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Older adults are more likely to suffer from social isolation. Loneliness is increasingly being recognized as being bad for our health. The good news is that mattering and belonging can flip the script. Our series explores these and other related concepts.
“I think I was 50 the first time a younger person in the office asked me when I was going to retire,” recalls Pamela, a 62-year-old government employee who lives in Edmonton. “He said it was high time people like me got out of the way to make room for people like him.”
Pamela, a pseudonym to protect her identity, has worked for the same department since the mid-1990s. She’s qualified, knows all the ins and outs and, according to her, actually trained her last two bosses for roles she applied for. She never even got an interview. She recently filed a workplace discrimination complaint against her employer, because she believes she’s the victim of ageism.
“Being constantly passed over for promotions is frustrating,” says Pamela. “Worse than that, though, is being made to feel like you’re a burden.”
Dr. Alison Chasteen, a social psychologist at the University of Toronto.
Pamela isn’t alone. A recent Employment and Social Development Canada survey found that almost half of respondents 55 or older felt they had experienced ageism, a form of discrimination that the World Health Organization says is one of the “most socially normalized.” Not only is age stigma prevalent, but it can also damage older adults’ abilities, says Dr. Alison Chasteen, a social psychologist at the University of Toronto.
“If you activate negative stereotypes in older peoples’ minds, that can elevate a cardiovascular stress response that can also affect memory function, so they don’t do as well on, say, a free recall test where you have to recall a list of items,” says Dr. Chasteen, noting that it’s also been shown to impact motor function.
Fixed mindsets
Internalizing negative stereotypes to the point that they feel like they define our characters isn’t unique to older adults experiencing ageism. Self-stigmatization is a common phenomenon that runs across all forms of stigma but, when it comes to ageism, there’s another layer, because older adults may, themselves, have held negative ideas about ageing when they were younger.
Given how pervasive and complicated age stigma is, an essential first step in tackling it is to stop using terms that carry negative connotations, such as “the aged,” “old-old,” “senior citizens” and “the elderly.” These imply a fixed identity and/or evoke images of frailty. By contrast, the term “older adult” reminds us that age is relative and ever-changing.
“Really what we’re talking about here is ageism,” says Katie Ellis, Program Manager at the Mental Health Commission of Canada, who recently led a research project on mental health and older adults in Canada. “Using language with negative associations really does have a negative impact on quality of life, because stigma can stop people from thinking they can get better access to care or participate in certain activities.”
Stigma and social exclusion go hand in hand. Pamela says that, even though she’s resisting the push for her to quietly retire from her life-long career, she’s often left out of after-work gatherings and finds that holiday parties can be awkward because she’s not in the cool kid crowd. She’s lucky to have good friends outside of work, but it’s easy to see why age stigma is closely associated with mood disorders, diminished well-being, and feeling less inclined to seek medical treatment, as well as loneliness and social isolation.
Mental Health Commission of Canada program manager Katie Ellis led a research project on older adults and mental health. Stigma can lead to a negative impact on quality of life.
Mattering and belonging – what’s the difference?
“I think the big thing with discrimination and prejudice and stigma is that you’re no longer seen as a unique person with valued attributes,” says Gordon Flett, Honorary President of the Canadian Psychological Association 2024-2025 and former York University Canada Research Chair. “A key element of ‘mattering’ is just being seen as an individual with valued attributes and, instead, you’re seen according to a prescribed box that you’re put into, and you feel unvalued or devalued.”
“Mattering” shares a lot of space with the idea of “belonging” but takes it a step further. It’s possible to belong to a club but still feel unimportant. Mattering means that people value your contributions and, simply enough, you matter. That sense of purpose and meaning seems to offer protective qualities, since it’s correlated with resilience and better health outcomes. Anti-mattering, on the other hand, is closely associated with discrimination and stigma.
“Anti-mattering is so destructive because it means treating people like they’re insignificant or invisible or unseen, unheard and unvalued,” Flett explains.
It’s hard to get people to see beyond stereotypes if you rarely, if ever, interact with people outside of your generation, though. Few Canadians do, since “age bubbles” define a lot of peoples’ social lives. As ageist as some workplaces may be, it’s not uncommon for people from different generations to work on projects together on the job site. By contrast, many social spaces are often tightly age-segregated in ways we don’t always even notice.
“I went to a wedding with my sister and my mother recently and we expected to spend the evening together,” says Dr. Raza Mirza, Director, National Partnerships for HelpAge Canada. “But my mother was sat at a table with older adults, and I was sat at a table with younger people who I didn’t have anything in common with. I would have far preferred to sit with my mother.”
The assumption that older adults only want to talk to people their own age is particularly striking to Mirza, whose career is focused on fighting age segregation through intergenerational projects. Although many are in their infancy, there are a lot of pretty cool projects aimed at getting people out of their age bubbles.
In Alberta, the Canadian Alliance for Intergenerational Living launched a pilot project last year that placed students looking for affordable housing into retirement communities in exchange for leading classes in, say, art, scholarship, or fitness.
St. Lawrence, a school in Champlain, Quebec, arranges intergenerational living situations by offering students two meals a day and free lodging in a residence for older adults in exchange for 10 hours of volunteer work in the home per week.
Vancouver’s Volunteer Grandparents has a “Family Match” program that sees older adults sign up to help mentor kids whose biological grandparents can’t play active roles in their lives. Ontario resident Heather Walker wanted to take part in the program but was too far away, so they made her a pen pal to a 15-year-old.
“She seemed like a younger me,” says Walker, who will celebrate her 70th birthday this summer. “Her passions were writing, and social justice and I had so many questions, my letter back was five pages long.”
Now she has a new role as a pen pal with an entire class in an elementary school. She helps them with things like sentence structure and sends them Valentine’s Day cards and other special treats.
Burst your bubble
One of the better-known age bubble-bursting projects is Raza Mirza’s “Intergenerational Classroom,” an initiative that sees a third-year University of Toronto Ageing and Health class pop up in a common room at Christie Gardens, a Toronto retirement community and long-term care home. Students and residents take the class together for the entire semester.
“It’s been highly, highly successful, because we facilitated a platform where people can feel valued,” says Mirza. “We keep hearing that people felt they had a role, felt that their contributions were meaningful, and felt a sense of belonging. But there was also reciprocity, so it wasn’t this older person who was just the recipient of information or sharing information. There was this back-and-forth exchange.”
Nobody gets stuck in the corner at the kids’ table, either. Everyone has a chance to break out of their age bubble and get to be seen as a unique person. It’s a fabulous model showing a path forward for us to fight against stigma, negative stereotypes, and anti-mattering. And, in fact, it might even help people re-define what “being old” means.
“We’ll start the class by asking the students, ‘At what age do you think a person is old?’,” says Mirza. “People say things like 40 or 50 or 60. Then, after being in the class and listening to older adults for 12 weeks we ask them the question again. They say things like, ‘I’m not sure’ or ‘I think old is a perception or a feeling.’ They focus on the similarities they have and the things that they have in common,” he adds. “They don’t focus on the age difference anymore.”
Resource: A free course on dismantling structural stigma in health care aims for meaningful change for people experiencing mental health and substance use issues.
Author: Christine Sismondo is a Toronto writer who hopes to one day live with friends in a communal living project modelled after The Golden Girls. In a perfect world, there’d be someone like Sophia in residence, because intergen living is the best.
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Older adults are more likely to suffer from social isolation; loneliness is increasingly being recognized as being bad for our health. The good news is that mattering and belonging can flip the script. Our series explores these and other related concepts.
When Pat Flude was experiencing painful side effects during her breast cancer treatment, a doctor from the pain clinic at Toronto’s Princess Margaret Hospital (PMH) gave her a “social prescription” for a mindfulness-based cognitive behavioural therapy class.
“I went every week for about three months,” says Flude, a 78-year-old retired teacher and cancer survivor. “The psychiatrist who led the program, Dr. Mary Elliott, was marvelous. It was so excellent; I even did a follow-up class in loving kindness.”
Since everyone in the class was also being treated for cancer, there was a real sense of community. Flude says she looked forward to the reunions that took place at quarterly graduate sessions. “For me, at that time,” she recalls, “it was really life’s blood.”
Although not every hospital is as proactive as PMH at offering prescriptions for things other than drugs, the “social prescribing” movement is growing by leaps and bounds. The guiding principle is to address the social determinants of health – non-medical factors that influence health outcomes – that are often neglected in medical settings. To fill that gap, primary health care providers refer a patient to a senior resource coordinator who steps in to “prescribe” wellness opportunities (specifically chosen classes or outings based on interest) often for older adults who have higher rates of being at-risk for loneliness and/or social isolation.
From isolation to inclusion
“The big one is social connection,” says Connie Newman, executive director of the Manitoba Association of Senior Communities. “We’ve got some older adults who haven’t been out of their apartments for too long. With a social prescription, we can connect them to one of Manitoba’s many older adult groups.
“Some might be at the local legion; in other communities, it could be the local senor centre,” Newman explains. “Wherever it is, the clients sometimes need a little support to join.”
Connie Newman, executive director of the Manitoba Association of Senior Communities: Social prescribing can open the door to connecting older adults to others in their communities.
Although research associating social isolation and loneliness with negative health outcomes began, in earnest, a little more than 40 years ago, programs to prevent or reverse these conditions and foster a feeling of belonging are relatively new. Spurred in part by the pandemic, which raised awareness of negative mental health effects associated with isolation, “social health” (well-being as an outgrowth of social connection), has become a hot topic lately. Japan and the United Kingdom both have ministries devoted to addressing loneliness, which some consider an epidemic, especially among older adults.
Here in Canada, the Canadian Coalition for Seniors’ Mental Health has recently launched the world’s first clinical guidelines for addressing social isolation and loneliness. Since older adults experiencing isolation often see health and social service professionals, clinicians are key people for identifying at-risk patients, so it’s very important to get them on board.
“Although there’s been a huge amount of research in the area focused on associated health risks there has been relatively little written from the perspective of how to actually help people,” says Dr. David Conn, a geriatric psychiatrist who works at Baycrest Health Sciences and the University of Toronto.
The guidelines, which are making their way into healthcare and community settings, are designed to help clinicians screen for loneliness and isolation, assess the problem and its causes and make helpful recommendations. In some cases, a social prescription might transform the quality of life of a person experiencing isolation but, for those with chronic loneliness, recovering from those feelings is often much more complicated.
Neuroscientists have even suggested that loneliness can re-shape the brain in ways that make social contact less rewarding, thereby making it harder—but not impossible—to “cure” loneliness. A meta-analysis of research found that a range of therapies including animal therapy, exercise, and cognitive behavioural therapy were associated with reduced feelings of loneliness in older adults.
The power of place in fostering connection
That’s a nugget of good news but, as we should all know at this point, prevention is, by far, the best intervention. Some researchers advocate for social prescriptions for people of all generations, as well as working to remove health equity barriers, so that we have a population that’s in good health as it moves into middle age. As Dr. Conn points out, problems with depression, hearing, vision, mobility, and chronic pain can impact our capacity for socializing and staying active.
Providing an environment for people to stay fit and connected to the community goes far beyond healthcare and even public health, since it involves reimagining a range of public spaces, some of which we take for granted. Over the past 20 or more years, we’ve heard a lot about the “third place”— spaces like barber shops, cafés, and shopping malls that are neither work nor home but can foster community and a sense of belonging. The next frontier may well be “fourth place”— streets, squares, bus stops — which, if well-designed, can help promote social health and cohesion. That can only work if they’re truly accessible, however.
“The design is often good in a privileged neighbourhood,” says Julie Karmann, PhD candidate at the University of Montreal’s School of Public Health. “But if you go into a more deprived neighbourhood, you can see that the street is no longer that accessible and not that pleasant for walking.”
Karmann’s work is based in the idea that the simple act of walking can help social health, of which connectedness is an important component. Even relatively well-designed fourth places, though, often miss the mark when it comes to being truly age-friendly.
“Basic improvements like more accessible and affordable transit, safer intersections, and well-maintained sidewalks are essential,” says Eddy Elmer, a Vancouver gerontologist and research consultant specializing in aging and mental health. “People don’t want to go outside if the streets are dark or feel unsafe, regardless of age, but this is especially true for older adults who worry about slipping, falling, or other hazards.”
Maintenance, regular snow and ice clearing, as well as accommodations for persons with disabilities should seem like a bare minimum, but austerity measures in various municipalities have often led to worsening conditions. While we wait for political change, social health programs such as prescriptions can help, especially the ones that move beyond the individual and involve the community.
More walks, more smiles
“One of my favourite programs is from the Netherlands, which has a whole strategy and campaign against loneliness,” says Conn. “One of the programs is an app that connects older people who don’t have a pet with a younger person who has a dog but doesn’t have enough time to walk the dog because they’re out working all day long. It has many benefits for all involved including the dogs!”
Burnaby B.C.’s “Say Hello” campaign is arguably even more effortless. Initiated in 2020 by local physicians worried about pandemic-induced social isolation and loneliness, the project encouraged folks to be a little friendlier to the people they passed on the street.
“It’s super simple, but yet requires a whole paradigm shift, because it has nothing to do with a physician or a clinic,” says Karmann. “Just implementing the norms of greeting in the neighbourhood or smiling to the person you meet in the street can make a huge difference with your sense of belonging.”
Karmann says it’s a tiny gesture that can have a big impact on the population, not just the individual.
“It’s just knowing the people around you,” she adds. “It can be as easy as asking, ‘How are you doing?’.
Author: Christine Sismondo is a Toronto writer who hopes to one day live with friends in a communal living project modelled after The Golden Girls. She’s not sure she’s met her Blanche yet, but hopes to soon, since someone’s got to keep things spicy. And pay the bills.
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Older adults are more likely to suffer from social isolation. Loneliness is increasingly being recognized as being bad for our health. The good news is that mattering and belonging can flip the script. Our series explores these and other related concepts.
In the summer of 2023, Vancouver Island resident Linda Fedun was feeling pretty lonely, even though social distancing measures had been lifted the year before.
“The pandemic started it, but it was when my back pain became serious that things got really bad for me,” says the 63-year-old retired daycare worker. “I couldn’t really go out. I’d be out for half an hour and then I’d have to go home in tears.
“Social isolation is hard,” she adds. “Especially since it’s just me and my two cats.”
Many older adults in Canada can relate. It’s hard to pin down exact numbers, but Statistics Canada has estimated about 30 percent of older adults are at risk of experiencing social isolation and, in 2019 and 2020, almost one in five reported feeling loneliness.
Social isolation is defined as having both a low quantity and quality of contact with others. It’s marked by an absence of mutually rewarding relationships and can lead to poor health, loneliness, emotional distress, and other negative health outcomes.
For some, that feeling is chronic. For Fedun, things improved after the doctors figured out a treatment plan for her osteoarthritis last October and she could finally reconnect with her community and get back to things like taking regular walks. One of these took her by an encampment she hadn’t even realized existed, even though it was only a few blocks from her home. There, she recognized an old acquaintance who told her she and her partner had been unhoused for months.
“I went right home and started looking for what I could spare,” says Fedun. “And then I realized it’s more than that. They needed much, much more than that.”
Fedun started asking for help from neighbours through her Nextdoor app, a social networking site that helps people connect with local folks for potlucks, buy-and-sell, and other exchanges. Members of her community responded enthusiastically with food, warm clothing, and propane for a Coleman stove. She organized pick-ups and drop-offs and connected with an advocate for the unhoused who gave her a “crash course” on housing insecurity. The pair launched a Go Fund Me campaign to help their unhoused friends get an apartment.
Social isolation is a thing of the past for Fedun and, perhaps unsurprisingly, so is loneliness. “I have a sense of purpose now,” she says.
For many, though, the answer isn’t as simple as getting back out, largely because social isolation and loneliness are two different things.
Social isolation and loneliness—what’s the difference?
“Social isolation is objective, such as the number of people in your life and how often you interact with them,” says Eddy Elmer, a Vancouver gerontologist and research consultant specializing in aging and mental health. “Loneliness, on the other hand, is more subjective. It’s the feeling that there’s a mismatch between the relationships you want and those you actually have, whether in terms of quantity or, especially, quality.
“One person can be fairly isolated but not feel lonely, whereas another can have a large social network, but feel quite lonely,” Elmer continues. “It all depends on their unique social needs and expectations.”
Since they’re two distinct problems, they require completely different approaches. And, generally speaking, it’s easier to reverse problems associated with social isolation than it is to help people overcome chronic feelings of loneliness.
“It’s probably normal to have some degree of loneliness from time to time,” says Dr. David Conn, a geriatric psychiatrist who works at Baycrest Health Sciences and the University of Toronto. “But for people who feel intense, chronic loneliness, the origins of that are often rooted in early life relationships and how they feel about people in general.”
Despite not being interchangeable, both social isolation and loneliness are associated with a range of negative health outcomes. In older adults, social isolation is correlated with frailty, cognitive decline, and depression, as well as increased chances of a premature death.
“The key word here is ‘correlated’ because establishing causation is not straightforward,” says Elmer. “But studies find that both loneliness and social isolation are associated with increased inflammation, weakened immune function, hypertension, cardiovascular disease, diabetes, and poorer sleep quality.”
That last symptom may be an important piece of the puzzle. According to the evolutionary theory of loneliness, poor sleep is part of a “hyper-vigilant” state triggered by social disconnection. In a nutshell, for early humans who lived in smaller hunter-gatherer tribes and had to work together closely for survival, being alone was dangerous. Loneliness is an unpleasant emotional response that might be an adaptive mechanism, since the pain of being alone can serve as a biological signal to restore social relationships and get back to safety.
Vancouver gerontologist Eddy Elmer: You can be isolated and not lonely; you can also have a wide social circle and still feel lonely. It all depends on one’s needs and expectations.
Mattering is good for the grey matter
Even though way fewer sabre-toothed predators are prowling around these days, being a member of a clan is still the safer and healthier choice for most people. A recent study from Carleton University found that higher belongingness is connected to better health outcomes for people of all ages—but particularly for older adults.
“What we found was that older individuals who felt they belonged to their neighbourhood were about six or seven percent healthier than people who didn’t,” says Mehdi Ammi, Associate Professor at Carleton’s School of Public Policy and Administration. “Belonging reduced most chronic conditions and was preventative in arthritis and anything connected to chronic stress.”
Social psychology proposes that high levels of belonging can help chronic stress, so it may offer a protective benefit to folks who feel like they have a place at the table. Though some positive psychologists say that while belonging is a good start, an even stronger protective benefit can be seen in people who feel like they matter.
“Belonging is fitting in and having a place,” explains Gordon Flett, Honorary President of the Canadian Psychological Association 2024-2025 and former York University Canada Research Chair. “Mattering is feeling a sense of significance and value within that place. For example, a person could be part of a community, but still feel they’re not being taken seriously.”
The correlation between loneliness and the feeling of not mattering is very robust, he says. “The research about loneliness and the elderly show that there are just too many people who don’t have any meaningful engagement of a prolonged nature with the people who matter to them,” Flett continues. “And they’re left to feel lonely. And when people feel alone and insignificant at the same time, we call that ‘double jeopardy’.”
Conversely, mattering is thought to provide a buffer of sorts that protects individuals from significant stress, whether it’s caused by loneliness, caregiving, loss of independence, and even financial issues.
“The bottom line is that knowing people value and care about you is very comforting,” says Flett. “And I think it also means that you’ll be more likely to ask people for help when you need it.”
It can be difficult for older adults to feel valued and have a sense of meaning, especially in North America, where the culture valorizes youth, fails to provide age-inclusive spaces or age-friendly cities, and views health as an individual responsibility as opposed to a collective one. All these things are factors in widespread loneliness amongst Canada’s older adult population.
While we wait for societal changes, many older adults who have the ability are finding ways of aging in community and generating mattering experiences for themselves. For some, that might be grandparenting. For others, it might be volunteering to help other older adults.
“My wife’s uncle Derek, who almost made it to 100 and lived by himself his whole life in Fort Qu’Appelle, Saskatchewan, was well-known for his volunteer work,” Flett offers. “He delivered Meals on Wheels to people younger than him into his 90s because he was in great shape.
“I once asked him if he ever felt lonely and he cut me off. He said, ‘Not for a second. Because I know there’s people out there who care. And I can get to them, and they can get to me’.”
Further reading: Home Alone: Aging without support is becoming more prevalent for older people in Canada. How can we stem the tide?
Author: Christine Sismondo is a Toronto writer who hopes to one day live with friends in a communal living project modelled after The Golden Girls. Since it was her idea, she gets to be Dorothy.
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Al Wiebe on the Winnipeg Foundation’s BeCause & Effect Podcast in May 2024.
Meet Al Wiebe: Born and raised in Winnipeg, Wiebe lost his job in advertising sales in 2009 and spent two and a half years without a home. He’s living in an apartment now and for more than a dozen years has been a tireless advocate for the importance of housing coupled with support. This is his story.
My dad was a hellfire-and-brimstone preacher. Very strict. My mom suffered from mental illness. My life as a child was not pleasant at all. I was a black sheep – I never felt like I belonged. I had to do a lot of things for myself. Maybe that independence helped me later.
My dad had a housing exterior company, doing siding and eavestroughs. I took it over when he went full-time into the ministry. I was 18. I went to the bank, bought a house and a truck, the whole works. Then I had my first kid a month later, then another one 11 months later. Talk about pressure.
King’s Coronation Medal
I wasn’t a good father or husband. I was focused on the business, and I was never there, so I didn’t have a great relationship with my kids.
I also struggled with depression for years. I was on and off anti-depressants. But I wasn’t on any medication for the five years before I lost my advertising job. I was too busy making lots of money. But when the company’s owner replaced me with his friend, I couldn’t handle the trauma. And I didn’t ask for help. I was a single guy, in my mid-50s, living a block away from work. My job was my life. I had no balance, no friends, and wasn’t really in contact with my family. I kind of lived in my own head.
Living in the car
I left the city for a while but ended up back in Winnipeg. I wanted to wallow in my misery. I had sold my Mercedes but still had a nice apartment. I just kind of ruminated and started thinking about suicide. I’m diabetic and stopped taking my drugs for that, which wasn’t good either.
Al Wiebe, at right, with Point Douglas Ward, Winnipeg, city councillor Vivian Santos in March 2025. Wiebe – a peer and community engagement trainer and housing director – was presented with the King’s Coronation Medal for his advocacy on ending homelessness and advancing lived experience leadership.
One day, I just walked away from the apartment with my bag. I’d eaten at a Vietnamese restaurant a few times and behind it there was an auto dealership that also had a scrapyard with cars they used for parts. I plunked myself down in the backseat of a ’64 Mercedes — I used to drive one so figured why not live in one for as long as I’m here. I thought I’d last for a night or two. But I spent 14 and a half months living in that car.
I’d be gone by seven in the morning and stay away until seven at night, because that’s when they closed. I didn’t use food banks or shelters or soup kitchens, none of that. I collected empty beer cans and change from people at drive-throughs. That’s how I existed. But I lost 32 pounds and became very ill. I developed pneumonia and neuropathy from my diabetes. I could hardly walk some days. I began to lose hope. I didn’t think I’d get out of there.
I went to the hospital three times and three times they turned me away because I was homeless. I was looking for psychiatric care and they treated me with disdain. They told me I had to “work on things.” Work on things? The only thing you can work on when you’re homeless is survival.
Signs of hope
A few days later, I went to another hospital, to the crisis stabilization unit, and then spent 24 hours laying low in my car. A couple days after that I went to St. Boniface Hospital. I was a real mess. When I finally saw a doctor, she changed the course of my life.
She said, “You’ve been everywhere and people either could not help you or would not help you, but today I’m going to help you. It’s like you’ve fallen off the edge of the world and don’t know where you are or who you are, and you don’t know how to help yourself. Starting today, you’re going to get better and get stronger. You’re going to start becoming the person you want to be.”
She gave me hope. She told me that I was carrying a lot of trauma and I had to start believing in myself. That someday, I would be able to help other people who were in this position.
After a month in the hospital, I spent 14 months in a shelter. I hated it. There were two killings while I was there. I got attacked and my ribs were broken. At times, I wanted to go back to the streets.
I finally found a home when I got an apartment across the street from the Ma Mawi Wi Chi Itata Centre after I got out from the shelter. It’s an Indigenous organization that does amazing service-provision work. It was a big green house, and I saw people milling around. So, I went in and asked if they needed any volunteers, because I needed purpose. I needed help myself, but I also needed something to do. They must have seen something in me. They allowed me to volunteer and, over a couple years, to take courses: suicide prevention, food handling, First Aid and CPR, non-violent crisis intervention. Class after class, workshop after workshop.
The things that make you a complete person
The greatest casualty of homelessness is a loss of self-respect and self-worth, dignity, and confidence. Everything that makes you a complete person and allows you to move forward. I lost all that in a big hurry, but every time I took another course, it was like I was opening a cupboard and putting in a jar of confidence, then another one, then another one. I become a more confident person slowly, not that swaggering, SOB advertising executive who could do anything. I was so arrogant in those days. But I began to feel better about things. I knew I was going somewhere. I started to feel that I could do more.
After two and a half years, I started working as a cook at a drop-in centre once a week. I was cooking lunch for 70 people. Then one of their case managers, whose job was to keep people in housing, quit. And they offered me a job. I hadn’t worked in five years. Two and half years of homelessness, two and a half years of recovery. I said, “Sure.”
Countering judgment and stigma
These days, I live in a one-bedroom apartment with a friend who I’m a caregiver for. I help run a housing first program and organize an annual human rights symposium. I do talks about homelessness and training sessions with people from all three levels of government, including local city councillors as well as police officers, firefighters, and paramedics. I talk to nursing students and hospital staff about poverty, stigma, and unconscious bias. “Are your judgements impeding your ability to give your best to the vulnerable?” Homeless people fill up emergency rooms, and they often treat people who are homeless in an inhumane way. Our health-care system doesn’t really understand the connections between homelessness and mental health. Our governments don’t, either.
Having an apartment is great, but the work gives me purpose, and I couldn’t have got here by myself. You can’t do anything without a home, that’s for sure. That’s why I’m big on housing first. You put somebody into housing, then you look after their needs. You can’t look after anybody’s needs on the street. And you can’t get by when 80 per cent of your income goes to housing.
People think that because you’ve spent time on the streets, you’ve lost something. In my case, I’ve gained so much wisdom. I’ve had a lot of success because I have lived experience. It helps you build trust. My experience gave me deep, deep empathy.
When you’re homeless, it exacerbates your mental illnesses. It compounds them by 10 times. Because there’s trauma just about every minute of every day. Because you don’t feel secure. But it’s not just housing. Having a place to sleep won’t make you healthy. You need a case manager. You need a counsellor. You need trauma-informed medical care. You might need to work on addictions. You need wraparound support. Otherwise, life could come crashing down on you again. Housing alone is not the answer. But it’s a big part of the answer.
Poverty can be just as traumatic as homelessness. People use so much energy every day and struggle so much, especially these days because of economic conditions. People are dropping from middle class into poverty — people who’ve never experienced poverty before — and people are dropping from poverty into homelessness. People really need access to the right services, because things are really difficult right now.
It’s rewarding to be helping keep people off the streets. Two years after I escaped homelessness, I came off my anti-depressants because I had a focus. That focus was other people. But for me, bridging the gap with my family is best thing about getting my life back together. Two of my children are in their 40s and one is 50 and we get along better than ever. They’ve all done really well for themselves. My daughter and I speak on a very cerebral level. My boys and I talk sports. One of my sons is in Winnipeg today for work and I’m going to see him for dinner tonight.
Did You Know?
- Roughly 60 percent of people who are homeless in Canada face mental health issues, according to a federal report that looked at 2020-2022 nationally coordinated point-in-time counts.
- According to the Homeless Hub online resource, mental illness can make you more susceptible to unemployment, poverty, social isolation and other challenges, all of which increase the risk of homelessness.
- Whether you are on the streets, in a shelter or some other liminal situation, the lack of stability and security can amplify psychological conditions.
- Access to safe and affordable housing, accompanied by a range of supports, is one of the most effective ways to end this cycle.
- A housing first approach is less expensive than public expenditures on health care, policing and other costs associated with homelessness, according to a CMAJ study.
Resource: Housing First in Canada
Author: As told to Dan Rubinstein, an Ottawa-based writer and editor who frequently writes about health issues.
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When I scroll through social media in the morning, groggily reaching for my phone an hour before my attendant care worker is scheduled to come and wake me up, I am almost always hit with some type of disability meme or post. They usually come in two flavours: one about how disabled people can do anything they put their minds to, or how the only disability that we have in life is a bad attitude, next to a picture of a disabled person defying the odds by scaling a mountain, skydiving, or something like that.
The second type of meme or post that I usually encounter is a magazine article detailing a beautiful person’s tragic accident that left them “wheelchair bound,” but “that doesn’t stop them from living their best life,” or something like that. These all-too-common representations in disability media leave us with very narrow views of disability. You either overcome disability and morph into a heroic figure, or you turn a tragic story into an uplifting one for others to draw out inspiration.
Not your tragic hero
We don’t only see these depictions in the media, they happen in real life as well. I can’t count on one hand the number of times that I have been approached by someone and told with their furrowed concerned brow, ‘I don’t know, if I were you, I think I might just kill myself,’ or the patronizing, ‘You don’t let your disability stop you, Andrew.’ There is rarely any space for a nuanced conversation about what it actually feels like to live in a disabled body, and let me tell you, it is so much more than those stereotypes.
One of the parts of living in a disabled body that is often discounted and entirely underrepresented is disability grief. My definition of disability grief is this: It is the grieving that comes as the result of living in a disabled body that copes with more loss and abrupt changes than most.
As a severely disabled person, I experience disability grief often – sometimes it comes up as a longing for something that I will never be able to do like running, jumping in the air and somersaulting, or even something as seemingly mundane as giving myself a shower. Other times, disability grief will come from some function that I lost the ability to do. I grieve that I can no longer use the toilet to go pee on my own and that I have to be catheterized everyday instead.
If I’m truly honest, the grief of losing that simple pleasure can’t be translated into words. I grieve that as I age in my disabled body, the pain is becoming more apparent, and it is becoming harder and harder to do many things that my disabled body used to do. All of this has had a major effect on my mental health; I find myself becoming more irritable, quicker to upset, and quicker to fall into depression.
Mental health professionals need to catch up
Kristen Williams
To understand disability grief and its effect on disabled people’s mental health better, I spoke to disabled psychotherapist (qualifying) Kristen Williams. She lives with cerebral palsy, anxiety, and major depressive disorder. She says that in her experience, disability grief is compounded.
“Disabled people are grieving the reality of our lives, and the things we cannot do, alongside our lost potential – the things we want but most probably will never have,” she says. I also asked her how mental health practitioners can help manage disability grief.
“The key is not to shy away from disability grief. Many people in the helping professions feel motivated to ‘fix’ or ‘help’ people, and sometimes this can look like offering solutions and encouragement, when we should be offering space and validation,” she says.
One of Williams’ takeaways is that therapists are not shielded from ableism – “a set of beliefs or practices that devalue and discriminate against people with physical, intellectual, or psychiatric disabilities and often rests on the assumption that disabled people need to be ‘fixed’ in one form or the other,” as defined by the Center for Disability Rights, a not-for-profit, community-based advocacy and service organization in the U.S.
Williams says that “clinicians experience it as much as they next person, so we have to examine it thoroughly, and strive to be anti-ableist in our practice.” I wanted to understand if Williams has seen a shift from disability grief to disability joy in her practice, and so I asked her.
“Part of moving towards disabled joy involves processing the sad, frustrating, and difficult moments that make up disability grief. Creating disabled joy looks like first understanding disabled grief.”
Getting to joy
I also spoke with my close friend Lorna Craig, who lives with multiple chronic illnesses including Lyme disease, endometriosis, and bipolar I. I asked her what disability grief looks like for her.
“For me, the way I usually experience it, because I have an acquired disability, it’s always comparing myself now to what my non-disabled self would be doing,” she says. “I think I spent many years grieving that person, and who she was, and what she might have been able to do.”
She continues, “These days I don’t know her. How do I know that she would have been a better version of myself?”
One of the key things that I gleaned from my conversation with Lorna was that disability grief is so much bigger than I think we understand it to be, and it is way deeper than just a buzz word. One of the things she said that I connect with so much is this: “Some days I wish my problems were more conventional instead of having a body that doesn’t cooperate and do what I want.” As someone living with invisible disabilities, Lorna highlighted that one of the things that brings her the most disability grief is not being believed by others.
I asked Lorna how all of this impacted her mental health and what she told me underscored just how important it is that we talk about disability grief and mental health.
“It ranges. Sometimes it can be a little irritating thought that stays with me throughout the day, and sometimes I can be curled up in a ball crying for days.”
I also asked her if she is seeing a shift from disability grief to disability joy.
“When it comes to my experience of chronic illness, I agree that you have to go through disability grief to find the joy. With my experience of mental illness, we haven’t really been given the chance to grieve and get to the joy. Sometimes, I think that mentally ill people don’t understand that they have a disability, and that they can claim that.”
Lorna and I talked for almost an hour about all of this, and she renewed in me just how important and ultimately complicated understanding disability grief and its effects on our mental health can be. Talking to both Lorna and Kristen, I learned that disability grief is different for each and every one of us living in disabled bodies and it is time that mental health professionals addressed their ableism so that they can understand disability grief.
I can’t wait to open my Instagram feed in the morning and see a disabled person with a caption that says, “I went to my therapist, and they helped me understand my relationship to disability grief.”
We’re not there just yet – but we could be.
Author: Andrew Gurza (they/he) is the author of the book, Notes From a Queer Cripple: How to Cultivate Queer Disabled Joy (and Be Hot While Doing It!), dozens of articles, and the viral hashtag #DisabledPeopleAreHot. He is a disability awareness consultant and podcast host.
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It’s more than just another self-help book. The Mental Health Guide for Cis and Trans Queer Guys (New Harbinger Publications, June 2025) blends personal reflection, clinical insight, and a heartfelt tribute to queer men navigating their mental health in a complex – and often contradictory – world.
Rahim Thawer, a queer Muslim social worker and doctoral candidate at the University of Alabama, draws deeply from his lived experiences, his professional work as a psychotherapist, and numerous conversations with queer and trans men.
They face myriad challenges throughout their lives, from the processes of coming out, to the nuances of growing older, and everything in between.
Topics including internalized shame, heteronormative culture, managing rejection, and substance use are explored in depth. For each subject, Thawer skillfully combines academic knowledge with real-life case studies, providing readers with practical tools and guidance to reflect on their own experiences.
Solid resource
The book is an excellent teaching resource for clinicians who may not fully grasp the historical and ongoing impact of gay, bisexual, trans, queer/questioning (GBTQ) men and their experiences. Although Thawer’s guide is primarily written with queer men in mind, it has already garnered attention from therapists and educators eager to better support queer communities, something Thawer is familiar with. In his private practice, he frequently supervises clinicians seeking cultural guidance for their cases.
For example, clinicians have approached him to say, “I’m working with a gay man struggling with shame,” or “I’m supporting a queer Muslim client who hasn’t come out yet.” These professionals are seeking a framework to understand underlying issues – and Thawer’s book provides just that. It breaks down complex issues such as internalized stigma, anticipatory rejection, and challenging family relationships – and turns it into actionable insights and interventions.
Thawer’s contributions to the field have not gone unnoticed. He is the recipient of the 2025 Mary Smith Arnold Anti-Oppression Award from Counselors for Social Justice in the U.S. and also received the 2025 Honorary Award in Education from the nonprofit South Asian Americans for Change. These accolades affirm his significant role in advancing culturally attuned practices across diverse communities.
I had the opportunity to chat with Rahim recently, and the following are some excerpts from our conversation.
Psychotherapist and doctoral candidate Rahim Thawer works in the U.S. and studied in Toronto. His new book speaks to complex issues in practical ways.
Q: What inspired you to do this? It’s a big subject and a challenging one. So, what was your motivation?
A: I started my professional work and career in the HIV sector and so many of the workshops we did that were geared to reduce risk of HIV transmission, and at other times, geared toward helping people live well with HIV, they were quite limited. They were all surrounding HIV and many communities that we met didn’t need that specifically. They needed something adjacent to that, like anti-homophobia, talking about sexuality more broadly, talking about the landscape of relationships. Now, arguably, all of that is related to HIV, but I wanted to decenter the epidemic and think about what are all the things in our subculture that contribute to our mental health outcomes? Because I think queer and trans guys live in a different world. We’ve got different norms, different expectations, our own culture, our own history. We live in multiple worlds, and I think that’s what determines our mental health outcomes. So, for me, I wanted to take both my lived experience as a queer guy and my work as a therapist to really think about what are all the things that affect our mental health.
The book that I wrote, it’s not a research book. I didn’t do a study to say what are the things that affect us. I thought, here are the things I’m seeing, and feeling, and living. What if we itemize those and talked about them? That’s where the idea came from.
Q: In the world around us, we’re hearing more and more of an upsurge in anti-gay, anti-queer, and especially anti-trans, rhetoric, both culturally and politically. How do you think that’s impacting or going to impact our community?
A: Well, I think the impact will be seen long term, because right now people have anxiety about their current rights or protections becoming limited, and that anxiety is legitimate. However, for people who are well-to-do, have been out for a long time, have access to lots of resources, they were able to do that because of rights, legalization of gay marriage, decriminalization of homosexuality, because of opportunities to afford mobility. In some cases, when you combine those things with male privilege, it paved a way for them, but those very successful people, still, I would see in my therapy practice struggling with shame, relationships, internalized stigma, and fraught relationships with their families of origin. So, my point is that even when people seem to be fine in the political sphere, the messages they’ve internalized at a young age stay with them for a long time. And that is to say that before this wave of anti-trans rhetoric showed up, we were struggling in many ways with our past. And I think the anxiety around the political condition is very valid, but I think the repercussions will be felt long term. And that part is very unfortunate because lots of people will say, ‘oh, we’ll just wait four years and then we’ll get somebody new.’ And I’m thinking, no, it doesn’t quite work like that. The message is the fear; you absorb it. It stays in your body. And it’s detrimental.
The Mental Health Guide for Cis and Trans Queer Guys
Q: Do you see any opportunities from a prevention perspective in the upcoming years?
A: Potentially. I think within the broader LGBTQ community, a lot of cisgender gay men, cisgender lesbians who are in their 40s, 50s, 60s, if they’ve been able to access some comfort in their world, in their life, in their time, this might be a time where they look inward into the community and support people who are still struggling. We’re going to need some serious solidarity with trans communities, and we have for a long time needed more internal solidarity with underhoused and homeless LGBTQ youth. That is a big problem in Toronto and other metropolitan cities.
I think what we’re seeing politically is defunding of all things DEI (diversity, equity, and inclusion). And if that means cuts to LGBTQ care, then we’re going to have to rely on a different economy, which has to be more communal and collective.
Author: Ed Mantler has led innovation and improvement in healthcare for more than three decades. He trained as a Registered Psychiatric Nurse, holds a Master of Science Administration, and is a Fellow of the Canadian College of Health Leaders.
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Amanda Friesen, a professor of political science and Canada Research Chair of political psychology at the University of Western Ontario, recalls talking to a colleague recently who said he had been feeling a lot of stress with “everything that’s happening” in politics. “It occurred to me, ‘you’re a political psychologist. Is political anxiety a thing?’ And I thought, ‘yes, it is.’ And so, he and I had this conversation.” Since then, Friesen has been called upon as a national commentator on the subject, offering advice on how to cope with “political stress” and avoid “political information overload.”
In the wake of rapid, even shocking, political, and economic changes in the past several months, many psychology experts and mental health counsellors across Canada have reported an increase in the number of clients confiding anxieties brought on by contemplating how political and societal changes will affect them.
Political psychologist Amanda Friesen shown here in Copenhagen during a research project: It’s about a balance between staying informed without the adverse effects.
The CBC recently reported a surge in “nervous googling” of terms such as “tariff” and “recession.” Many people say they are losing sleep worrying about what may come next – and feeling helpless in the face of all the turmoil. Some are turning off the news entirely to protect themselves from those difficult feelings. Others are addicted to “doom scrolling” and exposing themselves to hateful rhetoric on social media. Some are dealing with the emotional consequences of cutting off family members and friends over profoundly divergent opinions and beliefs. Depressive symptoms can be the fallout.
New world disorder
The trend is so pronounced, some mental health experts are wondering if “political anxiety disorder” should be made its own diagnosis, distinct from other forms of anxiety.
“There’s a lot of general anger and disbelief, I think,” says Stefanie Peachey, a registered social worker, accredited family mediator, and founder of Peachey Counselling and Family Support in Burlington and Oakville, Ontario. “[Clients are] saying to themselves, ‘What does this mean for me? I’m already so scared and anxious about finances, being able to afford my grocery bill or my rent. I don’t really understand tariffs, but I know that things might get more expensive for me. And how do I afford that?’”
Job loss, escalating prices on everything from groceries to building materials, and the lack of affordable housing – these issues are real and society-wide in their impact. Worrying is understandable, but if it leads to feelings of anger and helplessness that interfere with your life, finding ways to cope without shutting out reality is essential.
Social worker Stefanie Peachey: Worrying is understandable with all that’s going on. Therapists can help sort through complex issues and feelings.
“We need tools available for people because we don’t want them to disengage from democracy,” says Friesen. “I think it’s on journalists, social scientists, and political scientists to find ways to help people stay engaged and informed without adverse effects.”
Friesen suggests “setting up an intentional, formalized strategy” for consuming news. She employs one herself. “I do compartmentalize my news consumption. I never read the news before I go to sleep. I have a few subscriptions to news outlets where headlines of major and minor news stories get delivered daily or weekly. I read these stories and avoid jumping from link to link to link. I read and then stop and set it aside.”
Another way to deal with the uncertainties facing all of us is to be proactive in preparing for possible scenarios. “Let’s say that you work in an industry that one of the tariffs is going to impact. Reach out to your professional organization or your company and ask, ‘What’s going to be our response to this? Is there a way to prepare for it, remove some of that uncertainty?’” says Friesen. “We could imagine all sorts of scenarios that may or may not come to pass. Just get some concrete responses. Okay, this might happen or this or this, and here are some possible responses or plans we could make in response. It should make you feel better to know.”
Why tuning out completely isn’t the answer
Getting involved in your own community, or advocating for an issue you care deeply about, can go a long way to allaying feelings of helplessness. Focusing your time and energy on helping to further one cause is better than becoming paralyzed by feelings of emotional overload about every issue you read about, says Friesen. “Maybe there are some new environmental efforts in your community, or you have a friend who keeps bugging you to talk to the city about improving bike lanes. Do it. Find the things that you do have power over and focus on those,” Friesen advises.
Peachey echoes these suggestions. “As therapists, we’re often working with clients around uncomfortable thoughts and worries; all the ‘What ifs.’ For instance, for a client who is questioning their sexuality, and you worry, ‘What if I’m not accepted for this?’ We work around that fear and talk about all the supports that you may have in their life, and all the ways you can minimize some of the stress. It doesn’t mean that it’s not stressful or that the worry is wrong, but that the client’s thinking can be reframed. The same could be applied in this situation. How can we minimize the stress and focus on factors that may put us more at ease?”
In an article entitled, “How to cope with political and social uncertainty as a Canadian,” Peachey writes, “When we consciously shift our focus away from elements beyond our control and onto matters where our influence is meaningful, we not only conserve valuable mental energy but also gain a sense of empowerment.”
Peachey and Friesen agree that basic self-care – continuing to get enough sleep and exercise, eat well, moderate your news consumption, and practise mindfulness – just doing the things that bring you pleasure, connecting with friends and family who nurture and support you, are important now more than ever.
“It just doesn’t do any good to worry about politics every moment of the day. Live your life. Spend time with your people, enjoy the outdoors, immerse yourself in projects or activities that bring you joy. Burning out won’t help you be ready for future advocacy. This might be a marathon!” says Friesen.
Above all, says Peachey, remember that you are not alone. Many Canadians are feeling the same way and expressing their frustrations through concrete actions such as buying Canadian, or changing travel plans, for example.
If you need help, contact a therapist who can help you reframe your fears and anxieties and find positive ways to cope. As Peachey puts it, “Rather than dwelling on circumstances and behaviours that drain your emotional reserves, redirect your energy towards actions and initiatives that align with your cherished values. By doing so, you not only regain a sense of purpose and fulfillment but also nurture your mental well-being.”
Further reading: The Therapeutic Power of Blue Space.
Resource: Strategies to stay informed without feeling overwhelmed.
Author: Moira Farr is a national magazine journalist and instructor in Ottawa. She has been moderating her news consumption, altering her social media habits, and using the added time to volunteer more.
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The Canadian Mental Health Association’s Mental Health Week runs from May 5-11. This year’s theme is #UnmaskingMentalHealth and encourages people across Canada to look beyond the surface to see the whole person.
Perhaps you know the tune – about Eleanor Rigby.
“Wearing the face that she keeps in a jar by the door. Who is it for?”
In their classic song about loneliness, The Beatles sum up beautifully what it is like to live with a “high-functioning” mental illness. The song comes to mind, at times, like when I am in a bipolar mood episode, I always leave the house with my mask on. Often, this is literal. I painstakingly put on make-up, painting a face that denotes coping and professionalism (wing tips for bright eyes! Blush for pink cheeks to denote good health!). When I leave the house, I match the attitude and tone of the people I interact with, putting in enormous mental effort to calculate the actions that will make me appear “normal.”
This mask broadcasts a message of “I’m fine,” when inside, I am often anything but. When I arrive home in the evening, I wash off the painted face and watch it circle the drain, as a kind of illustration of how depleted I feel, before I fall into bed exhausted from the effort.
For me, this year’s Mental Health Week theme is a call to action. When we unmask mental health, we create the conditions for reducing stigma by promoting understanding and eliminating discrimination against people with mental illness.
Masking – what is it, who does it, and why?
Masking, also known as “camouflaging,” is precisely that – trying to blend in with societal expectations by suppressing symptoms or traits, according to Autism Canada. It is a concept that has been most studied in the context autism and attention-deficit/hyperactivity disorder and is linked to the concept of “smiling depression,” a colloquial term for those who may slap on a smile to disguise their inner feelings.
Zachary Houle lives with autism and schizophrenia. He notes that autism has become more celebrated in the media (“autism chic” is even a thing), but he notes that the media portrayals can remove the reality and complexity of illnesses.
“I find with schizophrenia, people immediately think I’m an axe murderer or I’m dangerous and violent,” he says. “It takes less energy to pretend to be normal than going into an office knowing that I’m going to get hazed, which has happened in the past.”
Houle notes that a lot has changed in the 20 years since his diagnosis and that he is in a very progressive and understanding workplace now, but he still masks daily as it has become his second nature.
He is not alone. According to a 2023 poll from Benefits Canada, 45 percent of Canadian employees with autism feel that they have to mask their autistic traits at work.
Tanya Lepine-Darwiche, a woman who identifies as being on the autism spectrum and who lives with anxiety, agrees. “Masking is about the world accepting me being able to walk into a room and have my opinion heard without them placing judgments on me because I’m neurodivergent,” she says. “It’s putting on a performance.” She notes that it is harder to maintain social relationships when she doesn’t mask. “It’s what I need to do to be socially acceptable.”
As Houle and Lepine-Darwiche both note, masking is very useful in promoting social interaction and protecting oneself, but it also comes with costs, primarily burnout and isolation.
“I’d like to be vulnerable with people, to show them how much I trust them, but at least in the workplace I feel like I can’t do that,” Houle says. Lepine-Darwiche shared about the effects of a day of masking on her personal life, when she would come home and need a three- or four-hour nap just to recoup her energy. “It was really difficult on me and my relationship with my wife and family before I understood that all of my energy was going to masking,” she confided.
How masking affects treatment
If you are “good” at masking and continue to function, this can lead to downplaying how much you are affected by your symptoms. You, essentially, mask to yourself, and your healthcare practitioner, thus contributing to underdiagnosis and a lack of mental health supports, something both Houle and Lepine-Darwiche have experienced.
Masking also affects the level of social support that one receives. For example, when your reply is, “I’m fine,” those in your social circle cannot know that you might need extra support.
In a 2019 Ipsos study of working Canadians, 76 percent of respondents stated that they would be completely comfortable with and supportive of a colleague with a mental illness, but first they would need to know that support was needed.
The descriptor “high functioning” is not part of any diagnosis, but it is a term that captures of the reality of many. If someone imagines those with serious mental illnesses as not being able to get out of bed or go to work, that might be the case. However, for others, such as Houle, Lepine-Darwiche, and myself, we can attest to functioning adequately even when our symptoms are quite severe. Even my psychiatrist has had to learn that seeing me with my makeup done and my work clothes on, doesn’t mean that I am doing well.
Jessica Ward-King publishes under the name The Stigma Crusher to educate others about mental health. For her, this year’s Mental Health Theme is a chance to share more about what it means to mask – and to unmask – in different social situations. Sometimes that is literal – painting on an “I’m fine” face – before washing it off for the day.
Stigma, disclosure, and masking
Stigma – in all its forms – is a big factor influencing the decision to mask. According to sociologist Erving Goffman (1922-1982), those who are neurodivergent or living with mental illness will make a concerted effort to hide their symptoms – or to be “discredited” by others. Even by today’s standards, where conversations about mental health are increasingly common, many people feel reluctant to share. The same 2019 Ipsos survey of working Canadians found that 75 percent of respondents would be hesitant – or would refuse – to disclose a mental illness to an employer or co-worker due to stigma and fear of discrimination.
Goffman and others have noted how most people wear masks in their daily lives, in terms of trying to present themselves in certain ways in certain circumstances, such as on social media or at work. Putting your best foot forward isn’t the same as masking, however, where the goal is to suppress a key part of one’s identity.
For example, I experience this dilemma in another context – one of “coming out” as a lesbian, an identity that I constantly have to choose to disclose or not in a variety of situations. For example, in a conversation I can skirt around my life with my wife by cleverly using gender-nondescript language, but this brings with it a veil of inauthenticity.
Coming out about my mental illness (or not) feels similar. Do I let people in with vulnerability – or not? This is a decision that I am constantly having to make, and the solution varies with the situation, the people involved, how safe I feel, and my impression of how this “coming out” might result in negative consequences.
Chicken-and-egg situation
Without stigma, there would be little need to put on a mask to begin with, but to reduce stigma, there needs to be connections between people with lived experience of mental illnesses and other human beings – so which comes first?
While education, awareness campaigns, commemorative days, and articles like this one are effective to an extent, interpersonal contact is key according to a 2021 study in Society and Mental Health.
This, however, requires people with lived experiences to unmask, one person and one situation at a time. In other words, you need to reduce stigma to allow people to feel safe to unmask, but you need people to disclose their mental illness and unmask to reduce stigma. Chicken, meet egg.
To break that cycle, allies can play a role in creating the conditions where people feel safe to share their challenges and to open up about neurodivergence and mental illness.
For me, this year’s Mental Health Week theme is a call to action – to be my authentic high-functioning, high-performing self, and to also be okay to not be okay.
It’s also about not expending all my energy to maintain a perfectly painted mask, about not just saying “I’m fine” to make sure no one else is uncomfortable, but to feel free to say that I am struggling if I feel safe enough to do so.
When I get home from work and wash off my makeup, I want to have energy left for my family, my hobbies, and my wellness.
Outside of the home, I want to be in a world where I can take off my mask. I won’t be able to brave it every time, in every situation, and with every person – and that’s okay. The mask can be protective when the situation warrants, but little by little, unmasking can make meaningful connections to change minds.
Author: Jessica Ward-King, aka the StigmaCrusher, crushes the stigma of mental illness by being radically open about her experiences living with bipolar disorder.
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One year after the Mental Health Commission of Canada (MHCC) was created in 2007, the non-profit established its Youth Council, a program designed to engage younger adults (18 to 30) in the MHCC’s mission to improve the country’s mental healthcare system. At the time, the Youth Council program was ground-breaking in that it signalled a move towards involving people with different perspectives and lived experience in the project of changing attitudes about mental well-being and removing barriers to accessing mental healthcare treatment.
The MHCC’s Youth Council is, at its core, an advocacy group working to amplify the voices of younger people. It’s run by folks with a commitment to positive change and helmed by Em Alexander and Colbi Mike, the council’s current co-chairs.
Colbi Mike, a young Indigenous mother, documentary filmmaker and law student from the Treaty 6 Territory in central Saskatchewan, is focused on, among other things, dismantling barriers to maternal mental health and the effects of oppression on Indigenous peoples.
Em Alexander, a queer mother of two and First Nations person with European ancestry from Newfoundland and Labrador, is passionate about mental health advocacy, as well as supporting people who have experienced trauma and those facing systemic barriers to accessing quality care.
We asked the Youth Council’s co-chairs to share their thoughts about the challenges facing young people today and how mental healthcare systems can better meet the evolving needs of people dealing with the ever-changing stresses associated with contemporary times.
Acknowledge that challenges for younger generations of adults are unique
Em Alexander and Colbi Mike
Em Alexander: People my age grew up in a very different environment than our parents and grandparents, who didn’t experience the overwhelming influence of technologies like digital media. We grew up with constant exposure to world events, which can have a big impact on young peoples’ mental health and well-being. That difference makes it especially important for mental health programs to include young peoples’ perspectives and input to be successful, engaging and meaningful to the people they serve.
Colbi Mike: Youth today face extra challenges, from our economy to mental health struggles and substance use to systemic racism. Indigenous youth, in particular, carry the burden of intergenerational trauma, and ongoing discrimination and many Indigenous mothers—honestly, I would say all—encounter systemic racism. I guess it’s just a lack of understanding of who we are as Indigenous people and where we are currently in out societal healing.
Bring more young people into conversations about mental health
Colbi says: Youth bring fresh perspective, lived experience, and innovative ideas to the table and, since they’re directly impacted by policies and programs, their involvement ensures that initiatives are relevant, effective, and empowering. Ignoring their voices in the past has led to gaps in understanding our needs. Involving young people not only builds better programming, it also fosters a sense of belonging, leadership, and accountability among young people. I think it’s imperative to involve people who’ve lived in this age of this time, and to empower them with a voice, right now.
Em says: Incorporating the voices of young people is a critical step in program development, particularly for programs that aim to serve youth. The Youth Council was established in 2008, and I consider the MHCC to be a leader in the field when it comes to including young people and people with lived experience in meaningful ways in their program and policy work. It’s so important for young people to be involved in decisions that will impact them.
Give people with lived experience of mental illness a bigger role in decision-making
Em says: It goes right back to the saying “nothing about us without us,” really. If you’re creating or updating policy that is relevant to people with lived experience, then they should be involved in that process from the start. Would you want someone to design support for you without listening to your experience or what you need, or what has or hasn’t worked before? Of course not. To get it right, you need to include lived experience. This is incredibly important in policy work because it can have lasting impacts on services, access, quality of care, and other things.
Colbi says: It’s absolutely critical to hear more from people with lived experience. Policy affects real lives and those impacted should have a seat at the table. People with lived experience have insights that professionals and decision makers might overlook, and their involvement ensures that policies are not only practical but also inclusive. Engagement also builds trust, accountability, and long-term success.
As an Indigenous mother, I have first-hand knowledge in navigating challenges such as barriers, cultural disconnect, and limited support systems. My lived experience helped me approach issues of empathy, cultural awareness, and ensure that programs and policies are grounded in real-life struggles and successes.
Em adds: As co-chair, my lived experience, both personally and as a caregiver, plays a role in my approach. My goal is to approach leadership from a trauma-informed and recovery-oriented lens, and to uplift and value the intersectional identities and experiences that our members hold. It’s been a very meaningful role for me to hold over the last several years and we operate very well as a council with respect, trust, and support.
The next steps include raising awareness, education and funding
Colbi says: Education is essential for reconciliation. Healthcare professionals need to understand the lasting impacts of residential schools, colonial policies, and systemic oppression to provide culturally safe care. While there have been efforts to include this education in some curriculum, the process is slow and inconsistent. Call to action #24 (from the Truth and Reconciliation Commission of Canada’s 94 Calls to Action) emphasizes that this is a priority, but we still need more accountability to ensure all healthcare workers are equipped to support Indigenous patients with respect and understanding.
Em says: From my own experience working at the intersection of non-profit and mental health sectors, there needs to be more support for the mental health workforce. We’re starting to see more awareness when it comes to that problem, but one of the biggest challenges I still see is good people wanting to be able to do more to help but, at a systemic level, not having the resources or capacity to do so. Sometimes this comes down to cost of services, access, wait times, or eligibility, but there’s no shortage of people wanting to support others. I sincerely hope that funding will be maintained for mental health care and related programs and initiatives throughout transitions in political governance.
We all have a role to play when it comes to providing support for people in need
Em says: When people are reaching out for support, don’t assume their identities, or their needs, or experiences – ask them, and listen with the intent to learn. It’s a challenging time right now, particularly for members of the 2SLGBTQI+ community. There are very real threats to safety for our community created by the hate and ignorance outside of our borders—and here in Canada, too. Check in on the people in your life from these groups because they are being targeted right now—BIPOC communities, 2SLGBTQI+ communities, immigrants/refugees, and others—and they need all the support they can get.
Colbi says: Mental health is deeply tied to the well-being of families and communities and yet mothers often face stigma, isolation, and limited access to safe mental health services. It’s important, therefore, to support mothers by investing in accessible and appropriate mental health care, childcare, and transportation.
We also need to keep creating programs that integrate cultural teachings and community support, because, for Indigenous people, healing often comes through reconnecting with our culture, language and communities. Investing in these areas can strengthen resilience and identity for future generations.
Author: Christine Sismondo, PhD, is a historian who writes about social issues. Her work is featured regularly in the Globe and Mail, and the Toronto Star. She is a National Magazine Award winner and the author of several books.
