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Aging without support is becoming more prevalent for older people in Canada. How can we stem the tide? A look at inclusive aging during Loneliness Awareness Week

“Why was it, she wondered, so difficult to believe that the old had been young, with the strength and the animal beauty of youth, had loved, been loved, laughed and had been full of youth’s unmeditated optimism?” — PD James

This past winter, my neighbours found one of our older residents wandering around downstairs in the laundry room hallway of our apartment building. She appeared to be lost and confused.

We ended up calling an ambulance once it became clear that she was unwell. She had been living across from me, but I never really knew her. That day, after a brief phone assessment, the dispatcher told us it would be a four-hour wait. Since there wasn’t any food in her fridge, some of us brought snacks and made her a few cups of tea while waiting for the ambulance at her kitchen table. After learning she was 91 and living alone, we asked her about people we might call. But it took a few hours of chatting before she told us that she had no children or siblings. The one exception was a nephew who lived hundreds of kilometers away, who was surprised when we called him, saying they had not spoken in years.

The events that January day were a turning point for her, and for me. She hasn’t been back since being taken to the hospital. I don’t know what ended up happening, and I will never find out because I am not part of her family. Still, later that evening I couldn’t help wondering whether this was what the future might look like for me.

Aging and loss
Aging can bring an accumulation of losses: loved ones, social networks, physical well-being, financial security, purpose, a sense of being part of the wider world, and even a sense of personal identity. These are the kinds of significant losses that “deeply challenge people’s sense of connection to the world around them,” according to Dr. Sam Carr, principal investigator for The Loneliness Project — which qualitatively explored older people’s experiences of loneliness in depth. Many of them spoke to the researchers about how aging presents unique challenges related to loneliness and isolation. The research — now published in Ageing and Society — generated over 130 hours of conversations. One participant’s experience with losing a spouse shows the extent these losses often have: “When he was gone, I didn’t know where I fitted anymore. I didn’t know who I was anymore because I wasn’t [upset]. You just existed. Went shopping, when you needed food. I didn’t want to see people. I didn’t go anywhere.”

In an interview study of older persons’ loss of meaningful connection, researchers at Malmö University in Sweden concluded that profound loneliness in later life can be understood as if the individual “is in a process of letting go of life.” Such an experience also “involves the body, in that the older person is increasingly limited in his/her physical abilities. The older person’s long-term relationships are gradually lost, and finally the process entails the older person’s increasingly withdrawing into him- or herself and turning off the outside world.”

Getting older without kin
In Canada, aging without support is also on the rise. Sometimes called “solo agers,” an increasing number of older adults are kinless, meaning they are without a spouse or living children (or the children live far away). Others who may not be technically kinless may still be isolated. Even though most of them want to age in place, kinlessness can lead older people into long-term care. As a country that already has one of the highest kinless rates in the world, how will Canada support and care for the increasing number of people in this group?

In the U.K., the issue is connected to a larger theme: loneliness as a growing health threat. In 2018, Prime Minister Theresa May called it “one of the greatest public health challenges of our time” when she established “the world’s first ministerial lead” to tackle loneliness. Japan’s Prime Minister Yoshihide Suga followed suit in early 2021, adding a new minister of loneliness to his cabinet. Its initial appointee, Tetsushi Sakamoto, was tasked with preventing and reducing widespread loneliness, social isolation, and the increased suicide rates accelerated by COVID-19 restrictions.

Such measures are grounded in evidence about the health and mental health risks of loneliness. Research has consistently shown that low social support or increased social isolation is one of the major risk factors for depression at all ages,” according to Dr. Keith Dobson, a professor of clinical psychology at the University of Calgary. The U.S. National Institute on Aging ties loneliness and isolation with “poor aging outcomes,” including higher rates of mortality, depression and cognitive decline.

Loneliness in significant numbers also comes with an economic impact. In the U.S., a decades-long increase in loneliness has reached the point where “more than two out of three working adults consider themselves lonely” — something that costs employers about $154 billion each year due to related health problems, productivity losses, and staff turnover. In England, 45 per cent of adults experience some degree of loneliness, which, according to a 2017 New Economics Foundation report, costs U.K. employers £2.5 billion (C$4.2 billion) each year. The data paints a dire picture, especially when you consider that much of it stems from pre-pandemic research.

It’s not the same for everyone
As we might expect, the effects of loneliness and isolation don’t impact everyone equally. Charitable organizations that support older persons witness first-hand how some people bear the brunt of overlapping life challenges. According to Gregor Sneddon, executive director of Ottawa-based HelpAge Canada, we know that “as people age and experience physical and cognitive impairments, their exposure to the world shrinks, as does their exposure to other people and they ‘bear the fruit of isolation.’ Add in a global pandemic that locks people in their homes, takes away their means of participating in the community and belonging, and disconnects them from family and friends, and the result is critical health effects.” But it is definitely “worse for those with little money. . . . Those who don’t have options are the most susceptible to loneliness, which we know, can be fatal.”

Does Canada need a minister of loneliness?
CARP interim chief policy officer Bill VanGorder understands that “loneliness and isolation doesn’t only affect people who may be considered a senior.” But he’s all for having a minister of loneliness in Canada “if that’s what it takes to address the impact of isolation and loneliness on Canadians. A minister would make sure that programs are in place to ease these issues, other parts of the government would be accountable to them, and maybe, finally, we could change the way we care for older Canadians.” In societies like ours that favour independence and individualism, we tend to let people sort out and manage their own challenges. But if you are unwell, isolated, and lacking support, that’s much harder to do.

The U.K. government is taking an integrated approach to this issue, recognizing that more needs to be done and everyone must play a role. Building an effective network of connection and supports requires government involvement as well as that of friends, family, employers, voluntary and community sectors, local authorities, and public health bodies. But that’s just the start. Its loneliness strategy is guided by a framework to improve and connect social services, reimagine community spaces, transportation, housing, and technology, holistic health approaches, and public health campaigns to raise awareness and reduce stigma around loneliness. One example is the government’s 2019 Let’s Talk Loneliness campaign, which challenges this stigma by emphasizing the importance of talking about it.

The program even uses social prescribing, where community connectors, health and well-being advisers, and community navigators support non-clinical needs (including those of people who feel lonely) by connecting people to community groups and services for practical and emotional support.

While the success of the U.K.’s integrated approach is still to be evaluated, regardless of future results, its common-sense principles seem more robust than the current fragmented and disconnected supports available in Canada. While some resources and programs exist, they can be difficult to find, especially if someone is isolated and has no internet access. And yet, the premise could not be simpler: communities benefit when we support the well-being of older people and their families. The same could be said for people who live with chronic illness or disability. A truly inclusive society benefits everyone.

What does the future of inclusive and healthy aging in our country look like? Is it a society that recognizes the value of older people, and the worth and dignity of all, putting aside ableism and prejudice? I hold out hope for a new vision of supportive and inclusive aging where we “create living environments in which these mechanisms of support are embedded and integrated into [our] communities.”

Resources for people in Canada:

Author: is the marketing and communications manager with the Mental Health Commission of Canada. Mental health is one of her passions.

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.

Sarah is 32 years old and has two young children. She used to be a primary school teacher. Sarah loves kayaking, hiking, and running. She ran her first marathon two years after her first child was born. But she doesn’t do that anymore – not since she developed Long COVID, also known as Post-COVID condition, due to a COVID infection two years ago.

There are many things that Sarah doesn’t do anymore.  She has stopped working, exercising, cooking, walking the dog, and driving. Sarah has to rely on her husband for everything. She is too ill to take care of or play with her children, and this makes her feel guilty. Most days, she has trouble getting out of bed or talking for too long. She is battling a laundry list of symptoms like dizziness, tachycardia, heart palpitations, headaches, and difficulty breathing. She spends most of her time lying down in a darkened room because too much light and noise makes her brain hurt. “I never knew it was possible to feel this sick,” she says.

Your life is cancelled until further notice

The experts call it functional impairment. People like Sarah would call it “your life as you know it is over.” You might find it surprising that a young, healthy person could be incapacitated by an illness like Long COVID. After all, a widespread misconception is that this illness only affects older people or those with underlying health conditions.  Hundreds of thousands of cases are proving otherwise.

 Sarah is now part of a growing group of people in Canada who are living with an invisible illness. You may not realize it, but you probably know at least one person who lives with some form of a chronic illness or disability. It’s understandable in a way – who wants to broadcast their health problems to the world? Many suffer in silence at home, invisible and ignored. But unlike some people who have well-documented, diagnosed conditions, people living with Long COVID are struggling to have their illness recognized, let alone treated. Many of them have faced gaslighting by medical professionals, who dismissed their experience, which led to long delays in diagnosis. A growing number of them are fighting to have their condition recognized by workplaces and insurance companies.

Many face a lack of understanding from family and friends.  “You don’t look sick” is something they are getting used to hearing. Or people tell them, “I feel tired at the end of the day, too.” For Sarah, it’s a lot worse than feeling tired – more like being hit by a freight train – but it’s too exhausting to keep educating people about her condition. It’s disheartening to have to keep fighting to be seen, believed, and understood. Like many others living with chronic illness, Sarah ends up feeling like she has to stay silent to make people feel comfortable.

Don’t go to an empty well for water

The world is not kind to people with disabilities. In an ableist society like ours, a person’s worth is defined by their productivity and abilities. We worship youth, beauty, and health, and any talk of illness is uncomfortable, so it’s avoided. So many people are uncomfortable with grief and feel they don’t have the skills to cope. They feel anxious seeing someone in pain, and because they can’t fix it, they feel helpless and awkward. So, cracks appear in relationships, distancing creeps in, the phone stops ringing, and friends quietly withdraw without a word. 

Caution – toxic positivity ahead

Despite good intentions, we often resort to toxic positivity. We tend to act as if only positive feelings are acceptable, so we tell people who are dealing with immense loss and grief to just be grateful they’re alive and to look on the bright side. Good vibes only! Just think positive, or don’t worry, be happy. People sometimes think that resilience means ignoring the bad things, but we shouldn’t be turning a blind eye to what people are going through. Sarah often feels that people want her to pretend to be okay instead of just being there with her, not to fix anything but to just acknowledge where she is.  

Some people truly don’t have the capacity to be supportive. But some people can show up and walk beside those who are going through a crisis. We can acknowledge the emotional experiences of those we care about. It is one of the most helpful things we can do for others.

A few tips for providing positive support without being toxic:

Estimated reading time: 5 minutes

  1. Be authentic in your interactions. Encourage others to express their feelings and thoughts and to seek help if they need it. Avoid telling them to “look on the bright side.”
  2. Be accepting and non-judgmental of others’ feelings and experiences rather than minimizing or dismissing them. Avoid trying to fix or change their feelings. Listen to them and offer support and understanding.
  3. Be aware of your emotional well-being and seek professional support if needed. Avoid pushing yourself or others to be positive and recognize that it’s acceptable to have negative emotions sometimes.

Knowing how to empathize with someone in tough times is one of our most important social skills. Honing your ability to connect with others authentically will not only benefit them, but it will make your relationships better.  

Estimated reading time: 5 minutes

It can be challenging to talk about mental health with friends and loved ones, as there is often a fear of being judged or misunderstood. In this post, I will share five tips for starting a conversation with your friend about their mental health.

Why it’s important to have conversations about mental health

Before we dive into the tips, let’s take a moment to discuss why it’s important to talk about mental health. Mental health issues are incredibly common, yet they are still heavily stigmatized in our society. Those who struggle with mental health often feel isolated and alone, which can aggravate their symptoms and lead to a worsening of their condition. By having open and honest conversations about mental health, we can help break down the stigma and create a more supportive and understanding environment. But the question is, how do you know when a friend is struggling with their mental health?

The signs that someone might be struggling with their mental health

Changes in behaviour

  • No longer participating in activities they once enjoyed
  • Isolating themselves from friends and family, and communicating less than normal
  • Change in appetite
  • Sleeping more and still feeling tired
  • Increased use of substances
  • Changes in care of personal appearance or living space
  • Being less productive at work or school
  • Posting worrying messages on social media

Changes in mood

  • Significant changes in mood, from very high to very low
  • Overreacting to situations
  • Sounding hopeless
  • Feeling anxious, or worrying more

Changes in what they say to you or others

  • “I hate myself.”
  • “I’m messing up everything in my life.”
  • “What’s the point?”

Common barriers to talking about mental health

There are many reasons why people might be hesitant to talk about mental health. Some common barriers include:

Stigma

As I mentioned earlier, mental health issues are still heavily stigmatized in our society. This can make it difficult for people to open up about their struggles, as they may fear being judged or misunderstood.

Lack of knowledge

Many people simply don’t know enough about mental health to feel comfortable discussing it. They may not know the right words to use or the best way to approach the topic.

Fear of making things worse

Some people may worry that bringing up mental health will only make things worse for their friend. They may feel like they don’t have the skills or knowledge to offer the right kind of support.

Now that we’ve talked about why it’s important to have conversations about mental health and some common barriers to doing so, let’s dive into some tips for starting the conversation.

1. Choose the right time and place

It’s important to choose a time and place where your friend feels comfortable and safe. You want to make sure they have your full attention and that there are no distractions that might make them feel uncomfortable or vulnerable. It’s also a good idea to choose a time when you both have plenty of time to talk, so you don’t feel rushed or interrupted.

2. Use open-ended questions

When you’re starting the conversation, it’s important to use open-ended questions that encourage your friend to share more about their experiences. For example, you might ask, “How have you been feeling lately?” or “Can you tell me more about what’s been going on for you?” This can help your friend feel like you’re genuinely interested in hearing about their experiences, rather than just trying to get them to open up.

3. Be non-judgmental

It’s important to approach the conversation with an open mind and a non-judgmental attitude. Your friend may be hesitant to share their experiences if they feel like they’ll be judged or criticized. Instead, try to listen actively and offer support without trying to “fix” their problems.

4. Share your own experiences

If you’ve struggled with mental health in the past, it can be helpful to share your own experiences with your friend. This can help them feel less alone and more understood. However, be careful not to make the conversation all about you – remember that the focus should be on your friend’s experiences and needs.

5. Offer ongoing support

After the conversation is over, it’s important to offer ongoing support to your friend. Let them know that you’re there for them and that you care about their well-being. Check in with them regularly and offer to help them find professional support if needed.

Starting the conversation is just the first step – it’s also important to know how to continue the conversation and offer ongoing support to your friend. Here are some tips:

Be patient

Remember that your friend may not be comfortable opening up right away. It’s important to be patient and give them space to share at their own pace.

Validate their experiences

It’s important to validate your friend’s experiences and let them know that their feelings are valid and important. This can help them feel more comfortable opening up in the future.

Help them find professional support

If your friend is struggling with mental health issues, it’s important to help them find professional support. This might mean helping them find a therapist or a support group, or even just encouraging them to talk to their doctor.

Talking about mental health can be difficult, but it’s crucial for both your own well-being and that of your loved ones. By following these five tips, you can start the conversation and offer ongoing support to your friend. Remember to approach the conversation with an open mind and a non-judgmental attitude, and to offer ongoing support even after the conversation is over. Together, we can break down the stigma surrounding mental health and create a more supportive and understanding environment for all.

Future directions for disability inclusion

Disability is often viewed as an issue that affects a small subset of the population. Yet the pandemic has broadened the scope of that definition — think long COVID symptoms — which could also include mental health conditions that affect most people at some point in their lives. In other words, disabilities — short-term and long-term — are likely to be a part of everyone’s life, whether personally or as a caregiver, and policy needs to catch up with that reality. While Canadian disability policy has made great strides in recent years, barriers to inclusion continue.

Making disability normal
As a person with disabilities, I need a variety of workplace accommodations to help reduce my pain and function well, including a flexible schedule, ergonomic workstation, dictation software, and the ability to work remotely.

I have hydrocephalus, cerebral palsy, and chronic pain as well as depression and anxiety, which further limit my ability to function. While chronic pain affects my mental health and I need psychotherapy, I can’t afford it because disability-related expenses like physiotherapy eat into my meagre income. I’ve managed to cut back on some expenses since the pandemic started, but my ability to do so is based on my need for isolation to avoid catching COVID, which would have devastating consequences for me (cerebral palsy affects breathing). On the other side, isolation itself comes with a cost: it leads to more depression, anxiety, and loneliness. Of course, that won’t be a surprise to people with disabilities and chronic conditions. Research shows that those of us who are living with such conditions have had the worst health and employment outcomes during the pandemic.

A wider spectrum to promote inclusion
I share my personal story to try and normalize the conversation around the accommodation process and advocate for a more streamlined approach. To close policy gaps and set a future course for disability inclusion, those with lived experience need to be at the table. As experts on their own lives, people who experience episodic or fluctuating conditions or invisible disabilities, for example, can make their daily challenges known to help inform policies around work, health care, and other systems. To ensure that policy reflects the needs of those it affects, scholars recommend that people with disabilities be included in research and be consulted as subject matter experts. Doing so would reduce barriers to social inclusion and bring policy questions around employment and financial security into the open.

An aging population also raises new questions; for instance, in connection with the decline in functional ability as people age. Shouldn’t disability policy account for the many who may find themselves coping with unexpected or new limitations in their daily lives?

In Canada’s most populous province, the Ontario Disability Support Program (ODSP) currently provides income and employment support along with drug benefits only to people with “substantial physical or mental impairment that is continuous or recurrent and expected to last a year or more.” That narrow definition focuses on permanent disabilities and chronic illnesses with no prospect of improvement — excluding episodic, temporary, or fluctuating disabilities like long COVID, which can include brain fog, shortness of breath, and other debilitating symptoms. While coverage has recently been included in the Ontario Health Insurance Plan, people with long COVID are having challenges navigating the benefits system, since it is considered “invisible and hard to diagnose.”

Closing the gaps
While social assistance programs are essential, functional limitations are central to receiving adequate benefits. In other words, the worse a person’s condition is, the more financial support they qualify for. At the same time, the program makes it hard for people with disabilities to break the cycle of poverty and income support. To get off social assistance, one must be able to work full time (or at least consistently enough to earn a living). But most people on ODSP can’t work, and those who can must often take low-paying jobs (with long hours in front of a computer) that don’t reflect their skill levels (like call centre jobs).

Unfortunately, these kinds of systemic barriers to employment are all too common. In 2019, I applied to the federal government inventory for students with disabilities, an employment initiative for students to work in the public service and gain valuable experience. However, my application was denied because of my part-time student status (the program was only available to full-time students). Although I explained that my disability made it necessary for me to study part time, that was not sufficient to be included in the pool.

Another example is from the Accessible Canada Act, passed in 2019, which aims to remove barriers related to employment, the built environment, communication, information, program delivery, and transportation. In many cases, work adjustments can be minor — a modified schedule, telework, or an ergonomic workstation — but cumbersome approval processes often lead to frustrating delays.

Similarly, the federal government has implemented a public service Accessibility Strategy that seeks to hire 5,000 people with disabilities by 2025. Applicants for these positions must provide medical documentation in each selection process to receive assessment accommodations. That sounds reasonable enough, yet having a centralized service for accommodation documentation would reduce the cost of doctor’s notes for people who often have limited incomes (and may not have access to a family doctor).

Bringing these barriers to light has been one part of disability advocacy. Other work has led to Bill C-22, the Canada Disability Benefit Act, a monthly amount that aims to reduce poverty for people with disabilities. Within a year after it passes (it is now before the Senate), the bill will provide them with much-needed funds and hope for a better future. Over that 12-month period, C-22 outlines plans to give “persons with disabilities from a range of backgrounds” the chance to collaborate on its regulations, application process, eligibility criteria, and the amount of the benefit. It is my hope that such consultations will lead to an expanded definition of disability and enable equitable access to adequate supports, so people with disabilities in Canada can participate fully in professional and civic life.

Author: is a peer support worker at the Sexual Assault Support Centre of Ottawa. She loves literature and is a graduate of the translation program at the University of Ottawa. In her spare time, she enjoys reading, writing book reviews, and doing yoga.

Angela Psimenatos

A peer support worker at the Sexual Assault Support Centre of Ottawa. She loves literature and is a graduate of the translation program at the University of Ottawa. Angela is a person with a disability who also has lived experience of invisible illness and is passionate about mental health and social justice. In her spare time, she enjoys reading, writing book reviews, and doing yoga.

Estimated reading time: 2 minutes

Who doesn’t love summer? Longer sunny days, outdoor activities, cottaging and camping, sports, social events, and relaxing and enjoying life. And for students, no homework. What could be better?

Summer trouble

For some children and young people who live with mental health concerns, summertime can be challenging. The disruption in routine and a loss of structure can affect anyone. But young people who live with anxiety, depression, eating disorders, or other health concerns can be seriously affected. Changes in sleep and eating habits can have big impacts.  Less structured days can lend themselves to spending too much time online and can aggravate an unhealthy attachment to social media.

Students may feel the loss of socializing with friends and peers during the summer break. Their health status might prevent them from participating in some social activities. Some may be hampered by finances, limiting their ability to participate in things that interest them. It’s not uncommon for young people to avoid some kinds of activities because of the discomfort they feel about their physical appearance. All of these challenging situations can lead to isolation,  loneliness, and poor mental health.

Tips for summertime wellness

Simple but effective ideas to help anyone maintain their mental wellness during the summer:

  • Go outside and get plenty of fresh air
  • Adopt or keep up a schedule of regular exercise
  • Eat a nutritious diet and regulate your eating schedule
  • Get enough sleep
  • Stay in touch with friends
  • Keep up with medication as prescribed
  • Maintain therapy or counseling sessions
  • Limit the time spent on social media and screen time
  • Join a summer camp, volunteer, or get a job
  • Get involved with social activities on a regular basis, such as sports, cultural activities, or hobby clubs

Summertime can be one of the most relaxing and enjoyable times of the year. Embrace these healthy habits and let the sun shine in!

Sharing your story — about achievements, traumas, truths, and wheel busters — can reinforce feelings of resilience or remorse. Finding the balance between advocating for change and protecting your mental wellness.

Discussing uncomfortable power dynamics, colonialism, and white supremacy are part of the daily discourse when you’re an anti-racism educator – but the recent increase in the volume and volatility of hateful messages and death threats following a public appearance, or a tweet, have had a chilling effect.

“The rise of white supremacy and right-wing extremism and violence is very real,” says Selam Debs, whose anti-racism educational work focuses on dismantling discriminatory systems and speaking truth to power. “It’s essential for us to recognize that.”

Debs closed the storefront portion of her Kitchener business after her family started receiving threats. Although the local media covered the story, their focus on the hate effectively buried the substance of Debs’s teachings and point of view. She and others are often hushed in this way (making the need to have such discussions apparent), but at what cost?

“If you’re doing a cost-benefit analysis on your own mental health and the power of making change, there’s no formula to follow,” says Jesse Wente, Anishinaabe author, commentator, and fellow death threat recipient. “Put social progress in the strainer, and when all the ugly comes out, what’s left?”

Selam Debs

Selam Debs

It’s a good question. Taking a quick scroll of the latest Twitter outbursts makes me want to extend the metaphor — some days it seems like the ugly is blocking the colander holes that might let light through.

“If it involves personal threats, and your notifications are on fire, you make a calculation,” Wente says. “You have to think of your family — and of the real progress that is possible. If you have a forum to make change positively — that’s a gain,” he adds, citing past swells of support on social media that have led to name changes for various sports teams over the years.

Such progress is undoubtedly helped by powerful stories. Not only do they stick in your head and help ground common experiences, they often provide insight, comfort — and motivation. Stories can also reduce stigma, which often happens when a person with mental health concerns opens up about their struggles. That’s one of the main reasons the Mental Health Commission of Canada amplifies the voices of lived and living experiences through its magazine and blog. (For those who are feeling ready to do so, its tips on Sharing Your Story Safely are a good place to start.)

Of course, the decision to share a personal story can involve complications. If it’s a family story, is it entirely yours to share? What about future fallout? Once it’s on the internet, you can’t take it back.

In 2006, former Washington Post reporter Pete Earley used a book to tell the story of his son “Mike’s” mental illness, in Crazy: A Father’s Search Through America’s Mental Health Madness. At that time, the relative anonymity felt right. Flash forward to 2022, and “Mike” (now 43) is ready to change that narrative. Appearing in the Ken Burns documentary, Hiding in Plain Sight: Youth Mental Illness, he consciously chooses to own his story, reveal his experience, and make space for others facing stigma by using his full name: Kevin Mike Earley. “If we’re going to say there’s no shame in having a mental illness, how am I going to go around using my middle name?” he asked in a Washington Post article about the film.

Shifting the discourse
“We’ve seen statues come down and school names changed to address colonial history,” Debs says. We are talking about the long game of raising tough topics to get to meaningful change. While questions about power dynamics and privilege have moved from whispers to full-throated discussions, without meaningful change these discussions are simply talk. So why share your story at all?

“I think there is a transformation happening, but there is a ridiculous amount still to do,” she says. In other words, incremental change is still change. Even so, we have to ask why some choose not to speak up.

“We understand why Black, Indigenous, racialized, queer, and disabled folks are not speaking up because there are consequences: you will not get upward mobility, you will be ostracized, you will be seen as aggressive and experience mental and emotional harm,” she says. “I think we need to differentiate between who we need to keep accountable for standing up and those who are not speaking up.”

Those who hold positions of power and benefit from unearned privileges need to do the work to speak up, she says, while making space for Black, Indigenous, racialized, queer, and disabled people to be heard safely, to be compensated for their labour, and to be allowed to lead conversations.

“I remember a time when, if you talked about microaggressions, you were seen as radical, but there’s now social currency within organizations to do this work. I think some are doing it because they know it’s the right thing to do, and some recognize the currency that comes with using terms such as diversity, inclusion, and equity,” she says. “The progress I have seen is the shift in focus from very passive language to addressing how racism, violence, and hate are showing up in the spaces we are in.”

Shifting the language we use can certainly transform the discourse. For example, well-meaning questions such as “How can we help disenfranchised poor people get more opportunity?” can be modified to ask “Who is perpetuating the harm, and what can be changed on a meaningful — as in a systemic — level?”

For Wente, it is also about the medium. He has a “hokey-pokey” relationship with social media, dipping in and out. “Recently I put my toes back in, and I can’t say I liked it. The failures of content moderation are more obvious these days,” he says, noting that his mental health improves when he’s online less. “That doesn’t mean I don’t say things that are meant to move things forward — I’ve just chosen a different venue to say them.”

It’s part of the reason he wrote Unreconciled: Family, Truth, and Indigenous Resistance: to shift the discussion from tweet wars to panels, speeches, and other forms that support more nuanced conversations. “This is my daily work — to change minds and shift things,” he says. “To me, this is a very serious thing, and it’s only effective when you’re also dealing with other serious people. I’ve come to understand that some social media platforms are not the venue for much seriousness at all. I want to see people in a room where we’re actually talking.”

Jesse Wente

Jesse Wente

Wente cites past online-offline movements like Idle No More as having real-world gains, but much has changed from that more digitally innocent time — cat photos have given way to daily death threats. The death threats he has received online and on his home phone have led him to the uncomfortable realization that change making now comes with this kind of exposure. “Social justice has always required awareness, balance, and risk,” he says. “Threats happen over the internet and in real life, meaning people who make real change are having to face that.”

Yet, normalized violence reflects a terrible state of affairs, and it is becoming more overt and seemingly acceptable.

“As activists and educators in anti-racism, we are constantly met with violence,” Debs says, which leads to constant states of burnout. “There is a need to self-preserve because telling our stories again and again can become a kind of trauma porn. We have to find a balance between educating or sharing parts of ourselves and preserving our own well-being.”

What does Debs offer to others on coping in these spaces? “I don’t think I have advice, other than I think it’s important to understand why it is the way it is,” she says. A focus on equity and healing for Black communities has given her a guiding path, one she speaks about through her teaching.

“Black liberation is the way by which I live my life,” she explains. “And it comes with many different elements: it’s about personal self-reflective examining and recognizing that systems need to change in order to truly access healing,” she adds. “It’s also learning about my culture, foods, and language as a Black Ethiopian woman.”

She says it is also about decolonizing from all the ways she has been conditioned to see herself as inferior, and that happens through sharing knowledge to create that sense of liberation for others. Sharing your story in this way is a long-term investment. “The intergenerational abundance and well-being are about planting trees that we may never fully receive shade from,” she says. “Our children and our children’s children will receive the abundance of what is planted today.”

Wente sees his work as an obligation that occurs in spaces where he is often the only Indigenous person. That standpoint is one of the ways he helps balance the risks and benefits of opening up. “Your perspective is not one that is heard often,” he says, as we talk about changing narratives. His view on sharing one’s story, he admits, may come across as overly idealistic — but he’s sticking with it.

“If everyone shared their story, it would be hard to deny some simple truths,” he says. “The more people share their stories, the safer it will be for others to do the same.”

Author: is the manager of Content and Strategic Communications at the Mental Health Commission of Canada.
Illustration: Holly Craib

Inset: Selam Debs, Blue Aspen Photography

Inset: Jesse Wente, Red Works

A long-time nurse reaches out to other health professionals to foster an open dialogue about stigma around mental health

Busy periods are common in any profession. Think of the morning rush in a local coffee shop, tight project deadlines, and new product launches – they all create stressors and excitement for employees.

However, the constellation of challenges is taken to a whole other level when we talk about the health-care system in Canada. Overcrowded emergency rooms have been pushed to the limit as the effects of COVID-19 continue to put pressure on our already fragile systems. In the face of such pressures, doctors, nurses, and administrative staff have worked hard to maintain service levels despite limited resources. Many still see no end in sight.

A study completed prior to the pandemic brought to light the toll workplace stress has had on the mental well-being of Canada’s nursing workforce — and the results were staggering. One in three nurses screened positive for major depressive disorder, one in four for generalized anxiety disorder, and clinical burnout. But most concerning of all was that 33 per cent reported having suicidal thoughts, and eight per cent said they had attempted suicide at least once in their lifetime.

How did we get here? And how much worse has the situation gotten since the pandemic?

Debbie Phillips, a registered nurse for over 30 years, with most of that time spent in the emergency department as a psychiatric nurse, has witnessed the increasing pressure placed on hospital staff first-hand.

“Because of cuts in funding to the health-care system, we were constantly tasked with doing more work while being given fewer resources. When I first started my career in the emergency department, if a patient needed to be admitted, we had beds available for them. By the end of my career, I was calling hospitals province-wide to find appropriate spaces for our patients to receive care, often waiting five days until beds became available.”

Unfortunately, her experience is not unique. According to The World Bank, the seven hospital beds per 1,000 patients seen in the 1970s and ‘80s now average less than three and is steadily declining. This regression has had a severe impact on the physical and mental well-being of hospital staff and the people they provide care for.

Giving but not receiving
While under their care, health-care professionals are responsible for our safety and well-being when we are most vulnerable. Over 700,000 of them fill these selfless and often thankless roles to make sure our physical and mental health needs are addressed.

Yet, with such a prolonged strain on our systems, the question of who is there to support their health needs can be overlooked.

One might think health-care workers have an acute sense of their physical and mental well-being, given their daily role in providing treatment for others. But that is not the case, Phillips says.

“Nurses often overlook warning signs of their own mental decline,” she notes. “We have the mindset that we know better, and we wouldn’t let ourselves get to that point.”

For those who do recognize these signs, resources can be scarce. Limited staffing means that sick leave requires proof of a physical ailment. There are no days off for feeling burnt out.

This limitation increases the stigma health-care workers face when it comes to their mental health. “You can’t just take a day off and rest,” says Phillips. “When you’re away from work, you feel guilty that you’re not there because you know your team won’t have additional resources to fill your spot. You know that people will be waiting for care, and that weighs on you. It adds more stress to the situation.”

Some are unaware of the stress they are placing on themselves, and others are too stigmatized to seek support, Phillips says. So where do we go from here? What resources are available to help those in need?

Resources for change
According to a paper in Nurse Leader from April 2022, 76 per cent of nurses in the U.S. who experienced workplace burnout did not seek mental health support. And just 42 per cent of health-care employees felt that their workplace valued their mental health.

Based on this and other evidence, the article calls for the transformation of “nurses’ perceptions and the cultural context that serves as a barrier to nurses caring for their well-being and accessing mental health care.”

Making investments to address stigma, it adds, “could also have a secondary benefit of improving nurses’ perceptions about mental health needs and care in their patient population.”

In Phillips’s experience, such investments in workplace mental health-related programs have been inconsistent. Since the funding grants that are periodically available are for one-off programs, she says, they fail to make a lasting impact on her team.

To address this gap, training must both adequately address employee needs and effectively reduce workplace stigma. One program specifically designed for those purposes is The Working Mind Healthcare, an adaptation of The Working Mind from the Mental Health Commission of Canada.

This evidence-based course is designed to shift the way employees think, act, and feel about mental health in the workplace. It aims to reduce the stigma around mental health and foster open dialogue between co-workers. As a facilitator for The Working Mind, Phillips has seen its impact on participants as they took the training.

“You could literally see lightbulbs coming on for people. Whether it was looking at the mental health continuum or the Big 4 coping strategies, you could see the expressions change on peoples’ faces as they were learning. You could tell they were having their eyes opened.”

Having a background in the health-care sector allows Phillips to connect with those she trains on a deeper level. It helps create an environment that promotes dialogue, knowing that everyone in the room has shared similar experiences.

The most frequent feedback she hears after her sessions is participants’ wish that they had taken the course sooner. “I think it should be part of orientation for everyone going to work in a health-care setting,” she says. “Why not set up the next generation for success as soon as they get in?”

Since tackling the stigma around mental health in health-care settings is a long-term challenge, it’s important that we all do our part to be mindful of the stress these workers are under when we encounter them.

Author: is a Marketing and Communications Specialist at the Mental Health Commission of Canada. He is a graduate of Carleton University’s Sprott School of Business and has extensive experience in sports and entertainment communications and marketing. Eric is the co-founder of mssn, a brand dedicated to raising funds and awareness for youth mental health in the Ottawa area.

Eric Gronke

A graduate of Carleton University’s Sprott School of Business, Eric has extensive experience in sports and entertainment communications and marketing. Eric is the co-founder of mssn, a brand dedicated to raising funds and awareness for youth mental health in the Ottawa area.

Florence K – musician, mother, CBC host, and doctoral candidate – takes the theme of this year’s Mental Health Week and shares her personal story of mental health challenges, wellness, and discovery.

I was 12 when I first heard Forrest Gump share his mother’s view on life from that park bench in Savannah, Georgia: “Life was like a box of chocolates — you never you know what you’re gonna get.” Lots of people have heard the famous movie line. But as I was to find out, it was a perfect description of what life had in store for me.

At first, I saw myself following the path I’d mapped out in my head hundreds of times during my teenage years. It was a dream that I hoped would lead me to a successful singing career, and I did everything in my power to make it a reality. As a teenager and young adult, I auditioned, competed, took advanced classes, accepted contracts in seedy bars, entertained at nightclubs in Atlantic City and Casablanca, sang at masses, and played piano (for years) in an Old Montreal restaurant. No audience, and no stage, was beyond my reach because they guaranteed I was moving closer to my dream.

I wanted to shine on stage, be embraced by the love of others, show what I had to offer, draw everyone’s attention, and transform my raw emotions into notes to bring them out of my being. Without being aware of it, I also probably wanted to fill what I now call my “inner hole.” At the time, the term mental health was certainly not part of the culture, and I had no words to define it. But it felt like a sense of emptiness fueled by negative, sometimes self-destructive, thoughts about myself. While it even led to experiences of suicidal ideation following a break up at age 14, I would never have thought “this is not normal” or “not everyone feels this way” — or that this hole has a name and there are ways to address it.

My solution at the time was to fill the emptiness with parties, alcohol, and drugs. Later, I did so by being on stage, since performing was an outlet for me. But no matter what I did, the emptiness continued to grow, slyly and subtly as I avoided asking myself about its presence. I shrugged it off and focused on my career — at 23, my first album, Bossa Blue, went gold — and the birth of my first daughter. My emptiness was filled during the early years of motherhood by the happiness and presence of my wonderful little girl.

Florence Khoriaty

Florence Khoriaty

After my first tour, I quickly went on to record second and third albums, both followed by a series of shows and promotional campaigns. I couldn’t have asked for more: my big dream was now a reality. My team saw international success for me, and my ambitions followed theirs. But at the same time, I felt my inner hole slowly opening again. My relationship with my daughter’s father was crumbling. I wanted to leave him but couldn’t, consumed by guilt at the thought of unravelling the nest we had built. I now had two worlds: one on stage, which was becoming an addiction, and one as a couple, which I was stepping back from. This guilt about a possible break up started engulfing me, sucking me into a spiral of persecutory thoughts. I hated myself, I blamed myself, and I was afraid. Yet I suffered in silence because of what I told myself: it was shameful to feel this way when so many people were living in war-torn countries while I had a full fridge, a healthy daughter, friends, money, and a job I loved. Before long, I began disappearing into my thoughts, losing my ability to concentrate. I also started losing weight, hair, and most of all, sleep. Insomnia was the beginning of the hell that would inhabit my head for the next eight months. I spent whole nights feeling my fingers tremble, looking at the clock in anguish, grabbing my skull, begging it to let in some quiet and let me rest.

People around me also started to worry. I couldn’t take care of my daughter anymore. I’d asked her father to leave, and he took me up on it, disappearing completely from the life of his five-year-old. Thankfully, my father, mother, and sister-in-law began taking care of her. The important thing was giving her a framework that could continue providing her with everything a child needs while her mom tried to get better. At this point, doing it alone was impossible. All I could manage was to put on my best, fake smile to get on stage with what little voice I had left. I was clinging to this part of my life, the only one I was still able to give something to, for 90 minutes, three times a week.

But the emptiness caught up with me.

What followed was a series of suicidal ideations and behaviours, medication trials and errors, and emergency room visits, while my loved ones looked on feeling completely lost. They weren’t equipped to deal with such a whirlwind, and mental health was so poorly understood in 2011 that they did not fully understand what had taken hold of their daughter, sister, and friend. My final admission to the ER came after an ambulance ride, escorted by two police officers.

While the following weeks were very difficult, they were lifesaving. Being in psychiatric care finally made me realize that I was sick — but also that I wasn’t alone: I felt understood and enveloped by the other patients. With an adjustment of my medication and psychotherapy, I began feeling better. Then, in 2017, when I was on the verge of a relapse, a psychiatrist gave me a diagnosis of bipolar II disorder. This diagnosis was a gift. I could finally understand this inner hole I’d been living with since my teenage years. I could put words to it and identify the symptoms, the triggers, and the tools and resources that could help me.

This quest for balance infused me with an enormous fascination for the brain and human behaviour. This passion became the driving force behind my return to university, where I completed a certificate in psychology, a master’s degree in mental health, then, after a bachelor’s degree in psychology I was finally accepted into a doctoral psychology program. My dissertation is inspired by my history, as it focuses on the possible links between creativity and bipolar disorder.

Today I am proud of my journey. It has been tortuous, unexpected, and fraught (I almost lost my life, more than once). But it has also led me to discover treasures hidden deep within myself that I never knew were there. Even though I live with this chronic disorder, my mental health is excellent. I aim for balance in my life, and I have learned to recognize and listen to the warning signs that could lead me into troubled waters. With my husband, two wonderful daughters, and a passion for my field of study, I now feel fulfilled. And if I was to run into Forrest Gump on the street, I would simply say, “Forrest, you were ab-so-lu-te-ly right!”

Author: is a singer, songwriter, pianist, and weekly host of C’est formidable! on CBC Radio One and CBC Music. She is completing her doctorate at UQÀM.
Inset photo: Matthew Eisman/Getty Images

I parked my car blocks away, terrified that if anyone saw me near the building they would know that I was one of the “crazy” people attending the meeting.  I walked slowly, almost turning back to my car 3 times before I made it to the door.  What kind of people would I find inside?  I put my hand on the handle, took a deep breath, and entered.

I found myself in a small, crowded but cheerful room – crowded with supplies, with cluttered workstations, with the smell of bad coffee and welcoming faces.  This was my first experience of peer support.  This was really my first experience of meeting other people who were open about their experiences with mental illness.  And this was the first meeting that changed my life.

Peer support offers benefits that are less accessible through traditional “medical model” treatments:

  • Recovery-oriented
  • Empowerment
  • Independence
  • Responsibility
  • Choice
  • Respect and dignity
  • Social action
  • Self-help
  • Hope

What I have learned from peer support

From my peers, I learned that recovery is possible and that it is a process, not a destination.  That some folks (me included) will struggle with mental illness throughout their lives, but that we can still live well with that illness.

I gained a sense of community, that I am not alone, or “crazy” or a “freak” – that I am instead a person in very good company with others who share or have shared my struggles, who understand my perspective and who respect and support me based on who I am.

I discovered that I do not have to be a passive recipient of care, but that I can be active in my own care and recovery.  I learned that I have agency and choice and a responsibility to help myself through my own journey with mental illness. 

I learned that I have a great deal to offer, too, to others who are struggling.  My experiences, as frustrating and often inexplicable as they seem, can help others make sense of their own lives and thereby become useful.  Bonus: I found that helping others can be a steppingstone on my own journey with recovery.

Peer support helped me crush my own self-stigma and counteract the stigma I encountered in my world.  It gave me hope for my future at a time when I wasn’t sure if the future was worth waiting for.  And it still has a regular place in my life, as indispensable to me as my medications and talk therapy.  It cannot replace those things, but also cannot be replaced by them – it is completely complementary. 

How to find peer support

There are a variety of forms that peer support can take – informal or formal, group-based, or one-on-one, in-person or virtual  – but if you are interested in taking the first steps the internet is the place to start.  In the years before the pandemic peer support required me to leave my house. Now there are a variety of internet-based options (which are great for many, including those of you living outside of bigger cities), but in-person options are starting to pop

You can’t learn anything from a pop up.

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