Debra Yearwood Archives - Mental Health Commission of Canada

Designing for Equity

Ian Peralta — Tue, 28 Jan 2025 05:00:42 +0000

By Debra Yearwood

Black History Month 2025 is focused on Black legacy, leadership, and uplifting future generations, a topic we’ve explored in The Catalyst through stories on rallying or searching for culturally appropriate care. In this piece, we ask how more equitable futures can be made possible through design for African, Caribbean, and Black communities, and others not represented by the “average.”

I was grocery shopping when a clerk approached and started processing my cart at the self-checkout. It was quiet. I didn’t ask for help, and she didn’t ask if I needed any. She just stood next to me and started putting my items through.

Some people might say that this is good service, but it didn’t feel that way. It felt like she thought I was too stupid or slow to understand how to scan my items. She didn’t approach other shoppers; a young man at one checkout and a mother with a small child at another. So, based on my past experiences, I wondered if she thought I would try to steal the groceries.

I am Black, and I’ve been followed through stores on more than one occasion. Yet my items were neither subtle nor expensive: paper towels, a bag of rice, and a few other items –hardly the slip-it-into-your-pocket selection. It also wasn’t busy enough for me to go unobserved, so what was the deal?

Then, another thought occurred to me as I was leaving, and she made her way over to “help” another client who had not asked. What we had in common was grey hair.

Bias is two steps forward, one step back

I wanted to sigh and dismiss it, but the more I thought about it, the more aggravated I felt. How many biases against you are too many?

I’m comfortable in my skin, doing what I love and doing it well, so why did that clerk bug me? Because her actions belittled me; they made me feel less. It upset me and I’m not alone.

According to an American Association of Retired Persons study, almost two out of three women age 50 and older in the U.S. report they are regularly discriminated against and those experiences impact their mental health.

Women – particularly women of colour – carry the burden of intersectional prejudices of age, ethnicity, gender, and socio-economic status, among others.

If you’re thinking, yes, but that’s the U.S., then know that in Canada, we face a similar picture. A 2024 Women of Influence survey found that eighty percent of women say they experienced ageism in the workplace. An equal number witnessed women in their workplace being discriminated against based on age.

How do they know? It shows up as being ignored when providing advice and then having the same advice applauded when it’s delivered by a younger or male colleague. It’s the snide comments, being passed over for promotion, or any number of things that make them feel unheard, unseen, or incapable.

Average Has Never Worked

Presumably, most people don’t think ageism, sexism, or racism are attributes to aim for, but beyond the morality considerations, the health costs, and the societal impacts, there are bottom-line business costs that come with these biases.

Sharon Nyangweso, founder and CEO of QuakeLab, a niche agency that applies an equity lens to solve corporate and social challenges, puts it best when she says that we need to see equity as a technical skill.

“Long gone are the days of effective business leaders seeing equity as a ‘nice to have’ or social thing done for a few employees,” she says. “Equity is about building better products, services, and processes. It’s about not injuring or killing people because we can’t see beyond the needs of the ‘average person.’”

Take, for example, pulse oximeters. These small sensors are clipped to a finger or toe and use light to measure oxygen saturation in the blood. They are everywhere. According to Fortune Business Insights, the market was valued at $2.24 billion in 2023 and is expected to grow to $3.56 billion by 2032.

It’s been known for decades that everything from skin pigmentation and melanin to nail polish affects a pulse oximeter’s ability to accurately measure oxygen saturation. For Asian, Black, and Hispanic patients, this can lead to inaccurate readings. Further, those inaccuracies may also be associated with disparities in care, according to the Journal of the American Medical Association.

“Would you call that device effective?” Nyangweso asks. “Would you say that someone who engineered a product that didn’t work for its intended audience was a good engineer? When equity is integrated as a skill set, it considers all people in the design process, and that produces better, truly universal products, processes, and services.”

Say what?

Our stores are filled with products that unintentionally fail to serve their intended audiences. If you’ve ever failed to get a response from an AI-assisted audio device because you have an accent, you quickly understand what it means to use a device created for “the average” user.

What happens when we use AI devices to make decisions that impact people? So far, we know that it can wrongfully send more Black people to prison, inaccurately predict healthcare needs of Black patients, produce sexualized images of Asian women, program ageism into job application processes, and the list goes on. AI isn’t awful, it’s just built with our societal biases.

It’s not just AI. We have smartphones, cars, fitness trackers, and knee prostheses built for men – although women and other genders are also users. Given that women are the primary decision makers for consumer purchases, representing 70–80 percent of all consumer spending and representing about half of the population, how is that effective design?

This is what comes from building for the “average,” which is code for white males. It’s an approach that results in ineffective products, processes, and services that show a bias against their target market.

Even more amazing, products built for the average white man don’t properly meet most of their needs either. Flip through The End of Average by Todd Rose to learn more about that.

Equity as a Required Skillset

When you operate in an environment that doesn’t fit you, or support you, and indeed seems engineered to harm you, it takes a toll. That’s in part why there is often an emotional layer that comes with discussions of diversity, equity, and inclusion (DEI).

Nyangweso described the intersection this way, “People have conflated the work that we do in this field with morality or moralization and that mixes things up and distracts us from talking about the problem we are trying to solve. Instead of addressing the issue the way you would any workplace challenge, people expect me – someone who works in this field – to be their assessors or the morality police,” she says.

“We need to force the question of equity to be a question of professional obligation and responsibility. I want to walk into the room as a professional. I’m not there to talk about everyone’s feelings. I’m not there to beat back decades of socialization.”

Not only is that an impossible task, but it distracts from the real work of DEI by placing an emotional burden on the people trying to fix real problems that create tangible threats to patients, consumers, and clients.

“To understand equity as a technical skill, and to do the work of the field, you have to appreciate the three segments or aspects of DEI work,” Nyangweso says, listing them as:

Equity as an intellectual activity or academic process.
Activism.
Professionalized equity.

Equity as an intellectual activity or academic process means research and data. For example, saying ageism is an issue can’t happen until someone does the work of measuring perceptions and impacts.

Activism, as Nyangweso describes it, is “that practical process where we are trying to reach liberation in the world.”

This work calls into question the status quo, forces us to have conversations about things we took for granted, and eventually leads people to question the way we do things and why we do them. It is the emotional lift that starts the ball of change rolling. How many conversations were prompted by Black Lives Matters or Every Child Matters?

Professionalized equity falls within change management tactics and is often how organizations implement the change processes required to become more equitable producers, suppliers, and employers.

Nyangweso notes that there are multiple intersection points with the three. “The work of activists supports the DEI sector, and makes professionalized equity work possible, and research is used to inform practices and approaches.”

All three segments are valid and serve different purposes. When we default to one without consideration for the others, then real change is not just hampered, it can become impossible. Similarly, when we try to use the tactics for one, to implement another, we will be disappointed by the results. For instance, using the tools of activism to develop tactics for professionalized equity will leave us frustrated by the constraints of a corporate environment and the speed of change.

Equity works

All workplaces do better when psychological safety, a byproduct of equitable spaces, is present. Psychological safety is about feeling free to be who you are at work. It’s about being able to engage without fear of punishment or other negative consequences. For employers, it not only improves the workplace environment, but psychological safety also means financial advantage through increased productivity and lower absenteeism and turnover.

We all live with the challenge of managing within an inequitable world. We can perpetuate those inequities by pretending they don’t exist, don’t impact us, or those around us – or we can take the initiative and make changes where we’re at. We can question why we ignore the advice of older employees; we can call it when we hear inappropriate comments about people based on age, gender, race, sexual orientation, or anything else that doesn’t reflect respectful engagement.

The absence of equitable thinking in the development of work has real world consequences. To do your job effectively, whether you’re a grocery store clerk or a product developer, you need to learn, understand and live diversity, equity, and inclusion.

Changing the Conversation

Ian Peralta — Thu, 14 Nov 2024 05:00:54 +0000

By Debra Yearwood

Download a copy

MHCC & Series – Diabetes Canada

I’d been looking forward to my MHCC & conversation with Laura Syron, President and CEO of Diabetes Canada, since I’d marked it in the calendar this summer.

My family is no stranger to diabetes.

It’s been a low thrum in the background of my life for as long as I can remember. For my mother and my many aunts, diabetes was something accepted. We had no preconceived notions about it and I’ve spent most of my life expecting to get it.

Today, we understand that many factors likely made them more susceptible; we’re of Bajan heritage, and diabetes is more common in African, Black, and Caribbean (ABC) folks.

But I became doubly interested in speaking with Laura when I learned that she herself had been diagnosed with type 2 diabetes at age 50.

That’s when her lifelong professional commitment to health advocacy became personal.

When life imitates work

Just moments after a quick hello and introduction on our virtual call, Laura apologized. “I’m sorry, my [glucose] monitor is beeping here,” she laughed ruefully. “This is life with diabetes. You’re never off the clock.”

Just back from her quarterly diabetes check-up, Laura generously reflected on her own experience with a diabetes diagnosis and her ongoing health management. While it was eight years ago, she said she recalls it like yesterday.

“I was sitting in the doctor’s office after a routine exam, and right out of left field she told me I had diabetes.”

Laura paused and took a breath.

“It’s hard to explain how unexpected that felt. How unprepared I was. I sat there, in stunned silence, without a clue about what to do next.”

But shock and dismay weren’t the worst part for Laura.

“I was so embarrassed.”

Here, I stopped her. “Embarrassed? But why?”

And in one of the more eye-opening conversations of my professional life, Laura unraveled the complex emotions that so many feel when hit with a diagnosis where lifestyle factors – can, but don’t always – play a role.

Laura Syron, President and CEO, Diabetes Canada

Shame. Blame. Guilt.

“Maybe I’d skipped too many workouts? Had I snuck an extra donut on the weekend? Was I lazy, unmotivated?”

Laura confided she considered hiding her diagnosis, even from her husband.

“In that moment, I didn’t like myself. I thought I deserved this.”

Laura isn’t alone in her experience.

In 2023, in a first-of-its-kind national survey, Diabetes Canada engaged with nearly 2,000 people with lived experience of diabetes. Laura’s feelings were borne out across the community. In fact, shame and blame were echoed by nearly 90 per cent of people living with type 1 diabetes and almost 70 per cent of those with type 2 diabetes.

Now, she has taken up the mantle, in the hope others won’t fall into that trap.

“I want people to be empowered in a way I wasn’t. I want them to know there’s a place they can turn to get information, to seek support, and to become self-advocates.”

In addition to a wealth of existing resources, Diabetes Canada has plans to create a conversation guide for health-care providers.

“It would have made all the difference if my doctor had delivered that same news: ‘You have diabetes.’ And simply added, ‘But it’s not your fault.’”

Stigma, which casts a long shadow on so many illnesses, doesn’t spare people living with diabetes.

But, said Laura, “We’re committed to changing the conversation.”

Rewriting the narrative

Diabetes Canada is working on three fronts.

“This is a marathon, not a sprint. I look at mental health, and how you’ve powerfully shifted the conversation out of the shadows. Today, we’re seeing those efforts bear fruit – from Bell Let’s Talk, to the FACES campaign.”

This is Laura’s ambition for Diabetes Canada. That people become more engaged – whether that’s corporate Canada, workplaces, or schools.

“Because from there, you see an uptick in research dollars, volunteerism you name it.”

To kick-start this virtual cycle, the organization is striving to get ahead of misinformation, which can double the burden on people living with diabetes, as it did for Laura when she was first diagnosed.

“Not only was I facing a major, life-altering diagnosis, but I also thought I’d caused it.”

They are also working against a general apathy.

“Society can be dismissive of diabetes. Don’t get me wrong, we have life-saving treatments. Type 1 diabetes used to be fatal before the advent of insulin. But that isn’t to say that managing a complex illness isn’t a tedious, often exhausting, balancing act. We’re trying to change the attitude that it’s ‘just’ diabetes.”

And finally, stigma.

Laura dubbed the reaction as a ‘societal shrug,’ or a ‘you’ve made your bed’ indifference. But she pointed out, even if that were true, not everyone has the same opportunities that can help with prevention.

“There are social, environmental, and biological factors at play. So, we’re trying to close the compassion gap.”

But it’s not just a deficit of empathy that people with diabetes experience.

It also depletes their finances and takes a toll on mental well-being.

Dollars and sense

“The cost is huge,” emphasized Laura. “I’m talking both in terms of the societal price tag and the individual’s out-of-pocket expenses.”

In just over a decade, the financial impact of diabetes has nearly tripled, from $13 billion in 2013, to $39 billion in 2024. In 2023, according to Telus Health’s annual drug trends report, diabetes medications remained the leading drug category for private insurance claims, with a nearly 30 per cent spike in eligible claim amounts as compared with 2022.

For people living with type 2 diabetes, the yearly outlay can quickly mount to over $10,000. For those with type 1, that figure rises to $18,000, taking a major bite out of any household budget.

Diabetes Canada has an information and referral line, 1-800-BANTING, named after the father of insulin invention, esteemed Canadian researcher, Dr. Frederick Banting.

Pre-pandemic, the calls they fielded were primarily centred on providing education.

“People were calling distressed because their sugars weren’t going down, or because they needed advice on different medication options, and sometimes because they just needed a listening ear.”

But since COVID, the nature of the calls has changed.

Feeling the squeeze

Today, the most frequent callers are people experiencing financial hardship.

“It’s empty wallets. An inability to pay for meds, to cover the insurance co-pay, or even buy the healthy foods so vital to diabetes management.”

I reflected that an ounce of prevention is worth a pound of cure.

Without access to the right services, supports, and treatments, that alarming cost curve isn’t going to trend in the right direction anytime soon.

“That high cost is compounded by a feeling of overwhelm. So, some people will look at what’s involved with diabetes management, in terms of dollars, yes, but also time, energy, mental load, and decide they’d rather opt-out entirely.”

That’s where things get scary, reflected Laura.

“Blindness, amputations, kidney failure, heart disease, these can all result from unmanaged diabetes,” and she continued, “when only about 10 percent of people with diabetes are cared for by an endocrinologist, the remainder rely on family doctors.”

This is a huge problem. According to the Canadian Medical Journal, 6.5 million people in Canada do not have access to regular primary care. In short, either they don’t have a family physician at all, or if they do, they can’t get timely appointments.

Laura has a solution. “We need to expand scope of practice for pharmacists, nurse practitioners, nutritionists. These allied health professionals are so integral. We need to rethink universal health care when so many people with complex needs, like diabetes, are falling outside of it.”

An overcrowded pool

Laura told me four million people in Canada have diabetes, but she provided a powerful analogy to illustrate her point.

“Imagine there are four million people with diabetes swimming in a pool.”

Some, like Laura, are in the shallow end. Others, with more severe illness, are struggling in deeper water.

“Then,” said Laura, “there are another six million people with their feet in the pool [with pre-diabetes], and millions more walking towards it.”

Add to these startling numbers that people living with diabetes are twice as likely to experience depression, and you have a scenario that’s doubly complicated.

“There’s diabetes distress, and then there’s depression, and we’ve got to be on the lookout for both.”

Diabetes distress comes from the constant anxiety and worry that stem from unrelenting decision-making, over and above the usual daily grind.

“One thing that’s unique about diabetes is that the onus is very much on the individual to manage their blood-sugar levels, and this could include lifestyle changes, oral medications, insulin injections, a pump etc.”

But calibrating those can be a challenge.

“It’s taken me eight years to find the right dosage. I won’t get into some of the awful side effects that can present when you don’t respond well to the meds, but at Diabetes Canada, this is exactly why we’re advocating for individualized treatments.”

Metabolizing trauma

Diabetes and depression go hand-in-hand, and Laura advocates embracing best-practices like trauma-informed care, which has long been a gold-standard in mental health treatment.

“We live in these imperfect systems, and I worry that the gap between the haves and the have nots is widening. And with this lack of access comes judgement – and judgement from healthcare providers can cause great harm.”

For example, a diabetic low or high can mimic intoxication. And, given that African, Black, and Caribbean people, as well as those of Indigenous heritage, have higher rates of diabetes to begin with, a bias – even an unconscious one – can turn deadly.

The whole conversation gets me to thinking about how we process trauma in the body, and the imprint it leaves.

People with depression have a 40 to 60 per cent increased risk of developing diabetes, and those living with diabetes are two to three times more likely to experience depression.

It’s that age-old “chicken and egg” conundrum.

But regardless of the order in which one develops these conditions, the metaphorical pool Laura spoke of is growing more crowded by the day.

“Someone slips in every three minutes.”

Until we can drain the pool, the life-sustaining supports these folks need include the kind of wraparound care Laura herself is lucky enough to have.

“Everyone living with diabetes should have access to medication, eye and wound care, a family doctor, and, of course, mental health care. This should be the rule, not the exception.”

Ending diabetes

In 2021, Canada celebrated the 100th anniversary of the discovery of insulin – among our country’s greatest achievements.

“As the birthplace of insulin, Canada has a legacy to uphold,” said Laura. “Yes, millions of lives have been saved, but millions more have diabetes than ever before. We cannot wait another 100 years for a cure.”

Laura points to a range of things people can do, to mark Diabetes Awareness Month, and to help Canada lead the world toward ending diabetes.

“You can get informed and know your risks, share information to raise awareness, or even take the time to declutter before winter, and donate clothes, décor, books, or small household items.”

As we end the call, Laura checks her monitor one more time.

“Won’t it be something when there comes a day when we’ve got a cure.”

Until then, Laura will remain on the clock – at home, and at work.

Author: Debra Yearwood

A communications pro with more than 20 years of executive experience in the health sector, expertly navigating everything from social marketing to crisis comms. When she’s not advising on the boards of Health Partners or Top Sixty Over Sixty, she’s busy finishing her book on thriving in later life (because why stop now?). Certified Health Executive by day, diversity advocate and magazine contributor by night—Debra’s the one you call when things need fixing or explaining.

The post Changing the Conversation appeared first on Mental Health Commission of Canada.

A Gutsy Move

Ian Peralta — Thu, 24 Oct 2024 04:00:21 +0000

By Debra Yearwood

Download a copy

My conversation with Lori Radke, President and CEO of Crohn’s and Colitis Canada got real, very quickly.

Given that 2024 marks Crohn’s and Colitis Canada’s 50^th anniversary, I asked Lori to reflect on that legacy. “Where have you been, and where are you going?”

“I can’t remember a time when Crohn’s and colitis wasn’t a thrum in the background of my own life,” explained Lori, an only child, whose mother was diagnosed while pregnant. “That’s over 50 years ago. And back then, there was zero information. Nothing.”

Five decades ago, despite its severity of symptoms, the disease was sloughed off by medical professionals as simply “all in your head.”

Mapping the mind-gut connection

Today, inflammatory bowel disease (IBD), of which Crohn’s and colitis are the most common forms, is understood to inflame the lining of the gastrointestinal tract. During acute flares, IBD can interrupt the digestive process from start to finish, including properly absorbing nutrients and eliminating waste. This can cause relentless diarrhea, severe cramping, and bloody stools. Treatments may stop working, and surgery is a frequent recourse.

In addition to physical symptoms, as many as a third of people living with IBD also experience anxiety and depression.

“Of course, today, we understand there is a deep mind-gut connection, and if we can successfully manage symptoms of stress through cognitive behavioural therapy, for example, we can better manage physical symptoms – but often that comes with an out-of-pocket cost. The hard truth is, we still don’t know what causes these incredibly painful and terribly inconvenient bowel diseases. And a cure isn’t yet on the horizon, though I hope we’re getting closer.”

Tech to the rescue

And it’s that gap, between where they are today, and a future cure, that Lori finds herself navigating.

“We were founded in 1974 by a group of concerned parents. Understandably, they wanted to find a cure. So, our efforts remained laser-focused on that, raising $150 million and distributing 400 grants – for research that is giving us realistic hope.”

But about six years ago, patients began urging the organization expand their mandate

“And we listened,” said Lori.

Patients affirmed that while finding a cure must be job one, improving quality of life, in the here and now, was a close second. Following those marching orders, Crohn’s and Colitis Canada quickly regrouped, zeroing in on the power of technology to open new doors – literally and figuratively.

The GoHere app is a prime example.

Conceived to serve an urgent community need – and created with the support of Amazon Web Services – it provides detailed information about publicly available washrooms in Canada with no-questions-asked access.

Retail chains, municipal buildings, government offices, and restaurants agree to be identified on the app. After downloading it, people can better plan trips and outings, or locate emergency washroom facilities nearby, without having to make a purchase or beg for admission.

It’s been downloaded 46,000 times, offering a trail of breadcrumbs to 3,450 publicly available washrooms, and counting.

Lori Radke, President and CEO, Crohn’s and Colitis Canada

Tackling the taboo

“It’s a simple idea, but it’s a huge game-changer,” explained Lori. “Having IBD isn’t like that one time when you or I had diarrhea last year. It can be utterly debilitating, and you can quickly find yourself isolated. Incontinence is still taboo. We all have bodily functions, but we have not normalized talking about them. GoHere is one way we’re trying to make a practical change – and, in doing that – change mindsets at the same time.”

In short, Crohn’s and Colitis Canada is striving to lessen the double burden of symptoms and stigma.

“We’ve created Crohn’s and Colitis Connect – a Facebook-style online platform exclusively for people living with IBD, and their caregivers – in direct response to a pressing desire for peer support among those living with the illness. It affects almost 0.9% of the population, so while it’s not uncommon, it’s rare enough that you may not know anyone who has walked a mile in your shoes.”

Which is where the Gusty Walk comes in.

Walking the talk

Held in 50 locations across the country, and racking in nearly $2.4 million, it’s both a major fundraiser, and a deeply valued community-building exercise.

“I remember this one family, and the daughter was just over the moon. She was practically glowing as she said to her dad, ‘Look! Look at the Port-o-Potties lining the route! You’re going to be able to do this!’ That kind of inclusion…we just don’t see enough of it.”

Speaking of inclusion, I asked Lori how workplaces are doing on the accommodation front, and what steps could be taken to make life easier for people who already bear the added burden of managing a complex, episodic illness – with often unpleasant and painful symptoms.

“I think there are small things employers can do, proactively. Tell people to take breaks throughout meetings should they need them. Normalize that. Offer wellness days, so people can choose to take time without having to give reasoning. But really, because gut and digestive health are not only invisible, but traditionally out of bounds for ‘polite conversation’, the only real solution is to ask for what you need. And that can be difficult.”

But Lori went on to say one of the things that brings her great joy is watching the tide slowly turn.

“Within our community, we have this brave group of influencers, like Paula Sojo, who lives with Crohn’s.”

The power of influence

Sojo underwent 15 surgeries and had an ostomy at 18. She’s turned something she says she once found repellant into a fashion statement, creating her own custom ostomy bag cover business.

“She is refusing to remain unseen, or to be silenced because her experience might make someone uncomfortable. She is standing up and saying, ‘I am beautiful, I am powerful, and above all, I am alive.’”

Because, added Lori, “As terrifying as the prospect of an ostomy can be, it can save your life.” And it’s this message, of pulling back the curtain, to better educate the public and even health-care providers, that is informing the way forward for the organization.

Life – interrupted

Awareness breeds understanding, which alchemizes into empathy. And empathy is critical for people living with Crohn’s and Colitis.

“It’s the only way we’ll create a society where the adults living with this today can speak openly and serve as role models to the overwhelming number of children who are being diagnosed and will have to navigate this journey throughout their whole lives.”

And while people are most often diagnosed before the age of 30, since 1995 the incidence of Crohn’s and colitis has doubled in kids under ten.

“It’s alarming, that’s for sure,” said Lori, who notes that in 2023, 11,000 people were diagnosed, meaning a new diagnosis every 48 minutes.

“It’s about so much more than numbers,” said Lori. “These are lives. Lives about to veer in a direction no one wanted or expected.”

Lives like a good friend of Lori’s 14-year-old daughter, who was supposed to spend the summer at camp, enjoying a carefree time with friends.

But instead of canoeing and campfires, she endured the season lying in a hospital bed, on a feeding tube, with a temporary stoma, having had 25 centimetres of her bowel resected.

After sharing this story, Lori paused, collecting herself. She glanced down at her desk and rifled through her papers.

“I prepared for this [interview], but this wasn’t in my notes. I was thinking about how when we go to see my daughter’s friend in hospital, my job is to support her mom. And if I wasn’t in this job, would I have the slightest idea how to do that? The answer is likely no. And that’s what we’re working so hard to change.”

Author: Debra Yearwood

The post A Gutsy Move appeared first on Mental Health Commission of Canada.

Making the Invisible Seen

Ian Peralta — Wed, 04 Sep 2024 04:00:02 +0000

By Debra Yearwood

Download a copy

Welcome to the first story in the MHCC & series, designed to get to know our Health Partners membership, and learn about where our realities intersect, and how best to support each other.

To mark Arthritis Awareness Month, observed every September, the Mental Health Commission of Canada’s Director of Marketing and Communications, Debra Yearwood, sat down with Arthritis Society Canada President and CEO, Trish Barbato, for a wide-ranging dialogue.

When I asked Trish what her biggest challenge is, as president and CEO of the Arthritis Society Canada, she surprised me by rhyming off a list of obstacles that sounded a lot like those we face here at the MHCC.

“You can’t see arthritis; it’s sneaky, one day you’re fully functional, the next you’re laid low by a flare; you’re isolated and afraid of the judgement that comes with being labelled as unwell.”

For those living with the illness, this translates to a familiar sounding refrain.

Dismissive attitudes. Check.

Difficulty planning. Check.

Dispelling myths. Check.

I nodded my head, as these realities echoed the concerns that we so often hear from people living with a mental health problem or illness.

Invisible. Episodic. Stigmatized.

A shared reality

Both arthritis and mental illness are covert tyrants. And with no cure in sight, people are often left to manage with imperfect diagnostics, limited treatments, and scarce resources.

Trish laid bare her challenge like this: “If seeing is believing, how do I make people really see arthritis for the havoc it wreaks on people’s lives, so they believe it to be worthy of the funding, recognition, and research it richly needs and deserves?”

As Trish shaded in the nuances of her monumental task, I asked her how she manages her own arthritis – something she’s endured in her hands for 20 years.

“We have a saying that motion is lotion,” said Trish, who defies all stereotypes as a certified fitness instructor and black belt in Kung Fu. “Movement really is the best medicine because without it, we can’t get the lubrication that eases our joint pain, or the benefits of improved strength and reduced fatigue.”

That’s an important message, because not only is there a tendency towards being sedentary when in pain, there’s also a known correlation between movement and improved mental health. Given that people who live with arthritis are more than twice as likely to face depression than the general population, I asked Trish about the relationship between chronic pain and mental health problems.

Pain is personal

She cited her mother as an example, who is debilitated by arthritis, her losses mounting until they cast a shadow on even life’s smallest pleasures.

“Pain isolates you by demanding your full attention. It wears you down to the bone – and putting on a happy façade can leave you feeling more depleted than before,” said Trish.

Describing living with chronic pain as a deeply personal and lonely journey, she went on to say, “It’s difficult to be robbed, a nickel at a time, of your mobility, your passions, your work life.”

In fact, arthritis is the leading cause of disability and workplace limitations in Canada. Yet, with knowledge and understanding, the possibility of accommodations could restore hope for those prematurely sidelined. Trish demonstrated this visually by holding up a strange-looking contraption I’d never seen before.

“It’s a vertical mouse!” she exclaimed. “Such a tiny ergonomic investment is a literal lifesaver for someone like me.”

Sadly, many younger people she’s spoken with are reticent about asking for accommodation, fearing negative reactions, or even disbelief.

The empathy gap

“There’s a huge misconception that arthritis is an older person’s disease,” explained Trish. “When in fact more than half of people affected are under 65.” And while as many as 20 percent of Canadian workers live with arthritis, there remains a lack of societal empathy about the profound nature of its impact.

Even among older adults, Trish adamantly rejects the narrative that pain and loss of mobility are the natural trajectory of aging, no different from grey hair or wrinkles.

Trish Barbato, President and CEO, Arthritis Society Canada

“This isn’t an insignificant illness,” said Trish. “You can’t just pull up your socks and get on with it. It’s complicated. Treatments, where they exist at all, come with their own downsides. Big medications equal big, sometimes scary, side effects. And for some forms of arthritis, a joint replacement is the only option.”

But wait times for surgery are often longer than the recommended six months, leaving people immobilized and in pain.

“I may go off on a tangent here,” she warned, laughing – but there’s nothing funny about the delays, which she called patently unacceptable.

“People’s lives are in suspended animation while they wait, and that has practical, financial, and mental health implications. There needs to be more accountability. Period.”

That’s one reason why Trish, together with 21 partner organizations from across the country, is grabbing the bull by the horns.

Actions speak louder than words

“We’re creating an Arthritis Action Plan, and the operative word is action!” she exclaimed. “I have zero time for dust-gathering tomes. Been there, done that. The very act of convening this group is itself an action statement, because we’re casting the net beyond the usual suspects.”

The action plan is being informed by a diversity of worldviews, because arthritis “hits different” depending on your age, race or gender, she says.

As the co-founder of the volunteer-run Menopause Foundation of Canada, Trish is an advocate for ending stigma and sparking dialogue on health areas traditionally considered taboo.

“We need to start dragging topics shrouded in stigma into the light, like the MHCC has done with mental illness,” she said, “and we need to see chronic illness through a prism of diverse experiences. We need to say, ‘Look, arthritis is experienced differently by menopausal women; by child-bearing aged women; by Black women.’ We can’t be satisfied with one-size-fits all.”

She went on to tell me a heart-breaking story of a new mother whose arthritis was so severe that she was unable to pick up her newborn. “And people say it’s no big deal?” Trish shook her head.

Joining forces

After talking at length with Trish, I am more convinced than ever that while our constituencies may identify with a particular illness, their lives could be enriched by greater access to a range of services that our current system is ill-equipped to provide.

“We have a phone line or info e-mailbox, and most often people are looking for services that fall outside our acute care system…they need mental health supports, physiotherapy or occupational therapy, expensive medications,” said Trish.

I ask her what happens when people can’t find or afford these services.

The answer – unsurprisingly – is they go without. It’s in these areas of overlap where we see the potential for shared problem-solving.

As Health Partners, we have an opportunity to amplify our collective areas of need.

And that is precisely what MHCC & intends to do.

Author: Debra Yearwood

The post Making the Invisible Seen appeared first on Mental Health Commission of Canada.

Is Mental Health Funny?

Danielle Impey — Tue, 30 Apr 2024 18:36:19 +0000

By Debra Yearwood

When you think of mental health, do you want to have a good laugh?

Humour is one of the most effective ways brands have to capture attention and be memorable. It’s not always easy, but if you can strike the right balance between tone and your target market’s funny bone, it’s gold.

Unfortunately, for most health brands, humour represents pitfalls. Fears of poor taste or making people feel minimized are real. This fear of funny means, for the most part, we are left tugging on heartstrings or seeking inspiration from the patient as brave soldier.

In fact, a few years ago, SickKids launched a brilliant campaign where they combined the two with children as gritty-eyed warriors fighting illness and injury. While there were critics of the VS Limits campaign, it did its job, surpassing the $1.5-billion goal.

When you are a mental health advocate, there is a lot on the line. With so much stigma associated with mental health, anything that might further confuse issues makes the use of humour thorny. Yet, if you are struggling with mental illness, you don’t always want to be immersed in the dark imagery that often accompanies stories of mental distress. Unfortunately, for a long time, mental health meant a series of images of people with their heads in their hands.

We contain multitudes

The reality is much more dynamic. Mental health discussions, even the toughest of them, can be about optimism, change, and recovery. We don’t have to go the warrior route. It is possible to go for and succeed with the holy grail of healthcare promotion: humour.

Ottawa Public Health has been a champion of that approach. When speaking to Kevin Parent, the social media lead, he noted that while the public health unit is often funny, they can get away with it because, first and foremost, they are always authentic. That means they express a variety of voices on their feed. Some are full of comedic relief; others are serious, sad, educational, and informative – essentially, the range of human emotions.

For example, during the pandemic, mask discussions lost all humour for me, and yet my inner sci-fi geek was tickled when they featured The Maskalorian with the quote, “This is the way.” It made a tiresome topic fresh and funny.

“We do everything we can to stay authentic,” Parent says. “If you understand your audience, if you take the time to know them, then you’ll know what they think is funny. You’ll also know when they need a laugh. It isn’t that a particular thing is right, and another is wrong; it’s more a case of what’s right – for right now.”

So, during the emergency phase of the pandemic, maybe mask-breath jokes were too soon – though, these days, most people would have experienced this and get the reference.

In recent years, constraints that have kept humour at bay in the health sector have fallen due to the popularity of social media influencers and the acknowledgement by health professionals that the voices of those with lived experiences are not only relevant but important in everything from research to recovery.

The shift in perspective was aptly demonstrated when that bastion of academic rigour, Harvard University, conducted best practice educational sessions with TikTok mental health influencers Rachel Havekost and Trey Tucker. The engagement brought better health information to the public through those popular feeds. However, it’s not always a successful partnership if the fit between knowledge and theatre isn’t right. No matter how well-intentioned or researched, if the content isn’t entertaining, it does not get viewed.

Some experts advise healthcare marketers entering the humour arena to be gentle. That’s not bad advice, but it does leave the content somewhat bland. When the Mental Health Commission of Canada decided to refresh a few years ago, it wanted to bring the brand into the light and occasionally tickle the funny bone. This meant banishing images that conjured deep unhappiness. You know them: a dark day and a sad person sitting alone on a bed, facing a corner. It’s usually in black and white to reinforce the glumness of the subject matter. If that wasn’t enough, there are also lots of clouds.

Silver linings

The change to optimistic imagery wasn’t simple. As many experts insisted, mental health isn’t always sunshine and daisies. The challenge is understanding what viewers are looking for so that good information can be digested.

I am not alone in saying nothing about dreary imagery draws me in and makes me want to learn, see, or hear more. If I also get served a lecture using technical language, I’m out. It’s not that dark and difficult times are never part of the mental health journey, but contributing to doom scrolling hardly seems progressive. Nor is it that viewers don’t want well-researched information, but anyone who has ever had a loss of mental health knows the process is not simple. There are good and bad times, sometimes in the same 24 hours. Regardless of where you are on the continuum, a little humour can go a long way. A good laugh can reduce stress and tension, provide relief from pain, improve your mood, and has a host of other well-documented impacts.

The issue is finding the right balance of information and entertainment. Infotainment is easy to say and hard to achieve. It’s fine to explain that laughter is the best medicine and cite a series of research studies, but putting humour into play while delivering information responsibly to an audience that often includes people at risk is difficult.

Mental health can be funny, but it can also be sad, scary, and complicated. For advocates, advertisers, and audiences, getting the balance right is not only essential, but it can also be life-altering.

Further reading: No more doom and gloom: How we’re using photography to inspire hope.

Resource: Fact Sheet: Common Mental Health Myths and Misconceptions.

Author: Debra Yearwood

Debra Yearwood

The post Is Mental Health Funny? appeared first on Mental Health Commission of Canada.

Remix Your Therapy

Alex Barankevych — Mon, 15 Apr 2024 21:04:35 +0000

By Debra Yearwood

The sounds of sorrow and hope amid a tangle of words on injustice, racism, and brutality often define conscious rap music. Their presence is an acknowledgement of the challenges faced and a call to Black communities to stay strong despite the pressures of prejudice. Music’s role in expressing the internal, external, and seemingly eternal conflicts arising from oppression makes it an important player in the survival of Black culture, identity, and mental health.

Everyday racism activities that permeate daily life become ‘normalized’ in the mainstream despite stated commitments to equity. These transgressions often appear mindless or habitual and while they hurt, it’s sometimes easier to ignore than battle every incident. When I was a political assistant on Parliament Hill many years ago, small green buses would wind their way around the precinct, bringing staff and members to different buildings. Regularly, the buses would drive past me. The drivers would see me flagging them but never considered that a Black woman could be a Hill staffer, so they drove by. They passed by me so often that when they did stop, I was startled.

The loop

Freda Bizimana

Given their frequency, these racist moments are regularly treated as too minor to address. However, their cumulative impact reproduces social relations of power and oppression and, over time, damages the health and well-being of Black people and other people of colour. In effect, everyday racism creates systemic racism, and systemic racism creates the environments that allow everyday racism to thrive. They both produce challenges to mental health.

When violence against Black citizens is normalized or overlooked with little to no reaction from agencies such as the media or government, then it would be easy to allow despair or cynicism to take over. According to a 2018 study published in The Lancet, Black Americans report upwards of 14 poor mental health days for every reported police killing of an unarmed Black American in their state of residence.

There’s all sorts of trauma from drama that children see

Type of s–t that normally would call for therapy

But you know just how it go in our community

Keep that s–t inside it don’t matter how hard it be

– Lyrics, J. Cole, “Friends” 2018.

The impacts are multi-generational. Discrimination experienced by a parent may also negatively impact their child’s mental health, even if that child did not experience the discriminatory treatment firsthand. In the same Lancet study referenced above, the impacts of “indirect” or “vicarious” racism were found to worsen the progression of inflammatory disease, sleep disturbances, chronic health conditions, and cognitive function – all of which decay mental health.

Music has been and remains an important part of Black cultural expression. Its ability to communicate complex messages and emotions is integral to its construction. It was fear of the effectiveness that led U.S. legislators to ban slaves from using drums in 1739. Almost 150 years later, in 1988, NWA’s single, “F–k tha Police,” drew similar concerns from authorities when it was released.

It’s not surprising then that rap music and hip-hop culture play an important role in not just expressing the concerns, fears, opportunities, and hopes of contemporary Black people but also providing an outlet to improve mental health in those same communities. In 1998, researcher and clinician Dr. Edgar Tyson introduced hip-hop therapy at the 20th Annual Symposium of the Association for the Advancement of Social Work.

Mama had four kids, but she’s a lesbian

Had to pretend so long that she’s a thespian

Had to hide in the closet, so she medicate

Society shame and the pain was too much to take

– Lyrics, Jay-Z, “Smile,” 2017.

Hip-hop therapy is a fusion of hip-hop, bibliotherapy, and music therapy. Music therapy has established credentials that stretch back to research done by Zane Ragland and Maurice Apprey as early as 1974. Similarly, bibliotherapy, which focuses on the use of literature, such as stories and poetry, to facilitate treatment, is also well established and has been proven to be effective by several systematic reviews in the treatment of emotional, physical, and mental health problems among adults.

Tyson’s groundbreaking research is the cornerstone of contemporary hip-hop therapy and lends itself well to culturally appropriate care, particularly among young people.

Toronto therapist Freda Bizimana, MSW, RSW, works with Black and racialized youth in conflict with the law at The Growth & Wellness Therapy Centre. She shared how challenging it is to reach Black youth, particularly those who have come to therapy because of their interaction with the justice system. “They don’t want to be there talking to a stranger,” she says. “Hip-hop gives us a bridge, a way to connect through something they love. It’s a modality that is not rooted in European experience. It brings back the drums common to the African Black diaspora.”

New release

In her practice, Bizimana notes that clients are not often engaged and start with one-word answers. She’ll look at their headphones and ask them what they are listening to. They’ll share their favourite songs, then delve into lyrics. At some point, Bizimana will ask them, ‘Do you ever feel that way?’ Suddenly, they are having a conversation. “This modality eases them into the process,” she says.

How does Bizimana respond to critics who question the efficacy or appropriateness of this therapeutic approach? “Hip hop is a mirror of society. If you have a problem with it, you need to look at what’s happening in society,” she says. “How are we addressing anti-Black racism? What is happening within our school systems with Black youth? What are we doing to deal with police brutality? Why are young people numbing themselves?”

No need to lie into your emerald soul

You surely know gold is always in your throat

Why not let it shine?

You’re in control of the dream

– Lyrics, Kid Cudi, “The Commander,” 2016.

Rap can surf off strife and act as a vehicle of escape. Political commentary set to a 4/4 beat transforms frustration with structural racism into an accessible anthem of collective experience. Kendrick Lemar’s album, To Pimp a Butterfly, provides political commentary on faith, culture, and race. The song “Alright” pulled those insights together and made its way onto Pitchfork and Billboard best-of lists for 2015. Lamar notes in the poem that runs before and after the song that the conflict is based on discrimination and apartheid. Like the songs of slaves, he sings that with God, things will be alright. The widescale popularity and uplifting beat eventually led to its adoption by the Black Lives Matter movement, reinforcing the relationship between conscious rap and activism.

Collective efforts

Rap’s themes of overcoming obstacles and surviving life’s challenges are specific as well as inspirational. They reflect the realities of daily life for many in Black communities. Hip-hop therapy takes rap music and other elements of hip-hop culture and blends them to create a culturally relevant therapeutic offering. Unlike regular music therapy, it also embraces group therapy. This allows for shared experiences and reduces the feelings of isolation that are often the consequence of racism. The evidence shows that it can reduce depression and anxiety while also improving communication and emotional expression.

Hip-hop therapy also does something else; it empowers. Rap music varies widely and can reinforce doctrines of sexism, commercialism, and drug culture. For Black women, it can be another source of disrespect and denial. Through hip-hop therapy, women can counteract those influences through the creation of lyrics and discussions that tell their stories in their voices.

“Hip hop gives a voice to Black youth,” Bizimana says. “It allows them to have a space to express, heal, and grow with a medium that is familiar. I’d like to see it used more frequently in Canada,” she says, noting that more therapists are adopting this approach through individual and group sessions. She is seeing schools incorporating it into curricula. “Sometimes help can come in the form of a coping playlist,” she says, “like a playlist for when you are sad and another for when you need motivation.”

Years ago, if asked, I would have expressed my disdain for hip-hop culture. It often struck me as self-flagellation, and I could not see why so many young Black people, particularly women, were enamoured with it. However, when my son began to play conscious rap for me, and I listened to lyrics that reflected my own truths, I could not help but rethink my opinions. Now, in moments of doubt and struggle, when cultural norms have stifled my options or limited my view, I find the music uplifting. No small wonder I would be caught by the appeal of hip-hop therapy. It captures and formalizes what many of us in the Black community already know: music heals, and no music heals as well as our own.

Further Reading: Weaving Through the Challenges

Resource: Experiences with Suicide: African, Caribbean, and Black Communities in Canada

Author: Debra Yearwood

Debra Yearwood

Illustrator: Holly Craib

Holly Craib explores the relationships between colour and light in her artwork. She won a 2023 Applied Arts award for a conceptual illustration series.

The post Remix Your Therapy appeared first on Mental Health Commission of Canada.

Putting the Men in Mental Health

Brett Stoner — Tue, 25 Jul 2023 18:04:24 +0000

By Debra Yearwood

It’s time to reframe masculinity — one step at a time

Beyoncé and Kendrick were crooning about America’s problems as our truck wound its way toward the trail. My husband, in the driver’s seat, was his usual jovial self as he chatted about music aligning with historical movements. It was 6:30 a.m. My husband is disgustingly and unabashedly a morning person, and we were on our way to an eight km hike along the Gatineau escarpment in Quebec.

Our son — who is in no way a morning person, or a hiker — was in the back seat. He was in charge of the music, and he was there to win a bet.

Despite my more taciturn demeanour, I was happy to be heading out that morning for the anticipated hike. It was the dynamic brewing between father and son that had me feeling cautious. Men can be weird and competitive, even when they’re trying to be chill.

Macho, Macho Man
The machismo started in the parking lot when my son stepped out of the truck wearing a sweater and holding his coffee.

“Leave your sweater and coffee here,” my husband said, which prompted my son to slip on his mutinous face and grip both his coffee cup and his sweater with determination.

Before the world’s dumbest argument over knitwear and a travel mug could unfurl, I said to my husband, “You’re not carrying it or wearing it, so stop trying to control it.” To my son, I added, “It’s going to be hot, and there will be bugs — are you sure you want to bring those?”

I started the hike in the lead spot to avoid the inevitable male jockeying for the alpha position. This is one of the reasons I think men are weird. Why does it matter who goes first? It’s not a race. There are no prizes. Societal norms do men no favours when they inspire them to be dominant.

My son has no idea which direction we are taking, and yet he edges forward to take the lead. My husband, who regularly encourages me to go first when it’s just the two of us, suddenly wants to set the pace. The scene makes me think it’s no small wonder that men’s mental health is in the state it is. How can you seek help when you are convinced you should have all the answers?

Yes, I know, not all men are the same. But the statistics weigh heavily and are unignorable.

In Canada, 12 people die by suicide every day — with Statistics Canada reporting up to 4,500 annually — and men’s suicide rates are three times as high as women’s.

According to research by the Mental Health Commission of Canada, compared to men in the general population, Indigenous men exhibit higher rates of suicidal behaviour, including suicidal ideation, attempt(s), and death. Suicide attempts are 10 times as high among male Inuit youth, compared to non-Indigenous male youth, and compared to heterosexual men, sexual minority men (such as those who identify as gay, bisexual, or queer) are up to six times as likely to experience suicidal ideation.

Boys don’t cry
My husband is brilliant in many ways — including being low-key when big things are happening to him — but I’m starting to wonder if this stoicism by him and our male friends is a mask for bottling emotions, something men are socialized to do. Health issues? It’ll go away on its own. Business problems? No big deal. Family woes? Don’t go there.

When you give it any thought at all, the statistics should come as no surprise. Men living in environments where they are expected to uphold norms such as strength, toughness, and self-reliance can feed into negative beliefs about mental health. Men who adhere strongly to these norms may find it more difficult to recognize signs of mental illness in themselves and others and be less likely to access mental health support.

Reframing “masculinity” to allow greater expression and recognition of emotion and help seeking is a good first step.

A new generation is getting this lesson at Eskasoni First Nation on Cape Breton Island. GuysWork, a Nova Scotia program that started in 2012, bills itself as “a safe space to address masculine toxicity.” It does so by having male facilitators talk with groups of adolescent boys about different issues — things like health care, mental health resources, intimate partner violence, and keys to healthy relationships. Elsewhere, NextGenMen’s Cards of Masculinity box set presents 50 bold questions on topics like objectification and hook-up culture to facilitate meaningful discussions about boys’ beliefs and behaviours.

These organizations are working to change the narrative of outdated masculinity that leaves men feeling isolated, unable to express their emotions, and reluctant to seek help when they need it.

Such collective efforts help de-stigmatize mental illness among men, enhance the quality of health-care provider relationships, and open new pathways for building better personal relationships.

Programs that allow for “shoulder-to-shoulder” action-oriented tasks (think camping, sports, art, auto mechanics), rather than face-to-face talk-focused therapy may help get the conversation going.

Moving forward
Back on the trail, my husband points to the preferred path up a rocky incline. My son, of course, takes an alternate and more complex route. Nope, no obvious symbolism there.

We dragged him out of bed to hit the trail because we were getting worried — he needs to do more to get his physical and mental well-being in order. So, my husband bet him he couldn’t get up early enough to join us.

My husband used to run to keep in shape, but after a series of health issues took running off the table, I started to worry about him. I suspect he did so as well. Then we discovered that, while he could no longer run, he could hike — and the world shifted. Running in the neighbourhood was good, but hiking in the forest was transformational.

Even better, hiking is something my husband and I could do together. Some of our best and most rewarding conversations have happened on the trail. We’ve tackled work problems while admiring wild trilliums and resolved deeply personal issues while glimpsing white-tailed deer. Talking things through is good for us; it makes us reflect more.

As we approach the trail’s end two hours later, my son is in the lead. His sweater is around his waist, his coffee mug is full, and we’re all smiling.

Resource: Men’s Mental Health and Suicide in Canada — Key Takeaways

Further reading: Weaving Through the Challenges: The ABCs of Finding Paths to ACB Mental Health Care

Author: Debra Yearwood, CHE, is the director of marketing and communications at the Mental Health Commission of Canada.

Illustration: Holly Craib

The post Putting the Men in Mental Health appeared first on Mental Health Commission of Canada.

Way To Go!

Brett Stoner — Tue, 28 Mar 2023 18:26:34 +0000

By Debra Yearwood

What makes a funeral great? The good, the bad, and the gaudy of saying goodbye.

Perhaps it’s a sign of age, but I find myself at more funerals lately — and I’ve started to rate them. No, I’m not evaluating how much money was spent on the spread, flowers, casket, or urn. Let’s be honest, whether you had it catered or cajoled your friends into helping, egg salad sandwiches are egg salad sandwiches. I’ve never attended a funeral for the food. The thing I’m rating is whether the event gives me and those closest to the departed the opportunity to grieve.

I’m not looking for a maudlin affair, nor am I trying to make myself sadder. I just want to feel like I can say goodbye and perhaps learn a thing or two about the person who passed.

I expect funerals to be as diverse as the dead. Some are formal affairs with participants sharing whispered conversation in church pews. Others are more casual gatherings held in a pub while images of the departed run in a loop meant to recall happier times. Still others change locations, churches, gravesides, or pubs as the rituals of death are played out according to the desires of the departed or those left behind.

Ire and brimstone
I don’t have a preference, really. The activity just needs to do what it should to help people grieve. What doesn’t impress me is when things unrelated to the process of saying goodbye take centre stage. I’ve lost count of the number of times I’ve showed up for a funeral service only to find myself in the middle of sales pitch on the benefits of going to church. (The word “eternal” is used a lot.)

Don’t get me wrong. We’re a captive audience and I can see the appeal of making such an appeal. I also have no objections to a religious service. But I am repulsed when the official takes the opportunity to dominate the moment, make a political pitch, heap guilt on the unfaithful, chastise the living for their lack of attendance or, in one instance, silence family members who wanted to say a few words of farewell.

Low scores also happen when the business of funerals becomes too apparent. A good example is when the officiant hasn’t taken the time to learn the name of the departed and either mispronounces or forgets it all together. Those are jarring experiences that pull mourners out of the moment and force them to consider the transactional nature of the event.

Sometimes, of course, things go horribly wrong, like when the dearly departed gets misplaced or the wrong body is cremated. In one funeral I heard about, instead of the usual photos of the loved one running in the background, mourners were accidentally shown four minutes of porn. Give that funeral a zero.

An out-of-the-box affair
If I’m being fair, the failure is not always the down to the officials. Quite often, the mourners or attendees make the event one to remember for all the wrong reasons. I’ve yet to take a selfie at a funeral, but apparently that’s an increasingly popular activity. Then there are the brawlers and catcallers who see the funeral as a great place to start a fight or settle a score, because who doesn’t go to a funeral to catch a boxing match — the end point in some decades-long petty pileup of grievances between estranged family members?

In China, exotic dancers at funerals became so problematic that some cities had to intervene. If you’re wondering how this came about, it’s based on the idea that large crowds at funerals are a sign of good luck for the deceased in the afterlife. So, to draw more people, some organizers started to bring in dancers. Since children also attend these funerals, the whole thing is just hard to justify.

Sometimes I want to ask if they could take that somewhere else or save it for after the funeral. Unlike weddings, there is no dress rehearsal. That means people are often emotionally raw, numb, or overwhelmed. Grief is also very personal and has different outlets for different people. Some cry, some don’t. Some yell, and some sink into themselves. People grieve for a few weeks, months, or years, and different cultures, personalities, loved ones, or stages in life will also affect how and how long we grieve.

No matter what your grief “tenure” is, the funeral is often the start, and it’s frequently where people remind themselves of their social safety net. While a 2022 mixed methods review of the effect funeral practices have on bereaved relatives’ mental health and bereavement outcomes was inconclusive, qualitative research provides additional insight: the benefit of after-death rituals, including funerals, depends on the ability of the bereaved to shape those rituals and say goodbye in a way that is meaningful for them. Findings also highlight the important role of funeral officiants during the pandemic.

Funerals can be a tangible way to show support for the living. They may provide companionship during a difficult time and can be a fundamental part of how we mourn. But they should help us to process the loss and actualize a person’s death. If the thing I’m discussing as I drive away is the officiant’s fail or the fight out front, then the funeral is a flop. I don’t go for dinner and a show. I’m not trying to be converted. I go to get and give support.

Author: Debra Yearwood has not planned her own funeral but knows there will be no selfie stations.

Debra Yearwood

Illustration: Holly Craib

The post Way To Go! appeared first on Mental Health Commission of Canada.

Weaving Through the Challenges

Brett Stoner — Tue, 21 Feb 2023 20:02:23 +0000

By Debra Yearwood

The ABCs of finding paths to ACB mental health care

My son asked me for help to see a therapist, and from where I sit that was a win. He recognized that he needed help, which speaks to his intelligence and self-awareness. Colour me a proud mom.

Not everyone can spot when they’re in trouble, and in the heavy machismo often promoted to young Black men through music and fashion, self-awareness is a powerful tool. That he could ask his mom for help makes me feel like I’ve done something right as a parent. I hate that he is hurting but love that he can see it and ask for support.

Less fun was moving through the conversation with him and realizing that he wanted a therapist he could relate to: an ACB (African, Caribbean, and Black) male. Don’t get me wrong. It’s a reasonable request. It’s just that finding a Black therapist in Canada is like finding a winning lottery ticket. They exist, but they’re few and far between.

So, I began the process of looking. At least I’m lucky enough to know some people who know some people. Maybe one of them can get me a lead on a therapist. But there’s also the wonder of Google. Believe it or not, Googling often works, and I soon found myself on the Canadian Psychology Today portal looking at an array of ACB therapists. The next hurdle was trying to figure out who would be the right fit. It’s not enough to be ACB, you’ve also got to have the right experience. But before I could even figure that much out, I found myself wondering what the difference was between a social worker and a psychotherapist, which seemed to be the main options. Are they the same? What’s the difference?

Big bucks and barriers to access
Price comes into it of course, and it ranges between $100 and $200 per session. It doesn’t seem like much for health care, but for many people this is an out-of-pocket expense. If you’re lucky, you’ll have some benefits, but mental health coverage varies widely. While some employers supplement coverage or provide different ways of accessing care, other programs come with fee limits or caps on the number of sessions.

If we consider the distribution of wealth in this country, we know that if you are part of an ACB community — in fact, part of any racialized community — you have less. Less income, less savings, less access. Actually, it sometimes feels as if the only thing we have more of is unemployment.

Adding to the cost is the fact that therapy is rarely a one-and-done process. You must engage, build rapport with the right therapist, and incorporate therapy into your regular life over time. Some studies suggest 12-16 weekly sessions, though in practice many therapists and patients prefer more, perhaps six months and 20 to 30 sessions. The full 12- to 30-week range translates to $1,200 to $6,000. That’s hardly small change. But there’s also another question: How do you decide what price will deliver the right service for you? Do people think of therapy the way they do wine: The more you pay, the better the therapist?

It leaves me wondering what happens if cognitive therapy isn’t enough. What if my son needs a prescription? Do I start the search for that rare beast — a family doctor — or do I look for the even more elusive psychiatrist? How will I help him cover the cost of medication?

I keep reminding myself that at least he had the confidence and comfort to ask for help, which is often the biggest hurdle to accessing care. But this is far from the case with many ACB families. Beyond economic constraints, they face lots of barriers to accessing mental health care — not the least of which is being discouraged by others’ misconceptions about mental illness. These fallacies include things like ‘mental health support is for people experiencing severe mental illness, not someone trying to deal with emotions or improve the quality of their lives’; ‘mental health problems will get better if you just leave them alone’; and — my personal favourite — ‘Black people who seek professional help have less faith in God’. There’s nothing like the added burden of cultural and emotional guilt when looking for such help. It all seems so complicated. The act of finding the right support is challenging for everyone, but doing it through an ACB lens can feel overwhelming.

Not black and white
Fortunately, people like Nicole Franklin, a Black therapist who believes representation in mental health matters, have started to create the paths we need to do so. Her clinic, Live Free Counselling Service, provides therapy and resources to members of racialized communities in Toronto and the Greater Toronto Area. For those outside Toronto, she provides information on Black-licensed social workers and therapists from across Canada who also practice under a trauma-informed, culturally responsive, and self-care-first lens.

While she advises that the “best time to go to therapy was yesterday,” she also cautions that “therapy is not a quick fix.”

Franklin suggests seeing a therapist once every week, month, or quarter (if you’re able), while understanding that affording a therapist, especially seeing one on a regular basis, can be a financial barrier.

Some clinics set no mandatory fees for service, while others can offer significantly reduced rates, if you are open to seeing a therapist-in-training (usually, a graduate student in psychotherapy or a counselling student completing practical hours for their internship). Other clinics can even adjust fees based on your current financial budget or income, whether you’re employed, in school, or between jobs.

Franklin also recommends due diligence when seeking services from any mental health professional. “Don’t be afraid to ask your therapist questions about their experience, and how they work with certain issues.”

Other areas you might ask about to help determine whether a particular therapist is right for you and your situation include their counselling education or training, service fees, professional values, personal beliefs, and overall therapeutic approach.

Not all client-therapist relationships work out the first time. So it may take a few tries before finding the best solution. According to Franklin, “It’s OK to end a therapeutic relationship that’s not a good fit, no matter what season of life you’re in.”

Some suggestions
My son’s dad and I help support his mental health journey. We give him what he needs financially and emotionally. But if we begin to falter, we are lucky to have a rich network of knowledgeable people to call on for support. If you or someone you know is tackling the challenge of finding therapy without that kind of help, consider the following advice from Franklin.

Look for a counselling service or network that subscribes to trauma-informed care.
A trauma-informed approach or TIA recognizes the link between trauma, violence, and negative health outcomes. TIA aims to enhance feelings of empowerment, resilience, and safety to help clients with a history of trauma (or who are experiencing traumatic events) take back control of their lives. See the trauma-informed care fact sheet on this holistic health care practice.
Consider a therapist who holds anti-oppressive values.
Anti-oppression psychotherapy helps clients reduce the effects of feelings and experiences related to trauma and violence so that they become empowered through the therapeutic healing journey.
Seek a therapist who deals with the issues you’re working on.
Establishing a client-therapist connection on common ground will help put your relationship on a stronger foundation. This is especially true if you’re meeting your therapist in a virtual setting. “If doing online therapy,” Franklin suggests, “consider if you might have another safer, private space to regularly engage in open and honest conversations.”
Shortlist and pre-interview therapists you’re considering.
“Look online and consult with more than one therapist — it’s like finding a relationship. You often need more than one date to find a good connection.”
Find a mental health provider who has received cultural competency or implicit bias training.
Do so if you’re unable to find an appropriate Black therapist in your neighbourhood or online.

ACB and BIPOC therapy resources and counselling services to consider

The Black Therapist Collective is a team of Black therapists in Ontario with networks across Canada. BTC also provides the Black Mental Health Fund, a donation-based resource offering subsidized services on a sliding fee scale to assist people in need.
The Black Therapist List is a directory of professional Black counsellors, life coaches, psychotherapists, psychiatrists, psychologists, and social workers in Canada and the U.S.
Healing in Colour offers a directory of BIPOC therapists across Canada who are committed to honouring their Statement of Values, which includes an anti-oppressive approach.
Psychology Today now lets you search for Canadian Black therapists based on your postal code.
Therapy for Black Girls, while headquartered in the U.S., this resource offers a searchable directory of virtual and in-office Canadian therapists based on your postal code.

Related articles in The Catalyst
Rallying While Black
Black Like Whom? Why We Use ‘ACB’ Over ‘Black’:
Fabiola’s Story

MHCC resources
Shining a Light on Mental Health in Black Communities

Author: Debra Yearwood, with additional research and reporting by Janelle Jordan.

Illustration: Holly Craib

The post Weaving Through the Challenges appeared first on Mental Health Commission of Canada.

Sugar and Spice — and Trying to Be Nice

Brett Stoner — Tue, 06 Dec 2022 18:54:31 +0000

By Debra Yearwood

Over the holidays my inner voice proves to be the most critical as I straddle the pull of a commercial Christmas and the deep-seated draw of Kwanzaa. On tackling the minefield of tackiness, tinsel, and trappings of the season.

This story is the first in the Mental Health for the Holidays series. While end-of-year celebrations can be a time of joy — they can also trigger feelings of stress and loss. Read the collection to learn how others were able to meet those challenges.

It always starts with childlike glee. The excitement, bubbling over with an irresistible anticipation of the merriment, the food, the socializing, and of course, the presents. Christmas time is the best. Well, almost. There are always undercurrents.

There’s the worrying about the consequences of all that good cheer. Actually, worrying doesn’t quite cover it. It’s more like gnawing than worry — more like guilt, really. You know how it goes. Should I try the yummy cookies? It’s Christmas after all. How many? Perhaps just one. . . they’re not that big. How much butter and sugar could they have? Oh, but they’re so good — and gone so quickly. I barely tasted that. Perhaps two, three. . . seventeen?

Then comes the guilt. I ate way too much. All that butter and sugar. Ugh. I think I can hear my arteries hardening. The familiar commitments to do better follow. Tomorrow I’ll have a salad. . . but then someone invited me out for lunch. Dinner with friends is on for the next day and of course all those friends I haven’t seen in, like, forever. Drinks! Wasn’t that a special bottle of rum! Oh, and the best Côtes du Rhône I’ve had in an age. Recriminations arrive in the morning, delivered in that scathing voice I reserve just for me. Ugh, again! But the see-saw of pleasure and punishment is just getting started.

I turn my attention to the glitter. All that sparkle and rich, scented greenery. Bright bulbs touch every surface until the house feels like a fairytale wonderland. I love the Christmas cheer. But is it excessive? How many garlands are too many? Is tinsel elegant or tacky? What does “less is more” even mean? What do designers think it means?

Soon I’m surrounded by magazines, each offering contradictory advice. My house isn’t that big, and I don’t have a bevy of assistants to help me add glamour. Could someone also explain to me why I would I want an all-white tree? Or an all-red one? It all seems less like Christmas and more like branding. Perhaps a more traditional approach is the way to go. But honestly, string popcorn just seems like a good way to invite a mouse infestation. Besides, the way the dog is eyeing the popcorn bowl has me thinking I’ll have to guard the tree 24-7. It all seems unnecessarily constrained and formal. Maybe I’m just too tacky.

How much money am I spending on decorations, food, presents? Too much. Not enough? How many families are doing without while I squander cash on the most useless items imaginable? I look at my silver bells laid carefully beside my silver reindeer and big bowl of shiny do-nothings and think, Wouldn’t that money have been better spent on a donation? Am I selfish and self-centered?

All these concerns mark the coming together of my neuroses — otherwise known as Christmas time.

But then there’s the secret guilt I hold close to my chest. The guilt of being Black while enjoying Christmas — I like to call it my Kwanzaa guilt. It starts to simmer a few months before the week-long celebration of African American culture, beginning on December 26th. Why the guilt? Because I don’t actually celebrate Kwanzaa. I’m not sure I even want to. Yet such an admission from a proud and — I like to think — progressive Black woman, can be tantamount to proclaiming my status as an Oreo or a coconut — Black on the outside, white on the inside.

Kwanzaa is not supposed to replace Christmas, but coming when it does certainly feels like competition. Healthier, more thoughtful competition. As I rub my hands in greedy anticipation of the fatty foods and rich desserts of my usual Christmas gluttony, I imagine the contrast to what my Kwanzaa sisters will be enjoying: fruits, vegetables, and corn. More guilt follows (not to be confused with the reams of gilt I’ll be spreading with abandon across my home, with nary a straw mat in sight).

Kwanzaa is the thoughtful creation of a Black academic. At its core, it’s a celebration of reflection, a seven-night toast to the Black diaspora, and our success in overcoming a multitude of struggles. It slides in, brimming with the aspirational concepts of unity, self-determination, collective work and responsibility, cooperative economics, purpose, creativity, and at the forefront, faith. For Kwanzaa, homemade gifts are offered, and commercialism is avoided. In lieu of string lights, we find seven candles burning.

Yet, despite its wholesome message and optimistic values, I shun it — instead embracing a holiday that has me wondering if any of the wise men were Black.

My Kwanzaa guilt didn’t start with its inception in the ‘60s or even its prominence in the ‘90s. No, my love of — OK, let’s face it — hate of Christmas started as a child. No one in my family looks like Santa and, until very recently, every tree angel had golden hair and the rosiest of cheeks. I got my first fireplace when I was 28, so there was no hope of Santa making his way down the chimney when I was a girl. And Barbados, which my family calls home, doesn’t have a single pine tree. In fact, from mistletoe and cranberries to rutabaga and turkey, for my family the traditional dressings of Christmas were an exploration in foreignness. Yet we embraced its customs and, over time, made them our own.

So every year I drag boxes upon boxes of Christmas décor out of the basement. I string lights outside and inside my home, and I sing and dance — like Carlton from The Fresh Prince of Bel-Air — to Christmas carols as I do so. Thank you, Sir Paul, I’m sim-ply haaaaaving a wonderful Christmas time. While Kwanzaa intentions are good, the trappings are even more foreign to me than Christmas. Why should I give up the traditions of a lifetime?

Though I’m not one, like a good Christian I’ve learned to change the holiday to suit my cultural needs. So this year, we’ll be serving rice and peas, fish, and oxtail. I’m looking at Weight Watchers for healthy Christmas recipes and, despite having a beautiful fireplace, we’ll be hanging our stockings along the banister by the front door. As usual, our treetop will be home to a glittering pair of lovebirds instead of an angel.

Every year I find new ways of making the holiday mine, adding touches of me and stripping away those things that reflect a colonial mindset. As I draft each of them to my own cause and purpose, I’m learning to make peace with the parts of Christmas that may have had a different meaning in the past. Hopefully, the only Oreos at my house will be those I enjoy while indulging in a Hallmark Christmas movie. Happy holidays!

More resources to support your well-being over the holidays:

How to Give Back (or Reach Out) This Holiday Season (Mental Health Commission of Canada)
Five Ways to Protect Your Mental Health This Holiday (Canadian Mental Health Association)

Author: Debra Yearwood, is a communications specialist living and working in Ottawa.

Debra Yearwood

The post Sugar and Spice — and Trying to Be Nice appeared first on Mental Health Commission of Canada.

Debra Yearwood Archives - Mental Health Commission of Canada

Designing for Equity

Related Articles

Bias is two steps forward, one step back

Average Has Never Worked

Say what?

Equity as a Required Skillset

Equity works

Changing the Conversation

Related Articles

When life imitates work

Shame. Blame. Guilt.

Rewriting the narrative

Dollars and sense

Feeling the squeeze

An overcrowded pool

Metabolizing trauma

Ending diabetes

A Gutsy Move

Related Articles

Mapping the mind-gut connection

Tech to the rescue

Tackling the taboo

Walking the talk

The power of influence

Life – interrupted

Making the Invisible Seen

Related Articles

Is Mental Health Funny?

Subscribe to Catalyst

Share This Catalyst

Related Articles

Debra Yearwood

Remix Your Therapy

Subscribe to Catalyst

Share This Catalyst

Related Articles

Debra Yearwood

Putting the Men in Mental Health

Subscribe to Catalyst

Share This Catalyst

Related Articles

It’s time to reframe masculinity — one step at a time

Way To Go!

Subscribe to Catalyst

Share This Catalyst

Related Articles

What makes a funeral great? The good, the bad, and the gaudy of saying goodbye.

Debra Yearwood

Weaving Through the Challenges

Subscribe to Catalyst

Share This Catalyst

Related Articles

The ABCs of finding paths to ACB mental health care

Sugar and Spice — and Trying to Be Nice

Subscribe to Catalyst

Share This Catalyst

Related Articles

Over the holidays my inner voice proves to be the most critical as I straddle the pull of a commercial Christmas and the deep-seated draw of Kwanzaa. On tackling the minefield of tackiness, tinsel, and trappings of the season.

Debra Yearwood