The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. In other words, health is about much more than not being sick. Youth can be a time of tremendous transition and change, which can bring along a great deal of stress as well. It is not surprising, then, that suicide accounts for 24% of all deaths in Canadians ages 15-24 (Canadian Mental Health Association). It is also estimated that 10-20% of Canadian youth are affected by a mental health disorder (Canadian Mental Health Association). While there are various policies in place to address mental health in young people, structural barriers are in place that make it difficult to reach out for help. The simple fact that young people have to reach out in order to receive help serves to further stigmatize mental health as something to be ashamed of. Many of the programs and services in place for mental health have exceedingly long wait lists and have become difficult to access.
The Status Quo: What’s being Done Already
Since 2003, funding for mental health programs has increased by 80% in Ontario, with an increased focus on child and youth mental health. In their recently released mental health and addiction strategy, the Ontario government cites goals such as “improv[ing] mental health and wellbeing for all Ontarians” and “creat[ing] healthy, resilient, inclusive communities”. While these are worthwhile goals, the strategy fails to identify tangible steps towards reaching these goals. For example, one of the steps towards the goal of improving the health of all Ontarians is to improve mental health literacy, making young people more aware of the mental health problems that can occur and encouraging discussion on this topic. The government proposes achieving this goal by creating education programs to be implemented in at-risk populations like Aboriginal communities and new immigrants to the country. Returning to the ultimate goal of improving the mental health of all Ontarians, then, why is this only being done in few, select communities? And if the goal of the Ontario government is to reduce the stigma surrounding mental health, doesn’t selecting certain “at risk” communities to implement programs only increase the stigma surrounding mental health? Wouldn’t the simplest solution be to incorporate mental health into all school curriculum?
Incorporating mental health into curriculum
While the Ontario Mental health and Addiction strategy identifies the importance of targeting schools as a site of intervention for mental health problems, the primary focus is on increasing the services available in schools. While providing mental health services in schools is a fantastic first step, coupling these services with mental health topic being incorporated into school curriculum would enhance the positive effects. Incorporating mental health topics into all school curriculum would achieve the goal of improving mental health literacy by ensuring that all young people are able to discuss topics on mental health. Mental health experts could work with teachers to develop strategies to facilitate discussion on topics such as depression, anxiety, suicide, relationship management, stress, time management, etc. This would serve to reduce the stigma surrounding mental health, and by creating a safe space where students know their voices are heard and validated, they would be more likely to come forward if they were experiencing a mental health concern. This would also allow for early identification of mental health problems, another goal of the mental health and addiction strategy.
Programs targeting Prevention
Many of the policies in place regarding mental health are targeted at prevention, with diet and exercise as well as self-esteem as the primary objectives. These programs fail to recognize the barriers to diet and exercise in low-income families. If there is no grocery store along a bus route, how are families supposed to buy healthy foods without a car? If the streets are not safe and there is no gym close by, how can we tell people to go to the gym more? In addition, “healthy” can mean different things in different cultures. Consider an immigrant family who never had the need to “plan healthy meals” because their lifestyle was naturally quite healthy in their county of origin. Upon moving to Canada, some new immigrants are faced with different foods (often, cheap = unhealthy!) and restricted outdoor spaces for exercise (especially in urban centres). These conditions take an extreme toll on mental health, because they contribute to physical, mental and emotional stress. This is a systematic barrier toward immigrant health, and it is difficult to address without proper prevention programs. Some programs do address these issues, but there may be language or economic barriers.
Focus on Crisis Intervention
The current structure of mental health services prioritizes need and usually waiting until a crisis occurs. There is an emphasis on crisis intervention, and while this is an essential component of mental health services, it should not be the only focus. Wait lists for mental health services are becoming increasingly long and the focus needs to shift to promoting mental health and wellbeing for all Canadians, particularly Canadian youth. As mentioned, this could begin by incorporating mental health education into school curriculum and providing mental health services in schools, then promoting these resources to students.
About this Series:
This blog series was written collectively by youth co-researchers in the Voices against Violence Western Group, which met during the winter of 2014. Working together over a period of 12 weeks, these youth identified salient themes in their shared experiences, as well as how these themes intersected each other in instances of structural violence or resistance against it. Mental Health is fourth in this series.