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New resource supports mental wellness following criminal justice involvement
When Mo Korchinski left prison, she wasn’t handed a kit with resources to help her turn her life around. There was no guide on how to readjust to an autonomous life. Instead, like many before her, she was given a plastic bag with her belongings and a ticket to where she came from.
“A lot of people who go to prison bring with them little more than the clothes on their backs, a traumatic past, and often either mental illness, addiction, or both,” said Korchinski, now the executive director at Unlocking the Gates Services Society. “This doesn’t mean we should be disregarded as worthless. For many of us, we’ve fallen on hard times or been dealt a losing hand. Incarceration should be about helping people make better choices. Educating them on new paths. Rehabilitation.”
Unfortunately, a lack of resources coupled with inconsistent integration between correctional health care, non-correctional health care, and broader social services leaves many in the justice system unsupported, both inside and outside of prison walls.
Such a lack of support has real-world consequences, especially when we consider substance use and mental illness among our country’s incarcerated populations. New Mental Health Commission of Canada (MHCC) research exploring vulnerabilities in Canada’s correctional settings shows that between 65 and 70 per cent of incarcerated people are living with problematic substance use. And in an earlier MHCC study, research found that 73 per cent of federally incarcerated men and 79 per cent of federally incarcerated women were living with one or more mental health problems or illnesses.
Of course, when a person is released these mental health and substance use concerns do not disappear — although in most cases any support they may have received on the inside abruptly ends.
A new direction (and directory)
To help bridge the gap, the MHCC has just released a detailed inventory that lists mental health and substance use programs in each province and territory for persons transitioning away from the criminal justice system, for their support networks, and for front-line service providers.
In addition to contact information and overviews of each service, the interactive inventory specifically highlights the resources available to priority populations. To ensure individuals access to the most accurate and complete list of supports, it will also be updated periodically.
For Emilie Coyle, executive director at the Canadian Association of Elizabeth Fry Societies, such an inventory should make a difference for people in transition. “It can be disorienting to try to re-establish ties in community or to forge a new community,” she explained. “Being able to look up the supports that are closest to you and are tailored to your needs takes so much of the guesswork out of an already disorienting experience. Supports can alleviate feelings of frustration, abandonment, and loneliness and replace them with feelings of security, hope, and motivation.”
Navigating the pandemic landscape
For those re-entering the community during the pandemic, finding support to integrate back into society can be especially challenging.
“The public health measures in place in the community — such as social distancing, suspensions and closures of in-person programs (including harm reduction services), and reduced access to housing supports — may worsen the risks and barriers for individuals transitioning out of correctional settings,” said Sandra Koppert, the MHCC’s director of Mental Health Advancement.
With this new resource, Koppert and her team hope to give justice-involved persons a solid foundation for rebuilding their lives.
“Trying to navigate available mental health and substance use services is a daunting task, and the pandemic adds even more challenges,” she added. “For someone being released from a correctional setting, this puts more obstacles in the way of trying to start a new chapter. The inventory is intended to make the process of turning the page a little bit easier.”
For Korchinski, supporting the transition back to society isn’t just important, it’s vital. “People need food, clothing, shelter, and support the day they are released, not just left back on the streets homeless. Supporting people on their journey out of the criminal justice system by connecting them with resources gives them the best chance to make the healthy decisions that will keep them alive.”
Suzanne Westover
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Inclusion, empathy, and healing
Well before the withdrawal from Afghanistan and the pandemic, there was already a crying need to support the mental health of people in the Veteran community.
But adding these further pressures to an already charged powder keg makes it clear that this need has only grown. In particular, the end of this 13-year mission has many asking, “What was it all for?”
For Veteran Sherry Lachine, meaning and purpose has come from helping her peers and their loved ones explore their feelings and giving them tactics very different from those used in the field.
Lachine is a master facilitator for the Mental Health Commission of Canada’s (MHCC’s) Mental Health First Aid (MHFA) Veteran Community program. She also owns Broadmind, a company that specializes in mental health strategies.
While Veterans are a core constituency in her work, offering support and training to their families and friends is also critical.
“Once you expand your focus from individual Veterans to the network of those around them, the number of people influenced by Veterans’ mental well-being reaches into the millions,” she said.
MHFA Veteran Community training is tailored to ensure that its participants can empathize with others’ lived experience and can offer a supportive network of listening ears and open hearts. Since the program began in 2016, through a partnership between the MHCC and Veterans Affairs Canada, over 3,700 people have been trained via in-person and virtual courses.
That’s not for me
The idea that MHFA training is only useful for those who have fought on the battlefield is a misconception Lachine stresses each time she talks about the course. “Mental Health First Aid is for everyone. It gives you relationship skills, parenting skills, and human skills, really — the things that each of us use in our daily lives.”
In fact, “That’s not for me” was the exact response her mother gave when Lachine first suggested she sit in on one of her sessions. “My mother went into the course under the guise that she was doing it for others, not for herself. But she quickly realized that it wasn’t the case and soon after became a huge advocate of the program, almost to the point of creating T-shirts to spread the message.”
While the program has adaptations tailored to specific communities like Veterans, it also offers training for anyone interested in becoming more adept at the human skills Lachine alludes to.
A safe space
Shared humanity is at the heart of a successful MHFA training session, she said. Referring to an especially moving session, where a Veteran confessed to feeling guilt about how he’d treated loved ones in the past, Lachine remembered seeing, almost immediately, the spark of recognition in the eyes of the other participants.
“The sense of healing and validation that came from others acknowledging those feelings and sharing stories of their own was a big “aha” moment for me,” she said.
The MHFA Veteran Community experience is special because it’s a judgment-free zone. Chances are that fellow trainees have walked in each other’s shoes or alongside someone who can relate — something particularly true for military spouses.
At a course in Ottawa, Lachine recalled playing a video that featured a service member deployed in Rwanda and the struggles that had followed him home. There wasn’t a dry eye in the room as spouses saw their own reality reflected on the screen.
“You can almost feel the collective exhale as participants let the relief of being validated wash over them,” she said. “There is strength in numbers. It helps chip away at the isolation that so often accompanies these struggles.”
The continued need for support
In the weeks following the Afghanistan withdrawal, the Veteran community was hurting.
“There’s a temptation to give in to futility, and the feelings were rubbed raw. More than ever, in these last months, having a place to grieve, to express frustration, to find meaning together has been a lifeline,” said Lachine.
In response, she modified her approach, being mindful of giving participants the space they need to sort through a catalogue of emotions that many of us can only imagine.
Over the last century, understanding about invisible battle scars has grown. The blunt diagnosis of shell shock following the First World War has evolved into a more nuanced understanding of a spectrum of operational stress injuries.
“And with that knowledge,” affirmed Lachine, “comes the responsibility to treat those wounds with every tool in our arsenal.”
While Remembrance Day for most is an opportunity to remember with gratitude, for members of Canada’s Armed Forces it may trigger a groundswell of emotion.
If you know a Veteran or a family member who you think might benefit from MHFA training, more information is available here. Veterans Affairs Canada offers additional mental health resources.
Eric Gronke
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A review of Jann Arden’s If I Knew Then
Only a few pages into Jann Arden’s new book, If I Knew Then: Finding Wisdom in Failure and Power in Aging, I am convinced she’s borrowed a tiny piece of my own experience with grief and put it on the page in my stead.
In her opening vignette, Arden describes trying to disconnect her deceased father’s phone line. I too wrestled with a telecom giant after my own dad died, and our experiences were mirror images. Arden and I both met with recalcitrant service agents unwilling to help, after failing to produce impossible-to-find account numbers, while being subjected to the indignity of the same pitiless hold music.
“Insensitive,” Arden’s breakthrough anthem, would have been a more appropriate, if ironic, choice.
Even the wretchedness of death and the hellishness of its attendant paperwork can’t dampen the undercurrent of Arden’s gallows humour. As a passionate fan, perhaps I expected a more earnest, angsty book. But of course, stand-up comics can be dour out of the spotlight. So why can’t an oft heart-broken songstress be funny?
I read If I Knew Then cover to cover on the eve of my 42nd birthday. The timing was impeccable. I was feeling a little melancholy, and this slim volume proved the perfect antidote.
Sober second thought
Arden — who will be opening the (virtual) Issues of Substance Conference in November, co-hosted by Canadian Centre on Substance Use and Addiction and the Mental Health Commission of Canada — doesn’t pull any punches about the roundabout way she came fully into her own.
She holds her sobriety like a talisman.
It’s through that clear-eyed lens that she’s open to recounting her journey, stumbling blocks and all. Her book is a mediation on the power of failure to teach us our most valuable lessons and a celebration of the insight and fortitude that deepen as they marinate over time.
In our hustle culture, where youth is king and running the rat race promises a badge of honour, Arden’s thoughtful prose is a reminder. Slow. The. Heck. Down.
As a woman who has found hard-won meaning in health, friendships, and work, Arden takes none of these blessings for granted.
She writes in language that is both intimate and informal. This isn’t prescriptive self-help; it’s more like “no pressure” help-yourself. You get the feeling that writing the book was as cathartic for Arden as it will be for her readers.
Finding success by embracing failure
We often have ideas about what success looks like. Arden peels back the layers of her own rise to stardom with poignancy and humour, assuring us that even Juno Award winners can look in the mirror and find fault with what lies behind it.
What was most interesting to me is the perspective Arden offers to those coming up behind her.
“Jann, I’d say to my younger self, you’re going to be very hard on yourself and feel ashamed and embarrassed. You’re going to question your sanity and your worth and your sexuality, and pretty much every decision you’re going to make is going to be difficult. . . . You’re going to spend years desperately hung over, and you’re going to fail epically, but you’re going to make it — you’re going to thrive, even. I wish I could take away the hard parts, Jann, but then you wouldn’t be me, and being me is super f*&%ing great.”
Of her alcohol addiction, Arden writes, “For me, the old saying about needing to hit rock bottom was true.” It was in claiming her self-respect and becoming a person of her word that ultimately silenced the doubts that drove her to drink in the first place.
Like many creative types, Arden’s other medicine was music. And this memoir is as much a love letter to the power of singing and songwriting as it is to her sobriety.
When I say the book was a perfect choice on the eve of my 42nd birthday, I’m referring to society’s preoccupation with the attributes of youth — especially when taken as synonymous with beauty and self-worth. Arden refuses to buy into a narrative where women diminish with age, becoming all but invisible in a society that, as she put it, “seemed to have little time for women who were over thirty-five, women who had lost their curb appeal and their usefulness.”
Not just skin deep
Instead, she has found that with age comes the maturity to wield the kind of power and wisdom born from disappointments, failures, and losses, the kind that remould a person time and again into a more empathetic, caring, and feeling human being.
Early on in her career, Arden sent out dozens of demo tapes in an era where grunge reigned supreme and a female singer-songwriter baring her soul, acoustic guitar in hand, could easily have been drowned out. Or worse yet, counted herself out.
Arden’s success hardly came overnight. Like others, she heard “No” countless times. But she also understood, deep in her bones, that you need just one “yes.”
Her big break was neither a fluke of fate, nor a stroke of luck. While timing was key — a recently heart-broken producer who zeroed in on Arden’s soulful potential — it was her unflagging persistence and refusal to bow under the weight of rejection that secured her future success.
“Destiny,” she writes, “is just another word for determination.”
Understanding failure as a teacher and age as the ultimate expression of its wisdom are at the heart of Arden’s book. She refuses to worship at the altar of youth, instead embracing the virtues of the “crone.”
“Becoming a crone,” she concludes, “gives you the sense and the stability and power to be who you are.”
Turning the trope of a frightening, wizened old woman on its head, Arden invites readers to contemplate the value of a beauty that isn’t skin deep.
What a perfect birthday gift.
Suzanne Westover
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Mental Health First Aid taught me life skills I didn’t know I needed
Taking the first step
From my very first day at the Mental Health Commission of Canada, praise for Mental Health First Aid (MHFA) training travelled like folklore. Whether through personal experience or testimonials from former participants, it seemed as if everybody knew of someone who had been affected by the course.
So I was definitely curious when my turn came to participate. Even so, I was also a bit skeptical. As someone who rarely finds the time to attend seminars or professional development courses, I had reservations about how much I might take away from the experience. As it turns out, the answer was plenty.
Like physical first aid, which gives people tools to identify and support someone experiencing a crisis until professional help is available, MHFA does so for people experiencing a mental health crisis. As an avid hockey fan, I’m familiar with the importance of having defibrillators at ice rinks and knowing how to use them. But this was new territory for me.
Building the foundation
The first of the course’s three modules was self-directed using an online portal. So I logged in the evening before and began digging through the course content so I’d have a foundation for the knowledge I’d need to participate in the second module the next day.
It didn’t take long to realize that I had been overestimating my knowledge of mental health issues, even in areas as simple as language.
I had never stopped to think about the stigma attached to the phrases I was using to describe mental well-being. “That person suffers from depression” or “that mentally ill person” seemed harmless. I didn’t realize that speaking that way stigmatizes someone living with mental illness. But I learned that in most cases person-centred language is much more respectful. So, instead of saying “a person is a schizophrenic,” it’s better to say “a person living with schizophrenia.” The difference is profound because no one wants to be defined by their illness.
Think about someone with a history of substance use. When we refer to that person as a “former addict,” we’re reducing them to their disorder. Saying “an individual in recovery” is not only less stigmatizing — it recognizes that person’s dignity.
This first part of the course helped me understand some simple changes I could make (and encourage among my family and friends) that could add up to a big shift in my mindset. As with hockey, it still takes a team effort, but knowing the role I play gives me a sense of purpose and confidence.
But as it turns out, language was just the warm-up.
Class is in session
The eye-opening experience in the self-taught portion of the course had me thinking that I’d be in for more realizations in the virtual classroom.
During the introductions, I noticed how diverse our small group was. East coast to west, grad students to staff members of Fortune 500 corporations, people came together from all walks of life with one common interest: supporting the mental health of those around us (or at least being prepared to do so).
My first “aha” moment came after a scenario we watched that showed a person experiencing a mental health concern. We were then asked to think about how we might respond. Listening to the facilitator discuss that scenario was a game changer.
Imagine a casual observer watching a hockey game. Their perspective is going to be totally different from the hawk-eyed vision of a seasoned coach. In this case, our “facilitator-coach” proceeded to point out some nuances and details that flew right past me and many of the others.
When the distressed individual lamented, “What’s the point in trying?” to my untrained ear I was hearing an off-the-cuff remark. But for an experienced mental health first aider, that was a cry for help.
That stopped me in my tracks.
I started thinking of all the times I had heard someone ask that same question and never gave it a second thought. Could I have missed something? It’s not usual for phrases like this (which can signal hopelessness) to pop up in conversations. We learned to take note of similar language and to better understand when these words are harmless and when they could be cause for concern.
I had always assumed the cries for help from someone experiencing a mental health crisis would be more of a yell. It turns out they can be as silent as a whisper.
It was becoming clear that some of the most effective ways to help someone in this situation are being observant, paying close attention to their words, and offering empathy.
Confident conversations
After a generous break (and three slices of home-made pizza) I sat back at my desk for the third and final MHFA module.
While the earlier scenarios focused on knowing what to look for and what questions to ask, these new ones involved developing the confidence to engage in the hard conversations that follow.
It was like we’d been given all the equipment to make it out onto the ice, and now it was game time.
The role of a mental health first aider is not to provide professional advice to those in crisis. Rather, it’s to connect the individual with appropriate support. That’s where the training comes in. How do you provide comfort and calm? Sometimes that means striking up one of those conversations that happens before a person is ready to reach out for formal support.
The first step is figuring out if you’re dealing with a crisis and, if so, what actions are needed. While all the students were able to pinpoint which situations involved a crisis, there was a big disparity between our proposed solutions and those from our coach.
This time, the gap wasn’t due to our knowledge. It was about our confidence.
I consider myself a confident individual. In fact, I’d consider all the students in my session to be confident in their own ways. Yet none of us was prepared to be as forthright as we needed to be in the face of a crisis. Knowing when to be empathetic and when to take action was the final lesson that day. I could now say wholeheartedly that I would be much more likely to act appropriately in a crisis given my new-found confidence, rooted in knowledge.
Checking in with yourself
Any reservations I may have had about the course are now in the past. Today, I see its value as clearly as I see the importance of the defibrillator on the arena wall.
That said, I feel obliged to mention another key theme in the course I didn’t touch on: how to take care of yourself when assisting others who are experiencing a mental health concern or crisis. A key part of MHFA is the need to check in with yourself, set healthy boundaries, and ensure that you don’t bow under the weight of carrying someone else’s burdens.
Just like training for a sport, you can’t go full out every day without building in some recovery time.
While being a mental health first aider doesn’t make you a mental health professional, it does give you the knowledge and confidence to help someone in need, listen with an open mind, and respond with empathy. If that sounds like something worth doing, you can find more information, including course dates and times, here.
As I found out firsthand, there is no down side to joining this team.
Eric Gronke
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New implementation toolkit offers practical resources for mental health and substance use care
Understanding recovery starts with acknowledging that every person is entitled to a satisfying, hopeful, and contributing life, even if they experience mental health problems or illnesses and/or substance use concerns. With that basic right comes a powerful shift to a path toward wellness that is rooted in hope, dignity, self-determination, and responsibility. In concrete terms, recovery-oriented practice encompasses a range of services and supports designed to meet each person’s goals and needs.
Practitioners, service providers, and policy makers in Canada (and around the world) increasingly recognize the principle of recovery as essential for improving mental health systems and outcomes. More importantly, it is embraced by persons with lived and living experience and their families, whose values and insights are crucially important for successful outcomes.
The time is ripe
To further advance the use of the recovery approach in mental health and substance use care, the Mental Health Commission of Canada (MHCC) has just released Recovery-Oriented Practice: An Implementation Toolkit. The new toolkit builds on the MHCC’s Guidelines for Recovery-Oriented Practice (Guidelines) and offers wide-ranging resources to show everyone across the health services system how to apply recovery-oriented approaches — no matter what their role, profession, discipline, seniority, or level of contact with service users.
The toolkit also outlines in detail how implementation of a recovery-oriented approach could work across different settings, from a large mental health hospital to a mid-size not-for-profit community mental health service to a small community support network. Included are ideas for using the Guidelines, examples of the progression through four action phases, and several tools, resources, and templates to support these efforts.
Persons with lived and living experience as equal partners
The importance of such values and insights is illustrated in the section on How to Take Action. Using the principles of implementation science, a method for turning best practices into actions, the toolkit emphasizes the significance of “co-production”: the process of engaging persons with lived and living experience as equal partners in identifying opportunities and creating solutions to improve services. Co-production is closely aligned with recovery-oriented principles through its use of a strengths-based approach and by valuing everyone’s participation.
Real-world examples
Eight real-world examples bring these ideas into more concrete terms through stories that shed light on the many ways recovery principles can be adopted and applied. One of these organizations has a long history of putting co-production at the heart of what they do.
CHANNAL (Consumer’s Health Awareness Network Newfoundland and Labrador) has been operated by and for persons with lived and living experience since its inception in 1989. As a non-profit network providing support, education, and policy advice, its main goal is to encourage recovery and self-determination by providing a safe space where people can support and learn from one another.
According to the organization’s public education supervisor Monica Fletcher, “the toolkit’s real-world section brings the large and somewhat idealistic concept of recovery into the realm of the possible, yet also makes it understandable and doable.”
While she is impressed by the way the toolkit maps out all the steps involved, she is realistic about what that means. “Make no mistake,” she explained, “implementation will take time to set up, assess, and complete — and commitment from the top down — although in the end, it will improve the lives of everyone involved. And that makes the effort worth it.”
Fletcher speaks from first-hand knowledge about such perseverance. In citing the process of instilling the skills and resources for recovery-oriented practice in CHANNAL’s workforce, she emphasized that “training and support is embedded into everything we do. All decisions the leadership team makes include feedback from our front-line peer supporters. We look to them for direction. If something doesn’t work, either for the people we support or our staff, we make changes. We allow all staff to take personal responsibility for their wellness. Even though this may look different for each person, it works. It’s a constant ebb and flow.”
For Troy, a CHANNAL service user who lives with schizophrenia, everything they do is about his recovery, not his illness. “I’ve seen counsellors, occupational therapists, family doctors,” he said. “It’s only at CHANNAL where I don’t feel like a victim.”
The growth of recovery
In CHANNAL’s case, the commitment to people with lived and living experience and to recovery has been central to changes across Newfoundland and Labrador. In 2017, the minister of Health and Community Services launched a new Provincial Recovery Council for Mental Health and Addictions, placing CHANNAL’s executive director in a leading role. Now, the organization not only advises the minister directly, its services have also grown exponentially (up 1,000 per cent between 2015 and 2020).
“It’s taken CHANNAL 10 years of concerted effort to get to where we are today,” said Fletcher. “When I started working here six years ago, there were only three front-line peer supporters. Now we have 33 staff members across Newfoundland and Labrador that we train and support. Many of our peer supporters work hand in hand with clinical teams while offering their training and experiential knowledge to support individuals in a professional and recovery-oriented manner.”
Organizations wishing to begin or further their implementation process can download the new toolkit from the MHCC’s Recovery page.
Suzanne Westover
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Roots of Hope suicide prevention and life promotion program set to flourish in eleven more communities
The challenges wrought by the pandemic are splashed across the news. They inundate our social media feeds and dominate our conversations (still masked and at a distance) if we run into neighbours at the convenience store or gas station.
But COVID-19 isn’t the only public health crisis our communities are contending with. Every year in Canada, suicide claims the lives of 4,000 people. The ripple of effect from each of those tragedies is felt by another 100 family members, friends, or colleagues. Suicide brings with it a special brand of devastation. Survivors of suicide loss claim their place in a club no one would wish to join.
Just as we are all at risk of catching COVID-19, under the wrong circumstances anyone can find themselves experiencing suicidal thoughts. Recent Leger polling commissioned by the Mental Health Commission of Canada (MHCC) and the Canadian Centre on Substance Use and Addiction revealed that while seven per cent of those surveyed experienced thoughts of suicide during the pandemic, that number jumped to 16 per cent among those with pre-existing mental health problems, and 25 per cent for those with a lifetime history of substance use disorders.
For MHCC president and CEO Michel Rodrigue, the reverberations of a close friend’s suicide are never far below the surface. “I am deeply invested in the success of our suicide prevention efforts because we know that if a region binds together and levels its resources, creativity, and determination, we can weave prevention into the fabric of our communities,” he said. “Now, more than ever, we have a collective responsibility to look out for one another.”
Rooted in the best evidence
The efforts Rodrigue refers to involve the five pillars of the MHCC’s home-grown suicide prevention and life promotion model, Roots of Hope. Apart from designing the model, the MHCC convenes participating communities to share knowledge and ideas and evaluates the evidence they provide to see what works best. When it was launched in Ottawa in September 2018, seven communities sourced the funding to join in.
Now, after applications streamed in from across the country, eleven more have been named as Roots of Hope participants in a second cohort. Known as Early Adopters, the group includes communities in various regions, from the mining city of Flin Flon, perched on the Manitoba-Saskatchewan border, to the municipality of Halton in southern Ontario.
“We saw an overwhelming interest in becoming a Roots of Hope Early Adopter,” said Ed Mantler, the MHCC’s vice-president of Programs and Priorities. “That communities were able to find the means to make this happen tells us that there is not only a great need but also a real willingness to invest the time, money, and emotional energy that will spark change.”
For Angela Fetch Muzyka, community development officer for the Town of Stony Plain, Alberta, the appeal is two-fold. “Working on Roots of hope is an important opportunity to advance efforts in our own community. But it’s also exciting to know that our successes and failures will guide future communities in their approach to suicide prevention.”
Just as the pandemic has shown us that, through a concerted effort, we can band together and protect one another from harm — even if that sometimes means staying apart — it reminds us that preventing suicide isn’t all that different.
Roots of Hope gives communities access to pools of knowledge and approaches based on the best evidence, but it’s not a one-size-fits-all prescription. Each chooses to focus on the populations most at risk in their areas.
For example, Pontiac, Quebec, will target its efforts toward the whole population, with a specific focus on men. The populations of interest in New Brunswick, the first Early Adopter to apply Roots of Hope across an entire province, will include youth, older adults, veterans, Indigenous peoples, and those with incomes below the poverty line. The Yukon, as the first territory to join the program, is zeroing in on those living in rural and remote communities and students attending Yukon University.
“You can quickly see the benefit of gathering the information gleaned from the various communities,” said Nitika Rewari, acting director of Prevention and Promotion Initiatives. “Suddenly, we’ve got access to approaches that work for people of diverse ages, backgrounds, and circumstances.”
Growing education
Central to Roots of Hope is homing in on the specific strengths and unique features of individual regions.
“Our board chair Chuck Bruce has likened it to building model planes,” said Rodrigue. “They come plain and colourless in a box and are brought to life by the hands that build them.”
Given the complex factors at play, Roots of Hope doesn’t purport to solve a problem as complex as suicide overnight. Still, it is possible to leverage what we do understand to better serve people who may be experiencing suicidal thoughts.
For example, many people who die by suicide visit their family doctor in the six months before they take their own lives. “Training doctors, health-care professionals, and other community leaders about how to spot the signs and how to have that difficult conversation is an important part of knitting tighter safety nets,” said Mantler. “So too is reaching out to young people who have lost a friend or a loved one to suicide.”
“Some of our communities told us that there was a hesitancy around how to broach the topic of suicide with children,” explained Julie McKercher, a program manager with the MHCC’s Prevention and Promotion team. “So we set out to create a resource to support those crucial conversations. As the big-picture convener with ready access to expertise, the MHCC can be responsive to those needs.”
And while education is a critical pillar in the Roots of Hope approach, so too is “means restriction.” “We need to look at how people take their lives and see if we can create barriers or restrict access,” said Rewari. “Many suicide attempts take place during a short-term crisis. Fewer completed suicides could result from barricades at train stations, limiting access to tall bridges, or encouraging people to safely dispose of unused prescription drugs.”
Hope in the time of COVID
“Just as we approached our management of COVID-19 with a concerted public awareness campaign centred on social distancing, mask wearing, testing, and staying home when sick,” said Rodrigue, “we can apply these same principles to creating public awareness about suicide prevention.”
While the pandemic has brought countless challenges, it has also illuminated how quickly we can marshal community responses to keep our residents safe. While that knowledge is fresh in our minds, we have an opportunity to apply it with equal determination and focus to promote life-saving measures like those identified by Roots of Hope.
In the words of Breanne Mellen, suicide program coordinator for the Early Adopter community in Medicine Hat, Alberta, “When we work together and honour the knowledge, experience, and abilities hidden within each of us, great things can and will happen.”
Suzanne Westover
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Mental Health Commission of Canada’s HEADSTRONG summits go virtual
When much of the world shut down in March 2020, HEADSTRONG program manager Fiona Haynes was heartsick.
HEADSTRONG summits are interactive gatherings that give young people the chance to learn about mental health and gain the tools they need to become anti-stigma champions and ambassadors in their schools and communities.
According to Haynes, “those of us involved in the program were able to see first-hand the positive impact we were having and also how great the need was — how much young people benefited from a safe space to listen, learn, and ask questions. But we were also encouraged by how incredibly empowered they felt when asked to put forward solutions.” Ever since she joined the program in 2016, Haynes has seen it grow through word of mouth from a single national summit to a program that has reached hundreds of thousands of students.
Finding a Plan B
“After the pandemic struck, I was in my living room, worried sick about how we were going to reach these kids, how we were going to make sure they knew they hadn’t been forgotten, how we were going to put out that lifeline and say, ‘We’re still here for you,’” she recalled. “But I soon discovered that I wasn’t the only one having those concerns. The whole team was thinking, We needed a Plan B.”
As it turns out, Plan B came together so quickly that Haynes now proudly calls it a “second Plan A.” She always knew that reaching fly-in and other remote communities would mean a re-think of conventional get-togethers. What she didn’t expect was that the new virtual summits, inspired by the existing HEADSTRONG concept but with distancing measures, would exceed her wildest expectations.
“We found the secret sauce,” said Haynes, who pointed to evaluation reports from the early pilot projects showing an equal effect across the range of positive behaviours that the in-person summits sought to promote — everything from help seeking to stigma reduction.
Traditional HEADSTRONG summits worked by gathering students together from various high schools over the course of a full day. After hearing inspiring stories of recovery, they participate in thought-provoking activities and become aware of the positive influence they can have to change attitudes and behaviours around mental health. Students then take their new-found knowledge back to their own school to help make it mentally safer, with support from a sponsor (teacher or school counsellor).
While the virtual edition follows a similar path, students remain in their classrooms while joining up with as many as five other groups. Led by MCs who have specific training in virtual communication, the events are split into 75-minute modules (being mindful of Zoom fatigue) that align with the summit’s three-part motto: (1) “Be Brave,” on mental health, mental wellness, and appropriate help seeking, (2) “Reach Out,” on understanding and challenging stigma, and (3) “Speak Up,” on how to take meaningful action.
Learning through connection
The way the summits are presented directly affects what participants take away from their experience. As one student put it, “I learned how neglected mental health is, the importance of reaching out, being mindful and aware, and realizing how strong and capable people with mental illnesses really are.”
This kind of heartfelt observation, said Haynes, is likely the result of “contact-based education,” which occurs when a HEADSTRONG speaker (often a young adult) shares their experience of managing or recovering from mental illness.
“Suddenly, it’s not so other,” Haynes explained. “We see students having their fears, insecurities, and vulnerabilities mirrored by a successful young person who is a good communicator and a positive role model — and then, it’s like a light switch: ‘I can have anxiety, I can feel depressed, I can feel alone,’ and I can also be a worthwhile person who can reach out for the support I deserve.’”
Such insight, in combination with knowledge of available resources, also gives students the confidence to offer appropriate support and encourage peers to seek help. Young people have an important role in this, given that friends are often the first line of defense when a problem crops up.
Building momentum
So far, HEADSTRONG’s three virtual pilots and official launch summit have all met with positive results.
“We had a tried and tested formula for in-person summits, and to see that translate well to a modified virtual version is heartening,” said Laura Mullaly, interim manager of knowledge mobilization with the Mental Health Advancement team. “We have rigorous evaluations that tell us, ‘Yes, this is working the way it’s supposed to,’ and to see those replicated with virtual summits means we can continue this important work, regardless of COVID measures.”
One comment on the virtual summit from a grade ten student says it all: “I’m more educated. I know how to get help, and I know how to help others.”
Suzanne Westover
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New policy brief underscores the plight of parenting in a pandemic
There is a “secret society” at the Mental Health Commission of Canada (MHCC), just like there is at every workplace across the country. Its members recognize each other through various signs and signals — some subtle, others less so.
Do you take calls in the blessed quiet of a car, in the bedroom closet, or in the relative peace of the furnace room? Are you the person at the meeting who switches off your camera so you can pour a bowl of goldfish crackers and offer feedback on an indiscernible drawing of a cat (or is it a crow)? Do you hear yourself saying, “I’ll help you find your shoe/bunny/imperceptibly tiny Lego accessory as soon as I finish writing this report/booking this meeting/drafting this article”?
If your answer to any of these questions is yes, chances are you’re part of the club.
Parents of young children have borne the brunt of COVID-19 stress — mothers especially. Consider new research from the MHCC (in partnership with the Canadian Paediatric Society), which found rates of depression during the pandemic among mothers of infants and children (age 18 months to eight years) rising to 42 per cent from nine per cent.
A growing need
Even before COVID-19, signs that we needed to rethink the services and supports available to families were already appearing, especially among those facing the additional stressors of financial insecurity, low social support, or racial discrimination. Pre-pandemic, less than 20 per cent of families had access to the greatest equalizer of disparities in the early years: affordable, licensed, early childhood education centres.
Since the pandemic began, families have been forced to deal with an additional range of unplanned complications, from social isolation and disruptions in child care and schooling to financial worries and loss of employment. Unsurprisingly, the result has been increased family conflict, including divorce.
My colleague, a parent who works in the MHCC’s Public Affairs department, is no stranger to this reality. “At the onset of the pandemic, I lost my mom, my husband lost his job, and my children lost their routine,” she explained. “There is no doubt in my mind that the adverse experiences parents are contending with have a trickle-down effect when it comes to children’s well-being.”
Her anecdotal findings are corroborated by the 40 per cent of Ontario parents who report behavioural and emotional changes in their children and the 61 per cent of parents across Canada who are concerned about managing their child’s behaviour, anxiety, emotions, and stress.
The search for new solutions
When looking at solving these real-world problems, our joint policy brief makes specific recommendations for decision makers to consider.
“We need targeted mental health supports for parents of young children,” said Brandon Hey, MHCC Policy and Research senior analyst. “And we need interventions that reduce parental stress and support caregiving needs.”
On that score, the Wellness Together Canada (2020-2024) portal is a great place for parents to start. Even before signing up for an account, basic information on managing anxiety for adults and children is readily available. With an account, you have access to an even broader array of resources, including evidence-based behavioural management courses, one-on-one (or group) counselling, and self-guided programs that allow you to track your state of mind.
Support starts with speaking up
My colleague who lived with mental illness prior to the pandemic, has seen her anxiety spike. “The other day I got an alert on my activity tracker. It told me my heart rate was through the roof but had the ‘sense’ to recognize I wasn’t exercising. Sometimes a mental health problem is as obvious as a flashing alarm on your watch, yet with others it’s more insidious.”
That’s why, affirmed Hey, we need measures that address short-term challenges while also considering how to create policies that improve outcomes down the road, such as early education, child care, income supplements, and protections from discrimination.
“The pandemic has exacerbated pre-existing service gaps and inequities,” he added. “The wait times are too long, the number of qualified practitioners too few, and the accountability measures too weak.”
“The struggle parents face is very real,” said my colleague. “No one does their best parenting under duress, and we know that when stress builds we run the risk of modelling less than perfect behaviour or show less than ideal coping strategies, which can have serious implications for our kids. But there is no shame at all in saying, ‘Look, I need help, I’m not OK.’”
And when people do reach out, said Hey, we need to make sure that that the right person is there to answer the call.
Suzanne Westover
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New virtual Mental Health First Aid course teaches adults to support the youth in their lives
Long before the pandemic, the need to support the mental health of young people was evident. With 50 per cent of all mental health problems established by age 14, the formative years of our youth are some of the most vulnerable. Now, by also having to face the impacts of COVID-19, that vulnerability in our youth has only grown.
For adults, it can be difficult to know how to relate to the young people in their lives, let alone how approach them about their mental well-being. To help open up those important conversations, the Mental Health Commission of Canada’s (MHCC’s) updated its MHFA Supporting Youth training and adapted it to a virtual format — and, as adults may be surprised to learn, “relating” isn’t part of the curriculum.
“When you’re talking to a young person about their experiences, it’s not about you,” explained Denise Waligora, a training and delivery specialist at the MHCC. “By the time you’re an adult, you’ve overcome hardship, and learned coping strategies along the way. The same isn’t necessarily true of youth. You have to be able to listen without minimizing their experiences or comparing them to your own.”
That kind of non-judgmental listening is just one of the strategies participants can expect to pick up from the new Mental Health First Aid virtual training. During the highly interactive 10-hour course, they will also learn how to recognize the signs of declining mental well-being and engage in conversations about those observations, assist in mental health or substance use crises, seek outside supports, and care for themselves as a “first aider.”
Focusing on the individual
Rather than offering a step-by-step approach to supporting all youth, course facilitators emphasize the role individuality plays. “Everyone has a baseline set of behaviours, moods, and attitudes,” said Waligora; for example, while one young person’s declining mental health could manifest in low grades or conflicts with friends, those things could be the norm for someone else.
The most important factor to be aware of, she said, is change. “As soon as we recognize a shift in any of these areas, we need to ask, How big of a deviation is this from that person’s baseline and how long has it been going on?”
In a similar way, effective conversational strategies and types of support may also vary depending on the individual. While some youth might be eager to share their feelings if given the opportunity, others may feel embarrassed and need more time. To help create a comfortable atmosphere, course participants are taught to approach youth more casually while engaging in an activity, as opposed to confronting them head-on.
“Whether it takes one try or five, you’re showing that young person someone cares about them.”
An updated approach
While the updates to MHFA Supporting Youth were based on the original in-person course, the content has undergone more than a virtual makeover.
One key addition, says Waligora, is a section dedicated to marginalized groups, including racialized, Indigenous, and 2SLGBTQ+ youth. “A young person from the 2SLGBTQ+ community may have a very different high school experience than their peers, for example. We have to learn about and acknowledge those differences to provide the most effective support.”
Another aspect of effective support (and further addition to the course content) is self-care for first aiders themselves. While participants are largely trained to support the youth around them, they are also taught to acknowledge the toll caring for others can take on one’s own well-being.
Finally, the updated course has shifted to include a more holistic approach to wellness. Rather than focusing on labels, the training follows a recovery-oriented model, emphasizing resilience and overall well-being in all areas of life.
Our collective responsibility
While the course was built for adults who interact with youth, as Waligora points out, that group extends far beyond parents.
“Almost all of us have young people in our lives, whether it’s relatives, neighbours, students, or employees. If you’re close enough to notice a change in a person, you’re close enough to offer your support.”
Late last year, the government of Saskatchewan echoed that sentiment by committing $400,000 to provide MHFA training in K-12 schools across the province.
“Our goal is to have at least one staff member in each school receive Mental Health First Aid training by December 2021,” said Saskatchewan Education Minister Dustin Duncan. “We are excited to support schools in ensuring students have access to mental health resources, and I encourage all provincial school divisions to take part to help remove the stigma around mental health.”
For Waligora, the bottom line is simple: “We have a responsibility to protect our youth. Every young person deserves a safe place to turn. As adults, we can be that place.”
