It’s not a marathon or a sprint, it’s a relay.

Understanding mental illness beyond the individual.

It’s not you, it’s the system.

Welcome to the first official blog post of my research journey.

A small introduction, my name is Sandy Rao, and I am a PhD Candidate in social work at the University of Calgary. The moment that most PhD students are waiting for, has finally come. Actually, I do not know if most PhD students are waiting for this moment as I do not have actual data to back that statement. So instead I’ll say, as a mature student (a decade out of the academy), I took this hiatus from my work as a health system executive for this moment to be able to ask the big questions that keep me up at night, and have kept up many youths, their families and their communities. Namely, how do we get young adults with mental health needs the care that they need, when they need it, where they need it and how they need it.

So, a little disclaimer, my research is not actually going to answer all of those questions, or at least not in full. I’d never finish my PhD in that case! But, it is attempting, systematically to chip away at that iceberg (in not a global climate crisis way though, let’s save those icebergs!). It is a complex problem, and some of the biggest issues we face today are, but we have to start somewhere and this is just one of the starting places in my program of research on looking deeply and thoughtfully at the barriers to healthcare from all the way upstream to the inception of an idea that a young adult needs healthcare; to, as a youth partner shared, sometimes with mental illness you don’t even know you need care, and that too is a barrier to accessing it.

At this stage my research is focused on looking at a mental illness - holistically, going beyond the symptoms of the illness and understanding how it changes and affects youth and young adults’ lives and how this has an impact on accessing care. The hope is, in understanding this more, we can find solutions to change the system to meet youth and families’ needs, instead of expecting youth and families to change themselves for systems that do not serve them. In another post, I’ll speak about the study in greater detail (coming soon!)

So, why the title? Well, I’m a runner. It’s a joy of my life and often times people that use the phrase, “it’s not a sprint, it’s a marathon” - well, I don’t think they’ve ever run a marathon! I think they are meaning to say it does happen quickly and that perhaps it’s a longer journey and maybe even that you need to pace yourself. And while it might be true, marathon, especially if not qualifying for the Boston marathon or trying to figure out how to get into the Disney marathon (if someone knows how to get registered for that, please contact me!) it is still a bit different, you’re doing the run usually on your own, going at your own pace, someone’s given you a map, an app, and water stations every 3KM. This is a little bit different, there’s no map to guide you and tell you if you’re going in the right direction and certainly if you are headed to your goal and certainly with my research, I do not go it alone. My research has both the elements of “patient-oriented research” (a term from the Canadian Institutes of Health Research) which basically means, you do research with the people that your research directly impacts. In my case, this would be with youth and youth adults that have mental health needs and are seeking care from the Canadian Healthcare System; and Integrated Knowledge Translation (or mobilization) which basically means, while creating new knowledge is awesome (and it is), the new knowledge I am hoping to create through my PhD is for the purpose of changing programs, policies, services and systems to improve the quality of health and the quality of life for Canadians. This means, I should be doing my research with the people that will actually use this information to make evidence-based and evidence-informed changes, and that’s why I’ve called it a relay. I can’t (and shouldn’t!) run this race alone. This work, if it’s going to have any meaning beyond a piece of paper that amounts to a degree, needs to be done with partners all the way through and at some points it will need to be handed off to others that will run the next leg of that race, be it community members, youth with lived experience, policy analysts or program leaders, to address the complex problems of today, we have to work together (as an Introvert this is hard for me BTW—I’m reading Susan Cain’s Quiet—she says that’s okay and that I’m special).

All that to say, I am thrilled to embark on this new research journey and share it with you all. I believe that it is essential to document the process of research for a few reasons 1) to make it transparent and to share power, if knowledge is power, and I think that it is, that knowledge should be shared; 2) often times research feels very inaccessible (I myself am still trying to figure out how the “academy” works and still learning about the “hidden curriculum” (a post about that later), so to make the process of research less “ivory-tower” and behind closed doors, to help us all to understand how the knowledge was made and thus, have more trust in it; 3) to have it be “open source” and by that I mean, there will be limitations to this research, limitations on the timelines, data that can be collected, limitations on the funding (or lack of funding!), limitations on what I can do as a student, but perhaps the ideas I share and the learnings along the way other researchers can amend, adapt, improve and take a step further in our relay, and finally, 4) for knowledge translation purposes getting the findings into the hands, minds and hearts to the people that can make the necessary changes to make a system that meets people in their moments of need.

Throughout this research journey, I will have had the opportunity to hear directly from young individuals with lived experiences of mental health concerns. Their stories and insights have been invaluable in shaping the direction of our research and ensuring that it remains patient-oriented.

Of course, research is not without its challenges. As we delve deeper into the experiences of young individuals with mental health concerns, we are constantly reminded of the systemic and structural barriers that exist within our healthcare system. However, we remain committed to this work and to the youth.

I hope that this blog will be a place where I can share not only my research journey but also my reflections, my frustrations, my triumphs, and my learnings. I hope to create a space where we can all learn together, grow together, and work towards creating a more equitable and just society. Thank you for joining me on this journey, and I hope you find it as exciting and meaningful as I do.