Five minutes with Dr Christina Marel

This month we spend five minutes with Dr Christina Marel.  Christina is Program Lead for Treatment and Translation in Complex Populations at The Matilda Centre for Research in Mental Health and Substance Use

Can you please tell us about a day in your life?
Every day is different, but most begin at The Matilda Centre for Research in Mental Health and Substance Use, which is a new (and very exciting) research centre at the University of Sydney. As Program Lead for Treatment and Translation in Complex Populations for our centre, I spend my days working on a number of projects that involve improving treatment for people with mental and substance use disorders, and translating findings into practice. While the office is nice and quiet, I try to get some writing done, or at least knock off the most important things for the day. I check on the progress of our online training platform for building capacity among healthcare providers to provide evidence-based treatment, meet with my team, catch up with students and post-docs, travel to meetings offsite, and of course try and keep on top of admin. I’m in the final phases of setting up an 18-20-year follow-up of the largest and longest naturalistic study of people with heroin dependence in Australia, so the next few years will also involve meeting participants around Sydney and conducting some physical health assessments. All in all, I’m kept well on my toes.

How do you define digital health?
To me, digital health is ultimately about providing evidence-based accessible healthcare to the community, and assisting health providers deliver best practice care. In that sense, digital health can overcome many of the barriers associated with the more traditional forms of healthcare – for example, lack of clinician confidence, time and resources; difficulty accessing appropriate services; stigma; difficulty engaging people in treatment; social/cultural prejudices; financial and/or geographical barriers. Digital health is also a forum for evidence-based innovation.

What do you think will enable digital health projects and innovations to succeed?
As with other health projects, digital health projects need the support of clinicians and services who use them, and strong partnerships between healthcare providers, researchers, carers, as well as people with lived experience. Most important however, is the need for digital health to be evidence-based, so clinicians and community members are provided with accurate information and quality care. And of course, funding is always an essential component of developing, trialling and ongoing maintenance of programs.

Have you come across any surprises or challenges along the way?
It’s been wonderful to see how well our online program has been received, and the level of support from clinicians and services around Australia and internationally. Developed in collaboration with clinicians, carers, people with lived experience and researchers, our program aims to increase the capacity of healthcare providers to manage and treat co-occurring mental and substance use disorders. Preliminary findings from an evaluation of our program indicates overwhelmingly positive support for the training program, with >90% of program participants agreeing/strongly agreeing that the program improved their confidence, skills and capacity to respond to co-occurring mental and substance use disorders. Furthermore, half reported that the training has led to specific changes in their clinical practice, with more than two-thirds reporting improved client outcomes. However, one of the constant challenges in this space is the importance of maintaining these programs, and the need for ongoing support and funding to achieve this.

Do you have any interesting resources or helpful networks people should know about?
In addition to our own portal (https://comorbidityguidelines.org.au/), there are several really useful evidence-based digital health platforms that have been developed for clinicians and community members, including methamphetamine (Cracks in the Ice: https://cracksintheice.org.au/), facilitated access to screeners and treatment (Eclipse: https://eclipse.org.au/); drug and alcohol information for teachers, parents and students (Positive Choices: https://positivechoices.org.au/).

A very big thank you to Christina for being our March member profile.