Released in April 2018, this is the second of three Difference Makers Discussion Papers CAMH and our presenting partner, Morneau Shepell, are releasing to continue to engage Canadians in a national conversation on mental health leading up to the Difference Makers Symposium on May 23, 2018.

INTRODUCTION

Mental illness affects us all. Whether we are the one in five who experience mental illness each year, or are impacted as the friends, family members, caregivers or colleagues of those living with mental illness, it is important to create mentally healthy spaces where we live, learn, work and play. Doing so will ensure our day-to-day experiences promote wellness and connect us to appropriate supports when we need them most.

In the fall of 2017, we celebrated a number of CAMH Difference Makers who introduced us to some best practices around creating spaces that support mental wellness and connect those facing mental health and addictions challenges to care. Their stories highlighted the following themes:



  • Strong leadership is invaluable and this can be found at all levels within an organization or space.

    • Standing on the frontlines of youth mental health, elementary school teacher Claire Wade is promoting wellness in her classroom and beyond.
    • Catherine Burrows is helping change attitudes and actions related to depression for a generation of Quebecois.
    • In whatever she does, mental health advocate Nicole McRorie always manages to go the extra mile.


  • New skills are needed. We must learn how to monitor and manage our own wellness, as well as to recognize the signs of others’ distress.

    • After his struggle with depression led to a severe video game addiction, Cam Adair sought help and created a space to help others like him.
    • Al-Kareem Visram is ensuring his aquatics colleagues practice mental health first aid at the pool in addition to traditional first aid.
    • Police officer Art Wlodyka is using his counseling degree to build better outcomes for those living with mental illness, as well as his fellow officers.


  • Investing in formalizing and normalizing initiatives is needed to create lasting change.

    • Dr. Marie-Hélène Favreau’s innovative leadership and strategy inspires change and raises awarenss for mental health across Canadian organizations.
    • Janet Campbell wants the almost 2,000 employees at the federal Department of Canadian Heritage and workers in the larger federal community to feel supported in addressing their mental health.
    • How did the City of Ottawa become the largest municipality in the world—and first in Canada—to make suicide prevention training available to all of its 17,000 employees? Meet Benjamin Leikin.


DIGGING DEEPER
Leadership at all levels: mental health in education settings

Creating mentally healthy spaces where we live, learn, work and play requires leadership at all levels. In education settings, it is important for policy makers and administrators to take leadership for supporting system-wide initiatives to promote mental wellness, but a purely top-down approach is not the answer. Teachers and other adult allies in the community, as well as students themselves, also have essential roles to play.

  • It is estimated that 1.2 million children and youth in Canada experience mental illness each year. 1

  • Results from the longest ongoing school survey of adolescents in Canada, administered by CAMH and focused on Ontario high school students, demonstrate that in 2015:

    • One in six (17 per cent) students rated their mental health as fair or poor, a significant increase over the 2007 rate (11 per cent), which was the first year of monitoring. 2

    • More than one quarter (28 per cent) of students report that, in the past year, there was a time they wanted to talk to someone about a mental health problem, but did not know where to turn. 3

  • Education settings are the site of significant life stage transitions, such as the move from secondary to post-secondary education, or from school to work. The Mental Health Commission of Canada’s 2017 Consensus Statement on the Mental Health of Emerging Adults describes this time of life as “a critical developmental stage - a time when young people deepen their understanding of their identities and relationships, take on new responsibilities and define their individual truths.” Not surprisingly, one of the eleven principles for a changed system the statement identifies is that “emerging adults are full co-creators of solutions designed to meet their needs.” 4

  • Those at the forefront of advocating for a continued focus on promoting mental wellness and connecting those who need it to care in education settings similarly recognize many successful initiatives rely on the involvement of student leaders. 5 From the Thrive program at University of British Columbia, to the Inquiring Mind program currently being piloted at universities across Canada (originally developed with student input at the University of Calgary), programs that engage leaders at all levels are showing promising results.

Eric Windeler

Eric Windeler

“Young people are far too often left out of decision making processes that directly impact their lives and the mental health space is no exception. In order to effectively address mental health issues for young people, it is vital that their voices are brought to the table in meaningful, constructive, and sustainable ways. They have the knowledge to understand their communities and are experts in the barriers that keep their peers silent, so it's essential that we all commit to moving forward with youth, not for them.”

Eric Windeler, CAMH Difference Maker and Founder of jack.org



New tools for a new normal: navigating mental health in online spaces

Online platforms have found their way into almost every aspect of how we live, learn, work and play. On one hand, our social media feeds are regularly serving up the latest articles on how the omnipresence of technology is affecting the mental health of a generation of young people. 6 On the other hand, the introduction of internet-based mental health supports are allowing those who gravitate towards digital communication, or whose geographical location limits access to in-person health services, to access care in new ways.7 Tips and tools to help tilt the balance towards positive online experiences are out there. 8 Are more needed?

  • Results from the CAMH student survey noted in the previous section demonstrate that in 2015:

    • The majority (86 per cent) of post-secondary students reported visiting social media sites daily. About one in six (16 per cent) students spent five hours or more on social media daily, representing a significant increase since 2013 (11 per cent). 9

    • One in 10 (10 per cent) played video games for five hours or more per day in 2015, and one in eight (13 per cent) reported symptoms of a video game problem. 10

  • The World Health Organization (WHO) has said it will include “gaming disorder” in a June update to its International Classification of Diseases (ICD). The disorder will be defined as a pattern of behaviour “characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.” 11

  • Youth are not alone in the steady increase in their use of technology. Nearly all Canadians under the age of 45 use the internet every day and usage remains strong for those aged 45 and above. 12

  • As part of the evolving dialogue around the growing number of hours we spend online, there are some pointing the potential value of online spaces as offering opportunities to speak more openly about mental illness.13

    • One in 10 Canadians across age ranges (and one-quarter of millennials) reported posting things online when they are experiencing difficulties, meaning that “scraping the internet” to help identify people who might be at risk for their mental health and offering assistance has potential, 14 a tool some social media sites are starting to roll out 15



Cam Adair

Cam Adair

"What inspires me the most about the work I do in mental health is how well those who struggle respond when they are able to learn and become educated through content that is accessible and relatable to their experience. Technology and online platforms are tremendous tools to reach those who need and want help. They are a bridge to build rapport and inspire connection. The starting point of healing.”

Cam Adair, CAMH Difference Maker and Founder of Game Quitters



The rule not the exception: supporting workplace mental health

Many adults spend the majority of their days in the workplace making these spaces critical opportunities for mental health promotion and for connecting those who need them to appropriate supports. Normalizing and formalizing initiatives not only improves the social and economic outcomes of employees and employers, it can contribute to the overall reduction of stigma in our society, promoting a greater understanding of the reality that there is no health without mental health.

  • The importance of workplace mental health has seized many in recent years due to growing evidence of the social and economic impacts from failing to address it, both for those who are employed and those who face barriers to employment as a result of their lived experience of mental illness. 16

  • Morneau Shepell carries out annual national mental health surveys of employees and employers. Results reveal that:

    • A large majority of workplace absences taken due to mental health reasons are not officially reported - 66 per cent of those who took time off for a mental health issue in 2016 did so unofficially. 17

    • More than half (54 per cent) of employees who have had a mental health absence have specific suggestions regarding what the workplace could have done to prevent their absence. This is twice the rate of employees who have had a physical health disability leave. 18

    • Employees and employers agree that the most important factor for a workplace mental health strategy is have a manager know what to do when an employee shows signs of distress. For employees, the second most important factor for a workplace mental health strategy is improving the overall work culture.19

  • The changing nature of work and social relationships must be kept top of mind in efforts to support mentally healthy work environments. For example, Morneau Shepell’s 2018 survey focused on stress revealed that both personal and workplace stress are on the rise:

    • Factors including workload and long hours, co-workers and job responsibilities were cited as the greatest contributors to workplace stress. 20

    • Female employees were more likely to report being under higher levels of workplace stress than their male counterparts. 21

    • On a personal level, both employees and managers cited financial issues, aging parents and feelings of isolation as the main sources of stress. 22

  • The Mental Health Commission of Canada’s National Standard of Canada for Psychological Health and Safety in the Workplace is a set of voluntary guidelines, tools and resources intended to guide organizations in promoting mental health and preventing psychological harm at work.

    • A case study of 40 Canadian organizations sharing their journeys in implementing the National Standard revealed that the top three actions they took to improve employee psychological health and safety were implementing respectful workplace policies and educating employees (78 per cent), providing employee assistance programs and other services addressing mental health (70 per cent), and enhancing mental health knowledge and awareness among employees (66 per cent). 23



Benjamin Leikin

Benjamin Leikin

“I see more and more people starting to understand that making mental health a priority in the workplace makes ethical and economic sense. To help organizations and employees move workplace mental health initiatives forward, Ottawa Public Health along with the Mental Health Commission of Canada developed interactive videos ( www.havethattalk.ca) and a facilitator guide for workplaces of all sizes. Check out the videos and guide to see what you can do to improve mental health in your workplace!”

Benjamin Leikin, CAMH Difference Maker and Supervisor of Ottawa Public Health’s Mental Health Team



CONCLUSION

There is a growing understanding of the value of investing in the creation of more mentally healthy spaces. As more and more of us embrace the need for concerted action, expanding our collective knowledge of best practices and positive experiences will become ever more important. Leadership at all levels, the development of new skills, and normalizing and formalizing initiatives are three valuable lessons to keep in mind as we each do our part to create more mentally healthy spaces where we live, learn, work and play. Moving forward, what next steps can we take and conversations can we have to promote mental health and connect those who need help with appropriate supports in our schools, online and in our workplaces? Also, be sure to read our final paper on Innovation!

1Mental Health Commission of Canada (2016). School-based Mental Health and Substance Abuse Project: Project Summary. Retrieved from https://www.mentalhealthcommission.ca/sites/default/files/SubstanceAbuse_SBMHSA_Summary_ENG_1_0_1.pdf

2Boak, A., Hamilton, H.A., Adlaf, E.M., Henderson, J.L., Mann, R.E. (2016). The mental health and well-being of Ontario students, 1991 2015: Detailed OSHUHS findings (CAMH Research Document Series No. 43). Toronto, ON: Centre for Addiction and Mental Health.

3 Ibid.

4Mental Health Commission of Canada (2017). Consensus Statement on the Mental Health of Emerging Adults: Making Transitions a Priority in Canada. Ottawa, ON: Mental Health Commission of Canada.

5“Students are not fragile flowers we must care about their mental health” (2017, October 5). [Editorial] The Globe and Mail. Retrieved https://www.theglobeandmail.com/opinion/students-are-not-fragile-flowers-we-must-care-about-their-mental-health/article36498798/

6Twenge, Jean M. (2017). Have Smartphones Destroyed a Generation? September 2017 Issues. The Atlantic.

7Mental Health Commission of Canada (2014). E-Mental Health in Canada: Transforming the Mental Health System Using Technology. Mental Health Commission of Canada. Retrieved from: https://www.mentalhealthcommission.ca/sites/default/files/MHCC_E-Mental_Health-Briefing_Document_ENG_0.pdf

8Heitner, H. (2017, January 5). Rules for Social Media, Created by Kids. The New York Times. Retrieved from https://www.nytimes.com/2017/01/05/well/family/the-unspoken-rules-kids-create-for-instagram.html

9Boak, A., Hamilton, H.A., Adlaf, E.M., Henderson, J.L., Mann, R.E. (2016). The mental health and well-being of Ontario students, 1991 2015: Detailed OSHUHS findings (CAMH Research Document Series No. 43). Toronto, ON: Centre for Addiction and Mental Health.

10 Ibid.

11 Oliveira, M. (2018, April 4). WHO set to recognize video game addiction as ‘disorder.’ The Globe and Mail. Retrieved from https://www.theglobeandmail.com/life/health-and-fitness/article-who-set-to-recognize-video-game-addiction-as-disorder/

12 Statistics Canada (2017). The Internet and Digital Technology. (85 per cent for those 45 to 54, 75 per cent for those 55 to 64, 61 per cent for those 65-74 and 35 per cent for those 75 plus). Catalogue number: 11-627-M.

13 Mental Health Commission of Canada (2014). E-Mental Health in Canada: Transforming the Mental Health System Using Technology. Mental Health Commission of Canada. Retrieved from: https://www.mentalhealthcommission.ca/sites/default/files/MHCC_E-Mental_Health-Briefing_Document_ENG_0.pdf

14 Ispos (2017). 3rd annual Canadian mental health check-up. Public Perspectives. Retrieved from https://www.ipsos.com/sites/default/files/2017-08/IpsosPA_PublicPerspectives_CA_April%202017%20Mental%20Health.pdf

15Ingram, D. (2017, November 27). Facebook to expand artificial intelligence to help prevent suicide. Reuters. Retrieved from https://www.reuters.com/article/us-facebook-suicide/facebook-to-expand-artificial-intelligence-to-help-prevent-suicide-idUSKBN1DR1YT

16Smetanin et al. (2011). The life and economic impact of major mental illnesses in Canada: 2011-2041. Prepared for the Mental Health Commission of Canada. Toronto: RiskAnalytica.

17Morneau Shepell (2016). Workplace mental health priorities: 2016. Retrieved from: https://www.morneaushepell.com/permafiles/63434/workplace-mental-health-priorities-2016-report.pdf

18Ibid.

19Ibid.

20Morneau Shepell (2018, January 30). Morneau Shepell finds strong correlation between workplace stress and employee retention. News Release. Retrieved from http://morneaushepell.mediaroom.com/2018-01-30-Morneau-Shepell-finds-strong-correlation-between-workplace-stress-and-employee-retention

21 Ibid.

22Ibid.

23Mental Health Commission of Canada. Case Study Research Project Findings. Retrieved from https://www.mentalhealthcommission.ca/sites/default/files/2017-03/case_study_research_project_findings_2017_eng.pdf