Today is January 28th, which means it's Bell Let's Talk day in the Canadian province of Ontario.
As a mental health professional, this day brings about mixed feelings.
Bell Canada is a massive corporation. How are they distributing the funds? Who decides the recipients of the fund and who is represented in the group of decision-makers? How do we acknowledge the positive impact of Bell Let's Talk while also holding a telecommunications giant accountable for their oppressive policies towards vulnerable inmates in Ontario jails?
Over the past few years, we have seen conversations around mental health becoming normalized. Young people, especially, are less reserved about discussing mental health concerns and sharing their struggles. This is amazing!
Of course, it's not the complete story. Many BIPOC communities and children of immigrants continue to struggle with the ongoing impact of intergenerational trauma on their mental health and the mental health of their family members.
A hashtag doesn't capture the impact of mental health issues on the most vulnerable communities. However, it's a door to a wider conversation and that is something to acknowledge.
There is clearly value in de-stigmatizing mental health issues. Reducing stigma means we have safe places (and people) to confide in. Talking about mental health sheds light on the reality that everyone goes through low points in life and many of us experience serious mental health issues that affect our day-to-day functioning. Not talking about mental health means we feel isolated and alone in our struggles, when nothing could be farther from the truth.
However, mental health is not a list of symptoms. It does not exist in a vacuum. Environment and life circumstances directly affect mental wellbeing. For this reason, TALKING about mental health can only take us so far
A conversation about how to improve mental health on a large scale MUST include the social determinants of health. Let's spend a few minutes on this topic!
A Quick Introduction To Social Determinants Of Health
The social determinants of health (SDH) are non-medical factors that influence our health and wellbeing
SDH include anything that shapes the conditions of our daily lives. Here is a more specific list:
- Income and job security
- Food security
- Ability and Disability
- Gender and gender identity
- Housing security and access to basic amenities
- Discrimination and systemic racism (many 'isms' and 'phobias' can be included here)
- Access to healthcare (including mental healthcare)
- Access to community support and socialization
- Economic polices. social norms, and political systems
SDH are crucial to understanding and challenging health inequities in our society. And this includes mental health inequities.
The Canadian Mental Health Association notes that freedom from discrimination and violence, social inclusion, and access to economic resources are three social determinants of health that are particularly important for mental health.
To understand this better, imagine a situation where these three factors intersect:
A person of colour comes into an emergency room. They are experiencing suicidal thoughts and feel extremely scared. Upon taking a history, the ER nurse learns that they have 3 kids and are about to be evicted from their apartment. They have not been able to pay rent in 3 months and are on the brink of being laid off from work due to pandemic restructuring. This person believes they will the first one to go in the company- they have always experienced feeling singled out and 'othered' by the mostly white management.
How can we talk about mental health in this scenario without talking about the housing crisis and lack of access to safe housing? How can we talk about therapy when this person is worried about how to feed their kids? And how can we discuss breaking the stigma of mental health when corporations can harbour systemically racist practices that cause employees to lose opportunities and never experience job security?
This is why the social determinants of health are so important to consider! Yes, breaking the stigma is important. However, we need to ensure that our efforts reach beyond those who carry privilege.
So, How Is Ontario Doing?
The pandemic has only deepened existing inequities in Ontario. We are in the middle of an affordable housing crisis.
Food insecurity and food deserts exist in Canada too, and race has a clear impact on food security.
These factors cannot be isolated from mental health, and certainly cannot be addressed in a single day. #BellLetsTalk gives us an opportunity to start a conversation and also to reflect on the complex nature of this issue. Simplifying it to talk alone does a massive disservice to the cause.
Wrapping Up: Sure, Let's Talk....And Also Act
Here are some unique charities supporting those who are experiencing housing insecurity and homelessness. Community Living is addressing the housing crisis from the perspective of those with developmental disabilities
Second Harvest recovers unsold food to provide hunger relief for many communities. Also check out the food banks and food security initiatives in your city!
There are so many more initiatives we can highlight. The important message I hope you take from this post is that mental health is not one-dimensional. To ensure mental wellness for the many (and not just for the privileged and few) we have to talk AND act. Talk AND donate. Talk AND advocate. Talk AND seek reparations. Talk AND hold corporations accountable.
Psychologist Gursharan Virdee says it best in this post:
Until next time!