If you ask Ryan Van Lieshout what he wants to achieve, he doesn’t hesitate for a second. “I want to know how to build a better brain,” he says, starting a rapid list. “I want to give children the best start in life. I want to help new mothers who are struggling do what they want to do.” He pauses and smiles. “Actually, that’s all one thing — I like to be efficient.”

Van Lieshout, McMaster’s Albert Einstein/Irving Zucker Chair in neuroscience and Canada Research Chair in the perinatal programming of mental disorders, explains that those things are all closely intertwined. Our brain’s plasticity — its ability to change — decreases with age and time. So he figures the best time to help reshape someone’s brain and mental health is when they’re a baby. And babies’ health outcomes are closely tied to maternal mental health and well-being.

So, he says, if you can help a new mother identify and treat her depression, for example, you’re ultimately improving mental health outcomes for both mother and baby.

With those outcomes in mind, Van Lieshout wants more widespread detection and prevention or treatment of post-partum depression. But it can be scary for a woman to go see a psychiatrist when she’s pregnant or when she’s just had a baby.

That’s why at least three of his current projects involve “task-shifting” — training nurses and peer counsellors to identify and address depression in new mothers.

“If you’re a new mother and you’re struggling, do you want to talk to someone who looks like me — a guy you’ve never met before in a suit, a psychiatrist,” Van Lieshout muses, “or to the peer or public health nurse you’ve already formed a rapport with, and who you’ve already discussed your entire post-partum experience with?”

Van Lieshout led a program a year ago to train public health nurses in the Niagara Region to deliver cognitive behavioural therapy (CBT) to new mothers who might need support.

He has also joined forces with Kids Can Fly, a non-profit organization based in Brantford, Ont. Van Lieshout is training local women — who themselves once had post-partum depression — to provide CBT to new mothers.

“These women have been through it themselves – they are living proof that you can get through this with help,” he says. “And if we can harness the power of how women support one another, we’d be foolish not to use it.”

Van Lieshout says he became a psychiatrist because he’s curious and nosy. “I like to ask people questions — there are so many factors that affect people’s mental health. I just want to know about them.”

But there’s more to it than that. Van Lieshout’s grandmother saw a psychiatrist after two of her children — his father’s siblings — took their own lives. “It helped her get back her life,” he says.

And his work has driven the same point home for him again and again. “There’s no more profound experience than helping a woman who is struggling find a way to be the person and the parent she wants to be.”

Sometimes, Van Lieshout says, women feel such a strong sense of shame that they’re struggling to cope after having a child, that by the time they’re driven to seek help, they can be very unwell.

“It’s a privilege when someone shares part of their life that they’ve never shared before, and trusts you when they’re vulnerable,” he says. “You treat them, support them, work with them in their journey to recovery. Seeing them re-engage with their children, their families, instead of feeling vulnerable and protecting themselves, opening up to them again.”

And that’s the impetus for the task-shifting: “If I can do this with one person, imagine helping many, many women,” he says. “I think if we can help a child just by treating their parent, and do it again and again with every woman who needs it, that’s truly population health.”

McMaster university psychiatrist Ryan Van Lieshout is training survivors of post-partum depression to treat new mothers struggling with depression.

For Lee-Anne Mosselman-Clarke, the depression felt so crippling that she couldn’t even shower, let alone leave her house.

Post-partum depression (PPD) had left the Brant County resident a shadow of her former self. It took a combination of cognitive behavioural therapy (CBT) and medication before she was able to bond with her baby.

Today, Mosselman-Clarke is a peer therapist, using the same therapy that helped her to guide other women through their own post-partum depression struggles. She conducts online group exercises aimed at rebuilding their self-esteem, focusing on activities they enjoy doing and staving off depressive thoughts.

“It can be highly emotional because a lot of things the clients talk about is exactly what I struggled with,” says Mosselman-Clarke.

“But hearing the women say, ‘I smashed that goal and achieved way more than I expected,’ is one of the best things a recovered person can hear. It is the kind of thing that makes me want to go back week after week.”

The peer-led CBT sessions are the brainchild of Ryan Van Lieshout, associate professor of psychiatry and behavioural neurosciences, who has extensively researched this type of depression and how best to treat it.

As part of his research, Van Lieshout and his team tested the effectiveness of peer-led CBT on 74 women, randomized into two groups of 37 each. The first group received CBT right away over nine weeks, while the second remained on a wait list during that time.

Van Lieshout first launched the CBT sessions in 2018 at a community centre in Brantford, until the pandemic forced sessions online in early 2020.

He said that mothers who received immediate CBT experienced “clinically significant improvements,” in depression and anxiety.

Ninety-five per cent were either fully recovered or significantly improved immediately after treatment and these improvements endured for up to six months.

Even better for Van Lieshout’s team, the mothers who underwent peer-led CBT therapy enjoyed a better subsequent relationship with their infants, with less feelings of anger and rejection.

“We are obviously hugely excited that a peer-delivered treatment is not only acceptable but effective,” says Van Lieshout, whose findings are published in the Journal of Clinical Psychiatry.

“This has a lot of potential because it is scalable. It may also be more appealing to mothers than traditional treatments within the health-care system.”

“People with PPD often see peers as trustworthy, empathic and as role models for recovery.”

While the CBT has already cured some mothers of depression, Van Lieshout said there are still huge barriers stopping women accessing the help they need.

These include access to care, with long wait lists and high costs making private therapy unaffordable for many, while post-partum depression itself remains a taboo subject, as peer therapist Sandy Hamilton knows all too well.

“I struggled with PPD more than 30 years ago and for me there was nothing. I want to take away the shame, as this condition is so common and still so taboo,” says Hamilton.

“Merely for women to register for this CBT program is a huge success, as there is still such a stigma attached to PPD.”

It was precisely this stigma that caused Hamilton native Stacey Quinn to bottle up her dark thoughts, a common PPD symptom, for fear of being judged by others.

“You have these awful thoughts and to be able to express them in sessions and see people nod along and realize that they thought them too is so comforting. That alone was so beneficial,” says Quinn, a recent peer CBT participant.

“This therapy should be offered to every woman facing PPD, as it is so helpful and offers people like us a guiding light through what can be a very tough condition to deal with.”

For mothers suffering from post-partum depression, speaking with those who have come out the other side is proving to be an effective treatment.