Women's College Hospital - Health Care for Women, Revolutionized

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Reproductive Life Stages Program (RLS)

This specialized program in the Department of Psychiatry at Women's College Hospital provides assessment and short-term treatment for women experiencing new or recurrent mental health problems, including anxiety, depression, mania and psychosis during the reproductive life stages (such as menstrual cycle, pregnancy, postpartum and the menopausal transition).

The program offers a combination of education, brief psychotherapy and medication, along with a multidisciplinary team approach, to assess and treat women, their partners and families. Examples of conditions for we provide assessment and care are:

  • mood and anxiety difficulties linked to pre-menstrual syndrome, depression and anxiety while planning or during a pregnancy;
  • postpartum depression, anxiety and psychosis; and
  • peri-menopausal mental health issues.

As well, the program has two child psychiatrists on staff who provide care to children of mothers with mental health issues, and one addiction psychiatrist on staff who provides consultation to our program for women who have addictions in addition to their mental health difficulties.

The program is also committed to educating healthcare providers and for conducting research to further understand mental health as it relates to women at each reproductive life stage.

The program’s interdisciplinary team of psychiatrists, mental health social workers and and other mental health professionals offer the following services:

  • Psychiatric assessment and recommendations
  • Psychotherapy (individual and group) and medication follow-up
  • Parenting support
  • Online mental health services
  • Child psychiatry
  • Addictions consultation

Intake and Booking Process [including telephone intake pre-assessment for pregnant and postpartum patients]

Prior to your visit, your physician or midwife will request a consultation from us by faxing us a referral form. If your referral is appropriate for our program, the intake and booking process is as follows:

If you are not pregnant or postpartum, an appointment date and time will be sent to your referring doctor’s office. You may be asked to complete a set of questionnaires which must be submitted to the RLS program prior to your consultation with the RLS psychiatrist. If the questionnaires are not completed by the due date provided to your referring doctor then your visit with the RLS psychiatrist will be cancelled. It may be rescheduled once the questionnaires are complete.

For pregnant and postpartum patients, we will call you to schedule a telephone pre-assessment with the RLS intake worker that will happen prior to your in-person visit with the RLS psychiatrist, and provide you with a consultation date with the RLS psychiatrist at the same time. If you have not heard from us within 1 week of your referral please call our program at 416-323-6230 to schedule your telephone intake. The RLS intake worker will ask you some questions about the reason for your referral, and any other information that will help us inform your assessment visit with the RLS psychiatrist. You will be asked to complete a short questionnaire over the phone so that we can better understand what symptoms you are having, and how severe these are. You must complete your intake telephone call prior to your visit with the RLS psychiatrist. If you have not done so, then your visit with the RLS psychiatrist will be cancelled. It may be rescheduled once the intake telephone call is complete.


What to expect at your first visit

When you arrive on the 7th floor, please proceed to check in at the information desk where you will be asked to fill out some important forms, including your current medications, and whether you would be willing to participate in research studies in our program if you are eligible. Please arrive 15 minutes early for your scheduled appointment to complete these forms.

Your first visit to our program will be with one of the RLS program psychiatrists who will help determine a treatment plan to meet your needs. Women who are pregnant or postpartum may be referred for additional services in the RLS program, including psychological therapy with a mental health therapist.

You are welcome to bring any children under the age of one in for your appointment. On-site child care is available through Stella's Playroom and should be booked in advance.


Wait times

At the present time, we are offering appointments for most referred patients within 8-12 weeks of the referral being received. If you are pregnant or postpartum, you may be given an expedited appointment based on your intake pre-assessment.


Booking an appointment

A referral by a doctor or midwife is required.

Physicians and clinicians

Download and complete the patient referral form from the Forms section below. Once completed, please fax to 416-323-6356.


Intake & Triage 

  • Josephine D’Agostino, SSW

Mental Health Therapists

  • Greer Slyfield Cook, MSW, RSW
  • Peckham, Meaghan, MSW, RSW
  • Kaeli Macdonald, BFA, MSW, RSW
  • Marsha Gallinger MSW, RSW
  • Lindsay Witton MSW, RSW

Psychiatrist Team

  • Dr. Alicja Fishell
  • Dr. Renu Gutpa
  • Dr. Aliza Israel (Child and Youth)
  • Dr. Jovana Martinovic
  • Dr. Cintia Padoin (Child and Youth)
  • Dr. Diane Meschino
  • Dr. Simone Vigod, RLS Program Lead
  • Dr. Lori Wasserman 

 


At any given time our team also includes social work and medical students, post-graduate medical trainees and fellows in psychiatry, obstetrics and gynecology, and family medicine, as well as clinical fellows from Canada and around the world.

The RLS program at Women’s College Hospital is actively involved in a variety of research initiatives at our institution and through partnerships with other hospitals. We aim to conduct research that improves the health of women with mental health issues and their families across the reproductive life cycle, including across the menstrual cycle, pregnancy, postpartum and in the menopausal transition.

Current Studies Recruiting Participants

We have several clinical research studies underway that are actively recruiting participants:

  • Postpartum Depression: Action Towards Causes and Treatment (PPD ACT) Canada

    Study funded by: Women's Mental Health Program, Women's College Hospital
    Principal Investigator(s): Dr. Simone Vigod

    Co-investigators: Dr. James Kennedy, Dr. Valerie Taylor, Dr. Cindy-Lee Dennis, Dr. Sophie Grigoriadis, Dr. Tim Oberlander, Dr. Benicio Frey, and Dr. Ryan Van Lieshout

    Postpartum mental health problems are common and cause enormous human suffering and costs to society. As yet, we do not have a complete understanding of the causes of postpartum mental health problems, including postpartum depression and postpartum psychosis. So, we cannot accurately predict who will develop them. We now know that postpartum mental health problems have a genetic basis. Understanding the genetic basis of postpartum depression and other postpartum mental health problems is an important goal that could lead to the development of preventive strategies and targeted treatments that could dramatically decrease suffering for women and their families.

    This research study uses an iOS app to identify Canadian women who have ever experienced postpartum depression or other postpartum mental health problems, and collect genetic information from them. Women can download the app from the Apple iTunes store. Those who have at any time experienced postpartum depression or postpartum psychosis will be offered the chance to provide a genetic sample.  Women can easily provide their genetic sample using a home-based saliva DNA collection kit (that the research team will send them), and mailing the sample back to the research team for analysis.  This study is open to any woman in Canada over the age of 18 who has ever had a live birth. For more information please visit, www.pactforthecure.com or email pact.canada@wchospital.ca

  • An Electronic Patient Decision Aid for Antidepressant Use in Pregnancy - RECRUITMEN SET TO OPEN - SEPTEMBER 2018

    Study funded by: The Canadian Institutes for Health Research (CIHR)

    Principal Investigator(s):Dr. Simone Vigod

    Deciding to start or continue an antidepressant medication during pregnancy can be a difficult and complex decision. If you are pregnant or planning a pregnancy, deciding whether you should start or continue an antidepressant medication for the treatment of depression, and are conflicted about what to do, you may be eligible to participate in a study examining whether or not an interactive website is a helpful tool for women who are making this decision.

    Please contact Dr. Simone Vigod (simone.vigod@wchospital.ca) if you are interested in being contacted for the trial once it begins.

  • Transcranial Direct Current Stimulation (tDCS) for Depression During Pregnancy - RECRUITMENT CLOSED - RESULTS COMING SHORTLY

    Study funded by: SickKids Foundation and the Canadian Institutes for Health Research (CIHR)
    Principal Investigator(s): Dr. Simone Vigod and Dr. Daniel Blumberger
    To prevent poor child outcomes, treatment of maternal depression in pregnancy is essential. However, for women who prefer not to use antidepressant medication to treat their depression, treatment options are limited. Transcranial direct current stimulation (tDCS) is a focal form of neurostimulation to treat depression that may offer pregnant women an effective treatment option for their depression without exposing the fetus to the effects of medication. If you are pregnant, currently experiencing depression, and have declined to use antidepressant medication treatment, you may be eligible to participate in our study on this non-medicinal treatment option.

    Read about the study in TRIALS | View our feature story on CTV
    For more information: contact Dr. Simone Vigod (simone.vigod@wchospital.ca)

  • Postpartum group for COUPLES - RECRUITMENT IS NOW CLOSED  RESULTS COMING SHORTLY

    Study funded by: University of Toronto, Department of Psychiatry Excellence Fund 

    Principal Investigator(s): Dr. Simone Vigod and Dr. Andrew Howlett
    Have you recently had a baby and are you or your partner feeling depressed? A research study to develop a therapy group for couples is being offered at Women’s College Hospital which may help you. You may be eligible to participate if you and/or your partner are currently feeling depressed, you have a baby who is less than 12 months old, and are living together with your partner.
  • POCS-R study - RECRUITMENT IS NOW CLOSED

    Site Principal Investigator(s): Dr. Simone Vigod, in collaboration with McMaster University and University of British Columbia
    We are currently running a study to validate the revised version of the Perinatal Obsessive-Compulsive Scale (POCS-R) in women. Participating in this study involves one study visit to consent to the study and complete questionnaires (approx. 30 minutes). This study visit can be before the patient’s clinic visit.
  • Using virtual care to reduce barriers to mental health care in postpartum women and full-time workers

    Study funded by: MOHLTC AFP Innovation Fund
    Principal Investigator(s): Dr. Jennifer Hensel
    We are currently recruiting for a study where women ican take advantage of personal computer videoconferencing as part of the therapy offered in the RLS program.


  • Virtual Psychiatric Care for Perinatal Depression (Virtual-PND): A Pilot Randomized Controlled Trial – RECRUITMENT IS OPEN

    Study funded by: Department of Psychiatry, University of Toronto 2016-2017 Excellence Funds 
    Principal Investigator(s): Dr. Lori Wasserman (WCH), Dr. Simone Vigod (WCH, acting PI), Dr. Ariel Dalfen (Sinai Health System)

    We are currently running a study to assess the feasibility of virtual psychiatric care for pregnant and or postpartum women with depression. The study is being conducted at both Women’s College Hospital (WCH) as well as at Sinai Health System (SHS).  The results of this pilot study will inform a potential future large-scale randomized controlled trial of virtual psychiatric care for perinatal depression.

    For more information: contact Dr. Simone Vigod (simone.vigod@wchospital.ca)


Other Ongoing Research Studies

In addition to the clinical research studies described above, our staff are engaged in high-quality research activities of relevance to women during their reproductive life cycle. Some examples:

  • Schizophrenia Understood in the Perinatal Period: Psychiatric Outcomes and Reproductive Trajectories (SUPPORT) III
    Principal Investigator: Dr. Simone Vigod

  • PACT Canada: Predictive Analytic Models of PPD Risk
    Principal Investigator: Dr. Simone Vigod

There are many resources available for both patients and their healthcare providers. The following are leading websites that will provide the answers to many of the questions you may have about mental health during reproductive life stages:

Patient Handouts

Educational Videos

Designed by Aileen Lin, the following series of videos provide information about mental health in pregnancy and the postpartum period.

  1. How can you tell if you are struggling with your mental health in pregnancy and postpartum? 
  2. Why am I struggling with my mental health in pregnancy and postpartum? Coming Soon.
  3. What kind of help is available if I am struggling with my mental health in pregnancy and postpartum? Coming soon

 

Pregnancy and Postpartum Community Resources
City of Toronto: Healthy Babies Healthy Children 
Provides support services, including home visiting for pregnant and postpartum women in their communities (also available from local public health departments outside Toronto)

Postpartum Support International
Open Forum: weekly telephone support via 800 bridgeline.
"Chat with an expert” Call schedule and access codes are available here, or call 1-800-944-4773 for more information

 

Women's Health Matters
Womenshealthmatters.ca provides trusted news, features and research findings on women’s health, as well as Health Centres offering in-depth information on women’s health topics.

  • Watch the video: What is Postpartum Depression?
    In the first video of the series she discusses the depression and anxiety components of the mental illness.

 

Forms

Please fax your referral to the Reproductive Life Stages Program at Women’s College Hospital at 416-323-6356.

Program - Patient Referral

Mother Matters: Online Support Group - Self Referral

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Location & Contact Information

Reproductive Life Stages Program
Women's College Hospital
76 Grenville Street
7th floor
Toronto, ON M5S 1B2

Phone: 416-323-6230 NEW #

Intake line: 416-323-7715

Fax: 416-323-6356

Hours of Service
Monday - Friday
8 a.m. to 4 p.m.

Accessibility
The hospital is fully accessible. All clinics have wheelchair accessible washrooms.


Referrals
A physician or midwife's referral is required. Access forms »

! Rapid consultation
Available upon request. See the Your Care tab or referral form for more information.


Amenities for Parents
The following washrooms on the 7th floor are equipped with change tables:

  • Room 7208 - inside main clinic doors
  • Room 7302 - north of main elevators

We offer a designated breast feeding area across from Room 7232.

Stella's Playroom
A supervised short-stay "play zone" for children is available to families tending to healthcare appointments at the hospital. Stella's Playroom is a free service that can be booked provided space is available. To learn more or request scheduled care during an appointment time call 416-323-6400 ext. 4085.


Are you a new mom adjusting to having a baby? Consider joining our online support group.

Mother Matters

Learn more about our online support group for new moms.



Learn more about Perinatal mental health with this video: Perinatal Mental Health


Research study on postpartum depression: Action Towards Causes and Treatment
Woman holding baby in field></a><br>
<a href=Learn more on how you can participate in this study.

Our Publications


  • Fully affiliated with:
  • University of Toronto

  • A member of:
  • Council of Academic Hospitals of Ontario (CAHO)