Dr. Jess Fiedorowicz is shining a light on mental health through his work and research at The Ottawa Hospital. Originally from the U.S., Dr. Fiedorowicz has been at our hospital since 2020 as the Head and Chief of the Department of Mental Health. He’s also a Professor and Senior Research Chair at the University of Ottawa and a Scientist at the Ottawa Hospital Research Institute. On top of all that, he is Editor-in-Chief of the Journal of Psychosomatic Research, a member of the U.S. Food and Drug Association Psychopharmacologic Drugs Advisory Committee, and still holds an adjunct position at the University of Iowa, where he continues to collaborate with colleagues studying bipolar disorder.
Q: When did you realize you wanted to become a doctor? How did you wind up specializing in psychiatry and mental health?
A: I had an interest in medicine from an early age. As a high schooler, I even took overnight calls for my hometown’s volunteer emergency medical service, the Coleman Area Rescue Squad. Pinned to my desk was a partially crumpled cutout from LIFE magazine of an image from W. Eugene Smiths’ “Country Doctor” photo essay. A canvas print of this image currently hangs on my office wall. My ultimate interest in psychiatry developed in the middle of medical school. Of my many years of study and training, my first two (non-clinical) years of medical school were the only two that I frankly did not enjoy. My first clinical experience in medical school, at the close of my second year, involved interviewing patients at the Milwaukee County Mental Health Complex. This experience reinvigorated my passion for medicine. The first patient I interviewed there had schizophrenia, and despite having been a psychology major as an undergraduate, this experience sparked my first consideration of psychiatry as a career. Later, on an internal medicine rotation, which I also enjoyed, I sought to work with a patient with schizophrenia who had been admitted for an unexplained fever. With this and other cases, I observed patients with mental disorders not receiving the same attention and quality of medical care as their counterparts on general medical services. My interest in psychiatry and the overall medical care of patients with mental disorders has persisted over my clinical and research career.
Q: As a relative newcomer to Canada, can you talk a little bit about why you choose to work at The Ottawa Hospital?
A: The Ottawa Hospital has a rich tradition of research with a clear focus on practice-changing research. This focus couldn’t resonate more with me as my research is only as valuable as the impact it might have on people’s lives. With my interests in both psychiatric and other medical care for patients with mental disorders, I saw real opportunities here to build interdisciplinary teams engaged in research questions relevant to mental health and those living with mental disorders.
Q: You’ve brought an interdisciplinary and team-science approach to the department. With this in mind, how will this help The Ottawa Hospital will stand out in the area of psychiatry/mental health in the coming year?
A: We are promoting ensembles or interdisciplinary teams that connect researchers in mental health with other disciplines, including other fields of medicine. We have recruited some talented mid-career researchers and will be training early-career physicians with research interests. We are restructuring our positions to provide time for research and other academic work with a mentoring and advising plan.
Q: How does community support for research ultimately help patients who have bipolar disorder?
A: There is great potential benefit of not just community support but community engagement to direct priorities and to identify projects that have the potential to really change people’s lives. We have a team “Mind over Miles” in the Tamarack Ottawa Virtual Race weekend raising money for practice-changing research in mental health and plan to involve patient/family advocates and clinicians as part of the committee to determine how any funds raised will be spent.
Q: The Ottawa Hospital is currently working towards the creation of a new, state-of-the-art health and research centre to replace the aging Civic Campus. What will this new hospital mean for your patients?
A: We couldn’t be more excited about the new Civic build and what it means for our community. The department of mental health has been actively involved in the planning, which will include inpatient units with private rooms and courtyard space, a new psychiatric emergency services, and state-of-the art clinics with plans to develop services in neuromodulation. This will be a healing and therapeutic space to address a long under-met community need for acute mental healthcare.
Q: You’re working on a “risk calculator” to help predict the onset of certain mood episodes. What makes this project so important and unique?
A: I was approached by colleagues in child psychiatry who developed a risk calculator in youth and young adults that predicts likelihood of recurrence of a mood episode in bipolar disorder. I have a lot of experience working with a large and well-characterized adult sample that was followed for up to 30 years. We used this data set to externally validate this risk calculator — that is, to see if it still worked when applied in a different setting with older patients. We found this risk calculator performed about as well as risk calculators already being used to manage heart disease, such as to determine whether someone might benefit from a lipid-lowering medication. Risk calculators have not found their way into psychiatry and similarly have potential to personalize medicine. They also might facilitate research by making it more feasible to study prevention, by reducing time and cost through selection of those at higher risk. This can help us gauge the benefit of any preventative treatments, which are harder to study and subsequently less often studied.
Q: What is the most important thing you’d want people to know about you, The Ottawa Hospital, and/or psychiatry/mental health?
A: With two psychiatric emergency services, 90+ inpatient beds, a day hospital program, outpatient services, a mobile crisis program, and specialty programs in eating disorders, first episode psychosis, and perinatal psychiatry, we are a major provider of mental healthcare in the region. We also integrate services into hospital programs, such as oncology, and are developing similar integration with neurology and respirology. Beyond integrating with other medical services in the hospital, we are committed to partnership with other providers of mental healthcare in the region and have coordinated several initiatives with other hospitals and providers to improve access.
“When I first arrived at The Ottawa Hospital, I felt broken. But when I left, I felt like I could go on and not just survive another day, but thrive.”– Petra Smith, who accessed our Perinatal Mental Health Program