Faces of U of T Medicine: Helene Polatajko

When you’re a kid, having a mental health condition makes it difficult to fit in. Professor Helene Polatajko helps kids achieve their unique goals so they can confidently engage with their peers. Polatajko is a faculty member and former chair of the Department of Occupational Science & Occupational Therapy. She spoke to Sandra Sokoloff about creating strategies that kids can use to cope in their environment.

How has your research investigated mental health?

My research looks at improving the lives of children who come under the mental health rubric. We work with kids who have developmental coordination disorder, learning disabilities, attention deficit disorder, and a number of other conditions that have a mental health component, for example acquired brain injury or traumatic brain injury, or dystonia. If you have dystonia, you’re going to move differently, be unable to do simple things that others can do easily, and therefore may possibly have difficulty making friends, getting picked for teams and so on. So these diagnoses often have effects on mental health resulting from feelings of rejection, low self-esteem, and depression.

The intervention approach we have developed helps these kids achieve their performance goals, as well as feeling included among their peers. An example is a ten year old boy we worked with early on in our research program who had a developmental coordination disorder. This young boy had difficulty doing such simple things as fold a piece of paper in two. He learned how to do that, and then how to make paper airplanes. In fact, he became so good at making paper airplanes that he became the go-to guy for paper airplanes in his school. Can you imagine the shift in him, in his self-esteem, going from not even being able to fold a piece of paper to becoming the paper airplane king of his school!

What has your work shown about environments that promote mental health?

Our research has shown more about environments that don’t promote mental health! What we’ve learned about environments and mental health is that when teachers and classmates don’t practice genuine inclusion, when they don’t make kids feel like they are genuinely part of the class or group, there are really negative effects on the kids.

One of the things our research team does is give kids strategies to apply in their environment. We can’t necessarily change the environment to prevent negative interactions or events, but we can teach kids strategies to deal with events when they arise. For example, we would help children develop strategies for dealing with being bullied.

Given what you know about environments that promote mental health, what steps can be taken to create them?

Certainly we can, and should, educate – particularly with children – about tolerance, acceptance, and respect for diversity. This approach has been going on for a very long time and has been notoriously difficult to accomplish, seemingly even more so in this age of social media. Although we know it’s important to have these programs in place, we know that social change is a long and difficult process. From my perspective, it’s very important that we teach children how to cope. We know that something like bullying might happen in the environment despite best efforts to abolish it, so we need to help kids cope.

A lot of research on environment and mental health is embedded in social theory - but that’s obviously not where I come from: I am an occupational therapist, not a social theorist. My perspective is that whatever is happening in the environment, the individual has to come to terms with it. Certainly there are environments that will make this easier and environments that will make it difficult.

What does your work show about strategies that individuals can use to support or maintain their mental health?

Developing strategies that support and maintain mental health is the focus of my research. Most recently we have been working on strategies that help people on dialysis deal with chronic fatigue! One thing we have learned that is really important – the difference between strategies that make things work or not work – is that each strategy has to be individualized to that person, and it has to address the goals of that person. This is what I tried to convey in my TEDxToronto Talk. We use techniques of guided discovery and dynamic performance analysis to help an individual identify strategies that are not currently working in a given situation, then we help that person identify and test different strategies that might help. Strategies have to be very individualized, whether it’s a strategy to develop a social skill, or how you hold your pencil. This has been so interesting in our research; we started with one population – kids with developmental coordination disorder – and now we’re working with 15-20 different populations, because the principles are the same: the strategy that’s right for you is the strategy that’s customized for you. There is no a priori list of strategies that will work for all people.

 

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