Defining a Strategic Focus in Bipolar Disorder
In October 2020, the Michael H. McCain family launched the Daymark Foundation with bipolar disorder as one of its two key priorities. We came into this space knowing that bipolar disorder is a complex condition that is challenging to diagnose, treat and manage. It soon became clear that advancing bipolar disorder at a systems level was an equally complex endeavour.
One of the challenges is the lack of agreement on priorities and strategies for advancing bipolar disorder. The evidence base for this condition is incomplete, and researchers are rightly pursuing a wide range of theories on everything from underlying mechanisms to pharmacological treatments to clinical interventions. Similarly, clinicians seem to be taking a variety of approaches, some that are mainly grounded in pharmacotherapy and others more holistic. To top it off, patients have wildly different experiences with the illness, depending on the timeliness of their diagnosis, the severity of their mood episodes, their response to treatment, and their social context. It’s hard to figure out what needs to be done when everyone has a different opinion.
One of the first frameworks the Daymark Foundation learned about as a sensemaking tool was “patient of today vs. patient of tomorrow”. Strategies like breakthrough research are critical for improving lives at scale, but they may not have impact in the short-term. Conversely, iterative improvements to treatment approaches and uptake of current evidence-based practices can have an immediate impact, but won’t have the same groundbreaking effect on future generations.
Are we seeking to impact the Patient of Today or the Patient of Tomorrow?
The Daymark Foundation applauds the new Breakthrough Discoveries for thriving with Bipolar Disorder (BD2) initiative, an integrated, collaborative approach that will address knowledge gaps in the basic disease mechanisms of bipolar disorder as well as factors influencing clinical approaches and outcomes. This initial $150 million investment by philanthropists Dave and Jan Baszucki, Sergey Brin, and Kent and Liz Dauten, led by Cara Altimus at the Milken Institute’s Centre for Strategic Philanthropy, is a critical effort at improving lives for the patient of tomorrow. We are delighted to be engaged with this group and to support it in any way we can.
As a modestly-sized foundation, we had to consider where we could add the most value and have the greatest impact in the bipolar disorder space. The need for better treatments is undeniable - indeed, in a survey of over 6400 people with lived experience, 89% of respondents agreed that there should be better ways to treat and provide care. However, within that same survey, less than 20% of participants cited the absence of symptoms as a measure of their wellness. Instead, the ability to function, to be independent or act according to one’s own will, having a purpose in life and “getting through the day” were viewed as top wellness priorities.
Knowing this, the Daymark Foundation made a strategic decision to focus the bulk of its initial financial contributions on improving quality of life. We began 2020 with the strategic learning question: “How might we help improve quality of life for Canadians with bipolar disorder at scale?” By referring to the notion of scale in this learning question, we are committing to not only supporting downstream interventions, but also systemic approaches for improving quality of life.
“How might we help improve quality of life for Canadians with bipolar disorder at scale?”
Our first three funded projects in the bipolar disorder space reflect our interest in improving quality of life:
CREST.BD is a collaborative research network committed to learning and sharing more about the psychological and social factors in bipolar disorder. The Daymark Foundation funded CREST.BD to finalize and launch its PolarUs app, which enables people with bipolar disorder to work on areas of life that matter to them.
Relief is a mental health organization grounded in the principle of self-management. We funded Relief to scale its group psychoeducation workshops, including one focused on bipolar disorder. This intervention helps people understand their illness and manage it on a day-to-day basis.
The Behavioural Insights Team is an organization that leverages behavioural science to find and test practical solutions to policy and practice challenges. We funded the Behavioural Insights Team to examine how to reduce the gap between symptom and diagnosis by improving case finding in primary care.
We are excited to continue pursuing this interest in improving quality of life for people with bipolar disorder, which will include a key focus on early detection and intervention. On this topic, we appreciate learning from bipolar disorder early intervention researchers around the world, such as Michael Berk, Sue Cotton, Jan Scott, Philippe Conus, Aswin Ratheesh and Craig McNeil, and to look for ways to integrate an early intervention approach to bipolar disorder in youth mental health settings in Canada.
We are also interested in finding ways to expand uptake of evidence-based psychosocial supports, such as peer support, Cognitive Behavioural Therapy, Family-Focused Therapy and Interpersonal and Social Rhythms Therapy. This is not just about funding the services, but also increasing referral rates and decreasing barriers to participation.
If you are working on any of these topics, or share an interest in improving quality of life for people with bipolar disorder, please connect with us via email, LinkedIn or Twitter.