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Older adults are more likely to suffer from social isolation. Loneliness is increasingly being recognized as being bad for our health. The good news is that mattering and belonging can flip the script. Our series explores these and other related concepts.
In the summer of 2023, Vancouver Island resident Linda Fedun was feeling pretty lonely, even though social distancing measures had been lifted the year before.
“The pandemic started it, but it was when my back pain became serious that things got really bad for me,” says the 63-year-old retired daycare worker. “I couldn’t really go out. I’d be out for half an hour and then I’d have to go home in tears.
“Social isolation is hard,” she adds. “Especially since it’s just me and my two cats.”
Many older adults in Canada can relate. It’s hard to pin down exact numbers, but Statistics Canada has estimated about 30 percent of older adults are at risk of experiencing social isolation and, in 2019 and 2020, almost one in five reported feeling loneliness.
Social isolation is defined as having both a low quantity and quality of contact with others. It’s marked by an absence of mutually rewarding relationships and can lead to poor health, loneliness, emotional distress, and other negative health outcomes.
For some, that feeling is chronic. For Fedun, things improved after the doctors figured out a treatment plan for her osteoarthritis last October and she could finally reconnect with her community and get back to things like taking regular walks. One of these took her by an encampment she hadn’t even realized existed, even though it was only a few blocks from her home. There, she recognized an old acquaintance who told her she and her partner had been unhoused for months.
“I went right home and started looking for what I could spare,” says Fedun. “And then I realized it’s more than that. They needed much, much more than that.”
Fedun started asking for help from neighbours through her Nextdoor app, a social networking site that helps people connect with local folks for potlucks, buy-and-sell, and other exchanges. Members of her community responded enthusiastically with food, warm clothing, and propane for a Coleman stove. She organized pick-ups and drop-offs and connected with an advocate for the unhoused who gave her a “crash course” on housing insecurity. The pair launched a Go Fund Me campaign to help their unhoused friends get an apartment.
Social isolation is a thing of the past for Fedun and, perhaps unsurprisingly, so is loneliness. “I have a sense of purpose now,” she says.
For many, though, the answer isn’t as simple as getting back out, largely because social isolation and loneliness are two different things.
Social isolation and loneliness—what’s the difference?
“Social isolation is objective, such as the number of people in your life and how often you interact with them,” says Eddy Elmer, a Vancouver gerontologist and research consultant specializing in aging and mental health. “Loneliness, on the other hand, is more subjective. It’s the feeling that there’s a mismatch between the relationships you want and those you actually have, whether in terms of quantity or, especially, quality.
“One person can be fairly isolated but not feel lonely, whereas another can have a large social network, but feel quite lonely,” Elmer continues. “It all depends on their unique social needs and expectations.”
Since they’re two distinct problems, they require completely different approaches. And, generally speaking, it’s easier to reverse problems associated with social isolation than it is to help people overcome chronic feelings of loneliness.
“It’s probably normal to have some degree of loneliness from time to time,” says Dr. David Conn, a geriatric psychiatrist who works at Baycrest Health Sciences and the University of Toronto. “But for people who feel intense, chronic loneliness, the origins of that are often rooted in early life relationships and how they feel about people in general.”
Despite not being interchangeable, both social isolation and loneliness are associated with a range of negative health outcomes. In older adults, social isolation is correlated with frailty, cognitive decline, and depression, as well as increased chances of a premature death.
“The key word here is ‘correlated’ because establishing causation is not straightforward,” says Elmer. “But studies find that both loneliness and social isolation are associated with increased inflammation, weakened immune function, hypertension, cardiovascular disease, diabetes, and poorer sleep quality.”
That last symptom may be an important piece of the puzzle. According to the evolutionary theory of loneliness, poor sleep is part of a “hyper-vigilant” state triggered by social disconnection. In a nutshell, for early humans who lived in smaller hunter-gatherer tribes and had to work together closely for survival, being alone was dangerous. Loneliness is an unpleasant emotional response that might be an adaptive mechanism, since the pain of being alone can serve as a biological signal to restore social relationships and get back to safety.
Vancouver gerontologist Eddy Elmer: You can be isolated and not lonely; you can also have a wide social circle and still feel lonely. It all depends on one’s needs and expectations.
Mattering is good for the grey matter
Even though way fewer sabre-toothed predators are prowling around these days, being a member of a clan is still the safer and healthier choice for most people. A recent study from Carleton University found that higher belongingness is connected to better health outcomes for people of all ages—but particularly for older adults.
“What we found was that older individuals who felt they belonged to their neighbourhood were about six or seven percent healthier than people who didn’t,” says Mehdi Ammi, Associate Professor at Carleton’s School of Public Policy and Administration. “Belonging reduced most chronic conditions and was preventative in arthritis and anything connected to chronic stress.”
Social psychology proposes that high levels of belonging can help chronic stress, so it may offer a protective benefit to folks who feel like they have a place at the table. Though some positive psychologists say that while belonging is a good start, an even stronger protective benefit can be seen in people who feel like they matter.
“Belonging is fitting in and having a place,” explains Gordon Flett, Honorary President of the Canadian Psychological Association 2024-2025 and former York University Canada Research Chair. “Mattering is feeling a sense of significance and value within that place. For example, a person could be part of a community, but still feel they’re not being taken seriously.”
The correlation between loneliness and the feeling of not mattering is very robust, he says. “The research about loneliness and the elderly show that there are just too many people who don’t have any meaningful engagement of a prolonged nature with the people who matter to them,” Flett continues. “And they’re left to feel lonely. And when people feel alone and insignificant at the same time, we call that ‘double jeopardy’.”
Conversely, mattering is thought to provide a buffer of sorts that protects individuals from significant stress, whether it’s caused by loneliness, caregiving, loss of independence, and even financial issues.
“The bottom line is that knowing people value and care about you is very comforting,” says Flett. “And I think it also means that you’ll be more likely to ask people for help when you need it.”
It can be difficult for older adults to feel valued and have a sense of meaning, especially in North America, where the culture valorizes youth, fails to provide age-inclusive spaces or age-friendly cities, and views health as an individual responsibility as opposed to a collective one. All these things are factors in widespread loneliness amongst Canada’s older adult population.
While we wait for societal changes, many older adults who have the ability are finding ways of aging in community and generating mattering experiences for themselves. For some, that might be grandparenting. For others, it might be volunteering to help other older adults.
“My wife’s uncle Derek, who almost made it to 100 and lived by himself his whole life in Fort Qu’Appelle, Saskatchewan, was well-known for his volunteer work,” Flett offers. “He delivered Meals on Wheels to people younger than him into his 90s because he was in great shape.
“I once asked him if he ever felt lonely and he cut me off. He said, ‘Not for a second. Because I know there’s people out there who care. And I can get to them, and they can get to me’.”
Further reading: Home Alone: Aging without support is becoming more prevalent for older people in Canada. How can we stem the tide?
Author: Christine Sismondo is a Toronto writer who hopes to one day live with friends in a communal living project modelled after The Golden Girls. Since it was her idea, she gets to be Dorothy.
This blog post presents a review of the current literature on Indigenous Perinatal Mental Health, exploring key themes, gaps, and emerging insights. Drawing on both academic sources and community-informed perspectives, this review is enriched by the voices of leaders from Indigenous-led associations who offer vital context, critique, and cultural grounding. Their commentary not only deepens our understanding of the complex interplay between perinatal mental health and Indigenous experiences but also affirms the importance of Indigenous leadership in shaping responsive, culturally safe care.
The Gaps in Research: Why Aren’t We Talking About This?
As I began researching this topic, I was struck by how little information exists on Indigenous Perinatal Mental Health (PMH). The absence of data speaks volumes; this issue has been overlooked for far too long. A 2020 systematic review published in the Canadian Journal of Psychiatry by Sawayra Owais & colleagues found that Indigenous women are nearly twice as likely to experience postpartum depression as non-Indigenous women, with prevalence rates reaching 31%. Despite this, culturally safe care remains scarce, forcing Indigenous women to navigate their struggles alone – often in silence.
This silence is not a choice but rather a symptom of a system that has long failed Indigenous mothers. PMH, essential to the well-being of both mother and child, remains riddled with barriers.
While many existing studies examine general barriers to maternal health care, very few explore the emotional toll these challenges create. A 2022 study by Zarish Jawad, Nikita Chugh, & Karina Daddar found that PMH services for Indigenous mothers are often inaccessible, underfunded, and culturally inappropriate, making it even harder for women to seek the support they need.
A Legacy of Mistrust
To understand why Indigenous mothers hesitate to seek PMH care, we must first acknowledge the deep-rooted mistrust in Canada’s health-care system. For generations, Indigenous families have been subjected to policies that severed the bond between parent and child, making it challenging to trust institutions meant to provide care. Health care settings have not historically been places of healing for Indigenous people.
Robin Smoker-Peters, Instructor of Indigenous Health at Western University, reinforces this reality: “These are not just events of the past. The last residential school in Canada closed in 1996, and forced sterilizations were still occurring up until a few years ago. This is not just history; it is still happening and continues impacting how Indigenous people engage with health care.”
Even today, Indigenous mothers fear that seeking PMH care may lead to child welfare involvement. According to Census 2021, Indigenous children make up 53.8% of those in foster care despite representing only 7.7% of Canada’s entire child population. Families are torn apart due to systemic biases rather than genuine concerns about parental capability.
A deeply harmful policy that reinforced this fear was the Birth Alert system, which flagged Indigenous mothers as child welfare concerns, often based solely on their connection to residential school survivors. As Smoker-Peters explains, it operated on the assumption that Indigenous mothers were unfit, leading to newborns being taken from their mothers without cause. While now banned in B.C., many Indigenous women still hesitate to seek PMH support.
The Disconnect
For Indigenous mothers, Western PMH frameworks lack the culturally grounded support they may need. A 2023 study by Christina DeRoche & colleagues found gaps in culturally appropriate care for Indigenous parents after surveying perinatal professionals about barriers diverse populations face in accessing PMH care.
One provider shared, “Do not forget about Indigenous PMH, as they are referred to us for obstetrical care, but we are unsure of what to do after [receiving] a diagnosis,” reflecting a system with no clear, culturally relevant care paths. Another noted the “lack of Indigenous-specific services for perinatal mood issues.” Even providers recognize their limited ability to offer culturally sensitive care, yet these gaps will persist without policy-level change.
Addressing Indigenous PMH means more than acknowledging disparities; it requires action that centers on Indigenous voices, traditional healing, and culturally safe care. Smoker-Peters stresses this point: “There is an overfocus on intergenerational trauma and not enough attention on how the system itself continues to be racist and harmful. Indigenous mothers should not be viewed through a deficit lens. They have immense strength and resilience, and the system needs to recognize that.”
Indigenous-Led Solutions: A Path Forward
Despite these challenges, Indigenous midwives and community-driven health programs are working to bridge these gaps. The National Indigenous Council of Midwives (NICM) has advocated for Indigenous-led maternal care that respects traditional knowledge while integrating modern medicine.
Claire Dion-Fletcher, past co-chair of NICM, emphasizes the systemic issues that Indigenous women face in health-care settings during a Canadian Senate meeting in March 2024: “I understand that doctors and all healthcare providers have expert knowledge in health and medicine… but we also have to recognize that Indigenous people and Indigenous women have expertise in their bodies. When we continuously, as health-care providers, say what we think is best for Indigenous people, we are taking away their ability to say what is best for them and to make decisions about themselves.”
Indigenous midwives are essential in ensuring reproductive care upholds autonomy and informed consent. NCIM Executive Director Ellen Blais states, “We are prevention by applying the principles of free, prior, and informed consent, continuity of care, culturally rooted care, and patient advocacy.”
This advocacy highlights the vital role Indigenous midwives play not only in providing care but also in championing the rights and dignity of Indigenous women.
Incorporating Indigenous midwifery into perinatal care models is more than a health-care improvement; it’s a step toward reconciliation. By supporting Indigenous-led maternal care, we can create a system where Indigenous mothers feel safe, respected, and empowered throughout their perinatal journey.
An important initiative is the Bringing Birth Home project, which aims to restore Indigenous midwifery and support community-based births, reducing the need for long-distance travel. As highlighted in the Association of Ontario Midwives’ article “Bringing Birth Home: Restoring Indigenous midwifery,” historically, every Indigenous community had a midwife providing comprehensive care, but colonial policies disrupted these traditions. This initiative works to restore midwifery practices and keep birth rooted in the community.
What Needs to Change?
For starters, Indigenous-led PMH programs need more funding and support from our government. Organizations are already doing this work but need the resources to expand their outreach.
Another big piece of the puzzle is representation. Indigenous women deserve to see themselves reflected in their care providers, yet there is a shortage of Indigenous health-care professionals. Dion-Fletcher explains that an Indigenous response “would be rooted in relationships and focused on prevention, and [she] thinks one of the key ways that we can do this is through Indigenous health-care providers, Indigenous midwives, Indigenous doctors, nurses, and patient navigators who are there to promote the autonomy.” Encouraging Indigenous students to enter these fields, providing scholarships, and ensuring that non-Indigenous health-care providers receive cultural safety training are all steps in the right direction.
It’s Time to Listen
For too long, Indigenous mothers have been left out of conversations that shape their PMH care. The barriers they face go beyond access – they’re rooted in history, trust, and the right to health care that respects who they are.
But the solutions already exist. Indigenous midwives and community health workers are offering impactful, culturally rooted support. If we genuinely want to see better maternal health outcomes for Indigenous families, policy makers should better engage and include Indigenous voices – by funding Indigenous-led programs, increasing representation, and ensuring that seeking help is seen as a right, not a risk.
As we push for change, we must also recognize the histories and rights of Indigenous peoples, whose voices have too often been ignored. Ultimately, this isn’t just about policy—it’s about people.
I acknowledge that the land on which this article was written and researched is the unceded and unsurrendered territory of the Algonquin Anishinaabe Nation.
Author: Mariam Hasan
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Al Wiebe on the Winnipeg Foundation’s BeCause & Effect Podcast in May 2024.
Meet Al Wiebe: Born and raised in Winnipeg, Wiebe lost his job in advertising sales in 2009 and spent two and a half years without a home. He’s living in an apartment now and for more than a dozen years has been a tireless advocate for the importance of housing coupled with support. This is his story.
My dad was a hellfire-and-brimstone preacher. Very strict. My mom suffered from mental illness. My life as a child was not pleasant at all. I was a black sheep – I never felt like I belonged. I had to do a lot of things for myself. Maybe that independence helped me later.
My dad had a housing exterior company, doing siding and eavestroughs. I took it over when he went full-time into the ministry. I was 18. I went to the bank, bought a house and a truck, the whole works. Then I had my first kid a month later, then another one 11 months later. Talk about pressure.
King’s Coronation Medal
I wasn’t a good father or husband. I was focused on the business, and I was never there, so I didn’t have a great relationship with my kids.
I also struggled with depression for years. I was on and off anti-depressants. But I wasn’t on any medication for the five years before I lost my advertising job. I was too busy making lots of money. But when the company’s owner replaced me with his friend, I couldn’t handle the trauma. And I didn’t ask for help. I was a single guy, in my mid-50s, living a block away from work. My job was my life. I had no balance, no friends, and wasn’t really in contact with my family. I kind of lived in my own head.
Living in the car
I left the city for a while but ended up back in Winnipeg. I wanted to wallow in my misery. I had sold my Mercedes but still had a nice apartment. I just kind of ruminated and started thinking about suicide. I’m diabetic and stopped taking my drugs for that, which wasn’t good either.
Al Wiebe, at right, with Point Douglas Ward, Winnipeg, city councillor Vivian Santos in March 2025. Wiebe – a peer and community engagement trainer and housing director – was presented with the King’s Coronation Medal for his advocacy on ending homelessness and advancing lived experience leadership.
One day, I just walked away from the apartment with my bag. I’d eaten at a Vietnamese restaurant a few times and behind it there was an auto dealership that also had a scrapyard with cars they used for parts. I plunked myself down in the backseat of a ’64 Mercedes — I used to drive one so figured why not live in one for as long as I’m here. I thought I’d last for a night or two. But I spent 14 and a half months living in that car.
I’d be gone by seven in the morning and stay away until seven at night, because that’s when they closed. I didn’t use food banks or shelters or soup kitchens, none of that. I collected empty beer cans and change from people at drive-throughs. That’s how I existed. But I lost 32 pounds and became very ill. I developed pneumonia and neuropathy from my diabetes. I could hardly walk some days. I began to lose hope. I didn’t think I’d get out of there.
I went to the hospital three times and three times they turned me away because I was homeless. I was looking for psychiatric care and they treated me with disdain. They told me I had to “work on things.” Work on things? The only thing you can work on when you’re homeless is survival.
Signs of hope
A few days later, I went to another hospital, to the crisis stabilization unit, and then spent 24 hours laying low in my car. A couple days after that I went to St. Boniface Hospital. I was a real mess. When I finally saw a doctor, she changed the course of my life.
She said, “You’ve been everywhere and people either could not help you or would not help you, but today I’m going to help you. It’s like you’ve fallen off the edge of the world and don’t know where you are or who you are, and you don’t know how to help yourself. Starting today, you’re going to get better and get stronger. You’re going to start becoming the person you want to be.”
She gave me hope. She told me that I was carrying a lot of trauma and I had to start believing in myself. That someday, I would be able to help other people who were in this position.
After a month in the hospital, I spent 14 months in a shelter. I hated it. There were two killings while I was there. I got attacked and my ribs were broken. At times, I wanted to go back to the streets.
I finally found a home when I got an apartment across the street from the Ma Mawi Wi Chi Itata Centre after I got out from the shelter. It’s an Indigenous organization that does amazing service-provision work. It was a big green house, and I saw people milling around. So, I went in and asked if they needed any volunteers, because I needed purpose. I needed help myself, but I also needed something to do. They must have seen something in me. They allowed me to volunteer and, over a couple years, to take courses: suicide prevention, food handling, First Aid and CPR, non-violent crisis intervention. Class after class, workshop after workshop.
The things that make you a complete person
The greatest casualty of homelessness is a loss of self-respect and self-worth, dignity, and confidence. Everything that makes you a complete person and allows you to move forward. I lost all that in a big hurry, but every time I took another course, it was like I was opening a cupboard and putting in a jar of confidence, then another one, then another one. I become a more confident person slowly, not that swaggering, SOB advertising executive who could do anything. I was so arrogant in those days. But I began to feel better about things. I knew I was going somewhere. I started to feel that I could do more.
After two and a half years, I started working as a cook at a drop-in centre once a week. I was cooking lunch for 70 people. Then one of their case managers, whose job was to keep people in housing, quit. And they offered me a job. I hadn’t worked in five years. Two and half years of homelessness, two and a half years of recovery. I said, “Sure.”
Countering judgment and stigma
These days, I live in a one-bedroom apartment with a friend who I’m a caregiver for. I help run a housing first program and organize an annual human rights symposium. I do talks about homelessness and training sessions with people from all three levels of government, including local city councillors as well as police officers, firefighters, and paramedics. I talk to nursing students and hospital staff about poverty, stigma, and unconscious bias. “Are your judgements impeding your ability to give your best to the vulnerable?” Homeless people fill up emergency rooms, and they often treat people who are homeless in an inhumane way. Our health-care system doesn’t really understand the connections between homelessness and mental health. Our governments don’t, either.
Having an apartment is great, but the work gives me purpose, and I couldn’t have got here by myself. You can’t do anything without a home, that’s for sure. That’s why I’m big on housing first. You put somebody into housing, then you look after their needs. You can’t look after anybody’s needs on the street. And you can’t get by when 80 per cent of your income goes to housing.
People think that because you’ve spent time on the streets, you’ve lost something. In my case, I’ve gained so much wisdom. I’ve had a lot of success because I have lived experience. It helps you build trust. My experience gave me deep, deep empathy.
When you’re homeless, it exacerbates your mental illnesses. It compounds them by 10 times. Because there’s trauma just about every minute of every day. Because you don’t feel secure. But it’s not just housing. Having a place to sleep won’t make you healthy. You need a case manager. You need a counsellor. You need trauma-informed medical care. You might need to work on addictions. You need wraparound support. Otherwise, life could come crashing down on you again. Housing alone is not the answer. But it’s a big part of the answer.
Poverty can be just as traumatic as homelessness. People use so much energy every day and struggle so much, especially these days because of economic conditions. People are dropping from middle class into poverty — people who’ve never experienced poverty before — and people are dropping from poverty into homelessness. People really need access to the right services, because things are really difficult right now.
It’s rewarding to be helping keep people off the streets. Two years after I escaped homelessness, I came off my anti-depressants because I had a focus. That focus was other people. But for me, bridging the gap with my family is best thing about getting my life back together. Two of my children are in their 40s and one is 50 and we get along better than ever. They’ve all done really well for themselves. My daughter and I speak on a very cerebral level. My boys and I talk sports. One of my sons is in Winnipeg today for work and I’m going to see him for dinner tonight.
Did You Know?
- Roughly 60 percent of people who are homeless in Canada face mental health issues, according to a federal report that looked at 2020-2022 nationally coordinated point-in-time counts.
- According to the Homeless Hub online resource, mental illness can make you more susceptible to unemployment, poverty, social isolation and other challenges, all of which increase the risk of homelessness.
- Whether you are on the streets, in a shelter or some other liminal situation, the lack of stability and security can amplify psychological conditions.
- Access to safe and affordable housing, accompanied by a range of supports, is one of the most effective ways to end this cycle.
- A housing first approach is less expensive than public expenditures on health care, policing and other costs associated with homelessness, according to a CMAJ study.
Resource: Housing First in Canada
Author: As told to Dan Rubinstein, an Ottawa-based writer and editor who frequently writes about health issues.
In Monica McAlduff, the First Nations Health Authority (FNHA) has found a leader whose personal journey mirrors the transformation they seek to create. The MHCC sat down to learn more about the new CEO, her vision for the organization’s next chapter, and her commitment to walking in a good way.
Home, at last
After nearly three decades serving within a system that gladly received her care, but never made her feel entirely welcome, Monica McAlduff is home at last.
As the incoming CEO of the First Nations Health Authority (FNHA), Monica’s quiet conviction shines through the screen during our virtual meeting.
“Culturally safe, patient-centered care is the beating heart of our organization’s mission,” she explains, her words carrying the weight of both professional expertise and lived experience.
For Monica, assuming leadership of the FNHA represents a milestone in a career carved with careful intentionality. Beginning with clinical psychiatric nursing, then pursuing advanced degrees and leadership, Monica understands intrinsically that First Nations patients can’t get well in an unhealthy system.
“As nurses, we may not naturally gravitate to leadership, because our instinct is to give care,” says Monica. Yet, it’s this person-first worldview that is often lacking at the highest levels of conventional health-care administration.
“As a nurse working with people living with substance use or mental health challenges, day- in, day-out, I saw how supporting someone in their wellness journey required treating the whole person – and understanding the context of their environment and relationships,” explains Monica.
It’s this philosophy, together with her unwavering belief in Indigenous resiliency, that she now brings to the challenges that lie ahead.
Rooted in care
Monica comes by her heart to serve honestly.
Her mother, a residential school survivor, worked as a nurses’ aide while instilling in Monica the values of hard work and integrity.
“My mother lives by the motto: if you’re going to do something, put your whole heart in it,” Monica says, her expression lighting up. “She never speaks a harsh word. When confronted with racism or hatred she rises above it. When I was growing up, she was determined that her past would not dictate her future, or the future of her family.”
As a second-generation residential school survivor, Monica understands intergenerational trauma from the inside out. She speaks candidly about still piecing together parts of her past that her grandparents felt best left buried until fairly recently.
This personal connection to colonization’s lasting harms shapes Monica’s approach to healing systems deeply scarred by historical trauma.
Monica McAlduff, CEO, FNHA
Walking between worlds
When I ask Monica about her early experiences as a psychiatric nurse, she becomes visibly emotional, wiping away tears from beneath her black-framed glasses. She describes seeing Indigenous patients being treated with disdain and disregard, and how she felt obliged to hold her own identity close, for fear of being discounted by her peers.
When I instinctively apologize for broaching this raw topic, she graciously responds: “In our culture, tears are healing. They aren’t something to hide.”
This duality – vulnerability alongside strength – defines her leadership approach.
“I worked in a system where I was forced to hide my own identity – something that, by rights, I felt deeply proud of,” she explains. “How could I provide authentic care while denying my authentic self?”
With racism and discrimination baked into the very bones of the healthcare system, healthcare workers who feel pressure to conceal or supress an essential part of their being can quickly find their identity eroding and their well of compassion running dry.
Seeking to resolve this contradiction would forge Monica’s life’s work.
That’s why today, she feels compelled to be as visible as possible, making the path easier for those coming behind.
“This role is more than a job for me,” Monica reflects.
It’s a way for her to honour her younger self. To smooth the path for others – regardless of what identity they may struggle to honour. And to rewrite the future.
Restoring faith in medicine’s highest calling: Do no harm
The ground-breaking cultural humility framework that FNHA has developed identifies and addresses inequities, creates cultural humility, respects knowledge holders, and walks alongside communities to address their needs.
The goal, says Monica eloquently, “is to plant a seed, and grow a meadow.”
And while she agrees there’s been collective progress, citing the United Nations Declaration on the Rights of Indigenous Peoples, the Truth and Reconciliation Commission’s 94 Calls to Action, and British Columbia’s provincial In Plain Sight Report, her focus is squarely on the work ahead.
“People are still dying in health-care settings because of bias and racism. No matter how stretched the system may be, and how hard people may be working within it, this is patently unacceptable.”
That said, Monica cautions that any standard – no matter how thoughtfully designed – is only as effective as its implementation.
“Checkbox exercises aren’t going to result in meaningful change,” she says. The FNHA itself underwent an assessment against the framework, because bias can seep through even the most stalwart bulwarks.
“What will signal progress is patient evaluation. When you hear from an Indigenous person that they felt seen and cared for, that’s the true litmus test.”
She says that will happen only when patients’ wisdom and expertise in their own healing journey are respected and supported, and the system is culturally safe for those providing care.
Ultimately, Monica believes that system-wide implementation of the framework will benefit everyone who walks through the doors, regardless of their background. But the imbalance faced by First Nations individuals seeking care is always at the fore of FNHA’s work.
A holistic approach
The First Nations Health Council – a provincial-level advocacy organization that represents, and is accountable to, First Nations in British Columbia, has developed a ten-year strategy addressing the social determinants of health. It recognizes that the “system” itself is a constellation of schools, water, land, healthcare, housing, family, community and culture.
“As the organization tasked with leading the implementation of this strategy, we at FNHA understand that health can’t be addressed in isolation,” she explains. “The same colonial systems that disrupted our health practices also disrupted our relationships with land, water, language, and each other.”
And when it comes to embedding First Nations ways of knowing and respecting cultural tradition across health-care systems more generally, Monica says the time for excuse-making is over.
“In our culture, it’s relational. Everything is based on relationships,” she explains. “Start with the basics. What territory are you on? What communities are nearby? Who am I? Who are you? How can we co-create together?”
Wholehearted leadership
As our time ends, Monica returns to her mother’s wisdom: “Lead with heart, or leave it to someone else.” For her, leading the FNHA represents the culmination of a deeply personal journey and an opportunity to transform health-care for the next seven generations.
“We can build a system where no Indigenous person has to hide who they are to receive or provide care. That’s the future I’m walking toward – one where cultural safety isn’t an afterthought, but the foundation.”
Monica stands firmly in two worlds, fluent in both the institutional language of health-care systems and the traditional approaches to wellness that have sustained Indigenous communities for millennia.
In closing, Monica returns to the light that guides her work.
“For us, for First Nations, culture is medicine. They are one and the same.”
Author: Suzanne Westover
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When I scroll through social media in the morning, groggily reaching for my phone an hour before my attendant care worker is scheduled to come and wake me up, I am almost always hit with some type of disability meme or post. They usually come in two flavours: one about how disabled people can do anything they put their minds to, or how the only disability that we have in life is a bad attitude, next to a picture of a disabled person defying the odds by scaling a mountain, skydiving, or something like that.
The second type of meme or post that I usually encounter is a magazine article detailing a beautiful person’s tragic accident that left them “wheelchair bound,” but “that doesn’t stop them from living their best life,” or something like that. These all-too-common representations in disability media leave us with very narrow views of disability. You either overcome disability and morph into a heroic figure, or you turn a tragic story into an uplifting one for others to draw out inspiration.
Not your tragic hero
We don’t only see these depictions in the media, they happen in real life as well. I can’t count on one hand the number of times that I have been approached by someone and told with their furrowed concerned brow, ‘I don’t know, if I were you, I think I might just kill myself,’ or the patronizing, ‘You don’t let your disability stop you, Andrew.’ There is rarely any space for a nuanced conversation about what it actually feels like to live in a disabled body, and let me tell you, it is so much more than those stereotypes.
One of the parts of living in a disabled body that is often discounted and entirely underrepresented is disability grief. My definition of disability grief is this: It is the grieving that comes as the result of living in a disabled body that copes with more loss and abrupt changes than most.
As a severely disabled person, I experience disability grief often – sometimes it comes up as a longing for something that I will never be able to do like running, jumping in the air and somersaulting, or even something as seemingly mundane as giving myself a shower. Other times, disability grief will come from some function that I lost the ability to do. I grieve that I can no longer use the toilet to go pee on my own and that I have to be catheterized everyday instead.
If I’m truly honest, the grief of losing that simple pleasure can’t be translated into words. I grieve that as I age in my disabled body, the pain is becoming more apparent, and it is becoming harder and harder to do many things that my disabled body used to do. All of this has had a major effect on my mental health; I find myself becoming more irritable, quicker to upset, and quicker to fall into depression.
Mental health professionals need to catch up
Kristen Williams
To understand disability grief and its effect on disabled people’s mental health better, I spoke to disabled psychotherapist (qualifying) Kristen Williams. She lives with cerebral palsy, anxiety, and major depressive disorder. She says that in her experience, disability grief is compounded.
“Disabled people are grieving the reality of our lives, and the things we cannot do, alongside our lost potential – the things we want but most probably will never have,” she says. I also asked her how mental health practitioners can help manage disability grief.
“The key is not to shy away from disability grief. Many people in the helping professions feel motivated to ‘fix’ or ‘help’ people, and sometimes this can look like offering solutions and encouragement, when we should be offering space and validation,” she says.
One of Williams’ takeaways is that therapists are not shielded from ableism – “a set of beliefs or practices that devalue and discriminate against people with physical, intellectual, or psychiatric disabilities and often rests on the assumption that disabled people need to be ‘fixed’ in one form or the other,” as defined by the Center for Disability Rights, a not-for-profit, community-based advocacy and service organization in the U.S.
Williams says that “clinicians experience it as much as they next person, so we have to examine it thoroughly, and strive to be anti-ableist in our practice.” I wanted to understand if Williams has seen a shift from disability grief to disability joy in her practice, and so I asked her.
“Part of moving towards disabled joy involves processing the sad, frustrating, and difficult moments that make up disability grief. Creating disabled joy looks like first understanding disabled grief.”
Getting to joy
I also spoke with my close friend Lorna Craig, who lives with multiple chronic illnesses including Lyme disease, endometriosis, and bipolar I. I asked her what disability grief looks like for her.
“For me, the way I usually experience it, because I have an acquired disability, it’s always comparing myself now to what my non-disabled self would be doing,” she says. “I think I spent many years grieving that person, and who she was, and what she might have been able to do.”
She continues, “These days I don’t know her. How do I know that she would have been a better version of myself?”
One of the key things that I gleaned from my conversation with Lorna was that disability grief is so much bigger than I think we understand it to be, and it is way deeper than just a buzz word. One of the things she said that I connect with so much is this: “Some days I wish my problems were more conventional instead of having a body that doesn’t cooperate and do what I want.” As someone living with invisible disabilities, Lorna highlighted that one of the things that brings her the most disability grief is not being believed by others.
I asked Lorna how all of this impacted her mental health and what she told me underscored just how important it is that we talk about disability grief and mental health.
“It ranges. Sometimes it can be a little irritating thought that stays with me throughout the day, and sometimes I can be curled up in a ball crying for days.”
I also asked her if she is seeing a shift from disability grief to disability joy.
“When it comes to my experience of chronic illness, I agree that you have to go through disability grief to find the joy. With my experience of mental illness, we haven’t really been given the chance to grieve and get to the joy. Sometimes, I think that mentally ill people don’t understand that they have a disability, and that they can claim that.”
Lorna and I talked for almost an hour about all of this, and she renewed in me just how important and ultimately complicated understanding disability grief and its effects on our mental health can be. Talking to both Lorna and Kristen, I learned that disability grief is different for each and every one of us living in disabled bodies and it is time that mental health professionals addressed their ableism so that they can understand disability grief.
I can’t wait to open my Instagram feed in the morning and see a disabled person with a caption that says, “I went to my therapist, and they helped me understand my relationship to disability grief.”
We’re not there just yet – but we could be.
Author: Andrew Gurza (they/he) is the author of the book, Notes From a Queer Cripple: How to Cultivate Queer Disabled Joy (and Be Hot While Doing It!), dozens of articles, and the viral hashtag #DisabledPeopleAreHot. He is a disability awareness consultant and podcast host.
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It’s more than just another self-help book. The Mental Health Guide for Cis and Trans Queer Guys (New Harbinger Publications, June 2025) blends personal reflection, clinical insight, and a heartfelt tribute to queer men navigating their mental health in a complex – and often contradictory – world.
Rahim Thawer, a queer Muslim social worker and doctoral candidate at the University of Alabama, draws deeply from his lived experiences, his professional work as a psychotherapist, and numerous conversations with queer and trans men.
They face myriad challenges throughout their lives, from the processes of coming out, to the nuances of growing older, and everything in between.
Topics including internalized shame, heteronormative culture, managing rejection, and substance use are explored in depth. For each subject, Thawer skillfully combines academic knowledge with real-life case studies, providing readers with practical tools and guidance to reflect on their own experiences.
Solid resource
The book is an excellent teaching resource for clinicians who may not fully grasp the historical and ongoing impact of gay, bisexual, trans, queer/questioning (GBTQ) men and their experiences. Although Thawer’s guide is primarily written with queer men in mind, it has already garnered attention from therapists and educators eager to better support queer communities, something Thawer is familiar with. In his private practice, he frequently supervises clinicians seeking cultural guidance for their cases.
For example, clinicians have approached him to say, “I’m working with a gay man struggling with shame,” or “I’m supporting a queer Muslim client who hasn’t come out yet.” These professionals are seeking a framework to understand underlying issues – and Thawer’s book provides just that. It breaks down complex issues such as internalized stigma, anticipatory rejection, and challenging family relationships – and turns it into actionable insights and interventions.
Thawer’s contributions to the field have not gone unnoticed. He is the recipient of the 2025 Mary Smith Arnold Anti-Oppression Award from Counselors for Social Justice in the U.S. and also received the 2025 Honorary Award in Education from the nonprofit South Asian Americans for Change. These accolades affirm his significant role in advancing culturally attuned practices across diverse communities.
I had the opportunity to chat with Rahim recently, and the following are some excerpts from our conversation.
Psychotherapist and doctoral candidate Rahim Thawer works in the U.S. and studied in Toronto. His new book speaks to complex issues in practical ways.
Q: What inspired you to do this? It’s a big subject and a challenging one. So, what was your motivation?
A: I started my professional work and career in the HIV sector and so many of the workshops we did that were geared to reduce risk of HIV transmission, and at other times, geared toward helping people live well with HIV, they were quite limited. They were all surrounding HIV and many communities that we met didn’t need that specifically. They needed something adjacent to that, like anti-homophobia, talking about sexuality more broadly, talking about the landscape of relationships. Now, arguably, all of that is related to HIV, but I wanted to decenter the epidemic and think about what are all the things in our subculture that contribute to our mental health outcomes? Because I think queer and trans guys live in a different world. We’ve got different norms, different expectations, our own culture, our own history. We live in multiple worlds, and I think that’s what determines our mental health outcomes. So, for me, I wanted to take both my lived experience as a queer guy and my work as a therapist to really think about what are all the things that affect our mental health.
The book that I wrote, it’s not a research book. I didn’t do a study to say what are the things that affect us. I thought, here are the things I’m seeing, and feeling, and living. What if we itemize those and talked about them? That’s where the idea came from.
Q: In the world around us, we’re hearing more and more of an upsurge in anti-gay, anti-queer, and especially anti-trans, rhetoric, both culturally and politically. How do you think that’s impacting or going to impact our community?
A: Well, I think the impact will be seen long term, because right now people have anxiety about their current rights or protections becoming limited, and that anxiety is legitimate. However, for people who are well-to-do, have been out for a long time, have access to lots of resources, they were able to do that because of rights, legalization of gay marriage, decriminalization of homosexuality, because of opportunities to afford mobility. In some cases, when you combine those things with male privilege, it paved a way for them, but those very successful people, still, I would see in my therapy practice struggling with shame, relationships, internalized stigma, and fraught relationships with their families of origin. So, my point is that even when people seem to be fine in the political sphere, the messages they’ve internalized at a young age stay with them for a long time. And that is to say that before this wave of anti-trans rhetoric showed up, we were struggling in many ways with our past. And I think the anxiety around the political condition is very valid, but I think the repercussions will be felt long term. And that part is very unfortunate because lots of people will say, ‘oh, we’ll just wait four years and then we’ll get somebody new.’ And I’m thinking, no, it doesn’t quite work like that. The message is the fear; you absorb it. It stays in your body. And it’s detrimental.
The Mental Health Guide for Cis and Trans Queer Guys
Q: Do you see any opportunities from a prevention perspective in the upcoming years?
A: Potentially. I think within the broader LGBTQ community, a lot of cisgender gay men, cisgender lesbians who are in their 40s, 50s, 60s, if they’ve been able to access some comfort in their world, in their life, in their time, this might be a time where they look inward into the community and support people who are still struggling. We’re going to need some serious solidarity with trans communities, and we have for a long time needed more internal solidarity with underhoused and homeless LGBTQ youth. That is a big problem in Toronto and other metropolitan cities.
I think what we’re seeing politically is defunding of all things DEI (diversity, equity, and inclusion). And if that means cuts to LGBTQ care, then we’re going to have to rely on a different economy, which has to be more communal and collective.
Author: Ed Mantler has led innovation and improvement in healthcare for more than three decades. He trained as a Registered Psychiatric Nurse, holds a Master of Science Administration, and is a Fellow of the Canadian College of Health Leaders.
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Amanda Friesen, a professor of political science and Canada Research Chair of political psychology at the University of Western Ontario, recalls talking to a colleague recently who said he had been feeling a lot of stress with “everything that’s happening” in politics. “It occurred to me, ‘you’re a political psychologist. Is political anxiety a thing?’ And I thought, ‘yes, it is.’ And so, he and I had this conversation.” Since then, Friesen has been called upon as a national commentator on the subject, offering advice on how to cope with “political stress” and avoid “political information overload.”
In the wake of rapid, even shocking, political, and economic changes in the past several months, many psychology experts and mental health counsellors across Canada have reported an increase in the number of clients confiding anxieties brought on by contemplating how political and societal changes will affect them.
Political psychologist Amanda Friesen shown here in Copenhagen during a research project: It’s about a balance between staying informed without the adverse effects.
The CBC recently reported a surge in “nervous googling” of terms such as “tariff” and “recession.” Many people say they are losing sleep worrying about what may come next – and feeling helpless in the face of all the turmoil. Some are turning off the news entirely to protect themselves from those difficult feelings. Others are addicted to “doom scrolling” and exposing themselves to hateful rhetoric on social media. Some are dealing with the emotional consequences of cutting off family members and friends over profoundly divergent opinions and beliefs. Depressive symptoms can be the fallout.
New world disorder
The trend is so pronounced, some mental health experts are wondering if “political anxiety disorder” should be made its own diagnosis, distinct from other forms of anxiety.
“There’s a lot of general anger and disbelief, I think,” says Stefanie Peachey, a registered social worker, accredited family mediator, and founder of Peachey Counselling and Family Support in Burlington and Oakville, Ontario. “[Clients are] saying to themselves, ‘What does this mean for me? I’m already so scared and anxious about finances, being able to afford my grocery bill or my rent. I don’t really understand tariffs, but I know that things might get more expensive for me. And how do I afford that?’”
Job loss, escalating prices on everything from groceries to building materials, and the lack of affordable housing – these issues are real and society-wide in their impact. Worrying is understandable, but if it leads to feelings of anger and helplessness that interfere with your life, finding ways to cope without shutting out reality is essential.
Social worker Stefanie Peachey: Worrying is understandable with all that’s going on. Therapists can help sort through complex issues and feelings.
“We need tools available for people because we don’t want them to disengage from democracy,” says Friesen. “I think it’s on journalists, social scientists, and political scientists to find ways to help people stay engaged and informed without adverse effects.”
Friesen suggests “setting up an intentional, formalized strategy” for consuming news. She employs one herself. “I do compartmentalize my news consumption. I never read the news before I go to sleep. I have a few subscriptions to news outlets where headlines of major and minor news stories get delivered daily or weekly. I read these stories and avoid jumping from link to link to link. I read and then stop and set it aside.”
Another way to deal with the uncertainties facing all of us is to be proactive in preparing for possible scenarios. “Let’s say that you work in an industry that one of the tariffs is going to impact. Reach out to your professional organization or your company and ask, ‘What’s going to be our response to this? Is there a way to prepare for it, remove some of that uncertainty?’” says Friesen. “We could imagine all sorts of scenarios that may or may not come to pass. Just get some concrete responses. Okay, this might happen or this or this, and here are some possible responses or plans we could make in response. It should make you feel better to know.”
Why tuning out completely isn’t the answer
Getting involved in your own community, or advocating for an issue you care deeply about, can go a long way to allaying feelings of helplessness. Focusing your time and energy on helping to further one cause is better than becoming paralyzed by feelings of emotional overload about every issue you read about, says Friesen. “Maybe there are some new environmental efforts in your community, or you have a friend who keeps bugging you to talk to the city about improving bike lanes. Do it. Find the things that you do have power over and focus on those,” Friesen advises.
Peachey echoes these suggestions. “As therapists, we’re often working with clients around uncomfortable thoughts and worries; all the ‘What ifs.’ For instance, for a client who is questioning their sexuality, and you worry, ‘What if I’m not accepted for this?’ We work around that fear and talk about all the supports that you may have in their life, and all the ways you can minimize some of the stress. It doesn’t mean that it’s not stressful or that the worry is wrong, but that the client’s thinking can be reframed. The same could be applied in this situation. How can we minimize the stress and focus on factors that may put us more at ease?”
In an article entitled, “How to cope with political and social uncertainty as a Canadian,” Peachey writes, “When we consciously shift our focus away from elements beyond our control and onto matters where our influence is meaningful, we not only conserve valuable mental energy but also gain a sense of empowerment.”
Peachey and Friesen agree that basic self-care – continuing to get enough sleep and exercise, eat well, moderate your news consumption, and practise mindfulness – just doing the things that bring you pleasure, connecting with friends and family who nurture and support you, are important now more than ever.
“It just doesn’t do any good to worry about politics every moment of the day. Live your life. Spend time with your people, enjoy the outdoors, immerse yourself in projects or activities that bring you joy. Burning out won’t help you be ready for future advocacy. This might be a marathon!” says Friesen.
Above all, says Peachey, remember that you are not alone. Many Canadians are feeling the same way and expressing their frustrations through concrete actions such as buying Canadian, or changing travel plans, for example.
If you need help, contact a therapist who can help you reframe your fears and anxieties and find positive ways to cope. As Peachey puts it, “Rather than dwelling on circumstances and behaviours that drain your emotional reserves, redirect your energy towards actions and initiatives that align with your cherished values. By doing so, you not only regain a sense of purpose and fulfillment but also nurture your mental well-being.”
Further reading: The Therapeutic Power of Blue Space.
Resource: Strategies to stay informed without feeling overwhelmed.
Author: Moira Farr is a national magazine journalist and instructor in Ottawa. She has been moderating her news consumption, altering her social media habits, and using the added time to volunteer more.
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The Canadian Mental Health Association’s Mental Health Week runs from May 5-11. This year’s theme is #UnmaskingMentalHealth and encourages people across Canada to look beyond the surface to see the whole person.
Perhaps you know the tune – about Eleanor Rigby.
“Wearing the face that she keeps in a jar by the door. Who is it for?”
In their classic song about loneliness, The Beatles sum up beautifully what it is like to live with a “high-functioning” mental illness. The song comes to mind, at times, like when I am in a bipolar mood episode, I always leave the house with my mask on. Often, this is literal. I painstakingly put on make-up, painting a face that denotes coping and professionalism (wing tips for bright eyes! Blush for pink cheeks to denote good health!). When I leave the house, I match the attitude and tone of the people I interact with, putting in enormous mental effort to calculate the actions that will make me appear “normal.”
This mask broadcasts a message of “I’m fine,” when inside, I am often anything but. When I arrive home in the evening, I wash off the painted face and watch it circle the drain, as a kind of illustration of how depleted I feel, before I fall into bed exhausted from the effort.
For me, this year’s Mental Health Week theme is a call to action. When we unmask mental health, we create the conditions for reducing stigma by promoting understanding and eliminating discrimination against people with mental illness.
Masking – what is it, who does it, and why?
Masking, also known as “camouflaging,” is precisely that – trying to blend in with societal expectations by suppressing symptoms or traits, according to Autism Canada. It is a concept that has been most studied in the context autism and attention-deficit/hyperactivity disorder and is linked to the concept of “smiling depression,” a colloquial term for those who may slap on a smile to disguise their inner feelings.
Zachary Houle lives with autism and schizophrenia. He notes that autism has become more celebrated in the media (“autism chic” is even a thing), but he notes that the media portrayals can remove the reality and complexity of illnesses.
“I find with schizophrenia, people immediately think I’m an axe murderer or I’m dangerous and violent,” he says. “It takes less energy to pretend to be normal than going into an office knowing that I’m going to get hazed, which has happened in the past.”
Houle notes that a lot has changed in the 20 years since his diagnosis and that he is in a very progressive and understanding workplace now, but he still masks daily as it has become his second nature.
He is not alone. According to a 2023 poll from Benefits Canada, 45 percent of Canadian employees with autism feel that they have to mask their autistic traits at work.
Tanya Lepine-Darwiche, a woman who identifies as being on the autism spectrum and who lives with anxiety, agrees. “Masking is about the world accepting me being able to walk into a room and have my opinion heard without them placing judgments on me because I’m neurodivergent,” she says. “It’s putting on a performance.” She notes that it is harder to maintain social relationships when she doesn’t mask. “It’s what I need to do to be socially acceptable.”
As Houle and Lepine-Darwiche both note, masking is very useful in promoting social interaction and protecting oneself, but it also comes with costs, primarily burnout and isolation.
“I’d like to be vulnerable with people, to show them how much I trust them, but at least in the workplace I feel like I can’t do that,” Houle says. Lepine-Darwiche shared about the effects of a day of masking on her personal life, when she would come home and need a three- or four-hour nap just to recoup her energy. “It was really difficult on me and my relationship with my wife and family before I understood that all of my energy was going to masking,” she confided.
How masking affects treatment
If you are “good” at masking and continue to function, this can lead to downplaying how much you are affected by your symptoms. You, essentially, mask to yourself, and your healthcare practitioner, thus contributing to underdiagnosis and a lack of mental health supports, something both Houle and Lepine-Darwiche have experienced.
Masking also affects the level of social support that one receives. For example, when your reply is, “I’m fine,” those in your social circle cannot know that you might need extra support.
In a 2019 Ipsos study of working Canadians, 76 percent of respondents stated that they would be completely comfortable with and supportive of a colleague with a mental illness, but first they would need to know that support was needed.
The descriptor “high functioning” is not part of any diagnosis, but it is a term that captures of the reality of many. If someone imagines those with serious mental illnesses as not being able to get out of bed or go to work, that might be the case. However, for others, such as Houle, Lepine-Darwiche, and myself, we can attest to functioning adequately even when our symptoms are quite severe. Even my psychiatrist has had to learn that seeing me with my makeup done and my work clothes on, doesn’t mean that I am doing well.
Jessica Ward-King publishes under the name The Stigma Crusher to educate others about mental health. For her, this year’s Mental Health Theme is a chance to share more about what it means to mask – and to unmask – in different social situations. Sometimes that is literal – painting on an “I’m fine” face – before washing it off for the day.
Stigma, disclosure, and masking
Stigma – in all its forms – is a big factor influencing the decision to mask. According to sociologist Erving Goffman (1922-1982), those who are neurodivergent or living with mental illness will make a concerted effort to hide their symptoms – or to be “discredited” by others. Even by today’s standards, where conversations about mental health are increasingly common, many people feel reluctant to share. The same 2019 Ipsos survey of working Canadians found that 75 percent of respondents would be hesitant – or would refuse – to disclose a mental illness to an employer or co-worker due to stigma and fear of discrimination.
Goffman and others have noted how most people wear masks in their daily lives, in terms of trying to present themselves in certain ways in certain circumstances, such as on social media or at work. Putting your best foot forward isn’t the same as masking, however, where the goal is to suppress a key part of one’s identity.
For example, I experience this dilemma in another context – one of “coming out” as a lesbian, an identity that I constantly have to choose to disclose or not in a variety of situations. For example, in a conversation I can skirt around my life with my wife by cleverly using gender-nondescript language, but this brings with it a veil of inauthenticity.
Coming out about my mental illness (or not) feels similar. Do I let people in with vulnerability – or not? This is a decision that I am constantly having to make, and the solution varies with the situation, the people involved, how safe I feel, and my impression of how this “coming out” might result in negative consequences.
Chicken-and-egg situation
Without stigma, there would be little need to put on a mask to begin with, but to reduce stigma, there needs to be connections between people with lived experience of mental illnesses and other human beings – so which comes first?
While education, awareness campaigns, commemorative days, and articles like this one are effective to an extent, interpersonal contact is key according to a 2021 study in Society and Mental Health.
This, however, requires people with lived experiences to unmask, one person and one situation at a time. In other words, you need to reduce stigma to allow people to feel safe to unmask, but you need people to disclose their mental illness and unmask to reduce stigma. Chicken, meet egg.
To break that cycle, allies can play a role in creating the conditions where people feel safe to share their challenges and to open up about neurodivergence and mental illness.
For me, this year’s Mental Health Week theme is a call to action – to be my authentic high-functioning, high-performing self, and to also be okay to not be okay.
It’s also about not expending all my energy to maintain a perfectly painted mask, about not just saying “I’m fine” to make sure no one else is uncomfortable, but to feel free to say that I am struggling if I feel safe enough to do so.
When I get home from work and wash off my makeup, I want to have energy left for my family, my hobbies, and my wellness.
Outside of the home, I want to be in a world where I can take off my mask. I won’t be able to brave it every time, in every situation, and with every person – and that’s okay. The mask can be protective when the situation warrants, but little by little, unmasking can make meaningful connections to change minds.
Author: Jessica Ward-King, aka the StigmaCrusher, crushes the stigma of mental illness by being radically open about her experiences living with bipolar disorder.
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Cancer.
It feels intensely personal when it happens to you. You think, “Why me?” Then, as you look at the statistics, you realize, “Why not me?”
Cancer is ubiquitous.
The day I received my cancer diagnosis, 675 other Canadians were hearing similar news. A stark reminder that I was part of a larger collective experience.
It’s happening to more and younger people. According to the Canadian Cancer Society, of those diagnosed with cancer in Canada, nearly 40 per cent are between the ages of 20 and 64. In other words, I’m in good company.
There are two sides to every coin, and while a cancer diagnosis is unlucky by any measure, the flip side is equally important.
I had comprehensive medical care, paid leave, a compass to navigate a complex system, and a network of supportive peers to buoy me up on my hardest days.
There’s a saying that we may all be in the same storm, but we’re not all in the same boat. That resonated deeply with me, once I was able to wrap my head around a new reality.
Not-so-normal
It all started in the fall of 2023. I was bone tired. No amount of rest would restore my energy levels. I couldn’t cook a meal or have a meeting without needing a nap. And I’d wake as tired as I was before.
Like a lot of men, stubbornness is among my hallmark traits. My spouse insisted I go to the doctor. Left to my own devices I may not have heeded the alarm my own body was raising. Being partnered with a strong and smart individual is another checkmark in my good fortune column.
But I’ll be honest. A diagnosis of prostate cancer felt like a slap in the face.
I was fairly young. Healthy. Fit. I ate right. It’s comforting to feel you have a modicum of control, and there are many things we can and should do to stay healthy. But it’s a kick in the teeth to realize those things aren’t always enough.
Try as you might, you can’t rationalize cancer away.
My cousin, and dear friend, died of prostate cancer at 59 – only months before my own disease came to light. He had to travel to Gatineau from Northern Quebec for treatment, another health disparity experienced by friends and neighbours in rural and remote communities.
Michel Rodrigue, President and CEO, Mental Health Commission of Canada.
A not-so-universal safety net
And while cancer doesn’t discriminate, socio-economic status does. Cancer is never a walk in the park. It’s a long, lonely night of the soul.
But my situation was offset by the ability to access psychological supports, medications, nutritious foods, and creature comforts.
Unlike 6.5 million people in Canada, I had a family doctor at the ready. Language wasn’t a barrier to understanding, and transportation and accommodation costs, when they were required, didn’t break the bank.
For many, the extreme of a cancer diagnosis is accompanied by a lifetime out-of-pocket costs – we’re talking about tens of thousands of dollars.
From where I sit, those of us who’ve walked this path and emerged, somewhat unscathed, have a responsibility to speak up.
Advocacy – for oneself or in the broader sense – is itself a privilege.
A healthy workplace: Antidote to illness
New research from the Canadian Cancer Society took the pulse of Canadians. Survey respondents were asked how they felt a cancer diagnosis might affect their finances. The responses were sobering:
- Nearly 30 per cent feared job loss
- Over 40 per cent anticipated career setbacks
- 80 per cent worried about long-term financial impacts
When you’re unwell, workplace support can be a lifeline. My experience was transformed by colleagues who did more than just accommodate – they actively supported my journey.
The stress and anxiety of my illness, an admittedly heavy burden, was lightened by colleagues sending supportive messages; shouldering the load while I was away; holding the space for me when I got back.
Flowers appeared on my desk. My team respected my treatment schedule; my uneven recovery; my uncertainty. When brain fog set in, they reminded me. When they saw I was flagging, they suggested we reconvene. When I wasn’t my best self, they gave me a pass.
But I couldn’t help reflecting on a critical inequity.
Cancer was met with visible support, while mental health challenges often remain shrouded in silence. We have a responsibility to fight back against the stigma that relegates a mental illness diagnosis as unworthy of the same empathy I received.
Peer-support: A priceless gift
Prostate cancer accounts for 20 per cent of new male cancer cases, but statistics don’t capture the human experience. The camaraderie with fellow patients, survivors and caregivers refilled my tank depleted by radiation.
That’s why I believe connection is our most powerful healing mechanism.
A naturally reserved person, I’ve worked to become more open as I age. Prostate cancer threatened this progress. It felt like a blight on my masculinity.
With others who had walked this path, I found a language of understanding that transcended medical terminology. We spoke about fears, and revealed vulnerabilities – both the mundane and monumental anxieties that accompany a cancer diagnosis.
To cope, or not to cope
Over the years, many of us have developed mechanisms to cope with life’s uncertainties – and the big “C” is a larger uncertainty than most.
But Cancer is stealthy. It undermines your confidence and robs you of the ability to concentrate and the energy to exercise.
My usual punishing bike rides through Gatineau Hills were out of the question. Over time, I grew to celebrate my smallest victories – a walk to the end of the driveway; taking the dog around the block.
A silver lining was rediscovering a love for music, forgotten in the hustle of daily life. When I felt like my feet were encased in cement, music let my spirit soar free.
Resilience isn’t about maintaining old capabilities. It’s about discovering new ones. But we’re not all given the same opportunity to do that.
From personal challenge to collective compassion
My experience threw into stark relief that privilege is the scaffolding on which resilience is built. I didn’t emerge from this journey transformed for the better because I did something remarkable to deserve it; I did so because I had the resources – financial and social – to be successful.
Resilience isn’t about returning to who you were, but about moving forward with newfound understanding. I’m committed to advocating for those who face greater challenges in their cancer experience.
Cancer shouldn’t be faced alone. It takes a society to mount the kind of powerful response we need.
