It’s okay to not be okay

  • Community   Thursday, June 9, 2022   Spencer Seymour

Mental health matters. It matters a great deal. Someone suffering from untreated mental illness can significantly increase one’s risk for self-harm or harm to others, poverty, homelessness, missed work or school, social isolation, family conflicts, drug or alcohol addiction, a weakened immune system, heart disease and other medical conditions, and a poor quality of life.

Suffering from mental illnesses doesn’t mean someone is crazy, weak, or over-dramatic. It doesn’t decrease one’s intrinsic value. It doesn’t make them any less of a human being.

The pandemic has only made things worse, cementing what was already a major problem as a raging wildfire. According to a study completed in Perth County by Dr. Leith Deacon and the University of Guelph looking at pre-and-post-pandemic mental health self-assessments, the number of people describing their mental health as excellent decreased by 45 percent, while the number of people assessing their mental health as poor increased by 79 percent. Females identified the highest amount of mental health decline while the study also saw a 100 percent increase in males between the ages of 18-29 calling their mental health poor. The pandemic forcing schools to close has also significantly increased mental health concerns in kids and teens.

Over the last decade or so, awareness about what mental illness is has increased significantly and the stigma surrounding it has begun to break down. We have seen a substantial increase in the number of people openly admitting to struggling with their mental health whereas, not too long ago, most people simply didn’t talk about what they were feeling. 

However, make no mistake, there is still a great deal of stigma surrounding this subject. One in five people in Canada will suffer from a mental health problem in their life but only about 30 percent of people actually seek help. Joelle Lamport-Lewis, Director of the Social Research and Planning Council for the United Way, said that locally, the stigma about seeking mental health care is far from neutralized.

“People don't seek help because of stigmas (prejudice and discrimination) attached to mental health problems. There is a sense of embarrassment or feeling ashamed. There is a worry that there will be judgement and being misunderstood. There is a great deal of discrimination. However, it is important to know that there are services that can help. And the earlier someone gets help, the less chance that the problem will come back or get worse.”

Addressing stigma associated with mental health concerns takes understanding, education and a closer look at our attitudes toward health. You can speak out against stigma, don’t judge, get educated, and pass on facts. Stigma often comes from a lack of understanding or fear. Inaccurate or misleading representations of mental health concerns contribute to both of those factors. Unfortunately, we are seeing a great deal of this present in Stratford.”

But even as community agencies and private counselling or therapy organizations work incredibly hard to treat those suffering, not enough is being done at every level of government to seriously attack the problem of mental illness.

One organization that has been active in trying to mitigate the issue is the United Way Perth Huron, which is headed by its Executive Director Ryan Erb. Recently, Erb told the Times that when people take the first step and reach out for help, they can get their foot in the door but receiving the help they need can take a long time.

“What we see on a fairly regular basis is that there are fairly long waitlists for support, including crisis support. That is what the system is mostly designed to do but it can take a while for people to access those services. Not only do we have a system that is strained because it’s under-funded but there are a lot of job transitions.”

“That makes it harder when people have a counsellor or support worker who suddenly moves to another job, that person has to start all over again. Generally, the intake process is also good and moves fairly quick, it’s more the wait for care that people seem to experience delays and long waits for”

In addition to the point about high job turnover in the field, Erb also noted that some organizations are also struggling to find employees which adds to the lack of supply of care services for those in need. Erb went on to explain that there is a great first point of contact available for people in the 2-1-1 phone service.

“We have 2-1-1 which is a fantastic service that anyone can access that can make an immediate referral. It’s the front door for anybody. You may not remember the phone number for a specific organization or maybe even the exact name of the organization but it’s easier to remember three digits.”

Both Erb and Family Services Perth Huron touted the 2-1-1 resource as being an important mechanism to help people take that first step, which Erb said can still be the hardest step in the process of seeking out mental health care. 

“I would say it’s true that people still do have a tough time taking that first step,” Erb said. “The pandemic did a good job at exposing that because, during that time, we had a lot of people say ‘this is the first time that I’ve reached out for help’, and it was a big decision for them to do that. And I think there was probably a large number of people that could have used some help but didn’t reach out. 

“Personally, there were times when things were very stressful and I did eventually go and seek counselling for a period of time. But to make that decision, you have to be willing to admit that you can’t do it all by yourself.”

A big reason many still feel hesitant about reaching out for support or telling people that they are experiencing issues with their mental health is the stigma surrounding it. The stigma is indeed less prevalent now than it likely has ever been, but it hasn’t been fully broken down.

“Generally we’re better off than we were a few years ago but it’s like the first layer of the onion and we as a society haven’t been able yet to go to the next step of supporting someone over a longer stretch,” Erb said. “It’s getting better in some ways. I think people are much more open to talking about their mental health and seeking help when they need it. But I still think we need to be more ready and comfortable in sustaining our efforts to be there and support someone struggling over the long term.” 

“It’s one thing to be briefly friendly, it’s another to walk with someone through a longer difficult period and sustain that initial effort. Unfortunately, there’s still a stigma with saying ‘I’m seeing a counsellor’, or admitting that you need help.”

Erb pointed out that positive things are being done to address the problem but it’s also clear that we haven’t done enough to truly address the scope of the mental health crisis.

“It’s certainly not all bad. There’s a lot of work being done by the Mental Health and Addiction Alliance and many of the things that we as a community felt should happen have begun. There’s also a lot of good work being done at the provincial level to align services.”

“My understanding is that there are still challenges for people who need multiple services. If a person is with one agency and moves to another, they have to tell their story twice because some agencies aren’t equipped to share information. There’s a lot of challenges for people to access the services in a way that’s easier for the client.”

Another element of the response to the mental health crisis that Erb felt was working well was the ride-along program operated by the Stratford Police and Huron Perth Healthcare Alliance in coordination with the Stratford General Hospital which has partnered an officer with a member of a multidisciplinary team of social workers, nurses, and occupational therapists. An example of such a pairing is Stratford Police Constable Darren Fischer and mental health professional Natalia Kowalczyk. Fischer and Kowalczyk also spoke to the Times recently and talked about how the program has improved the police’s response to mental health-related disturbances.

“It’s really improved the crisis response to mental health concerns in the community,” Fischer said. “Historically, when someone was experiencing a mental health crisis, they would call the police and officers would attend and do their best to deal with that situation.” 

“However, with having this program in place, we’re now able to attend with the expertise of a social worker. We’re able to provide that one-on-one, face-to-face interaction that allows us to deal with that situation then and there as opposed to taking the person out of their home or their safe space and taking them to the hospital to get them that conversation.”

According to Fischer, the volume of mental health-related calls is manageable but also mentioned that the more the program is supported, the better it is as it would allow the police and their ride-along social workers to help more people. Kowalczyk elaborated on this by noting that, in a perfect world, the program would be available any day, any hour.

“It’s not as much about how many social workers we have during the day because we have one person per detachment right now,” said Kowalczyk. “However, that’s only from 8:00 a.m. to 4:00 p.m. and obviously, crises do not stop at four o’clock. So having more people would be helpful as it would allow us to expand the hours of the program which we’re definitely trying to do.”

Responding to a mental health crisis is obviously an emotionally-charged situation. Both Fischer and Kowalczyk feel that this method is very effective as it allows the police response to be tailored to fit each encounter thanks to having someone trained to deal with mental health concerns present.

“[How we deal with a call] is different for every situation,” Fischer explained. “We always go in with the main goal of providing assistance and de-escalation. We introduce ourselves and tell people that we’re there to help. We try to engage in conversation and figure out what’s going on. I think we’re good about incorporating other community services and supports to continue that level of assistance once we’ve left that initial interaction.”

“A lot of the work is done in that initial interaction but a lot of work is also done after that as well,” Kowalczyk added. “I think one of the main points of the program is that we’re not all working as silos anymore. Not only the police and the hospital but other agencies and organizations in and around Stratford. Mental health care works better when all of these supports are working together.”

“I really don’t have a set, rigid process. It really is unique to every situation and we’re there to assess risk, but we’re also there to provide support. Someone experiencing a mental health disturbance, it’s definitely not their best day. Most likely, it’s one of the worst days of their life.”

There can also be some misconceptions about what a mental health crisis looks like and Fischer and Kowalczyk described the various calls in which mental health may play a significant factor and their kind of partnership can be beneficial.

“We’ve attended people who receive notifications of a loved one’s passing,” mused Kowalczyk. “We’ve attended to domestic disputes. I feel like we’re useful in so many different situations because so many different situations that the police get called to, emotions can run high and there can be mental health crises in so many different situations.”

“A crisis is different for everybody,” Fischer added. “Typically, what people look at as a crisis is someone who is actively wanting to self-harm. But that isn’t the only kind of crisis one could have.”

“Someone could be in crisis at the scene of a motor vehicle collision where their life has just been turned upside down. There may not even be serious injuries but it’s just such a traumatic event that a person could be in crisis at that moment. If you have your house broken into and your personal space and personal property has been taken from you, that’s a very traumatic event.”

Mental illness doesn’t only manifest itself as a crisis for the police to respond to. In many cases, it’s much more subtle and invisible and people suffering in silence can fall through the cracks if they don’t have the support to seek help, which then can make their issues even worse. Lamport-Lewis said that early intervention and prevention are critical pieces in dealing with mental illness. More integration and defragmentation of services are also needed to close the gaps. 

She also listed four items to tackle the problem from a youth perspective:

• Increase comprehensive school health and post-secondary mental health initiatives that promote mental health for all students and include targeted prevention efforts for those at risk;

• Remove barriers to full participation of people living with mental health problems or illnesses in workplaces, schools (including post-secondary institutions), and other settings;

• Remove financial barriers for children and youth and their families to access psychotherapies and clinical counselling;

• Remove barriers to successful transitions between child, youth, adult, and senior mental health services.

Lewis also told the Times that governments can do more to address this issue, specifically by breaking the stigma surrounding mental illness with education and treating mental health as part of general public health.

“It is important to support governments to adopt mental health policies and to integrate mental health policy into public health policy and general social policy, because mental health can cause a heavy burden for societies, impedes the development of other health and development targets, contributes to poverty and differentially affects the most vulnerable and, last but not least, because mental health itself is of intrinsic value as is physical health.”

“In developing mental health policy, it is important to include consideration of stigma about mental health issues and mental illness. The impact of stigma results in a lack of attention from governments and the public, which then results in a lack of resources and morale, decaying institutions, lack of leadership, inadequate information systems, and inadequate legislation. By resulting in social exclusion of people with mental illness, stigma is detrimental not just to people with mental illness, but also to the health of society as a whole. All too often our services are departure points for exclusion when they should be stepping stones for social inclusion.”

Even as our society has taken steps in the right direction to recognize mental health and addiction as medical conditions, best remedied not by harsh punishments or belittling the person suffering, there is still a long way to go. Too many people still suffer in silence because they fear being ridiculed for their suffering. Too many people are stuck on a waitlist because there isn’t the service capacity to meet the demand. Too many people face a barrier to getting the help they need. It’s time to change that. It’s time to make sure everyone who needs help can get it. It’s okay to not be okay.This is the fourth part of the Stratford Times’ ‘Need To Know’ story series – a collection of stories defining and detailing issues, giving voters in Stratford a basis to form or refine their opinions ahead of the 2022 provincial and municipal elections. These stories are a-political in the sense that they do not endorse any particular candidate(s). They have been written only to help provide you the necessary data to come to an informed opinion.

This is the fourth part of the Stratford Times’ ‘Need To Know’ story series – a collection of stories defining and detailing issues, giving voters in Stratford a basis to form or refine their opinions ahead of the 2022 provincial and municipal elections. These stories are a-political in the sense that they do not endorse any particular candidate(s). They have been written only to help provide you the necessary data to come to an informed opinion.