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Activating an entire school community (parents, peers, education workers) can reduce the nefarious long-term impacts of bullying — a look at promising models to create kinder environments for kids
Bullying, including cyberbullying, is a growing and worrisome epidemic. Not only have one in three children been bullied at some point in their lives, the long-term impact on young people and adults can be life changing. An increasing body of evidence points to its detrimental effects on people’s mental and physical health. Studies also show that there can be lasting impacts in terms of future social and financial outcomes.
“It’s part of life”
Contrary to lingering social attitudes, we now know that bullying is not just an inevitable part of growing up or a harmless rite of passage. Bullied children and adolescents have a much higher risk of developing psychosomatic symptoms than those who escape it. Commonly reported problems linked to bullying include poor health, loss of appetite, sleep disturbances, headaches, abdominal pain, breathing difficulties, and fatigue.
For Eric, it started in elementary school, where the bullies targeting him kept up a relentless campaign of abuse. Its effects, he recalled, included anxiety, headaches, nausea, weight loss, and the absolute erosion of his self-worth. But those weren’t Eric’s only worries. After two years, with no hope in sight, he had reached his breaking point: “I didn’t care whether I lived or died,” he said. His family, desperate to find help, turned to a psychiatrist, who took Eric out of school and put him into intensive treatment. Thankfully, after some time, things turned around for him. In fact, he ended up becoming a kind of champion of the underdog among his peers. Today, Eric describes himself as “lucky.”
A young person being bullied can feel isolated, have trouble trusting people, and lack quality friendships. Should they end up believing that they can’t do anything to change their situation, they may stop trying. This feeling of defeat can also lead to hopelessness and a conviction that there’s no way out, often because they think telling someone won’t change anything. They might also prefer to suffer silently rather than risk escalation or imagine that the bullying will eventually end if they just keep quiet.
As bullied young people become adults, they may continue to struggle with relationships and avoid social interactions. Difficulties with self-esteem and trusting others can undermine significant personal relationships as well as their social and work lives. Victims of bullying also have a greater risk of emotional disorders in adulthood, including depressive and anxiety disorders, panic disorder, generalized anxiety, and suicide.
“There is clear evidence that a wide range of childhood adversity has long-term negative effects on both mental and physical health,” said Dr. Keith Dobson, a professor of clinical psychology at the University of Calgary. “Further, the emerging literature demonstrates a strong linkage between bullying and later depression and other health problems.”
Role modelling
Why does bullying still happen? Many experts point to the lack of a systematic approach to tackling the problem in schools. For a long time, it was left to teachers to address bullying behaviours — and for that to happen they would have had to witness it. Beyond that, the responsibility for reporting the problem was often left to the student, which meant that much of it was never reported.
Enter proactive bullying prevention.
The research on anti-bullying interventions is extensive, with numerous school-based programs having been evaluated scientifically. Some, like the KiVa program in Finland, focus on mobilizing the bystanders who witness bullying. These work through the power of peer responses to inhibit or fuel such behaviour.
Other programs seek instead to actively create a kinder school environment. The most prominent of these, the Olweus Bullying Prevention Program, is also one of the most widely tested. Developed by the late Swedish-Norwegian psychologist, Dan Olweus, it’s rooted in the idea that bullying is often the product of a wider culture’s tolerance toward victimization. On that basis, it tackles bullying from the perspective of a school’s entire ecosystem.
Olweus therefore works by changing the social climate around bullying: raising awareness among students, adopting anti-bullying norms, and having teachers clearly communicate their anti-bullying attitudes. But it also goes beyond the student-teacher dynamic. Every adult in the school gets basic training about bullying — not just educators and administrators — but cafeteria staff members, bus drivers, custodians, and others.
The program is effective when all these adults function as positive role models, reinforce good behaviours, and refuse to allow victimization. As part of this process, clear expectations are set for acceptable behaviour, as are the consequences of failing to abide by them. In ending their support for the culture of secrecy around bullying, each person helps to create an environment where reporting it is appropriate and expected. When saying no to bullying becomes everyone’s responsibility, it is soon ingrained in a school’s culture.
The research strongly supports the success of whole-school programs to decrease bullying behaviours. In fact, a recent study of 69 randomized clinical trials concluded that such interventions not only reduce the incidence of bullying and victimization but also improve the mental health of students.
A kinder community
When parents commit to the prevention of bullying, especially if they actively participate, a school program will be more successful. Parents can set a good example by getting involved, raising awareness, and supporting anti-bullying measures.
But since bullying is not confined to school corridors and the playground, and not all children who are bullied ask for help, parents and caregivers should also be on the lookout for warning signs. These include unexplainable injuries; lost or destroyed clothing, books, electronics, or jewelry; frequent headaches or stomach aches; feeling sick or faking illness; or changes in eating habits (like suddenly skipping meals or binge eating). In this last scenario, kids may be coming home from school hungry because they didn’t eat lunch. They may also have difficulty sleeping or frequent nightmares, declining grades, loss of interest in schoolwork (or not wanting to go to school), sudden loss of friends or avoidance of social situations, feelings of helplessness or decreased self-esteem, or self-destructive behaviours such as running away from home or harming themselves.
As well, parents can empower their children to stand up to bullies. Start by talking about what bullying is and what healthy friendships are and are not. Children themselves can also learn how to report bullying when they see it. Here, it’s important that parents help them understand why they don’t want to be a bystander and offer them practical knowledge on how to handle the situation. Taking such steps can make a big difference in the outcome.
Programs such as HEADSTRONG, offered by the Mental Health Commission of Canada, can also play an important role in supporting healthy school environments by providing students and youth the tools, confidence, and inspiration to become leaders for mental health and wellness in their schools and communities.
While bullying can have long-term negative effects, it doesn’t have to, according to Dobson. What is important is to act and intervene for the sake of others and yourself. If you know of a child who is being bullied, try to understand what’s going on and intervene if doing so is indicated. If you’ve been bullied and are living with the ongoing consequences, resources are available to help you improve your well-being.
Nicole Chevrier
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First Nations First Aiders support individuals and strengthen communities
Those who teach Mental Health First Aid in First Nations communities have lived experience with trauma. Roger Chum’s experience is a stark example.
“I have a personal story,” said Chum, a member of the Omushkego Moose Cree First Nation near James Bay, and a residential school survivor. “I tried to take my life, too, as a young man because of all the trauma I was walking with.”
He was saved with the support of others, and now, years later, he’s a counsellor in the First People’s Centre at Canadore College in North Bay. He also travels to communities across Canada to co-facilitate sessions in the Mental Health Commission of Canada’s (MHCC’s) Mental Health First Aid (MHFA) First Nations program, where he sees reflections of his own pain in others.
“The common themes in all the training I’ve done — in communities from B.C. to Nova Scotia to Prince Edward Island to Ontario — seem to be suicide, racism, and discrimination that people face when they’re trying to walk in two worlds, trying to live in general Canadian society but keeping their cultural and Indigenous identity at the same time, trying to balance that,” Chum said.
He estimates that he’s trained about 2,700 people to be Mental Health First Aiders since the mid-2010s, when he completed training to be a MHFA First Nations co-facilitator. In turn, those First Aiders have gone on to support thousands of people in their communities. When those who receive support to help survive their own psychological turmoil go on to help others, it creates a cycle of support that strengthens entire communities.
What sets MHFA First Nations apart
Today, about 70 First Nations co-facilitators provide MFHA training across Canada, primarily in First Nations communities but also elsewhere. Chum, for example, continues to conduct sessions for members of the Greater Sudbury Police Services, most of whom are non-Indigenous.
MHFA is a series of actions that people can take to support those who may be experiencing a crisis or decline in their mental health. While the commission offers various MHFA programs, none are quite like MHFA First Nations.
The MHCC conducts regular reviews of the course. A recent update adapted its broader objectives beyond regular MHFA training, which is very much about the skills participants might use and the actions they might take to support someone whose mental health is declining.
Some areas of the MHFA First Nations coursenow have a lot to do with building community through activities that engage the group as a whole and addressing systemic issues that have impacted First Nations people more directly — things like social determinants of health, systemic racism, and colonization.
Learning to train Mental Health First Aiders
The program’s ongoing success relies on two First Nations master trainers, Amanda Petit and Mary Wabano-McKay. These trainers teach the course First Nations people take to become MHFA co-facilitators, who in turn teach community members to be Mental Health First Aiders.
“I couldn’t imagine taking a course such as MHFA First Nations and having it delivered by a non-Indigenous person,” said Wabano-McKay, a Mushkegowuk (Cree from Attawapiskat First Nation), who lives in Sault Ste. Marie and works for Algoma University as vice-president of Nyaagaaniid — student success and Anishinaabe initiatives. “How could they relate to the lived experience and life experiences of First Nations people without having that lived experience?”
She added that Indigenous master trainers “serve as positive role models in communities among our peers and colleagues to show that not only did we inherit a lot of loss, grief, and trauma, we’ve also inherited resiliency, strength, and determination. Those things are imbued in the co-facilitators that deliver the MHFA First Nations course across the country.”
To become a co-facilitator, candidates go through 20 hours of group instruction, then spend two days working one-on-one with master trainers to go deeper into the material and demonstrate that they can deliver the MHFA First Nations course. To be accredited as a co-facilitator, they must complete further requirements within one year.
Impacts, obstacles, ways forward
The course content to become a co-facilitator can be disturbing, Wabano-McKay pointed out. In addition to going through the colonial legacy of TB hospitals, residential schools, the 60s Scoop, and other intergenerational traumas, it covers “how all of these are continuing to have serious impacts on First Nations people, on overall wellness, on mental health — from anxiety and depression to substance use and psychotic disorders.
“Such material can often be triggering for those who take the course,” she said, which is why co-facilitators are on site when an MHFA First Nations workshop is held. Community Elders are also invited to provide further support to participants, as needed.
Another potential obstacle for co-facilitator training is for candidates to get past their own stigmas about mental health and understand that everyone has it.
For co-facilitator Laurie Belcourt, a Treaty 8 Nations of Alberta employee from Bigstone Cree Nation, the course was a revelation.
“It changed who I was,” she said. “The way I think about people, the way I interact with people, it’s different. I’m a lot more understanding, I’m a lot more empathetic. It’s helped me understand that people have mental health problems. They’re not just looking for attention; they just don’t know how to deal with what’s going on.”
Through the MHFA First Nations course, Belcourt passes on that empathy and understanding to help First Aiders learn how to recognize mental health struggles in their communities, perhaps in their own families or circles of friends. “You’re that bridge between where they’re at, and where they need to go,” she said.
Co-facilitators are not there to provide professional care. Rather, their task is to listen and provide support in the moment, much like physical first aid. The next step, said Wabano-McKay, is to “connect the person to appropriate professional help and explore other supports people may have within their community. We let them know that their role as Mental Health First Aiders is to be that go-between, to give somebody that opening to be able to say, ‘I’m not okay, and I need some help.’”
Because every First Nations community has its own history, all of these interactions are carried out while respecting each tradition and culture. As Chum puts it, we’re always finding that “their food is different, their ways of knowing are different, their culture is different. We’re a very diverse people right across this place we call Turtle Island.”
Mental Health First Aid is provided to a person developing a mental health problem, experiencing a mental crisis, or a worsening of their mental health. More than 500,000 Canadians have been trained since 2007 and you can as well. Find a MHFA course online or in person.
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I was diagnosed with bipolar II disorder, exacerbated by postpartum depression shortly after my son was born. When I first heard my psychiatrist say I was diagnosed with bipolar I did not want to believe it. I had preconceived notions that people living with bipolar are scary, unstable, hyperactive, have split personalities and are not able to function in society. How could I be diagnosed with something like this? It did not make sense to me that a partner, mother, and teacher like myself would be diagnosed with bipolar disorder. My own stigmas surrounding mental illness and bipolar disorder stopped me from accepting the diagnosis. I was ashamed of this disorder and wanted to hide it from others that way I had been hiding it for all these years.
Accepting my diagnosis
It took a while for me to truly understand and accept my diagnosis. Months of therapy with a counselor and my psychiatrist plus the proper medication, helped me realize that I had actually been living with undiagnosed bipolar for a long time. I had been functioning with this disorder by putting a mask on for my audience. I finally decided to take off the mask when my son was around 5 months old. I was tired of hiding who I was and wanted to share my story with friends and family. My wish was that by sharing my story it would help other people living with mental illness know they are not alone. For months, I kept dragging my feet about sharing my story. I worried about what would people think of me and if they would accept me after they found out I have bipolar disorder. And this is what stigma is all about. Worrying about what others would think of me and keeping my story hidden was contributing to the stigma surrounding mental health.
For the most part, talking about mental health is not a part of our everyday lives. But what if this wasn’t the case? What if we could share that we have a mental illness without worrying? What if it was as easy as saying what you had for breakfast that morning? Mental illness is not something that people choose. After I wrote about my experience with being diagnosed, I decided that I would become an advocate for mental health whenever I got the chance. I no longer wanted to stay quiet about my diagnosis because I have been wearing a mask for too long. I started writing to different publishers and speaking up to friends and family whenever I got the chance.
Breaking the silence
Stigmas are still strong in our society but the more we bring up the subject of mental health, the more we can begin to break the stigmas. I remember sitting at a baby mommy group that I have attended for several months. The group facilitator always started off each baby class with a light ice breaker question, asking us about our favourite movie or where we would like to travel. The moms and I always shared lighthearted answers to these questions. One day the facilitator asked us to tell the group about one thing no one would ever guess about us. This was my chance to break the stigma and share about my bipolar. I went back and forth with this idea while other moms shared their very tame and predictable answers. Finally, it was my turn and I nervously said, “something that you would never guess from me is that I live with bipolar disorder”. As I looked around the room no one was saying anything or making eye contact with me, it was something that no one was expecting to hear. The facilitator thanked me for being brave enough to share this with the group, and she told me how more people needed to do this. By letting others know your journey we can start to break the stigma.
Mental health doesn’t have to be the elephant in the room. I am proud of the accomplishments I have had while dealing with a bipolar diagnosis. This diagnosis is no joke and for people to lead successful lives while dealing with an often-debilitating illness is amazing. Having spent some time on social media platforms, I have found that there are strong individuals sharing their stories. The stigma of mental health is diminishing because people are brave enough to talk about it and share. They are not sharing for attention; they are sharing for connection. When we connect with someone who shares our mental illness it gives us hope. Hope that we can survive and live with our mental illness every day. Our mental illness does not have to define us. So, if you are hesitating about sharing your story just do it; you’ll be glad that you did. Sharing your story with even one person who is going through what you are going through can make all the difference and is one step closer to helping break those stigmas.
Author: Jamie Rose
A longtime elementary school teacher and a mother to a beautiful one-year-old boy. When her son was born, she was hospitalized and later diagnosed with bipolar disorder, exacerbated by postpartum. Jamie vows to advocate for mental health awareness and to continue crushing the stigmas. In her spare time, Jamie can be found playing volleyball, walking her dog, and listening to 90s rock music.
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Using person-first language to make an important distinction
This article is part of the Catalyst series called Language Matters.
When talking about mental health, the language we use falls into two broad categories: person-first or identity-first. At the Mental Health Commission of Canada (MHCC), we typically use and recommend person-first language, but that choice may not apply in all situations.
What’s the difference?
Identity-first language leads with the illness or condition as opposed to the person experiencing it. For example: “schizophrenic person” uses schizophrenia as a descriptor before referencing the individual. Conversely, person-first language focuses on the individual while de-emphasizing the illness or condition. So, in this instance, if using person-first language, you could say, “an individual who lives with schizophrenia.”
The language used to talk about mental health or substance use can play an important role in reducing — or reinforcing — stigma. By focusing on the individual, person-first language underscores the fact that a diagnosis is only one component of someone’s overall being. It also shows respect for an individual as a person rather than as “abnormal,” “dysfunctional,” or “disabled.” For that reason, it is considered less stigmatizing and is often preferred in the mental health and substance use context.
That said, it’s important to bear in mind that this preference is not universal. As one friend explained, “I don’t live with bipolar disorder. It’s not my roommate.” For her, using identity-first language — “I’m bipolar” — better represents how deeply intertwined the condition is with every aspect of her life, while person-first language has a minimizing effect.
For others, identity-first language is rooted in the relationship between their personal and cultural identities and their condition. For example, deafness, which has a rich culture unique to those who share the experience, often emphasizes abilities over disabilities. In that case, “deaf person” might be preferred over “person who lives with deafness.”
How to choose?
In an American Psychological Association survey of 3,000 individuals living with a range of conditions, 70 per cent chose “person with a disability” when asked about the language that best describes them. “Disabled person” was chosen by just eight per cent.
When writing, the MHCC recommends person-first language as a first choice, unless you know that an individual or group describes themselves otherwise. When talking to a person with lived and living experience, listen for or ask them about the language they use. It’s not about getting it “right” on the first try. It’s about listening, learning, and championing the use of respectful, non-stigmatizing language — whichever form that takes.
Amber St. Louis
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Educators play many roles and are increasingly called on to support youth mental health. Organizations are responding by equipping teachers with Mental Health First Aid training and tools.
In Canada, mental illness affects more than 1.2 million children and youth. By the time they reach age 25, that number rises more than six-fold to 7.5 million. These figures show just how much the early years provide the foundation for mental health and resilience throughout a person’s life. Since the start of the pandemic, concern over the mental well-being of youth has increasingly been a topic of discussion, particularly with the disruption of their routines.
Yet, as young people navigated from online school and back to in-person classes, the enormous pressure teachers have felt to develop additional skills for handling this mental health crisis has also affected their well-being. According to a June 2021 University of British Columbia survey, about 80 per cent of teachers reported experiencing moderate (56.7%) or serious (22.9%) mental distress.
As a result, the Toronto District School Board (TDSB) and the government of Saskatchewan have been investing in mental health training to give teachers the necessary tools to maintain mental well-being — for themselves and their students.
“As education workers, we work to educate Canada’s future generations,” said Mara Boedo, an executive officer with Toronto Education Workers (TEW), whose 17,000 CUPE members (local 4400) include TDSB employees. “This means that every positive change we can help our members make will impact the students in their care — and this will stay with them for the rest of their lives.”
The TDSB, which serves nearly 250,000 students across the district, has been investing in The Working Mind (TWM) since 2018. The course’s stigma-reduction focus is designed to promote mental health in the workplace by giving participants tools designed to assess their own mental wellness, identify signs and symptoms, and develop healthy coping strategies.
Mara Boedo
Teaching the teachers
After taking TWM, one participant’s recovery from mental distress became noticeable to others, including her family doctor, who asked, ‘What are you doing differently?’ “I have a new vision for myself,” she said. Through the course, participants work on changing behaviours and attitudes around mental illness by discussing resiliency, investing in their mental wellness, and exploring stigmatizing attitudes.
The participant was sharing this story with her TWM facilitator Cherill Hiebert, which led her to remark on the importance of teaching others about the small steps anyone can take to improve their mental well-being — rather than waiting until it gets to the point where a person needs professional help.
“That was the most powerful thing I have heard,” Hiebert said. “Without the program, that person would have had no vision because she had no hope.”
For these organizations, TWM signifies a proactive approach to their members’ mental well-being. But what happens when it’s too late for proactive measures? How can teachers prepare for a mental health crisis developing right in front of them? These have been long-standing questions for the Saskatchewan government.
Cherill Hiebert
Preparing for crisis
In December 2020, Saskatchewan announced a $400,000 commitment to provide Mental Health First Aid (MHFA) training to at least one staff member in each school in the province. MHFA enables individuals to provide help for someone who is either developing or going through a worsening mental health problem or experiencing a mental health crisis. Just like a person might provide physical first aid until medical treatment is available, MHFA is given until appropriate support is found, or the crisis is resolved.
When this funding was announced, Education Minister Dustin Duncan encouraged all the provinces’ school divisions to help remove the stigma around mental health. Such strong ministry support paved the way for coordinating training in 733 schools for 926 staff members. Every division now has MHFA responders with specific knowledge to support youth when they need it.
A hopeful future
These efforts to provide a more inclusive and sustainable approach to mental health in educational environments do not stop there. The National Standard of Canada for Mental Health and Well-Being for Post-Secondary Students, created by the Mental Health Commission of Canada (MHCC), enables academic institutions to better support students and integrate mental health into their services and systems. A starter kit to help them align their policies with the Standard and reaffirm their commitment to student mental health has now been downloaded more than 2,000 times, in settings of all sizes across the country. The Standard has also helped institutions continue their emphasis on student voices and perspectives, as we’ll see in a video series this fall where students will discuss mental health in post-secondary institutions.
The range of resources the MHCC has developed for the education sector is at the forefront of mental health and well-being for students, teachers, and faculty alike. One other example available to individuals and institutions is The Inquiring Mind Post-Secondary, an evidence-based training program to promote mental health and reduce stigma around mental illness.
Putting the right tools in hands of the people who educate Canada’s youth allows this impact to spread. In reflecting on the training and feedback received from participants, Boedo notes, “We are not only changing people’s lives, but we are also learning to change the way we approach the situations that are outside of our control.”
MHCC training programs are designed to increase mental health literacy, reduce stigma, and provide skills and knowledge to manage potential or developing mental health problems. To find courses and learn more, visit the MHCC Mental Health Training page.
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The pandemic has been a stressful event for most of us. Being locked away at home, away from the hustle and bustle, triggered a few emotions for me. Adjusting to the “new normal” has not been easy, it has been a strenuous process. However, I decided what I would prefer to learn from the entire experience is that the pandemic prompted deeper conversations about mental health. It highlighted the importance of mental health issues and coping strategies. I believe it encouraged people to come forward, providing them with a safe space, and allowed them to address their unsettling experiences and feelings of despair.
Two years of isolation not only highlighted the importance of preserving one’s mental health but led to mental health care services becoming available to a wider population. Online therapy and counselling are now a cost-efficient method of delivering interventions remotely. Online psychotherapy is a relatively new realm with benefits and drawbacks. However, I think it is the first step towards a more affordable and accessible mental healthcare.
I have always been intimidated by the idea of getting into a therapeutic relationship. It is not my lack of faith in professional assistance, but rather a fear of dealing with emotions that follow, my incapacity to control my thoughts or even work through the process of healing. Despite being a student in this field, acknowledging my struggle with maintaining my mental health has not been easy.
At the end of last year, I decided to start with therapy. It occurred to me that the first step of healing is to accept that you are experiencing a range of emotions with which you are not entirely comfortable. Next is to know that help is available, and lastly, it is to encourage oneself to depend on mental healthcare as long as it is needed.
Being attentive to our mental health is just as important as ensuring our physical wellness. As someone new to therapy I would say, it is necessary to value and embrace the emotions brewing within us, whether they are perceived as good or bad. Relying on assistance is not a sign of weakness but of strength. It is important that we treat ourselves with the warmth we deserve.
Author: Riya Mitra
A recent clinical psychology postgraduate student. She loves to research the realms of mood disorders, learning disabilities, trauma and grief, and the socio-cognitive approach in psychology. She is passionate about mental health advancement and inspiring a change in how we perceive mental illness and psychological intervention. In her spare time, Riya can be found writing, reading the works of female poets, or watching cinema.
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A national suicide prevention number – to launch in November 2023 – will bring 24-7 support to everyone
You’re a single mother in downtown Ottawa, off work due to COVID and distressed that you can’t cover the costs of rent and feeding your family. You’re an Indigenous teenager in northern Alberta trying to escape an abusive relationship. You’re a middle-aged man in New Brunswick who hasn’t told anyone how deep your depression is, and you feel like you can’t fight your suicidal urges anymore. You’re a refugee in small-town Ontario whose first language is not English, and you are experiencing frightening flashbacks to traumatic experiences of war. You’re a nurse in Vancouver, demoralized by the anti-vaccine protestors shouting at you as you go to work, where staffing shortages have brought you and your mental health to the breaking point.
Who do you call?
If you’re lucky, you’ll find the compassionate ear of a well-trained helpline counsellor in your community, who’ll listen as you tell your story, determine your level of suicide risk, de-escalate your stress, and connect you with the resources you need to get through this challenging moment in your life and set you on the way to long-term solutions and better times.
Still, in your state of mind you may not know where to turn. You might feel ashamed or embarrassed to admit you need help; or worse, you could be having suicidal thoughts. You might not feel up to searching for a 1-800 number — maybe you don’t have easy access to the internet and don’t know what supports are out there.
But what if we had a national three-digit suicide emergency helpline that everyone knew as well as they know 911?
That idea has been under serious study and development in Canada for several years, with enthusiastic support among suicide prevention experts, mental health professionals, and politicians at every level of government. Countries like the Netherlands and the United States have implemented a three-digit number, and in Canada a suicide hotline – 9-8-8 – will be accessible in all parts of Canada by the end of 2023.
According to Statistics Canada, about 11 people a day — 4,000 a year — take their own lives in this country. While the causes and circumstances vary, each loss is a tragedy that, for a host of unique and complex reasons, wasn’t prevented.
As the pandemic has unfolded, distress centres throughout Canada have been reporting higher numbers of people calling for help, particularly around addiction, job loss, the effects of inflation on the cost of living, and food insecurity. For those in the prevention field, a national suicide emergency number makes more sense than ever.
“The concept is widely accepted,” said Sean Krausert, executive director of the Canadian Association for Suicide Prevention (CASP). Based in Canmore, Alberta, Krausert was among many in the suicide prevention field in Canada (and internationally) consulted by the authors of Considerations for Implementing a Three-Digit Suicide Prevention Number in Canada, a 2021 MHCC policy brief that reviewed relevant literature and information.
“It’s more the logistical issues of putting this in place that will take time,” he said. “There needs to be a great degree of awareness in the public and strong funding to create a national service.”
Given Canada’s vastness and diversity, launching and maintaining a three-digit suicide prevention number is a complex task. Not only must such a service be built on the principles of equity and cultural inclusion, but it must also have a consistent technological infrastructure.
For example, for 9-8-8 to function from coast to coast to coast, 10-digit dialing needs to be in place where 7-digit dialing is still the norm, such as in Newfoundland, Labrador, northern Ontario, and Yellowknife. The Canadian Radio-Television and Telecommunications Commission (CRTC) says it may take until November 2023 to make the transition to 10-digit dialing in those locations. When the 9-8-8 system is up and running, all calls and texts to 9-8-8 will be directed to a mental health crisis or suicide prevention service, free of charge.
Additionally, access to well-trained counsellors must be made available 24-7 in every region of the country to serve diverse needs and to ensure that the help people require can be provided — whether they live in an urban centre or remote area, are young or old, speak English, French, or another language, or suffer from addiction, abuse, or mental illness. That means having one number for anyone in a suicidal crisis to connect to, no matter their walk of life, or their circumstances.
“Like a lot of guys, I always thought that whatever I had to deal with in my life, I would deal with it alone,” said Érick Légaré, in a 2019 video for the Association québécoise de prévention du suicide. Légaré, now 50, attempted suicide at age 45 and is grateful for the help he found when he was struggling. Today he has an urgent message for those who are feeling suicidal: “If you need help, know that it’s out there. You just need to let go and accept it. Talk to someone.”
Clearly, a national suicide helpline is a valuable addition to the supports already in place at the local and regional levels in Canada. “Whatever service it is, it is essential to provide immediate mental health supports 24 hours a day to the people in distress who call in,” said Andrea Poncia from Ottawa’s Community Suicide Prevention Network, who also pointed out that, for a national phone line to be effective, “funding has to be scaled up and maintained long term.”
Leslie Scott, manager of media and communications with the Distress Centres of Ottawa and Region, agrees that a national three-digit suicide emergency phone service is a good idea, and, once implemented, could take pressure off local non-profit distress centres.
“COVID has been intense,” said Scott, with more calls to the service than ever before. To succeed, a national service will need a “huge marketing campaign” to make sure people know it exists and understand what it provides. Like Poncia, Scott believes funding is essential for training those answering the phones, so they’re competent in best practices for helping a person in a suicidal crisis. Phone counsellors at distress centres in Canada now receive Applied Suicide Intervention Skills Training (ASIST), which enables them to offer “suicide first aid” to anyone who needs such support. National phone line counsellors will also need that, along with solid knowledge of what services are available to whoever calls, wherever they may be. That will enable them to triage and direct people to the appropriate help, both short and long term. An Indigenous teenager in Alberta will need something different than a middle-aged man in New Brunswick, an elderly farmer in rural Ontario, or a recent refugee of war with PTSD whose first language is not English.
“You need people who know how to actively listen,” said Scott. You have to be able to gauge a person’s mood, get into the nitty gritty with them. You need to be able to get to the heart of their story.”
The creation of a national three-digit suicide emergency hotline also serves another critical function: reducing the sense of stigma people may feel about asking for help or admitting they have a mental health concern. Scott notes that those taking the first step toward getting support may internalize stigmatizing language and perspectives.
“Unfortunately, some people still think that if they call for help, they’ll be taken away to the ‘loony bin.’ But of course, that is not the case,” said Scott. Knowing that there’s a phone number that anyone in Canada can use, any time, should contribute to the awareness that every human being goes through struggles, help is available, and you are not alone.
Karen Letofsky, one of Canada’s leading experts on suicide prevention — she became an Order of Canada member in 2007 in recognition of her years of service in this field — said the idea of a national suicide prevention number is something leaders in the distress centre community have championed for many years, getting started on partnerships to push the idea into reality in 2015. “We knew we needed a reasonable plan, and some pilot money. Once we had that we could start organizing. It’s been an ambitious goal to build capacity. If you increase access to a service like this, it means you need adequate resources and proper staffing to ensure success.”
It’s “a massive undertaking to provide universal access to a national suicide number,” she added, “but it’s definitely a worthy goal that will normalize asking for help.” While the many details surrounding funding, technological infrastructure, linking services, and training across the country are being worked out, Letofsky is optimistic that the partner organizations will continue to develop the best model for Canada.
Organizations that have been working with the MHCC and CASP include the Canadian Mental Health Association, the Centre for Addiction and Mental Health (CAMH), the Public Health Agency of Canada, Veterans Affairs Canada, and Kids Help Phone. Together, they’ve also consulted with organizations such as 113 Suicide Prevention in the Netherlands and the Substance Abuse and Mental Health Services Administration in the U.S., which also has a hybrid model that lets people choose to either text or phone the three-digit number.
More than anything, said Letofsky, the key to providing a quality service will be to ensure that those who answer the phones are “responders who are well trained in listening.”
It’s that one-on-one connection made between a caring human being and another in distress that’s critical. “Let’s not get caught up in numbers, statistics, and algorithms. Every person is unique. We don’t want to lose the personal story.”
The MHCC offers webinars, toolkits, learning modules, and a range of other resources on its Suicide Prevention page.
Moira Farr
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This blog post discusses trauma.
When I was sixteen, I ran away because it wasn’t safe at home. I couch surfed, stayed with friends, lied about my age to stay in a shelter, and rented squalid rooms in boarding houses. Eventually, I found a place to stay with some people in a derelict house. My rent was $35 per month. I slept on the floor and kept my clothes in garbage bags. I couldn’t afford cardboard boxes.
I fell in with a bad crowd, the kind of people who gravitate toward and use vulnerable young people. Because I had nowhere to go, I became enmeshed in that situation, a place far too adult for an immature person who was lost. It was a dark and insular world, filled with shadows, secrets, half-truths, and shame.
I managed to keep going to school, and for a while, I kept up the pretence of normal. But after some time of going to school on a few hours of sleep, sometimes hung over with substance use, things started to slip. And even though I looked sleep-deprived and usually went without lunch, what caught the attention of the school guidance counsellor was my free-falling marks. What interested him most was my academic plunge, but he did not think to ask me about my situation. Or maybe he thought of asking and decided not to. “Pull yourself up by your bootstraps” was his advice to me.
For all sorts of reasons, I was falling through the cracks of the system. I craved the help and guidance of adults and could find no way to ask for it. The shame kept me silent. Only one of my teachers, a nun, noticed that something was wrong or chose to notice, and reached out. What if she hadn’t?
It’s been a long journey from there to here. From balancing on an abyss to a solid footing.
It might seem like stating the obvious, but living this way is not good for your mental health. I want to share what I wish I had known then and the lessons I learned the hard way.
- Just being here is a miracle in itself. The odds of coming into this world are mind-boggling and almost impossible. Always remember this, no matter how hard things get.
- You are the expert on what you feel and what you need.
- Being a people-pleaser will drain you of your energy and vitality faster than anything else.
- No-one will understand you and that’s not really important. What is important is that you understand you.
- Being judgemental is based in fear. A day spent judging yourself and others is an exhausting day.
- Don’t count the days. Make the days count. Stop saying you don’t have time.
- Get clear on what is important to you and ruthlessly direct your time, attention, and energy to that. Don’t get co-opted by someone else’s agenda unless you choose to.
- Perfectionism is the fastest and surest road to unhappiness. Constantly seeking approval and being a slave to perfectionism is based in fear.
- Don’t be afraid of your uniqueness. Show the world who you are.
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Navigating the transition from full house to empty nest
One of the main ironies of parenting is that your job is to make yourself irrelevant. Babies are born, children are nurtured and grow up, and then one day — eventually — most are independent enough to move out of the family home.
At least that was a typical trajectory in Canada. These days, the transition isn’t always so linear. Economic challenges such as the high cost of housing and precarious employment, as well as socio-demographic shifts like the need for more post-secondary education, mean so-called “boomerang” kids leave and then return, sometimes repeatedly.
For the parents who are left behind, whether temporarily or forever, this passage into the next phase of life can be difficult to navigate. Yet, as a parent, it also represents an opportunity to renew relationships with yourself, your partner, your friends, and your family, including the child or children who are making the leap into their adult lives.
My wife and I are on the cusp of this change: Our twin daughters will be starting university this fall. To help prepare for this double departure, Lisa and I are spending a lot of time talking to friends, neighbours, and colleagues whose children have already left or are about to leave home.
One friend told us that her kids moving out changed her life more profoundly than when they were born. Another, whose father-in-law moved in after his daughters went to university, talked about the sense of flux in his household, with caring for aging parents also affecting the configuration of his nest. My own mother cautioned me that our house might feel like a train station for a while: you won’t know who’s coming or going, or how long they’ll stay.
Next station
Although the range of reactions and circumstances varies greatly, as a whole what people told us reflects research findings and advice from mental health professionals. For Simon Fraser University gerontology and sociology professor Barbara Mitchell, the “stereotype of the empty nest syndrome has largely been debunked as a cultural myth.” She takes a matter-of-fact view of this and other major changes in life. That is, to approach the empty nest phase as one of many junctions in a fluid existence while staying mindful and ready for whatever might follow.
Mountain biking in Charlevoix, Quebec: The author with Daisy, Lisa Gregoire, and Maggie. Transitioning from full house to empty nest is an opportunity to renew relationships with yourself, your partner, your friends, and your family, including the children who are making the leap into their adult lives
“Most parents actually find it to be a positive experience,” Mitchell says. “They’ve done their job and are now free from day-to-day responsibilities. They’ve established roots for their children — and wings — so they can become autonomous adults.”
Despite that general trend, if rooted in a traditional mom-as-homemaker role, some women feel a strong sense of loss when the kids leave, as of course do some men. While this sadness and disorientation (commonly called “empty nest syndrome”) are often short-term, she points out that about 20 per cent of parents struggle with it, and in extreme cases it can require intervention.
Mitchell, who has been researching family transitions since she was a graduate student in the mid-1980s and is perhaps the only academic in Canada with this expertise, notes that the empty nest is a relatively recent phenomenon in North America. Historically, at least one child regularly stayed with aging parents, especially in rural areas. But as our population became more urban, as life expectancies rose, and as the affluent middle class boomed after the Second World War, mothers and fathers increasingly found themselves alone in their later years.
Of course, parents from what she describes as “collectivist cultural groups” often have entirely different experiences, such as remaining within a multi-generational household or viewing the departure of a child for education or marriage as a sign of success. “The context of the family environment is important,” says Mitchell. “There are many potential complexities.”
Among these complexities are compounding stressors like health issues or retirement, which can exacerbate negative emotions.
Mental health and wellness in Canada is in fact influenced by numerous factors, including life experience, workplace, and family environments, and social and economic conditions that fundamentally impact our well-being.
Edmonton psychologist Loriann Quinlan, who specializes in treating adults with anxiety and has helped clients with empty nest syndrome and other life transitions, knows that every individual and family experiences this change differently. And since it can be accompanied by a range of emotions, from sadness and grief to excitement and joy, she advises clients to approach the process without judgment, to sit with any discomfort, and to engage in self-care.
Taking the time to become better acquainted with yourself, your partner, and others in your circle can be healthy, she says, because as parents we invest a tremendous amount of time and energy into relationships with our children. No wonder we’re knocked adrift and feel empty when such a critical part of our identity — for so many years — is no longer clearly defined.
As parents, we invest a tremendous amount of time and energy into relationships with our children. No wonder we’re knocked adrift and feel empty when such a critical part of our identity — for so many years — is no longer clearly defined. —
Making the shift
This transition also offers a chance to appreciate the perspectives of the young adults who are leaving and taking steps toward independence.
“It’s an amazing opportunity for parents and kids to see each other through a new lens,” Quinlan says, “and to shift the dynamic and hopefully connect on a deeper level.”
To get there, she recommends keeping the lines of communication open. Talking about thoughts and fears helps us understand where other people are coming from. Not shying away from conversations about well-being also helps us know when it’s time to reach out for support. That could simply be a chat with a friend or connecting with a more formal mental health resource.
While the internet is making that access a little easier, rapidly advancing communication technologies and other recent phenomena, such as the pandemic and the tight housing market, are also influencing how parents deal with the departure of their children, notes Mitchell, who wants to do more research on the impact of these “overlapping factors.”
On one hand, young adults are stepping into an increasingly uncertain world; on the other, you can make a video call with them no matter where they are. At least in theory.
My friend Eleanor Fast, who will be seeing her younger son off to university when my girls leave next fall, confesses to “stalking” her older son online while he’s been away at college in the U.S. for the past two years. He doesn’t always respond to her texts, and it can be difficult to schedule video calls, so she checks his Instagram feed — “for proof of life” — and looks to see if he’s posted any recent running routes on the exercise app Strava.
“The world may be more difficult than it was when I was 18 and left home,” says Fast, “but kids still need to get out there. They’ve been isolated for the past couple years because of the pandemic and have missed a lot of living.”
COVID was Fast’s biggest concern when her son left home — she was worried he would be lonely doing online classes while confined to a dorm room — but turns out he was fine. And although she and her husband truly enjoyed having a full house, they found it really nice when there was just one kid to focus on. They’re already planning activities they can do as a couple, such as taking long-distance bicycle trips together.
“I love my kids and love being with them,” says Fast, “but I want them to have their own lives, and making plans for the future helps counteract the sadness of them leaving.”
That sums up the mindset Lisa and I have as we reflect on the past and prepare for our next chapter. One of our daughters will be moving several provinces away in a couple months, and even though the other will be going to university in the city where we live, and recently decided to stay at home instead of residence in first year, we’re conscious of the fact that this is simply a new rhythm to experience.
Our children are no longer children. They — and we — are both excited and nervous about the journey ahead. And like many times over the past 18 years, we can learn a lot from them.
