Dr. Harriet MacMillan

Dr. Harriet MacMillan has devoted her life to finding ways to improve the lives of some of the most vulnerable members of society - children and women who suffer abuse. The McMaster University professor is a pediatrician, psychiatrist and an expert on child maltreatment including physical, sexual and emotional abuse. Much of her research focuses on the epidemiology of violence against women and children, as well as evaluation of interventions aimed at prevention.

Her interest in these fields was sparked by her father, a retired pediatrician. "My father was very interested in disadvantaged children, and I heard from a very young age about what happens to children who have been exposed to abuse and neglect," said MacMillan, who earned her MD at Queen's University and completed a residency in pediatrics at the Hospital for Sick Children in Toronto before coming to McMaster as a psychiatry resident in 1987.

She is a professor in both the departments of pediatrics and psychiatry and behavioural neurosciences, as well as an associate member of clinical epidemiology and biostatics and psychology. She carries on her clinical work through McMaster's Child Advocacy and Assessment Program, and is a member of the Offord Centre for Child Studies, a research organization which examines influences on children's development.

Dr. MacMillan firmly believes communities have to be involved in efforts to improve the lives of all children, particularly those who suffer maltreatment. Many of her research projects focus on how to identify those who are being abused or are at risk of abuse. A recently completed project, called the Family Connections Study, showed that children who have already been abused are at a high risk for recurrent abuse, which points to the crucial need for strategies to prevent abuse in the first place.

The study found that even when an intensive program of home visitation was provided by public health nurses along with follow-up by child protection authorities, the likelihood of recurrence was very high: the intervention did not substantially reduce recurrence of either physical abuse or neglect. "The high rates of recurrence in this study suggest that substantive efforts must be invested in prevention of child abuse or neglect before a pattern is established," said MacMillan.

Another of Dr. MacMillan's research projects involves how best to identify abused women through health care settings. In a multi-site, randomized controlled trial, health care professionals will ask all female patients in the experimental group about abuse, regardless of whether any is suspected. The study will help gauge whether universal screening for abuse will prevent subsequent violence.

Other research projects include investigating the relationship between exposure to child maltreatment and women's mental health, examining the relationship between psychiatric disorders and a history of child abuse, and a study of female youth to determine if the hypothalamic-pituitary-adrenal response to stress is a predictor for victims of abuse to develop depression.

All of these studies aim to uncover the factors that put children at risk of emotional impairment, said MacMillan. Knowing the risk factors will help professionals who work with children determine ways to prevent abuse and its inherent fall-out later in life. Previous research projects have shown the high prevalence of child abuse, with one in three boys and one in five girls suffering some degree of physical abuse while growing up.

Dr. MacMillan has earned numerous awards for both her clinical and teaching abilities, including the Excellence in Clinical Teaching Award from the Provincial Association of Interns and Residents of Ontario, the Jock Cleghorn Excellence in Clinical Teaching Award from the Psychiatry Residents' Association of McMaster University, and the Naomi Rae-Grant Award for Excellence in Community Psychiatry from the Canadian Academy of Child Psychiatry.

She previously held a five-year Wyeth Canadian Institutes of Health Research Clinical Research Chair in Women's Mental Health, and last year was elected a member of the Ray Helfer Society, which consists of physicians recognized by peers as experts and leaders in the field of child abuse and neglect.

For further information, please contact Dr. Harriet MacMillan using the Email contact form or by phone at 905 521-2100 ext 74287