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Welcome to HC Link's blog! Our blog will provide you with useful information on healthy community topics, news, and resources, as well as information on HC Link’s events, activities, and resources. Our bloggers include HC Link staff and consultants, as well as our partnering organizations, clients, and experts in the health promotion field.

Please note: opinions in posts are those of the author and are not necessarily the opinions of HC Link or our funder.

We look forward to engaging in thought-provoking conversation with you!

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Tackling Substance Use Problems in Ontario

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by Jewel Bailey - CAMH 

It’s National Addictions Awareness Week, a perfect time to take a closer look at how to tackle alcohol and other substance-related harms. In Ontario, we’ve been grappling with challenges such as the opioid overdose crisis, alcohol-related harms, and the uncertainties surrounding the legalization and regulation of cannabis. These are complex public health problems that demand comprehensive solutions.

As a knowledge broker in EENet’s Health Promotion Resource Centre (part of the Provincial System Support Program at the Centre for Addiction and Mental Health), I’ve been working on various provincial mental health promotion policy initiatives. One consistent theme? We can’t keep focusing on treatment. We have to address risk and protective factors and create environments that support health and well-being.

Interestingly, when it comes to mental illness and addictions, research shows that people are more sympathetic and less stigmatizing to those with mental illness than those with addictions, who are often seen as having made an individual choice.  But let’s talk a bit about the role of the environment pertaining to the opioid overdose crisis.

Opioid medications are a type of painkiller. Some can be purchased over the counter, while others are prescribed by a dentist or doctor. In Ontario, there has been an overprescribing of opioids, the doses are high, and the period of use set by physicians is longer than needed. Some have argued that these factors have contributed to the opioid epidemic. According to Public Health Ontario, opioid-related deaths have soared to 136 percent since the early 2000s. In 2016, 865 Ontarians died from opioid-related causes. This is an example of how the practice and regulatory environment can contribute to poor health outcomes. However, the provincial government has created Ontario’s Strategy to Prevent Opioid Addiction and Overdose and has increased access to naloxone kits which are used to prevent opioid overdose.

Environment can also have an impact on harmful alcohol use. It is well established that increased physical availability of alcohol contributes to increased consumption and alcohol-related harms. Close to 1.5 million Ontarians (15%) reported consuming alcohol in harmful/hazardous ways within the past year, based on the 2015 CAMH Monitor report. The 2015 Ontario Student Drug Use and Health Survey showed that hazardous/harmful drinking increases with grade. Harmful alcohol use is associated with a range of social, health, and financial costs and is the leading cause of death and disability in the province. 

Tackling harmful alcohol use requires a multi-pronged approach that focuses on building the skills of individuals, working with communities to address issues such as social norms around alcohol use, intervening in different settings, and influencing the policy environment.

Another substance of public health interest is cannabis. Some find the legalization and regulation of cannabis to be concerning, while for others, this is a welcome move by the federal government. After all, banning people from possessing, producing, and trafficking in cannabis, and criminalizing those who use it, have not stopped cannabis consumption. On the other hand, legalization with little regulation can contribute to increased use with significant social and health harms. The federal government has proposed a model which includes both legalization and regulation. Ontario is already thinking ahead, and created the Safe and Sensible Framework to Manage Federal Legalization of Cannabis. This plan outlines what the provincial government will do to manage the use and sale of cannabis.

Cannabis-related harms increase with use, and when a person starts at an early age. Frequent use is associated with dependence, mental health problems, and impaired driving. Adolescents who use cannabis often are also vulnerable to health harms. The CAMH Cannabis Policy Framework recommends a public health approach for preventing cannabis-related harms. This entails addressing the underlying determinants of health, and focusing on health promotion and prevention. I am really convinced as a knowledge broker in mental health promotion that these are some of the major strategies for tackling substance use problems.

As we discuss solutions to problematic substance during this week, let’s not focus only on individual-level actions, but let’s consider the multiple environments people are surrounded by (family, community, policy) and use these as intervention points. By positively influencing the environment we will certainly have an impact at the individual level.

PS: Here is a list of resources you can use when working with clients or program users, or for planning or policy development:

Alcohol

Opioids

Interactive Opioid Tool

Cannabis

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Playing Back Your Conference Stories

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By Naomi Tessler, Artistic Director, Branch Out Theatre

 

Once Upon a time, there was a conference. A conference that aimed to explore issues of inclusion, equity and working across difference. A conference that created space for participants to critically reflect upon their role in co-creating community transformation: with everyone, for everyone. At this conference there were many moments of inspiration, mixed with conflicting points of view. The result: Two days of deep unpacking, radical learning and the etchings of a new road map to community change.

 

Let’s Watch! …

 

These are the magic words you’ll hear at the closing playback theatre performance by Branch Out Theatre for the upcoming HC Link conference. You and your fellow conference attendees will be invited to share your conference reflections, stories and experiences (like the summary painted above) and Branch Out Theatre’s playback theatre troupe will play those moments back to you- on the spot- through improvisation. Branch Out Theatre will co-create a space with you to harvest your learnings, deepen your understanding and strengthen your connections.

With each reflection shared and each story told, our actors will use different playback theatre forms to animate the experiences being recounted. Each form will vary in length and depth and serve to capture the heart of what each conference attendee shares. We’ll use sound and movement to play out a montage of feelings you’ve had throughout the conference. We’ll perform impromptu rants to help make sense of any conflicts or challenges. We’ll re-enact your full stories about the seeds of wisdom and the roots of support you’re taking back to your community practice.

Whether or not you’re up for being a teller: one who shares an experience or story, the whole audience grows more connected as each story is played back. A personal experience gracefully transforms into a universal experience as the audience witnesses the story unfold onstage. Watching your fellow conference attendee’s story played back, you will undoubtedly see speckles of your own experience within it. The chance to have your story played back is like a gift, and our Branch Out Theatre playback ensemble: Alicia Payne, David Jan Jurasek, Victoria Haist and Will Kwan, conducted by Naomi Tessler, looks so forward to helping you unwrap it! To see pictures of past playback theatre performances, click here.

Playback theatre is one of the applied theatre practices that Branch Out Theatre works with to facilitate community engagement, creative play and critical reflection. We also specialize in Augusto Boal’s Theatre of the Oppressed, which centralizes pertinent issues of injustice in order to empower individuals and communities to be agents of change.

Check out videos from our various applied theatre project’s and performances here. Through our participatory workshops, trainings, community arts projects and interactive productions, we aim to inspire personal and collective transformation, and set the stage to rehearse towards social change across Canada.

We look so forward to Branching Out through Theatre with you and playing back your stories on November 21st at 3pm. Let’s Watch!

To learn more about Branch Out Theatre, please visit: www.branchouttheatre.com

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How can we work “with” people in poverty?

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On November 21st, join Gillian Kranias and Jason Hartwick as they re-examine the way we work with people who live in poverty. They will host an interactive workshop at our conference about strategies for working with people living in poverty in ways that respect their priorities.

How is this important? When working with people who are different from ourselves, our charity-based culture often sets us up to work “for” community members. Following this habit, we can end up in a mess. We carry and create biases around people who live in poverty. We feel rushed to produce results that reflect organizational priorities, not community priorities. We assume things and overlook local knowledge and particularities. Often, for example, we see a “problem” and propose a simple “evidenced solution”, when the local reality is a complex of interrelated issues and options which need to be discussed, sorted through and prioritized with community leadership and ownership.

 

So, how do we shift into working “with” people? To begin: make sure community members feel on their own ground and comfortable. To begin: allow community members to co-lead the process. To begin: resource their leadership, and talk openly and ongoing about how to shift resources towards a more fair sharing of power and leadership.

There is a story of a low-income community which started organizing Friday night dinners at the local recreation centre, providing a safe space where community members could include their children (including teens), share food and dialogue about different community issues and priorities – all facilitated by partnership members.

In this workshop, on November 21st, participants will build awareness and skills through stories and a case study, community development values and principles, collaborative learning and reflection activities. Participants will leave with direction and hope for engaging better “with” people who live in poverty.

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Getting Under the Skin: What is the Role of Cities in Mental Health and Illness?

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By Jewel Bailey - CAMH 

Here’s a compelling fact: half of the workforce in the Greater Toronto and Hamilton area is suffering from a mental health issue – that’s more than 1.5 million people! This begs the question: how does the place where we live, play, and work impact our mental health?

It’s well established by researchers that people who live in cities have higher levels of mental illness than their rural counterparts. The United Nations predicts that by 2050, 70 percent of the world’s population will live in cities. Currently 85 percent of Ontarians live in cities. As more people move to urban areas, the need for experts from different fields to focus on how city living impacts mental well-being will become increasingly important.

One of the international experts who has studied mental health and the metropolis is Professor Nikolas Rose from King’s College, London. He examined years of research on how mental health is shaped by city living. Rose says scientists have made the connection between mental illness and factors such as social exclusion, racism, and poverty, but what they have not determined is the process through which the “city gets under the skin”. He believes that as scientists from various disciplines work together they might be able to explain the process through which urban living affects the brain.

Other findings from Rose’s work include the following:

  • Cities should be viewed from an ecological perspective, with humans co-existing in a complex, ever-evolving environment. There is constant social stress produced by “noise, sprawling transport networks, the cacophony of diggers and concrete mixers, scaffolds and cranes”. Humans are not passive in these environments, but are always negotiating these spaces.

  • Researchers identified stress as one of the reasons for elevated levels of mental illness among urban dwellers. One group of researchers found that people who are born in cities, and continue to live in urban environments, process stress differently, which might be linked to why there are higher levels of stress in urban areas.

  • Stress is a subjective experience based on people’s perception of what is occurring around them. How a person interprets an element in their environment (e.g. crowding) determines whether it’s stressful or not; what one person considers stressful might not be stressful for another.

What is one of Rose’s more interesting points? He states that in the aftermath of a traumatic event, most people do well just speaking with family and friends. Only a few will require ongoing intervention by a mental health provider. This highlights the resiliency of humans.

While researchers such as Rose continue their work, policymakers are asking the question: what can cities do to improve the mental health residents? New York provides a good example of what can be done. The city has created a comprehensive mental health plan called Thrive NYC which is built on 6 principles. Dr. Gary Belkin, Executive Deputy Commissioner of Mental Hygiene in the New York City Department of Health and Mental Hygiene, and one of the leaders of the plan, notes that NYC had to rethink and restructure how mental health services were delivered, and also engage citizens in the process. One of the six principles is partnering with communities to improve mental health.

Thrive NYC’s work began by assessing where people go and how they access services. According to Belkin residents may not always access services in traditional mental health facilities so the system must reach people in their natural settings. For example, in this video, Thrive NYC worked with a Black faith-based organization to reach members of that community. The plan recognizes community stakeholders as “innovators in their own health” and builds the capacity of community-based organizations to increase access to programs and services. The success of Thrive NYC has sparked other international cities, such as London, to launch similar strategies.

Both Rose and Belkin were in Toronto recently, delivering talks on mental health and city, as part of a series hosted by the Provincial System Support Program at CAMH and the Wellesley Institute. You can find links to their presentations below.

As we turn the spotlight on the reality of mental illness during mental illness awareness week, let’s consider how we can build healthy, vibrant communities in rural and urban areas. Because more people are migrating to cities, where there are higher rates of mental illness, cities require unique attention. Cities touch the lives of residents in multiple and intimate ways. The urban environment can be a source of stress and happiness, but working to create supportive environments, and strengthening communities for action, as Thrive NYC has done, can impact the mental well-being of all residents.

Here are links to some resources:

  1. For more information on Thrive NYC and the principles click here

  2. To watch Rose’s presentation click here

  3. To watch Belkin’s presentation click here

  4. About mental health and mental illness

  5. Mental health first aid

  6. The friendship bench

Share your views - what do you think cities in Ontario can do to promote the mental health of residents and support those living with a mental illness?

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Safe BBQing techniques to enjoy a healthy Labour Day weekend

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With labour day just around the corner, I wanted to share with you some basic rules for food safety in meal preparation that was shared on on the Ontario Ministry of Health and Long-Term Care website.

According to Minister of Health and Long-Term Care, Dr. Eric Hoskins and Ontario's Chief Medical Officer of Health, Dr. David Williams, reminding Ontarians of proper food preparations is key to avoiding food born illnesses.

In the summertime, food poisoning increases due to more people preparing food on the grill, defrosting raw meats like burgers, and making more salads on flat surfaces. To avoiding cross contamination and food poisoning, follow these simple rules.

Clean you hands often when preparing meals, clean surfaces and utensils with soapy warm water. Bacteria loves getting onto hands and in cutting boards, kitchen ware, cloths, knives, etc.

Keep raw meat separated from ready to eat foods like veggies, fruits, breads, and salads. Keep the separate both when you’re preparing them and as you store them.

Thoroughly cook all your food, especially meats and poultry but also veggies if you’re cooking them on the safe grill.

Keep food and leftovers in the fridge and get groceries into the fridge within 2 hours of purchasing them - especially for meat, poultry and dairy products.

To ensure you’re following the guidelines above, you can take some extra precautions such as:

Using a food thermometer to test the temperature of your food as it cooks.

Never keeping food at room temperature for more than 2 hours

Don’t defrost your meat on countertops, rather keep it in a container and let it defrost slowly in the refrigerator or under cold water in the sink.

Keep packaging of your meat firm and tight, even double bag it to be sure no juice will leak onto your ready to eat foods.

Follow cooking instructions accordingly to make sure you’re preparing your food correctly and safely.

Following these tips can help you avoid the unfortunately symptoms of food poisoning that can range from mild to severe. If you do become ill and suspect food poisoning, consult a physician or go to your nearest hospital for urgent care if symptoms appear severe. By following these rules above, however, you should significantly decrease your chances of becoming ill due to food poisoning.

Enjoy your Labour Day weekend !

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