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There is no strong silent type when it comes to men’s mental health
By Michel Rodrigue
Michel Rodrigue, left, enjoying a soft drink (a treat!) in preparation for the hockey game – the Montreal Canadiens, of course.
Long before I knew what mental health was, I knew that men didn’t talk about it. Certain topics were simply off the table, with deep personal feelings heading the list. To talk about those things would be unnatural, unwelcome, and uncomfortable — not to mention unmasculine.
It was only later, when I learned the concept of stigma, that I understood the truth. When men stay silent, it hurts everyone, most of all themselves.
Of the roughly 4,000 suicide deaths in Canada each year, 75 per cent are men. For men between the ages of 15 and 39, suicide is the second leading cause of death (after accidental death). Clearly, we have a lot to talk about.
Stigma breeds silence
My father worked in construction most of his life. In his all-male crew, if someone was injured on the job, the first aid response was unflinching. There was no hesitation about doing or saying the wrong thing. There was no reassessment of that person’s masculinity or judgment of their character. Everyone understood the reality — that it could have happened to any of them.
In the same way, no one is immune to mental illness. Yet, if someone would have had a panic attack on the job site, I suspect the response would have been entirely different. That’s stigma at work.
But there’s another feature that sets mental illness apart — it’s invisible.
We can see the limp of an injured leg or read the temperature of a fever. Mental health problems, on the other hand, often hide in plain sight. —
I learned this the hard way when I lost a close friend to suicide.
From the outside looking in, Sylvain had everything to live for. A loving wife, two beautiful daughters, a caring family, close friends, and a thriving business. At least, that’s what we thought.
It was only after his death by suicide in May 2005 that we learned he’d been pretending to go to work for many months.
I try to imagine what that time must have been like for him. How ashamed and embarrassed he must have felt to keep that secret so closely guarded. I think about the role stigma played in his death. And I think about how much work we still have ahead of us, especially men.
Turning insights into action
In my seven years with the Mental Health Commission of Canada, I’ve learned a lot about men’s mental health. I’ve learned about the growing evidence of a distinct male-type depression, characterized by externalizing symptoms such as irritability, anger, and substance use.
A young Michel with his parents Lionel and Lucille.
I’ve learned that while loneliness, substance use, and depression are among the strongest risk factors for suicidal behaviour in men, other factors put certain subgroups at an even higher risk. For example, the rates of attempted suicide for First Nations, Inuit, and Métis who identify as sexual and/or gender minority men (including gay, bisexual, men who sleep with other men, and transmen) are up to 10 times as high as for men in this group who are non-Indigenous.
But perhaps the most important thing I’ve learned is that, as men, we need to get comfortable being uncomfortable. Talking honestly about our mental health is one of the best ways we can protect it, no matter how unnatural it might feel at first.
At best, the cost of silence is isolation, even in the company of other people who would willingly offer their support. At worst, that silence can cost a life. It’s time for all men to embrace the discomfort, break through the masculine ideals, and leave nothing off the table.
Michel Rodrigue is president and chief executive officer of the Mental Health Commission of Canada.
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Showing Support Means Not Having All the Answers
Cuba Gooding Jr. as Rod Tidwell and Tom Cruise as Jerry Maguire from the 1996 film, which led to countless “help me, help you” memes.
A popular quote from the movie Jerry Maguire is, “Help me help you.” It comes from the scene where the namesake character, played by Tom Cruise, is coaching football player Rod Tidwell, played by Cuba Gooding Jr., who is digging in his heels and resisting advice. It’s a familiar exchange that you may recognize in yourself. I know I do. If I see someone in pain, I have the strong desire to jump in and “fix” what I believe to be the “problem.” Despite that desire, I have learned that support does not equal fixing. It’s not my job or your job to fix others.
Let’s start at the point where you have recognized a mental health “problem,” say with a loved one, colleague, or friend. Perhaps you see the signs and symptoms of a decline in their mental well-being, or else the person has told you directly that they are going through a mental health problem. In that moment, it can be tempting to think, “What has worked for me will work for them.” If that happens, it’s natural to want to try and fix things by giving advice on how to make it all better. You may even want to give them a toolbox full of fix-it things.
But there are good reasons not to do that.
“Effective support can also involve sitting beside someone — not speaking a word, simply being there while providing a safe space for them just to be.” —
SHOULDA, COULDA, WOULDA
First, it’s best not to assume we know how that person feels and what they should do. I often say, “Don’t let anyone “should” on you today, and don’t “should” on yourself. So, let’s get away from our preconceived notions of what the person should do.
Whenever I hear the word should, I try to consider where it’s coming from and what intentions are behind it. Who has the right to say what we should do anyway? Who are they to decide what is best?
The desire to fix by “shoulding” ignores other possibilities. What if they’ve already tried what worked for you and had little success? What if it’s the first time someone has really been a witness to their pain? What if they say, “everything is fine,” and go away? What if your timing isn’t their timing (excluding situations of imminent harm to themselves or others)?
A more helpful approach is focusing on how their behaviour is impacting the life they want to live. It’s better to build rapport and trust or encourage them to seek professional (or other) support than put them on your to-do list. They are not your project. And there’s no need to keep at them with questions such as, “Did you do what I told you to do?”
FEELING HUNGOVER
Another potential reaction to trying to fix things is having the person ignore you the next time they see you. Whenever that happens, we tend to blame ourselves: “Did I say something wrong?” “Did I overstep?”
I invite you not to take those thoughts on, since the person may in fact be experiencing shame, denial, or fear. When people disclose something personal and share their emotional pain, it usually leaves them feeling vulnerable.
It’s what I often refer to as the “vulnerability hangover.” They’ve just shared something that leaves them with a gaping emotional hole — that open, raw feeling. In such situations they may be having internal dialogues like, “They must think I’m weird or have a character defect” or “Maybe they don’t like me anymore.”
Yvette Murray
On top of the symptoms they may be experiencing, going through a decline in their mental well-being will affect their self-esteem and self-worth. Strong feelings of “I’m not good enough” or “There must be something ‘wrong’ with me” can rear their ugly heads.
As a psychotherapist, my training involved having to do my own inner work along with group work. One of the biggest “aha” and healing moments I had during that time was when I recognized pain in a colleague or mentor. In that moment I thought, “You mean, you feel this way, too?”
Such an experience provides hope, optimism, and comfort in knowing that someone is not the only one with such feelings. It helps them focus on how to feel better without the extra burden of what my good friend and mentor Janine Driver calls, “stinkin’ thinkin’,” the internal dialogue and self-stigma that can directly interfere with our healing journey.
KNOWING ME, KNOWING YOU
To truly support someone, “Help me help you” really is the best approach. How do we do that? The first step is asking them! For example, ask “How can I best support you?” “What do you think would happen if you did this or that?” “How can I support you today?” “What does help look like for you?”
You could also remind them of what worked for them before. Everyone of us has been through challenges. To overcome them, chances are we’ve used support systems, inner strength, perseverance, courage, and persistence. Reminding the person what they’ve previously come through can be helpful. When someone feels better, they tend to forget that.
Have you ever had a bad flu and thought to yourself, “I don’t know how I’m going to function in the next hour, never mind getting up and going to work the next day”? Fast forward a few weeks, and someone at the office reminds you, “Remember, you were off sick that week?” “Ah, I had forgotten ‘cause now I feel better.” By reminding someone what has helped them before, know that it could be the very thing that helps them now.
Effective support can also involve sitting beside someone — not speaking a word, simply being there while providing a safe space for them just to be. When I don’t feel good, having someone trying to make me feel good or change how I’m feeling can be counter-productive.
Having empathy is key, as American researcher Brené Brown says, while making sure not to jump in with “at least” statements: when someone tells you they are getting a divorce, for example, and you respond with something like, “Well, at least you got married.” Some might find such a comment funny, but it may not be helpful. A more empathetic response would be “Thank you for sharing that with me. Please help me understand what you are going through.”
Key aspects of supporting other people are listening and communicating non-judgmentally. Those things become a lot easier once you remind yourself, “It’s not for me to put my belief systems about how life ‘should’ be or how people ‘should’ act onto others. It’s their life and experience, not mine.” By connecting as an authentic fellow human being, heart to heart, and by really listening, you are going to provide excellent support.
For those that have a hard time receiving support, allow me to whisper in your ear, “know that helping you, helps me too!”
Photo: ©TriStar Pictures/Courtesy Everett Collection
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Staying mentally well in a digitized world
While Digital Health Week was a celebration of the advantages of connected care — from virtual consultations to e-health records to useful apps — it was also an opportunity to reflect on how we maintain our best mental wellness in an increasingly digitized world.
“There’s no doubt that the pandemic has increased our reliance on virtual connectivity and social media,” affirmed Dr. Keith Dobson, professor of clinical psychology at the University of Calgary. “And while there are some positives associated with our capacity to remain plugged in to our relationships, we can’t be blind to the very real pitfalls.” —
Those pitfalls are having an especially adverse effect on the mental health and wellness of young people — especially young girls.
“Our brains tend to believe what we can see,” Dobson said. “While intellectually, we might comprehend that a photo is doctored, that an image has been filtered or retouched — a waist nipped in, eyes made bigger — our brain doesn’t readily make that distinction.”
Seeing is believing
Dobson explained that the primacy of our sense of sight is largely why we as a society are so enamoured with digital platforms like Instagram that offer powerful visual stimulants. We’re also reeled in by the hit of dopamine, the feel-good hormone that kicks in when we’re using a medium that offers us easy wins. Likes, hearts, shares, and comments give us bite-sized endorphin rushes, without requiring much in the way of effort.
“Normally, we get a sense of well-being from an accomplishment,” he added. “Something that has required us to invest meaningful time, energy, and effort. Instead, social media provides us with a short-cut. But it’s one that comes at a high cost. The industry we’re up against is a formidable foe — one that has invested billions to buy access to our innermost thoughts and most intimate insecurities.”
Ironically, Dobson noted, we don’t need to feel good while we’re actively engaging on social media. That activity might make us feel less-than, unattractive, not-good-enough. But interestingly, when we shut down our phones, we start to feel good again.
The ‘negative feedback’ loop
“It’s called a negative feedback loop,” he said. “Think of it like this: you have a negative thought — ‘I’ve left the stove on,’ for example. Then you need to check the stove to make sure it’s off. After you find relief in checking, the pattern begins again.”
Holly Craib, a 21-year-old art student in Ottawa, agreed. “I don’t even consciously decide to check my social media. In a moment of boredom, quietness, or loneliness, I just automatically reach for my phone and start scrolling.” She describes the frustration of an hour or two slipping by, checking Twitter or “doom scrolling,” pulling herself up short when she realizes she’s making herself insecure by comparing her accomplishments to those she’s seeing on her feeds.
Dobson echoed Craib’s assessment, explaining that there are myriad things that pull us toward social media. We may fear we’re missing out. Then there’s the pull of social currency: wanting to be sure we can contribute to a conversation about a particular social media event, personality, or meme.
But things can take a dangerous turn when our insecurities are being mined as precious data by organizations seeking to profit from our distress. Eating disorders have increased during the pandemic, and researchers are connecting the link between being in lockdown and having constant access to tempting content that reinforces negative thoughts and damaging behaviours.
A love-hate relationship
“It’s a vicious cycle,” said Craib. “I think like a lot of people my age, I have a love-hate relationship with my phone. I’ll often see friends posting the equivalent of ‘you’ll have to reach me on my landline’ because they are taking a breather from all the noise on social media.”
Once you’ve shown an interest a certain kind of content, algorithms designed to snag your attention quickly respond with reinforcing information. Suddenly, a single search like “How to lose five pounds” becomes a tsunami of diet content. If you weren’t convinced you needed to slim down before that innocuous search, you’re suddenly inundated with the message that you absolutely do.
“And therein lies the danger of being a passive consumer,” said Dobson. “I realize that the tools we have in our arsenal are relatively weak against a billion dollar behemoth that lives in our pocket and seemingly reads our minds, but that’s why we’ve got to be doubly savvy.”
Coming to grips with virtual reality
If you grew up with Seventeen magazine, for example, which you could read and put aside, it may be hard to conceive just how ubiquitous social media’s influence has become. It’s not just the latest trends, funny jokes, and a way to stay in touch with grandma. It’s the whole world in the palm of your hand — and for a lot of young people it becomes their validation, their connection, and their biggest detractor.
Craib said cutting herself off from her phone would be like cutting a lifeline, especially during COVID. “Virtual connection has been part of my life since I was logging on to MSN Messenger when I was in elementary school. I got my Facebook account when I was 13. I don’t know how not to connect with people this way. But I also understand it’s playing on my vulnerabilities, and that’s a fine line to walk.”
Dobson advocates education as the most powerful tool we have — especially for parents of young people. He urges parents to learn about social media and to openly discuss the content their children are seeking, teaching them from an early age how to be critical consumers. “Having them ask, ‘What is the purpose of this image?’ And then, ‘How does it make me feel?’ gives them an opportunity to see if their thoughts are being distorted by unhealthy, unrealistic standards of beauty or accomplishment, for example.”
He also advocates clear boundaries that, he readily admits, won’t necessarily be easy to enforce.
“Some obvious ones for me are no phones in the bedroom, time-limited access to phones and computers, and pursuing other activities that give you an endorphin rush that’s earned without strings attached.”
Learning an instrument, exercising, going for a walk, or having a meaningful conversation with a close friend are social media alternatives that give our brain a feel-good boost, without the inevitable crash.
But for Craib, the work she does as an artist keeps her tethered to the platform she finds most problematic. “Instagram is a natural place to showcase my art, which I love making. But it’s also a forum where you can start to feel unseen, drowned out, or less prolific. I suppose in that way it’s a bit like having a frenemy. On the one hand, you’re able to put yourself out into the world. And, on the other, the world is there to respond.”
Taming the beast
But for April Yorke, there are ways to tame the beast. During her time as the Mental Health Commission of Canada’s manager of digital marketing, she has mastered the skill of making social media work for her, rather than the other way around. And she’s quick to point out that using the platforms can also have positive mental health benefits.
“One of the best things about social media is that it lets you home in on your interests. If you love puppies, fly fishing, and knitting, you can bet you are going to see puppies and fly fishing and knitting, morning till night.”
But if you sense that the algorithm has turned against you (when #HowToLoseFivePounds is all the content you see), Yorke recommends turning the algorithm to your advantage. “Start searching for what makes you happy. When you find it, make sure you like, follow, subscribe, and comment — any action you can take to engage with it. It won’t take long for the algorithm to pick up on where your new interests lie and start pushing you in that direction.”
And if you are still seeing something you don’t like? “Report it. Block the account. Social media gives you those options because they don’t want to show you stuff you don’t want to see and eventually lose you as a customer. Complete the feedback loop by also making it clear what you don’t want.”
Craib is also a proponent of this approach. “I’ve given Twitter a list of words or phrases or subjects a mile long that I am not interested in reading about ad nauseam. It’s not perfect, but it’s a step in the right direction.”
Dialing it back
If those two options aren’t enough, Yorke has another idea. “Act like a feuding celebrity and take yourself back to zero. Unfollow absolutely everyone you are currently following. Remove your own posts and photos that you no longer wish to see.”
Yorke has a friend who took a multi-year break from social media. When he made his return, he used only one network and carefully curated who he was following.
“Now,” said Yorke, “using social media makes him feel inspired in a way that it never did before.”
It’s not usual to see articles recommending strategic avoidance or deleting apps altogether. While that may be the right move for some — it’s not really an option for social media managers or people like Craib, who are required to leverage the connectivity of social media to showcase their work or run a business.
But as Yorke said, “Once you winnow down your list of follows, it doesn’t take as long to ‘get caught up’ (whatever that means), so you spend less time on the app. Now I mostly see my close friends and ads for travel bags with lots of pockets — an important reminder that a big wide world beyond the screen is out there.”
Illustrator: Holly Craib https://www.hollcee.com/
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Putting psychological safety and physical safety on equal footing makes for good policy and practice. A look at changing the narrative within the oil and gas sectors
When the language of isolation, quarantine, and lockdown predominates, there isn’t much room for words like socialize, connect, or empathize. Yet even though the pandemic has made our workplaces more prone than ever to stress and anxiety, creating a culture that gives workers the confidence to ask for mental health support has always been a challenge.
Steve Tizzard knows first-hand what the experience of stigma toward mental health problems at work looks like. He has worked at Hibernia, an oil platform on the Grand Banks of Newfoundland and Labrador, for 25 years and has been front and centre during the company’s shift toward supporting mental wellness.
Tizzard characterizes the earlier stigmatizing attitudes in stark terms:
“You have depression? Go home, you cannot cut it in this industry. You have anxiety? Suck it up, partner, don’t let anyone else hear you say that! Relationship problems? Financial problems? Addiction? All part of the industry. You’re a rough and tumble oil-rig worker; these things cannot affect you!” —As a result, workers often felt they needed to hide their problems and didn’t feel they could ask for help.
Today, of course, these attitudes are giving way. More and more employers understand that mental health problems can affect anyone, no matter what position or industry they’re in, and as Tizzard points out, help is only a conversation away. Teaching workers that it’s OK to let another worker know they’re struggling, having a bad day, or are in crisis — while knowing they will not be judged — is a powerful tool in a workplace.
This simple approach has worked for many Hibernia employees, and its power, Tizzard said, comes from the fact that it is led by workers themselves. Instead of relying on professional supports alone, workers know that others are ready to listen and assist, if necessary. His experience has also taught him that this method may be more effective and immediate than conventional strategies in workplace psychological safety.
He passionately believes in the power of sharing lived experience in open dialogue during workplace safety meetings. “We need to constantly find ways to discuss mental health in the same way as physical health in our workplaces,” he said. By educating workers, saying the words “mental health” in safety meetings and including them in occupational health and safety initiatives, stigma can be reduced.
That said, putting psychological safety on par with physical safety can still be a challenge. As Tizzard puts it, “for some organizations it’s OK to have a sprained ankle but not anxiety. It’s acceptable to bring physical safety issues to the forefront of the workplace agenda but not concerns about psychological safety.”
Despite such challenges, his active support of psychological health and safety at Hibernia has helped it make significant strides. In 2015, the Hibernia wellness committee Tizzard founded was recognized by Canada’s Safest Employers, which awarded the company a gold medal for psychological safety.
When asked what others might look out for when seeking to establish a psychologically safe workplace culture, he said, “any advocate or passionate worker ready to implement a workplace program will need to know it’s not a smooth road much of the time. At first, stigma will always be the main factor in gaining momentum, but the mindset of workers and managers can also hinder success.”
For a program to succeed, Tizzard added, many factors need to line up. What is essential is having a foundation of support from ownership, management, occupational health and safety, and of course, workers themselves. Some of the tools Hibernia is using include micro-learning, wellness boards, and Mental Health First Aid (MHFA) training.
MHFA is a Mental Health Commission of Canada program that teaches people how to offer help to someone who is developing a mental health problem or experiencing a mental health crisis or worsening mental health. Since 2007, almost 600,000 people in Canada have been trained.
According to Tizzard, by combining the right information and skills with an open mind, “trained and caring workers on our shop floors can be so effective in reducing physical and mental injury. It’s an avenue for help that many might not think could exist, but it can be the front-line resource for people in need. I live it every single day.”
Steve Tizzard has worked on the Hibernia platform since 1997, for the last 22 years in a communications, weather, and ice-management capacity. He is the founding member of the offshore wellness committee that serves workers in the oil and gas industry. Apart from the gold medal in psychological safety Hibernia received in 2015, it earned the CM Hincks Workplace Award in 2017 from the Canadian Mental Health Association for excellence in fostering workplace mental health. Steve is also an MHFA instructor and is certified as a psychological health and safety advisor. To learn more about his work, visit www.allthebestconsulting.com.
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When I first learned that Carolyn Bennett had been named Canada’s inaugural minister of mental health and addictions, I was overcome with gratitude.
Naturally, I was grateful for the growing spotlight on mental health and substance use — a light that has expanded both in scope and intensity over the past two years. But I was equally thankful to be gaining a new ally — one that I hoped could help answer the question that drives all of us at the Mental Health Commission of Canada (MHCC): How can we best support the people of Canada through these challenging times?
Last month, I had the opportunity to sit down with the minister for a virtual interview that would answer that question and many others.
Taking a holistic approach
As we began our conversation, it didn’t take long to recognize that, while Minister Bennett may be new to the role, she was well steeped in the topic. When asked which misconception about mental health she would most like to correct, she answered without hesitation.
“Everyone needs to understand the difference between mental health and mental illness,” she told me. “When Dr. Brock Chisholm (The World Health Organization’s first director-general from 1948 to 1953) said, ‘there is no true health without mental health,’ he was right. We can’t talk about physical health without considering the mental, emotional, and spiritual aspects of a person’s well-being.”
With a long career as a family physician before entering politics, Minister Bennett carries a deep understanding of the inextricable link between mental and physical health. She also knows first-hand what happens when that link is overlooked.
“Working in family medicine,” she said, “you hear about people’s difficulties every day. I remember seeing executive reports come in, knowing the patient was struggling with family problems and other issues, but none of those things were included. Someone’s cardiogram or body mass index doesn’t paint a full picture of how well that person is.” Such a disjointed approach, she added, contributes to the stigma around mental illness.
Fortunately, she said, COVID-19 has given us a new opportunity to make a change for the better. As the disease has taken a steep toll on both physical and mental health, it has also underscored the intersection between the two.
“With COVID, people have gotten better about admitting when they’re struggling,” she explained. “If even one out of every two people can speak up when their mental health is deteriorating, it will reduce the stigma and we’ll be in a much better position to address the issues long term.”
Opening new doors to care
Of course, as Minister Bennett was quick to point out, stigma is just one piece of the puzzle. And responding to the new and existing mental health needs in Canada will require innovation and co‑operation at every level.
One example of that innovation is the Stepped Care 2.0 © model — championed and scaled up by the MHCC — which provides the least intensive form of support deemed appropriate, which is then “stepped” up or down as needed. In Newfoundland and Labrador, the model contributed to a 68 per cent reduction in wait times for mental health services — and Minister Bennett is hopeful for similar success elsewhere.
“In post-secondary institutions, for instance, it’s not that every student needs a psychologist,” she explained. “They may get the support they need from proper orientation or peer counselling.”
In another example, the minister cited a study of 40 women in need of perinatal mental health support. Of those 40, only two met the criteria that would require a specialized perinatal psychiatrist.
“The provinces and territories are excited about this model. They’re doing a great job working together and learning from each other to implement these sorts of programs and advance our understanding in many areas,” she said, noting their shared focus on developing culturally safe, trauma-informed care. “They’re working across boundaries to share the best ideas and make them even better.”
The high praise for provinces and territories brings up the question that some have asked since the Minister of Mental Health and Addictions post was created. Where does the federal government best fit into the health care equation?
“The delivery of health care is provincial or territorial. But whatever we can do at the federal level to lighten the load, we should. Health — including mental health — is a shared responsibility between all orders of government,” she said.
The minister is also passionate about the federal government’s other role in improving mental health, one that starts from the inside.
“We have mental health challenges across all branches of government,” she said. “Veterans, Corrections, Indigenous, RCMP. So how do we become an exemplary employer? We have to be able to take care of our own people and walk the talk when it comes to mental health.”
Drawing on outside strength
When our discussion turns to safeguarding her own mental health, Minister Bennett’s insights reaffirm much of what we know about protective factors.
She talks about the importance of social connection, expressing gratitude for her great team at work, and her partner, Peter, who she describes as her number one supporter. “I could be working all night for three days, and he still greets me like I’m Gretzky after a hat trick when I get home.”
She also talks about physical activity, describing walks with her yellow lab, Ripley, beneath the magical tree cover of Toronto’s Beltline Trail, and hobbies like Oscar homework, which comes with the territory when you’re married to someone in the film industry.
Finally, she talks about the peace she finds in nature, particularly during visits to Georgian Bay. “I need to look out at that point where the sky meets the water — to notice how the water looks different every time,” she said. “Being able to see something bigger than yourself, something that you can’t control, is a good reminder that plans can change.”
And it’s exactly that philosophy that the minister hopes to help instill for Canada’s people during this pandemic period and beyond.
Charting the path forward
“There are two kinds of immunizations important for Canadians right now,” she said. “One is for COVID-19, and the other is immunization against uncertainty.”
Here, she is referring both to the pandemic and other global issues like climate change, which increase our levels of stress and anxiety.
“Resilience is recognizing that your day isn’t going to go exactly as you planned it out in your agenda —and learning to be OK with that,” she said. “We need to provide people with the tools to build that kind of resilience and autonomy when things don’t go according to plan.”
“I also hope we’ll get better at being able to reach out to those who may be struggling, those who don’t seem like themselves. COVID has taught us that we can be together while apart. How can we leverage that to build resilience and show people that they aren’t alone?”
Answering that question on a nationwide scale is at the heart of the minister’s ambitious mandate — one that she is ready and eager to fulfil.
“We aim to have a mental health strategy that everyone can see themselves in. That will mean looking to national standards and establishing minimum expectations to build on,” she explained. “Out of that, we’ll ensure that money meant for mental health goes to mental health through transfers and collect more research and data in the process. Understanding those outcomes will be critical in making the best decisions in the future.”
Over the longer term, the minister hopes to help build a more cohesive system of care.
“We’ve been fighting this patchwork quilt of non-systems for a long time. How do we make sure mental health is totally integrated into systems of health? This can’t be the turf of this profession or that,” she said. “We need to move away from a scope of practice with hard lines and toward core competencies that can expand. That’s how we’ll create a more modern and effective way of getting people what they need when they need it.”
It’s a tall order, but Minister Bennett has spent her career proving that she’s not afraid of a challenge.
“We can do this,” she said. “Canadians are counting on it.”
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The shift to permanent hybrid office schedules in post-pandemic workplaces presents a unique challenge for managers and team leaders. Although flexible work has been shown to reduce psychological and physical stress in previously non-remote employees, a distributed team requires different approaches in managing employee orientation, performance issues, and conflicts. While the pandemic may have emphasized the importance of mental health in the workplace, leaders may find that the human elements of their roles, including their ability to regularly connect and relate with their employees, have become more complex.
The Mental Health Commission of Canada (MHCC) has created a resource for managers looking to minimize the virtual divide in the workplace. The Manager’s Toolkit: Leading in a Hybrid Work Environment provides actionable guidelines for managing workplace conflicts and maintaining social cohesion.
“The Manager’s Toolkit provides useful and concrete information to people supporting and leading others, to help them resolve workplace challenges in a way that puts people first,” says Nicole Chevrier, Marketing and Communications Manager at the MHCC.
Most importantly, The Manager’s Toolkit presents a strategy for integrating mental health awareness into hybrid environments and helps managers to recognize signs of declining mental health in employees.
“Applying The Manager’s Toolkit to assess the mental health of your team is similar to how medical professionals scan and evaluate the health of their patients,” explains Dr. Ellen Choi, Assistant Professor in Human Resources and Organizational Behaviour at Toronto Metropolitan University (formerly Ryerson University).
The resource includes workplace scenarios and actionable solutions for a multitude of managerial responsibilities affected by hybrid work. These include strategies for managing performance issues, conflict resolution, onboarding, mental wellness, and mental health awareness.
Using A People-First Lens When Addressing Performance Issues
Because signs of burnout, anxiety, and stress are less apparent during virtual interactions, the first sign of an employee in distress may be in their performance.
“You may find out that it’s not entirely a performance issue, and that other underlying factors are contributing to this change,” explains Samuel Breau, Manager of Access to Quality Mental Health Services at the MHCC.
Virtual teams will make the ability to understand employee issues more important, and more challenging at the same time. The Manager’s Toolkit provides strategies for leaders to evaluate their existing processes for performance measurement and productivity with a more holistic view of the employee. This includes encouraging dialogue around burnout and anxiety, responding with empathy, and supporting employees in prioritizing their mental health.
Dr. Ellen Choi – Photo credit: Ivey School of Business, Western University
Creating A Conversation for Conflict Resolution
Because distributed teams may interact less, conflicts are more likely to be reflected in meetings, emails, and collaborations, without a clear space for conversation. In hybrid environments, the role of a manager in facilitating critical conversations is emphasized, says Dr. Choi. “Honest conversations test the temperature of the hybrid workplace, so when vitals are low in the team, leaders can step up and hold that space or steady it for others.”
The Manager’s Toolkit provides useful strategies for leading conflict resolution in a way that models open communication, to prevent further issues from repeating.
Thinking Outside the Box in Virtual Onboarding
Engaging with work teams is an important way for new employees to feel included, informed, and connected, and managers can help to make this experience fun for all. Julia Armstrong, a manager of the Mental Health and Substance Use program at MHCC, suggests using input from your employees’ own interests and hobbies to plan virtual team warm-ups and social events, for a more authentic experience.
“This is so critical, and not just when onboarding. Find out how team members would enjoy spending time together before assuming you know what folks want,” explains Armstrong. “Sometimes the simplest gatherings can foster the most meaningful connections when you need them most.”
Normalizing Health and Wellness: A Prevention, Not A Cure
Creating a safe space to talk openly about mental health in the workplace is equally as important for employees as it is for managers, says Dr. Choi. “You can’t empathize with others’ vulnerability if you yourself can’t be vulnerable. If you’re unable to stop judging yourself, it prevents you from allowing yourself to be vulnerable, and you may end up just judging other people’s vulnerability as weakness.”
Dr. Choi believes keeping mental health top of mind starts from within. Specifically, managers who may feel the pressure to ‘hold it together’ or be ‘all-knowing’ should regularly practice self-compassion.
“When you feel you have no room to fail, when everyone’s counting on you, you may have limited access to ‘be human’. Without that buffer around our own psyche that allows for vulnerability, there is only a brittleness, and that’s unsustainable,” says Dr. Choi. “Challenge defeating self-talk or self-doubt by relating to the parts of yourself that are overwhelmed by asking ‘am I doing the best I can?’ [or] ‘what do I need right now to give myself a break?'”
Checking In, Not Checking Up, On Staff
Managers of hybrid teams must find new ways to monitor the mental wellness of their teams, and taking a leading role in destigmatizing mental health can make this task easier. The Manager’s Toolkit provides multiple strategies for creating dialogue around mental health at work, including casual check-ins, sharing their own stories, and understanding the signs of declining mental health through training, like The Working Mind.
Whichever approach feels most comfortable, having an open mind while lending an ear to employees is at the heart of creating a safe space of trust and communication between managers and teams in a hybrid workplace.
“We can apply the same principles of being a compassionate leader that listens attentively, observes and checks in when noticing changes,” explains Samuel Breau. “A hybrid model means being even more disciplined in practicing those listening and observing muscles.”
The Manager’s Toolkit serves as a resource for managers navigating the changes of hybrid workplaces with a mental health focus. Find more information on The Mental Health Commission of Canada, and further resources here.
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Featuring: MHCC board directors Carole Shankaruk, Kellie Garrett, and Cheryl Fraser
It’s easy to make assumptions about people based on their academic accomplishments, professional successes, or philanthropic contributions. But sometimes if you pull back the curtain, you discover untold depths and hardships that reveal a more valuable story than a five-sentence biography can.
A recent Zoom conversation with three Mental Health Commission of Canada (MHCC) board directors is a powerful reminder that the most important accomplishments may be the ones without accolades.
The passion for mental health shared by Carole Shankaruk, Kellie Garrett, and Cheryl Fraser was born from deeply personal experiences. For each woman, walking through a place of darkness has motivated them to be the light for others.
Accidental advocates
Carole Shankaruk
All three women calling in seemed to be visibly collecting their thoughts before recounting their personal journeys — which undoubtedly unfolded more neatly in retrospect than in reality.
“I’ll be honest,” said Shankaruk from her home near Winnipeg, “part of me was dreading this conversation. Reliving the past can bring up so many painful emotions.”
Rather than bury them or hold back, though, she brandished her Kleenex and began relating the story that changed her life. As a clinical social worker, Shankaruk thought she had the necessary tools to handle whatever motherhood might throw her way.
“But when it’s your own child who is suffering, who’s in pain, you might as well throw the playbook out the window.”
At age seven, the debilitating pain her son Noah had been experiencing was diagnosed as Crohn’s disease, an ailment that causes a notoriously painful inflammation of the bowel.
In Fraser’s case, the journey began only a few months after her son Jamie was born. “He started to appear constantly frustrated, he wasn’t eating properly, and then his development seemed to slow down,” she said. “The doctors couldn’t find anything medically wrong with him, but we knew he needed help, and more importantly he needed someone to advocate for him.”
A mother’s love (and guilt)
Kellie Garrett
One of the first things Shankaruk recalls was the difficulty of dealing with her son’s pain. “We tried so hard to manage it, but it interfered with virtually everything.” She remembers feeling tremendous guilt, a burden she still bears today. “Did I intervene forcefully enough? Was there more I could have been doing?”
As she expressed this thought, tentatively at first, she was encouraged by Garrett, an executive coach, speaker, and consultant, calling from her home in Regina.
“Oh, the guilt!” she said. “As mothers, I don’t know if we can ever entirely free ourselves from it.” Garrett herself experienced undiagnosed postpartum depression following the birth of her second child, which occurred on the heels of her mother’s death and a cross-country move.
“I had this notion that ‘this’ is what motherhood is,” she explained. “Exhaustion, being overwhelmed, isolation . . . that it was all just part and parcel of what you have to trudge through. Being in a new city, I didn’t have friends to confide in. Also, my partner wasn’t able to recognize the signs and symptoms, and I had had a less than ideal family life growing up, so I didn’t have a positive model to draw on.”
Garrett gathered herself before delving more deeply into the mental illness that had left its mark, both on her mother and her grandmother before that. “My grandmother faced unimaginable hardship when her husband abandoned the family. She had a breakdown, went through shock treatment several times, and was ultimately diagnosed with bipolar disorder. My mother also lived with major depression throughout her adult life. When my own son began to experience depression, I felt like it was his rightful legacy. And feeling like somehow my bloodline was toxic, that it had poisoned the well . . . it’s hard to reckon with that.”
Here Shankaruk jumped in. “We blame ourselves for so much, and in doing that we not only contribute to the stigma that surrounds mental illness, we’re also left trying to pour from an empty cup. When it comes to motherhood, we experience traumas big and small, but we don’t necessarily have the language to name them or the tools to address them. So we soldier on without realizing that we’re perpetuating some of the harms we most wish to avoid.”
Fraser’s self-blame wasn’t centred on Jamie’s condition but on an inability to offer protection in his most vulnerable setting — the classroom. While he’d always had challenges in school — exacerbated by his learning differences, limited coordination, and towering stature — Grade 6 was a turning point.
“At a birthday party for Jamie, I overheard a boy mention a teacher who was throwing things,” she explained. “When I asked about it, the floodgates opened. All the boys began to tell me how their teacher had been forcing Jamie to fetch his coffee and throwing chalkboard brushes at him when he gave incorrect answers in class. I was horrified.” As it turned out, the teacher had a history of mistreating students with extra needs.
Fraser and her husband removed him from the school, only to have to transfer him twice more. By the eighth grade, Jamie had had enough. Frustrated by years of being misunderstood, by students and teachers alike, he walked into his principal’s office and announced: “If you don’t do something, I’m going to kill myself.”
“At that point, we really had to step in and take over,” Fraser said. “Jamie had a hard time trusting adults, but he needed to trust us. Thank God he did.”
In Shankaruk’s case, the middle years saw an improvement in Noah’s general happiness. Although he still battled waves of pain, as a young adult he was doing well. “He was working and the future was bright,” she said, growing visibly emotional. “But then one day on a job site Noah complained of his pain to a friend. Without thinking, he took a pill that was offered. And while it relieved his immediate physical symptoms, it also unleashed an addiction that would eclipse the pain of his Crohn’s.”
The decisions her son made while using substances led to an arrest and a court appearance. “I was so terrified, I was carrying so much anger at how he was being treated, I was literally shaking from head to toe with repressed feelings. Yes, he’d make a mistake. Yes, he’d taken pills that altered his behaviour and clouded his judgment. But where was the rest of the story? Why wasn’t anyone asking about his chronic illness? Why wasn’t anyone painting a picture of all that he had achieved? Why is the system so punitive when rehabilitation — or in my son’s case, medical intervention — should be the goal? This is such a beautiful human being, and he’s been reduced to a number on criminal registry.”
“I’m so sorry,” Garrett interjected. “I didn’t know any of this.” The two pause for a moment, as if in solidarity for the lonely paths so many mothers must walk before finding some peace or solace.
“My one son was born with autism,” she said. “And I spent much of my time focused on his needs, while my other son slipped into anxiety as a child and later depression. . . . I feel badly that he was lost in the shuffle.”
Both women threw themselves into work, a soothing balm when their home lives were feeling chaotic. “I was good at my job,” Garrett recalled, “and I knew what I was doing. There was no manual for motherhood. It felt like a science experiment. You’re flying blind, yet it’s the thing that women are conditioned to believe should come most naturally. When I was younger, I didn’t know how to reach out for help. Worse, I would have felt shame for needing it.”
Finding reprieve
Cheryl Fraser
Today, Shankaruk, Garrett, and Fraser are aware that the wisdom gained from their hardships may help someone else who has begun that kind of journey — it’s the reason they agreed to share such personal stories.
“The advice I would give to anyone struggling, whether it’s as a new mom or for any other reason, is to reach out and find your people,” said Shankaruk. “For me, it was a women’s spiritual group. Most were much older than I was, and that age gap was such a blessing. They were further down the road, were able to see potential pitfalls before I could, and had invaluable advice born from experiences I hadn’t yet had.”
Ultimately, Garrett also found solace in female friendships, although she noted that the narrative around women’s desire to compete rather than lift others up needs to be rewritten. “I don’t think women are inherently more competitive with each other or are driven by a desire to undercut. I think society has set impossible expectations and put us in a perpetual state of scarcity.” The solution, she said, “is to reframe the conversation. It should be about the way so many women are very supportive. How can we create space for and celebrate the women in our lives who are clearing new paths and forging opportunities that benefit us all?”
Both Garrett and Shankaruk have also found their footing by embracing nature. “To go into my garden, to be surrounded by natural beauty, that’s where I feel most at home,” said Shankaruk, who is Métis and often turns to the land for healing.
“There is power in giving our experiences room to breathe,” she added. “There is power in naming our traumas, in owning our challenges and, in turn, sharing the hard-won knowledge with others.”
As Fraser points out, sometimes that hard-won knowledge stems from a gut feeling, and that’s exactly her advice for other parents. “Trust your instincts. If you feel like something is wrong — with your child or yourself — it probably is,” she said. “It might take a long time to get the answers and solutions you need, but don’t stop searching, and don’t stop advocating.”
“It’s also so important,” Garrett emphasized, “to find people who are able to see and love you for yourself. If you have a sick child or are overwhelmed by the demands of motherhood, it can feel like you’re only two dimensional — like you’re just a mom and an employee, for example.”
She also believes carving out some personal time, just for yourself, is critical (while giving any partner the same privilege). “Finding the space to connect with yourself and pursue what matters to your soul outside parenting actually makes you a better parent.”
“When Connor was diagnosed with autism, I cried for two years straight. I wouldn’t wish that on anyone. I thought about suicide more than once. The only thing that kept me alive was my children, and some visceral, bone-deep conviction that I couldn’t leave them.”
A fresh perspective
Today, all three women have gained some of the objectivity that comes with time.
“I didn’t realize it then,” Fraser said, “but the sum of my experience with Jamie led me to be a different kind of caregiver for my own mother when she started to decline with Alzheimer’s. I learned to truly prioritize joy, and that it’s possible for someone to be happy, no matter what stage they’re in or what form that happiness takes.”
Garrett had a similar epiphany. “For a long time, I was angry with my own mother. But with some distance, I now believe she was doing the best she could. In forgiving her shortcomings, I’ve been able to extend some of that compassion to myself. That is the ultimate gift.”
Shankaruk agreed. “This is what we hope for. That we forgive our parents their imperfections and hope our children give us that grace. Because motherhood, in all its messy complexity, has led me to discover untold strengths and unimaginable love. But we need not walk that road alone.”
Illustrator: Kasia Niton – https://sunnystreet.studio/ Instagram: @sunnystreet.studio
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People 85 and older make up Canada’s fastest-growing population segment, increasing at nearly four times the rate of the total. Also growing quickly is the number of evidence-based tools and strategies to help them live longer, happier, and more fulfilling lives, which is good news, since the size of this group will triple over the next few decades.
From research to resources
How does getting older affect our mental health? For Dalhousie University professor of psychiatry Dr. Keri-Leigh Cassidy, “contrary to popular notions that things only get worse as we age, research shows some things can actually improve. Throughout our lives, our brains continue to grow and rewire through neuroplasticity. While we may be more likely to encounter loss and adversity as we age, we can also become better at handling life’s challenges. The research also shows that levels of happiness, compassion, and gratitude increase with age.”
A recognized leader in late-life psychotherapy, mood, and anxiety disorders, Cassidy chairs the Atlantic Seniors’ Mental Health Network and is the clinical academic director of Dalhousie’s geriatric psychiatry program. In 2011, she launched Fountain of Health, a national non-profit initiative that shares the current science on well-being, resilience, and optimal aging while offering webinars and courses for individuals, organizations, and clinicians.
“People often don’t recognize how much influence they can have on their health,” she said. “For example, we now know that genetic factors account for only 25 per cent of human life expectancy and that unhealthy lifestyles are responsible for more than 85 per cent of chronic diseases.”
Cassidy also cites research showing that those who adopt specific habits are more likely to live longer and report higher levels of happiness and satisfaction. As detailed on the Fountain of Health website, these habits fall into general categories such as physical activity, social interaction, brain challenges, mental health self-care, and positive thinking.
“Our thinking, including how we think about aging, is a fascinating new area of research,” she said. “A Yale University study found that people with a more positive self-perception of aging outlived those with a more negative view by 7.5 years. Regular self-care through yoga, mindfulness practice, and healthy sleep habits can also improve mental well-being. Knowing the signs and symptoms of mental illness — and being willing to reach out for professional help, if needed — is also vitally important.”
Life begins at 60
Top Sixty Over Sixty founder Helen Hirsh Spence came to a similar conclusion about the way we think about aging when she approached retirement age. It was then that she began to fully appreciate the harmful impacts of ageism and the stereotypes associated with retirement.
“Common descriptions such as ‘put out to pasture’ or ‘permanently on vacation’ can have a pernicious effect by reinforcing negative views,” she said. “People who internalize these views risk losing their sense of purpose as they age. And as the research shows, they can end up shortening their lives as a result.”
After a career in education, Spence started the for-profit social enterprise in her late 60s to help counter ageism and harness the talents of older adults in Canada. She believes that most of us have long undervalued older people and the contributions they can make to society.
“My life’s work is now dedicated to reframing the conversation about aging,” she said. “There are two parts to Top Sixty Over Sixty: showing businesses and organizations how to benefit from age-diverse workforces, and helping older people reinvent themselves with confidence and agency.”
Practical, evidence-based tips
The increased levels of isolation due to the pandemic make it particularly important to adopt habits that protect both physical and mental health. To help older adults protect their mental wellness during COVID-19, the Mental Health Commission of Canada teamed up with Cassidy to develop a tip sheet with practical, evidence-based guidance. For example, the first tip recommends focusing on what we can control, such as practising self-care and incorporating healthy routines into our daily lives.
Now in her early fifties, Cassidy has become increasingly disciplined about her own self-care.
“It’s easy to feel overwhelmed by the ongoing pandemic,” she said. “To counter this, I follow the tip about limiting my exposure to news media, especially right before bedtime. I also make time to exercise and express gratitude, and I connect with a group of friends every week by video conference. These habits help me stay balanced and appreciate the good things in life.”
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Dr. Manon Charbonneau remembers the day vividly, though she’d rather forget it.
“So that’s it, then — cancer,” she recalls saying in disbelief with her eyes locked on the digital images of her mammogram. The radiologist confirmed the diagnosis, and in a moment her world was “completely dismantled.”
As a clinical psychiatrist, Charbonneau had dedicated much of her life to helping other people. “I’d wanted to be a doctor since I was five years old,” she said.
Yet, the long road unfolding before her would mean a marked shift. “While I used to say I was going to grow up and cure cancer, instead cancer found me.”
At the time of her diagnosis, Charbonneau had been practising at a hospital in rural Quebec. And although her medical background helped prepare her for what cancer would do to her body, it did not prepare her for the toll it would take on her mind.
A legacy of battling stigma
Many years before her diagnosis, Charbonneau was confronted by another debilitating illness — depression.
Manon Charbonneau
“I had reached such a low place that I almost left my residency. Then, one of my professors told me that whatever I chose to do, I should never talk about my depression because it would hurt my career,” she said. “So that’s exactly what I did — put my head down and stayed silent.”
Without a word to anyone in her professional sphere, Charbonneau fortunately managed to overcome her depression. Afterward, her career took off, and she eventually became president of the Canadian Psychiatric Association (CPA). At the end of her CPA presidency in 2008, nearly 20 years since she’d first dealt with depression, she decided it was time to break her silence.
In her final address as CPA president, Charbonneau candidly described her personal experience with depression, leaving many in the crowd stunned.
“At the time, no one — let alone health professionals — was talking about their own mental health problems,” she said. “I saw an opportunity to change that.”
Charbonneau’s candour ultimately led to the creation of the CPA’s working group on stigma and discrimination, which she chaired for the next 10 years. “Telling my story was a way for me to close the door on my time as CPA president as well as on my depression.”
What she didn’t know was that her cancer diagnosis would come later that year, opening the door to let depression come back in.
Suffering in silence
“After my diagnosis, everything moved very quickly,” Charbonneau recalled. Before she knew it, she had a treatment plan that included surgery, chemotherapy, and radiation.
Yet, as her intensive treatments began to wreak havoc on her body, she noticed signs of her depression returning. “It was insidious,” she said. “Slowly my thoughts and mood started changing until I was consumed by depression all over again.”
Battling breast cancer and a major depressive episode at the same time, Charbonneau was struck by the stark contrast in support between the two.
“Cancer treatment is like a giant pink hot-air balloon. You’re lifted up with support — good funding, good programs, a team that checks in on you every day. Everyone comes together to take great care of you,” she said. “In mental illness, there is no balloon.”
Even with the robust treatment plan Charbonneau received for her cancer, psychological services were not part of the program. “When it comes to mental health, cancer patients are mostly left to fend for themselves.”
Charbonneau is not alone in her experience of having to deal with cancer alongside mental illness. As a recent Mental Health Commission of Canada (MHCC) fact sheet (developed with the Canadian Partnership Against Cancer) points out, the estimated prevalence of depression and anxiety in people treated for cancer is at least double what it is in the general public.
Citing a large survey of adult cancer survivors in Canada, the fact sheet also notes that nearly 80 per cent experienced at least one emotional concern in the one to three years following their treatment, many of which were not met.
The difference in support between Charbonneau’s cancer and depression extended beyond her care team, who she noted, did the best they could within the limits of the health-care system.
Socially, she says, we think of mental and physical illness very differently — something she realized with striking clarity one afternoon while recovering at home.
“I woke up from a nap to 19 flower arrangements, 37 missed calls, and what seemed like hundreds of messages of support from friends, colleagues, and even patients,” she said, adding that for a moment she wondered whether she’d already died. “But in all those cards and voicemails, my mental health was never mentioned.”
For Charbonneau, that experience was a poignant reminder that the stigma around mental illness was alive and well.
“People just don’t know what to do or say when someone is dealing with mental illness, so they say nothing,” she said. “Without that support, the road to recovery gets pretty lonely.”
The power of hope
In the thick of a second depressive episode and taxing cancer treatments, Charbonneau found herself with little motivation. “Some days I couldn’t even bring myself to take a shower, let alone take the steps I needed to get help for my depression.”
But after some difficult conversations with her husband and two children, she realized that she could no longer push her depression aside. If she was to make a full recovery, it needed to include her mental health.
As she worked with professionals to overcome her depression for the second time, Charbonneau began to feel more hopeful for the future — something she considers key to recovery. “As mental health professionals, a huge part of our job is instilling hope — hope that recovery is possible and that a higher quality of life is waiting for you.”
She also found hope for her physical recovery from an unexpected source when asked to attend a charity event almost a year away. “Suddenly I thought, maybe I’m not dying after all. I think I’m going to live to be at this event. That was a huge turning point for me.”
For others struggling to cope with a serious illness — mental, physical, or both — Charbonneau emphasizes the importance of vulnerability. “Reach out to someone you trust and really open up. It’s only by being honest about how you feel that you can get better. Help is there if you’re willing to ask for it.”
An agent of change
Even for Charbonneau, being vulnerable is easier said than done. She hesitated when the people at Bell Let’s Talk asked her to become an ambassador and share her experience with depression and cancer.
“After taking such a long break from sharing my personal story, I had to overcome self-stigma to do it again,” she said. “Working in health care, it’s hard to admit to being less than 100 per cent. But everyone close to me told me that I had to do it, and they were right. Vulnerability is what leads to change.”
That change in the way mental illness is perceived has become the backbone of Charbonneau’s advocacy work. In addition to Bell Let’s Talk, she has also spread her message as a member of the MHCC’s board (2013-19) and continues to work as a trainer for its Mental Health First Aid program.
As she continues to advocate for change at every level — from individual attitudes to the health-care system and public policy more broadly — she often comes back to her own experience. “I picture that big pink hot-air balloon that carried me through my cancer treatment, and I think, ‘when will the balloon arrive for those living with mental illness? Where is their balloon?’”
Perhaps the only thing stronger than Charbonneau’s drive to find that balloon is her belief that we can all help. In describing how motivated she is by the power of individual actions, she cites a favourite quote: Be the change you wish to see in the world. “We are all agents of change,” she said. By shifting the way we think about, talk about, and care about mental health, we can create the change we wish to see.”