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Firefighter Steve Jones on the merits of The Working Mind First Responders course
When firefighter Steve Jones first completed his course to become a trainer for The Working Mind First Responders (TWMFR), he was encouraged to share some of what he’d learned with his crew.
“What I thought would be a 15-minute conversation turned into three hours,” said Jones, an acting platoon chief with the Burlington Fire Department. “Guys opened up about serious mental health problems in their families and in themselves, things that I had no idea were going on. That was the moment it hit me — we all know someone who’s struggling.”
TWMFR, which has recently been updated and adapted to a virtual format (until in-person learning can safely return), is designed to build awareness, reduce stigma, strengthen resilience, and encourage mental health conversations among first responders.
Participants are introduced to tools like the colour-coded mental health continuum to increase self-awareness, as well as to coping strategies and resources to better support themselves and each other.
Jones notes that while the material is deceptively simple, its impact extends far beyond the classroom. “Trajectory is one of the most important concepts. One short conversation about mental health, or the moment of courage it takes to say “I need help,” can alter someone’s trajectory forever. That’s what makes this course so powerful.”
A series of double standards
Part of that trajectory shift comes from the course’s emphasis on reducing stigma, which as Jones points out, often manifests as double standards around mental illness.
“When someone returns to work after a back injury, we don’t question whether it’s going to hold up on the job. We trust the process to clear them for duty and move on. But when someone returns after a psychological injury, that implicit trust isn’t there.”
Even more pervasive, he says, is the self-stigma that often comes from admitting one’s own struggles or having sought support — a point he tries to emphasize as a facilitator.
“I’ll ask my group to raise their hands if they think their crew would come to them if they needed to talk, and most hands go up. Then I turn the table, and ask if anyone would reach out to a teammate to share their own challenges, and the response is much different. First responders want to help people, but asking for help is a whole different beast.”
Steve Jones
Saving lives begins at the station
Recognizing stigma as a barrier to support his own department is partly what led Jones to become a trainer for TWMFR. Since then, the course has been rolled out across Burlington Fire, leading to a palpable culture shift (and an increase in employee and family assistance program use) that has resulted in other departments reaching out for guidance.
While Jones’s enthusiasm for TWMFR is largely driven by the positive impact it’s had in his own department, it’s the transformation he sees in his participants that continues to feed his passion. “There’s nothing more rewarding than having someone come up to me at the end who says, ‘I really needed this,’ he explained.
“I truly believe I’ve saved more lives in my five years as a trainer for TWMFR than in my 20 years as a firefighter.”
That sentiment was echoed early on in Burlington Fire’s rollout of the course by a surprise guest speaker — a retired fire captain who had asked to speak to the group at the beginning of a session.
“He reminded us that, as firefighters, we invest hours into training that will keep us safe in the field. There are drills for all types of situations so that when the floor gives out beneath you, all you have to do is call ‘mayday’ and you’ll be rescued. . . . But when you’re struggling with a mental health problem, and it feels like the floor is giving out, there is no ‘mayday.’ By training to protect our mental health, we’re training to save lives.”
As Jones recalls, the message struck a chord with everyone in the room. The retired captain was not only a well-respected mentor, he was someone who had seen the consequences of neglecting mental illness across his career, including losing a teammate to suicide.
“After that day, he came back and spoke to every training group before the start of the course. No matter how many times I heard it, his words hit home and my trajectory shifted a little bit more.”
To learn more about the benefits of TWMFR Virtual for your organization, contact solutions@openingminds.org
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An impossible juggling act
Because the effects of the pandemic are not felt equally, the Mental Health Commission of Canada (MHCC) is turning its attention to populations that are disproportionately affected — including women.
“Women make up the majority of our organization,” said Karla Thorpe, the MHCC’s vice-president of Public Affairs and Organizational Performance. “Every day over the last year, we’ve been hearing from female staff in particular about having to juggle an impossible number of tasks, and we need to recognize that these realities have mental health ramifications.”
Thorpe herself is all-too-familiar with the mental toll arising from the COVID era’s push and pull.
“Personally, this past year was among the most challenging I’ve weathered. I had to move my elderly parents into a care home at the height of the pandemic. With long days of Zoom meetings, followed by caregiving visits in full PPE, there were times when normalcy felt so far out of reach,” she recalled. “Yet, I recognize my own good fortune. The challenge for those who have had to take longer-term leaves or don’t have the luxury of paid time off is even more complex. This is especially true for people without the resources to seek the support they need.”
A disproportionate toll
Women are no stranger to the role of primary caregivers, which is why up to one-third of working mothers have considered quitting their jobs since the onset of COVID. And the weight of leaving the workforce can be a heavy burden.
That’s why the MHCC created a mini-guide specifically designed to support the mental wellness of women who have been sidelined from the workforce, whether by pandemic business closures, caregiving, or other responsibilities.
Liz Horvath, manager of the MHCC’s Workplace Mental Health team, was game to support this resource from the word go. “I’ve walked a mile in those shoes,” she said, referring to a dark time when she was waitressing to support her child as a single mother. “I was studying, working, parenting, and all the time made to feel that my contributions weren’t valued, weren’t worthy. I was considered “just” — as in just a waitress. I was on a treadmill that was grinding me down.
But when I left that work in search of some greater meaning, I was faced with significant barriers despite the valuable knowledge and skills I had gained as a single mother, a waitress, and a student,” she explained. “The constant struggle wore down my resilience and left me in a state of crushing depression, at a time when stigma was very high and access to support services was really limited.”
Recalibrating for mental wellness
Yet there are ways, Horvath acknowledged, to walk a path of unemployment without losing confidence and connection. Equally, there are ways to create some space for self-care, even when the scales are tipped heavily toward workaday realities.
“Staying connected sounds trite, but it’s so important,” she said. “Whatever your area of work, from front-line service to the corner office, there are online groups or forums, volunteer opportunities, career counselling, and online aptitude tests. Embracing these types of connections, when I could, was very helpful.”
Thorpe concurred, adding that, “for women, confidence can be a stumbling block, especially during times of unemployment. That’s one reason we designed this resource to help women reframe their thinking. A gap in a CV is an opportunity to demonstrate experience that was gained outside the workplace. A set of skills we’ve learned in one area can be applied to another — because it’s our capacity to learn and grow that’s important.”
The mini-guide is an easy-to-use reference guide, with practical tips and resources on everything from mental health supports to financial literacy.
“In the winter, the MHCC had created a tip sheet to help employers support and welcome women returning to work after an absence,” said Horvath. “But we realized there was still an important gap to fill. What about the wellness of women during that time away? How can we make sure they feel supported?”
Supporting each other
For Thorpe, being a woman in a leadership position comes with an added responsibility. “As a female leader, I want to help break down the systemic barriers women continue to face in the workplace. Too often women take themselves out of the running for a job without even applying. Or we don’t ask for mentorship or we fail to negotiate a raise. As leaders, male and female, some of the onus for changing our systems, processes, and cultures at work to accommodate the realities of women’s lives — so we get the best possible talent — is on us.”
Horvath agrees, and is hopeful that resources like the new mini-guide will help women see their futures in a brighter light. “Taking an absence from the workforce comes with all kinds of challenges, but it also brings fresh opportunities. With the right support, the ending of one chapter can lead to a better one. I know it did for me.”
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MHCC welcomes new president and CEO Michel Rodrigue
Michel Rodrigue
Change is never easy, conceded Louise Bradley, C.M., outgoing president and CEO of the Mental Health Commission of Canada (MHCC).
“But that doesn’t mean it isn’t necessary,” she said from her home office in Newfoundland, where she’s been working throughout the pandemic.
“I spent a lot of time reflecting as I went on early morning hikes. Moving on from the MHCC wasn’t a decision that was taken lightly . . . but once it was made, it did feel like a weight had lifted.”
Bradley has been championing the advancement of mental health for her entire career, beginning with her earliest days as a nurse on a psychiatric unit. “People expressed sympathy, implying that I wasn’t up to snuff for a real nursing job,” she said, laughing. “I can see the humour in it now, but at the time it was cutting.”
For over a decade, Bradley has brought her expertise on direct health care provision and administration to the MHCC leadership table, and that effort has borne fruit.
“I look at where we are today, and my heart really does swell with pride at our collective achievements. Truth be told, that’s when I knew it was time to step aside. I never wanted to leave a job undone, and with a new strategic plan in hand, deeply committed leaders and staff, and exemplary partnerships, it’s time to pass the baton to someone who is ready to tackle the next ten years.”
Passing the baton
MHCC board chair Chuck Bruce conceded that Bradley’s decision took him by surprise . . . at first. “But then I reflected on what it means to be a CEO for a full decade. And Louise went above and beyond running the place. She took it upon herself to speak to countless audiences in Canada, and around the world, to change minds, to open hearts, to open doors. And that level of commitment is what you see reflected in the strategic plan the board envisioned.”
It is appropriate, then, that the architect of the new plan — Answering the Call — would be the person stepping into the role of president and CEO on March 24. As vice-president of Public Affairs and Organizational Performance, Michel Rodrigue has been walking in lockstep with Bradley for the last five years. In that time, he has helped to create a culture of forward-thinking innovation that has led to key breakthroughs like championing the Stepped Care 2.0 e-mental health initiative and knitting together communities in the name of suicide prevention with the national Roots of Hope program.
An eye to the future
“When we were building this new plan, I didn’t know how the future would unfold, but I did know that the board had a bold, ambitious vision that built on the foundational pillars Louise embedded in our organizational culture,” said Rodrigue. “And now, as we embark on the next decade, we can take the knowledge we gain, year over year, and compound our progress.”
Rodrigue, a CPA by trade, with wide-ranging executive leadership experience, believes his greatest asset is curiosity. “I am someone who loves learning, loves challenging myself, and loves being challenged. I went back to school later in life to complete an executive MBA and become a chartered professional accountant, and I found that experience energizing. Too often we become entrenched in our identities, but I think we have to constantly revise our thinking.”
In good hands
Bradley believes Rodrigue’s open-mindedness will serve him well. “The mental health landscape is constantly changing. Best practices are always emerging. You can’t afford to be static in your thinking, and Michel is someone who is willing to listen to the experts and is unafraid to change course.”
Bruce agrees. “We had an exemplary list of candidates, as you might expect for an organization as well respected as the MHCC. But Michel rose to the occasion time and again in the process. He not only understands the organizational culture and helped set us on a course for the next decade, he also has the kind of questioning mind-set that goes hand-in-glove with quiet confidence. You cannot run this organization without a willingness to bring a learner’s mind to work every day.”
As the MHCC begins a new work plan with a new president and CEO at the helm, Bradley for her part, has one last question.
“I wonder what great things the organization will do next?”
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Stephanie Knaak
In conversation with structural stigma researcher Dr. Stephanie Knaak
Stephanie Knaak has been studying structural stigma for the better part of a decade. She’s an expert in the foundational policies, laws, and practices in our health-care system that put people who live with mental illness at a disadvantage.
“But that doesn’t mean I have all the answers,” said Knaak from her home office in Golden, B.C., where she’s been working since the onset of the pandemic. “Sometimes I get overwhelmed. It’s a beast of a challenge to tackle because some people can’t see structural stigma, and others are suffocating under its weight. It all depends on where you’re sitting.”
When asked how something so invisible to some and dead obvious to others can be addressed, she paused. “In health-care settings, if you aren’t measuring it, it just doesn’t matter. We’ve got to show providers and administrators the true cost of these blind spots by giving them tools that can bring them to light. Then, we’ve got to use the evidence of those gaps to make a case to close them.”
New frontiers
Knaak and her colleagues at the Mental Health Commission of Canada (MHCC) are charting new territory. For example, they are mapping out the topography that people living with mental illness must face when seeking basic physical health care.
“A person’s mental health may have nothing to do with the reason for their visit, but it becomes a huge barrier to getting timely and proper diagnosis and treatment — because physical complaints are often dismissed or seen only through the lens of their mental health diagnosis. The system doesn’t have the right checks and balances to make sure these kinds of blind spots get caught,” she explained. “This is the equivalent of a mountain, and we’ve got to identify it on a map so we can point to it and say, ‘How are we going to scale this?’”
Unlike the early explorers who were blind to their own limitations, Knaak approaches this new body of research with the humility born of experience.
“We’re finding out new things every day. This area of study is massive. It’s almost intimidating to put a stake in the ground, because its constantly shifting beneath you. But someone has to be first. Someone has to say, “OK, we have to get better because people are bearing the consequences of system inertia. We’ve got to get the wheels in motion. Even if we have to backtrack and start again, we’ve got to get moving.”
If you build it . . . they will come (around)
Knaak believes that by forcing policy change in health-care settings a different attitude will follow. “Take handwashing, for example. Because it has standards for when, where, and how to do it, hospitals measure it so they don’t fall outside the protocols. If we want things to change for people living with mental illness, we need to write protocols that explicitly name and address the behaviours that are manifested by structural stigma.”
“In a way, it’s easier to change the mind of one individual,” said Knaak, who has worked to develop many of the MHCC’s Opening Minds anti-stigma training programs. “But what excites me is the ripple effect when you’re doing work to change the entire culture of care. It has the capacity to improve the experience of every person who walks through the door.”
Putting a stake in the ground
Up next for Knaak and the structural stigma team is creating the tools to help organizations plot a course toward improved care. This could include structural stigma report cards, client satisfaction surveys, and other measurement tools.
“It’s all in the service of identifying the barriers and pitfalls that can create such dispiriting and damaging experiences for people when they are vulnerable and at their place of greatest need,” said Knaak. “Essentially, we’re asking people who are working hard within a flawed system to unlearn what they’ve been conditioned to believe and to be open to doing things differently — not only as professionals, but as people.”
Knaak is referring to the way stigma is so imprinted on the DNA of organizations — as well as our own. “It’s like stigma at the cellular level, literally. It’s thrumming below the surface all the time, and it can erupt at any moment with disastrous results.”
When the professional becomes personal
Knaak is familiar with what that looks like. She has watched a loved one try to get help from a system that is not designed to effectively address the needs of a person living with mental illness.
“It’s ironic that my work came home to roost. All the things I was documenting as a researcher were laid bare. I had data points and key informant interviews and hundred-page reports. They all said the system was broken. But when you experience it up close, how it sometimes impedes the healing process more than it helps it along. . . . For me, this work has now become more personal, and more imperative, than ever before.”
When asked what success looks like, Knaak’s answer is surprisingly simple. “I often hear my family members who’ve experienced cancer laud the system for the timely, effective, compassionate care they received. All I want is the same thing when someone experiences mental illness.”
“Surely,” she said, “that’s not too much to ask?”
This is the third in a three-part series on structural stigma. Previously we talked to a care provider and a service user.
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MHCC launches virtual course — delivered by first responders, for first responders
Pauline Meunier
For Pauline Meunier, a paramedic of 26 years, it took a trip to the allergist to give her anxiety a name.
“What I thought were allergic reactions turned out to be panic attacks,” she said. “Before I was asked about anxiety, it never occurred to me that my mental health could be the problem.”
That difficulty in recognizing one’s own mental injury or illness, she explained, is common among first responders, as is the undertone of stigma or self-stigma that may prevent someone from seeking help.
Now, as a training and delivery specialist with the Mental Health Commission of Canada’s (MHCC’s) Working Mind team, and a facilitator for the new The Working Mind – First Responders (TWMFR) Virtual course, Meunier is helping to break the cycle.
“First responders know that taking care of their physical health is critical to performing at their best,” she said. “Through this training, we want them to understand that caring for their mental health is equally important.”
The freshly revamped course is now being delivered virtually (until it becomes safe again to do so in person). Using an evidence-based approach, it gives first responders the knowledge they need to self-assess and also to talk about mental health — including strategies to help them cope with challenges and resources to seek out when they need support. To maximize the material’s resonance, its scenarios and terminology are tailored to each relevant group (e.g., paramedics, firefighters, police), and the course’s facilitators all come from first responder backgrounds.
A mental health pulse check
For those who work in the helping professions, especially in the extreme situations faced by first responders, it can be easier to recognize distress in someone else than in oneself. But the course’s mental health continuum model offers a way to help them do so. It matches a range of thoughts, attitudes, and behaviours to a colour-coded mental health spectrum: green (healthy), yellow (reacting), orange (injured), and red (ill).
For Meunier, that continuum — in the form of a wallet card — led to her own personal breakthrough.
“While attending a presentation, I was staring at the miniature mental health continuum on my table when it struck me — I was deep into the orange and I needed help,” she said. “As paramedics, we aren’t good at putting ourselves first. But as I learned first-hand, the continuum can be an effective tool for all first responders to check in with themselves and recognize when they need extra support.”
Leveraging language
One new component in the updated course is an emphasis on language. Based in part on the MHCC’s Language Matters guide, participants learn the value of using person-first language (where appropriate) as a powerful way to reduce stigma around mental illness and substance use.
Based on research showing that labels like “crazy” or “addict” can perpetuate stigma and discourage help seeking, participants are encouraged to use language that paints a more accurate picture by putting the human first and the condition second; for example, “this person is living with a mental illness or an addiction.”
“In the field, it’s easy to rely on labels as a sort of shorthand for easier communication,” Meunier explained. “But if we make an effort to use respectful language, we can help overcome stigma rather than contribute to it.”
The way forward
While there is still a long way to go in reducing stigma and establishing parity between mental and physical health among first responders, Meunier is hopeful for the future.
“If there’s one group who cares about excelling at their jobs, it’s first responders,” she said, adding that with the help of courses like TWMFR Virtual, the idea that mental wellness is part of that success is gaining traction.
“The most rewarding thing about facilitating these courses is receiving messages from participants who say things like, “it all makes sense now” or “this explains so much.” Those moments of realization can be life changing — I know it was for me.”
To learn more about the benefits of TWMFR Virtual for your organization, contact solutions@openingminds.org
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New MHCC resource aims to support women sidelined from the workforce
Even before the onset of COVID-19, statistics told a story of a persistent unequal division of labour, with women shouldering more unpaid housework and caregiving responsibilities than men.
As quarantine measures began, the toll on women only deepened — both at home and at work. One recent study found that mothers were more than twice as likely as fathers to be worried that their work performance was being judged negatively because of caregiving responsibilities.
“The statistics are stark — yet not surprising if we look at the context,” said Louise Bradley, the Mental Health Commission of Canada’s (MHCC’s) president and CEO. “Not only am I concerned about losing — literally overnight — the hard-won progress toward equality that was gained over decades, I am also worried about the mental wellness of women who are being asked to make an impossible choice.”
According to a recent national survey, one-third of working women have thought about quitting their jobs because they are juggling home-schooling, homemaking, parenting, and professional responsibilities.
For those who do leave their jobs, re-entering the workforce can lead to a fruitless game of catch-up.
A new resource
When it’s time to go back into the working world, women are confronted with emotional and practical challenges that their male counterparts rarely have to consider. To assist employers who wish to support women employees in making a strong return to the workforce — while keeping mental health front and centre — the MHCC has created a new resource.
The recommendations emphasize the importance of things like flexibility, workload management, and empathy, regardless of the reason for needing time off.
“Few workplace resources account for the unique challenges faced by women, and that’s a problem,” said Tiana Field-Ridley, an MHCC implementation specialist on the Workplace
“My mother is contemplating a return to work after spending her prime earning years supporting her elderly parents. It just illustrates that women may need support making the transition in and out of the workforce more than once in their lives. Our minds may turn to gaps associated with maternity leave, but we’ve got to broaden our thinking to span a woman’s entire professional life.”
In addition to supporting women’s mental wellness through the transition back to work, the new resource encourages employers to be aware of implicit biases that may be limiting their hiring pool and work to strengthen policies so they uplift women.
“We’ve got to re-educate employers about gaps on resumes, for example,” said Liz Horvath, manager of the Workplace Mental Health team. “A gap shouldn’t automatically be interpreted as an alarm bell. It might have also been an opportunity for that person to explore and gain new skills while tending to someone else’s needs. Caring for a sick relative can lead to incredible growth in a person’s compassion or organizational skills.”
As Horvath points out, being able to reframe a woman’s expertise following an absence has great value, especially when you consider that 62 per cent of the jobs lost between February and March of 2020 were held by women.
“Many of the jobs in schools, child-care centres, hotels, restaurants, and shops were gendered roles. But that in no way diminishes the skills required to pull them off,” she said.
Start with transparency
For employers, welcoming women back to work can also include postings for new jobs.
“Attracting great female candidates can be greatly enhanced by transparency in job postings, which could include anything from being vocal about diversity to enthusiastically promoting flexibility,” said Horvath. “That could also translate into offering on-the-job training, in recognition of the fact that women will often take themselves out of a race before it has even begun.”
“I’ve seen this throughout my entire career,” added Bradley. “That adage about a woman seeing a job posting and choosing not to apply because she only has 80 per cent of the qualifications, whereas a man may throw his hat in the ring even if he’s got significantly less, is trite because it’s true. So, as organizations we’ve got a responsibility to be as inclusive as possible lest we alienate great contributors.”
Above all, said Field-Ridley, the best way any of us can support a woman who is returning to the workforce is to build her up. “It takes a lot of confidence to return to work after an absence,” she said. “With the right approach, employers can create a supportive environment for women to flourish and meet their full potential.”
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New community-based research explores cannabis consumption during pregnancy and parenthood
Late last year, the Mental Health Commission of Canada (MHCC) announced its funding of 14 community-based research projects to explore cannabis use in priority populations. All the initiatives address important and often overlooked groups in research, including youth, immigrant, refugee, ethnocultural, racialized, and Indigenous populations. One such group is pregnant individuals and parents, the focus of a unique research project based in Ontario.
A fresh perspective
“To date, research about cannabis consumption during pregnancy and parenthood has been clinical in nature, emphasizing cannabis as a ‘risk’ and its association with ‘substance abuse,’” said lead researcher Allyson Ion. “Our team is taking a different approach by focusing on the experiential knowledge of pregnant individuals and parents. As people who consume cannabis, they are at the heart of the issue.”
In addition to people with living experience, the research includes providers in perinatal care and child welfare, along with other health- and social-care leaders who can share first-hand insights into the kinds of tools that may be needed to strengthen direct care practices and policies.
For Krista Benes, director of the MHCC’s Mental Health and Substance Use team, this inclusive approach is at the core of what sets community-based research apart. “The lens of first-hand experience is invaluable,” she said. “If we really want to understand the relationship between cannabis consumption and pregnancy and parenting, who better to involve than the individuals who live those realities every day?”
Expanding the conversation
Despite cannabis being the most commonly consumed substance during pregnancy, the stigma surrounding its consumption is pervasive. That stigma, the researchers fear, may hamper opportunities for honest and helpful conversations in health- and social-care spaces and create barriers for individuals seeking out information and support.
“Many pregnant people and parents continue to experience surveillance around their cannabis consumption because of broader notions about what it means to be a ‘good’ parent,” said team member Saara Greene. Yet current research on the effects of cannabis consumption during the perinatal period is ambiguous, and health-care guidelines and practices are largely based on laboratory research using animal models and controlled clinical studies.
While the research team acknowledges that cannabis may not always be “harm-free,” they say more research is needed to determine the relationship between cannabis consumption and perinatal and parenting outcomes — as told by the parents themselves.
“There is a significant lack of research looking into the intentions and desired effects of cannabis consumption during the perinatal period and while parenting,” said team member Kelly Pridding. “We believe that more holistic, participatory, and community-based research approaches will go a long way toward dispelling myths and misconceptions and expand this important conversation.”
A knowledge-to-action framework
The initial phase of the research involves a series of dialogue-based sessions exploring different experiences and perspectives among the stakeholders on the intersections of cannabis, pregnancy, parenting, and mental health. Using a knowledge-to-action framework, researchers will then turn the feedback from those conversations into practical tools and recommendations.
“The most exciting thing about this work is the potential to create real-world practice and policy applications,” said Ion. “Our goal is to develop concrete tools, practice approaches, and/or policies that can be applied in perinatal care and child welfare practice settings, ultimately strengthening the quality of care and reducing cannabis stigmatization in the process.”
As Benes sees it, this project represents an important new chapter in cannabis research. “We still have a long way to go in closing the knowledge gap between mental health and cannabis consumption in priority populations,” she said. “But every time we include those populations in the work that is ultimately meant to serve them, we make that gap a little bit smaller.”
With special thanks to research team members Allyson Ion, Saara Greene, Theresa Kozak, Gabrielle Griffith, Kelly Pridding, Claudette Cardinal, and Gary Dumbrill (in collaboration with the McMaster Health Forum). Team members wanted to specifically express their gratitude for MHCC funding and also acknowledge the financial support received from the Social Sciences and Humanities Research Council and the Canadian Centre on Substance Use and Addiction.
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Samaria Nancy Cardinal and the cost of neglecting recovery
Samaria Nancy Cardinal learned two important lessons at her father’s knee: the power of persistence and the importance of mustering courage in the face of oppression.
Those lessons have served her well on a long and winding journey to recovery from mental illness. When asked about how she became a patient advocate, she paused, burdened by the weight of her response.
“I lost 15 to 20 years of my life because of misdiagnosis and ineffective treatment,” she said from her home in Calgary, where she will graduate with a diploma in social work this spring. “I was labelled bipolar, and when that happens it may as well be tattooed right on your forehead. Within the system, you cease to be a person and are defined solely by your illness.”
For Cardinal, separating one’s humanity from one’s disease is anathema to her Indigenous heritage.
“We see people for all of what they are — their physical, emotional, mental, and spiritual selves are inextricably linked. You can’t understand why someone is experiencing symptoms like mine if you simply tick boxes from a medical manual. You’ve got to be willing to dig a little deeper, to ask ‘why’?”
A failure to appreciate
But, as Cardinal pointed out, that digging takes time, and our health-care system is built to prioritize the speed of diagnosis, rather than the value of achieving recovery. She says it’s one of the many ways the very structure of care needs to change.
As the daughter of Douglas Cardinal, the first Indigenous architect in Canada, the metaphor she teased out is no surprise.
If a house is riddled with toxic mould, she said, you wouldn’t slap pretty yellow paint on the walls and call the problem sorted. To make that house safe and livable you need to rip out the rot and rebuild it from the studs.
In the same way, she argued, the health-care system’s twin crises of unconscious bias and discrimination need to be named and remedied — with no time to waste.
“My father couldn’t get his degree in Canada because of racism. It’s true that he didn’t let discrimination crush his dreams. He went on to study at the University of Texas in Austin and became one of this country’s most celebrated names in the field,” Cardinal said, pointing to achievements like the Canadian Museum of History. “But his talent only underscores the potential we’re wasting if we’re pushing people down rather than lifting them up.”
Finding the exit
She understands first-hand how people can spend years on a quest for mental health support, living a half-life in the shadow of an illness, unable to claim their rightful place as contributing members of society.
“I can never get back the time I lost,” said Cardinal, who became emotional as she reflected on all that was taken from her. “But what I can do is try to be part of rebuilding a system that puts recovery at its centre.”
Helping others has become her own North Star as she strives to advocate for a system where symptoms are not evaluated without examining their root causes. It was this motivation that led Cardinal to be part of the Mental Health Commission of Canada’s efforts to dismantle the barriers to care created by structural stigma.
“For the record, my bipolar diagnosis wasn’t accurate,” said Cardinal. “I was pumped full of medication, with the dose ramped up time and again because it wasn’t working. Can you imagine treating someone for cancer, discovering their tumour is continuing to grow, and the medical team refusing to change protocols? There would be a hue and cry.”
But for years, there was no such outrage for Cardinal.
She walked a seemingly endless, dark, lonely tunnel without any sign of an exit. The light finally appeared when her symptoms were correctly diagnosed as post-traumatic stress disorder, and she was finally able to access the tools needed to tame her trauma.
Seeing and hearing others
Despite her own experience, or perhaps because of it, Samaria is determined to be the light for others.
“You can’t imagine how desperate you can feel when no one will listen, when no one will believe you, when you’re dismissed and disregarded time and time again.”
Cardinal now plans to pursue an advanced degree in social work, and her agenda is a simple one.
“When I see someone sit down across from me, I will see the person first. Period. I will give them what I was denied: recognition of their humanity. And in that small way, I will be working to rebuild something that’s broken.”
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Ambitious 10-year strategic plan aims at transformational change in Canada’s mental health landscape
For Chuck Bruce, board chair of the Mental Health Commission of Canada (MHCC), the need to invest in mental health isn’t a question — it’s an imperative.
“I’ve worked with tangible investments my whole career,” said Bruce from his home office in Newfoundland and Labrador, where he runs the province’s largest public sector pension fund. “I typically see a return in terms of dollars and cents — but you can’t put a price on mental wellness.”
That’s why Bruce, together with the MHCC’s board of directors, set out to draft a blueprint that could help renovate a mental health system with dangerous gaps and cracks still running through its foundation.
Building on past successes
“Answering the Call isn’t prescriptive,” he said, referring to the MHCC’s freshly released 10-year strategic plan. “It’s a bold, ambitious vision to uplift the voices of lived experience, enhance co-operation across our many partnerships, and dig into those areas that have been overlooked far too long. We cannot afford to stall the progress on mental health promotion, mental illness prevention, and supports and treatments just as we are hitting our stride as an organization.”
The new plan is supported by three pillars: Inquire, Inspire, and Improve. For Bruce, “they are the lifeblood of what we do at the MHCC: We open minds by seeking out the best research and disseminating it. We open hearts by combating stigma in all its forms — including structural barriers (that are as invisible as they are dangerous). And we open doors with improved access to services through cutting edge demonstration projects.”
The right frame for growth
“As a board, our job isn’t to tell the experts who make up the MHCC’s leadership and staff how to go about creating this change. For the same reason, I wouldn’t tell a builder where I wanted load-bearing walls or how to engineer my bathroom. Instead, I might say, I want an open concept home with lots of light.”
In the new plan, the MHCC’s board has left plenty of room for the creativity, responsiveness, and entrepreneurship that have been a hallmark of the organization’s first decade.
“When I first became acquainted with the MHCC, on their workplace advisory committee, my knowledge of the organization’s footprint was reasonably narrow,” said Bruce. “Many years later, I’ve come to realize that, while we’re a relatively small group, we’re spotting and plugging holes at every turn. From community-based suicide prevention to creating mentally healthier university and college campuses or delivering resiliency and anti-stigma training, we make use of every last funding dime to create the kind of society that reflects our shared ideals — recovery chief among them.”
The road ahead
When asked what success might look like for the 10-year plan, Bruce paused. “I don’t want to predict where this plan will lead us because I believe in the power of compound knowledge.”
The idea is built on the investment principle that dollars increase over time through the strength of compound growth. “It’s the most powerful tool we have to create wealth,” he said. “And reinvesting in the knowledge we gain is the most powerful means to create transformational change.”
For Bruce, that change is within our grasp — and always has been.
“When my mother was diagnosed with breast cancer 25 years ago, my father didn’t want it discussed. It was family business, and it was private. Period.”
On reflection, Bruce suspects that shame played a role in his father’s perception of breast cancer. “And he wasn’t alone in that. But over the years, we’ve seen the Run for the Cure gain momentum and grow, we’ve seen the CN Tower light up pink, we’ve seen speciality appliances and lipsticks with a portion of proceeds going to breast cancer research. And the implicit message in all of this is that there is no shame. I’d say it has worked for many health issues, but we aren’t there yet when it comes to mental illness.”
Measuring progress
If the MHCC’s strategic plan is successful, Bruce said, there will be similar markers along the way.
“We’ve got to celebrate the victories. The e-mental health interventions that hurdle geographic barriers. The standards that are changing how we study and work. The Mental Health First Aid program that’s trained more than 500,000 people in Canada (and counting). Each of these is narrowing a gap or filling a crack. Building a solid foundation.”
And until that work is done, Bruce is convinced that by reinvesting our knowledge to open minds, hearts, and doors, there will be a marked net profit.
“I’m a numbers guy, after all,” he conceded. “We’ll be measuring our returns and reporting on progress to our key investors — and that’s every single person living in this country. Because mental health . . . matters to all of us.”