Health Research | 2014 | Health

Attention to knowledge translation (KT) has increased in the health care field in an effort to improve uptake and implementation of potentially beneficial knowledge. We provide an overview of the current state of KT literature and discuss the relevance of KT for health care professionals working in mental health.

Weeding out the information: An ethnographic approach to exploring how young people make sense of the evidence on cannabis.

Harm Reduction Journal | 2013 | Health

Contradictory evidence on cannabis adds to the climate of confusion regarding the health harms related to use. This is particularly true for young people as they encounter and make sense of opposing information on cannabis.

Approaches to understanding and addressing treatment-resistant depression: A scoping review

Harm Reduction Journal | 2012 | Health

Treatment-resistant depression is associated with significant disability and, due to its high prevalence, results in substantive economic and societal burden at a population level.

Knowledge translation in mental health: A scoping review

Healthcare Policy | 2011 | Health

Intensified knowledge translation (KT) efforts are considered important in the field of mental health in order to accelerate the implementation of various developments in research, policy and practice.