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  • September 2023
  • 4 minutes

Mental Health Approaches | Dr. Peter Farvolden

  • Dr. Peter Farvolden
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In Brief

In this Inside RGA Q&A, Dr. Peter Farvolden, Mental Health Consultant, talks about his research into personality and temperament, the importance of accessible evidence-based treatment, and why he is fascinated by the intersection of insurance and mental health.

What inspired you to pursue a career in psychology and what do you enjoy most about working in the field of mental health?

I grew up in a family of math-obsessed engineers but ended up going in the opposite direction. At university, I first studied philosophy and ethics, which led to an interest in theories of cognition and neuroscience, and then eventually into clinical psychology. I was fascinated by the complexity of the questions and the insights of my teachers and mentors. 

I’ve been lucky to work nearly my entire career as a dual scientist-practitioner. As a practitioner, I’ve enjoyed engaging and satisfying clinical work with patients to solve their individual problems. As a scientist, I have collaborated with research teams to try to better understand how basic temperament and personality processes contribute to psychopathology and resiliency. 

What has been the focus of your research around mental health?

Overall, my work has focused on increasing access to effective evidence-based treatments and determining which interventions work best for whom and when.

At the Centre for Addiction and Mental Health (CAMH), I started researching personality and psychopathology to better understand the role of basic temperament and personality factors in the onset of and recovery from mood and anxiety disorders. All of us are born with a temperament, a way of being in the world. That disposition then interacts with outside factors – family, society, culture – to create our personality. My teams looked upstream to study the role of our basic temperaments in predicting mental illness, individual resiliency, and recovery outcomes.

In 2001, in the early years of the internet, I led research on web-based moderated self-help programs for smoking cessation, alcohol use, depression, and anxiety. This eventually led to the development of the MindBeacon iCBT (internet cognitive behavioral therapy) platform, which is now one of Canada’s leading providers of digital therapy treatments. 

I also ran the Psychological Trauma Program at CAMH for many years, which at the time was the specialty PTSD clinic for the Ontario Workplace Safety and Insurance Board (WSIB). Many of our patients worked in construction, manufacturing, and other heavy industries, or were first responders. They had suffered devastating physical injuries and were frequently struggling with psychological injuries, too. This is where I really started to appreciate the mind-body connection, disability management and workplace mental health.

A woman leads a brainstorming session
RGA's 2023 Global Mental Health Survey provides insights into insurers' current offerings and initiatives related to mental health and a unique view of where the industry may be headed.

Why were you interested in getting involved at the intersection of mental health and insurance?

I am thrilled to join RGA and delve into insurance and mental health. The issues and challenges at this intersection include some of the most interesting long-standing questions in psychiatry and psychology. These questions include:

  • Questions of stigma, fairness, and equity in access to services (be it treatment or insurance products).

  • The relationship between mental and physical health in all its complexity. For a long time, we separated physical and psychological health. Now we understand that mental health is health. By modeling the relations between human physical and psychological health, we can better understand where and how to intervene.

  • The puzzle of what is a “normal coping response” versus a “mental illness,” or, if you will, the difference between symptoms and illness. We know from high-quality longitudinal studies that almost everyone will meet diagnostic criteria for a mental illness at some point in their lives. Life throws us challenges that we struggle to cope with, at least for a while. That is the human condition. Fortunately, most mental health symptoms and disorders resolve rapidly and those who experience them return to their roles at work and home. When does a normal adaptive response become an illness? And how do we tell the difference? 

  • The challenge of understanding the relations among early, remote, or distal risk factors and more proximal factors in precipitating the onset of symptoms and illness. Distal risk factors include temperament, social factors or physical health. Proximal events could include the death of a loved one, the loss of a job, or other stressful events. We have much to learn about the relationships between those factors and how they relate to the onset and treatment of mental illness.

  • The challenge of understanding diagnosis of mental health disorders in the context of the plethora of diagnoses, the problem of comorbidity, the unreliability of diagnoses across providers, and the unreliability/instability of diagnoses over time.

  • The challenge of making effective evidence-based treatments widely available and the challenge of understanding what works for whom. How do we use rapidly developing technology, including AI, in a timely, responsible and effective way?

  • The question of what makes for an effective wellness intervention or an effective mental wellness intervention in the workplace.

As insurers expand mental health benefits, the industry will continue to wrestle with all these questions. The potential impact is huge. Pre-pandemic, in 2019, one in every eight people in the world suffered from a mental disorder. The pandemic drove a 25% increase in depression and anxiety disorders, so now approximately one billion people in the world live with poor mental health. It’s wonderful that industry leaders like RGA are focusing more intently on mental health products and new approaches for the risk assessment of people living with mental health problems. 

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Dr. Peter Farvolden
Dr. Peter Farvolden
Mental Health Consultant