Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Social Work

Faculty/School

Lyle S. Hallman Faculty of Social Work

First Advisor

Robert (Bob) Basso

Advisor Role

Advisor

Second Advisor

Ginette Lafreniere

Third Advisor

Tara Marie Watson

Abstract

The legalization and commercialization of cannabis in Canada has renewed concerns among mental health professionals regarding its effects on young people with mental health difficulties. Early and frequent use of the main cannabis constituent Δ-9 tetrahydrocannabinol (THC) increases risk for developing psychosis in vulnerable populations, and consumption is common among youth in Early Psychosis Intervention (EPI) programs. Continued THC use after an episode of psychosis is associated with negative psychosocial outcomes, though a secondary cannabis component, cannabidiol (CBD), may have therapeutic or harm reduction potential. While many young people in EPI services use THC despite clinical advice to abstain, their views toward its risks and benefits are not well understood. Further, the social context surrounding cannabis use among youth who have experienced psychosis has been understudied due to the emphasis on quantitative methods in the cannabis and psychosis literature.

This dissertation addresses gaps in the literature by focusing on the risks, motivations for use, and social context related to cannabis use among youth who have experienced psychosis, including the history of stigma and discrimination toward cannabis users and people with experiences of psychosis, and the current sociopolitical environment that affects them. Particular attention is given to factors associated with the emergence of psychosis, including traumatic stress, immigration, racial discrimination, and economic disadvantage. To better understand the views of cannabis-consuming youth who have experienced psychosis, a qualitative study blending Interpretative Phenomenological Analysis with Qualitative Description was conducted with a sample (n=15) of young people in Ontario EPI programs. This study investigated participants’ reasons for using cannabis, perceptions of risk, and views toward its impact on their relationships with friends and family. The study also explored perspectives on CBD, THC concentrates, cannabis education, and harm reduction. The findings shed light not only on the personal and social meanings participants ascribed to this drug, but also its effects on their quality of life. The purpose of this dissertation is to further research related to cannabis and psychosis while simultaneously illuminating the voices of youth in EPI programs and informing strategies to improve mental health practice with this population. Implications for service provision, cannabis education, harm reduction, and future research are provided.

Comments

Acknowledgements

I would like to start by thanking my advisor Bob Basso and doctoral committee members Ginette Lafrenière, Cory Gerritsen, and Tara Marie Watson for guiding me throughout the course of this project. I would like to thank my partner Chelsea, and kids Aria and Avi, for being so loving and patient as I spent hours away from them to work on this research. I would also like to thank my parents and family for supporting and motivating me to take on this significant commitment. The Wilfrid Laurier Faculty of Social Work has been incredibly kind and helpful throughout this whole process. A special thank you to my CAMH manager Tanya Connors, who suggested I apply to Laurier, believed in me, and gave me the flexibility to start my studies. You have all inspired me to achieve things that I never thought were possible, and I will always remember your support and encouragement.

Importantly, I would like to thank the research participants, the managers of EPI programs I collaborated with, and the staff who introduced the study to their clients. I could not have done this study without you, and I sincerely appreciate the time and energy you contributed to this research. I would also like to thank the EPION program coordinator, Lindsay Turner, who was instrumental during the early stages of my study in connecting with EPI programs. The financial support provided by the Social Sciences and Humanities Research Council (SSHRC), the Ontario Graduate Scholarship (OGS), and the Hilary Weston Scholarship was also extremely helpful in getting my family and me through my education. Lastly, I would like to thank everyone who kept me grounded over the past five years, including my wonderful friends and neighbors.

Convocation Year

2024

Convocation Season

Fall

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Available for download on Saturday, June 26, 2027

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