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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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It’s “cannabis” not “marijuana” and other interesting learnings from the Hon. Anne McLellan


By Jane McCarthy, Parent Action on Drugs

cannabis 1131526 1920Complex. Challenging. Broad societal impact. Words that come to mind when thinking about the legalization and regulation of cannabis in Canada. I recently had the opportunity to hear the Honourable Anne McLellan, chair of the Government of Canada’s Task Force on Cannabis Legalization and Regulation, also use these words when she spoke at the University of Waterloo School of Public Health and Health Systems about the work of the task force and where we are headed. Having scanned the 106-page Task Force report, it was a welcome opportunity to learn more about the recommendations, how they came together (80 diverse position statements taken into consideration) and how quickly so (five months), in a more dynamic way. While Ms. McLellan recapped the general public health approach and principles upon which the legislation introduced last month by the federal government is based, i.e., take a cautionary approach and protect the public’s health and safety, she imparted some interesting and important side notes, a few I’d like to share here.

  1. It’s cannabis, NOT marijuana, from here on, folks! —as we go forward, we need to stop using the term marijuana in our messaging and replace it only with the correct botanical name. Marijuana is slang and typically is thought of as the dried flowers of the cannabis plant for smoking or ingesting. Cannabis can be consumed in many different forms in multiple ways, so we need to re-educate ourselves and those we work with and serve.

  2. There is soooo much we don’t know about this plant!—We know some things about THC and CBD, and there is still more to learn about them, but what do we know about the 104 other active ingredients in cannabis? Not much. Are they harmful or helpful? We need to know. There will be a huge focus on primary research in the botanical sciences and merging that knowledge into the biomedical space. Interested in studying plants? There should be plenty of work available in that field as we move forward.

  3. Why recommending the minimum legal age be 18 years makes sense—It’s true the developing brain is more vulnerable to harms associated with cannabis use until 25 years of age. Contrary to recommendations made by medial associations and others to set it higher, the task force made this recommendation for a number of valid reasons. First, it makes practical sense for Provinces and Territories to choose to harmonize it with their legal drinking age, three of which have set that age at 18. Second, although it seems counter intuitive to not set a higher age when the focus is to protect youth, setting the minimum age too high would encourage an illicit market targeting youth and thus, leaving them more vulnerable to the harms associated with unregulated substance content and criminal interaction. Third, most Canadians reporting use of cannabis in the last year are 15-24 years of age. Usage falls off dramatically after age 25 to about 10%. If the legal age were 25, it would criminalize the bulk of users and wouldn’t have much of a harm reduction impact, now would it? The Task Force believes that with quality public education, most people by age 18 can make an informed decision.

  4. It’s a gender target market, so far—Males by far out-number females in terms of recreational cannabis consumption, approximately to the tune of 3:1. However, once legalized in Colorado, consumption did see a rise among females. It will be interesting to see if that holds true in Canada as well.

  5. Education is key: from creating clarity around legalization to promoting health and safety—Ms. McLellan noted that many from the recreational use cannabis advocacy community only seem to hear the word legalization, while the word regulation goes unnoticed. Just because it will become legal, doesn’t mean it’s a free for all for cannabis to be consumed by anyone, anywhere, anytime. People must be educated to understand the rules and be held accountable to them for public safety. And while we must move away from a psychology of prohibition to legal use, proper public education is required to address both the benefits and harms to mitigate both fear among those opposed to legalization and the misguided belief that there are no harms associated with cannabis among the fervent advocates. To keep children and teens safer, longer, it is paramount that parents and other adults involved with youth, and youth themselves, receive effective education about the potential harms to the developing brain ahead of legalization and on-going.

In a nutshell, there is much to learn about cannabis, its effects, and how to best legislate production, distribution, and use to promote public health and safety. Every aspect of society will be impacted in some way by legalization and regulation of recreational cannabis from perceived norms to business development to educational opportunities to healthcare to law enforcement to—you name it! Thus, the Task Force has recommended legislation that is cautious and flexible to respond to evolving knowledge and experience. As health educators and promoters, we must get ahead of the legalization and teach the risks of developmental harms to youth and risks associated with problematic patterns of use at any age. We must target and engage parents, health care providers, educators, community workers, and youth themselves to develop and evaluate effective tools about facts, norms, and making healthy, safe choices around cannabis, regardless of what the laws will look like.

 

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What Program Components Are Effective for Promoting Mental Health in the Early Years, School Years, and Transition-Age Youth?

By Jewel Bailey, CAMH Health Promotion Resource Centre

May 1-7 2017, is Mental Health Awareness Week. This annual event provides another opportunity to raise awareness about the importance of good mental health and what is required to achieve and maintain positive mental well-being. The Evidence Exchange Network within the Provincial System Support Program at CAMH, produced three evidence briefs that examine program components that are effective for promoting positive mental health in the early years, school years, and among transition-age youth. Selected findings for the three groups are presented below:

earlyyearsEarly Years

Home visiting and group-based parenting programs were identified as priority areas for this evidence brief since evidence demonstrates a high return on investment for these two types of interventions.

    1. Program components associated with effective home visiting include: utilizing appropriately and/or professionally trained home visitors, applying a clearly articulated theory of change, having more intensive programs, and teaching parents responsive parenting, behavior management, and problem-solving.

    2. Components associated with effective group-based parenting programs include: teaching parents emotional communication skills, disciplinary consistency, positive interactions with the child in non-disciplinary ways, and requiring parents to practice new skills with their own child during group sessions.

Read the Early Years Evidence Brief

schoolagedSchool-Aged Children

  1. Social emotional learning (SEL) programs are one category of mental health promotion interventions that foster the core competencies and skills to help children and adolescents manage emotions, relationships, and conflict.

  2. Components of effective SEL programs include using a whole school approach, SAFE (sequenced, active, focused, and explicit) components, interactive training methods, involvement of parents, and a focus on skill development. Programs delivered across all school levels have shown to be effective, though it is inconclusive whether longer programs are more beneficial than shorter programs.

Read the School Years Evidence Brief

 

tayTransition-Age Youth (TAY)

  1. Mental health promotion, prevention and early intervention supports for TAY must include interventions both on campus and in community-based settings that are diverse, integrated, and comprehensive.

  2. Skills-based programs that incorporate supervised behavior practice and feedback, such as those aimed at building cognitive-behavioral skills, mindfulness, or relaxation, have been shown to be effective at reducing levels of psychological distress among post-secondary students.

  3. Early evidence has demonstrated that integrated service centers, on campus or in the community, are effective at increasing access to mental health supports for TAY and somewhat effective at reducing psychological distress.

Read the TAY Evidence Brief


Findings from these evidence briefs informed the recommendations presented to the Ontario government by the Mental Health and Addictions Leadership Advisory Council in its 2016 Annual Report.

 

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Improve the Built Environment to Promote Food Access in your community: Questions, Responses and Helpful Links from our online discussion

By Kyley Alderson, HC Link

builtenvirofoodaccessheaderOn April 13th 2017, HC Link consultant Paul Young from Public Space Workshop joined with 50+ participants to share ideas, resources and information to help us improve the built environment to promote food access in our communities.

This online discussion focused on the physical/built environment, which is one key component of the overall food environment. Research and our experience shows us that the built environment can affect food access. There is a distinction between programming for food access in contrast to providing physical space (e.g. a municipal parking lot available for a food market) which can then support programming.

Below, we are sharing the questions that were asked, responses from Paul and participants, as well as helpful links and resources. Feel free to scroll to questions that appeal to you, and don’t forget to check out additional resource links at the bottom of the blog! If you have any remaining questions, or want clarification on the information provided, you can email Kyley at This email address is being protected from spambots. You need JavaScript enabled to view it..

Poll 1.

The discussion began with a few poll questions to get participants thinking about how the built environment can affect food access–

How close are you to your healthy food store where you regularly shop?
Is your community designed with food disbursed throughout it or is it located in one area of town?
Some communities are disproportionately affected by lack of access to healthy food. For people in your community that may be on fixed or low income, check all that apply. (Options included healthy food stores within walking distance, having food banks, community kitchens, or food markets nearby, and having more unhealthy vs healthy places nearby).

After the poll the discussion was guided by questions submitted by participants.

Questions and Reponses

1. What is a food swamp? What is a food desert? How can we identify where there is a need in my community?

  • Food Swamp – areas with more fast food and unhealthier food options

  • Food Desert – areas with limited healthy food options

  • Taking a geographical perspective on food access – you can map out food resources (healthy and unhealthy) to see where there is a need in your community.

  • Transportation is a key issue for food desserts.

  • Working with planning departments, you can look for ways to incentivize grocery stores to come into the community.

  • Zoning – (e.g., Toronto’s Residential and Commercial or RAC zoning). Toronto has been experimenting with this and looking for ways to incorporate shops into the bottom of higher apartment residential buildings. Planning departments have started to open up this discussion – to look at introducing mixed land uses and incentives for shops to be located there (in areas where there are food desserts).

  • Toronto Public Health/ Food Share – Pop up markets and mobile food markets – having a market on a regular schedule to bring food into the community.

  • Healthy Corner Stores Initiative – Toronto Public Health has piloted a program to encourage convenience stores to sell some healthy food options.

2. What strategies can you suggest to reduce food swamps? At a policy level, when an area is zoned for commercial how do you control what types of food outlets are approved?

  • There is a chain of agreements that fall into place – planning departments can have some influence in this and can work with developers in early stages when tenants are determined.

  • Example - PAN AM games village (now the Canary District) in Toronto – they had an influence over what types of establishments could lease store front locations. There was a restriction on chains (although there could still be independent unhealthy shops), but that is example of influence.

  • Still early days on working with developers on this.

  • Montreal and NYC seem to be leading the charge on this.

Participant shared:

  • Haldimand-Norfolk Health Unit collaborates with the planning department and we are invited to pre-cons with the planners. We attend and then try to educate the developers about the benefits of healthy foods vs. risks of unhealthy foods, or highlight they are close to a school so we don't recommend fast food/convenience store. They don’t have to listen to our advice but many of the developers are interested and do take our suggestions.

3. In rural areas, where there is limited/no public transportation, do you have any suggestions for how people can access food (whether through grocery stores, farmers markets, etc.)?

  • One strategy - Work with planning department to get food stores to locate near the downtown – where people are living and where transit may be connected.

  • There is a current trend to locate retail by highways – this makes it very difficult if you don’t have a car. Speak with your planners.

  • Strategy – connect with farmers.

    • Look for opportunities for Good Foodbox model.

    • Community shared agriculture (CSA)– where there are a series of drop spots where people can pick up produce at a location that is easy/in close proximity to where they are living.

    • Farm gate retail – where farmers can bring produce into town, such as a weekly market, or set up stand/money box at the end of their driveway (may need access to car still for this option).

    • Shuttles and Ride Sharing – organize weekly trips to grocery store and share transportation costs. Some agencies might have access to a shuttle bus – might be a way to connect pick up and drop offs to food stores.

Participants shared:

4. What resources/education documents exist to assist in enabling stakeholders and decision makers to understand the impact of transportation on food access?

  • Maps can help – you can start to see where concentrations of food stores are and see where populations of higher need are living, and calculate the distance between the two. You can layer in information about the transit system and see where they are/are not connected.

  • Food By Ward – connected to the work of Toronto Food Policy Council. They have produced a number of maps that serve as a good model for mapping out resources (including community kitchens, markets, food stores, etc.)

  • Toronto Urban Growers are also doing mapping work to show where food resources are located.

  • Mapping helps to point out needs and gaps.

  • Housing and Transportation Index – looks at cost of housing and transportation combined. We might think we have affordable housing, but do we when we consider transportation in car dependent locations?

  • Shuttles, cab sharing, changing a transit system to connect higher need communities with food stores can be explored.

  • Working with planners and developers to bring in healthier food stores – real opportunity with new developments especially.

5.How can you gain public or political support for investments in the built environment as they relate to food access?

  • Drawing on experience at the South Riverdale CHC– They started a food working group with a wide representation of stakeholders. A working group is foundational for setting up strategies to address local challenges.

  • A working group adds credibility when speaking with decision makers, local elected representatives – to advocate for change.

  • Mapping – Paul is currently making food (and recreation) maps that list food resources within a 2 km radius around schools in Toronto’s tower neighbourhoods. Maps have icons for a variety of resources, e.g. – Farmers markets, community kitchens, etc. When decision makers see there is no icon on the map for one of the resources (food markets for example) they might begin to think – we don’t have this and we should. Maps are helpful and compelling tools for pointing things out to decision makers, especially food desserts and food swamps.

Participant shared:

  • In my experience, one needs to provide clear evidence to help people understand what the problems are and, especially, what the problems are not (e.g. in Toronto "food deserts" are not a big problem, but "food swamps" are). Then being very clear on potential solutions and what you need from decision makers to realize it. Precision and clarity is not something that's been a priority among public health actors but we need to get better at it.

6. How do you evaluate success/use of map by public?

  • Just in process of doing this with the school maps - sending out survey to teachers, asking if they are aware of the map and if they are using it in the classroom, etc.

  • If maps are available online – you can look at how many people are downloading the map from your website.

7. What criteria, resources or standards could be used to establish what is deemed a healthy vs an unhealthy food outlet?

  • Dieticians can visit each store and do an analysis on what is sold there. For the school maps we are relying on their expertise and their criteria to tell us whether it is a healthy food store or not and the percentage of healthy/unhealthy food in the food outlets.

Participants shared:

  • Developing a food charter as a first step to incorporating food access and influencing the food environment could be useful. Food charters could be the basis for food strategy and food policies. Find out more about Toronto's Food Policy Council here: http://tfpc.to/

  • In Toronto we created definitions of "healthier" and "less healthy" food outlets that we applied to public health inspection data as part of food envir't mapping. It's meant for use as an analytical tool, not in any way as a public designation. Happy to share that approach with anyone.

Poll 2.

Before moving on to further questions, we asked two more poll questions to get participants thinking about how land use planning policies might be affecting the built environment and its effect on food access.

If you have any new developments where you live, does the new community have shops (including food stores) located near homes (within walking distance)?

  • Development patterns are changing. We are coming out of an era where we put all the residential areas in one part of town and all the retail in another – which made us very depending on driving.

  • More recent developments have started to incorporate retail on ground floor.

  • Still a lot of urban sprawl going on.

The Provincial “Places to Grow” plan is in place to protect farm land and natural features in the Greater Toronto and Hamilton Area. Has your municipality set out land use policies in the Official Plan to protect agricultural lands?

  • Most municipalities have an urban growth boundary – a boundary line that development is permitted to occur within to prevent sprawl and preserve farm land.


8.
What municipal policies have shown impact for improving access to healthy foods in a community and/or at the neighbourhood level?

  • Growth boundaries to prevent sprawl and preserve farm land

  • Mixed-use zoning – to encourage a retail and place to work in the community

  • Supporting existing downtowns – bring food shopping into downtown where people are living. Look for ways to support this in planning policies.

  • Story in The Star a few years ago – a couple moved to downtown Milton to be closer to shops and leave car at home. But as development unfolded, large format retailers (including food stores) were located on the outskirts of town and the downtown became more of a boutique retail area. Couple had to use the car to get their everyday shopping needs. Policies that enable new retail areas outside of existing communities can have an impact on food access.

  • Residential Commercial Zoning. Communities can introducing retail (even small scale convenience) into residential areas that don’t have any retail currently.

  • Municipalities can also introduce policies to enable community gardens at various scales. Fresh City Farms at Downsview park for example.

  • Designating areas for markets – Bellville has a formalized market downtown. Can also look at simpler models where policies allow parking lots to be used for markets at certain times.

  • By-laws such as allowing hens in the backyard for fresh eggs.

Participant shared: http://www.rentthechicken.com/


9. Erinn Salewski: Are there opportunities to insert food access language into municipal planning documents ie. City Master Plan, etc.?

  • Yes - see examples above

  • There are a number of documents that shape community planning - Official Plan, secondary plans with more detail (e.g., park space schools and lot sizes).


10. People living in poverty (whom, they themselves or people they know, also tend to experience higher levels and frequency of crisis) may not have energy or time (due to life as well as working multiple jobs) to go to a community garden/participate in a community garden - ideas for options?

  • Look for ways to overlap community gardens with other services/programs (i.e. have a garden in close proximity to other services)

  • Support people in having small scale gardens (i.e. balcony, vertical gardens). South Riverdale CHC has a demonstration rooftop garden set up.

  • Making it easier for people to garden by bringing it closer to where they are. It can be incorporated right on to the front lawn of a community organization, for example.

  • Note about Equity – food banks are a piece of the food access picture, but other models like a community kitchen or a subsidized good food market (Food Share is making it easier to get these markets set up in Toronto) are good options as well, and are often less stigmatizing.

Participants shared:

  • Connecting people to other services (i.e. social services) in the community is also important


11. Teaching children about respect for the environment is an important aspect of sustainability, and may contribute to how children make decisions about the environment as they grow older. I firmly believe that this process should start while children are young. A large number of Child Care Centres are located in strip malls, where children have limited access to gardening. What do others think about having Child Care Centres located in 'safe environments' (geographically) which provide greenspace opportunities for children to grow their little gardens, and develop physical literacy at the same time?

  • With regard to engaging students in schools, when students and teachers are involved in the garden design process first – it builds up support for the idea.

  • If space is restrictive, might need to look at vertical gardens or gardening indoors (planting seedlings in the window and taking home)

  • In terms of child care centres in strip malls (may be a health impact when located near a busy road).

12. How can schools be supported to provide healthy options for students and contribute to the food security issues in the larger community?

  • Paul is working with Toronto Public Health to show students where food is located in their neighborhood (as well as recreation resources). Teachers have a toolkit to incorporate this map into their class lessons/curriculum. Into Kids Health

  • At South Riverdale CHC Paul assisted schools in designing and planning gardens, and getting commitment from principals and teachers to support the garden (schools don’t often have resources to initiate this process).

  • Evergreen Learning Grounds – has resources and dollars for school ground greening programs (including gardens).

  • The Good Food Café (Food Share) – looks at how cafeteria food can be made healthier.

Participants shared:

  • In our community, the high school construction classes build all of the plots for the community gardens/ greenhouse. The Local Food Co-Op has a plot in their greenhouse that they provide for free to schools who do not have school gardens. Connections to other organizations can be key. www.cloverbeltlocalfoodcoop.com

  • The Ministry of Education does incorporate well-being (including physical literacy) in their How Does Learning Happen - Ontario's Pedagogy for the Early Years. NRC was involved in consulting with the Ministry of Education on how to incorporate Food literacy in to this document as well.

  • The tower garden/ vertical aeroponics approach has always looked interesting. A high school in Toronto has used them, good for areas with limited space.

  • Student Nutrition Program supports schools to provide healthy foods to students.

  • Interesting stuff happening with vertical hydroponics happening in the far north too. This is a fun story (one of many) http://www.cbc.ca/news/canada/north/naujaat-nunavut-growing-north-project-1.3633295

13. In Canada, over 6 million tonnes of food that is perfectly good, and wholesome to eat is thrown in the garbage every single year; Yet 1 in 8 homes struggle to put enough food in the table. What models have you encountered that reduces food waste while improving food security and food access?

  • Second Harvest – Food rescue matching. Electronic app to connect consumers to food. If you’re running a business that has food that will expire, this app helps you connect.

  • South Riverdale CHC – has relationship with some bakeries – provides bread at the end of the day.

  • Important to build relationships between agencies and local food providers.

  • Urban fruit harvesting programs - Not far from the Tree

Participants shared:

For more resources on this topic, please see our Resource Sheet that was prepared for this online discussion.

 

 

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Connecting Through Stories: an exploration of relationships through art making and connection to the Land

 

An HC Link Regional Gathering: March 30, 2017
Baggage Building Arts Centre in Thunder Bay.

Written by Lorna McCue, HC Link/OHCC

Every two years, HC Link works with local community organizations and groups to plan and co-host regional gatherings across the province that respond to regional needs and issues. These gatherings support the development of cross-sectoral and diverse community partnerships by providing opportunities to engage stakeholders across the region in a community-building event.

In Thunder Bay, a connection was made by HC Link with Alana Forslund, Coordinator of the Community Arts & Heritage Project, which initiated a discussion about the role of the arts in a healthy community. She brought Carol Kajorinne, Public Programming Coordinator for the Art Galley of Thunder Bay into the conversation who, in turn, invited others to join in.

The gathering was co-sponsored by HC Link and the Thunder Bay Art Gallery, with the organizing group doing the bulk of the work to develop the program, promote it to prospective participants, recruit facilitators and procure the art materials.

Members of the regional gathering organizing group were:
• Lorna McCue, Ontario Healthy Communities, a member of HC Link
• Carol Kajorinne, Public Programming Coordinator, Art Galley of Thunder Bay
• Crystal Nielsen, Community Artist
• Michelle Richmond-Saravia, founder of beSuperior Consulting and representative of Thunder Bay Indigenous Friendship Centre’s Long Life Care Program
• Michelle Kolobutin, Community Clothing Assistance

In planning the gathering, the group agreed that racism against Indigenous people was a pressing issue in Thunder Bay, and felt there was a need for non-Indigenous people to gain a greater understanding of the historical impacts of colonization and residential schools. They saw the regional gathering as an opportunity to make a contribution to Article 63 of the Call to Actions contained in the Truth and Reconciliation Report, which calls for “building student capacity for intercultural understanding, empathy, and mutual respect”, and to Article 83, which calls for “a strategy for Indigenous and non-Indigenous artists to undertake collaborative projects and produce works that contribute to the reconciliation process”.

This event aimed to create intergenerational connections through art and story. It brought together more than 45 people, including about 20 Gr. 6 & 7 students from a neighbouring school, elders and seniors from the Thunder Bay Indigenous Friendship Centre and Community Clothing Assistance, college students, artists, storytellers, and other community members. People from different cultures, from ages twelve to people in their eighties, were engaged in a creative process that combined sharing their stories with a collaborative weaving project, with a focus on learning and growth.

The event began with an opening smudge ceremony, led by Elder Diane Michano-Richmond. Michelle Richmond Saravia, of beSuperior Consulting, shared a story of her journey and invited other to share their stories throughout the day. One elder reminisced about his negative experience at a residential school.

       lornablogpic11    
Elder Diane Michano-Richmond    
Photo by Lorna McCue

Eleanor Albanese, a community-engaged artist, guided the collaborative weaving project. The participants were seated in groups of 6-8 around tables with a weaving frame and strips of cloth of a variety of colours and patterns. Eleanor laid out about a large number of pictures of a variety of subjects, such as people of different ages and races, different plants and animals and landscapes, along the windowsills that spanned the long room. She invited participants to go up, one table at a time, to view the pictures and select one to bring back to their table. Once seated again, they took turns explaining what they liked about the picture and what meaning it had for them. Many stories were shared in this way. Each person then took a marker and wrote meaningful words or drew a picture or symbol on a strip of cloth. They shared their words or symbols with others at their table, then, as a group, they worked on weaving the strips of cloth into the weaving frame.

 

 

 

 

  lornablogpic2 
A weaving created by a group of elders. Photo by Michelle Richmond Savaria

The group took a break for lunch, which was catered by Fox on the Run, a locally owned restaurant and catering service. Managing the lunch service was challenging, due to the narrow shape of the somewhat overcrowded room and the diversity of the participants regarding mobility, dietary needs and cultural considerations. However, with several helping hands from students and other helpers it all worked out.

 

 

 

lornablogpic3

Students explain the meaning of their weaving.  
Photo by Lorna McCue

When the groups completed their weavings, they showcased them at the front of the room and explained the meaning of some of the elements. There were many exclamations about the beauty of the weavings and a warm, positive mood was apparent at the close of the gathering.

 

 

 


Because of the diversity of the participants and varying literacy levels, it was decided not to have each participant complete an evaluation form, but to pose a series of reflective questions to the members of the organizing group. While there were some suggestions for improvements, all felt that the gathering was successful in meeting its objectives. As Eleanor Albanese said: “Community-engaged art making breaks down barriers of all kinds.” Other comments from the organization group included:


It was moving for me to see how people really did share their stories, and wove their stories together, both symbolically and literally.


For the seniors and Elders, it provided a creative and social opportunity. The youth had the opportunity to share and hear stories through art making as well as devour some nurturing food. I heard some profound stories come out of the youth! I feel that no matter the age, everyone had a valid and meaningful story to share.


For something like this to be successful, it takes a high level of experience in community-engaged arts and also cultural knowledge; it takes humility; it takes a group of people all working together with a common goal; it takes a spirit of helping each other and helping the participants feel both welcomed into a space and comfortable in the space; it takes hot tea and coffee, and food to share!  It takes courage and a positive view of the future, as well as acknowledgement of the pain of the past (in the instance of residential schools and our history.)   In other words, it takes tremendous thought and planning.  And even though things did not go perfectly, in my view, it was a special day.  And, of course, there is always room to grow and learn. 




For those interested in viewing the “Connecting Through Stories” weavings, they will be on exhibit at the Thunder Bay Art Gallery Community Room from May 9-24.

 

       

Thank you for your generous support throughout organizing this wonderful event. It’s been a pleasure working with you and OHCC/HC Link.

Carol Kajorinne and the Thunder Bay Art Gallery

       
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Discharge Planning in Hospitals: How can we improve?

By: Megan Ferguson BSW, RSW


social work 1

Discharge planning is a vital component of a patient’s hospital stay, it is the moment where the healthcare team connects patients and their close family members with integral resources so that they can receive follow up healthcare services in the community. However, as I am developing my career as a hospital social worker, I notice that in many hospitals social workers are tasked with both coordinating discharge planning and providing emotional support to patients and families (Mizrahi & Berger, 2001). However, within these two tasks, social workers perform multiple sub-tasks including 1) Assessing a family’s social situation, 2) Consulting with interdisciplinary team members about patient care planning, 3) Identifying the psychological, emotional, social or spiritual barriers that interfere with treatment or discharge planning, 4) Engaging in advocacy on behalf of patients and families, 5) Providing crisis and emotional counselling and/or intervention, 6) Counselling around end-of-life, grief and bereavement issues, 7) Counselling around suspected abuse, 8) Addressing substance misuse issues, as well as 10) Engaging in writing, teaching and research activities (Gregorian, 2005, p.4). Patients that are typically seen by social work are patients who lack social supports, need assistance with income, need assistance with locating accessible and stable housing and individuals who may struggle with addiction or mental health challenges. Social workers are also the core discharge planners and lead the team to transition patients back into the community with the resources and support that they require.

Although I quite enjoy my work as a hospital social worker, my experience as a frontline social worker has allowed me to understand the obstacles and limitations that social workers in health care have to face in order to advocate for their patients while following multiple policies, standards, and guidelines. Tensions exist between “advocacy and collaboration” as well as, “commitment to patients and the organization” (Mizrahi & Berger, 2001). I find it challenging at times to maintain provincial, and regional guidelines of social work, while also following the Canadian Association of Social Workers’ (CASW) Code of Ethics (2005) and Guidelines for Ethical Practice (2005). The health care system also requires social workers to abide with hospital patient flow and length of stay standards, which can also further complicate patient care when many social issues are prevalent. Within these challenges Dr. Anna Reid, Former President of Canadian Medical Association, stated that “An estimated one in every five dollars spent on health is directly attributable to the social determinants of health,” in her final address (Eggertson, 2013, p. E657). However, these social determinants of health bring forward multiple barriers. Some of the most prevalent barriers may include income, housing, and food insecurity, which is further maintained by oppression and discrimination against minority groups such as women and First Nations individuals (Raphael, Curry-Stevens, & Bryant, 2008). These barriers force social workers to advocate on behalf of patients and families in order to work towards change and make social and policy adjustments to empower patients to better their health and well-being.

Social workers have a very large role and this role may differ depending on the client, and the unit that a social worker is working on. Collaboration is also so important when working in healthcare, unlike other social services agencies where social workers may make up the majority of professionals working in that area (Gregorian, 2005). Instead, hospital social workers play a more consultative role where they aim to collaborate with many disciplines each day (Gregorian, 2005). However, more emphasis must be placed on the importance of collaboration and interdisciplinary teamwork in order to initiate better patient outcomes and eliminate the power struggle between healthcare disciplines.

As social workers, we often work in collaboration with community social services agencies such as income and housing government organization as well as nonprofit organizations that assist with mental health and addiction. However, not enough of these organizations exist and we must continue to support these agencies in order to have resources that community members can draw on in times of crisis.

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Megan Ferguson is a Master’s student in the School of Social Work at the University of Calgary. Megan holds a BSW as well with a Specialization in Aging. She also sits on the Board of Directors for A & O: Support Services for Older Adults. Megan currently works as a Social Worker for the Acquired Brain Rehabilitation Program and Stroke Rehabilitation Program at a hospital in Winnipeg.

References

CASW. (2005). Social work Code of Ethics. Ottawa: CASW.
CASW. (2005). Guidelines for Ethical Practice. Ottawa: CASW.
Eggertson, L. (2013). Health equity critical to transforming system, says outgoing CMA president. Canadian Medical Association Journal, 185(14), E657-E658, DOI: 10. 1503/cmaj.109-4588.
Gregorian, C. (2005). A career in hospital social work: Do you have what it takes?. Social Work in Healthcare, 40(3), 1-14. DOI: 10.1300/J010v40n03_01
Mizrahi, T. & Berger, C.S. (2001). Effect of a changing health care environment on social work leaders: obstacles and opportunities in hospital social work. Social Work, 46(2), 170-182
Raphael, D., Curry-Stevens, A. & Bryant, T. (2008). Barriers to addressing the social determinants of health: insights from the Canadian experience. Health Policy, 88(2-3). DOI: 0.1016/j.healthpol.2008.03.015

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