I've worked in healthcare for a long time and in a variety of nursing roles. Over the years I've witnessed how the determinants of health:  income, social network, education, physical environment, genetics and gender among them, impact the people we serve. The context of a person's life is, as we know, key to their health.

Mental health is a significant determinant of well-being that crosses all disciplines. It's a relevant conversation in virtually all aspects of care, and in the midst of a trademark prairie winter there is no better time to have it.  So let's take a moment to consider how we, as nurses, are equipped to promote mental health in our patients— and maybe pay a little more attention to our own, as well.

Let's put things into perspective.

  • One in five people in Canada will experience a mental health problem or illness in any given year, with a cost of over $50 billion to our economy.
  • 70% of adults living with a mental health problem or illness say their symptoms started in childhood.
  • 60% of people with a mental health problem or illness won't seek help for fear of being labeled.
  • 500,000 Canadians, in any given week, are unable to work due to mental health problems or illnesses.
  • One in three workplace disability claims are related to mental health problems or illnesses.*

It's clear that any overall health strategy needs to pay particular attention to mental health, given its considerable impact on our physical, social and economic well-being.

The Mental Health Commission of Canada agrees, and in its foundational document, Changing Directions, Changing Lives: The Mental Health Strategy for Canada, it outlined the fundamental architecture for a national vision relative to mental health improvement. The Commission is expected to announce a recommended course of action in 2017 From a health region perspective, it's clear the strategy must live and breathe not just on a policy level, but in our homes, schools, communities and workplaces.

So what can we, as healthcare providers, do to advance the cause?

First, let's acknowledge that it's real, that it matters to health outcomes, and that it impacts both the people we serve and the colleagues we work with.

Second, let's admit there's a stigma attached to mental illness that compels many to deny the need for treatment, hide their anguish, and maybe even self-medicate. Fear and shame feed a reluctance to tackle the problem, masking its consequences.

Third, let's understand that mental illness impacts everyone - of every age, culture, gender or socio-economic strata. In fact, an estimated 1.2 million Canadian children and youth are affected by mental illness, while less than 20 percent will receive appropriate treatment*.  We need to do all we can to support treatment options at this formative stage of development, knowing that early intervention pays dividends in quality of life at all stages.

Good mental health contributes to physical health and wellbeing in our later years, too. The Commission states that by 2030, nearly one in four Canadians will be a senior, and the likelihood of experiencing a form of mental illness increases as we age. Caregivers of older adults are also strained by the emotional demands of attending to aging parents, other family members and friends.

Something else to remember is that mental health challenges can make communication difficult, obscuring other care needs. While our minds and bodies work together, they are at times at odds with each other.  Let's be aware of available supports and do all we can to build connection between those valuable services and the people who need them. There are some great options for mental health first aid courses here.  

Still, many care journeys start with one small step forward, like gently saying something as simple as, "Are you okay? I've got time to talk," or "you know, I've noticed you've seemed down lately. What's happening?"  Our WRHA EAP program is there to help, and there are plenty of great resources to be found in the region's online wellbeing guide.

The bottom line: If you're struggling, tell someone; if someone you know is struggling, ask them. What might seem like a small gesture could make all the difference, helping someone out of the dark and proving that it's better, and a lot less lonely, in the light.

Lori Lamont
Vice President, Interprofessional Practice and Chief Nursing Officer

* The Mental Health Commission of Canada, 2016

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