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Catalyst


A CONVERSATION WITH CANADA’S FIRST MINISTER OF MENTAL HEALTH AND ADDICTIONS,
CAROLYN BENNETT


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When I first learned that Carolyn Bennett had been named Canada’s inaugural
minister of mental health and addictions, I was overcome with gratitude.

Naturally, I was grateful for the growing spotlight on mental health and
substance use — a light that has expanded both in scope and intensity over the
past two years. But I was equally thankful to be gaining a new ally — one that I
hoped could help answer the question that drives all of us at the Mental Health
Commission of Canada (MHCC): How can we best support the people of Canada
through these challenging times?

Last month, I had the opportunity to sit down with the minister for a virtual
interview that would answer that question and many others.

Taking a holistic approach
As we began our conversation, it didn’t take long to recognize that, while
Minister Bennett may be new to the role, she was well steeped in the topic. When
asked which misconception about mental health she would most like to correct,
she answered without hesitation.

“Everyone needs to understand the difference between mental health and mental
illness,” she told me. “When Dr. Brock Chisholm (The World Health Organization’s
first director-general from 1948 to 1953) said, ‘there is no true health without
mental health,’ he was right. We can’t talk about physical health without
considering the mental, emotional, and spiritual aspects of a person’s
well-being.”

With a long career as a family physician before entering politics, Minister
Bennett carries a deep understanding of the inextricable link between mental and
physical health. She also knows first-hand what happens when that link is
overlooked.

“Working in family medicine,” she said, “you hear about people’s difficulties
every day. I remember seeing executive reports come in, knowing the patient was
struggling with family problems and other issues, but none of those things were
included. Someone’s cardiogram or body mass index doesn’t paint a full picture
of how well that person is.” Such a disjointed approach, she added, contributes
to the stigma around mental illness.

Fortunately, she said, COVID-19 has given us a new opportunity to make a change
for the better. As the disease has taken a steep toll on both physical and
mental health, it has also underscored the intersection between the two.

“With COVID, people have gotten better about admitting when they’re struggling,”
she explained. “If even one out of every two people can speak up when their
mental health is deteriorating, it will reduce the stigma and we’ll be in a much
better position to address the issues long term.”

Opening new doors to care
Of course, as Minister Bennett was quick to point out, stigma is just one piece
of the puzzle. And responding to the new and existing mental health needs in
Canada will require innovation and co‑operation at every level.

One example of that innovation is the Stepped Care 2.0 © model — championed and
scaled up by the MHCC — which provides the least intensive form of support
deemed appropriate, which is then “stepped” up or down as needed. In
Newfoundland and Labrador, the model contributed to a 68 per cent reduction in
wait times for mental health services — and Minister Bennett is hopeful for
similar success elsewhere.

“In post-secondary institutions, for instance, it’s not that every student needs
a psychologist,” she explained. “They may get the support they need from proper
orientation or peer counselling.”

In another example, the minister cited a study of 40 women in need of perinatal
mental health support. Of those 40, only two met the criteria that would require
a specialized perinatal psychiatrist.

“The provinces and territories are excited about this model. They’re doing a
great job working together and learning from each other to implement these sorts
of programs and advance our understanding in many areas,” she said, noting their
shared focus on developing culturally safe, trauma-informed care. “They’re
working across boundaries to share the best ideas and make them even better.”

The high praise for provinces and territories brings up the question that some
have asked since the Minister of Mental Health and Addictions post was created.
Where does the federal government best fit into the health care equation?

“The delivery of health care is provincial or territorial. But whatever we can
do at the federal level to lighten the load, we should. Health — including
mental health — is a shared responsibility between all orders of government,”
she said.

One of the best examples of this, we agreed, is the federal government’s rapid
response in addressing the mental health impacts of COVID-19 though Wellness
Together Canada, an online portal offering free mental health resources ranging
from self-led courses to crisis support. To date, 2.2 million people in Canada
have used the portal, which was built on the Stepped Care 2.0 framework.

The minister is also passionate about the federal government’s other role in
improving mental health, one that starts from the inside.

“We have mental health challenges across all branches of government,” she said.
“Veterans, Corrections, Indigenous, RCMP. So how do we become an exemplary
employer? We have to be able to take care of our own people and walk the talk
when it comes to mental health.”

Drawing on outside strength
When our discussion turns to safeguarding her own mental health, Minister
Bennett’s insights reaffirm much of what we know about protective factors.

She talks about the importance of social connection, expressing gratitude for
her great team at work, and her partner, Peter, who she describes as her number
one supporter. “I could be working all night for three days, and he still greets
me like I’m Gretzky after a hat trick when I get home.”

She also talks about physical activity, describing walks with her yellow lab,
Ripley, beneath the magical tree cover of Toronto’s Beltline Trail, and hobbies
like Oscar homework, which comes with the territory when you’re married to
someone in the film industry.

Finally, she talks about the peace she finds in nature, particularly during
visits to Georgian Bay. “I need to look out at that point where the sky meets
the water — to notice how the water looks different every time,” she said.
“Being able to see something bigger than yourself, something that you can’t
control, is a good reminder that plans can change.”

And it’s exactly that philosophy that the minister hopes to help instill for
Canada’s people during this pandemic period and beyond.

Charting the path forward
“There are two kinds of immunizations important for Canadians right now,” she
said. “One is for COVID-19, and the other is immunization against uncertainty.”

Here, she is referring both to the pandemic and other global issues like climate
change, which increase our levels of stress and anxiety.

“Resilience is recognizing that your day isn’t going to go exactly as you
planned it out in your agenda —and learning to be OK with that,” she said. “We
need to provide people with the tools to build that kind of resilience and
autonomy when things don’t go according to plan.”

“I also hope we’ll get better at being able to reach out to those who may be
struggling, those who don’t seem like themselves. COVID has taught us that we
can be together while apart. How can we leverage that to build resilience and
show people that they aren’t alone?”

Answering that question on a nationwide scale is at the heart of the minister’s
ambitious mandate — one that she is ready and eager to fulfil.

“We aim to have a mental health strategy that everyone can see themselves in.
That will mean looking to national standards and establishing minimum
expectations to build on,” she explained. “Out of that, we’ll ensure that money
meant for mental health goes to mental health through transfers and collect more
research and data in the process. Understanding those outcomes will be critical
in making the best decisions in the future.”

Over the longer term, the minister hopes to help build a more cohesive system of
care.

“We’ve been fighting this patchwork quilt of non-systems for a long time. How do
we make sure mental health is totally integrated into systems of health? This
can’t be the turf of this profession or that,” she said. “We need to move away
from a scope of practice with hard lines and toward core competencies that can
expand. That’s how we’ll create a more modern and effective way of getting
people what they need when they need it.”

It’s a tall order, but Minister Bennett has spent her career proving that she’s
not afraid of a challenge.

“We can do this,” she said. “Canadians are counting on it.”



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