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I was driving my car down the street, heading to a movie with a friend, when all of a sudden: WHAM! A pothole. My tire was in there before I could react, and I don’t know what it did – bent my alignment or twisted my suspension or something (can you tell I’m no mechanic?) – but the next thing I know, I am stranded by the side of the road and being towed to the shop, facing a very hefty bill and a long process just to make her roadworthy again. And I missed my movie.
I feel like my life with a mental illness is like that sometimes. I can be cruising along just fine when some bump in my path derails my whole journey leaving me miffed, frazzled, phoning for help and not really knowing what is going on, missing the things in life that I enjoy, and facing a long (and often expensive) road to recovery.
Now, if you’ll indulge me in sticking with the car metaphor for a while, no amount of oil changes, brake jobs, or filter changes were going to prevent me from hitting that pothole or from my car getting damaged. And that, I propose, is the difference between mental health and mental illness.
Mental health is the general running of my car. I can take care of it – get regular services, change the wipers, fill the reservoirs, change the filters, and keep it clean – or not, and so, the general condition and running of my car can be good or not. Mental health is just like that. We can do the things we need to do to keep ourselves in tip-top condition or neglect our self-care and just barely keep running on fumes.
Mental illness is what happens when something actually goes wrong with my car – it breaks down or gets damaged. Poor maintenance can contribute to things going wrong, to be sure, in both cars and mental health. But sometimes, those (literal or figurative) “bumps in the road” break an axle and send you calling for help and needing care before recovery can happen. They can come out of the blue (like my pothole) or out of a longer, more drawn-out process of becoming worn down (say, wearing out your brakes), but either way, a trip to the professionals for some help is the result.
I mentioned the expense of getting my car fixed by a professional mechanic. Sometimes I can call my dad, or a friend, to come and help me – tweak something, fill a reservoir, change a fuse, that sort of thing. But sometimes, the only way I am going to get my car to run again is to take it to the mechanic. That is sort of frightening and not always accessible – sometimes, I can’t afford either the time or the money it will take. Getting help for my mental illness is like that too. It takes time, and, in the case of private psychotherapy and prescription medication, it can have significant costs. And not everyone can afford it.
No metaphor is perfect, and this one, too, cannot be taken too far or too literally, but it can be helpful to think through the differences between mental health and mental illness and how they are connected.
I missed my movie, but my friend picked me up from the shop, and we got takeout and streamed TV instead. Then I dusted off my bike and made it to work the next day – with sore legs, but successfully. Having my car break down wasn’t the end of the world, and with some time, money, and effort (which I am privileged to be able to invest), I got my car back on the road. My life with mental illness is like that, too – with the help of friends and family, I keep living life (not without hiccups and disappointments but living it nonetheless!) and eventually end up back on my road to recovery.
Author: Jessica Ward-King
BSc, PhD, aka the StigmaCrusher, is a mental health advocate and keynote speaker with a rare blend of academic expertise and lived experience. Equipped with a doctorate in experimental psychology and firsthand knowledge of bipolar disorder, she’s both heavily educated and, as she likes to say, heavily medicated. Crazy smart, she’s been crushing mental health stigma since 2010.
Estimated reading time: 3 minutes
This resource was published in 2023. The data may be out of date.
Years ago, my Roman Civilizations professor began the course by having people shout out things from the Romans that we still use today. Students called out things like cement, roads, and the [Julian] calendar. After a while, he told us to think smaller. No matter what we said, it wasn’t small enough. Smaller, smaller, smaller.
So, what’s the very small thing we can thank the Romans for? Our alphabet.
If you’re reading this, you probably use the same alphabet as me – the Roman alphabet. But what you probably don’t use is the same font.
When we were working out our new brand, we knew we wanted a new font. We wanted an accessible font. When I went looking for one, what I didn’t bargain for was how many fonts would fail a simple accessibility test.
Note: While we strive to make our content as accessible as possible and we regularly test our website to make sure it is WCAG AA or AAA compliant, we know we aren’t perfect. If you have any suggestions on how we can be more accessible, please send them to digital@mentalhealthcommission.ca.
Even if you are unfamiliar with the accessibility test, you’ve probably seen text where the capital ‘I’ looks identical to a lower case ‘l’.
Add one more symbol, and you’ve got the test. It’s called the I – l – 1 test.
I – l – who?
This test is exactly as simple as it sounds. Go ahead and test the default font in your texts or email. Type an upper-case I (eye), a lower-case L (el), and the number 1 (one).
Do they look suspiciously similar? Maybe like this:
Yeah.
You might be thinking that you can still tell the I and the l apart. And if you can, that’s great. But for people with visual disabilities, it isn’t so easy.
And let’s say that you are reading content from an organization that uses a term like … oh, let’s just choose one at random … “mental illness” a lot, that I-l confusion can be a real sticking point.
For accessibility, think smaller
The connection between visual and learning disabilities and mental health is closer than you think. In our own research, we’ve found that 25-50% of individuals living with chronic disease will experience depression.
According to the Canadian National Institute for the Blind, an estimated 1.5 Million Canadians identify themselves as having sight loss. In a 2021 CDC study, it was reported that 1 in 4 adults with vision loss reported anxiety or depression.
According to the International Dyslexia Association, 15-20% of the population has a language-based learning disability. Dyslexia is the most common cause of reading, writing, and spelling difficulties. It’s also associated with anxiety and depression.
Given these numbers, it’s pretty much guaranteed that some people interested in mental health and mental illness also have visual or learning disabilities. In both cases, an accessible font can make it easier to process information. It’s only one part of how we make content accessible, and it’s a small one, but it turns out that it’s an awfully important one, too.
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Getting started on a new plan for meaningful change
“I used to believe I was a bad person trying to be good,” says Steven Deveau, executive director of the 7th Step Society of Nova Scotia, a peer-run organization offering support to individuals who’ve been incarcerated. “My mindset changed when I realized I was a sick person trying to get well.”
As a person with lived experience of criminal justice involvement, Deveau’s sentiments could be widely shared among those who interact with the criminal justice system. Among federally incarcerated individuals, 73 per cent of men and 79 per cent of women meet the criteria for one or more current mental health disorders. Such statistics point to a need for increased access to quality mental health services, both within corrections and the community, as well as other prevention and early intervention supports like housing and education. As with all mental health concerns, it’s critical to ensure that people get help when they need it. Yet tangible progress toward these goals has so far been wanting.
Not just another report
“People ask me for my opinion. They ask, ‘What can we do to make things better?’” says Mo Korchinski, executive director of Unlocking the Gates Services Society. “And then it sits on a desk, and it stays in a report. I just want to see action.”
Inspired by this and other calls to produce meaningful change, the Mental Health Commission of Canada (MHCC) is developing an action plan for Canada to support the mental health and well-being of people who interact with the justice system. It draws on the expertise of those with lived and living experience, along with other experts who have highlighted these issues for years. The action plan also relies on relevant work from the past two decades — including the MHCC’s 2012 Mental Health Strategy for Canada, which lists criminal justice as a priority — and what is currently being done to focus on actions capable of implementation. The scope of this national project will be broad and comprehensive, including a focus on upstream prevention and early intervention, structure, law reform, and system transformation, and an assessment of mental health supports for all types of criminal justice involvement, from first contact with police to community reintegration and every stage in between.
Inside the system
“I articled in a criminal court duty counsel office, and in that role I immediately recognized the intersectionality of mental health and the justice system,” says A.J. Grant-Nicholson, principal lawyer with Grant-Nicholson Law and project adviser for the action plan.
A.J. Grant-Nicholson
“All too often, I saw accused persons with cognitive challenges, trauma, psychiatric illness, and/or substance use and mental health concerns that related to their criminal charges. Quickly, I deduced that the justice system was the system of last resort — and sometimes the default system — for persons with mental health-related issues,” he says.
Grant-Nicholson’s career has long been focused on the topic. Following his articling program, he worked as a mental health staff lawyer at Legal Aid Ontario, the first position of its kind in the province. There, he represented clients who came before the Consent and Capacity Board and acted as duty counsel at a forensic psychiatric hospital as well as in mental health court.
“I observed that the justice system was not an ideal place to remedy mental health conditions,” he says. “Defence lawyers, prosecutors, justices of the peace, and judges are not clinicians. Criminal law is a blunt instrument that is limited in its ability to provide therapeutic support for accused persons with mental health-related needs.”
Grant-Nicholson acknowledges that there is “increasingly more mental health support in criminal courts, such as having a designated mental health court where accused persons can be connected to mental health workers and mental health-related programming.” However, he finds that “the availability and overall level of support is not consistent across all jurisdictions — and sometimes, accused persons are not aware of the mental health supports available to them.”
As a legal representative for detainees, Grant-Nicholson has seen a significant portion of incarcerated people with serious mental health and/or addiction issues, and he finds the intersection between mental health and the justice system readily apparent in detention facilities.
“It has been my experience that correctional institutions are suboptimal for mental health recovery and that incarceration itself exacerbates mental illness,” he says. “I have also seen the frequent pattern of clients with mental health conditions backsliding once they are released from detention and, subsequently, their almost inevitable re-entry into the justice system. This is often due to barriers in accessing health and social services in the community and/or finding suitable housing when they are discharged or released.”
Seeing these gaps, Grant-Nicholson is seeking to make meaningful change. “My hope is that the action plan will provide stakeholders with insights so the justice system will be better equipped to support mental health, and over time, fewer people with mental health conditions will be incarcerated and the recidivism rate will decrease for this population.”
Grant-Nicholson says that is why an action plan for Canada on mental health and criminal justice is so vital. Deveau of the 7th Step Society of Nova Scotia also sees hope with the project and the people who are part of the committee. It has the power to change lives and change communities, he says.
“I have this saying that I woke up today sober and not in prison — the physical or the mental one — so it’s a good day,” he says. “Some of the smallest things can be the greatest motivators.”
Learn more about the action plan and how you can contribute to its success.
Resources: Mental Health and Criminal Justice: What is the Issue?
Further reading: A Name and a Face: A filmmaker illustrates how easy it is for someone living with mental illness to end up on the street or get caught up in the criminal justice system.
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It’s time to reframe masculinity — one step at a time
Beyoncé and Kendrick were crooning about America’s problems as our truck wound its way toward the trail. My husband, in the driver’s seat, was his usual jovial self as he chatted about music aligning with historical movements. It was 6:30 a.m. My husband is disgustingly and unabashedly a morning person, and we were on our way to an eight km hike along the Gatineau escarpment in Quebec.
Our son — who is in no way a morning person, or a hiker — was in the back seat. He was in charge of the music, and he was there to win a bet.
Despite my more taciturn demeanour, I was happy to be heading out that morning for the anticipated hike. It was the dynamic brewing between father and son that had me feeling cautious. Men can be weird and competitive, even when they’re trying to be chill.
Macho, Macho Man
The machismo started in the parking lot when my son stepped out of the truck wearing a sweater and holding his coffee.
“Leave your sweater and coffee here,” my husband said, which prompted my son to slip on his mutinous face and grip both his coffee cup and his sweater with determination.
Before the world’s dumbest argument over knitwear and a travel mug could unfurl, I said to my husband, “You’re not carrying it or wearing it, so stop trying to control it.” To my son, I added, “It’s going to be hot, and there will be bugs — are you sure you want to bring those?”
I started the hike in the lead spot to avoid the inevitable male jockeying for the alpha position. This is one of the reasons I think men are weird. Why does it matter who goes first? It’s not a race. There are no prizes. Societal norms do men no favours when they inspire them to be dominant.
My son has no idea which direction we are taking, and yet he edges forward to take the lead. My husband, who regularly encourages me to go first when it’s just the two of us, suddenly wants to set the pace. The scene makes me think it’s no small wonder that men’s mental health is in the state it is. How can you seek help when you are convinced you should have all the answers?
Yes, I know, not all men are the same. But the statistics weigh heavily and are unignorable.
In Canada, 12 people die by suicide every day — with Statistics Canada reporting up to 4,500 annually — and men’s suicide rates are three times as high as women’s.
According to research by the Mental Health Commission of Canada, compared to men in the general population, Indigenous men exhibit higher rates of suicidal behaviour, including suicidal ideation, attempt(s), and death. Suicide attempts are 10 times as high among male Inuit youth, compared to non-Indigenous male youth, and compared to heterosexual men, sexual minority men (such as those who identify as gay, bisexual, or queer) are up to six times as likely to experience suicidal ideation.
Boys don’t cry
My husband is brilliant in many ways — including being low-key when big things are happening to him — but I’m starting to wonder if this stoicism by him and our male friends is a mask for bottling emotions, something men are socialized to do. Health issues? It’ll go away on its own. Business problems? No big deal. Family woes? Don’t go there.
When you give it any thought at all, the statistics should come as no surprise. Men living in environments where they are expected to uphold norms such as strength, toughness, and self-reliance can feed into negative beliefs about mental health. Men who adhere strongly to these norms may find it more difficult to recognize signs of mental illness in themselves and others and be less likely to access mental health support.
Reframing “masculinity” to allow greater expression and recognition of emotion and help seeking is a good first step.
A new generation is getting this lesson at Eskasoni First Nation on Cape Breton Island. GuysWork, a Nova Scotia program that started in 2012, bills itself as “a safe space to address masculine toxicity.” It does so by having male facilitators talk with groups of adolescent boys about different issues — things like health care, mental health resources, intimate partner violence, and keys to healthy relationships. Elsewhere, NextGenMen’s Cards of Masculinity box set presents 50 bold questions on topics like objectification and hook-up culture to facilitate meaningful discussions about boys’ beliefs and behaviours.
These organizations are working to change the narrative of outdated masculinity that leaves men feeling isolated, unable to express their emotions, and reluctant to seek help when they need it.
Such collective efforts help de-stigmatize mental illness among men, enhance the quality of health-care provider relationships, and open new pathways for building better personal relationships.
Programs that allow for “shoulder-to-shoulder” action-oriented tasks (think camping, sports, art, auto mechanics), rather than face-to-face talk-focused therapy may help get the conversation going.
Moving forward
Back on the trail, my husband points to the preferred path up a rocky incline. My son, of course, takes an alternate and more complex route. Nope, no obvious symbolism there.
We dragged him out of bed to hit the trail because we were getting worried — he needs to do more to get his physical and mental well-being in order. So, my husband bet him he couldn’t get up early enough to join us.
My husband used to run to keep in shape, but after a series of health issues took running off the table, I started to worry about him. I suspect he did so as well. Then we discovered that, while he could no longer run, he could hike — and the world shifted. Running in the neighbourhood was good, but hiking in the forest was transformational.
Even better, hiking is something my husband and I could do together. Some of our best and most rewarding conversations have happened on the trail. We’ve tackled work problems while admiring wild trilliums and resolved deeply personal issues while glimpsing white-tailed deer. Talking things through is good for us; it makes us reflect more.
As we approach the trail’s end two hours later, my son is in the lead. His sweater is around his waist, his coffee mug is full, and we’re all smiling.
Resource: Men’s Mental Health and Suicide in Canada — Key Takeaways
Further reading: Weaving Through the Challenges: The ABCs of Finding Paths to ACB Mental Health Care
This resource was published in 2023. The data may be out of date.
Estimated reading time: 4 minutes
July is disability pride month.
This means a great deal to me because, for the first time in my life, I am disabled. I developed a debilitating and chronic post-viral condition after contracting COVID-19. My life has changed dramatically and has become, well, unrecognizable to me. I used to hike, walk, and dance. Go out and meet friends. Travel. Now I use a walker. I have a disabled parking sticker. I struggle to do a lot of things that I used to do.
And I am not the only one.
In Canada, 1 in 5 people have at least 1 disability.
That’s 6.2 million people.
In fact, you probably know someone who is living with a disability or chronic illness.
Did you know:
- Persons with disabilities had an average annual income of about $11,000 less (in 2019) than persons without disabilities.
- Persons with disabilities have higher costs that limit their ability to save for the future.
- Working-age persons with disabilities are twice as likely as their peers without disabilities to be in poverty.
- 59% of persons with disabilities are employed compared to 80% of persons without disabilities.
- 50% of persons with disabilities reported experiencing barriers that limit their ability to move around public buildings and spaces.
See more data from Stats Can
Disability is a tricky word. According to the dictionary, disability is:
- lack of adequate power, strength, or physical or mental ability; incapacity.
- a physical or mental handicap, especially one that hinders or prevents a person from performing tasks of daily living, carrying out work or household responsibilities, or engaging in leisure and social activities.
- anything that disables or puts one at a disadvantage.
To me, all these definitions signify less than or a deficiency, weakness, and incapacity. These definitions are not helpful and are not altogether accurate. They tell only part of the story. And they tell it from an ableist perspective.
What is ableism?
“Ableism is the discrimination of and social prejudice against people with disabilities based on the belief that typical abilities are superior. At its heart, ableism is rooted in the assumption that disabled people require ‘fixing’ and defines people by their disability.”
Discrimination, exclusion, and ableism add up to many challenges and barriers for people living with a disability, contributing to:
- negative perceptions about what a person with a disability is able to do
- buildings, workplaces, and work tools that are not accessible
- systemic barriers like rules and practices that exclude and discriminate
Living with a disabling chronic illness
“Why are you fine one day and not another, they ask. I am, in fact, not fine one day. One day my symptoms are manageable, and I am functional, and on other days, they are not, and I am not.”
“On days when I have not slept well, doing simple tasks (getting up, showering, eating) takes up all my energy. I do the best I can and simply do fewer things when my energy is low. On good days, I have enough energy to do one or two tasks. For example, if I am to prepare a meal, that is the only thing I will do that day because, by the end, I’m exhausted. Simple things like phone conversations sap my energy.”
“I’ve lost friends because they didn’t understand that I have limited energy, and so I would have to cancel plans. I don’t look sick, so it’s hard for people to understand. On the other hand, I am now more careful about who is in my friend group. The people who are in my circle of friends are understanding even though many don’t experience chronic pain.”
“Although chronic pain is part of my living experience, it does not define my life. Pain, whether physical or emotional, is a real issue that needs to be acknowledged. The fact that pain is invisible does not make it any less real for those who experience it. Compassion and a willingness to listen and learn from people living with pain will go a long way.”
“Things people say to me:
- You don’t look sick
- Everybody gets tired
- You should get out more
- You’re just depressed
- You need a more positive attitude
Unfortunately, I’ve experienced this denial of my experience quite often.”
What you can do
Whether you live with a disability or not, everyone has a responsibility to promote equity, diversity, and inclusivity of all people.
It starts with some basic principles:
- Accessibility and living barrier-free is a human right.
- Everyone should have an opportunity to participate and contribute.
If you agree with these principles, there are things you can do. You have taken the first step of becoming an ally simply by paying attention. If you would like to take the next step:
- Learn about the lived experience of people living with disability.
- Familiarize yourself with the issues.
- Raise awareness of accessibility by talking about it.
- Stand up for the principles of equity, inclusion, and social justice.
Resources
Council of Canadians with Disabilities
Author: Nicole Chevrier
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If it’s just not working, then don’t ghost. Name your needs.
In a famous episode of the popular TV series Curb Your Enthusiasm, Larry David, the curmudgeonly main “character” (said to be an exaggerated version of himself), decides he must end therapy after seeing his middle-aged psychiatrist at the beach in a thong. When he announces his intention to leave, the psychiatrist seems surprised by the decision and keeps pressing Larry to tell him why it’s over. Larry keeps hedging, then ungracefully bolts.
In reality, the question of why and how to end therapy — to “break up” with your therapist — is for most more complicated than this scenario suggests. Ideally, the decision to move on is mutual, anticipated, and planned. If your therapist is a good fit, and you’ve developed a trusting relationship, you’ll both probably know when it makes sense to do so. It’s also likely that you’ll be able to discuss it openly: you’re feeling better; you’ve worked together toward gaining insights on the challenges that brought you into therapy, you’ve grappled with grieving, worked to improve or let go of toxic relationships, begun to heal from trauma, etc. Now, you both sense that you have the tools and understanding to deal with situations that trigger anxiety or other issues. You’ve grown, your therapist has genuinely helped you, and with respect and goodwill on both sides, the time to part has come.
But what if you and your therapist are not such a good fit? They’re just not “getting” you, and it seems unlikely that you’ll feel better any time soon. While the most frequent advice is to “shop around,” in practice it can be hard to tell your story — in all its intimate, painful details — multiple times to different strangers. That kind of reluctance can tempt you to stick with the therapist you’ve been working with, despite your reservations.
At this point, it’s all too easy to rationalize your way back into familiar territory. Maybe you’re relying on community or employee services, where choices are more affordable. Maybe you have trouble asserting yourself. Maybe you don’t want to say something that might hurt your therapist’s feelings or invite some kind of judgment. While each of these reasons might be valid, continuing on when you’re not fully invested will be an unfortunate waste of time for you both.
Take “Jean,” for instance, a woman in her 60s who sought therapy when she found herself stuck getting over the death of a pet. Her online therapist, a woman in her 30s, seemed to pigeonhole Jean as a lonely empty nester who needed to get out more. “Yet I’m not lonely,” says Jean, a creative spirit who is happily married, sees her grown children often, and enjoys a wide circle of friends. “She was very nice, but she was off about who I am.” Jean felt stereotyped, but being conflict-avoidant, didn’t know how to convey it. She ended up leaving after completing several sessions and didn’t seek out another therapist. Eventually, she moved past her grief on her own, without the external help and insight she had been looking for. Jean still wonders if, with the right therapist, the process might not have taken so long or been so painful.
So, though it may not be easy, if you’re dissatisfied for any reason, you owe it to yourself and your therapist to communicate your feelings and end the therapeutic relationship.
Starting well
Of course, incompatibility can be avoided by finding a good fit from the beginning. Many therapists detail their specialties and training in online biographies, which makes it easier to narrow the field and choose someone with expertise in what you’re experiencing — someone who has a good chance of understanding and appreciating who you are and what you need.
According to Lindsey Thomson, a registered psychotherapist based in Kanata, Ontario, and public affairs director for the Canadian Counselling and Psychotherapy Association, with 13,000 members across the country, as you go through this process “it’s important to be truthful about your preferences. Let’s say you’re a woman who wants to work on your experience of a past trauma that makes you uncomfortable talking with a man. Or maybe you’re part of a marginalized community and feel more comfortable with someone who shares the same cultural background. If you have preferences like that,” she says, “you need to find someone who meets them.” Many therapists, including Thomson, offer a 30-minute complimentary session to help potential clients test the waters and see if the fit is good for both people.
Also essential is understanding what type of therapy the counsellor is offering and what their overall philosophy is. As Thomson points out, studies suggest that what matters most is the dynamic between client and therapist. “This is a working relationship we’re dealing with,” she says, “you know, human to human. If something comes up that you don’t agree with, or if you don’t like the way the therapist has framed something — or you were challenged, and you weren’t ready for it — bring that up. It’s really important. Yes, it can be uncomfortable. But just know that all therapists want to know what’s going on for you in that process.”
Definitely don’t “ghost”!
While therapeutic situations differ, says Thomson, clients will average between 12 and 20 sessions, particularly with goal-oriented models like cognitive behavioural therapy (CBT).
“Let’s say I’m a client in therapy with generalized anxiety, and I’ve had 10 sessions. I’ve noticed a decrease because I’ve been working on some behaviour changes to help reduce it. At that point, the therapist can do a progress check on my initial goals and see how I’ve been doing with practising those skills — whether it’s behaviour changes, regulating emotions, or challenging an automatic negative thought to let it go and move on. Do I feel confident that I can maintain that without the therapist’s support?” For the therapist in this situation, says Thomson, rather than a complete termination, “maybe we switch the frequency of sessions. I typically see clients every two weeks. So why don’t we try seeing each other once a month for what we call maintenance-type therapy? If the skill implementation isn’t going so well, then we can go back to where we left off.”
At every stage of the process, the key to success is being comfortable communicating your feelings. You’re there to gain insight and develop the skills to grow, heal, and cope. Your therapist should be in your corner all the way.
If they do or say something truly unprofessional, and the organization they are registered with has a code of ethics and disciplinary measures, you can make a complaint. Check the laws and regulations in your province or territory to determine how to proceed in this kind of situation.
Resource: Fact Sheet: Common Mental Health Myths and Misconceptions.
Further reading: Weaving Through the Challenges: The ABCs of Finding an ACB Therapist
Moira Farr
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A friend of mine is struggling with her mental health. Something happened recently that sent her life into a tailspin, and she is having trouble coping. She can’t stop crying and is barely eating and sleeping. She has lived with depression for a long time, and it’s been manageable, but now she is at an all-time low. I’m worried about her. I’ve been talking to her about it, and I suggested she get some help from a therapist, but she isn’t ready. “I’ll just find a way to get through it on my own,” she says. Sound familiar?
I know firsthand that it can be tough to recognize when you need help. Years ago, when I was going through a major life crisis, it took me too long to ask for help. Later, I could see that I should have reached out to someone sooner. Why is it so hard to ask for help with our mental health? Would it surprise you to know that 60% of people with a mental health problem don’t seek help?
The power of stigma
That’s the power of stigma. I was worried about what people would think. The shame of admitting to myself that I was having a problem was so paralyzing that it kept me from getting help. I became filled with self-doubt. I started to lose trust in myself. Was I going to become one of ‘those people’? My imagination went wild with images of dismal institutions with bars on the windows and shock therapy.
The world influences our beliefs
Where did I get these ideas? We can call it cultural conditioning. We have been influenced to think of mental illness as frightening and debilitating and to see people who are dealing with mental health problems as unstable, violent, or dangerous. The media plays a big part in perpetuating the harmful stereotypes of mental illness. Mass media, television, and film have been shaping our ideas for a long time about what mental health and mental illness look like. The villains in the movies are so often characterizations of a person with a mental health condition. There are countless depictions of people with a diagnosis of schizophrenia portrayed as violent, unstable, and dangerous. These are not accurate or fair representations.
Just as media needs to be viewed with a critical eye, we should check our own assumptions about mental health and mental illness. We can inform ourselves about the facts, and we can learn how to be better allies to others.
5 Ways you can help
Everyone has a role to play in creating an inclusive community. Here are 5 ways you can help:
- Get the facts. Educate yourself about mental illness and share with family, friends, work colleagues, and classmates.
- Get to know people with personal experiences of mental illness so you learn to see them for the person they are rather than their illness.
- Be aware of your attitudes and behaviour. Choose your words carefully. Avoid stigmatizing people by seeing the person first and not labelling them by their mental illness.
- Challenge myths and stereotypes. You can help challenge stigma by speaking up when you hear people around you make negative or wrong comments about mental illness.
- Treat everyone with dignity and respect. Offer support and encouragement.
Where to find help
All those years ago, I wish help had been easier to find. Things have changed! If you or someone you care about might need some support, there are many options now. Here are some suggestions:
Wellness Together Canada (2020-2024)
To connect with a mental health professional one-on-one:
- call 1-888-668-6810 or text WELLNESS to 686868 for youth
- call 1-866-585-0445 or text WELLNESS to 741741 for adults
Kids Help Phone
Call 1-800-668-6868 (toll-free) or text CONNECT to 686868. Available 24 hours a day, 7 days a week to Canadians aged 5 to 29 who want confidential and anonymous care from trained responders.
Visit the Kids Help Phone website for online chat support or to access online resources for children and youth.
Mental Health Services across Canada
Find a Canadian Mental Health Association in your area
Hope for Wellness Help Line: 1-855-242-3310
Offers immediate mental health counselling and crisis intervention to all Indigenous peoples across Canada. Phone and chat counselling is available in English, French, Cree, Ojibway and Inuktitut.
Author: Nicole Chevrier
An avid writer and photographer. A first-time author, she recently published her first children’s book to help children who are experiencing bullying. When she isn’t at her desk, Nicole loves to spend her time doing yoga and meditation, ballroom dancing, hiking, and celebrating nature with photography. She is a collector of sunset moments.
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The Future Ready Initiative’s community-helping-community model supports people to strive and thrive.
Amina (not her real name), a young mother of four, faced serious challenges when she separated from her husband. Although she had lived in Canada for more than 10 years, she was isolated in her home, and the fear and stress of suddenly finding herself on her own were overwhelming. She urgently needed psychological counselling and help with learning English, doing her banking, buying groceries, and navigating the city’s public transport. “It is such a humbling and inspiring story,” says Ramzia Ashrafi, clinical practice team lead for Future Ready Initiative (FRI), which has supported hundreds newcomers across Canada since its inception two years ago.
The Future Ready team connected Amina with mentors, both professionals and volunteers (also called “family navigators”) who recognized her situation as an emergency and fast-tracked the help she needed. Within weeks, she had received counselling from a practitioner who specializes in helping immigrants and refugees. “After eight or nine months she was very comfortable expressing herself in English, and with no additional support, found a house and a job that allowed her to financially sustain herself and her children,” says Ashrafi.
Amina’s is one of many success stories to emerge from the initiative, which has multiple programs targeting youth, families, and seniors in need of support with mental health, education, settlement, and employment. “It’s the community helping the community build resiliency,” says Aleem Punja, national operations officer at Future Ready Initiative, whose stated core values are “individual agency, dignity, and equity.”
Not surprisingly, the number of people in need of their support has increased significantly since the pandemic hit three years ago.
“It has not been easy,” says Punja, “but we are doing our best.” FRI is a new national organization with 24 staff members and 500 community volunteers across Canada, yet it is able to provide the range of support services so many need.
The positive energy generated by all those involved in FRI is reflected in the virtual exhibition, Journey Upstream, a moving showcase of art, photography, music, spoken word poetry, graphics, and testimonials illustrating the experiences, hopes, and dreams of those new to Canada looking to connect with others. According to the exhibition’s description, it “aims to tell the story, via different and unique perspectives, of how the Future Ready Initiative fosters hope and builds resilience, and equips families and individuals with resources that enable them to confidently overcome challenges and thrive.” The priority given to mental health support is sharply illustrated in one of the photographs: a chain-link fence adorned with three simple black and white signs — YOU MATTER, YOU ARE NOT ALONE, DON’T GIVE UP.
The multidisciplinary Future Ready Initiative mental health case management team includes social workers, nurses, and psychotherapists specially trained in crucial areas such as suicide prevention, addiction, grief, and post-traumatic stress disorder. For those fleeing war and persecution, there is a particular need to offer care “in a trauma-informed way,” says Punja. That means building partnerships with numerous sister organizations, such as ABRAR Trauma and Mental Health, that can offer timely support, virtually or in person. Whether it’s the loss of loved ones to COVID-19, pandemic-related mental and physical health issues, or disruption to income and education due to the disease, war, settlement, or political upheaval — all have had a massive social impact on individuals and families.
For some, reaching out for help still carries a stigma, says Punja. Admitting you are having trouble finding a job, paying bills, or feeding your family is stressful enough, but dealt with in isolation such problems can seem impossible to overcome. Making it easier for people to ask for and receive help means connecting with them in a way that lets them see how everyone has challenges and everyone benefits from helping others. “Maybe a cousin helps you with English, or a neighbour does your taxes,” he says. Changing the language and the dynamics between the helped and the helpers also makes the process of helping someone get back on their feet less stigmatizing. “We don’t talk about ‘poverty’ but rather ‘vulnerability.’”
It also helps to focus on goals: an individual or family may be in a tough place now, but by helping them map out a path to better times, Future Ready emphasizes people’s agency and resilience as they find their own best strategies for success.
As well, helping others be “future-ready” means focusing on community connections as vital to mental health (in addition to direct interventions like counselling and coaching). Events that bring people together, such as musical performances, art exhibitions, sports, and those tailored especially for youth, families, or seniors have been successful in integrating newcomers and helping them stay positive and optimistic despite challenges and obstacles.
FRI’s Impact Report 2022 notes a number of positive milestones for the organization. “Since its inception in 2021, FRI delivered holistic and tailored support in the areas of family mentorship, future of work, mental health, settlement excellence, and youth mentorship to over 727 individuals.” It provided 560 hours of service to people with mental health risks. This included helping individuals on long waiting lists find care from a mental health or primary care doctor and supporting family members who were worried about the mental health of a loved one. Future Ready Initiative also assisted more than 100 family navigators and mentors “to competently manage sensitive situations while avoiding burnout.”
Ali Masroor Bigzad, who emigrated with his family from Afghanistan in September 2021 and currently lives in Sherbrooke, called his submission to the Journey Upstream exhibition “Spark of Hope.” It was FRI that gave him that hope. “Upon our arrival, the FRI officer came to our place and welcomed us on behalf of the community leadership and asked if we needed anything. We were all so happy that these institutions were here, reigniting that hope in us for a better future. The staff supported our settlement in different ways. The FRI member gave me advice about the different education pathways I could take. Without him, it would have been difficult for me to seek out the right path to start my educational journey.”
FRI staff, family navigators, and mentors have every intention of carrying on with the initiative to provide hope and real service to help every member of the community thrive on their journeys.
Moira Farr
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It took me a long time to tell my Catholic parents that I am a lesbian. I remember coming home from university one Christmas with my heart in my throat. This was going to be the time. I wanted to do it over the phone so that I wouldn’t have to see their faces, so that I could hang up and cry into my pillow, but I couldn’t do that to them. So, I first sat down with my mother by the fire, over a cup of eggnog, and just…said it. “Mom, I’m a lesbian.”
It took me years to utter that simple phrase, but it would take far longer before I felt ready to “come out” about my mental illness.
Pride is a funny thing. This month, we celebrate 2SLGBTQIA+ pride, and it is a celebration of all that our community has fought so hard for and achieved, and a commemoration of how far we still need to go.
We hesitate to mention mental health and 2SLGBTQIA+ in the same breath and for very good reason – it was only in 1973 that homosexuality was finally removed as a “mental disorder” in the DSM (the “Bible” of psychiatry), but it continued to make an appearance for those “distressed by their homosexuality” until the most recent edition in 2013. Gender dysphoria continues to be a diagnosis that is even required before gender-affirming treatment is begun. The stigma around mental illness intermingles with the stigma around the 2SLGBTQIA+ community and continues to complicate the picture.
And yet we know that members of the 2SLGBTQIA+ community, particularly youth, are more susceptible to mental illness and suicide. There are a variety of complex reasons for this, but many of them come down to the breakdown of family and social supports, and the social stigma that comes with the territory of being anything but straight and/or cis-gender. Bisexual, genderqueer, and trans individuals face particular stigma even from within the 2SLGBTQIA+ community. Homelessness is a problem specifically for 2SLGBTQIA+ youth. And intersectionality plays a huge role in the marginalization of 2SLGBTQIA+ persons since white, cis-gender gays and lesbians are less likely to struggle with their mental health than the rest of their rainbow family.
The fear of mixing talk of mental illness with talk of the 2SLGBTQIA+ community is damaging for those who are struggling and are in need of support that caters to their specific needs. Sexual orientation and gender identity are integral parts of a human being that have a lot to do with that person’s mental health and are bound to play a role in any existing mental illness. Any treatment that ignores these parts of me would never have given me a good result. In my episodes of depression, my delusional guilt about my homosexuality needed to be addressed. In my mania, hypersexuality and risk-taking needed to be addressed in the context of my sexual orientation. To do otherwise simply would not have worked. I do not have a mental illness because I am a lesbian, but I am a lesbian who has a mental illness. To forget that is to do a disservice to me – and ultimately to the whole 2SLGBTQIA+ community. This is one of those areas in which we still have a ways to go.
I was lucky. My mother simply laughed. “Oh finally!” she said, “We wondered when you would tell us!” You see, it seemed that my parents had suspected for years. Relief flooded through me when she finished: “Your father and I don’t care who you love, as long as they make you happy.” (I did, however, wish they had told me this years before…it would have made the coming out so much easier!) Thanks, Mom and Dad.
Author: Jessica Ward-King
BSc, PhD, aka the StigmaCrusher, is a mental health advocate and keynote speaker with a rare blend of academic expertise and lived experience. Equipped with a doctorate in experimental psychology and firsthand knowledge of bipolar disorder, she’s both heavily educated and, as she likes to say, heavily medicated. Crazy smart, she’s been crushing mental health stigma since 2010.
