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A confession
My conversation with Christine began with a confession.
A year and a half ago, I experienced a heart attack that came seemingly out of nowhere –despite having no known risk factors. This unexpected health challenge was a transformative experience, connecting me more deeply with the world of heart disease and mental health.
After my admission, Christine and I dove into a compelling conversation, ranging from individual responsibility to national accountability.
She began by pointing out that while there are factors over which people have some control, there are others, like my age for example, which are incontrovertible. She highlighted decisions we can take to improve our overall health and wellness, from getting good quality rest, to eating well, and exercising.
But her advice comes with a big caveat.
Uncovering inequities
“We have to remember,” she said, “these choices aren’t always available. Not everyone has the same access to affordable, nutritious food, and the time and opportunity for physical activity.”
So, while eight of every 10 cases of premature heart disease and stroke are preventable, risk factors aren’t so easily boiled down.
“Ethnicity, family history, genetics, age, sex,” Christine explained. “These are just the beginning. Where you live and your economic situation play equally critical roles in heart health.”
This insight underscores a crucial truth: social determinants of health aren’t peripheral –they’re central to understanding disease prevention and recovery.
Given her professional role, and her academic background in population health, Christine naturally views challenges through an equity lens. During our conversation, I found my own understanding of the complexities facing those living in recovery expanding well beyond my personal experience.
The sex factor
One striking revelation was the historical gender bias in medical research.
Until now, two-thirds of all heart and stroke research has focused on men. This statistic is particularly alarming given that heart disease is the number one cause of premature death among women, with many experiencing unrecognized symptoms.
To be honest, I felt left in the dark about this inequity, which disadvantages my wife and daughter.
If you want to learn more, Heart & Stroke has some great resources to help women better understand their own risks and have conversations with their healthcare providers.
It’s all part of an effort Christine and the organization are mounting to improve women’s heart and brain health through research, education, and dismantling systemic barriers.
Heart & Stroke has launched awareness campaigns featuring prominent Canadian women like television and film producer Lisa Meeches, R&B artist Deborah Cox, and actress Julie Du Page. Their stories normalize conversations about recovery and provide platforms for shared experiences.
For example, women are hit hardest by depression following stroke, as explored in Stroke and mental health: the invisible and inequitable effects on women, a report that looks at the higher risk of mental and emotional challenges women face after stroke.
Christine Faubert, Vice President, Health Equity and Mission Impact
Creating a life-saving culture
Beyond their focus on priority populations, Heart & Stroke is also a big proponent of collective action for various conditions including cardiac arrest – which is when the heart suddenly and unexpectedly stops beating.
“An individual level of awareness around medical emergencies such as cardiac arrest is a good start,” Christine noted. “But we also need a national push to build a culture of cardiac safety.”
This is echoed in an excellent piece in the Globe and Mail by Heart & Stroke CEO Doug Roth. He writes there are about 60,000 out of hospital cardiac arrests in Canada each year, and only one in 10 survive. Those that do owe their lives to a confident bystander, who quickly and ably administered CPR and had access to an automated external defibrillator (AED).
Putting your heart into it
Heart & Stroke is instrumental in upping general knowledge and competence including through programs like CardiacCrash. It’s a dramatic, team-based interactive program that teaches hands-only CPR and AED skills.
When not carrying out duties as Board Chair of the MHCC, I am the CEO of Provident10, which delivers management and oversight of the public service plan in Newfoundland and Labrador – one of Atlantic Canada’s largest public sector pension plans. In that capacity, I’ve committed to building CardiacCrash into our organization’s plans for 2025 – and I’d urge other leaders to do the same. I vowed to become re-certified in CPR this year, a promise I fulfilled in late January 2025.
“AEDs are essential life-saving devices. But we need to ensure they are registered, maintained, and people know how to use them,” said Christine.
And while public awareness and education is one side of the coin, the other is Heart & Stroke’s work in the broad category of policy change.
From policy insights to tangible progress
“We’re working to create healthier conditions across the board, because the onus shouldn’t be on the individual alone,” said Christine, who noted the death rate from heart or stroke related disease has decreased by 75 percent, largely due to concerted policy efforts.
This push has tangible impacts, from eliminating trans-fats in Canada’s food supply, to educating the public about smoking risks. Over the past several years they’ve been turning their attention to emerging health challenges like vaping and nicotine pouches.
But Heart & Stroke is also using its considerable influence to cultivate a nation-wide support network for those affected by heart disease and stroke, and their caregivers.
“We want to scale up things that work, and so we evaluated the peer-support aspect of our Facebook communities, for example – one for caregivers and one for people in recovery – and the feedback from users is tremendous.”
Heartfelt support
Heart & Stroke is extremely fortunate to have an army of supporters and volunteers willing to share their stories, dispense tips and advice, and be a listening ear for others.
This I can relate to.
The weight I felt following my own heart attack was lightened immensely through informal peer support.
And here, I would be remiss if I didn’t name names.
The MHCC’s own president and CEO, Michel Rodrigue, happened to be diagnosed with prostate cancer only weeks after I’d had open heart surgery. This shared experience of ill health threw us together in an intimate and unexpected way.
I described it to Christine as, “Close enough, yet far enough away.” We were able to unburden ourselves to each other, in a way that would have felt too heavy to offload onto our spouses or loved ones.
I said, “It reminded me, yet again, that our brains and our bodies aren’t separate entities.”
To that end, I was interested to learn about a program Heart & Stroke is funding to tackle the emotional impacts of stroke. Dr. Swati Mehta, a psychotherapist at St. Joseph’s Healthcare London’s Parkwood Institute, has developed a 10-week self-directed course that teaches people how to cope in the face of an altered reality.
Drawing on community engagement and the principles of cognitive behavioural therapy, it’s a stepping stone to help people manage their emotional well-being after stroke.
And it’s the kind of approach we should be taking across the board – a beautiful segue to the final question I put to Christine.
A Valentine’s Day wish
As we prepare to mark Valentine’s Day, which has taken on new meaning since my own experience, I expressed that my wish wasn’t for chocolates or a fancy heart-healthy dinner (though that would be nice!) but rather to see a healthcare system that embeds mental health across chronic disease management and major illness recovery, just as Dr. Mehta is doing.
Christine responded in kind.
“I’d like to unwrap new knowledge to better understand what barriers are preventing people from making the best recovery possible or living the best lives they can with a heart condition or stroke. I’d like to see greater access to education, resources, and supports as people navigate a complex and imperfect system. And, of course, my ongoing wish is to put patients at the heart of every aspect of healthcare.”
These are themes that are explored in a report Heart & Stroke just released on congenital heart disease to mark Heart Month.
Interestingly, my own experience has slowly proven to be one of transformation.
And it’s happened from the inside out.
What I once thought of as vulnerability has become a source of strength.
I’ve allowed a private experience to become a public call to action.
And I’ve gained a deep empathy for those battling a health challenge – be it heart disease, mental illness, or both – who don’t have the same resources, access, and choices that I do.
This awareness has sparked a renewed conviction that with privilege comes responsibility.
To that end, I offered to lend my voice as a survivor of heart disease – and as a mental health advocate – in support of Heart & Stroke.
Because we all contain multitudes.
And there is still so much work to do.
To get involved yourself, or to find supportive services and resources, visit www.heartandstroke.ca.
Author: Chuck Bruce is an impassioned leader, lifelong learner, and national mental health advocate with more than 30 years of senior executive experience. As the inaugural CEO of Provident10, Chuck oversees the administration of Newfoundland and Labrador’s Public Service Pension Plan, managing an $11B fund and serving over 60,000 members with integrity and a commitment to excellence.
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The Book Club series profiles good reads that challenge stereotypes and stigmas.
I imagine Jonathan Stea has an “I Heart the Scientific Method” fridge magnet because his book, at times, has the ring of your high school science teacher trying to drum up enthusiasm for the concept to a tough crowd. Eventually it may land.
Mind The Science
Stea comes by it honestly. He is an adjunct assistant professor in the department of psychology at the University of Calgary and a full-time practicing clinical psychologist. He frequently takes to social media to debunk myths and correct facts. (Sometimes his mom even hops online to take on the trolls).
He writes for a lay audience with nuance, avoiding finger-wagging or dumbing-down tones. Stea offers compelling stories along with an overview of how to evaluate research and explains the importance of assessment, testing, peer-review, and various research methods. It’s solid information.
Except that he is battling a tide of speedy hot takes in our online world – a vast hyper-verse of snake oil-type claims from innumerable self-appointed “experts” in physical and mental health, celebrity endorsers, and others that cluster under the all-encompassing nebulous term “wellness.” It’s a vast and largely unregulated domain where many an influencer can hang up their shingle and freely offer tips that can range from cutesy to deadly.
Is it all bad? No. For example, you can shell over good money for a menu plan that aligns with the season and sounds vaguely spiritual. It likely tastes great and offers a cozy kind of comfort, but then there are more grim cases like that of Kirby Brown who attended a “Spiritual Warrior” retreat in Arizona. In 2009, Brown and two other participants died in the final activity of the retreat, a poor imitation of a Native American “sweat lodge.” Twenty other participants were taken to local hospitals.
Consumer safety
The Brown family focused their grief into an organization called SEEK Safely, designed to educate the public about the potential harms of the wellness industry, provide consumer information, and promote safety and accountability. Stea details their story in the book subtitled, “Saving Your Mental Health from the Wellness Industry.”
What might we need saving from? Well, it depends. Stea writes with humility about humanity – recognizing our contradictions, flaws, and changing circumstances. He shares his personal experience of caring for a loved one, grappling with the frustration of ineffective treatments. As a young person, he felt bewildered by science’s limitations. How is it that something capable of sending a man to the moon could also leave those closest to you in “a fog of health uncertainty”? he asks.
As a fellow mere mortal who will eventually fall sick, Stea wonders what he might do in the future. “Will I reach for the healing crystals? Maybe. Desperation is intoxicating.”
That vulnerability in moments of crisis can leave people open to being exploited at a time when they may be seeking growth, deeper meaning, connection, and a soft place to land in a world that is chaotic and confusing. Moreover, ineffective treatments can produce harm, drain your pocket, and erode trust in scientific foundations. At the same time, Stea notes, some wellness treatments may provide coziness and a sense of warmth in a fragmented healthcare system that may not have time for comfort or calm bedside manners. It’s a matter of knowing the difference.
More than just fluff: Is your therapist real or a feline? The case of George the Cat illustrates the importance of understanding how wellness practitioners are regulated in your jurisdiction.
Stea seems hopeful and offers faith in people’s capacity to sort through piles of information. I try to share that view, but more often I wonder about our ability to constantly evaluate the material coming at us in order to make informed decisions.
Do most people, moving through life at breakneck speed, pause to reflect on their “favourite” thinking errors and logical fallacies? I am fond of self-awareness, but not everyone may have it at all times, or in moments of heated exchange, the kinds that are perpetuated by online interactions and algorithms.
The key is to develop it. “This awareness is our friend when trying to figure out the legitimacy of particular mental health-related assessments, diagnoses, and treatments,” Stea writes. In addition to quantitative and qualitative scientific methods, Stea talks about Indigenous ways of knowing as something not to be co-opted as well as the value of lived experiences, where people share subjective takes on their lives, events, and ideas.
Things to watch for
Stea offers helpful tips for developing science literacy, and includes a lay overview of randomized control trials, and other evidence-based processes. He warns of pseudo-clinical jargon that masquerades as science but does not adhere to research methods. A key flag – the evasion of peer-reviewed studies.
“Science is a self-criticizing machine,” he says. “Peer review essentially involves having experts in a scientific field grade each other’s work and decide if it passes or fails,” he explains. “People who promote pseudoscience are experts at dodging the peer review process. They will either avoid it entirely or self-publish on blogs, websites, newsletters, or social media. They will claim that their pet theories cannot adequately be tested with current scientific methods, or they will claim that the ‘scientific establishment’ is biased against them,” he writes.
Stea demystifies the concept of science overall, noting that it’s something to regard as a tool or process and not something to believe in, he says. “Science isn’t a God. Or a unicorn.”
Healthy skepticism
To stem the tide, Stea offers an easy-to-implement practice – tame your search bar. Essentially, he explains, it is like going to the grocery store and avoiding impulse buys. The key: Go with a list. “Why are you looking online? Knowing what you need – such as ways to improve your health or a therapist – can keep you out of rabbit holes,” he says.
Thinking critically about information is a helpful skill when navigating an overwhelming online landscape and if you need a reminder, you can make George the Cat your screensaver. The domestic orange-and-white housecat was registered as a hypnotherapist with three UK industry bodies by a BBC journalist, exposing the flaws of certification and credentials. This example, while amusing, can serve as shorthand. “We all fall for fake science news at times to varying degrees, and it’s easier in hindsight to see what went wrong,” Stea writes.
Learning from those errors and developing media and scientific literacy can offer a sense of structure and control, as fake science news continues to perpetuate.
Further reading: Book Club – All in Her Head: How Gender Bias Harms Women’s Mental Health.
Resource: Online Disinformation: If it raises your eyebrows, it should raise questions.
Author: Fateema Sayani feels like “regression analysis” can be used ironically, these days. She frequently writes The Book Club section for The Catalyst.
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Black History Month 2025 is focused on Black legacy, leadership, and uplifting future generations, a topic we’ve explored in The Catalyst through stories on rallying or searching for culturally appropriate care. In this piece, we ask how more equitable futures can be made possible through design for African, Caribbean, and Black communities, and others not represented by the “average.”
I was grocery shopping when a clerk approached and started processing my cart at the self-checkout. It was quiet. I didn’t ask for help, and she didn’t ask if I needed any. She just stood next to me and started putting my items through.
Some people might say that this is good service, but it didn’t feel that way. It felt like she thought I was too stupid or slow to understand how to scan my items. She didn’t approach other shoppers; a young man at one checkout and a mother with a small child at another. So, based on my past experiences, I wondered if she thought I would try to steal the groceries.
I am Black, and I’ve been followed through stores on more than one occasion. Yet my items were neither subtle nor expensive: paper towels, a bag of rice, and a few other items –hardly the slip-it-into-your-pocket selection. It also wasn’t busy enough for me to go unobserved, so what was the deal?
Then, another thought occurred to me as I was leaving, and she made her way over to “help” another client who had not asked. What we had in common was grey hair.
Bias is two steps forward, one step back
I wanted to sigh and dismiss it, but the more I thought about it, the more aggravated I felt. How many biases against you are too many?
I’m comfortable in my skin, doing what I love and doing it well, so why did that clerk bug me? Because her actions belittled me; they made me feel less. It upset me and I’m not alone.
According to an American Association of Retired Persons study, almost two out of three women age 50 and older in the U.S. report they are regularly discriminated against and those experiences impact their mental health.
Women – particularly women of colour – carry the burden of intersectional prejudices of age, ethnicity, gender, and socio-economic status, among others.
If you’re thinking, yes, but that’s the U.S., then know that in Canada, we face a similar picture. A 2024 Women of Influence survey found that eighty percent of women say they experienced ageism in the workplace. An equal number witnessed women in their workplace being discriminated against based on age.
How do they know? It shows up as being ignored when providing advice and then having the same advice applauded when it’s delivered by a younger or male colleague. It’s the snide comments, being passed over for promotion, or any number of things that make them feel unheard, unseen, or incapable.
Average Has Never Worked
Presumably, most people don’t think ageism, sexism, or racism are attributes to aim for, but beyond the morality considerations, the health costs, and the societal impacts, there are bottom-line business costs that come with these biases.
Sharon Nyangweso, founder and CEO of QuakeLab, a niche agency that applies an equity lens to solve corporate and social challenges, puts it best when she says that we need to see equity as a technical skill.
“Long gone are the days of effective business leaders seeing equity as a ‘nice to have’ or social thing done for a few employees,” she says. “Equity is about building better products, services, and processes. It’s about not injuring or killing people because we can’t see beyond the needs of the ‘average person.’”
Take, for example, pulse oximeters. These small sensors are clipped to a finger or toe and use light to measure oxygen saturation in the blood. They are everywhere. According to Fortune Business Insights, the market was valued at $2.24 billion in 2023 and is expected to grow to $3.56 billion by 2032.
It’s been known for decades that everything from skin pigmentation and melanin to nail polish affects a pulse oximeter’s ability to accurately measure oxygen saturation. For Asian, Black, and Hispanic patients, this can lead to inaccurate readings. Further, those inaccuracies may also be associated with disparities in care, according to the Journal of the American Medical Association.
“Would you call that device effective?” Nyangweso asks. “Would you say that someone who engineered a product that didn’t work for its intended audience was a good engineer? When equity is integrated as a skill set, it considers all people in the design process, and that produces better, truly universal products, processes, and services.”
Say what?
Our stores are filled with products that unintentionally fail to serve their intended audiences. If you’ve ever failed to get a response from an AI-assisted audio device because you have an accent, you quickly understand what it means to use a device created for “the average” user.
What happens when we use AI devices to make decisions that impact people? So far, we know that it can wrongfully send more Black people to prison, inaccurately predict healthcare needs of Black patients, produce sexualized images of Asian women, program ageism into job application processes, and the list goes on. AI isn’t awful, it’s just built with our societal biases.
It’s not just AI. We have smartphones, cars, fitness trackers, and knee prostheses built for men – although women and other genders are also users. Given that women are the primary decision makers for consumer purchases, representing 70–80 percent of all consumer spending and representing about half of the population, how is that effective design?
This is what comes from building for the “average,” which is code for white males. It’s an approach that results in ineffective products, processes, and services that show a bias against their target market.
Even more amazing, products built for the average white man don’t properly meet most of their needs either. Flip through The End of Average by Todd Rose to learn more about that.
Equity as a Required Skillset
When you operate in an environment that doesn’t fit you, or support you, and indeed seems engineered to harm you, it takes a toll. That’s in part why there is often an emotional layer that comes with discussions of diversity, equity, and inclusion (DEI).
Nyangweso described the intersection this way, “People have conflated the work that we do in this field with morality or moralization and that mixes things up and distracts us from talking about the problem we are trying to solve. Instead of addressing the issue the way you would any workplace challenge, people expect me – someone who works in this field – to be their assessors or the morality police,” she says.
“We need to force the question of equity to be a question of professional obligation and responsibility. I want to walk into the room as a professional. I’m not there to talk about everyone’s feelings. I’m not there to beat back decades of socialization.”
Not only is that an impossible task, but it distracts from the real work of DEI by placing an emotional burden on the people trying to fix real problems that create tangible threats to patients, consumers, and clients.
“To understand equity as a technical skill, and to do the work of the field, you have to appreciate the three segments or aspects of DEI work,” Nyangweso says, listing them as:
- Equity as an intellectual activity or academic process.
- Activism.
- Professionalized equity.
Equity as an intellectual activity or academic process means research and data. For example, saying ageism is an issue can’t happen until someone does the work of measuring perceptions and impacts.
Activism, as Nyangweso describes it, is “that practical process where we are trying to reach liberation in the world.”
This work calls into question the status quo, forces us to have conversations about things we took for granted, and eventually leads people to question the way we do things and why we do them. It is the emotional lift that starts the ball of change rolling. How many conversations were prompted by Black Lives Matters or Every Child Matters?
Professionalized equity falls within change management tactics and is often how organizations implement the change processes required to become more equitable producers, suppliers, and employers.
Nyangweso notes that there are multiple intersection points with the three. “The work of activists supports the DEI sector, and makes professionalized equity work possible, and research is used to inform practices and approaches.”
All three segments are valid and serve different purposes. When we default to one without consideration for the others, then real change is not just hampered, it can become impossible. Similarly, when we try to use the tactics for one, to implement another, we will be disappointed by the results. For instance, using the tools of activism to develop tactics for professionalized equity will leave us frustrated by the constraints of a corporate environment and the speed of change.
Equity works
All workplaces do better when psychological safety, a byproduct of equitable spaces, is present. Psychological safety is about feeling free to be who you are at work. It’s about being able to engage without fear of punishment or other negative consequences. For employers, it not only improves the workplace environment, but psychological safety also means financial advantage through increased productivity and lower absenteeism and turnover.
We all live with the challenge of managing within an inequitable world. We can perpetuate those inequities by pretending they don’t exist, don’t impact us, or those around us – or we can take the initiative and make changes where we’re at. We can question why we ignore the advice of older employees; we can call it when we hear inappropriate comments about people based on age, gender, race, sexual orientation, or anything else that doesn’t reflect respectful engagement.
The absence of equitable thinking in the development of work has real world consequences. To do your job effectively, whether you’re a grocery store clerk or a product developer, you need to learn, understand and live diversity, equity, and inclusion.
Further reading: Rallying While Black.
Resource: Psychological Health and Safety Training and Assessment.
Author: Debra Yearwood looks for silver linings – and not just in her hair – she is the Director of Marketing & Communications at the Mental Health Commission of Canada.
Illustration by Holly Craib
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If we gave The Catalyst magazine a sub-theme for 2024, it would be Learning and Listening. Stories covered lived experience of mental health and new approaches to therapy, as well as deeply insightful reflections on wellness, mental health research, and new ideas. If you missed some of these stories in 2024, we welcome you to take a tour through the magazine with notable highlights from the year that was. Happy 2025.
Good reads and recommendations
Books on mental health cover the gamut from research to personal tales, to a combination thereof. The Book Club series looks at works by Canadian authors, exploring the sub-themes and ideas. For example, the book Lifeline: An Elegy by author Stephanie Kain, centres around the author’s complicated relationship with a woman diagnosed with suicidal depression. Kain writes about the indignities of a locked ward, having to administer heavy medications, supporting someone through the after-effects of electro-convulsive therapy, and her own well-being. This article about this book received a Canadian Online Publishing Awards nomination. The awards will be announced in February 2025.
Read it: https://mentalhealthcommission.ca/catalyst/book-club-lifeline-an-elegy/
Have you picked up a copy of All In Her Head: How Gender Bias Harms Women’s Mental Health? In it, author Misty Pratt shares her story of a nervous breakdown, anxiety, and depression; her strategies, sessions with therapists, and how these intersected with life stages, such as the birth of her children. The Ottawa author and science researcher weaves in her lived experiences with trenchant analysis of contemporary research through a biopsychosocial lens (a model that looks at biological, psychological, and social factors that influence our lives). It’s a great read with captivating storylines and analysis.
Read about it: https://mentalhealthcommission.ca/catalyst/book-club-all-in-her-head/
Did You Know?
Jessica Ward-King is known as the Stigma Crusher and contributes frequently to The Catalyst through service stories that offer insights and tips. She shows how to be a good ally to transgender and nonbinary people in a political and social climate that can be downright hostile and dangerous.
Read: Rallying as an Ally: https://mentalhealthcommission.ca/catalyst/rallying-as-an-ally/
Naloxone kits can reverse an opioid overdose and should be easily accessible. It is not only those members of the population who live with substance use concerns who could owe their lives to naloxone; it is also people who live with chronic pain and take prescription pain medications – or someone who could get into that pain medication by accident. It is all of us who, in our daily lives, could come across other people who – for whatever reason – have overdosed on opioids.
Read: Kit in Hand: https://mentalhealthcommission.ca/catalyst/kit-in-hand/
Hip-hop therapy is a fusion of hip-hop, bibliotherapy, and music therapy. Toronto therapist Freda Bizimana, MSW, RSW, works with Black and racialized youth in conflict with the law at The Growth & Wellness Therapy Centre. She shared how challenging it is to reach Black youth, particularly those who have come to therapy because of their interaction with the justice system. “They don’t want to be there talking to a stranger,” she says. “Hip-hop gives us a bridge, a way to connect through something they love.” This article received a Canadian Online Publishing Awards nomination. The awards will be announced in February 2025.
Read Remix Your Therapy: https://mentalhealthcommission.ca/catalyst/remix-your-therapy/
Her Story and Her Story
A personal narrative offers particular insights into a life story. The Lived Experience section highlights these stories. In 2024, we met 26-year-old Gillian Corsiatto of Red Deer, Alta., a published author – her debut novel, Duck Light, asks the serious question: “How can one break free of societal expectations?” – and more books and plays are underway. She’s also been a keen improv performer with Bullskit Comedy. She has three part-time jobs: She is a community educator and youth group leader for the Red Deer branch of the Schizophrenia Society of Alberta and has been a guest speaker for The Mental Health Commission of Canada’s Headstrong youth program; she manages social media and recruitment for the Red Deer Royals marching band (in which she used to play the tuba); and has taken a job wrapping and packaging caramels for a small, home-based business. If you have never met a person who lives with schizophrenia – you just did.
Read: What is It Like Living with Schizophrenia?: https://mentalhealthcommission.ca/catalyst/what-is-it-like-living-with-schizophrenia/
Meanwhile, Jessica Ward-King, who you know as the Stigma Crusher, frequently shares her personal stories, in addition to writing educational articles. In Yes, Me, the mental health advocate – who has a doctorate in psychology and first-hand knowledge of bipolar disorder – explains why her mental illness has classified Ward-King as a person with a disability under the employment equity act.
Read: Yes, Me: https://mentalhealthcommission.ca/catalyst/yes-me/
Watch for more great stories in 2025 – you can receive them directly in your inbox once a month by subscribing here: Catalyst Sign-Up – Mental Health Commission of Canada
Fateema Sayani edits The Catalyst and contributes frequently to the Representations and Book Club sections.
Fateema Sayani edits The Catalyst and contributes frequently to the Representations and Book Club sections.
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This piece is part of the Mental Health for the Holidays series. Our annual literary collection delves into various seasonal subtopics. We’re looking at good tidings, bad partings, and new traditions — things that emerge from estrangements, changes, and major shifts. While end-of-year celebrations can be joyful, they can also trigger feelings of stress and loss. Read the collection to learn how others were able to meet those challenges. Here’s a previous series on moping, coping, and hoping. Warm wishes for the holidays.
It’s been a long journey, this band. Rheostatics’ first show was in October 1980, at The Edge in Toronto and I remember the tears as often as I remember the screams of delight. It comes with the territory: the battles, the distress, the close-to-the-bone existence between four kids, who became four adults, who became four older adults. Scars heal and wounds mend, and the triumphs of shows, albums, and tours recede giving way to time passed, but the essence of simply surviving is the element that I stand behind lo these forty-plus years. Somehow, we made it.
For many musicians and people working in other disciplines, art gives us our point of emotional release. And with that release — with the doors of the heart flying open and the head swimming in an ocean of ideas and dreams — you’re never sure what will flow forward: ecstasy, anger, staggering bouts of laughter, and peals of distress. Being in a band is like playing in an endless field occasionally laid with mines and an unseen river of pathos. The hard times might not seem healthy, but they are, and the good times might feel like they’ll last forever, although anyone who’s experienced them long enough knows they will not.
Soul proprietor
Playing music with others means navigating, spiriting, and occasionally bartering with the depths of another person’s soul. If the art is any good it has to hurt a little coming up, and that vulnerability can be trying, even when it’s cresting over beautiful melodies created by someone you know closely and well. In Rheostatics, there was always the knife’s edge of nervous tension when a person brought in a new song. Minutes later, you’d be honouring and celebrating its existence by working hard to get it where it had to be, fully grown, but we were always aware of the author’s tender struggle to present it and bring it to life.
Still image from a video by Mark Sloggett.
“The sound of the crowd cheering came at me like a magnificent cloud of singing, crying birds. I’ll never forget it for as long as I live.”
We live, mostly, in a world where we’re taught to conform and suppress artistic expression— the greater forces of commercial society would have us behave “normally” rather than scream into a microphone at top volume with an army of friends raging behind you — but music and art dares your voice to be heard. As a mental health exercise, it leaves you happy and free, but as a social gesture, it’s still unsettling to many. There’s a clip I saw recently of Yoko Ono wailing over a Chuck Berry song performed on the Mike Douglas show, and its fearlessness left me staggered. It was pure release, pure voice, pure personality without a worry about how it would be processed by the host, the crowd, or the band. It was a sterling musical gesture; unencumbered by worry or comportment; unafraid by what anyone other than the singer would feel.
Playing in a band is easy. Playing in a band is hard. You have to learn how to get along, but you also have to learn to honour the release. Of course, there’s the functional and technical side about assembling a song so that it, more or less, makes sense, but the best times are when you’re on that wave and you’re unconscious of how or whether it’s working. The worst part is when others can’t find the wave, leaving the writer defeated, forlorn. But embracing failure is as important as achieving success. Not every song is going to create that shared feeling, but when it does: woah. You’re pulling people into your vulnerability and, if you’re lucky, you’re sharing it with dozens, hundreds, maybe thousands of strangers who are also pulled to it.
One time, during a performance at Massey Hall, I could feel all of these things happening — it was an ethereal moment, shroud in light and joy — and after the song ended, I told myself to stop and listen. The sound of the crowd cheering came at me like a magnificent cloud of singing, crying birds. I’ll never forget it for as long as I live.
Hello darkness, my old friend
With performers, there’s always darkness married to the light and, in the ‘90s, I recall, that darkness was rarely acknowledged as something to be addressed, wrestled with, and met head on. If someone had a worrying performance, or behaved worryingly, we lapsed into the mythology that the person was merely artistically petulant or troubled; they were bearing an artist’s soul through the difficult process of making good art. But recent musicians from Menno Versteeg of Hollerado to Kendrick Lamar to Big Boi of OutKast have been bold faced in recognizing the unhealthy environment in which so many musicians exist: endless touring hours, booze delivered nightly into your dressing rooms, unhinged schedules, the pressure to be better than your last creation, a stigma that haunted Van Halen’s Eddie Van Halen to his last days.
The signs of struggle are clearer now than they’ve ever been to the point that musicians are more aware of the demons, and fans tilt on the side of forgiveness rather than wanting their favourite bands to be wild and raw at all costs. People like Miranda Mulholland have advocated for venues with more non-alcoholic products, and, at the West End Phoenix newspaper storefront where we hold shows, we’ve staged “sober” gigs without alcohol sales. It’s taken generations, but we finally understand the danger and absurdity of an occupation where, the moment you show up for work, a tray of iced Bud is laid at your feet. We had — and continue to have — a great career, but I wonder if we could have fought through the hard gigs if we weren’t often relying on booze to get us to the end. But that scar has also healed.
Surviving has allowed us to look back at this life, this career, in the fullness of its landscape, but that’s not to suggest that, for newer musicians, it has to be the same. Maybe the cover has been torn off the facade; the seal removed from the prescription. Maybe now it doesn’t have to be as rough and dangerous as it is smooth and beautiful. Maybe you can get near the end without feeling you’ve paid too much for it.
Further reading: Common Mental Health Myths and Misconceptions.
Resource: How Alcohol and Suicide are connected – A Fact Sheet.
Author: Dave Bidini, has had countless sobering realizations as publisher of the West End Phoenix community newspaper in Toronto. He has so many favourite songs.
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This story is part of the Mental Health for the Holidays series. Our annual literary collection delves into various seasonal subtopics. In 2024, we’re looking at good tidings, bad partings, and new traditions — things that emerge from estrangements. While end-of-year celebrations can be joyful, they can also trigger feelings of stress and loss. Read the collection to learn how others were able to meet those challenges. Here’s a past series on moping, coping, and hoping. Warm wishes for the holidays.
It was in May 2021 that my sister announced she would not be getting a COVID-19 vaccination, despite the fact that most of us over age 60 were relieved, if not joyous, that we could do so. I was stunned. It was difficult to believe that my older and only sibling, a vibrant, well-educated, well-travelled woman in her 70s, would make such a reckless and, to me, foolish decision.
It was also the moment when the wider meaning of it hit me full force: the emotional connection we’d had my entire life would never be the same again.
My tears watered the vegetable seedlings I’d planted in the garden boxes my partner built during the lockdown days when everyone was doing backyard improvements and baking bread. I thought about all the things my sister had meant to me throughout my life and about how much I had admired and loved her. Although we live in different countries, we always kept in close touch and routinely visited each other over the years. It was viscerally sad to me that somehow, propaganda machines had hooked her better angels and rerouted them onto a hellish path she did not see — one that looked strewn with hazards to me. I worried. I did not think it unreasonable that she could die a miserable, preventable death, with no vaccination against a virus that was killing millions of people in every part of the world, particularly in her age group.
Outrage machine
Yet I really shouldn’t have been surprised by my sister’s decision to refuse vaccination. For years, I had watched with increasing horror as her left-leaning politics gradually and then precipitously veered from a desire for social justice and a willingness to stand up for the underdog toward a vortex of far-right talking points that cast doubt on anything found in “the MSM” (that is, the mainstream media; the world of conspiracy theories is full of loaded jargon), preferring instead rants generated by blatant mis- and disinformation. I felt constantly sideswiped by her increasingly angry, irrational messages, coming via email, text, Facebook, Twitter (X), and WhatsApp. It pained me to think of someone spending their retirement years watching alarmist YouTube videos and sharing them with others (who most likely would not watch them) in a constant attempt to spread the outrage.
My sister, seeing herself as a committed peace activist, was causing a lot of conflict in her personal relationships. In her mind, it was those who did not believe as she did who were the problem. It was her job to relentlessly try to convert them to her way of seeing. Bombarded by this constantly, I began to feel like collateral damage, a casualty of what has come to be known as the culture wars.
I’m hardly alone in this experience. Many family relationships have been fractured in recent years by political polarization largely engendered by social media, which is used by those who seek wider audiences for political or financial gain and have discovered that extremism sells. Stories of people who have lost a family member or friend to conspiracy thinking now abound on the internet. Support groups also exist for those trying to come to terms with what has happened to a loved one. Therapists now see greater numbers of people who either believe in conspiracy theories or are dealing with someone close to them who does. Some psychologists suggest that, while belief in conspiracy theories is nothing new, it should now be treated as a public health issue.
I came to understand that the arrival of COVID-19, with its public health measures, mandates, and lockdowns, was more like a final straw for people like my sister, not a freshly discovered reason to hate governments and the evil cabals behind them. It was I who had been in denial about how monumental the shift was and how long it had been in the making. For a long time, I did what I thought was right. I tried to show her evidence that the information she was basing her views on was largely flawed, that reputable sources had thoroughly debunked the junk science and plain lies she now espoused, and that social media algorithms had perniciously infected the internet, planting falsehoods and manipulating opinion by exploiting people’s confirmation bias, placing them in filter bubbles that just keep reinforcing the worst, most extreme, usually wildly off-base beliefs. I even sent her academic papers by scholars who had studied the nature of contemporary propaganda coming from “news” sources my sister admired.
Persistence is futile
I am sure she did not read them, and I eventually understood that this “rational” approach was never going to work. Her views are based on belief and emotion, not fact or evidence. It was easy for her to dismiss all of my sources — and me along with them. She’d done her “research,” cherry-picking material that supported her pre-existing notions and rejecting as false anything that did not accord with these views. Others in her circle, lifelong friends, were as alarmed as I was and tried similarly to reason with her, again to no avail. It saddened me to see her alienate people she had known and loved for decades.
The barrage of falsehoods and rage intensified as the pandemic stretched on. She and a small number of brave, enlightened “dissidents” had “the truth” that others for some reason could not see, and she did not hesitate to tell us all this, over and over with monotonous, obsessive regularity. Nothing would change her mind. Arguing was pointless. When I asked her to stop sending anti-vax material, it offended her, serving only as proof of my closed mind and an unreasonable dismissiveness toward non-mainstream but perfectly valid ideas. While 30-second Google searches were enough to find ample evidence to debunk whatever or whoever she was defending, telling her this made no difference.
To be truthful, I was not always rational in my responses. I called nonsense many times, was dismissive of what I knew was insidious propaganda, and could not believe my sister did not see what was obvious to me. I regret some of my lashing out. So I changed tack at one point and told her simply that I loved her and was worried about her health while asking that she reconsider her sources of information. In response, she told me she was worried about my health (she believed vaccinations could damage DNA) and staunchly defended her sources. She stubbornly doubled down, no longer responding to friendly, non-political messages, which made me feel slighted and resentful. In her zeal, all that mattered was politics, and any other discussions were superficial and useless. One result was that we corresponded less often, but in the absence of communication, I continued to worry.
It affected my mental health — I lost sleep ruminating on how it was possible that this had happened and what I could or should do about it. I regaled my partner and friends with endless rants of my own whenever a new message arrived filled with wild untruths. I could not accept the reality and felt helpless to change the trajectory it seemed my sister was on — I didn’t know toward what, but in my mind, it was something bad. And it sometimes felt like boundaries were being crossed, as one person felt free to express themselves while the other knew they could not respond without having an argument. I got a lot of pounding headaches keeping my thoughts to myself.
At times, I wondered if my sister could continue this way. But I have learned that it is possible to believe in what seems preposterous, even damaging things, and still be able to function in the world. I have also learned, through therapy and time, that it is possible to have a relationship with my sister despite our differences, even if it is strained, even if she doesn’t always respond as I would want. It certainly makes for clumsy communications during the holiday season, as we swerve away from testy topics, but that will have to be the new normal if I want any sort of relationship with her.
It’s not possible to unpack every complexity of a family relationship in a short article. I am a kid sister, probably forever a hapless teenager in my sister’s mind. Why would she take seriously any criticism or concern I might have toward her choices and beliefs? There is nothing new about her doggedness, her willingness to stand up for what she thinks is right, and her comfort at being marginal in her opinions. (We do need to remind ourselves that, as amplified as the voices of disinformation are (thanks to social media), these voices remain a minority; in the case of COVID vaccination in Canada, 83.2 per cent of us did get shots; in older age groups and some regions, more than 95 per cent did).
While I cannot say I am at peace, I have edged toward acceptance. As a mutual friend wisely observed, your sis is an adult who has made her own choices and must live with them. They further suggested that I continue to send my newsy family messages, to not take the bait when she throws down what feels like insults to my intelligence — to keep the heat down as much as possible — and just carry on. It is difficult sometimes, and I still worry, but I do accept this as a necessary strategy.
And I do, and always will, love my sister.
Further reading: Five Tips for Starting a Conversation About Mental Health
Resource: Better Supporting the Mental Health of Older Adults in Canada
Eleanor Sage
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Welcome to the sixth installment in the MHCC & series, designed to get to know our HealthPartners membership, and discuss where our realities intersect, and how best to support each other.
The MHCC’s Director of Prevention and Promotion Initiatives, Nitika Rewari Chunilall, sat down with Sarah Butson, CEO of the Canadian Lung Association, to understand the massive implications that come with the inability to breathe well, and the work of the organization.
As you’re reading this, take a deep breath.
Breathe in for four seconds. Hold for four. Exhale for four.
Feel the sensation of your lungs contracting and expanding. As you consciously breathe in, you may begin to relax. This technique, called box breathing, is widely used to calm stress or anxiety.
You’re signalling to your parasympathetic nervous system that you’re safe. And you’re sending a steady stream of oxygen to the rational, thinking part of your brain.
This is just one example of the power of breath.
And it got me thinking that while health care systems may operate in stubborn silos, the brain and body do not. With this in mind, I sat down with Sarah Butson, CEO of the Canadian Lung Association (CLA), to better understand the massive implications that come with the inability to breathe well, and what the organization is doing to raise societal consciousness and much-needed funding.
On the doorstep of a 125-year legacy
CLA began as a movement in 1900 to control the spread of tuberculosis (TB) and provide better patient care. The organization has been evolving ever since, expanding their mandate to include COPD, asthma, cystic fibrosis, pulmonary fibrosis, lung cancer, and more.
“I would say our biggest strength of these last 125 years – and I can’t say I was around for all of them! – is keeping pace with the world around us. From taking the fight to Big Tobacco, to pushing back against the alarming trend of vaping, we’ve remained relevant because we haven’t taken our eye off the ball,” Sarah said during a virtual interview from Toronto.
While she’s been an integral part of CLA for 15 years, Sarah has only been at the helm for a whirlwind six months.
“Our outgoing CEO of nearly a decade, Terry Dean, left big shoes to fill. But this issue is deeply important to me – both professionally and personally,” said Sarah.
Sarah Butson, CEO, Canadian Lung Association
Sarah herself lives with asthma, as does her youngest daughter.
“The visceral panic that comes from being breathless is hard to describe unless you’ve lived it. The only thing more terrifying is feeling that fear for your child. Breathing is something so many of us take for granted,” she said. “It’s part of CLA’s mission to flip the script, making us truly value our breath, and inspiring people to take action to protect it.”
Playing the long game
One of the organization’s biggest challenges is conveying the urgency of prevention.
“Prevention doesn’t have the cachet of immediacy,” Sarah emphasized. “Take wildfires, environmental pollutants – be they indoors or out – poor ventilation in workplaces…these all lead to deleterious, and even fatal, breathing concerns. Every year, 15,000 people die due to air pollution.”
But the challenge remains making that connection and getting policy makers to act on it.
One area where Sarah credits CLA for having outsized influence is the reduction of tobacco use, specifically among young people.
“It’s an uneven match – because we simply don’t have the resources or the funding of big industry. We’ve had to work doubly hard to get our message out, in response to what we now know was a covert effort to hook millions of people on one of the most addictive substances out there.”
Yet, CLA’s persistence has paid off. About 4.2 percent of people 15 to 19 smoke cigarettes, and that number continues to trend downward.
But there’s still work to be done.
More broadly, some three million Canadians smoke cigarettes. That’s about 12 percent of the population – more than double the federal government’s target of less than five percent by 2035.
Given smoking is still the leading cause of preventable death in Canada, the organization refuses to back down. “Even,” said Sarah, “as we face a constant barrage of new challenges.”
In August of 2024, CLA celebrated successful efforts to keep nicotine pouches out of the hands of children and young people.
“We have to stay vigilant,” said Sarah. “There’s no other choice.”
Living and breathing advocacy
Among the CLA’s most powerful lung health champions are those who once fell victim to Big Tobacco.
I pointed out to Sarah an interesting nuance in the language she used.
“You say ‘fell victim,’ which is a powerful way to reframe the conversation about smoking.”
Sarah agreed. “Language matters, because it can do more than change how we talk about something, it can change how we think about something. And, ultimately, how we behave.”
Today, smoking is out of sight out of mind. But that fight was hard-won.
“It used to be pervasive, well-marketed, and socially acceptable,” said Sarah. “People started and found that, even when they wanted to, they couldn’t stop.
“They [former smokers] look back with outrage, and want to see meaningful system-level change,” she explained. “This isn’t about shaming and blaming. Most people who smoke want to quit. The best way to support that is through compassion.”
We agreed that a big part of rewriting the narrative is putting the stories back into the hands of those who’ve lived them. I echoed that the MHCC similarly has found some of our most effective advocates in the lived experience community.
And their courage is a powerful antidote to stigma and its many harms.
A loss for words
To that end, CLA released a report in 2018 looking specifically at the stigma associated with lung disease. Of those surveyed, 45 percent said they had put off going to the doctor for fear of judgement.
I couldn’t help but draw parallels with the experience of those living with mental illness. Health-care provider stigma is something the MHCC has been working hard to address, and our conversation reinforced the need for swift action.
“I’d love to say that we’ve made great strides since the release of the Stigma Report, but speaking up is still a challenge for our community. When actions may have led to a disease, it’s hard to resolve. People may feel unworthy of care…and sometimes that fear materializes because the care isn’t as empathetic as it could be.”
Sarah goes on to explain that the addiction is so strong that even people who receive a diagnosis may not be able to quit the behaviour, which can in turn spiral into social isolation.
“On the flip side, some lung diseases are inherited, or environmental, and yet people make false assumptions.”
Either way, leading with empathy is always best practice.
Just as mental illness can be perceived as a moral failing, lung disease can be maligned as the result of a lifestyle “choice,” even when it may be caused by factors that have nothing to do with cigarettes.
We also found common ground when discussing substance use, such as tobacco, to self-medicate conditions like anxiety. In response, CLA has created valuable resources, particularly targeted to young people, to spotlight healthy coping behaviours that can replace tempting quick fixes – like reaching for a vape.
Research points to a link between vaping and depression, for example, with people who vape being more likely to report mental health concerns. Feelings of anxiety or low mood can trigger a desire to vape, and yet vapes and e-cigarettes contain toxins harmful to overall health.
This intersection in our work underlines the importance of raising our voices as a collective in the name of a more responsive, compassionate, and equitable health care system – one that recognizes the whole person.
“It comes back to that long game, again,” said Sarah. “Helping people protect their healthy lungs – and supporting others to live well with lung disease – is part of our mission. Unfortunately, not everyone has the same resources.”
Informed choices
“We need to give people the right amount of information,” stressed Sarah, who pointed to various evidence-based information available on the CLA website, from “What’s the big deal about Radon,” to “How to protect your lungs from wildfire smoke.”
“But” she cautioned, “if you overwhelm people, it can lead to paralysis.”
I concurred but asked about the importance of recognizing that the burden isn’t an individual’s to bear alone.
Sarah quickly agreed. “Not everyone has the same opportunity to breathe freely,” she said. “There are fundamental equity issues that actively work against making the desired changes. We’re only as healthy as the systems we live within.”
And sometimes those systems perpetuate ill health – especially among pockets of the population made vulnerable by race, socio-economic status, gender identity etc.
This reality is something CLA is highlighting in their new three-year strategic plan, proof positive of the organization’s agile response to changing societal circumstances, including a better understanding of the social determinants of health.
Beyond identifying the problem, CLA is closing the gap in services.
For example, the organization has developed a virtual pulmonary rehabilitation program, Breathe Better, Stay Strong, to improve understanding of disease management, offering the kind of information that might usually be available through a family doctor – save for the 6.5 million Canadians without primary care.
As part of this program, the CLA has created virtual support groups, which offer peer-support and reduce the social anxiety and isolation often experienced by people living with lung disease.
I reflected that within our fractured system, charities play an outsized role in closing the gap between available health care and illness-specific needs. Which is why we need to band together in pursuit of shared goals.
Goals that include raising the alarm about the vaping landscape in Canada, or, what Sarah has called the new “Wild West.”
Groundhog Day
When I ask Sarah what keeps her up at night, she acknowledges that Canada’s high rate of vaping is like reliving the early days of cigarette promotion all over again. And she’s unafraid to say that the CLA, and all health promotion organizations, need to do more.
“We don’t have 60 years of evidence about the harms of vaping, as we do with cigarettes, but we do know that we shouldn’t be breathing in anything that isn’t (ideally clean) air, or medication as prescribed,” said Sarah.
Yet vaping remains popular, and Sarah worries about not only its long-term effects, but also the potential to act as a gateway for cigarettes, which could set back the tremendous strides made to reduce the harms caused by smoking.
“We need to see strong action on flavoured vapour. That’s one of our most important policy asks. We’ve got to nip this in the bud, so we don’t end up with six decades of hard evidence of the harms of vaping, at the cost of the health and wellness of today’s generation of young people.”
Sarah and I reflected briefly on the prevalence of vaping shops, which I’ve seen sprout up in some of the remotest corners of the country, in stark contrast with the dearth of accessible health care, especially mental health care.
“I take heart though,” said Sarah. “Because this time we’re equipped. We’ve seen the playbook before. We just need to mobilize and mount strong counter measures.”
When I ask what keeps her engaged after nearly two decades in lung health, she doesn’t hesitate.
“You only have to experience a true inability to breathe one time for it to stay with you the rest of your life. And when you’ve experienced that, you never take a single breath for granted.”
I wrapped up the fascinating conversation with a final question.
“If you had a magic wand, and a single wish, what would it be?”
Without missing a beat, Sarah replied: “For everyone to breathe with ease.”
Until then, Sarah remains committed to CLA’s motto. “We aren’t just there for people with lung disease,” emphasized Sarah. “We’re there for people with lungs.”
Author: Nitika Rewari Chunilall is the Director of Prevention and Promotion Initiatives at the Mental Health Commission of Canada.
December 3 marks the annual International Day of Persons with Disabilities, a UN Day to promote the rights and well-being of persons with disabilities.
I live with bipolar disorder, a chronic psychiatric condition characterized by extreme variations in my mood, energy, activity levels, and cognition. Despite these extremes of mood and energy, I am fairly high functioning in life and at work, where I hold a senior level knowledge-economy position. I have developed a variety of coping mechanisms, such as masking, to accompany these mood states and make me perform like I am “normal,” but many days it is an uphill battle, and I feel like I have to try twice as hard as anybody else to succeed. I have even had to change my career path and goals because of my struggle with this mood disorder.
Throughout my life, I have struggled, thinking that this was a “me problem,” that I had to change the way that I interacted with the system so that I could be successful. I ran myself ragged trying to succeed in a system that is made to be equal for everyone – a laudable goal – but was ultimately disadvantaging due to my mental illness.
Eye-opening discovery
Then I discovered the Employment Equity Act (EEA). The broad purpose of the act is to achieve equality in the workplace so that people are not denied employment opportunities or benefits because of their identity or level of ability. Moreover, the act exists to “correct the conditions of disadvantage in employment experienced by women, Aboriginal peoples, persons with disabilities and members of visible minorities.” (My emphasis).
I had always thought that a disability was, you know, like the symbol. Physical. Wheelchair ramps to allow access to buildings, or maybe even screen readers for people with low or no vision, but a mental illness? I did a deep dive into the act and found this passage:
“A person with a disability has a long term or recurring physical, mental, sensory, psychiatric or learning impairment and:
- considers themselves to be disadvantaged in employment by reason of that impairment
- believes that an employer or potential employer is likely to consider them to be disadvantaged in employment by reason of that impairment.
This definition also includes persons whose functional limitations owing to their impairment have been accommodated in their current job or workplace.”
Well, that tracks. In fact, it kind of describes my experience of the workplace to a tee. So, my mental illness qualifies me as a person with a disability? What does that actually mean?
There are a few things to unpack here:
Stigma and labels
First, there is the stigma associated with a label like “disabled.” This stigma is rooted in ableism, which is an attitude that views and treats people without disabilities as the “normal” ones and those with disabilities as somehow inferior or “other.” This stigma, which I summed up earlier as a “me problem,” (self-stigma) challenged my view of myself as a capable person and employee. It also made me worry that, if I were to self-identify as a person with a disability, managers would be hesitant to hire me based on that stigma and fear around how difficult it would be to work with me.
Disadvantage
Why would I try to overcome that self-stigma, risk the stigma of others, and choose to self-identify, and declare that I am a person with disability? Because of the disadvantage in employment that my mental health causes. Living with bipolar disorder can cause me to struggle to do my job within the “one-size fits all” system of work. The way that my brain and body functions when I am in a mood episode can limit my ability to succeed. I feel that these functional limitations caused by my mental illness disadvantage me in terms of achieving my goals at work and advancing in my career.
Not a me problem
The EEA doesn’t just stop at identifying that a barrier or disadvantage exists, however, it goes one step further: accommodation, which says, “employment equity means more than treating persons in the same way but also requires special measures and the accommodation of differences.”
Through various measures of accommodation in the workplace, I have found that I can achieve my potential and excel at my job. These accommodations are tweaks to my work environment (this could be physical, temporal, or social) and processes that help me to meet expectations. The key here is that instead of those disadvantaging barriers being a “me problem” they become a systems problem that the system needs to make space for and offer opportunities to remediate.
What accommodation can look like
The trick is identifying the functional limitations, and the changes that could help overcome those limitations. So, if a medication change is making me super groggy in the morning, perhaps a change of my work hours to a later start time is in order. If working from the office is too taxing on my energy during a depressive episode, maybe the place of work needs to change to allow for working from home. If my motivation or decision-making is reduced, more frequent and structured direction from my boss, and slightly expanded deadlines might be in order. If I am having trouble concentrating while reading complex documents, a screen reader could help.
Whatever the functional limitation, there is often an accommodation that can help me work through and balance out the disadvantage caused by my disability. Beyond that, my employer actually has a duty to accommodate, meaning that they cannot refuse a reasonable accommodation up to the point of undue hardship. The goal is to level the playing field – not confer any advantage – where equity, which differs from equality, is the aim.
Representation and changing the narrative
There is one final, very significant piece to the EEA. It aims to correct underrepresentation of members of designated groups in the workplace. That means that employers are encouraged and supported by the Act to hire and retain members of designated groups, including persons with disabilities, in an effort to balance out the systemic barriers that have prevented persons with disabilities from participating fully in the workforce.
Stigma and ableist attitudes persist in society and in the workplace, but the EEA gives me the legislative background – and the courage – to advocate for myself. It has empowered me to be assertive and forthright about the tools and conditions I need to succeed in the workplace as a person living with mental illness. Ultimately, it makes me a better employee, ensuring that I am consistently able to work to my full potential and contribute to the aims of my organization.
Further reading: Mental Health at Work — It Matters. How to Start the Conversation.
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MHCC & Series – Diabetes Canada
I’d been looking forward to my MHCC & conversation with Laura Syron, President and CEO of Diabetes Canada, since I’d marked it in the calendar this summer.
My family is no stranger to diabetes.
It’s been a low thrum in the background of my life for as long as I can remember. For my mother and my many aunts, diabetes was something accepted. We had no preconceived notions about it and I’ve spent most of my life expecting to get it.
Today, we understand that many factors likely made them more susceptible; we’re of Bajan heritage, and diabetes is more common in African, Black, and Caribbean (ABC) folks.
But I became doubly interested in speaking with Laura when I learned that she herself had been diagnosed with type 2 diabetes at age 50.
That’s when her lifelong professional commitment to health advocacy became personal.
When life imitates work
Just moments after a quick hello and introduction on our virtual call, Laura apologized. “I’m sorry, my [glucose] monitor is beeping here,” she laughed ruefully. “This is life with diabetes. You’re never off the clock.”
Just back from her quarterly diabetes check-up, Laura generously reflected on her own experience with a diabetes diagnosis and her ongoing health management. While it was eight years ago, she said she recalls it like yesterday.
“I was sitting in the doctor’s office after a routine exam, and right out of left field she told me I had diabetes.”
Laura paused and took a breath.
“It’s hard to explain how unexpected that felt. How unprepared I was. I sat there, in stunned silence, without a clue about what to do next.”
But shock and dismay weren’t the worst part for Laura.
“I was so embarrassed.”
Here, I stopped her. “Embarrassed? But why?”
And in one of the more eye-opening conversations of my professional life, Laura unraveled the complex emotions that so many feel when hit with a diagnosis where lifestyle factors – can, but don’t always – play a role.
Laura Syron, President and CEO, Diabetes Canada
Shame. Blame. Guilt.
“Maybe I’d skipped too many workouts? Had I snuck an extra donut on the weekend? Was I lazy, unmotivated?”
Laura confided she considered hiding her diagnosis, even from her husband.
“In that moment, I didn’t like myself. I thought I deserved this.”
Laura isn’t alone in her experience.
In 2023, in a first-of-its-kind national survey, Diabetes Canada engaged with nearly 2,000 people with lived experience of diabetes. Laura’s feelings were borne out across the community. In fact, shame and blame were echoed by nearly 90 per cent of people living with type 1 diabetes and almost 70 per cent of those with type 2 diabetes.
Now, she has taken up the mantle, in the hope others won’t fall into that trap.
“I want people to be empowered in a way I wasn’t. I want them to know there’s a place they can turn to get information, to seek support, and to become self-advocates.”
In addition to a wealth of existing resources, Diabetes Canada has plans to create a conversation guide for health-care providers.
“It would have made all the difference if my doctor had delivered that same news: ‘You have diabetes.’ And simply added, ‘But it’s not your fault.’”
Stigma, which casts a long shadow on so many illnesses, doesn’t spare people living with diabetes.
But, said Laura, “We’re committed to changing the conversation.”
Rewriting the narrative
Diabetes Canada is working on three fronts.
“This is a marathon, not a sprint. I look at mental health, and how you’ve powerfully shifted the conversation out of the shadows. Today, we’re seeing those efforts bear fruit – from Bell Let’s Talk, to the FACES campaign.”
This is Laura’s ambition for Diabetes Canada. That people become more engaged – whether that’s corporate Canada, workplaces, or schools.
“Because from there, you see an uptick in research dollars, volunteerism you name it.”
To kick-start this virtual cycle, the organization is striving to get ahead of misinformation, which can double the burden on people living with diabetes, as it did for Laura when she was first diagnosed.
“Not only was I facing a major, life-altering diagnosis, but I also thought I’d caused it.”
They are also working against a general apathy.
“Society can be dismissive of diabetes. Don’t get me wrong, we have life-saving treatments. Type 1 diabetes used to be fatal before the advent of insulin. But that isn’t to say that managing a complex illness isn’t a tedious, often exhausting, balancing act. We’re trying to change the attitude that it’s ‘just’ diabetes.”
And finally, stigma.
Laura dubbed the reaction as a ‘societal shrug,’ or a ‘you’ve made your bed’ indifference. But she pointed out, even if that were true, not everyone has the same opportunities that can help with prevention.
“There are social, environmental, and biological factors at play. So, we’re trying to close the compassion gap.”
But it’s not just a deficit of empathy that people with diabetes experience.
It also depletes their finances and takes a toll on mental well-being.
Dollars and sense
“The cost is huge,” emphasized Laura. “I’m talking both in terms of the societal price tag and the individual’s out-of-pocket expenses.”
In just over a decade, the financial impact of diabetes has nearly tripled, from $13 billion in 2013, to $39 billion in 2024. In 2023, according to Telus Health’s annual drug trends report, diabetes medications remained the leading drug category for private insurance claims, with a nearly 30 per cent spike in eligible claim amounts as compared with 2022.
For people living with type 2 diabetes, the yearly outlay can quickly mount to over $10,000. For those with type 1, that figure rises to $18,000, taking a major bite out of any household budget.
Diabetes Canada has an information and referral line, 1-800-BANTING, named after the father of insulin invention, esteemed Canadian researcher, Dr. Frederick Banting.
Pre-pandemic, the calls they fielded were primarily centred on providing education.
“People were calling distressed because their sugars weren’t going down, or because they needed advice on different medication options, and sometimes because they just needed a listening ear.”
But since COVID, the nature of the calls has changed.
Feeling the squeeze
Today, the most frequent callers are people experiencing financial hardship.
“It’s empty wallets. An inability to pay for meds, to cover the insurance co-pay, or even buy the healthy foods so vital to diabetes management.”
I reflected that an ounce of prevention is worth a pound of cure.
Without access to the right services, supports, and treatments, that alarming cost curve isn’t going to trend in the right direction anytime soon.
“That high cost is compounded by a feeling of overwhelm. So, some people will look at what’s involved with diabetes management, in terms of dollars, yes, but also time, energy, mental load, and decide they’d rather opt-out entirely.”
That’s where things get scary, reflected Laura.
“Blindness, amputations, kidney failure, heart disease, these can all result from unmanaged diabetes,” and she continued, “when only about 10 percent of people with diabetes are cared for by an endocrinologist, the remainder rely on family doctors.”
This is a huge problem. According to the Canadian Medical Journal, 6.5 million people in Canada do not have access to regular primary care. In short, either they don’t have a family physician at all, or if they do, they can’t get timely appointments.
Laura has a solution. “We need to expand scope of practice for pharmacists, nurse practitioners, nutritionists. These allied health professionals are so integral. We need to rethink universal health care when so many people with complex needs, like diabetes, are falling outside of it.”
An overcrowded pool
Laura told me four million people in Canada have diabetes, but she provided a powerful analogy to illustrate her point.
“Imagine there are four million people with diabetes swimming in a pool.”
Some, like Laura, are in the shallow end. Others, with more severe illness, are struggling in deeper water.
“Then,” said Laura, “there are another six million people with their feet in the pool [with pre-diabetes], and millions more walking towards it.”
Add to these startling numbers that people living with diabetes are twice as likely to experience depression, and you have a scenario that’s doubly complicated.
“There’s diabetes distress, and then there’s depression, and we’ve got to be on the lookout for both.”
Diabetes distress comes from the constant anxiety and worry that stem from unrelenting decision-making, over and above the usual daily grind.
“One thing that’s unique about diabetes is that the onus is very much on the individual to manage their blood-sugar levels, and this could include lifestyle changes, oral medications, insulin injections, a pump etc.”
But calibrating those can be a challenge.
“It’s taken me eight years to find the right dosage. I won’t get into some of the awful side effects that can present when you don’t respond well to the meds, but at Diabetes Canada, this is exactly why we’re advocating for individualized treatments.”
Metabolizing trauma
Diabetes and depression go hand-in-hand, and Laura advocates embracing best-practices like trauma-informed care, which has long been a gold-standard in mental health treatment.
“We live in these imperfect systems, and I worry that the gap between the haves and the have nots is widening. And with this lack of access comes judgement – and judgement from healthcare providers can cause great harm.”
For example, a diabetic low or high can mimic intoxication. And, given that African, Black, and Caribbean people, as well as those of Indigenous heritage, have higher rates of diabetes to begin with, a bias – even an unconscious one – can turn deadly.
The whole conversation gets me to thinking about how we process trauma in the body, and the imprint it leaves.
People with depression have a 40 to 60 per cent increased risk of developing diabetes, and those living with diabetes are two to three times more likely to experience depression.
It’s that age-old “chicken and egg” conundrum.
But regardless of the order in which one develops these conditions, the metaphorical pool Laura spoke of is growing more crowded by the day.
“Someone slips in every three minutes.”
Until we can drain the pool, the life-sustaining supports these folks need include the kind of wraparound care Laura herself is lucky enough to have.
“Everyone living with diabetes should have access to medication, eye and wound care, a family doctor, and, of course, mental health care. This should be the rule, not the exception.”
Ending diabetes
In 2021, Canada celebrated the 100th anniversary of the discovery of insulin – among our country’s greatest achievements.
“As the birthplace of insulin, Canada has a legacy to uphold,” said Laura. “Yes, millions of lives have been saved, but millions more have diabetes than ever before. We cannot wait another 100 years for a cure.”
Laura points to a range of things people can do, to mark Diabetes Awareness Month, and to help Canada lead the world toward ending diabetes.
“You can get informed and know your risks, share information to raise awareness, or even take the time to declutter before winter, and donate clothes, décor, books, or small household items.”
As we end the call, Laura checks her monitor one more time.
“Won’t it be something when there comes a day when we’ve got a cure.”
Until then, Laura will remain on the clock – at home, and at work.
Author: Debra Yearwood
A communications pro with more than 20 years of executive experience in the health sector, expertly navigating everything from social marketing to crisis comms. When she’s not advising on the boards of Health Partners or Top Sixty Over Sixty, she’s busy finishing her book on thriving in later life (because why stop now?). Certified Health Executive by day, diversity advocate and magazine contributor by night—Debra’s the one you call when things need fixing or explaining.
