Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
Using person-first language to make an important distinction
This article is part of the Catalyst series called Language Matters.
When talking about mental health, the language we use falls into two broad categories: person-first or identity-first. At the Mental Health Commission of Canada (MHCC), we typically use and recommend person-first language, but that choice may not apply in all situations.
What’s the difference?
Identity-first language leads with the illness or condition as opposed to the person experiencing it. For example: “schizophrenic person” uses schizophrenia as a descriptor before referencing the individual. Conversely, person-first language focuses on the individual while de-emphasizing the illness or condition. So, in this instance, if using person-first language, you could say, “an individual who lives with schizophrenia.”
The language used to talk about mental health or substance use can play an important role in reducing — or reinforcing — stigma. By focusing on the individual, person-first language underscores the fact that a diagnosis is only one component of someone’s overall being. It also shows respect for an individual as a person rather than as “abnormal,” “dysfunctional,” or “disabled.” For that reason, it is considered less stigmatizing and is often preferred in the mental health and substance use context.
That said, it’s important to bear in mind that this preference is not universal. As one friend explained, “I don’t live with bipolar disorder. It’s not my roommate.” For her, using identity-first language — “I’m bipolar” — better represents how deeply intertwined the condition is with every aspect of her life, while person-first language has a minimizing effect.
For others, identity-first language is rooted in the relationship between their personal and cultural identities and their condition. For example, deafness, which has a rich culture unique to those who share the experience, often emphasizes abilities over disabilities. In that case, “deaf person” might be preferred over “person who lives with deafness.”
How to choose?
In an American Psychological Association survey of 3,000 individuals living with a range of conditions, 70 per cent chose “person with a disability” when asked about the language that best describes them. “Disabled person” was chosen by just eight per cent.
When writing, the MHCC recommends person-first language as a first choice, unless you know that an individual or group describes themselves otherwise. When talking to a person with lived and living experience, listen for or ask them about the language they use. It’s not about getting it “right” on the first try. It’s about listening, learning, and championing the use of respectful, non-stigmatizing language — whichever form that takes.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
Educators play many roles and are increasingly called on to support youth mental health. Organizations are responding by equipping teachers with Mental Health First Aid training and tools.
In Canada, mental illness affects more than 1.2 million children and youth. By the time they reach age 25, that number rises more than six-fold to 7.5 million. These figures show just how much the early years provide the foundation for mental health and resilience throughout a person’s life. Since the start of the pandemic, concern over the mental well-being of youth has increasingly been a topic of discussion, particularly with the disruption of their routines.
Yet, as young people navigated from online school and back to in-person classes, the enormous pressure teachers have felt to develop additional skills for handling this mental health crisis has also affected their well-being. According to a June 2021 University of British Columbia survey, about 80 per cent of teachers reported experiencing moderate (56.7%) or serious (22.9%) mental distress.
As a result, the Toronto District School Board (TDSB) and the government of Saskatchewan have been investing in mental health training to give teachers the necessary tools to maintain mental well-being — for themselves and their students.
“As education workers, we work to educate Canada’s future generations,” said Mara Boedo, an executive officer with Toronto Education Workers (TEW), whose 17,000 CUPE members (local 4400) include TDSB employees. “This means that every positive change we can help our members make will impact the students in their care — and this will stay with them for the rest of their lives.”
The TDSB, which serves nearly 250,000 students across the district, has been investing in The Working Mind (TWM) since 2018. The course’s stigma-reduction focus is designed to promote mental health in the workplace by giving participants tools designed to assess their own mental wellness, identify signs and symptoms, and develop healthy coping strategies.
Mara Boedo
Teaching the teachers
After taking TWM, one participant’s recovery from mental distress became noticeable to others, including her family doctor, who asked, ‘What are you doing differently?’ “I have a new vision for myself,” she said. Through the course, participants work on changing behaviours and attitudes around mental illness by discussing resiliency, investing in their mental wellness, and exploring stigmatizing attitudes.
The participant was sharing this story with her TWM facilitator Cherill Hiebert, which led her to remark on the importance of teaching others about the small steps anyone can take to improve their mental well-being — rather than waiting until it gets to the point where a person needs professional help.
“That was the most powerful thing I have heard,” Hiebert said. “Without the program, that person would have had no vision because she had no hope.”
For these organizations, TWM signifies a proactive approach to their members’ mental well-being. But what happens when it’s too late for proactive measures? How can teachers prepare for a mental health crisis developing right in front of them? These have been long-standing questions for the Saskatchewan government.
Cherill Hiebert
Preparing for crisis
In December 2020, Saskatchewan announced a $400,000 commitment to provide Mental Health First Aid (MHFA) training to at least one staff member in each school in the province. MHFA enables individuals to provide help for someone who is either developing or going through a worsening mental health problem or experiencing a mental health crisis. Just like a person might provide physical first aid until medical treatment is available, MHFA is given until appropriate support is found, or the crisis is resolved.
When this funding was announced, Education Minister Dustin Duncan encouraged all the provinces’ school divisions to help remove the stigma around mental health. Such strong ministry support paved the way for coordinating training in 733 schools for 926 staff members. Every division now has MHFA responders with specific knowledge to support youth when they need it.
A hopeful future
These efforts to provide a more inclusive and sustainable approach to mental health in educational environments do not stop there. The National Standard of Canada for Mental Health and Well-Being for Post-Secondary Students, created by the Mental Health Commission of Canada (MHCC), enables academic institutions to better support students and integrate mental health into their services and systems. A starter kit to help them align their policies with the Standard and reaffirm their commitment to student mental health has now been downloaded more than 2,000 times, in settings of all sizes across the country. The Standard has also helped institutions continue their emphasis on student voices and perspectives, as we’ll see in a video series this fall where students will discuss mental health in post-secondary institutions.
The range of resources the MHCC has developed for the education sector is at the forefront of mental health and well-being for students, teachers, and faculty alike. One other example available to individuals and institutions is The Inquiring Mind Post-Secondary, an evidence-based training program to promote mental health and reduce stigma around mental illness.
Putting the right tools in hands of the people who educate Canada’s youth allows this impact to spread. In reflecting on the training and feedback received from participants, Boedo notes, “We are not only changing people’s lives, but we are also learning to change the way we approach the situations that are outside of our control.”
MHCC training programs are designed to increase mental health literacy, reduce stigma, and provide skills and knowledge to manage potential or developing mental health problems. To find courses and learn more, visit the MHCC Mental Health Training page.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
A national suicide prevention number – to launch in November 2023 – will bring 24-7 support to everyone
You’re a single mother in downtown Ottawa, off work due to COVID and distressed that you can’t cover the costs of rent and feeding your family. You’re an Indigenous teenager in northern Alberta trying to escape an abusive relationship. You’re a middle-aged man in New Brunswick who hasn’t told anyone how deep your depression is, and you feel like you can’t fight your suicidal urges anymore. You’re a refugee in small-town Ontario whose first language is not English, and you are experiencing frightening flashbacks to traumatic experiences of war. You’re a nurse in Vancouver, demoralized by the anti-vaccine protestors shouting at you as you go to work, where staffing shortages have brought you and your mental health to the breaking point.
Who do you call?
If you’re lucky, you’ll find the compassionate ear of a well-trained helpline counsellor in your community, who’ll listen as you tell your story, determine your level of suicide risk, de-escalate your stress, and connect you with the resources you need to get through this challenging moment in your life and set you on the way to long-term solutions and better times.
Still, in your state of mind you may not know where to turn. You might feel ashamed or embarrassed to admit you need help; or worse, you could be having suicidal thoughts. You might not feel up to searching for a 1-800 number — maybe you don’t have easy access to the internet and don’t know what supports are out there.
But what if we had a national three-digit suicide emergency helpline that everyone knew as well as they know 911?
That idea has been under serious study and development in Canada for several years, with enthusiastic support among suicide prevention experts, mental health professionals, and politicians at every level of government. Countries like the Netherlands and the United States have implemented a three-digit number, and in Canada a suicide hotline – 9-8-8 – will be accessible in all parts of Canada by the end of 2023.
According to Statistics Canada, about 11 people a day — 4,000 a year — take their own lives in this country. While the causes and circumstances vary, each loss is a tragedy that, for a host of unique and complex reasons, wasn’t prevented.
As the pandemic has unfolded, distress centres throughout Canada have been reporting higher numbers of people calling for help, particularly around addiction, job loss, the effects of inflation on the cost of living, and food insecurity. For those in the prevention field, a national suicide emergency number makes more sense than ever.
“The concept is widely accepted,” said Sean Krausert, executive director of the Canadian Association for Suicide Prevention (CASP). Based in Canmore, Alberta, Krausert was among many in the suicide prevention field in Canada (and internationally) consulted by the authors of Considerations for Implementing a Three-Digit Suicide Prevention Number in Canada, a 2021 MHCC policy brief that reviewed relevant literature and information.
“It’s more the logistical issues of putting this in place that will take time,” he said. “There needs to be a great degree of awareness in the public and strong funding to create a national service.”
Given Canada’s vastness and diversity, launching and maintaining a three-digit suicide prevention number is a complex task. Not only must such a service be built on the principles of equity and cultural inclusion, but it must also have a consistent technological infrastructure.
For example, for 9-8-8 to function from coast to coast to coast, 10-digit dialing needs to be in place where 7-digit dialing is still the norm, such as in Newfoundland, Labrador, northern Ontario, and Yellowknife. The Canadian Radio-Television and Telecommunications Commission (CRTC) says it may take until November 2023 to make the transition to 10-digit dialing in those locations. When the 9-8-8 system is up and running, all calls and texts to 9-8-8 will be directed to a mental health crisis or suicide prevention service, free of charge.
Additionally, access to well-trained counsellors must be made available 24-7 in every region of the country to serve diverse needs and to ensure that the help people require can be provided — whether they live in an urban centre or remote area, are young or old, speak English, French, or another language, or suffer from addiction, abuse, or mental illness. That means having one number for anyone in a suicidal crisis to connect to, no matter their walk of life, or their circumstances.
“Like a lot of guys, I always thought that whatever I had to deal with in my life, I would deal with it alone,” said Érick Légaré, in a 2019 video for the Association québécoise de prévention du suicide. Légaré, now 50, attempted suicide at age 45 and is grateful for the help he found when he was struggling. Today he has an urgent message for those who are feeling suicidal: “If you need help, know that it’s out there. You just need to let go and accept it. Talk to someone.”
Clearly, a national suicide helpline is a valuable addition to the supports already in place at the local and regional levels in Canada. “Whatever service it is, it is essential to provide immediate mental health supports 24 hours a day to the people in distress who call in,” said Andrea Poncia from Ottawa’s Community Suicide Prevention Network, who also pointed out that, for a national phone line to be effective, “funding has to be scaled up and maintained long term.”
Leslie Scott, manager of media and communications with the Distress Centres of Ottawa and Region, agrees that a national three-digit suicide emergency phone service is a good idea, and, once implemented, could take pressure off local non-profit distress centres.
“COVID has been intense,” said Scott, with more calls to the service than ever before. To succeed, a national service will need a “huge marketing campaign” to make sure people know it exists and understand what it provides. Like Poncia, Scott believes funding is essential for training those answering the phones, so they’re competent in best practices for helping a person in a suicidal crisis. Phone counsellors at distress centres in Canada now receive Applied Suicide Intervention Skills Training (ASIST), which enables them to offer “suicide first aid” to anyone who needs such support. National phone line counsellors will also need that, along with solid knowledge of what services are available to whoever calls, wherever they may be. That will enable them to triage and direct people to the appropriate help, both short and long term. An Indigenous teenager in Alberta will need something different than a middle-aged man in New Brunswick, an elderly farmer in rural Ontario, or a recent refugee of war with PTSD whose first language is not English.
“You need people who know how to actively listen,” said Scott. You have to be able to gauge a person’s mood, get into the nitty gritty with them. You need to be able to get to the heart of their story.”
The creation of a national three-digit suicide emergency hotline also serves another critical function: reducing the sense of stigma people may feel about asking for help or admitting they have a mental health concern. Scott notes that those taking the first step toward getting support may internalize stigmatizing language and perspectives.
“Unfortunately, some people still think that if they call for help, they’ll be taken away to the ‘loony bin.’ But of course, that is not the case,” said Scott. Knowing that there’s a phone number that anyone in Canada can use, any time, should contribute to the awareness that every human being goes through struggles, help is available, and you are not alone.
Karen Letofsky, one of Canada’s leading experts on suicide prevention — she became an Order of Canada member in 2007 in recognition of her years of service in this field — said the idea of a national suicide prevention number is something leaders in the distress centre community have championed for many years, getting started on partnerships to push the idea into reality in 2015. “We knew we needed a reasonable plan, and some pilot money. Once we had that we could start organizing. It’s been an ambitious goal to build capacity. If you increase access to a service like this, it means you need adequate resources and proper staffing to ensure success.”
It’s “a massive undertaking to provide universal access to a national suicide number,” she added, “but it’s definitely a worthy goal that will normalize asking for help.” While the many details surrounding funding, technological infrastructure, linking services, and training across the country are being worked out, Letofsky is optimistic that the partner organizations will continue to develop the best model for Canada.
Organizations that have been working with the MHCC and CASP include the Canadian Mental Health Association, the Centre for Addiction and Mental Health (CAMH), the Public Health Agency of Canada, Veterans Affairs Canada, and Kids Help Phone. Together, they’ve also consulted with organizations such as 113 Suicide Prevention in the Netherlands and the Substance Abuse and Mental Health Services Administration in the U.S., which also has a hybrid model that lets people choose to either text or phone the three-digit number.
More than anything, said Letofsky, the key to providing a quality service will be to ensure that those who answer the phones are “responders who are well trained in listening.”
It’s that one-on-one connection made between a caring human being and another in distress that’s critical. “Let’s not get caught up in numbers, statistics, and algorithms. Every person is unique. We don’t want to lose the personal story.”
The MHCC offers webinars, toolkits, learning modules, and a range of other resources on its Suicide Prevention page.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
Navigating the transition from full house to empty nest
One of the main ironies of parenting is that your job is to make yourself irrelevant. Babies are born, children are nurtured and grow up, and then one day — eventually — most are independent enough to move out of the family home.
At least that was a typical trajectory in Canada. These days, the transition isn’t always so linear. Economic challenges such as the high cost of housing and precarious employment, as well as socio-demographic shifts like the need for more post-secondary education, mean so-called “boomerang” kids leave and then return, sometimes repeatedly.
For the parents who are left behind, whether temporarily or forever, this passage into the next phase of life can be difficult to navigate. Yet, as a parent, it also represents an opportunity to renew relationships with yourself, your partner, your friends, and your family, including the child or children who are making the leap into their adult lives.
My wife and I are on the cusp of this change: Our twin daughters will be starting university this fall. To help prepare for this double departure, Lisa and I are spending a lot of time talking to friends, neighbours, and colleagues whose children have already left or are about to leave home.
One friend told us that her kids moving out changed her life more profoundly than when they were born. Another, whose father-in-law moved in after his daughters went to university, talked about the sense of flux in his household, with caring for aging parents also affecting the configuration of his nest. My own mother cautioned me that our house might feel like a train station for a while: you won’t know who’s coming or going, or how long they’ll stay.
Next station
Although the range of reactions and circumstances varies greatly, as a whole what people told us reflects research findings and advice from mental health professionals. For Simon Fraser University gerontology and sociology professor Barbara Mitchell, the “stereotype of the empty nest syndrome has largely been debunked as a cultural myth.” She takes a matter-of-fact view of this and other major changes in life. That is, to approach the empty nest phase as one of many junctions in a fluid existence while staying mindful and ready for whatever might follow.
Mountain biking in Charlevoix, Quebec: The author with Daisy, Lisa Gregoire, and Maggie. Transitioning from full house to empty nest is an opportunity to renew relationships with yourself, your partner, your friends, and your family, including the children who are making the leap into their adult lives
“Most parents actually find it to be a positive experience,” Mitchell says. “They’ve done their job and are now free from day-to-day responsibilities. They’ve established roots for their children — and wings — so they can become autonomous adults.”
Despite that general trend, if rooted in a traditional mom-as-homemaker role, some women feel a strong sense of loss when the kids leave, as of course do some men. While this sadness and disorientation (commonly called “empty nest syndrome”) are often short-term, she points out that about 20 per cent of parents struggle with it, and in extreme cases it can require intervention.
Mitchell, who has been researching family transitions since she was a graduate student in the mid-1980s and is perhaps the only academic in Canada with this expertise, notes that the empty nest is a relatively recent phenomenon in North America. Historically, at least one child regularly stayed with aging parents, especially in rural areas. But as our population became more urban, as life expectancies rose, and as the affluent middle class boomed after the Second World War, mothers and fathers increasingly found themselves alone in their later years.
Of course, parents from what she describes as “collectivist cultural groups” often have entirely different experiences, such as remaining within a multi-generational household or viewing the departure of a child for education or marriage as a sign of success. “The context of the family environment is important,” says Mitchell. “There are many potential complexities.”
Among these complexities are compounding stressors like health issues or retirement, which can exacerbate negative emotions.
Mental health and wellness in Canada is in fact influenced by numerous factors, including life experience, workplace, and family environments, and social and economic conditions that fundamentally impact our well-being.
Edmonton psychologist Loriann Quinlan, who specializes in treating adults with anxiety and has helped clients with empty nest syndrome and other life transitions, knows that every individual and family experiences this change differently. And since it can be accompanied by a range of emotions, from sadness and grief to excitement and joy, she advises clients to approach the process without judgment, to sit with any discomfort, and to engage in self-care.
Taking the time to become better acquainted with yourself, your partner, and others in your circle can be healthy, she says, because as parents we invest a tremendous amount of time and energy into relationships with our children. No wonder we’re knocked adrift and feel empty when such a critical part of our identity — for so many years — is no longer clearly defined.
As parents, we invest a tremendous amount of time and energy into relationships with our children. No wonder we’re knocked adrift and feel empty when such a critical part of our identity — for so many years — is no longer clearly defined. —
Making the shift
This transition also offers a chance to appreciate the perspectives of the young adults who are leaving and taking steps toward independence.
“It’s an amazing opportunity for parents and kids to see each other through a new lens,” Quinlan says, “and to shift the dynamic and hopefully connect on a deeper level.”
To get there, she recommends keeping the lines of communication open. Talking about thoughts and fears helps us understand where other people are coming from. Not shying away from conversations about well-being also helps us know when it’s time to reach out for support. That could simply be a chat with a friend or connecting with a more formal mental health resource.
While the internet is making that access a little easier, rapidly advancing communication technologies and other recent phenomena, such as the pandemic and the tight housing market, are also influencing how parents deal with the departure of their children, notes Mitchell, who wants to do more research on the impact of these “overlapping factors.”
On one hand, young adults are stepping into an increasingly uncertain world; on the other, you can make a video call with them no matter where they are. At least in theory.
My friend Eleanor Fast, who will be seeing her younger son off to university when my girls leave next fall, confesses to “stalking” her older son online while he’s been away at college in the U.S. for the past two years. He doesn’t always respond to her texts, and it can be difficult to schedule video calls, so she checks his Instagram feed — “for proof of life” — and looks to see if he’s posted any recent running routes on the exercise app Strava.
“The world may be more difficult than it was when I was 18 and left home,” says Fast, “but kids still need to get out there. They’ve been isolated for the past couple years because of the pandemic and have missed a lot of living.”
COVID was Fast’s biggest concern when her son left home — she was worried he would be lonely doing online classes while confined to a dorm room — but turns out he was fine. And although she and her husband truly enjoyed having a full house, they found it really nice when there was just one kid to focus on. They’re already planning activities they can do as a couple, such as taking long-distance bicycle trips together.
“I love my kids and love being with them,” says Fast, “but I want them to have their own lives, and making plans for the future helps counteract the sadness of them leaving.”
That sums up the mindset Lisa and I have as we reflect on the past and prepare for our next chapter. One of our daughters will be moving several provinces away in a couple months, and even though the other will be going to university in the city where we live, and recently decided to stay at home instead of residence in first year, we’re conscious of the fact that this is simply a new rhythm to experience.
Our children are no longer children. They — and we — are both excited and nervous about the journey ahead. And like many times over the past 18 years, we can learn a lot from them.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
Addressing a void in mental health care systems
Fabiola Phillipe
Fabiola Phillipe — mother, sister, and friend — was kind, compassionate, generous, and humble. She also lived with mental health challenges that stemmed from experiences of loneliness and isolation during her youth. As she struggled with depression, she began using substances — as a comfort and a substitute for the support and understanding she needed.
Before her death in 2017, Fabiola’s struggle with addiction had lasted nearly two decades. While these years included periods of both contentedness and hopelessness, help always seemed beyond her reach.
As she sought out different institutions over several years, she either had difficulty accessing services or was turned away because her needs were considered beyond the scope of care. In response to such experiences, Fabiola began staunchly refusing treatment — despite the urging of family members — who felt unequipped and powerless to support her while trying themselves to navigate confusing health-care systems.
Based on the gaps they saw in the system, Fabiola’s sister, Marie Philippe-Remy, and daughter, Lydia Philippe, launched Fabiola’s Addiction and Mental Health Awareness and Support Foundation (FAMHAS) in 2018 to promote awareness and advocate for change in mental health care for African, Caribbean, and Black (ACB) communities.
Missing pieces
Fabiola’s sister, Marie Philippe-Remy
According to a Columbia University psychiatry department article, the adult Black community is less likely to seek support even though its members have a 20 per cent greater chance of living with serious mental health problems. Black emerging adults (ages 18-25) were also described as experiencing “higher rates of mental health problems and lower rates of mental health service use compared to White emerging adults and older Black adults.” While there are many reasons for such lower access rates in ACB communities, a 2020 Ottawa Public Health study emphasized three common themes: cost, wait times, and difficulty finding culturally competent providers with a shared identity and experience. By making care more difficult, these barriers exacerbate their mental health challenges.
As she provided support to Fabiola, Marie began learning more and more about mental health care systems. Yet, as her main champion, she often felt depleted when she could not find the care her sister needed. She was also regularly frustrated by her own inability to understand how Fabiola felt trapped by her depression and substance use. “How can you not want to get better?” she recalled asking herself at one point. Although caregivers who experience mental health challenges when supporting a loved one in crisis frequently express such sentiments, Marie’s question would help define FAMHAS’s focus: to address access barriers and stigma while offering complex, nuanced, community-focused care for ACB people experiencing mental health challenges.
Access and understanding
Fabiola Phillipe
Once FAMHAS was launched, it didn’t take long for Marie and Lydia to realize that ACB communities had little formal knowledge on mental health. Even after a dedicated search, there was no way to ignore this glaring gap. Where, they wondered, was the research, information, and organizations geared to mental health in these communities? With no answer in sight, they decided to use their own lived and living experience and reach out to their network.
“The best way to learn and reach the community was by actually talking to people,” Marie said. She explained that connecting with people who had been through similar situations was key to connecting, spreading awareness, and promoting understanding. Mental health has many faces and stories, but if you don’t see those people and hear their stories, how do you move past something like stigma?
The urgency of the foundation’s work became increasingly clear after key themes emerged from just a few conversations. For example, Marie and Lydia found that people wanted to break through what they saw as taboo. Simply having an open conversation about mental health and acknowledging it as a priority provided space for people in ACB communities to speak more freely. Without having to explain or defend themselves, meaningful conversations soon followed — and that had a domino effect. When FAMHAS presented its first Black Men Experience workshop, there were just two participants. But as word spread, it grew to 15, then 20. The Real Talk: Black Youth workshop saw a similar pattern.
“So many people are suffering in silence, and simply knowing that there’s help out there can change somebody’s life,” Marie said, noting that support is needed for those experiencing mental health challenges and other issues. She therefore advocates through FAMHAS for support systems that spread across networks and communities in a culturally relevant way, while acknowledging the complexity and diversity within ACB communities, which comprise numerous religions, cultures, languages, and ethnicities beyond a single “Black umbrella.”
That said, more work is needed to treat people in these communities with mental health concerns. Recent research from the Mental Health Commission of Canada (MHCC) found that trust is improved when the help seeker believes a health professional can relate to their experience. From the deep-rooted impacts of anti-Black racism to intergenerational trauma and cultural biases, sharing common ground facilitates connection building between patients and care providers. Unfortunately, few ACB psychotherapists are available in Canada today.
Because representation, cultural competency, and questions of affordability loom large — as do long wait lists — Marie sees that endorsing mental health work as a viable career path for ACB individuals is an important step in meeting this challenge. In the meantime, other steps being taken can be seen in the MHCC’s Case for Diversity project, a compilation of practices that are working in communities across the country.
So far, FAMHAS itself has also been able to offer 1,629 hours of free counselling — across seven provinces and territories in nine languages — to 701 applicants through a network of mental health professionals who have dedicated their personal time to the success of its mission. About 20 ACB professionals were able to see more than 400 applicants in three months, with a maximum wait time of just two weeks.
Marie is intent on building the foundation’s directory so more people can access such services. While free counselling is on hold until FAMHAS reignites its fundraising events, a gala is in the works for May 2023 that will help them generate funds while bringing communities and organizations together to celebrate ACB art and contributions to mental health awareness.
She is keen to continually cultivate community — the identity, belonging, and connection that lead us to a sense of safety, security, and happiness — in other words, the things that make us all feel supported and less alone.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
Talking to retail, front-line, and essential workers about their pandemic experiences
For employees, the past two-plus years have been a whirlwind. After COVID-19 threw the world into disarray, people were forced to grapple in the dark and adjust to new work environments.
While the months passed, we went from lazy days on the couch and socially distant driveway beers with neighbours to becoming lethargic, lonely, and frustrated as the lockdown cycles began taking their toll. Wave after wave kept crashing, but we slogged through while feeling imprisoned in our homes day after day.
Megan Di Lucca
Well, at least some of us did.
This experience of COVID-19 is not universal. Lounging on the couch and lingering on the driveway is an option if you have shelter. But the reality is that many people don’t have the free time or space to enjoy these luxuries. Complaints about Zoom fatigue can sound trivial if you’re on the front lines doing essential work and have never had the option of working from home.
Yet that’s the case for the vast majority of Canada’s employees who sustain our society, whether they work in retail, manufacturing, and construction or as medical personnel, social workers, and delivery drivers.
Among them is Megan Di Lucca, a cashier at Save-On-Foods in Victoria. Looking back to those first frantic days of 2020, she recalled the unusual behaviour from some customers; in particular, how they relieved their stress by snapping at one another or at staff members.
“With everyone buying as much toilet paper, canned goods, and random products (like yeast) as they could, all I could do was to ring in their unusual choices with a smile and do my best to help ease their stress by listening. While hearing what customers had to say helped them, it also helped me realize that it was important not to let others’ personal matters affect me.”
Yet Di Lucca was experienced enough to be able to find her way through such challenging situations. For those who are new to the workforce, that isn’t always the case. As Ottawa theatre-chain manager Shane Bennett pointed out, “many people in front-line and retail roles are young and inexperienced or are trying to balance personal issues while working in fast-paced environments.” Beyond those challenges, most of these roles are paid less on average than other jobs and are classified as contract or “gig positions” that offer few if any benefits or leave provisions. Because such employees can’t work from home if they’re ill or fear being exposed to the virus, their choice is as harsh as it is simple: go to work or sacrifice a day’s wages.
Shane Bennett
Compounding factors
In speaking with friends and colleagues who work in essential roles, it’s clear that they’re trying to come to terms with the shifts their lives have taken during the pandemic. Many are contending with personal issues, which have been made more difficult by stressors such as the threat of illness, financial strain, job insecurity, and diminishing mental health.
Not only have front-line workers faced layoffs and uncertainty in their jobs, they are also at greater risk of exposure to the virus. Many go home to immunocompromised family members after having to work a shift with inadequate personal protective equipment.
While managing their own stress, these workers have also been forced to deal with the stress of countless others each day. This may not be a new phenomenon for those who work with the public, but the situation has certainly gotten worse during the pandemic. In addition, they’ve been made responsible for enforcing ever-changing public health mandates — safety measures that are new to everyone, including themselves. When employers expect them to monitor actions to keep patrons and themselves safe, front-line workers take the brunt of the frustration from the customers who refuse to comply. With so many other stressors in their lives, that’s an enormous responsibility — one that has increased the abuse, harassment, threats and violence they face. According to Bennett, his theatres have been forced to call police on multiple occasions to help them deal with such incidents.
Because employees can’t work from home if they’re ill or fear being exposed to the virus, their choice is as harsh as it is simple: go to work or sacrifice a day’s wages. —
Pathways to support
Front-line workers do jobs that are typically undervalued and require a lot of physical and emotional energy. One example is “Sabrina,” a veterinary technician at an animal hospital in Eastern Canada who worked in emergency and critical care as well as speciality surgery. The hospital was the only 24-hour location in her region. It also accepted cases from remote locations (including Nunavut and Newfoundland and Labrador), making it essential to locals and clients across this wider area.
At the beginning of the pandemic, Sabrina’s workplace provided room for dialogue and supported employees who had to care for their children, were themselves unwell, or experienced reservations about bringing the virus home to immunocompromised family members. But after a few months this open approach seemed to change. Still, she worked her regular shifts and often stayed longer to assure the job was done correctly, putting in 10-12 hours on her feet while backfilling for others who had left the clinic. As demand continued to surge, Sabrina put in many extra weekends. Yet eventually, she became burned out and — with a sense of disillusionment — decided to leave.
“Sabrina”
As with many care workers in this situation, her decision was a difficult one. Contending with a sense of guilt about what would happen to the clinic’s quality of care if she left didn’t allow much time to tend to her own health. When she did start down the path of addressing these concerns, she pushed them from her mind when she thought about the tedium of it all. “You have to do a lot of legwork to get the help you need, and so you can feel less inclined. When you’re physically and mentally exhausted, the last thing you want to do is go figure out how to help yourself,” she explained.
Sometimes that sense of bureaucracy does become a barrier. That’s especially so for front-line workers in short-term or contract positions, who must endure long wait times and probationary periods to access care. Having to change roles and negotiate new contracts can also feel like too many hoops to jump through, especially when people are also dealing with financial and other stressors.
At the same time, such experiences are opening conversations around the workplace shifts that are needed to support front-line and essential workers — beyond platitudes. For example, employers are helping their staff implement empathetic listening in their interactions. Or, like Bennett’s theatres, they are investing in The Working Mind, evidence-based training from the Mental Health Commission of Canada that helps participants overcome stigma around mental illness. “The Working Mind is all about giving managers the tools to see changes in their staff and identify where they are on the mental health continuum,” he said. “It gives us a template to frame difficult conversations and be mindful about the mental health of our teams.” Once managers have the skills and tools they need, his company intends to roll out The Working Mind to all its employees. “I hope that makes it easier to discuss mental health in the workplace,” he added, “and that it allows our workers to feel better supported.”
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
They’re called comfort foods for a reason: sugar, salt, and carbs give us a quick boost of flavour and familiarity. Making the case for comforting foods that nourish our mind and body.
“You are what you eat” — We’ve all heard the saying. It’s meant to nudge us toward healthier choices, but it doesn’t reflect all the links between diet and health, including the connections it has with chronic conditions such as diabetes, high blood pressure, obesity, and stroke. It also doesn’t include research over the past 50 years showing how much nutritional choices effect our brain and mental health, which is so striking that we should probably add “Good food for a good mood” to the phrase.
Dr. Bonnie J. Kaplan
Research into the connections between nutrition and mental health began in 1972, when Bonnie Kaplan, then a grad student in experimental psychology, started looking into the physiological and psychological effects of malnutrition during pregnancy and the first few years of life. When she published “Malnutrition and Mental Deficiency” in the Psychological Bulletin that same year, her results struck a chord. She was deluged with requests for reprints of her groundbreaking research, which became the precursor to the field of nutritional psychology. The article’s key takeaway still resonates: “We can’t control our genes, but we can control what we eat so that we can be better nourish our brains and our mental health,” wrote Dr. Kaplan, now a retired research psychologist.
More recently, she co-authored The Better Brain: Overcome Anxiety, Combat Depression, and Reduce ADHD and Stress with Nutrition with Dr. Julia Rucklidge. The book takes a nutrition-first approach to mental health in relation to resilience with a focus on tryptophan — an essential amino acid in the nutrients we can consume — and its connection to serotonin, the “feel-good hormone” that can affect our mood. A short article like this could never fully explain the process of enzymes, co-factors, and chemical reactions involved, but a building-block effect Kaplan describes in her lectures has led her students to the “aha” moment where they can see these connections and are inspired to improve their diet.
The book’s suggestions for healthy eating are by now well known — whole foods (not ultra-processed), fewer carbs, less salt and saturated fats, and a preference for Mediterranean-style cooking — and originate in the “SMILES” trial (2017). In that study, participants with severe depression were randomly placed into two groups, one receiving social support and the other nutrition counselling that recommended a Mediterranean diet of fruits, vegetables, legumes, seafood, olive oil, and seeds. While both groups’ symptoms improved twelve weeks later, people in the Mediterranean diet group saw greater improvement, with 32 per cent of participants’ depressive symptoms going into remission (versus eight per cent for the social support group).
You seem “hangry”
I ask Kaplan: Can you give me a sense of how that happens? Well, she explains, “We cannot eat serotonin in food, right?” Like a rapt student I jot down the key point: “There is no food that contains the feel-good hormone, so we must eat things that enable our bodies to manufacture serotonin and other necessary micronutrients.”
Suddenly, I feel peckish. Chips come to mind — mmmm, all that satisfying salty, carby crunchiness. Except that I also just learned we need at least 30 different micronutrients to properly support our brain’s metabolism, which runs every minute of every day. Such ultra-processed foods can fill our stomach, but they also starve our brain because they’re deficient in vitamins and minerals. It’s the cerebral equivalent of feeling hangry when you’ve waited too long to eat. Kaplan calls this state “hidden brain hunger,” which happens when we consistently lack necessary micronutrients, so the brain lacks what it needs to function optimally and support our mental health. Why is this “hidden”? Because the resulting effects are not always directly felt.
These days, price hikes from inflation make stocking the pantry with such foods a costly challenge for many. Having limited access to fresh foods is also a problem, particularly for those living in food deserts, who must pay even more with the additional time and travel. —
No easy answers
It turns out that our brain is actually the greediest organ in our body: while it accounts for just two per cent of body weight, it absorbs at least 20 percent of all the nutrients we consume, Kaplan says. Feeding that beast means nourishing the brain with micronutrients. Canada’s latest food guide snapshot shows us what this could look like: filling half the plate with a rainbow of fruits and vegetables, and each of the other two quarters with protein and whole grains.
If only it were that simple.
These days, price hikes from inflation make stocking the pantry with such foods a costly challenge for many. According to Food in Canada magazine, grocery prices have spiked more than seven per cent over the past year — the fastest increase in 13 years. Canada’s Food Price Report forecasts that the most significant increases for 2022 will be in the healthy food category, including dairy and vegetables. That means, an average family of four will pay nearly $15,000 for food this year, almost $1,000 more than in 2021. Having limited access to fresh foods is also a problem, particularly for those living in food deserts, who must pay even more with the additional time and travel.
While Kaplan’s findings can tempt us to draw easy parallels between a change in food and mood, depression is a complex state for those who experience it. We should also keep in mind that changes in diet alone are no substitute for seeing our physician or therapist and taking prescribed medications. Still, as the field of nutritional psychology grows, it is helpful to see its recommendations become part of an integrative or alternative treatment for mental health challenges, something that one in five people in Canada live with.
Views and opinions expressed in this article do not necessarily represent the views and opinions of the Mental Health Commission of Canada.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
It’s Pride Month! These celebratory events — signature weeks and months, T-shirt days, and other public acknowledgments — provide visibility and a sense of collectivity. Let’s not let the colours fade when the calendar changes.
We skipped toward the main drag with our extended family for some quality time after months apart because of pandemic isolation orders. It was nice to be off screens and among people as we took in the sights on a Sunday in small-town Ontario. This day had all the check marks: great weather, ice cream stands, antique shops, people picnicking, and traffic that halted for jaywalkers zigzagging from shop to shop. At the strip’s entrance was a rainbow crosswalk, providing a highlight for pedestrians entering the busy thoroughfare, and visibility of another kind. Pride crosswalks are designed to promote inclusion and awareness of 2SLGBTQ+ communities, and they range from six-colour rows to chevroned designs that underscore intersecting identities.
Like a lot of municipal infrastructure, this particular project needed an update after a few years of wear and tear. The chipped paint seemed like a bit of handy symbolism as I reflected on Pride Month and many symbolic days and months that bring people together around an issue and idea — which sometimes fade away when the calendar page flips.
The well-being of people with diverse gender identities can be greatly affected by the characteristics, norms, practices, and spaces of our institutional environments. This is reflected in the things we see and the actions we take. —
On this day
“I’m Black all year,” a friend likes to quip as we head into February and she bemoans the litany of requests for very visible speaking engagements, which arrive in the weeks before Black History Month, while offers for secure and steady paid work in her field never materialize. When you experience the gap between a passing visibility and the very real inability to provide for yourself, acknowledgment months can sometimes feel like window dressing. I suppose that’s part of the risk of putting a lot of energy into special months or T-shirt days. But it might also lead us to ask ourselves what contribution is being made. Is it a surface effort? A small step toward systemic change? I’m not ready to write off these events just yet — though their snapshot effect may obscure the complexity of the lived and living experiences in the communities being recognized.
The tagline for GLADD, the American media advocacy organization, says that it “rewrites the script for LGBTQ acceptance.” Its Pride Month Resource Kit for journalists takes a huge step toward this by highlighting some of the pitfalls and assumptions telegraphed through footage and images in Pride events coverage. “No single image should be put forth as representative of either the LGBT community or the range of events that occur at Prides,” it counsels, noting that “colorful and unconventional participants play an important role at Pride events and celebrations.” GLAAD encourages journalists to “avoid the tendency to ignore the diversity that exists at Pride events,” since relying on “outrageous or over-the-top images and footage marginalizes subjects by taking them out of context to depict them as abnormal — perpetuating misconceptions.”
These suggestions bring to mind the drag parade float images of past coverage and lead me to realize how such things can become visual shorthand for progressive movements that are dynamic and complex. Such movements can also quickly become co-opted from their origins in social change. Recent protests to counter “rainbow-washing” — supporting anti-2SLGBTQ+ interests while claiming public allyship with 2SLGBTQ+ communities — have emerged alongside calls to extend Pride initiatives beyond one month, particularly in remote communities.
Representation matters
The well-being of people with diverse gender identities can be greatly affected by the characteristics, norms, practices, and spaces of our institutional environments. This is reflected in the things we see and the actions we take. For the Catalyst, the Mental Health Commission of Canada’s (MHCC’s) online magazine, this means avoiding oversimplification in our storytelling while emphasizing recovery and optimism. We want to offer hope, but not false hope — and no single, tightly construed narratives. In other words, we believe it’s important to recognize the both-and in any given experience — a perspective illustrated in recent COVID-19 research. New Leger polling for the MHCC and the Canadian Centre on Substance Use and Addiction shows that 2SLGBTQ+ communities have faced heightened rates of stigma, discrimination, and harassment during the pandemic yet were also feeling more resilient, hopeful, accepting, and inclusive.
The poll’s other findings reflect a similar complexity. While about one-quarter of 2SLGBTQ+ respondents reported excellent or very good mental health during the pandemic, rates were significantly lower for 2SLGBTQ+ youth, people from low-income households, and those from East and Southeast Asian, South Asian, and African, Caribbean, and Black (ACB) communities. This same pattern was found in connection with the stresses of COVID-19. Though only half of 2SLGBTQ+ respondents reported being able to cope with pandemic stress, fewer 2SLGBTQ+ youth and ACB respondents could do so.
On an individual level, we also have a chance during Pride Month to reflect on its evolution and what it means for Indigenous communities. As well, we might consider why something so seemingly simple as crosswalks are being subjected to defacing and vandalism, thus reducing the visibility of that quiet sign of support. In context of the pandemic, Pride can be a chance to build networks to support 2SLGBTQ+ youth and racialized communities, who are contending more than most with overlapping crises, by being an ally throughout the year.
Subscribe to Catalyst
Subscribe to get our magazine delivered right to your inbox
Share This Catalyst
Related Articles
When older adults make the move into care homes, it becomes essential to forge new bonds. Finding ways through loneliness and isolation with music.
Evidence that strong interpersonal connections are essential to our mental and physical health is growing. And these ties may be more important as we age, particularly among older adults living in retirement residences and long-term care homes. According to Dr. Kristine Theurer, who’s been a researcher in the long-term care sector for more than two decades, “We all yearn to connect with others, and for many people, moving into a residence means seeing friends and family less frequently. So it’s crucial for them to make new connections.”
The harmful effects of social isolation and loneliness on mental and physical health are well known. Several studies have found that isolation increases the risk of cardiovascular disease, obesity, anxiety, and depression and that loneliness can lead to depression, alcoholism, and suicidal thoughts.
During the pandemic, public health measures such as masks, physical distancing, and size limits on gatherings have added to social isolation and loneliness. In retirement and long-term care homes, in‑person visits with family members and volunteers were banned for months, and residents only interacted with staff wearing protective masks, face shields, and gowns.
While these conditions pushed isolation to the limit for these residents, growing public concern was at least able to bring more attention to the issue and give Theurer a chance raise awareness about fostering human connections. A 2015 article she was the lead author on in the Journal of Aging Studies article had already documented the value of standardized peer support and peer mentoring. “The Need for a Social Revolution in Residential Care” argued for an overhaul of programming in retirement residences and long-term care by incorporating activities that advanced residents’ social identities, encouraged reciprocal relationships, and increased social interaction. The goal of that vision was to transform the model of resident care into one of resident engagement — a state that covers basic needs but also allows people to thrive and be enriched.
“Many homes focus on light group activities, such as games and crafts, without recognizing that the crucial benefits actually come from meaningful interactions between peers,” Theurer said. “The focus needs to be on building those meaningful connections.” —
She began harnessing the power of peer support groups and peer mentoring to foster meaningful interactions in 2011, after founding Java Group Programs. The efficacy of the organization’s three research-based programs — Java Music Club, Java Memory Care, and Java Mentorship — has since been demonstrated in a series of studies. Today, hundreds of retirement residences and long-term care homes across North America have implemented them. The most popular is Java Music Club, a peer support activity that focuses on interaction and altruism.
Laura Forsyth, regional manager of life enrichment for Chartwell, a company that runs more than 200 residences across four provinces, has seen its effectiveness firsthand: “For our residents, Java Music is magical,” she said. “I regularly see residents who don’t know one another bond and connect through the program.” After we implemented it in 2014, “Java Music has been so successful that it has influenced Chartwell’s corporate culture. We now emphasize meaningful interpersonal connections in nearly everything we do.”
While preventing social isolation and loneliness might sound easy, it isn’t — especially for older adults struggling to adapt to life in a retirement residence or long-term care home. Most residences and homes don’t offer programming that fosters meaningful connections.
“We still have much to learn about the mental health and well-being of people living in long-term care and how to optimize their quality of life,” said Danielle Sinden, who is the director of the Centre of Excellence in Frailty-Informed Care. Part of Perley Health, which serves a community of more than 600 seniors in long-term care and independent-living apartments, the centre conducts and shares the practical research needed to improve care.
Several of its research projects focus on the mental health and wellness of older adults. One pairs up residents living with Alzheimer’s disease with university students and tracks the results over many visits. Another promotes social connection, emotional health, and meaning in life through an online peer support group. The centre is also evaluating Java Music among a group of residents in long-term care.
“I think there’s something about being a passive recipient of care that fosters loneliness and depression,” said Theurer. “Helping others is a pathway to joy and meaning. Properly designed group programs provide opportunities for people to help their peers. And that makes us feel good.”
Informal caregivers who are concerned about the mental well-being of loved ones can find other strategies to help build connections in the Caring for Older Adults During COVID-19 tip sheet from the Mental Health Commission of Canada and in ongoing research into other aspects of caring for older adults.