Catalyst Newsletters Archive - Page 26 of 32 - Mental Health Commission of Canada

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Author: Suzanne Westover

Suzanne Westover

An Ottawa writer and former speechwriter, and Manager of Communications at the Mental Health Commission of Canada. A homebody who always has her nose in a book, she bakes a mean lemon loaf (some would call her a one-dish wonder) and enjoys watching movies with her husband and 14-year-old daughter. Suzanne’s time with the MHCC cemented her interest in mental health, and she remains a life-long learner on the subject.

MHCC winter mini-guide aims to give workplaces seasonal boost

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

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

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

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

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

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

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

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

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

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

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

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

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

Author: Amber St. Louis

Amber St. Louis

MHCC champions a variety of suicide pre- and postvention resources

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

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

Update to a key media resource

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

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

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

The power of language

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

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

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

MHCC resources for those affected by suicide

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

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

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

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

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

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

Author: Amber St. Louis

Amber St. Louis

For caregivers, finding the right balance is key

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

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

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

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

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

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

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

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

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

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

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

Author: Amber St. Louis

Amber St. Louis

Give back, or reach out

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Author: Suzanne Westover

Suzanne Westover

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Dips in mental health are not just part of getting older. The Mental Health Commission of Canada’s Denise Waligora explains how to best support seniors’ whole health. This podcast episode is in the English language only.

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COVID-19 pandemic has exposed the poor management of long-term care homes across Canada.

It is no secret that the COVID-19 pandemic has exposed the poor management of long-term care homes across Canada. According to the Canadian Institute for Health Information (CIHI), “More than 840 outbreaks have been reported in LTC facilities and retirement homes, accounting for more than 80% of all COVID-19 deaths in the country” (p.1). Many argue that ageism has been the leading factor in apathy towards older adults’ overall mental and physical wellbeing. Overt ageism is also widespread. For instance, Twitter has been flooded with “#boomerremover,” a hashtag used to make fun of the overrepresentation of COVID-19 deaths among older adults. We oppose ageism, whether implicit or overt, and offer in this blog some reasons on why we fight for the mental wellness of older adults.

Ageism During COVID

Despite having a “rapidly aging population,” Canada continues to witness widespread ageism in various manifestations (Guidelines, 2020). This trend has drastically increased during the COVID-19 pandemic. Various news articles have drawn attention to the way social media has facilitated the propagation of a new wave of ageism: “‘Boomer Remover’ is the Morbid Meme Millennials are Sharing”(New York Post), “Coronavirus: Le Virus de L’agisme” (Le Devoir), and “A Certain Horrible Subset of the Internet is Calling the Corona Virus ‘Boomer Remover”(Business Insider).

A recent study notes the prevalence of ageism in three Western countries:

Despite divergent policies in the 3 countries [Australia, the United Kingdom, and the United States], ageism took similar forms. Public responses to lockdowns and other measures cast older adults as a problem to be ignored or solved through segregation. Name-calling, blame, and “so-be-it” reactions toward age vulnerability were commonplace. (Linchenstein, 2020)

In another study, researchers found that the majority of the 18,000+ tweets related to senior’s vulnerability to COVID-19 they analyzed expressed concern over the wellbeing of older adults. However, many millennials used “#boomerremover” to make light of the impact of COVID-19 on seniors (Jimenez‐Sotomayor et al., 2020). The health and mental wellbeing of older adults in Canada is not a joke.

Why We Fight for Seniors Mental Wellness

The Mental Health Commission of Canada’s (MHCC) Guidelines for Comprehensive Mental Health Services for Older Adults in Canada (2011) provides an overview of the growing proportion of seniors in Canada’s population and the state of seniors’ mental health. The Guidelines note that:

Canada’s population is currently undergoing a fundamental shift: during the next quarter century, the proportion of Canadians aged over 65 will nearly double as the entire baby boom generation turns 65… As a result, by 2036 nearly one out of every four Canadians will be a senior, outnumbering children for the first time in history. (p. 6)

Thus, ageism has the potential to affect a growing number of Canadians as our population ages. The impact of ageism on older people is further compounded when individuals are living with a mental health problem or illness. The Guidelines (2011) state: “Seniors who experience a mental health problem or illness may face a ‘double whammy’ of stigma: the stigma of being older in addition to the stigma of mental illness” (Guidelines, p. 6).

Finally, the Guidelines (2011) contend that,

The most tragic complication of mood disorders is death by suicide. Although research shows that older men have the highest suicide rate in Canada, it is widely believed that published suicide rates still underestimate the total number of deaths by suicide for older men and women, due, in part, to the stigma of suicide. Currently, men aged 80 and older are the group with the highest suicide rates in Canada (p. 15).

The MHCC is committed to fighting ageism based on three principles:

Discrimination is never okay. Whether it is ageism, racism, sexism, homophobia, or any other form of discrimination, making fun of any aspect of someone’s identity is damaging and dangerous. We assert the dignity of all people—everyone deserves respect. We care about older adults’ mental health and wellbeing because they are human beings. Period.
Intersectionality matters. While Professor Kimberle Crenshaw originally created intersectionality theory to explain the “double whammy” of race- and gender-based discrimination and its effects on African American women, we can also apply this theory to the plight of older adults in Canada. In addition to other forms of discrimination they may experience, older adults with mental health problems or illness also face a dehumanizing combination of stigma related to mental health and stigma surrounding old age works. This must end.
Mental illness has the potential to kill. Research has shown that older people are more likely to die by suicide due to ongoing mood disorders such a depression (Guidelines, p. 15). When we dehumanize older adults through ageism, even if in jest, and fail to advocate for their physical and mental wellbeing, we are potentially contributing to the deaths of fellow Canadians.

In short, we assert that the lives and mental wellbeing of seniors matter and can never be laughed off as a joke.

To learn more about the great work being done across Canada to advocate and support the mental wellbeing of older adults, follow the links below:

BrainXchange, https://brainxchange.ca/

Canadian Academy of Geriatric Psychiatry, http://www.cagp.ca/page-182559

Canadian Coalition for Seniors’ Mental Health, https://ccsmh.ca/

Mental Health Commission of Canada Seniors, https://www.mentalhealthcommission.ca/English/what-we-do/seniors

References

CIHI, “Pandemic Experience in the Long-Term Care Sector How Does Canada Compare With Other Countries?” https://www.cihi.ca/sites/default/files/document/covid-19-rapid-response-long-term-care-snapshot-en.pdf

Lichtenstein, B. (2020). From “Coffin Dodger” to “Boomer Remover”: Outbreaks of Ageism in Three Countries With Divergent Approaches to Coronavirus Control, The Journals of Gerontology: Series B, gbaa102, https://doi.org/10.1093/geronb/gbaa102

Jimenez‐Sotomayor, M.R., Gomez‐Moreno, C., & Soto‐Perez‐de‐Celis, E. (2020), Coronavirus, Ageism, and Twitter: An Evaluation of Tweets about Older Adults and COVID‐19. J Am Geriatr Soc, 68: 1661-1665. doi:10.1111/jgs.16508

MHCC’s Guidelines for Comprehensive Mental Health Services for Older Adults in Canada (2011), https://dev-mhcc.pantheonsite.io/wp-content/uploads/2021/06/Senior_Care_Guideline_2018_eng.pdf

Elizabeth Peprah is a current PhD Student in Human and Social Services with a concentration in Community Intervention and Leadership at Walden University. She is a graduate of a master’s degree in Women’s and Gender Studies at Carleton University where she researched the connection between mental health and sexual assault trauma. Elizabeth further discovered the importance of adequate mental health services for victimized women while working with women in a bail residency program with the Elizabeth Fry Society of Ottawa. She blogs on gender-based violence at serwaaspeaks.com and has been a Knowledge Broker with the MHCC since January 2020.

Author: Unknown

Roots of Hope flourishing on the Burin Peninsula

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

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

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

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

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

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

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

Illustrator: Kati Oliver

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

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

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

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

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

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

Author: Amber St. Louis

Amber St. Louis

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.

Author: Suzanne Westover

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Filling in the knowledge gaps on cannabis use and mental health

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