Have you ever noticed how often the terms ‘crazy’ or ‘insane’ are used in endearment or as a compliment? ‘That idea is so crazy… it just might work‘ or ‘We got an ‘insane amount of work done last week‘.
We have a strange relationship with friends, family, co-workers and strangers who suffer from mental illness. There is compassion – but uncertainty as to what we need to be compassionate about. There is understanding – but without understanding the personal hell being experienced. There is knowledge – but about a medical condition that is still largely a mystery. There is a willingness to be inclusive – but not without some apprehension.
These themes and others were explored at the May 17, 2017 Financial Management Institute – Edmonton Chapter (FMI) conference. This was done through speakers,notes, hand outs, links, surveys and of course an opportunity to discuss and ask questions.
The Speakers, Notes and Some Great Links
FMI was honored to have a stellar line of up speakers and an equally fantastic moderator. Biographies and background information for each of the individuals are available in the pre-conference notes. Nevertheless, a quick synopsis of the perspectives that each of the presenters brought to the proceedings.
[Editors note, the material below is a combination of a particular speaker’s presentation, content from the other speakers, additional material added for context and editing for brevity and clarity. Nevertheless, all of the speakers have reviewed and acknowledged the following broadly represents their contributions to the conference].
- Scott Aylwin, Covenant Health.
- Georgette Reed, City of Edmonton.
- Pamela Kollross, City of Edmonton.
- Laurel Kirchner, Covenant Health.
- Linda Shaw (and Flynn).
- Robert Manolson, Powerful Play Experiences.
- Isabel Henderson, Glenrose Rehabilitation Hospital.
- Survey Says….
- What Happens Next.
- Sources and Links.
Scott opened with the facts as well as a reminder that public health issues do evolve. For example, sixty plus years ago, smoking was portrayed as having health benefits and now cigarette packaging lists the consequences of this dangerous habit. The stigma of mental illness is following a similar trajectory. Part of this change is the recognition of the costs in both cash and lost productivity of mental illness, for example:
- Reasons for referrals to Employment Assistance Programs:
- Psychological – 40%
- Marital issues – 20%
- Family issues – 15%
- The last two likely have a strong mental wellness dimension.
- The Population Stats Shows the Individual Impact (source CMHA, ).
- 20% of Canadians will personally experience a mental illness in their lifetime.
- Mental illness affects people of all ages, educational and income levels, and cultures.
- Costs: $7.9 billion in 1998 – $4.7 billion in care, and $3.2 billion in disability and early death.
So what can an individual do, Scott provided the following advice:
- Be a Mental Health Ambassador.
- Ask a question instead of knowing everything
- Don’t chime in with gossip
- Be less judgemental
- Don’t be tolerant (of stigmatization), be inclusive.
Georgette brought very personal experiences of managing mental illness as an elite athlete, coach and as the Health & Wellness Coordinator, Fire Rescue Services. In a way, mental illness and athleticism are inter-twined. You would have to be crazy to subject your body to the stresses to become an elite athlete. This level requires physical and mental fixation on achieving a singular goal. Nevertheless, physical activity is integral to mental wellness and for many, the physicality of sport is a release for the mind.
As much as sport is a wee bit crazy, running into a burning building or attending to a horrific traffic accident is even more so. While most of us may experience 1-2 traumatic events in our lifetime, first responders can see that many in a single shift. This continual emotional vista [*] takes it toll psychologically. For this reason, Georgette works with city fire rescue crews to help them process and better manage their own mental wellness. Often this support is not active but is simply a matter of being a good listener whom the individual can trust and build a bond with.
Listening and trust does not require years of training either in the gym or in the classroom. These are things that all of us can bring to our families, communities and work places. That is not to say they are easy. In fact listening to someone may take much more discipline than wanting to jump and solve their problem.
[* Editors note, for more on emotions in the work place, see this series of blogs on the ‘Healthcare Ethos‘.]
Have you ever seen the pictures of the men building the Hoover Dam? Until the 1930’s, protective wear for workers was an optional luxury. Now it would be surprising to walk past a construction site and NOT see the workers not wearing safety equipment such as a helmet or eye protection. In due course, the same may be said about programs for Psychological Health and Safety in the Workplace.
Pamela Kollross, City of Edmonton,Health Promotion Consultant, Corporate Safety & Disability Management, is responsible for the City of Edmonton’s Psychological Health and Safety Pilot project. This program has a number of objectives, one of which is to move the City from being a good place to work to being a “Great Place to Work”. While this may seem to be a nice-to-have discretionary activity, it has profound cost savings and productivity implications. Engaged employees work safer and produce more than their disinterested equivalents. This is not about exploiting or ‘tricking’ staff into worker more – it is about creating a community that employees want to work for, desire to stay at and are willing to be promoted within.
The Psychological Health and Safety in the Workplace CSA Standard uses 13 psycho-social factors to describe a safe and productive work place. The pilot project will begin with measuring these factors using the Guarding Minds at Work Survey which will help to focus the interventions so the project can make the most meaningful improvements for their employees. Here is a look at the factors from the standard:”
- Psychological support
- Organizational Culture
- Clear Leadership and Expectations
- Civility and Respect
- Psychological job fit
- Growth and Development
- Recognition and Reward
- Involvement and Influence
- Workload Management
- Psychological Protection
- Protection of Physical Safety
Hard-hat falls within the last factor, physical safety, but what about the other 12? Pamela’s group has piloted a program with a group of city of employees who are often on the receiving end of abuse and as a result considerable stress – the 311 operators. 311 is a city information hotline and for the most part callers are glad to have the inquiry answered. Unfortunately a minority of the callers do not share this respect and are abusive.
The pilot will measure a series of base line values for the first 12 factors listed above. After this, a series of activities will be initiated such as putting into place action teams, support networks and inventories of resources available. At the end of the pilot, the 311 operators will be re-surveyed to measure the improvement in the 13 psycho-social factors and there will be comparisons made between pre and post levels of absenteeism, employee assistance program utilization, short and long-term disability statistics. Stay tuned for the results!
If you cut your finger or have a minor accident in the work place, you may go to the staff nurse, the lunch room first aid kit or even the medic in the first aid station. What happens when you injure your mental health – where do you go for that? How do you even know that you or a co-worker needs some help? Finally, where exactly is the mental health first aid station?
Covenant Health has implemented two programs to support mental health first aid: Code You and the Elephant in the Room. Both focus on individual mental wellness. Code You reminds staff of the importance to take care of their own mental well-being. A series of programs and resources are available so that no staff member feels they must struggle with stress, anxiety or mental illness on their own.
On the badges of numerous Covenant Health staff is a small elephant, the mascot of the Elephant in the Room program. This elephant signifies the willingness of the employee to listen to another staff member’s circumstances and mental health problems in a supportive and non-judgemental manner.
Laurel, Wellness Advisor, Occupational Health and Safety, Covenant Health, shared these programs with 73 individuals who registered to hear and understand how they could implement similar programs in their own organizations. While each organization’s culture and business circumstances differ, both programs can be tailored so that mental health first aid is readily available to anyone who needs it.
Linda Shaw is used to being upstaged by her side kick Flynn. An Australian Labradoodle, Flynn is a therapy dog and not a service, dog. The difference is that Flynn loves to be petted and does not mind lots of attention. In contrast, service dogs serve their respective owners. As a result, petting and attention is not only discouraged it could be dangerous to both the service-animal and the person relying on the dog.
Why is a therapy dog needed and why at the Northern Alberta Institute of Technology? Linda provided an anecdote in which she was asked that very question by an instructor. Before she could answer, a group of students who just completed a stressful exam, turned the corner and exclaimed ‘There is Flynn, that is just what we need!’. Flynn got a few minutes of pets, hugs and attention and the students left appreciably reduced in stress and ready for their next academic challenge. Linda turned back the instructor who immediately said, ‘Okay, I get it now‘.
Linda is careful to slowly introduce Flynn to new students. Flynn is never forced on anyone and both respect that individuals may have cultural or personal-experiences that create an aversion to dogs.
Other than a calm disposition and training, Flynn is a typical family pet. However before you start bringing your dog to work in the hopes of reducing staff anxiety, planning and forethought is critical. Firstly, understanding what is the problem and how might a therapy animal (dog, cat, hedge hog, etc.) help? Next, establish an incremental introduction of the animal into the environment. This is as much to habituate the animal as it is to help the people adjust. Finally, it is critical to constantly measure the performance of the animal relative to the original purpose.
Therapy animals are not legislated nor is there an acknowledged certification process. However, organizations such as organizations such as TAAILS (Therapeutic Animal Assisted Interventions Leadership Society) can help you design and implement a therapy animal program. Be prepared to be upstaged however by your new side kick.
Robert Manolson, Creator & Facilitator of Powerful Play Experiences, is the guy you call when you need a high wattage event. He will quickly turn a room of the most reserved wall flowers into an engaged and lively group. Robert does not just break the ice, he can pulverize it.
On any day of the week, Robert can struggle with anxiety/ self-doubt/ anger/ or an immediate drain on his energy that often makes the simplest task a daunting prospect. How do you reconcile his high wattage business life with his dead-battery mental health? The answer is they are both Robert. In many respects the creativity and passion he brings to a facilitation engagement needs the black dog  that Robert fights off each day of the week.
Robert uses a variety of strategies to maintain emotional and mental well being. During the conference, 13 strangers held up placards with what helps him. For example, help comes in the form of his loving wife (Sharon), the attention he gives to his two cats, maintaining his medication schedule, regular check ins with his physician and psychologist, eating well, staying hydrated or using a SAD lamp during the winter. Robert provided a capstone to the morning’s material and personalized what otherwise could have been an abstract or conceptual discussion. Most importantly, Robert demonstrated the abilities and contributions an individual living with and managing their mental illness can bring to an organization – or to a room full of wall flowers.
Isabel Henderson; Senior Operating Officer Alberta Health Services, Glenrose Rehabilitation Hospital; kept all of the above going and did a fantastic job being the continuity between the speakers. This included reminding the participants of the importance to complete the ‘Mental Health Myth Busters’ surveys.
How does a rehabilitation hospital fit into a mental health conference? The Glenrose treats not only the physical illness or injured but also the mental equivalents.
The Glenrose is the largest freestanding comprehensive tertiary rehabilitation centre in North America and offers services to children and adults on an inpatient, outpatient and outreach basis. Opened in 1964, the 244-bed facility has developed an international reputation for excellence in key areas of complex rehabilitation and specialized geriatrics. The Glenrose offers highly specialized assessment, treatment, consultation and technology services, as well as education for patients and families through more than 120 clinics and services.
In addition to rehabilitation services for all age groups, areas of focus also include mental health and psychiatric services for children and seniors, as well as cardiac rehabilitation for adults. 
Woven through the presentation was a game called ‘mental health myth busters’. Myth busters was a series of questions designed to judge the audience’s perceptions of mental health facts, myths and urban legends. A detailed analysis is beyond the scope of this article (and likely the subject of a future article); nevertheless, certain preliminary trends could be identified. The methodology behind myth busters is described in the blog ‘3lbs of Jell-O versus Some Crazy* Statements‘. Both the panelists and the audience were asked 40 questions for which they rated their views on a scale of 1-5:
A list of the questions and generally accepted opinion (aka the ‘right answer’) is available here [LINK] and was the basis for the following analysis.
The panel showed strong similarity in opinions for nearly all questions and only minor differences between the following five questions:
- Q6. Prevention doesn’t work. It is impossible to prevent mental illnesses.
- Q22. Mental health problems are purely biological or genetic in nature.
- Q23. Mental health disorders are often life-long and difficult to treat.
- Q36. Bringing a new baby into the family can be challenging both physically and emotionally. New parents can experience large mood swings.
- Q37. The legalization of marijuana will not impact on the prevalence of mental illness in society.
- Q38. Eating disorders are not just about food. They are often a way to cope with difficult problems or regain a sense of control.
The audience showed a wide variation in responses (all questions had all five possible responses from 1 to 5). While some of these may be ‘spoiled surveys’, the following are the top five questions (in order) for which there was a difference between the audience and the generally accepted answer was the greatest.
- Q15. Electroconvulsive therapy (ECT), also known as shock therapy, is painful and barbaric. (Audience average 2.7 (mostly NEUTRAL), generally accepted answer 1: FALSE).
- Q26. Many people with schizophrenia are violent. (Audience average 2.0 (somewhat FALSE), generally accepted answer 1: FALSE).
- Q27. Split personality is the new term for what we used to call Schizophrenia. (Audience average 2.3 (somewhat FALSE), generally accepted answer 1: FALSE).
- Q31. We all feel nervous or worried at times. This anxiety can be a helpful feeling when it motivates us or warns us of danger. (Audience average 3.8 (somewhat TRUE), generally accepted answer 5: TRUE).
- Q21. Mental health professionals make a ton of money off of people suffering from these disorders.(Audience average 2.0 (somewhat FALSE), generally accepted answer 1: FALSE).
The FMI-Edmonton Chapter has wanted to do this conference for a number of years and is pleased that it was an acknowledged success. 176 individuals (inclusive of panelists, volunteers and audience members) registered for the event from all three levels of government.
176 individuals within the Edmonton area now have a better appreciation for what is mental illness and how a variety of organizations are helping to keep their staff and clients mentally-healthy. But can we do more? The program itself could easily be reproduced in other Canadian cities having a FMI chapter. Each of these cities will have organizations equivalent to Covenant Health, the Glenrose hospital or passionate people implementing programs such as those discussed above. Certainly the details and the personalities will be different – and that is okay. Each city needs to introduce the work that numerous indviduals are doing within their respective communities.
FMI and the Canadian Mental Health Association can both play an organization and coordination role in this work. Just a thought for the moment… but the idea of taking this conference on the road is crazy enough it just might work!
. Fast Facts about Mental Illness, Canadian Mental Health Association (CMHA), accessed 2017-05-22: www.cmha.ca/media/fast-facts-about-mental-illness.
. Therapeutic Animal Assisted Interventions Leadership Society. Linda is a founding member of this organization. In addition to the website, the society also has a Facebook page. TAAILS website, accessed 2017-05-23: www.taails.com. Facebook/TAAILS.
 Winston Churchill popularized the expression ‘his black dog’ to refer to depression. The origin of the term goes back to Roman times however. Variety of sources including: www.jppreston.com/the-history-of-the-black-dog-as-metaphor.
. Adapted from Wikipedia, Glenrose Rehabilitation Hospital, accessed 2017-05-22: www.wikipedia.org/Glenrose_Rehabilitation_Hospital.