{"id":69,"date":"2023-01-19T15:33:20","date_gmt":"2023-01-19T20:33:20","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/rebootyourresiliencywithselfcare\/?post_type=chapter&p=69"},"modified":"2023-11-01T18:56:13","modified_gmt":"2023-11-01T22:56:13","slug":"mental-health","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/rebootyourresiliencywithselfcare\/chapter\/mental-health\/","title":{"raw":"Mental Health","rendered":"Mental Health"},"content":{"raw":"The World Health Organization (WHO) defines Mental Health as\r\n
\u201cA state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.\u201d[footnote]World Health Organization. (2022). Health and Well-Being. Retrieved from: https:\/\/www.who.int\/data\/gho\/data\/major-themes\/health-and-well-being[\/footnote]<\/blockquote>\r\nThe Mental Health Continuum Model in Figure 2.1 illustrates different behaviors that individuals may manifest as they move back and forth along the continuum. Do you notice any similarities to the behaviors depicted in the Stress model in the previous chapter?\r\n\r\n[caption id=\"attachment_73\" align=\"aligncenter\" width=\"1162\"]\"\"<\/a> Figure 2.1 Mental Health Continuum.[\/caption]\r\n\r\nSince March 2020, the COVID-19 pandemic has impacted the life of everyone in the world. The mental health of Canadians was hard-hit by the pandemic. The most recent statistics available from Statistics Canada state that \u201cduring the period from April to June 2021, one-quarter of Canadians reported experiencing high levels of stress most days, and nearly half of Canadians considered that their stress levels were worse than prior to the pandemic\u201d.[footnote]Statistics Canada. (2021). Canadian Social Survey: Covid-19 and Well-being. Retrieved from: https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/210924\/dq210924a-eng.htm[\/footnote] Does this fit your experience with yourself or what you have witnessed in those around you?\r\n\r\nBroken down into age groups, \u201cCanadians aged 35 to 44 (36%) were the most likely to indicate that they found most days quite stressful or extremely stressful, followed by those aged 45 to 54 (30%) and those aged 25 to 34 (29%)\u201d.[footnote]Statistics Canada. (2021). Canadian Social Survey: Covid-19 and Well-being. Retrieved from: https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/210924\/dq210924a-eng.htm[\/footnote] This indicates that 25-54 year olds appeared to feel the stress of the pandemic more acutely. In fact, 77% of Canadian adults reported negative emotions such as being \u2018worried or anxious,\u2019 \u2018bored,\u2019 \u2018stressed,\u2019 \u2018lonely or isolated\u2019 and \u2018sad\u2019 as a result of the COVID-19 pandemic.[footnote]Canadian Mental Health Association. (2021). How are we feeling? Canadians are worried, bored, stressed, lonely and sad. Retrieved from: https:\/\/cmha.ca\/how-are-we-feeling-canadians-are-worried-bored-stressed-lonely-and-sad\/[\/footnote] Suicidal thoughts and feelings in the general population have elevated to and remained at 8% since the pandemic began- a marked increase from the previous stable 2.5% statistics from 2016.[footnote]Canadian Mental Health Association. (2021). How are we feeling? Canadians are worried, bored, stressed, lonely and sad. Retrieved from: https:\/\/cmha.ca\/how-are-we-feeling-canadians-are-worried-bored-stressed-lonely-and-sad\/[\/footnote] This is alarming!\r\n\r\nGlobally, the World Health Organization (WHO) found that since the beginning of the pandemic, global prevalence of a decrease in mental health, specifically anxiety and depression, increased by 25%, reflecting the Canadian average. [footnote]World Health Organization. (2022). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. Retrieved from: https:\/\/www.who.int\/news\/item\/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide[\/footnote]These are startling percentages that indicate an acutely urgent need for more mental health resources.\r\n\r\nAre you stressed?<\/strong>\r\n\r\nSome days are better than others. That\u2019s a normal part of life. However, it\u2019s also important to \u201ccheck in\u201d with your emotions every so often to keep yourself as mentally and emotionally well as possible. Self-awareness is key for ensuring overall good health.\r\n\r\nSometimes, it\u2019s hard to know if it\u2019s stress or anxiety affecting you. While both stress and anxiety cause physical and mental symptoms, generally stress is a response to an external cause, and it goes away once the situation is resolved. Anxiety, on the other hand, is generally an internal reaction to stressors. It usually involves a persistent feeling of dread or apprehension that doesn\u2019t go away, and that interferes with how you live your life. Figure 2.2 illustrates some differences and similarities between stress and anxiety.\r\n\r\n[caption id=\"attachment_321\" align=\"aligncenter\" width=\"1024\"]\"\"<\/a> Figure 2.2 Stress vs Anxiety[\/caption]\r\n\r\nWhile anxiety is generally characterized as undue worry and unwarranted fear, depression usually involves a deep sense of sadness and hopelessness. Depression can have overlapping symptoms with anxiety, yet there are significant differences between the two disorders.\r\n\r\nAnxiety and depression are umbrella terms that cover various mental health disorders. Anxiety, for example, can include conditions such as generalized anxiety disorder, phobias, and panic disorders. Depression can include various disorders such as major depressive disorder, seasonal affective disorder, and post-partum depression, to name a few. Many people experience anxiety and depression concurrently. In fact, nearly 50% of people with depression are also diagnosed with anxiety.[footnote]Anxiety and Depression Association of America. (2022). Anxiety Disorders - Facts and Statistics. Retrieved from: https:\/\/adaa.org\/understanding-anxiety\/facts-statistics[\/footnote]<\/span>\r\n\r\nAccording to a January 2022 survey completed by the Centre for Addiction and Mental Health (CAMH), approximately 25.1% of Canadians currently reported feeling moderate to severe anxiety, with 24.1% reporting feelings of loneliness and 22.3% disclosing feelings of depression.[footnote]Centre for Addiction and Mental Health. (2022). Covid-19 National Survey Dashboard. Retrieved from: https:\/\/www.camh.ca\/en\/health-info\/mental-health-and-covid-19\/covid-19-national-survey[\/footnote] Of note, \"those between 18 and 39 years old reported the highest levels of moderate to severe anxiety, loneliness, and feelings of depression of any age group (33.5 per cent for anxiety, 29.1 per cent for loneliness and 27.7 per cent for feelings of depression).\"[footnote]Centre for Addiction and Mental Health. \u00a0(2022). Covid-19 National Survey Dashboard. Retrieved from: https:\/\/www.camh.ca\/en\/health-info\/mental-health-and-covid-19\/covid-19-national-survey[\/footnote] All of these percentages rose about 6% compared to the last survey done in July 2021, indicating a worsening of mental health as time goes on. Also of concern was 24% of Canadians stating they were unable to access mental health care help.[footnote]Centre for Addiction and Mental Health.\u00a0 (2022). Covid-19 National Survey Dashboard. Retrieved from: https:\/\/www.camh.ca\/en\/health-info\/mental-health-and-covid-19\/covid-19-national-survey[\/footnote]\r\n\r\nThese percentages are in severe contrast to a Statistics Canada study that analyzed Canadian mental health statistics between 2000 and 2016. Their findings illustrated that the prevalence of reported depression and anxiety remained stable during those 16 years, with depressive disorder approximately 5.4%, and anxiety disorder 4.6%.[footnote]Dobson, K., Vigod, S., Mustard, C., & Smith, P. (2020).Trends in the prevalence of depression and anxiety disorders among working-age Canadian adults between 2000 and 2016. Statistics Canada. Retrieved from: https:\/\/www150.statcan.gc.ca\/n1\/pub\/82-003-x\/2020012\/article\/00002-eng.htm[\/footnote] I'll do the math for you - that is currently a 23% increase in depression and a 28.9% increase in anxiety during these pandemic years.\r\n\r\nDespite these alarming percentages of people who participated in a survey disclosing they have or have had mental health issues, in reality, many are not so keen to speak up about it. While awareness and understanding of mental health may be on the rise, stigma continues to be an issue for many people. There are multiple reasons for this. Discomfort or avoidance in admitting there\u2019s a problem. Embarrassment in asking for help. Shame. Aversion against \u201cshrinks\u201d.\r\n\r\nThere needs to be a shift in attitudes and behaviors where talking about your mental health is as natural as saying you have a headache.\r\n\r\nBecause mental health is as important as physical health, and it\u2019s nothing to be ashamed of.<\/em><\/span>\r\n\r\nHow many times have you automatically asked someone \u201cHow are you?<\/em>\u201d and their automatic reply is \u201cGood, you?<\/em>\u201d Would it make you uncomfortable if they said \u201cNot great, really. I\u2019m feeling down today<\/em>\u201d? Is that more of an answer than you were looking for, thinking \u201cUgh, I was just being polite\u201d? Or can you look at this as an opportunity to really listen<\/em> to what someone has to say, giving them an outlet and perhaps making a world of difference in their life?\u00a0 And reciprocally, what would it take for you<\/em> to be honest when asked the question \u201cHow are you?<\/em>\u201d You are hereby challenged to give this a try \u2013 the results might surprise you.\r\n\r\nMental Health First Aid<\/strong>\r\n\r\nBarriers to accessing mental health care in Canada are mainly due to not knowing where to get help, an inability to pay for services, excessive wait times, scarcity of available mental health professionals, insufficient government funding, and lack of access due to geography (rural) or demographics (youth or Indigenous populations).[footnote]Moroz. N., Moroz, I., & D\u2019Angelo, M.S. (2020). Mental health services in Canada: Barriers and cost-effective solutions to increase access. Healthcare Management Forum. 33(6):282-287. Retrieved from: https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/0840470420933911#bibr7-0840470420933911[\/footnote]\r\n\r\nThe Canadian Federal government, along with Provincial\/Territorial governments recognized the need to attend to increased mental health demands for Canadians, so in 2017 they formed an agreement called the Common Statement of Principle on Shared Health Priorities.[footnote]Government of Canada. (2018). A Common Statement of Principles on Shared Health Priorities. Retrieved from: https:\/\/www.canada.ca\/en\/health-canada\/corporate\/transparency\/health-agreements\/principles-shared-health-priorities.html[\/footnote] This agreement conceptualizes interventions to increase mental health access for Canadians, including increasing access to community-based mental health and addiction services for children and youth (age 10-25) and those with complex health needs.[footnote]Government of Canada. (2018). A Common Statement of Principles on Shared Health Priorities. Retrieved from: https:\/\/www.canada.ca\/en\/health-canada\/corporate\/transparency\/health-agreements\/principles-shared-health-priorities.html[\/footnote]They recognize that preventative measures and early interventions can reduce the burden on the health care system overall.\r\n\r\nCanadian mental health services have recognized the need for E-mental health access, and such programs are becoming increasingly available. Federal mental health programs vary as do the resources available across the provinces and in communities. Here are a few specific to Canada and British Columbia.\r\n\r\nThe\u00a0LifeLine Canada Foundation<\/a>\u00a0is a non-profit that focuses on suicide prevention by cultivating knowledge about risk factors, offering access to online resources and developing local support programs. The site also has an\u00a0app<\/a>\u00a0with a plethora of information and guidance including e-counselling, text and chat functions, and self-management tools.\r\n\r\nThe\u00a0HeretoHelp.bc.ca<\/a>\u00a0website features mental health and substance use information, including personal stories, magazine articles, information sheets, workbooks, screening self-tests, and help by email to find community resources.\r\n\r\nFurther, HereToHelp has a series of 11 Wellness Modules<\/a> that support well-being. The modules are as follows:\r\n