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Roots of Hope flourishing on the Burin Peninsula
In 2018, Newfoundland and Labrador’s Burin Peninsula became the first of eight communities to sign on to the Mental Health Commission of Canada’s (MHCC’s) Roots of Hope project — a community-led suicide prevention initiative that aims to prevent suicide with strategies adapted to the local context.
“With such strong wellness leaders throughout Newfoundland and Labrador, advancing life promotion work in the province is an incredible thing to be a part of,” explained Gioia Montevecchi, a consultant with the province’s mental health and addictions division who is also co-chair of its life promotion suicide prevention working group. “Community partnership lies at the heart of the upcoming life promotion suicide prevention plan, and it has informed all of the work happening to transform the mental health and addictions system in Newfoundland and Labrador. We have incredible social capital in the province and vast networks of people working to advance tailored suicide prevention initiatives.”
Three years into the five-year demonstration project, Burin Peninsula has made great strides. “I’ve seen a big change in our community already,” said Denika Ward, coordinator for the area’s Roots of Hope project. “When people used to ask what I did, and I replied with ‘suicide prevention,’ I was met with a lot of silence and blank stares. Now, more people understand the value of what we’re doing and want to be a part of it.”
All community initiatives are centred on Roots of Hope’s five pillars, which include everything from building public awareness to reducing access to potentially dangerous situations (means safety). On Burin Peninsula, public awareness has been at the heart of the effort thus far, and with great success.
Ward led the development of a community suicide awareness presentation, covering topics like warning signs, stigma, starting a conversation, and information about local and provincial resources.
Following the high attendance at the event and a growing demand from the community, project members have adapted the presentation to first responders and youth audiences (as additional requests continue to come in). An online version of the initial presentation will soon be available at BridgethegApp, Newfoundland and Labrador’s repository of mental health resources.
In addition to ongoing public awareness, Burin Peninsula has set its sights on another priority area: men’s mental health. With men accounting for three-quarters of suicides in Canada, it’s easy to understand why.
Illustrator: Kati Oliver
Fortunately, the community doesn’t have to look very far for guidance. A Roots of Hope community in Edmonton has made suicide prevention among men a key action area, complete with a subcommittee dedicated to men’s mental health outcomes.
Some of the activities directed toward men include expanding access to psychoeducational services, offering additional support groups for depression and anxiety, advocating and securing funding for new programming, and participating in existing community initiatives to further develop preventive approaches for those at risk of suicide.
“Sharing knowledge between communities is foundational to the success of the Roots of Hope model,” said Uyen Ta, MHCC program manager for the Prevention and Promotion team, who works closely with the Burin Peninsula community. “The collaborative approach allows communities to learn from each other’s successes and understand how they’ve overcome different challenges along the way.”
Montevecchi agrees. “Communities are the experts on the challenges they face and on the strengths they have to overcome them. Harnessing the knowledge and experience of diverse populations while providing meaningful support for community-led efforts can create a groundswell of impactful work.”
That said, one challenge that none of the communities could have anticipated is COVID-19. To help them and others better understand this new reality, the MHCC has just created a COVID-19 and Suicide policy brief exploring the potential impact of the pandemic on mental health and suicide rates in Canada. Included are insights into which potential risk and protective factors to monitor and identifying current opportunities to influence these trends. While largely directed toward policy makers and those working in health care, the brief’s core message applies to everyone: even in a pandemic, suicide is preventable.
For Ward, the bottom line is simple. “Suicide prevention is everybody’s business. You don’t need clinical skills or training to make a difference. We can all play a part in saving a life.”
Amber St. Louis
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Filling in the knowledge gaps on cannabis use and mental health
“We are all experts in our own right,” declared Krista Benes, director of the Mental Health Commission of Canada’s (MHCC’s) mental health and substance use team. “And that is the premise of community-based research.”
In short, she explained, too often the experiences of underserved groups — or those who are socio-economically disadvantaged — are overlooked in conventional academic research. “But how can we know why young people in the 2SLGBTQ+ community who live with mental illness use cannabis, for example, if we don’t involve them in our research project?”
To better understand how cannabis use affects such marginalized groups, the MHCC is funding 14 projects from across the country to the tune of $1.4 million over two years. Six are Indigenous-led, while others touch on immigrant, refugee, ethnocultural, racialized, and senior populations who experience layers of oppression.
“We saw clear gaps in knowledge around the relationship between cannabis and mental health among groups who are best placed to lead their own explorations,” Benes said, as she explained the three tenets of meaningful community-based research.
First, representatives from the community in question lead the research — that is, they frame the issue they want to explore. Members then participate in every phase of the inquiry. And finally, they become part of the positive social change that occurs as a result of the findings.
“If we believe that community-based research begins and ends with people, then we’re putting our money where our mouth is,” said Louise Bradley, MHCC president and CEO. “It’s no longer just about appearing in a peer-reviewed journal. It also entails a greater focus on practical improvements. Applied research like this allows us to partner with communities to help them improve their circumstances.”
One example is the video series the project team is creating to raise awareness about the harms of stigma. Led by a team from RADAR (Recovery Advocacy Documentary Action Research), participants will craft and distribute videos about cannabis and mental illness.
“This isn’t just some guy in a white lab coat saying, ‘Hey, don’t judge people,’” explained Rob Whitley, RADAR’s principle investigator. The videos will be directed, produced and will feature people who can speak to the topic first-hand. “In this case, public awareness is a side-effect of fostering empowerment, recovery, and resiliency for the filmmakers.”
Benes is genuinely looking forward to what the projects could uncover: “I wish we didn’t have to limit the number to just 14. The extraordinary interest we received, and the caliber of the applications, speaks to the need for this kind of research. There are so many unpursued avenues when it comes to cannabis and mental health — especially among underserved groups.”
The projects will include some of the first examinations of cannabis use and mental health in Métis communities and the first Indigenous-led research of its kind.
“What’s so exciting about this is the prospect of what we’re going to learn and the gaps we’re going to bridge,” said Benes. “The beauty of community-based research is that our goal — no matter the project — is net positive social change.”
And that’s an outcome the MHCC is proud to get behind.
Suzanne Westover
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MHCC President and CEO Louise Bradley reflects on the power of resiliency
There is no doubt that COVID-19 is stretching us thin.
Protecting our physical health isn’t without cost to our mental wellness. As social beings, isolation is taxing. As a species that likes to plan, uncertainty is exhausting. As creatures of habit, we don’t cope well when our routines are upended. Add to this financial strain, home schooling and the anxiety of contracting the virus, it’s no wonder an emotional storm is brewing.
A low mood, and feelings of fear, anger, frustration are perfectly understandable responses to an entirely unfamiliar and abnormal situation. It’s important to validate those feelings and name their provenance. Just as sadness and grief are to be expected after a death, right now, we’re all grieving something — big or small.
We don’t have a crystal ball, but lessons learned from previous disasters and epidemics tell us that cumulative stresses and losses will result in significant mental health problems for some. We shouldn’t be ignoring ongoing symptoms that are interfering with sleep, seriously impeding productivity or resulting in substance misuse. Mental health services, already straining at the seams, will need an infusion of funding and injection of innovation to cope with rising demand.
But in this challenging context, it’s more important that ever to draw the careful distinction between the red flags that signal mental illness, and the more general malaise many of us may be feeling. We shouldn’t conflate a reasonable emotional response to our curtailed freedom and constricted social lives with a diagnosis.
Even more importantly, we shouldn’t assume we’re powerless in this situation.
As human beings, we’ve been gifted the capacity to not only overcome obstacles, but to learn and grow from hardships. We’re talking about resiliency — which can be nurtured by individuals and communities.
Just as we can strengthen our physical muscles by eating well, exercising regularly and getting enough sleep, we can also practise flexing and honing our resiliency. Going for a daily walk, phoning a friend, prioritizing gratitude or writing in a journal are healthy ways to manage our emotions. Taking small steps to control our situation can do wonders to improve our perspective. Simple things like making our bed can give us a sense of control, while baking a loaf of bread can give us a sense of purpose.
The outlook we bring to the challenges thrown up by COVID-19 can help predict how well we’ll emerge from the global crisis. If we believe that it’s possible to learn and grow from hardships, that they can teach us lessons in compassion and deepen our relationships, then we can find meaning from our suffering. Surviving an ordeal doesn’t make us resilient.
But tapping into what we’ve learned to be better equipped for the next curve ball does.
While COVID-19 has laid the foundation for many of us to cultivate resilience, it has also exposed the very real gaps and sinkholes that threaten the most vulnerable among us. Self-care only goes so far when schools are closed, long-term care is ravaged by infection, and job losses are widespread.
Practicing resiliency while living in traumatic situations is akin to rebuilding amidst the rubble. We must have access to underpinnings like safe and affordable housing, a living wage, strong community supports, and protection from racism and other forms of discrimination — in addition to robustly funded mental health services. These are the wellsprings from which resiliency can flow.
We have an opportunity to knit together, as a society, to create better safety nets and to innovate more equitable and inclusive policy.
Months of lock-down will have an affect on all of us. But if we’re able to see our experience as one that’s given us pause to reset our priorities, refocus our energy and reframe our worldview, we may emerge, not just as more resilient people, but as a more just and resilient society.
COVID-19 may be stretching us thin, but with resiliency, we can rebound.
Louise Bradley
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The Working Mind training goes virtual
If there was ever a need for crisis training, it was during the onset of COVID-19. That’s one reason the Mental Health Commission of Canada (MHCC) stepped into the breach by offering virtual training to more than 5,139 essential workers, who took over 574 courses between April and October.
Now, the MHCC has expanded its virtual offerings to include an updated version of one if its most popular courses — The Working Mind (TWM).
“TWM Virtual combines elements of the original TWM with virtual crisis training to create one complete course,” explained Pauline Meunier, training and delivery specialist for the MHCC’s Opening Minds program. “It’s the best of both worlds.”
The evidence-based program was designed to initiate a shift in the way employees and leaders think and feel about mental health by addressing barriers to care, reducing stigma, and strengthening personal resilience. Each training module includes case studies, videos featuring people with lived experience of mental illness, reference guides, and practical handouts.
“Most adults spend two-thirds of their waking hours at work,” said Louise Bradley, president and CEO of the MHCC. “Now, with many workplaces operating remotely, I would argue that those hours are stretching. That’s certainly been my experience. So it’s more important than ever that employers have the tools to support their workers, especially since mental distress may be harder to detect when people aren’t working under one roof.”
One popular tool to help workplaces keep their finger on the pulse of employee mental health is the mental health continuum model, which highlights a spectrum of thoughts, attitudes, and behaviours associated with different mental health levels, from “healthy” to “reacting” to “injured” to “ill.”
For John Horne, vice-president of Safety, Health, and Environment at Nutrien, it’s been invaluable. “The mental health continuum provides an accessible approach and common language for the organization to talk about mental health. TWM’s emphasis on teaching employees and leaders to focus on actions that can be taken early on the continuum ensures that we can be proactive in giving employees the support they need for their mental well-being.”
As a former paramedic chief, Meunier knows the value of prioritizing mental health in the workplace firsthand. “You never know who’s struggling. Many employees put their work first, at their own expense,” she explained. “If you aren’t investing in and supporting the mental health of your employees, it will cost you down the road — whether through loss of productivity or an inability to keep moving forward at work.”
TWM Virtual offers a five-hour course for employees and a seven-hour version for managers. While both address similar topics — self-assessment, stress, stigma, and resilience — the manager’s course emphasizes the role leaders play in supporting their staff. Managers are given techniques to assist employees who may be struggling, including how to approach conversations about suicide.
One organization that recognized the value in this skill set was Enbridge, which had arranged TWM training for leaders in its major offices before the pandemic hit. “At Enbridge, safety is at the core of everything we do,” said human resources specialist Lisa McCarney, “and that includes the psychological health and safety of our employees. We have now pivoted to virtual training, which allows us to reach leaders wherever they are working: whether in the major offices, at home, or in our smaller and more remote locations.”
As with the traditional TWM programs, TWM Virtual is based on scientific evidence and is subject to rigorous pre- and post-evaluation outcome measures. Course instructors are also held to a high standard, undergoing extensive training not only to deliver the content effectively, but also to create the safe environment needed to foster open conversations about mental health.
“What sets TWM Virtual apart is the high level of care for participants,” said Charles Boyer, manager of business development for the MHCC’s Opening Minds and Mental Health First Aid programs. “Throughout each course, moderators pay careful attention to make sure participants are doing well, opening up virtual breakout rooms whenever they are needed. We want participants to feel safe, comfortable, and engaged.”
For Meunier, the message to employers who are considering the training is simple. “Investing in the mental health and well-being of employees is crucial to the overall health of your organization. Whatever you invest today, you’ll make back tenfold tomorrow.”
Amber St. Louis
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New national student standard aims to bolster mental wellness in post-secondary institutions
Attending college or university can be an exciting period of growth, exploration, and independence — but it can also be a time of tremendous pressure and stress. Well before the onset of the pandemic, the 2019 National College Health Assessment found that more than half of post-secondary students in Canada felt so depressed it was difficult to function, and nearly 70 per cent felt overwhelming anxiety.
To support post-secondary institutions in promoting positive mental health outcomes on and off campus, the Mental Health Commission of Canada (MHCC), in collaboration with CSA Group, have created the National Standard of Canada: Mental Health and Well-Being for Post-Secondary Students.
This new standard — the first of its kind in the world — is a set of voluntary guidelines developed in consultation with diverse stakeholders, including students, administrators, service providers, and people with lived and living experience of mental illness. Its goal is to provide a consistent, evidence-based framework schools can use to enhance existing mental health strategies or develop new ones.
“While it’s too soon to understand the full impact COVID-19 will have on students’ mental health, we know the pandemic has added a layer of complexity,” said Sandra Koppert, the MHCC’s director of Mental Health Advancement. “Implementing this new standard is a chance for post-secondary institutions to reinforce their commitment to student mental wellness, both now and after the pandemic.”
To help schools build momentum, the MHCC has launched a starter kit for its new standard, which includes a variety of resources, next-steps, and key considerations to support their alignment with the framework.
“Given the diversity of these institutions, we can’t have a one-size-fits-all solution,” said MHCC president and CEO Louise Bradley, who emphasized that “the framework isn’t dissimilar to the National Standard of Canada for Psychological Health and Safety in the Workplace, which needed to work ‘for shops on Main Street and banks on Bay Street.’ For colleges and universities, their size, geographic location, and areas of specialty — not to mention their vision and values — will all determine how they wish to tailor their actions.”
Koppert agrees that the customized approach to improvement is what sets the new standard apart. “Many schools have great mental health initiatives already in place, but as circumstances change, the needs of students change with them. This standard provides a framework that helps schools adapt and expand their programs to ensure they’re as effective as possible.”
“Consider the COVID reality,” added Bradley. “With courses shifting online, instructors may become the primary point of contact for many students. So it’s more important than ever to equip them with tools that can help them recognize the signs of mental distress and support their students effectively. To that end, some institutions may choose mental health training for faculty, which directly aligns with the evidence-based recommendations in the standard.”
For Ed Mantler, the MHCC’s vice-president of Programs and Priorities, “this new standard helps institutions see that many aspects of their policies can be seen through a mental health lens. From accommodation policies to diversity and inclusion efforts to subsidies and grants, all impact mental health and need to be understood as such.”
Research shows that students who get the mental health support they need are more likely to succeed in their classes and graduate.
But as Bradley points out, the benefit of supporting student mental health goes beyond the bell curve.
“Understanding mental health and wellness, knowing when and how to seek help, and breaking down stigma are lessons that will prepare students well for the rest of their lives. To me, that spells success.”
Suzanne Westover
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Donovan Taplin harnesses the power of lived experience
Back in the spring, at the height of the pandemic, Donovan Taplin happened to see that the Mental Health Commission of Canada (MHCC) was seeking a new board director.
“The timing was perfect,” said Taplin. “The bulk of my work as vice-chair of the technical committee in charge of developing the post-secondary standard for student mental health was behind me, but I felt that my contribution was just getting started.”
Louise Bradley, president and CEO of the MHCC, strongly agreed. “I first heard Donovan speak at Newfoundland and Labrador’s provincewide youth mental health conference in 2015, and his talk still resonates with me today.”
But when Taplin recalls his first meeting with Bradley, it’s not the view from the podium that comes to mind. “At that point, I had shared my struggles with mental illness with just one close friend, and now I was about to get on a stage and share those struggles with hundreds of strangers. I was terrified. Then, a woman seated next to me took my hand (she could see I was trembling) and whispered, ‘You don’t have to do this. If you aren’t ready, I’ll wave that MC away, and they’ll figure out a Plan B. I’ll be right here with you.’”
Bradley smiled when hearing of Taplin’s recollection. “It’s a reminder, I think, that while kindness costs us nothing, the result can be priceless — and that’s certainly the case with Donovan’s advocacy.”
Taplin said that those grounding words propelled him onto the stage that day, which has since opened the doors to sharing some of the wisdom born from lived experience.
“I grew up on a rural island community in Newfoundland and Labrador (N.L.). I didn’t have clinical or social support or even a language to discuss how debilitated and overwhelmed I was when it came to my mental health. I also knew that I was queer, and that feeling unsafe and unaccepted was contributing to how unwell I felt all the time. Eventually, I took a boat to St. John’s for my first therapy session, even though I was afraid that my being queer would be a valid reason for refusing to treat me. Thankfully, I was wrong and that’s when my recovery began.”
Here, Taplin paused to emphasize that the discrimination 2sLGBTQ+ people face isn’t a relic of the past.
“After my undergrad, just a few years ago, my partner and I moved to Toronto — a city that represented all the things I craved: inclusivity, progressive values, rich diversity. And yet my first experience with the city was being denied an apartment, explicitly because I was part of a same-sex couple.”
Taplin has since stayed in the city following graduate studies to work at the University of Toronto’s Health and Wellness Centre but is now sometimes feeling the weight of shifting roles.
“On the one hand, I’ve just been one of the most prominent student voices on the committee that set out to transform how post-secondary students are supported at colleges and universities. On the other, my current work with administrators lets me see some of the institutional challenges involved. Those will take time to unravel before we can realize something closer to the wellness-driven community envisioned in the Student Standard.”
Taplin explained that the Student Standard is meant to be a bridge, a means to get students together with the administration to co-create higher-learning communities where students aren’t left on their own to navigate a complicated system.
Such efforts on the National Standard of Canada: Mental Health and Well-Being for Post-Secondary Students were recently recognized through a CSA Group Young Professional Award, which acknowledged Taplin’s compassionate and dedicated leadership.
The governance skills needed to co-lead the Student Standard technical committee took root at the tender age of 19, when Taplin was elected as a town councillor for Wabana, Bell Island, N.L. In that role, they helped establish the community’s first recognition of Mental Illness Awareness Week as well as Pride Month. Since that time, Taplin’s ability to effect positive change is reflected in positions on the Premier’s Youth Advisory Committee (N.L.) and the Prime Minister’s Youth Council.
That spirit of creating improved circumstances for all is what drew Taplin to the MHCC’s board. “I see the organization as a bit of a lantern, showing individuals, organizations, and governments a way forward toward improved policy, better access, and ultimately, parity in funding.”
Bradley concurred. “We can only burn as brightly as the hearts and minds that fuel our work. There is no doubt in my mind that Donovan is going to challenge us and buoy us up. In some ways, I have watched Donovan grow up — certainly I’ve witnessed very formative years. One thing I know for sure: the future of mental health advocacy is in good hands.”
Suzanne Westover
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Medical student, peer supporter and mental health champion Armaghan Alam embraces a new challenge
Armaghan Alam (who goes by Army) comes by his passion for mental health honestly. At 14, he found himself an ocean away from his family at a boarding school in Ontario.
“I was born in Pakistan, but we moved around a lot,” recalled Alam, who is currently a medical student at the University of British Columbia. “My family was living in Saudi Arabia, but I chose to pursue schooling here.” The gulf between Alam and his family left him feeling isolated and adrift. Peer support became a veritable lifeline.
“I quickly saw the value of a listening ear and, in turn, lending a hand to others,” he said, a belief he carried to McGill University, where he helped expand its peer support initiatives and quickly became a campus champion.
Now, at UBC, he’s found himself in a culture where it’s a much harder sell. “It’s ironic, really, because if anyone needs to be able to decompress with someone who understands the depth of their experiences, it’s medical students.”
But the “hidden curriculum” that puts self-sacrifice at the top of the syllabus makes them reluctant to come forward.
“I think there’s a wall that health-care providers have to put up in order to care for their patients,” he said. “We’ve got to be able to compartmentalize to do our job effectively. But when it comes to managing our own emotions, the wall can become our undoing.”
That such stigma was slowly being peeled back in recent years among health-care workers isn’t in dispute. Yet Alam worries whether those delicate incisions into the entrenched culture of stoicism will be overgrown by the scar tissue left by COVID-19.
“Just as we were beginning to talk seriously about health-care providers caring for themselves, we have a global pandemic that is seeing their selflessness being celebrated in all corners of the world. We’re holding up our health-care workers as the heroes they are — but when do they get to take off their proverbial capes and put their feet up? Who is looking after them?”
Alam likens the pandemic to a chronic disease that needs to be managed rather than an acute symptom that can be more readily addressed — and everywhere he turns, he sees its mental health implications.
“To look after mental health means good social policy, sound economics, and a functioning justice system,” he said. “It means addressing racism, intergenerational trauma, and the cultural barriers to care.” As a member of an immigrant community, Alam’s perspective offers a lens into the unique hurdles facing ethnocultural groups, where mental illness remains highly stigmatized.
Being an avid reader and life-long learner, mental health offers him endless avenues of fascinating study. And when he considers his future career, Alam is confident that, regardless of the speciality he ends up pursuing, he won’t stray too far from his passion.
“Whether I elect to focus on psychiatry or surgery, the fact is, every patient is more than just the sum of their diagnosis. Some of the most profound, life-changing conversations I’ve borne witness to have happened just before a patient goes into surgery. Staring down your mortality is one of the most powerful things anyone can experience. Being there with them in that moment — that’s not too far removed from why I fell in love with peer support.”
Bringing his skills and experience full circle, Alam is excited to offer his spirit of curiosity to the Mental Health Commission of Canada’s (MHCC’s) board of directors, where he’s keen to learn from experts in economics, justice, and governmental affairs.
“On several occasions, I’ve had the privilege of speaking with Dr. David Goldbloom (the MHCC’s former board chair), someone I looked up to in my formative years. To have a seat at the table he once helmed . . . it’s an honour beyond measure.”
Suzanne Westover
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A call for communities to join our Roots of Hope Early Adopters initiative
When the Mental Health Commission of Canada (MHCC) launched its Roots of Hope suicide prevention project in eight communities across Canada, the concept was ambitious: Build on community expertise to implement interventions tailored to the local context, while developing a wider evidence base of best practices, guidelines, and tools fit for a national scale-up.
But with the initial demonstration phase of the project slated to take place over five years, others began asking how their community might get involved without having to wait so long. Eager to share the model as widely as possible, the MHCC’s Prevention and Promotion team answered the call by developing the Roots of Hope Early Adopters initiative.
Like the demonstration project, the strategies and activities developed by Early Adopters will be based on Roots of Hope’s five pillars: specialized supports, training and networks, public awareness campaigns, means safety, and research.
“This program was born from community demand,” said Nitika Rewari, manager of Prevention and Promotion Initiatives at the MHCC. “Early Adopters will be the first to learn from what’s happened so far in the demonstration project as they begin building their own action plans, all with the guidance of the commission.”
Much of that guidance will be in the form of a community of practice (CoP), consisting of representatives from fellow Early Adopter communities and MHCC program staff. The CoP meetings will give Early Adopters access to tools and resources already developed in the demonstration project. It will also let them ask questions, share what is and isn’t working, and draw from the collective well of experience. It’s a model that’s proven invaluable for the first eight Roots of Hope communities, who continue to draw on their own CoP meetings for guidance, knowledge sharing, and connection.
“The diversity of communities represented in the CoP has been incredibly informative to the work we are doing in Iqaluit,” said Opal Mcinnis, PhD, territorial manager of mental health and addictions facilities with the Nunavut government. “As a project site that is in its early days of planning, the CoP has created excitement for what we can look forward to achieving.”
Denika Ward, a suicide prevention coordinator with the Burin Peninsula community, agrees about the value of the CoP. “It has allowed for networking with individuals from various communities involved in the Roots of Hope project across Canada and contributed to the positive, long-lasting effects of suicide prevention efforts for residents of the Burin Peninsula.”
While the eight demonstration project communities and the Early Adopters will operate independently, all the findings will ultimately contribute to a national scale-up of the Roots of Hope model. As communities band together to find the most effective strategies for them, they will simultaneously lay the groundwork for a Canadian model of community-led suicide prevention.
For Ryan Walsh, Prevention and Promotion program manager, that combination of long- and short-term rewards is what sets the Early Adopters initiative apart. “Not many communities can say they directly contributed to suicide prevention on a national scale. Early Adopters have a rare opportunity to demonstrate their commitment to suicide prevention, benefit from what the demonstration project communities have learned, and be at the forefront of the Canadian model.”
As Walsh is quick to point out, the opportunity to be an Early Adopter is not limited to large, urban areas — far from it. “Part of the project’s strength comes from the diversity of the participating communities. What works for one area may be completely unfeasible for another. The more we can learn from those differences, the more successful the model will be in reducing the impact of suicide across the country.”
Interested in becoming a Roots of Hope Early Adopter? Email Nitika Rewari for more information at nrewari@mentalhealthcommission.ca
Amber St. Louis
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How one group is making strides toward better access to psychotherapy
“Parity,” “shorter wait times,” “fewer barriers,” “what we need, when we need it.”
Those were some of the key words and phrases members of the psychotherapy policy implementation network (PPIN) shared when asked to describe what better access to psychotherapies means to them. At their first meeting last February, of course, they couldn’t have imagined that a brewing pandemic would heighten the urgency of their work.
The PPIN consists of thought leaders, people with lived experience, Canadian health‑care provider associations, clinicians, researchers, and other experts. Its goal is to develop recommendations for the federal government that will increase access to psychotherapies in the Canadian health-care system. In its role as secretariat, the Mental Health Commission of Canada (MHCC) acts as an impartial facilitator of the group’s activities. Dr. Karen Cohen, CEO of the Canadian Psychological Association (CPA), co-chairs the network alongside the MHCC.
“While some publicly funded psychotherapies exist in hospitals and mental health centres, they have long waiting lists and many people cannot afford the services offered in private practice,” noted Louise Bradley, the MHCC’s president and CEO. “Yet these treatments are essential to our population’s health.”
The network is a place to share information, explained Kam Tello, the program manager for the MHCC’s Access to Quality Mental Health Services. “We have to look at what’s available in each jurisdiction, what’s working, and where the gaps are from different perspectives. It’s a collaborative effort.”
The PPIN is currently drafting a declaration on the need to enhance access to psychotherapy. In charting the process and recommendations about how to do so, it will consider funding models, quality assurance, implementation, and outcome-based measurements of care.
This work has taken on even more significance in light of the fears, uncertainties, job losses, and economic instability wrought by COVID-19. For Cohen, the need to close the gaps in access to psychological services has increased in urgency as individuals, families, and communities cope with the physical and mental health impacts of the pandemic.
Canada’s public and private health sectors have thankfully stepped up to offer mental health services and supports. Examples include CPA’s crisis response initiative for front-line health-care workers and social workers, the addition of counsellors/psychotherapists as employee benefits for government workers, and the federal government’s Wellness Together Canada portal with free resources and counselling.
While these enhancements are a step in the right direction, unfortunately, many are program based and may only be temporary. To improve wellness and treat illness over the long term, we need sustainable investments in mental health services and supports.
“That’s why the PPIN is focused on long-term solutions,” said Tello. “When COVID-19 is behind us, perhaps along with many of the programs and services it has inspired, people in Canada will still need access to meaningful, evidence-based mental health treatments, maybe more than ever.”
To develop recommendations that fit the Canadian context, the PPIN is also looking abroad. The United Kingdom and Australia have their own expanded access programs, built on grant- and insurance-based models, which serve as important case studies in crafting a built-for-Canada solution. (Visit the MHCC’s Expanding Access page for a more in-depth look at these examples.)
While the PPIN has much work ahead, its members are encouraged by the shift in the mental health conversation.
“There seems to be growing recognition that mental health is part of health and should be treated equally,” said Tello. “There’s more interest from employers, more coverage from the media, and more discussion about access and why it matters.”
Bradley concurs. “Access to better mental health care could be a deciding factor for curbing an echo pandemic in mental illness as we (eventually) emerge from COVID-19. If there is a silver lining to the challenges we’re hurdling now, it may be the recognition that physical health is only half the battle. There is no health without mental health.”
As the conversation about physical and mental health parity gains steam, the PPIN is striving toward meaningful action to achieve it. By developing sound recommendations, the group hopes to help position Canada as a global leader in expanded access to psychotherapies.
For Maureen Abbott, manager of the MHCC’s Access to Quality Mental Health Services, the composition of the network itself only makes such an outcome more likely. “The members offer relevant personal and professional experience regarding access to psychotherapies. But a great strength of the group is respecting and valuing members’ diversity of opinions and perspectives as they reach consensus during the decision-making process.”
Update, February 2022: The work of the PPIN is now complete! Read The Time is Now: Considerations for a National Psychotherapy Program.
