Population Mental Wellness: A CPHA position paper

Suzanne F. Jackson

Post date: March 15, 2021

Parts of the Canadian Community as Partner (CCAP5e) chapter “Community Mental Health Promotion” also avoid the trap of focusing on mental illness treatment by emphasizing the broader socio-environmental conditions at the population level that determine whether people flourish or languish. Reneé Robinson and Candice Waddell, the chapter authors, identify stigma, social exclusion, lack of safe and affordable housing, unemployment, unhealthy workplaces, interpersonal violence, bullying, suicide, cultural discontinuity, justice system issues, and finally the limitations of existing health and mental health services as factors affecting population mental health. Although they are stated in the negative, it is pretty easy to turn them into positive wordings to list what promotes mental health and wellness.

Both the CPHA position paper and the CCAP5e chapter emphasize intervention early in the life cycle. But there are some differences. The CPHA document refers to the mental health issues created by current public health crises like the COVID-19 pandemic, climate change and the opioid crisis. The profile of mental health and how to promote it as well as mitigate mental illness is already gaining more attention as a result of the pandemic. However, the bulk of the attention is on individual and family strategies (e.g., help lines, on-line counselling services in the workplace).

Many of the strategies required to prevent transmission of COVID-19 society-wide do not promote mental health, but rather actively work against it. For example, I will refer to the three key factors that promote mental health that I raised at the beginning of this blog:

• (1) Provision of economic security (adequate food and shelter) – I have been appalled by the number of private landlords that have evicted tenants in Toronto during the pandemic, when tenants have lost their jobs and struggled to pay the rent, and when the usual support services (like shelters and relocation programs) are closed. This has increased stress tremendously for these families. On the other hand, I have also seen a positive response from grassroots organizations to connect to community residents and distribute food to those who need it the most.

• (2) Social inclusion and freedom from discrimination – The neighbourhoods most hit by cases of COVID-19 in Toronto have been racialized communities, full of new immigrants hoping for a start in Canada, often crowded into housing and working in essential services such as grocery clerks, taxi drivers, and personal support workers, who also run the risk of being exposed. Seniors all over the city have been isolated in their homes with little social contact because socialization programs offered by agencies were stopped, and family and friends could not visit due to lockdowns. Isolating people in their homes and preventing social gatherings of family and friends indoors has exacerbated feelings of isolation for everyone, especially for those who do not have access to the internet.

• (3) Freedom from violence in all its forms – There have been reports of increases in domestic violence. Children have been under-stimulated when the schools were closed, even with the offer of on-line classes, because of the lack of internet access for many families (poor equipment or inability to afford the internet fees).

The offer of CERB by the federal government was a godsend for many families (addressing the issue of economic security); the existence of Zoom and other internet social connection platforms has been a lifeline for some, and grassroots community members who connected to their neighbours by telephone or WhatsApp in mutual aid “pods” has been wonderful for social and emotional support (addressing social inclusion); and increased public and media attention to women (#MeToo), people of colour (“Black Lives Matter”) and Indigenous people (Truth and Reconciliation Commission) all addressing discrimination are positive.

After the pandemic is over, much will need to be done to develop healthy public policies and create supportive environments for mental health. A lot of information will come out of research being done during the pandemic about what can be done by governments, service providers and community organizations to strengthen individual resilience, mentioned in both the CPHA position paper and the CCAP5e chapter. But even more can be learned about what community resilience is and how to strengthen community action during public health crises. The CPHA paper states that community resilience is an aggregation of individual and family resilience. I believe that community resilience is something separate and that strengthening communities and the power of their relationships with city departments involved in emergency response will be important in mitigating some of the mental health harms brought about by crises like the pandemic.