Improving Dementia and Mental Health Care Through Team-Based Brain Medicine

June 23, 2025

Meet Dr. Sara Mitchell

Dr. Sara Mitchell is a staff neurologist at Sunnybrook Health Sciences Centre and Director of the Azrieli Brain Medicine Program at the University of Toronto. She is also an Affiliate Scientist in the Evaluative Clinical Sciences program at Sunnybrook Research Institute and holds academic appointments in both the Department of Medicine (Neurology) and the Department of Psychiatry at the University of Toronto where she is an Assistant Professor.

She co-chairs TDRA’s Investigations and Treatments Clinical Table Working Group and played a key role in supporting the Temerty-Tanz-TDRA Initiative. She is co-chair of the dementia strategy at Sunnybrook Health Sciences Centre.

Can you share a bit about your academic and professional background, and what first drew you to the field of dementia and neurodegenerative disorders?

I took an unusual path to get into studying dementia and brain diseases. For my undergraduate degree, I studied psychology and philosophy of science at McGill University. I was curious about how ideas like memory and free will connect to the brain.

Since there wasn’t a clear program to study only the brain (i.e., ‘brain school’), I went to medical school at McMaster University, and was one of few students at the time accepted with an unconventional arts background. This helped me see medicine in a new way—thinking about people as whole beings, not just their biology.

After medical school, I chose to study neurology to gain a deeper understanding of how the brain works and what happens when it gets sick. Neurology gave me strong training in brain anatomy and circuits, but it also opened my eyes to the complexity of the whole person and the importance of thinking more holistically about what people are experiencing.

That is why I decided to focus on cognitive neurology, which looks at how abilities like memory and thinking work – and what happens when they slowly decline. Working with people and families affected by these diseases showed me how brain changes affect a person’s identity, daily life, and relationships.

To learn more, I completed a fellowship in cognitive neurology and neuropsychiatry at Massachusetts General Hospital in Boston at Harvard University. I also earned a master’s degree in public health from Harvard T.H. Chan School of Public Health, focusing on clinical effectiveness—studying how healthcare systems work, and how to make them better for people. I am especially interested in how we can design better processes and systems for people living with complex brain diseases.

Your work spans both neurodegenerative and neuropsychiatric conditions. What are the main areas you focus on, and how do they connect?

I focus on complex brain disorders—diseases that affect how people think, feel, and behave. These include neurodegenerative diseases like dementia, where the brain slowly loses function over time, and neuropsychiatric conditions like depression, which affect emotions and behavior.

Even though these problems can come from different causes like brain injury, stroke, or tumors, many symptoms overlap. For example, memory loss, sadness, and trouble concentrating can happen in many brain disorders.

My main focus is dementia because I care deeply about helping people living with these diseases and their families. But I also work with people who have other brain problems in our Brain Medicine Clinic. There, we bring together different types of doctors and care to treat the whole person—their brain, psychological health, relationships, and social situation.

Some diseases, like behavioral variant frontotemporal dementia, show how neurodegenerative and neuropsychiatric problems are linked. This disease changes a person’s personality and behavior so much that they might see a psychiatrist before a neurologist. This shows how the two areas connect in real life.

Right now, many people living with these complex symptoms face delays in diagnosis and care because the health system treats these problems separately. We need better teamwork and faster, fuller ways to help people and their families.

Is there a project or initiative you're excited about right now, and what impact do you hope it will have?

I am excited about three big projects:

First is the Brain Medicine Program. It brings together doctors from different areas to care for people living with complex brain problems, like memory loss or mood changes. We are improving how doctors are trained so they feel more prepared to treat these conditions through an innovative fellowship program. We are also creating a new care pathway for people living with complex brain disorders in our interdisciplinary brain medicine clinic.  We recently held our second annual conference, which helps build a community working on these issues.

Second is the Dementia Strategy at Sunnybrook, which I co-lead. We are working to make care for people living with dementia more connected and less confusing, whether they are in the hospital or living at home. We are also making sure people can access new treatments and tests as soon as they become available. We collaborate with community partners to help people better understand dementia and the impact it has on individuals, families, and communities.

Third is a new program focused on women’s brain health. Women are more likely to develop conditions like dementia, but we know very little about how things like menopause affect the brain. We are creating a clinic and research program to learn more, and to give better care to women with brain health concerns, while also training doctors in this important area.

How do you see dementia care evolving, and what role does interdisciplinary collaboration play in that?

I think we are entering a new and exciting time in how we understand, diagnose, and treat dementia. There are new medicines that may slow the disease and new tools—like blood tests and other “biomarkers”—that help us diagnose it earlier and more accurately. This will finally lead to better care and more hope for people living with dementia.

To make the most of this progress, I believe we need three big changes:

1. Better public understanding of what dementia is.
2. Health system readiness to use new tests and treatments.
3. More support from governments so people can get the care they need—both at home and in long-term care.

It will take time, but we are already starting to see these changes.

Interdisciplinary teamwork is a huge part of this. Dementia care involves many types of doctors—like family doctors, geriatricians, psychiatrists, and neurologists—and other health care professionals like occupational therapists, physiotherapists, social workers, and speech therapists. In the past, we often worked separately, but now we are learning to work more closely together. This kind of teamwork helps people get better care and helps improve the whole health system.