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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.
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Is spirituality back? Can micro-messages delivered via WhatsApp offer measurable improvements on well-being? These, and other ideas, were on the table at the 9th annual Electronic Mental Health International Collaborative (eMHIC) congress, hosted in September in Ottawa by the Mental Health Commission of Canada. Hundreds of delegates from dozens of countries came together to expand their thinking under the theme Digital Building Capacity: 24/7 Mental Health Support for All. The Catalyst team drew selected snack-sized insights and concepts for inspiration.
1. The Big Three
If you’re a young person, this likely comes as no surprise: their top three concerns are jobs, mental health, and climate. This finding from UNICEF guided the development of USupportME, an on-demand psychological support platform for youth. Piloted in several Eastern European and Central Asian countries, the platform is flexible and can be branded for use in different regions. With GDPR compliance and security support, it offers scalable white-label mental health services.
2. Ending the Google Loop of Despair
SANE, an Australian health organization for people with complex mental health issues, coined the term for a familiar cycle: being sent to a website, then a helpline, then a primary care physician, and finally referred to a psychologist—only to face a six-month wait, leading people back to “Dr. Google.” To break this cycle, SANE created a new model of psychosocial support focused on choice, continuity, open access, and quick response. Their approach includes self-referral, telehealth, digital programs, and group sessions, with an Indigenous-governed online learning space in their recovery community. They offer ongoing care, eliminating the traditional discharge model. “The future is in blended care models,” says CEO Rachel Green. It’s tech in service of people.
3. Soul Decisions
“Where did the soul go in clinical psychology?” asks Allan Donsky, a professor in the Department of Psychiatry at the University of Calgary and consultant at the Canadian Institute of Natural and Integrative Medicine (CINIM). He advocates for more contemplative therapeutic practices, beyond strictly diagnosis driven interventions, aimed at fostering self-awareness. Developing inner literacy can help people transition from languishing to flourishing by addressing big questions of self-acceptance, purpose, freedom, and relationships. Donsky notes that existential therapy was largely discarded in the 1970s, but there is a renewed interest in exploring inner dimensions—what might be called the heart, spirit, or soul. “What does it mean to be human?” he asks? It’s a universal question. “Every culture around the world has its ways of contemplating the deeper aspects of life.”
4. Family First
Mental health advocate Nicole Waldron referred to family caregivers as the very first responders. They are first on the scene to help family members, and they are often the unseen link in mental health care. Waldron gave a powerful address calling for better data collection and ecosystem support for family caregivers for their wellness, advocacy, and education. “What does a CTO mean? What does an SDM mean? How do you navigate a system where your loved one has been criminalized?”
(A CTO refers to a community treatment order and an SDM stands for substitute decision-maker).
Credit: eMHIC
5. One-Stop Help
Where to start? When there are so many options to choose from and you need support, what is the first step? Kids Help Phone launched Resources Around Me at the conference. It’s a directory of trustworthy resources from all across Canada. Kids Help Phone had 20 million interactions in 2020, and this directory helps them provide more support in more places and in more ways – virtual, text, in-person, and more.
6. Expressing Emotions in Sign Language
In Bangladesh, there are a total of 500 practitioners – 300 psychiatrists and 200 psychologists – for a population of 180 million – that’s a giant gap to fill. That’s where PhD researcher M Tasdik Hasan of Monash University in Melbourne, Australia, is piloting a project co-designed with deaf people, caregivers, healthcare providers, and sign-language interpreters. He notes deaf communities, in Bangladesh and the world over, are historically ignored when it comes to accessible and inclusive mental health solutions. They co-designed culturally and linguistically tailored tools to provide basic mental health terminology – such as PTSD, stress, and depression – in sign language.
7. Building Capacity in Small and Remote Communities
The ATIPAN Project provides telehealth services to Indigenous communities in the Western Visayas region of the Philippines, where access to healthcare is often limited by distance, challenging terrain (including islands, mountains, and agricultural or coastal areas), armed conflict, language barriers, and financial constraints. To address these challenges, the project implemented community-based patient navigators and infrastructure development over two years. Named after the Hiligaynon word atipan (“to take care of”), the project offers free consultations, training for community coordinators, and basic medications.
8. What’s App with That?
The Pode Falar project provides mental health support to Brazilians aged 13-24 through a website, Instagram, and WhatsApp. It features a chatbot named Ariel, who handles automated triage and offers assistance based on the complexity of users’ concerns. Users can access self-care tips (“I want to take care of myself”), read or share anonymous stories about overcoming challenges (“I want to be inspired”), and connect with a human agent for additional support (“I want to talk”). This large-scale initiative addresses mental health in an under-resourced area and was highlighted in a panel discussion: “Are Low to Middle Income Settings Ready to Benefit from Digital Mental Health Tools?” The program supports text, email, and WhatsApp messaging services.
Steal These Ideas
The congress’ regular sessions titled “Brag & Steal” offer permission to take projects that have worked well elsewhere and apply them to your own work. In that spirit, we want to underline a few cool concepts.
Pop Up Mental Health
Those attending a mental health conference tend to be a niche bunch, so why not bring it to the people? The Time to Change program that ran for 15 years in the UK until 2021 campaigned to reduce stigma through social contact. People with lived experiences of mental health issues had two-way conversations with unknown members of the public to debunk myths about mental illness. They went to concerts, libraries, and farmers’ markets, said Sue Baker, OBE, founder of Time to Change.
Of Sound Mind
Composer, sound artist, producer, and DJ Satya Hinduja, founder of Alchemic Sound Environment, taps into the connection between sound, music, technology, and health. Hinduja led a deep listening experience, designed to invoke states of reflection, receptivity, and exchange. Thinking about sound as a therapeutic experience gave participants a chance to reflect on the noises around them, frequencies, vibrations, and their own interiority.
North Star
There are so many mental health apps out there – how do we know what to trust? At the congress, the Mental Health Commission of Canada released Canada’s First E-Mental Health Strategy. This guiding star document has six priorities and 12 recommendations to chart the future direction and development of e-mental health in Canada. Use it to advocate, guide, and develop your work.
Narrative Care
Step by Step is a web application used in Lebanon that provides mental health support through storytelling. In the program, fictional characters with depression visit a healthcare worker, and users learn coping skills from a 15-minute illustrated story, observing how the character applies these techniques in their life. The second 15-minute segment is interactive, with the healthcare professional character delving deeper into therapeutic techniques and offering activities for users to reinforce what they’ve learned.
Overheard at eMHIC
- On getting things done: The words “collaborative action” – shortened to “collaboraction” was the name of the game – working together to advance mental health access.
- Beyond shiny objects: It’s not about technology per se, rather, “it’s about people and trust.” The tools enable this work and digital has no geopolitical boundaries.
- Making space for our work: Ian Hickie, professor of psychiatry, Brain and Mind Centre, University of Sydney, Australia, talked about “the Uberization of mental health.” If those with lived experience and research capacity in this field don’t respond appropriately, it leaves room for others to step in to respond consumer priorities: access, choice, competitive pricing, user experience. Worldwide, demand for personalized mental health services far outstrips supply.
- The meaning of it all: “We all get lifted when someone believes in us,” said eMHIC executive director, Anil Thapliyal, in his closing comments.
Coming up: The 10th annual congress takes place in Toronto, November 2025. Register your interest and learn more at: https://events.emhicglobal.com/register-your-interest-for-emhic-2025/
Further reading: Tech Support: Online mental health support is breaking down barriers.
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My conversation with Lori Radke, President and CEO of Crohn’s and Colitis Canada got real, very quickly.
Given that 2024 marks Crohn’s and Colitis Canada’s 50th anniversary, I asked Lori to reflect on that legacy. “Where have you been, and where are you going?”
“I can’t remember a time when Crohn’s and colitis wasn’t a thrum in the background of my own life,” explained Lori, an only child, whose mother was diagnosed while pregnant. “That’s over 50 years ago. And back then, there was zero information. Nothing.”
Five decades ago, despite its severity of symptoms, the disease was sloughed off by medical professionals as simply “all in your head.”
Mapping the mind-gut connection
Today, inflammatory bowel disease (IBD), of which Crohn’s and colitis are the most common forms, is understood to inflame the lining of the gastrointestinal tract. During acute flares, IBD can interrupt the digestive process from start to finish, including properly absorbing nutrients and eliminating waste. This can cause relentless diarrhea, severe cramping, and bloody stools. Treatments may stop working, and surgery is a frequent recourse.
In addition to physical symptoms, as many as a third of people living with IBD also experience anxiety and depression.
“Of course, today, we understand there is a deep mind-gut connection, and if we can successfully manage symptoms of stress through cognitive behavioural therapy, for example, we can better manage physical symptoms – but often that comes with an out-of-pocket cost. The hard truth is, we still don’t know what causes these incredibly painful and terribly inconvenient bowel diseases. And a cure isn’t yet on the horizon, though I hope we’re getting closer.”
Tech to the rescue
And it’s that gap, between where they are today, and a future cure, that Lori finds herself navigating.
“We were founded in 1974 by a group of concerned parents. Understandably, they wanted to find a cure. So, our efforts remained laser-focused on that, raising $150 million and distributing 400 grants – for research that is giving us realistic hope.”
But about six years ago, patients began urging the organization expand their mandate
“And we listened,” said Lori.
Patients affirmed that while finding a cure must be job one, improving quality of life, in the here and now, was a close second. Following those marching orders, Crohn’s and Colitis Canada quickly regrouped, zeroing in on the power of technology to open new doors – literally and figuratively.
The GoHere app is a prime example.
Conceived to serve an urgent community need – and created with the support of Amazon Web Services – it provides detailed information about publicly available washrooms in Canada with no-questions-asked access.
Retail chains, municipal buildings, government offices, and restaurants agree to be identified on the app. After downloading it, people can better plan trips and outings, or locate emergency washroom facilities nearby, without having to make a purchase or beg for admission.
It’s been downloaded 46,000 times, offering a trail of breadcrumbs to 3,450 publicly available washrooms, and counting.
Lori Radke, President and CEO, Crohn’s and Colitis Canada
Tackling the taboo
“It’s a simple idea, but it’s a huge game-changer,” explained Lori. “Having IBD isn’t like that one time when you or I had diarrhea last year. It can be utterly debilitating, and you can quickly find yourself isolated. Incontinence is still taboo. We all have bodily functions, but we have not normalized talking about them. GoHere is one way we’re trying to make a practical change – and, in doing that – change mindsets at the same time.”
In short, Crohn’s and Colitis Canada is striving to lessen the double burden of symptoms and stigma.
“We’ve created Crohn’s and Colitis Connect – a Facebook-style online platform exclusively for people living with IBD, and their caregivers – in direct response to a pressing desire for peer support among those living with the illness. It affects almost 0.9% of the population, so while it’s not uncommon, it’s rare enough that you may not know anyone who has walked a mile in your shoes.”
Which is where the Gusty Walk comes in.
Walking the talk
Held in 50 locations across the country, and racking in nearly $2.4 million, it’s both a major fundraiser, and a deeply valued community-building exercise.
“I remember this one family, and the daughter was just over the moon. She was practically glowing as she said to her dad, ‘Look! Look at the Port-o-Potties lining the route! You’re going to be able to do this!’ That kind of inclusion…we just don’t see enough of it.”
Speaking of inclusion, I asked Lori how workplaces are doing on the accommodation front, and what steps could be taken to make life easier for people who already bear the added burden of managing a complex, episodic illness – with often unpleasant and painful symptoms.
“I think there are small things employers can do, proactively. Tell people to take breaks throughout meetings should they need them. Normalize that. Offer wellness days, so people can choose to take time without having to give reasoning. But really, because gut and digestive health are not only invisible, but traditionally out of bounds for ‘polite conversation’, the only real solution is to ask for what you need. And that can be difficult.”
But Lori went on to say one of the things that brings her great joy is watching the tide slowly turn.
“Within our community, we have this brave group of influencers, like Paula Sojo, who lives with Crohn’s.”
The power of influence
Sojo underwent 15 surgeries and had an ostomy at 18. She’s turned something she says she once found repellant into a fashion statement, creating her own custom ostomy bag cover business.
“She is refusing to remain unseen, or to be silenced because her experience might make someone uncomfortable. She is standing up and saying, ‘I am beautiful, I am powerful, and above all, I am alive.’”
Because, added Lori, “As terrifying as the prospect of an ostomy can be, it can save your life.” And it’s this message, of pulling back the curtain, to better educate the public and even health-care providers, that is informing the way forward for the organization.
Life – interrupted
Awareness breeds understanding, which alchemizes into empathy. And empathy is critical for people living with Crohn’s and Colitis.
“It’s the only way we’ll create a society where the adults living with this today can speak openly and serve as role models to the overwhelming number of children who are being diagnosed and will have to navigate this journey throughout their whole lives.”
And while people are most often diagnosed before the age of 30, since 1995 the incidence of Crohn’s and colitis has doubled in kids under ten.
“It’s alarming, that’s for sure,” said Lori, who notes that in 2023, 11,000 people were diagnosed, meaning a new diagnosis every 48 minutes.
“It’s about so much more than numbers,” said Lori. “These are lives. Lives about to veer in a direction no one wanted or expected.”
Lives like a good friend of Lori’s 14-year-old daughter, who was supposed to spend the summer at camp, enjoying a carefree time with friends.
But instead of canoeing and campfires, she endured the season lying in a hospital bed, on a feeding tube, with a temporary stoma, having had 25 centimetres of her bowel resected.
After sharing this story, Lori paused, collecting herself. She glanced down at her desk and rifled through her papers.
“I prepared for this [interview], but this wasn’t in my notes. I was thinking about how when we go to see my daughter’s friend in hospital, my job is to support her mom. And if I wasn’t in this job, would I have the slightest idea how to do that? The answer is likely no. And that’s what we’re working so hard to change.”
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.
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The Book Club series profiles good reads that challenge stereotypes and stigmas – part of our Representations section on pop culture and mental health.
It’s not just gender bias – though that’s a useful umbrella term for the various societal ills, long-held beliefs, lack of data, historical hangups, and stigma that negatively impact mental health care for women.
All In Her Head
Author Misty Pratt is a science communicator and researcher based in Ottawa. She brings in medical research, interviews with practitioners, and her lived experience with mental health care into a book (Greystone Books, May 2024) that dismantles outdated concepts like hysteria, critiques the self-care industrial complex, and examines cultural constructions of mental illness.
It’s not you, it’s capitalism
In chapter 7 – titled Are You Mentally Ill or Mentally Overloaded? – Pratt underlines the link between burnout and depression, based on a study of Finnish employees. It suggests that people suffering from burnout are more likely to become depressed, while those with depression are more vulnerable to burnout.
Within this loop, Pratt notes that when women experience burnout – in a broad sense of being overly exhausted by the mental load and daily life – it is sometimes diagnosed as anxiety or depression. However, this could be a false diagnosis that overlooks larger economic and social issues – such as the patriarchy (Chapter 6) – leading to ineffective treatments.
Pratt asks readers to consider their situation more holistically. In other words, is the reason you can’t get out of bed more about the climate catastrophic world you live in, your economic situation, or a lack of power– rather than about you as a person?
Empowering eye-opener
“Personally, this realization completely changed the way I relate to myself and my mental illness,” Pratt writes. “I believe that misdiagnosing burnout feeds the illusion that mental illness is due to a personality flaw, negative mindset, my family’s genes, or an imbalance in my brain rather than an understanding that is closer to the truth: I’m facing a social problem that has real, lived emotional consequences.”
She found this realization freeing but notes it can be distressing to know you don’t have as much control over your well-being as you may have thought or been led to believe. However, a broader more fulsome view can set you “on a path to rediscover your own capacity, the ways in which you are limited, and what tiny actions of resistance you can make.”
Pratt is careful to not define what that resistance could or should look like for anyone. She checks her own biases in the book, actively avoiding what she calls the trap of “White Woman Wellness Syndrome,” that carries a privilege and often pushes simple fixes that are trendy or culturally appropriative. There are no affiliate links to jade eggs or corny affirmations to be found here. Rather, wellness culture and self-care are reimagined in a way that touches on our multitudes: spiritual, social, relational, cognitive, emotional, and financial.
Rewriting her story
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. She 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).
Another through line is the story of Pratt’s grandmother, Dorothy Mavis Buckler, who was contending with bipolar disorder in the 1980s, a time when we knew much less, stigma was painfully and systemically strong, and treatments were rudimentary. Pratt recalls her view as a then-five-year-old observing her grandmother’s state.
“When we lose our mind, where does it go?” she writes. “As our mind drifts past, do we jump and try to grab at it, as a young child would chase after a wayward balloon on a windy day?”
Clinicians acted as if her grandmother’s symptoms were exaggerated. Pratt explores the narrative of hysteria and wonders what might be different now for her grandmother. Contrasted with Pratt’s own experiences and research, the reader is left with a hopeful feeling – that things have improved, even if there is so much more to do.
For example, when Pratt gets lightly “manifesto-y” toward the end, her call-to-action is so sensible and straightforward that one wonders – why aren’t we there yet?
“My wish is for all women to have access to effective biopsychosocial treatment options, to consent only once properly informed, to receive support for their preferences and values, and to have better care in coming off medication,” she writes.
“This can be done in collaboration with psychiatrists, psychologists, social workers, patient advocates, and anyone else working toward better mental health care. In other words, we can find common ground to stand on, a place where the door opens to choices for each and every individual who wants them.”
Further reading: Lifeline: An Elegy: Stephanie Kain’s novel changes the narrative on supporting someone with mental illness.
Resource: Where to Get Care – A Guide to Navigating Public and Private Mental Health Services in Canada.
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The power of optimism
When I sat down with Kimberley Hanson to talk all things HealthPartners, I was curious to understand her optimism about the future of workplace fundraising.
“Charities are being asked to do more, with less. Illnesses are on the rise, but pocketbooks are stretched. What do we do?”
Kim smiled, a knowing expression on her face. “That’s the million-dollar question. According to Statista, charitable donations were down 371.7 million dollars from 2021 to 2022.1
She went on to say, “We’re living in polarizing times. And people are feeling pessimistic about the future. This bears out in surveys, and it’s no wonder. The pandemic is still casting a long shadow. Cost of living is up. The health-care system is stretched to the breaking point. And yet, I remain an optimist.”
Kim’s glass half-full outlook comes, in large part, from the work she does to bring awareness into workplaces across the country about the irreplaceable contributions of HealthPartners’ charities.
“They fill tremendous gaps. These charities are focused on the needs of people today – education, advocacy, services, and supports – and they are committed to finding better treatments and cures for tomorrow. We will all likely need their help at some point – whether that’s due to cancer, heart and stroke, ALS, the list goes on – and we will certainly know someone who does,” said Kim.
Collateral benefits
Given the importance of these issues to people in Canada, by bringing these charities to work, employers signal that they understand and are creating an opportunity for employees to conveniently learn more and contribute to something meaningful.
By engaging volunteers, HealthPartners provides access to those with lived experience to share their personal stories. The power of their first-hand accounts is two-fold.
They bring home the profound importance of the work carried out by HealthPartners’ charities, while empowering employers to foster a culture of generosity and social responsibility.
It’s in doing this double duty where the magic happens.
“It’s an antidote to pessimism. And it’s got tremendous collateral benefits. We’re seeing participating workplaces move the needle on accommodations, as just one example. Hearing about a person’s struggle to disclose, say, arthritis or anxiety…fearing a dismissive ‘pull up your socks’ attitude, can create fresh awareness and empathy. A light bulb goes on, and employers start asking themselves: How could we improve the experience of our own employees who might be struggling?”
Rejecting the machine mindset
Kim went on to explain further.
“Employees aren’t automatons. They come to work with their whole being. And they’re largely motivated by finding meaning – not just in their tasks and responsibilities – but in being part of a social fabric that aligns with their values. In short, why I am here, beyond the paycheck? Employees who feel that their employers were highly committed to their communities were two times likelier to be satisfied with their job. Employees who participated in donating and volunteer programs at work were 2.3 times as likely to stay at their job for the next two years.2”
This is borne out in employee engagement and retention, decreased absenteeism, and higher productivity. In fact, surveys conducted by HealthPartners on the heels of workplace campaigns show upwards of 95 per cent of employees are onboard with workplace giving, and 91 per cent would do so again.3
A shared language
Given the average adult spends a third of their life at work, Kim believes workplaces can be foundational in changing mindsets and dispelling myths.
I reflected that the MHCC made normalizing mental health at work a cornerstone of our stigma-busting efforts, sharing the belief that what gets talked about around the watercooler trickles down to the dinner table.
A great example of this is MHCC’s Opening Minds workplace training, which gives employees the tools and shared language to talk openly about mental health problems and illnesses, challenges and changes negative attitudes, and ultimately, reduces stigma. Both in the workplace, and beyond.
And stigma is hardly exclusive to mental illness.
In fact, many HealthPartners’ charities have heard from their communities that tackling stigma is top of the priority list.
Kim heartily agrees. “If I could wave a magic wand to make a major change within our health-care system, it would be the eradication of stigma. It cuts across virtually all our partners. It prevents people from seeking help. It contributes to the misallocation of funds. And it seeps into the unconscious bias of health-care providers themselves, which can compound or worsen the outcomes of illnesses.”
Kim has experienced stigma’s long reach first-hand. At 20, she began losing an alarming amount of weight. Her doctor dismissed her concerns, despite the hard-evidence of a blood-glucose test pointing to diabetes. Sadly, she didn’t present as a “typical” diabetes patient, so her concerns were roundly dismissed.
“That bias cost me two years of my life,” said Kim. “But by addressing stigma and the flip side of the coin, discrimination, we can make access to care more equitable.”
The collective advantage
Kim described the knock-on effect of collective action as being the secret to advancing changes that benefit everyone more rapidly.
When she worked for Diabetes Canada, for example, Kim set her sights on a National Diabetes Framework. She was told she’d never get buy-in from other health charities, focused as they were on their own needs.
But as a patient, and an advocate, Kim rejected this failed logic.
“This is not a zero-sum game,” said Kim, who forged strong alliances across the sector in pursuit of what she knew to be a mutually beneficial goal.
“I have diabetes, so that naturally puts me at greater risk for a host of other conditions: cardiac, kidney, depression…so whatever we can do to help people better manage or ward off the development of diabetes, will naturally be good news across the health-care spectrum. And that applies to many other illnesses as well.”
To a member, each charity is looking for ways to delay or prevent the onset of illness, where possible. And, when the cause of illness remains a mystery, as it often does, no stone is being left unturned in the pursuit of greater understanding.
Given the irrefutable comorbidities that link the communities of so many HealthPartners’ charities, a ‘better together’ approach makes sense, both morally and practically.
A holistic shift
“We aren’t walking organs,” said Kim. “For far too long we’ve treated people’s symptoms in isolation. A nephrologist for kidneys. A cardiologist for heart disease. You get the idea. But when something malfunctions in a complex system, what are the chances that another element of that system might fail? High. So, we need to start treating the whole person.”
And, Kim emphasized, that includes giving people with lived experience a voice at the health-care system decision-making table.
It’s this humanistic approach that sets HealthPartners apart.
Through workplace fundraising campaigns, it recognizes that employees are complex and multi-faceted, many spurred on by a drive to make a positive difference.
And via the health charity partnerships it forges, it highlights that differences don’t preclude common ground. Ultimately, it’s this powerful collective that will create a more responsive, inclusive, equitable health-care system – for all of us.
In the absence of a magic wand, Kim will continue to roll up her sleeves in service to this work.
- https://www.statista.com/statistics/478794/total-charitable-donations-in-canada/ ↩︎
- Imagine Canada 2019, Profit, Purpose, Talent: https://imaginecanada.ca/sites/default/files/2019-11/Profit_Purpose_Talent_WEB_EN.pdf ↩︎
- To be published in HealthPartners annual report – March 2025 ↩︎
Author: Allison Cowan
