Catalyst Newsletters Archive - Page 13 of 18 - Mental Health Commission of Canada

COVID may steepen the climb for those affected by eating disorders

Content Warning: This article contains information about thoughts and behaviours related to eating disorders.

The first week of February marks Eating Disorders Awareness Week, a national public awareness campaign dedicated to shedding light on the reality of eating disorders (EDs) and the people they affect. Before COVID-19, EDs had one of the highest mortality rates of any mental illness. Now, with routines upended and isolation at its peak, the journey toward wellness is even more arduous for some.

“When you live with an eating disorder, free time is a dangerous thing,” said Wendy Preskow, president and founder the National Initiative for Eating Disorders (NIED). “In the absence of many pre-pandemic outlets and routines, the voices encouraging ED behaviours only become louder.”

Preskow isn’t just speaking from her nine years of experience running NIED. She is also a full-time caregiver to her daughter Amy, who has struggled with eating disorders for over 20 years.

“With so many of Amy’s prior activities and distractions taken away, I can feel the tension of her free time,” said Preskow. “I have to keep her company just to help her get through the day. When you’re in that state, every second counts.”

A perfect storm
For the one million or so people in Canada diagnosed with an ED — and the countless others suffering in silence — the empty space in the day is just one of the challenges during a pandemic.

Increased anxiety, uncertainty, and a perceived lack of control can all encourage ED behaviours (i.e., restricting, binging, purging, or overexercising) — which are often used as coping mechanisms in times of stress. Add to that the advent of “the quarantine 15” (the potential weight gain associated with the pandemic), and it’s not hard to understand why crisis lines and services for EDs and have had a marked influx since the arrival of COVID-19.

A strained system
Unfortunately, as Preskow pointed out, these services were already stretched to their limit prior to the pandemic. Now, the situation is dire. “Many outpatient programs have had to completely shut down, and others have seen their wait-lists double or triple,” she said. “So many people need support, but they can’t find it.”

In some cases, the search for help includes parents seeking treatment for young children, who are increasingly engaging in dieting behaviours that may heighten their risk of developing an ED.

As a recent Globe and Mail article noted, “Children as young as 9 and 10 are being treated for eating disorders. Pediatricians say many of their new patients are sicker and more underweight than those typically seen before the pandemic, while the wait time for outpatient referrals has doubled to six months.”

or Preskow, these trends are not acceptable. “When you’re seeking help for a loved one with an ED, waiting doesn’t feel like an option.”

The challenges of caregiving
In the early days of Amy’s illness, Preskow recalls how each filled-up program, unavailable service, or unanswered query felt like a devasting blow to her and her husband.

While NIED isn’t a service provider, she has still channelled that experience into her daily work. “When someone reaches out, I do my best to follow up right away,” she said. “I remember how it felt to be absolutely desperate for guidance. I wouldn’t wish that on anyone.”

To this day, Preskow said, being a caregiver is a constant challenge. And after 20 years, she’s still overcome with fear when she sees Amy calling. “I’ve asked her to text me a heart before she calls so that I know everything is OK. Then I can answer without panicking.”

For other caregivers struggling to navigate their loved one’s illness, Preskow urges unconditional love above all else. “We have to remember that having an eating disorder isn’t a choice. It can be hard not to take setbacks personally, but that person needs love and encouragement, no matter what.”

The road to wellness
While COVID-19 has ushered in a new wave of challenges for those affected by EDs, support is still available. NIED’s list of resources includes options for immediate support, interactive tools, and a variety of other programs. The National Eating Disorder Education Centre (NEDIC) also offers many helpful resources, including a helpline and a list of COVID-19-related information, events, and support.

As for Amy’s journey, after two long decades, she’s managed to find a new footing. “Right now she’s climbing the tallest mountain in the world,” said Preskow. “There’s still a long way to go, but it’s worth every step.”

Author: Amber St. Louis

In conversation with Dr. Thomas Ungar, the first in a series

When Thomas Ungar, psychiatrist-in-chief at St. Michael’s Hospital and associate professor at the University of Toronto, was asked to describe the structural stigma that spells poorer health outcomes for people living with mental illness and substance use disorders, he responded in a most unusual way.

“Perhaps I should tell you about the silly garbage cans,” he said from his office in Toronto, where he engages in a daily campaign to help his peers and colleagues in other specialties better understand the complex nature of mental illness.

A hospital where he once worked brought in some “efficiency people” to tighten the budget. At one point, they determined that garbage receptacles in clinical spaces would be emptied daily while those in “administrative” or “non-clinical spaces” would only be done every two weeks.

“I don’t see patients in rooms with sinks,” Ungar explained. “And the litmus test for “clinical space” by the powers that be was, you guessed it, whether or not it had a sink.”

For Ungar, the implicit bias was clear. For “real” medicine, you need to wash your hands. Psychiatric work — the lowest paid specialization in medicine — didn’t make the cut.

Medical versus mental health care needs
Such an example may sound insignificant, but Ungar has dozens, if not hundreds like it. In fact, he collects these small indignities like unwanted mementos. They serve as a constant reminder that providing mental health care remains the poor cousin of practising in the purely physical realm.

Taken as a whole, they add up to an immeasurable inequity.

“There was the time when I went to a meeting to get some equipment I needed for my department,” he recalled. That included new locks, because some doors on his floor had been kicked in, and improved video monitor safety equipment. But these seemingly straightforward requests were quickly brushed aside. “I was told to talk to facility management or IT because, again, my needs weren’t ‘real’ medical needs.”

“And,” added Ungar, “we’re always being left behind. When a hospital moves to a brighter, newer space, the psychiatry department is invariably told we’ll be joining ‘soon.’ Then ‘soon’ becomes months, and in some cases years. We’re left behind in crumbling, run-down buildings because we’re told having a dedicated space for mental health care is better for the patient. Who are we kidding? It’s just more palatable for everyone else.”

The effects of mental health care inequity
Yet Ungar’s greatest frustration isn’t that his speciality is sidelined. It’s that people suffer as a result.

“When you present to the emergency room, regardless of your mental health history, you should be given an appropriate physical workup. Only in psychiatry would the treating physician refer someone to you directly, without doing such a rudimentary exam. Imagine an ER doctor taking one look at you and saying, ‘Right, I think it’s your heart, off to cardiology you go.’”

This cavalier, and all-too-prevalent, attitude can have dire consequences. Ungar himself is familiar with cases where patients have died of blatant neglect because of “diagnostic over-shadowing.”

“It’s when an assumption is made that physical complaints are not relevant or reliable because someone has an underlying mental illness or substance use disorder,” he explained, “and it’s not acceptable.”

Dealing with structural stigma
Ungar finds himself swimming against the tide in a profession where stigma is so entrenched, and unconscious bias so pervasive, that most of the well-meaning professionals practising within it are totally unaware of its existence.

“It’s not unlike racism,” he explained. “You don’t have to throw around epithets or be blatantly discriminatory to uphold implicitly racist societal norms. Being unaware of something doesn’t make you a bad person, but it doesn’t make you part of the solution either. The same is true for stigma. Just because you don’t use pejorative terms doesn’t mean you aren’t unconsciously dismissing a patient as ‘badly behaved’ or ‘morally corrupt’ because they are presenting in a way that’s uncomfortable or inappropriate.”

While the beauty of not knowing is that it can be fixed, a complete paradigm shift is a generational proposition, and Ungar doesn’t have that kind of time.

“It doesn’t mean I’m not trying,” he laughed, but he also thinks additional strategies are needed. “I’m leveraging quality of care as a central tenet of why we need to address structural stigma,” he said, noting that building certain patient safeguards into hospital policy may be the quickest route to fulfilling the Hippocratic Oath.

A new way forward
“For it to count, we need to measure it,” Ungar noted, “and not just in egregious situations that trigger a coroner’s inquest.” Here, he recounted an instance where a patient died of a pulmonary embolism because concerns about his mental health overshadowed the physical discomfort he was experiencing.

Ungar wants to change the rules of the game, full stop. He wants hospitals to assess structural stigma against qualifiers that effectively dismantle it. “For example, if we require all patients to receive a physical exam within one day of being admitted, suddenly it doesn’t matter whether Dr. Smith thinks it’s necessary. It’s simply required.”

This kind of intervention is what Ungar refers to as a health-care system “hack”: a quick and imperfect shortcut to improve results, while the longer-term work to shift attitudes and behaviours plods along in the background.

To help health-care administrations understand, evaluate, and score structural stigma against a framework that breaks down the barriers putting treating mental illness at a disadvantage, Ungar is working with a team at the Mental Health Commission of Canada (MHCC) to create tools and new standards.

Describing this project, he said, “If we can measure and monitor those barriers and get them on a mandatory dashboard or at-a-glance report card, then a red-light indicator will scream out for attention and require a fix. I won’t have to try and advocate, negotiate, or convince others one provider at a time. I’ve had it with that.”

In fact, Ungar sees this path as a decisive way forward. “The work I’m doing with the MHCC is the most exciting of my professional career. I’m not aware of this kind of work being done anywhere else. It’s the kind of progressive, thoughtful policy shift we’ll look back on in two decades and say, ‘I can’t believe we didn’t do that sooner.’ Our current practices will seem as outmoded to our future selves as bloodletting does to us now.”

Until then, Ungar plans to continue using his considerable influence to call out stigma wherever he finds it.

“Of course I will,” he said with a laugh, “even if that means telling stories about silly garbage cans.”

Webinar
Register here for the first webinar on the MHCC’s work to combat mental illness- and substance use- related structural stigma in health care settings — to be held Tuesday, February 9, 12-1:30 p.m. ET — featuring professors Thomas Ungar, Heather Stuart, Jamie Livingston, Javeed Sukhera, and Stephanie Knaak. Participants will increase their understanding of structural stigma, learn about its sources and consequences, and gain insights into how it can be addressed.

Watch this space
In the March Catalyst we’ll be speaking with patient advocate Samaria Nancy Cardinal about the harmful effects of structural stigma users are experiencing in the health-care system.

Author: Suzanne Westover

MHCC winter mini-guide aims to give workplaces seasonal boost

In Canada, most people are all-too-familiar with the physical challenges of working through the winter. From dressing to driving, the importance of changing the way we operate to protect ourselves from the cold goes without question. It’s too bad we rarely give our mental wellness the same consideration.

This winter, because mental strain in the workplace may be especially pronounced, employers should be equipped to support themselves and their staff members.

A new workplace resource
The Mental Health Commission of Canada’s (MHCC’s) new Mini-Guide to Help Employees’ Mental Health Through Winter offers employers a roadmap to wellness during the chilly season.

“Many leaders recognize that this time of year can be hard on employees. But the tools and resources out there are piecemeal,” said Liz Horvath, manager of Workplace Mental Health at the MHCC. “To help employers spend less time searching for solutions and more time applying them, we’ve gathered a wide range of practical advice and helpful resources in one place.”

The mini-guide lays the groundwork for its recommendations by exploring some of the most common reasons for mood changes in the winter months. For some it’s the lack of sunlight, for others it’s poorer eating habits or reduced physical activity. Whichever factors are at play, it’s their cumulative effect that can make it more difficult for employees to feel focused, engaged, and productive — both inside and outside the workplace.

A season of cold and COVID
This year may be especially difficult for those who experience a lower mood in winter. Some challenges are unique to the pandemic, like nostalgia about life before COVID, while others may be amplified versions of familiar concerns.

“Employees may face increased social isolation, financial strain, or uncertainty about the future — which are all linked to poorer mental health outcomes,” Horvath explained. “Before the pandemic, mental health conditions accounted for around 30 per cent of disability claims. But with the added burden of COVID-19, putting mental wellness at the centre of workplace culture is even more critical.”

Focus on flexibility
One key theme throughout the mini-guide’s recommendations is flexibility, which, as Horvath emphasized, needs to be tailored to effectively reduce stress. “It’s important for employers to engage with staff to define what flexibility means for each person,” she said, adding that even in fields with more limited options employers can still take steps to ensure that staff have adequate time to rest and are offered leniency when possible.

The guide offers several suggestions to help employers be more flexible, from allowing workers to modify their hours and focusing on output to identifying key priorities and letting the extras slide when they need some relief. Whatever form flexibility takes, the goal is to promote equilibrium for employees, which will in turn reduce undue stress.

“If we’re running out of energy, we can’t continue to produce at the same level,” said Horvath. “Flexible working arrangements can go a long way in helping employees create balance in their lives and improve their mental well-being at work and at home.”

Guidance for every season
While the guide is presented through a winter lens, its recommendations and resources apply year-round. Suggestions to help employers communicate with empathy, offer the right type of support, and help build coping strategies will continue to serve them long after the ground thaws.

Horvath couldn’t agree more. “By taking steps to foster more supportive workplaces today, employers will help themselves create a healthier, more resilient workforce for the future.”

With the right guidance, there’s no reason for any employee to leave their mental health out in the cold.

Author: Amber St. Louis

COVID spurs need for fresh input to better serve people in Canada

The Mental Health Commission of Canada (MHCC) is always looking to improve the tools and resources we create to support front-line care providers, policy makers, and those who use mental health services. So, to help us build on the work we do to support people in Canada, we’re inviting you to respond to a short survey.

Your feedback is especially important this year because of the pandemic, which has challenged us to move outside our typical wheelhouse. While we usually create information and tools that support system-level change, the sudden need for credible, reliable mental health information gave us an unexpected new challenge.

When COVID hit, and people started to isolate at home, our followers on social media began sending us questions. Questions about media consumption and its impact on mental wellness, questions about how to listen effectively and with compassion, questions about how to navigate living in an abusive home.

In response, with the support of our rich and varied network of experts, our newly created COVID-19 Resource Hub quickly began filling up with an array of tip sheets and other resources.

“What we’ve seen in recent years has been the flourishing of incisive, enterprising, and award-winning longer-form journalism that has taken the discussion of suicide much deeper, to considerable public benefit,” said Cliff Lonsdale, who led the editorial team responsible for the guide’s content. “But the journalists doing that work often had little relevant guidance to help them choose ethical approaches for the different kinds of stories they were telling.”

The revised suicide chapter includes recommendations to help journalists go beyond reporting individual incidents and dig deeper into causes, higher-risk populations, policy shortcomings, and protective factors — while emphasizing the importance of context and independent judgment.

The power of language

The guide also reinforces the media’s power to shape the public lexicon by using non-stigmatizing language. For example, journalists (along with the rest of us) should opt for “died by suicide” as opposed to “committed suicide,” which attributes a value judgment to the act and suggests moral or legal wrongdoing.

“Writing about mental illness in all its richness, and with all its challenges, need not cause stigma,” notes Globe and Mail health columnist André Picard in his foreword to the guide. “Rather, it provides us with a rare chance to bring about meaningful social change alongside a golden opportunity to better journalism.”

Delve deeper into the materials covered in the guide, with resources that include case studies and video clips, at the Mindset website.

The Catalyst newsletter also became a vehicle for sharing practical mental health information, with articles ranging from how to hone one’s resiliency to expert advice on supporting the mental wellness of caregivers.

Our goal has been to provide relatable, thoughtful content to as many people as possible, reinforce the importance of help-seeking behaviours, and remind people that there are many ways to access free mental health supports.

Because we benefit from the advice and input of grassroots stakeholders, who see different gaps and needs, we’d love to hear from you. Thank you in advance for responding to our survey.

Author: Mental Health Commission of Canada

How real empathy never begins with ‘at least’

This winter, many of us are going to be called on to support friends and family at a distance.

But according to Kids Help Phone volunteer Cleo Edgington, who is also a program coordinator for Prevention and Promotion Initiatives at the Mental Health Commission of Canada (MHCC), “knowing how to do that well takes practice.”

While empathy may be natural to some of us, that doesn’t mean we know how to effectively convey it — especially over the phone or through a text message.

“Put it like this,” said Julia Armstrong, who is also a Kids Help Phone volunteer (plus a former counsellor) and the acting manager for Mental Health and Substance Use at the MHCC, “empathy never begins with ‘at least.’”

What Armstrong is getting at is the unconscious habit many of us have of trying to find a silver lining. “We don’t realize how unhelpful it is to say, ‘At least you have your health’ or ‘At least you have a home’ to someone who’s in a dark place. Doing that not only diminishes their feelings, it also layers them with guilt.”

Active listening: What it actually means

In a sit-down video chat with three MHCC staff members who moonlight as text or phone supporters, it became clear that active listening is a skill we all need to develop, and even if we think we’ve done so there’s no shame in needing a primer.

“It’s actually counterintuitive,” said Edgington. “Because you want to help people, you think, ‘How can I fix this?’ but that’s not your job. Your role as someone with a listening ear is to meet them where they are, validate their feelings, and be present as they tell you what they are or aren’t ready to do.”

Armstrong agreed. “We can’t assume responsibility for the problems others are having. That robs them of the confidence that comes with finding their own solutions. Besides, solutions are unique to each person. It takes humility to understand that you can walk alongside someone on their journey without leading the way.”

The right way to share

There are, it turns out, specific ways to meaningfully support the people in our lives. And one of the most important, which the three supporters echoed throughout our conversation, is to take yourself out of the equation.

“It can be so tempting to say, ‘I’ve been there,’ or, ‘I know how you feel,’ or even something specific like, ‘When I lost my pet…’, said Armstrong. This intention to connect and reaffirm the shared human experience is good. But by turning the spotlight on ourselves, we’re inadvertently diminishing the pain being disclosed to us in that moment. So instead, if you keep that intention but alter the approach, the impact you’ll have will be completely different.”

To illustrate, Edgington gave a couple of examples: “Just say, ‘That must be so hard’ or, ‘I can see why that’s devastating.”

And be specific, added Armstrong. “Use feeling words, so the person you’re talking to can correct or redirect you if you’re wrong. If you say something like, ‘It’s understandable to feel depressed,”’ the person might text back, ‘I’m not sad, I’m pissed!,’ which tells you that you need to recalibrate the conversation.”

Getting out of the way

The goal with active listening, whether you’re on the phone with your grandma or texting with your nephew, is to hold up a mirror so they can see their situation more clearly.

“As the listener,” said Edgington, “there’s a second reason for not reflecting your own experience back to them: doing so implies that you’ve got the same resources, the same tools, the same trajectory. And that may not be the case.”

Armstrong and Edgington also caution us against the harms of toxic positivity. “Telling someone it’s going to be OK isn’t a panacea. In fact, it can do more harm than good. We might have lived through something, and we might want to reassure them that they’ll overcome this dark time, but it’s not inherently helpful. Sometimes, it can make them feel worse,” Edgington explained.

The gift of listening

For Ryan Murphy, the MHCC program manager for Prevention and Promotion Initiatives, who also volunteers with Ottawa Victim Services and Kids Help Phone, the satisfaction that comes from supporting others goes beyond listening well.

“Yes, you’re validating feelings. Yes, you’re creating a safe space free from judgment. But you’re reminding people of their own problem-solving skills. You’re reaffirming their resourcefulness and, maybe above all, you’re letting them see their own worth. That doesn’t feel like a passive activity.”

This was certainly the case when, during one of his volunteer shifts, he found himself texting with a girl on her 10th birthday.

Clearly emotional, Murphy recalled the text coming in like it was yesterday. “She messaged and said her birthday had gone completely unnoticed. She felt she didn’t have any friends, and her family gave her no acknowledgment whatsoever.”

So, he said, they “celebrated” together. And what comprised that celebration was Murphy reaffirming to a lost and lonely child that she was deserving. “I was able to tell her, I hear you, I’m with you, and you are a worthy human being.”

Armstrong, tearing up herself, said to Murphy, “Think about that for a second. Think about what a gift you were able to give her. And think about how lucky she was that her text landed in your lap. For all the negative, she is going to look back on that day and know that someone — someone as special and empathetic as you — cared.”

Enter COVID

While all three affirm that volunteering in this way is deeply meaningful, they also admit that the pandemic is diminishing everyone’s capacity for giving — including those we rely on to pick up the phone or answer the texts.

“I feel incredibly energized after these interactions,” Murphy said, “but I don’t have the stamina to do as many sessions as I did before COVID-19.”

Armstrong understands that feeling. “Even as someone who derives tremendous satisfaction from this work, you have to know your limits, and you have to give yourself permission to set boundaries.”

That advice spills over into personal life as well.

“When acting as supports for others, we can’t neglect our own health and wellness, and it’s important to not only listen to others, but also to ourselves,” said Murphy.

For more information on how to get involved in supporting those in need, visit Kids Help Phone and Ottawa Victim Services.

Author: Suzanne Westover

MHCC champions a variety of suicide pre- and postvention resources

The way our country thinks about, talks about, and prevents suicide has evolved considerably over the past several years. A crucial part of that shift is due to improved reporting practices, something largely credited to a guide written by and for Canadian journalists, Mindset: Reporting on Mental Health (Mindset).

“Since its debut in 2014, Mindset has become the leading resource of its kind in Canada,” said Louise Bradley, the Mental Health Commission of Canada’s (MHCC’s) president and CEO. “There is no doubt that the media is a key player in raising awareness and shaping public opinion about mental illness, a fact that underscores the importance of responsible and informed reporting.”

Update to a key media resource

Late last year, the Canadian Journalism Forum on Violence and Trauma, with support from the MHCC and CBC News, released the third edition of Mindset. Among its key additions is an extensive update to the chapter on suicide reporting, meant to help journalists explore the topic in a more robust way without causing undue harm.

The power of language

Delve deeper into the materials covered in the guide, with resources that include case studies and video clips, at the Mindset website.

MHCC resources for those affected by suicide

While thoughtful media coverage may spell a sea change in our collective understanding, those who’ve been affected by suicide need specialized resources. Together with our partners, the MHCC has developed two toolkits that offer practical support a little closer to home.

One is for people who have been affected by a suicide attempt; the other, for people who have lost someone to suicide. Both toolkits include coping and support strategies, crisis planning, tips on sharing your story, and messages of hope.

At the school or community level, it can be hard to know what actions to take following a death by suicide (also called “postvention”). The Postvention Program: Being Prepared to Act in the Event of a Suicide webinar was developed to help communities prepare for and navigate that difficult period.

On top of its toolkits and webinars, the MHCC was a proud collaborator on a series of suicide fact sheets related to bullying, injury prevention, trauma-informed care, older adults, sexual minorities, and transgender people. Along with general information, the documents include key statistics, practical tips, and additional resources.

See the complete list of MHCC resources on our suicide prevention page.

For Bradley, we all have a role to play in preventing suicide: “The more we illuminate the darkest corners of stigma — be it through responsible media coverage or public education — the more lives we can save.”

Author: Amber St. Louis

For caregivers, finding the right balance is key

The holiday season is synonymous with giving. Many of us dedicate our time and attention to causes close to our hearts and to people in need of support. For unpaid or family caregivers, though, giving is more than a seasonal gesture of goodwill. And this year, as the rest of us prepare for a more subdued holiday season under the shadow of COVID-19, these caregivers must find a way to strike a balance between caring for their loved ones and giving back to themselves.

“We know that many caregivers experience heightened levels of stress and anxiety,” said Louise Bradley, the Mental Health Commission of Canada’s (MHCC’s) president and CEO. “Now that the pandemic has upended our routines and altered our best-laid plans, it’s more important than ever for caregivers to re-assess what’s working, and not let their own mental health fall by the wayside.”

Denise Waligora, an MHCC Mental Health First Aid (MHFA) training and delivery specialist, understands this balancing act all too well. “Both my mom and dad have serious physical conditions, and my dad was diagnosed with Alzheimer’s last year,” she explained. “I’m fortunate to be able to work remotely while caring for them, but leaving time for myself hasn’t been easy.”

One of the biggest challenges, she said, is learning to set boundaries. “One evening my mom started listing all the things she wanted us to do after dinner, and I finally had to speak up. I reminded her that after long days filled with appointments and obligations, I needed some downtime in the evenings. As caregivers, we have to recognize when it’s getting to be too much and learn that saying ‘no, not right now’ is OK.”

To Waligora, carving out downtime is an important act of self-care. “Even if it’s limited,” she said, “take whatever time that’s there and don’t feel guilty about it. We all need time to recharge.”

While caregivers of all kinds face similar challenges, those caring for older adults know that supporting their loved one’s mental health can often be more difficult than meeting their physical needs. Fortunately for Waligora, being a facilitator for the MHFA Seniors course has helped her bridge the generational divide.

“I don’t think my parents have ever been told it’s ok to feel the way they do,” she explained. “The course has taught me the importance of validating their fears. It’s also improved my communication skills with my parents and opened conversations that may not have happened previously.”

To help others facing similar communication barriers, Waligora contributed some special insights to the MHCC’s Caring for Older Adults During COVID-19 tip sheet, which offers practical advice to support the mental health of older loved ones.

Equally important is communication from the caregivers themselves. Caregiving can be an isolating job, especially during a global pandemic when social gatherings have all but disappeared. But as Waligora points out, maintaining social connection is invaluable to caregivers. “Never be afraid to reach out to your support system,” she said. “You don’t always have to be the ‘strong’ one — It’s OK to ask for help.”

Bradley agrees. “Caregivers are prone to putting their own mental wellness last,” she said. “But no one can pour from an empty cup. Caring for yourself, whatever form that takes, will help you be a healthier, more effective caregiver.”

To learn more about implementing self-care into your life, read the Mental Health First Aid COVID-19 Self-Care and Resilience Guide. “Caring for a loved one is noble, valuable work,” said Bradley, “but giving yourself the gift of self-care is priceless.”

Author: Amber St. Louis

Give back, or reach out

While Dr. Keith Dobson doesn’t have a miracle cure for the holiday blues, he’s got a prescription for improving our outlook: We need to manage expectations.

“This isn’t going to be a holiday like any we’ve had before, so we’ll all need to adjust our vision to ensure the season matches the reality,” said Dobson during a phone interview. “But by far the biggest worry I’ve heard, and the greatest increased risk factor for mental distress, is loneliness.”

Unfortunately, beating back the shadow of social isolation has perhaps never been more difficult. “We hear about technology as a great way to deal with loneliness, and it can be a veritable lifeline for some. But I know a number of seniors, for instance, who feel no affinity for, or inclination to use, FaceTime or Zoom. That’s a real gap that we need to address, whether by writing letters or making those much-needed phone calls.”

While Dobson often suggests volunteerism or community giving to combat social isolation, that too is going to look different this year.

“With so many charitable events pivoting to virtual formats, getting involved doesn’t afford the same level of social interaction,” he said. “Not only that, but the mere concept of being asked to give can be overwhelming for some people because they feel tapped out just putting one foot in front of the other.”

Dobson explained that psychologists typically talk about three broad factors that influence the risk of developing mental illness: biological, genetic, and social. While biological and genetic factors remain unchanged, the psychological — in particular the social challenges associated with the pandemic’s influence — have tipped the scales toward having more mental health challenges.

“What this means is that, for many people who are struggling, we’re probably not looking at prescribing medications or using treatments (like cognitive behavioural therapy) to combat negative thought patterns. Rather, we are focusing on changing behaviours.”

Dobson gave several examples of what this different approach could look like. For people who tend to be perfectionistic and hypermotivated, managing the pandemic marathon might require letting some of those extra things that create stress slide.

“Saying no is going to be key, especially those smaller tasks that we might normally tackle with gusto. If you’re a dedicated holiday baker and the idea of getting out your mixer is too much to bear, consider supporting a local bakery if your pocketbook allows. If you’re someone who always hosts the holiday party, but the concept of throwing a Zoom Christmas makes you feel like you want crawl under the covers, politely explain that this year you’re not the right person for the job.”

If, said Dobson, you’re someone who can’t seem to find any motivation, then tackling small hurdles can be an effective way to get back on track. “Simple things, like getting up at a regular time and making your bed, can be small habits that help set the tone for a more productive day.”

This holiday season, Dobson’s advice is simple. “Take control of those things you can control and let go of the rest.”

He emphasized that this year, unlike others, reaching out for support could bring some relief. “If you’re a small-business owner who has always given back to your community, but your livelihood now hangs in the balance, there is no shame, no shame whatsoever, in reaching out to receive rather than to give.”

For many, added Dobson, we’re approaching a tipping point in the pandemic. “Anxiety is a forward-looking emotion. We worry about and anticipate the worst of things to come, and that floods us with cortisol and can send us into the fight, flight, or freeze response. In contrast, depression is more about mourning the things we’ve lost, and in that state, we may find ourselves tired or filling the void with unhealthy activities such as eating or drinking too much.”

As the pandemic drags on, and we move collectively from a more anxious state to a depressive one, Dobson emphasized how important it will be to keep an eye on our own wellness and assess our well-being with tools like the mental health continuum model.

If the holiday season gets to be just too much, talking to a professional can help.

“What works for one person right now might be the opposite of what someone else needs to hear. Thankfully, portals like Wellness Together Canada give people the option of having personalized advice from a trained therapist at no cost.”

Grief, said Dobson, is a difficult emotion to manage, especially over the holidays. And we are all grieving something — big or small. “As we cope with this grief, being kind to others (and to ourselves) is maybe the best coping mechanism we’ve got.”

Dr. Keith Dobson is a professor of clinical psychology at the University of Calgary and a senior consultant with the Mental Health Commission of Canada.

Author: Suzanne Westover

Roots of Hope flourishing on the Burin Peninsula

In 2018, Newfoundland and Labrador’s Burin Peninsula became the first of eight communities to sign on to the Mental Health Commission of Canada’s (MHCC’s) Roots of Hope project — a community-led suicide prevention initiative that aims to prevent suicide with strategies adapted to the local context.

“With such strong wellness leaders throughout Newfoundland and Labrador, advancing life promotion work in the province is an incredible thing to be a part of,” explained Gioia Montevecchi, a consultant with the province’s mental health and addictions division who is also co-chair of its life promotion suicide prevention working group. “Community partnership lies at the heart of the upcoming life promotion suicide prevention plan, and it has informed all of the work happening to transform the mental health and addictions system in Newfoundland and Labrador. We have incredible social capital in the province and vast networks of people working to advance tailored suicide prevention initiatives.”

Three years into the five-year demonstration project, Burin Peninsula has made great strides. “I’ve seen a big change in our community already,” said Denika Ward, coordinator for the area’s Roots of Hope project. “When people used to ask what I did, and I replied with ‘suicide prevention,’ I was met with a lot of silence and blank stares. Now, more people understand the value of what we’re doing and want to be a part of it.”

All community initiatives are centred on Roots of Hope’s five pillars, which include everything from building public awareness to reducing access to potentially dangerous situations (means safety). On Burin Peninsula, public awareness has been at the heart of the effort thus far, and with great success.

Ward led the development of a community suicide awareness presentation, covering topics like warning signs, stigma, starting a conversation, and information about local and provincial resources.

Following the high attendance at the event and a growing demand from the community, project members have adapted the presentation to first responders and youth audiences (as additional requests continue to come in). An online version of the initial presentation will soon be available at BridgethegApp, Newfoundland and Labrador’s repository of mental health resources.

In addition to ongoing public awareness, Burin Peninsula has set its sights on another priority area: men’s mental health. With men accounting for three-quarters of suicides in Canada, it’s easy to understand why.

Illustrator: Kati Oliver

Fortunately, the community doesn’t have to look very far for guidance. A Roots of Hope community in Edmonton has made suicide prevention among men a key action area, complete with a subcommittee dedicated to men’s mental health outcomes.

Some of the activities directed toward men include expanding access to psychoeducational services, offering additional support groups for depression and anxiety, advocating and securing funding for new programming, and participating in existing community initiatives to further develop preventive approaches for those at risk of suicide.

“Sharing knowledge between communities is foundational to the success of the Roots of Hope model,” said Uyen Ta, MHCC program manager for the Prevention and Promotion team, who works closely with the Burin Peninsula community. “The collaborative approach allows communities to learn from each other’s successes and understand how they’ve overcome different challenges along the way.”

Montevecchi agrees. “Communities are the experts on the challenges they face and on the strengths they have to overcome them. Harnessing the knowledge and experience of diverse populations while providing meaningful support for community-led efforts can create a groundswell of impactful work.”

That said, one challenge that none of the communities could have anticipated is COVID-19. To help them and others better understand this new reality, the MHCC has just created a COVID-19 and Suicide policy brief exploring the potential impact of the pandemic on mental health and suicide rates in Canada. Included are insights into which potential risk and protective factors to monitor and identifying current opportunities to influence these trends. While largely directed toward policy makers and those working in health care, the brief’s core message applies to everyone: even in a pandemic, suicide is preventable.

For Ward, the bottom line is simple. “Suicide prevention is everybody’s business. You don’t need clinical skills or training to make a difference. We can all play a part in saving a life.”

Author: Amber St. Louis

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Roots of Hope flourishing on the Burin Peninsula