Jehannine Austin

WHAT ARE YOU WORKING ON?

Jehannine Austin

“My great great grandmother signed her marriage certificate with an ‘X’ because she couldn’t read or write,” explains Jehannine Austin, Canada Research Chair in Translational Psychiatric Genomics and associate professor in UBC Vancouver’s Department of Psychiatry and Department of Medical Genetics.

Austin speaks with candour and empathy about the “hard-core working-class background” that fuelled her interest in mental health and genetics and is quick to point out she was the first on either side of her family to reach the post-graduate level and the first woman in her family to go to university.

”By the time I’d graduated, I’d accumulated all of this education that felt like an enormous privilege which I felt really powerfully driven to try to use in order to benefit others in some way.” Austin pauses and then adds quietly: “That’s what it’s all about, using this privilege I’ve accumulated to make things better in some way.”

In addition to her work leading the translational psychiatric genetics lab at BC Children’s and Women’s Hospital site, Austin recently became the executive director of the BC Mental Health & Addictions Research Institute. One might feel intimidated by her list of achievements but in person, you quickly come to realize that her ‘super power’ is, in fact, her ability to make people feel completely at ease and welcomed, which in turn allows for honest, frank, discussions.

Down to earth, witty and sincere, Austin’s excitement about her work is palpable. As she explains the methodology behind her counselling process, it’s clear that removing the stigma and shame around mental illness is something she takes personally. Not only has she herself suffered from depression and anxiety, she’s seen many patients over the years who, in one way or another, have suffered and needlessly blamed themselves for their own conditions because they weren’t aware of all of the genetic and environmental factors contributing to their condition. She wants to change all that.

Dr. Jehannine Austin sat down with UBC’s Brand and Marketing to discuss her work and what inspires her research.

Q
What drew you to studying and working in the field of psychiatric genetics?

A: My family history of mental illness really motivated me to get into this area. Various people in my family have experienced different types of psychiatric problems. I have had my own experiences with depression and anxiety as well; it’s very personal.

When I was studying for my PhD, I was looking for genes that might make someone more vulnerable to schizophrenia or bipolar disorder, and my family was really interested. They wanted to know whether these conditions are genetic and what it might mean for them and so on. I found that I just didn’t have the language to be able to explain to them what my PhD research really meant in a meaningful way and it was this that really drove me into genetic counselling.

This was a way that I could get the training I needed to be able to help families like mine understand what we know from research about the causes of these conditions, as well as help them [in what] it means to deal with all of the emotional issues that often get attached to explanations for cause of illness.

Q
For those of us who may not know, can you explain what psychiatric genetics is and why it’s relevant to people with mental illness, and their families?

A: Research in the area of psychiatric genetics has shown us that there are all sorts of different types of genetic variations that can increase somebody’s risk of developing these conditions; and there is an enormous amount of variability between individuals — even among those who have the same diagnosis — in terms of the factors that have contributed to illness development. Broadly, we know it’s genes and experiences working together that contribute to the development of psychiatric illnesses, but [also it’s] different genes and different experiences in different individuals. Psychiatric disorders are considered ‘complex disorders’ for this reason.

Jehannine Austin's hands

In terms of why this is relevant to people with mental illness and their families, as human beings we need to understand the reasons for why things happen, particularly when it’s a bad thing. When a bad thing happens, we need to understand why, because this can give us a sense of control over the possibility of future similar bad things.

When a psychiatric disorder arises in a family, it’s almost always thought of as an unequivocally bad thing. People need an explanation for cause; they need to know why it happened so badly, that if they are not provided with an explanation that’s coherent and that meshes with their own existing understanding, they create their own explanation for cause of illness based on their experience.

Unfortunately these explanations we come up with about causes of illness often make us feel guilty, ashamed, fearful or stigmatized. This can interfere with our ability to manage the condition effectively. Those emotions get in the way — and that truly is where genetic counselling comes in — because genetic counsellors take what we understand from research about the causes of a condition and we make that understandable to those who don’t have any specialist background in that area.

We help people understand how they got sick but also help them to understand how we can use that as a framework to better manage their mental health going forward.

Quote

In the future that I like to imagine, we all have a family genetic counsellor in the same way that we have a family doctor today.

Q
In 2012 you founded the world’s first specialist psychiatric genetic counselling service at BC Women’s Hospital & Health Centre in Vancouver. Since then, your clinic has provided services to more than 500 families across the province. What have these families taught you?

A: I have learned that people with lived experience of mental illness and their families have enormous resilience, but this is a population that has many unmet needs. I have learned that though from the researcher’s or scientist’s perspective, we have a tendency to think that we need to have all of the tiny specific details about how genetics contributes to the development of mental illness figured out before we can help people with this knowledge.

From the family’s perspective, this is not true. For example, just having the opportunity to learn about how genes and environment contribute together to the development of these conditions can be enormously empowering… understanding that it’s not your fault if you have mental illness, but there are things that you can do to protect your mental health, that can also be can be really powerful. Knowing that everyone has some genetic vulnerability to mental illness, this too can be a really big deal. So, basically, I have learned that psychiatric genetic counselling can be really beneficial for people.

Recovery from mental illness diagram
Q
What would be the impact of genetic counsellors if they were more common in our medical profession?

A: I think the broader integration of genetic counsellors into medicine — throughout all medical disciplines —could produce interdisciplinary collaboration that would help physicians to help their patients benefit to the fullest possible potential from genomic medicine.

In the future that I like to imagine, we all have a family genetic counsellor in the same way that we have a family doctor today. We would meet with our family genetic counsellor periodically throughout our lives and they would help us make meaning of our own genetic information as it becomes salient, and they would help us to consider health behaviours that we may want to adopt as they become relevant in the context of our genomic information. The demand for genetic counsellors is increasing dramatically, and around the world we are working towards training greater numbers of people in this discipline to meet the increasing need.

Quote

Genetic counsellors take what we understand from research about the causes of a condition and we make that understandable to those who don’t have any specialist background in that area.

Students in the hallway
Q
How do you take care of your own mental health?

A: Taking care of my own mental health is a very serious consideration. I’m not one of these people that work sixty-hour weeks; it’s more like forty-five [hours] most of the time. I have an absolutely outstanding team of people — I’m not a micro-manager — so I’m good at delegating and good at finding people who care as much about the things I’m trying to achieve as I do. It’s a team effort.

Exercise is also very important to me and I absolutely love CrossFit so I leave work at four p.m. at least three days a week to do it. I did try meditation but it was a disaster and triggered a panic attack. In the entire hour-long class I did not get past the ‘number two’ in breath counting and that was only because I cheated. I was in a hot, sweaty state of anxiety because everyone else looked so serene.

So it’s important to understand these things are not one-size-fits-all. Mindfulness — simply paying conscious attention to what you’re feeling — works best for me.

Story Credits

Special thanks to our story partner: Jehannine Austin, Associate Professor/Canada Research Chair & MSFHR Scholar, Medical Genetics, Faculty of Medicine, Psychiatry, Faculty of Medicine

Story team: UBC Brand & Marketing — Margaret Doyle, Digital Storyteller; Paul Joseph, UBC Photographer; Lina Kang, Web Coordinator; Adrian Liem, Manager, Digital Communications; Mormei Zanke, Assistant Writer.

Published: November 2017