Edmonton Social Planning Council

Category: Social Issues: Health

  • Blog: From Trauma to Healing: The Impact of Childhood Abuse and Neglect on Adult Mental Health

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    Childhood trauma not only affects the present lives of children, but it can affect their future as adults. Their mental health can be impacted for the long term. However, a good support system can have powerful positive effects on their lives, creating resilience. 

    By Alejandra Hasbun, Practicum Student

     

    Childhood is the most essential time for development. A child who experiences neglect, too much stress, and trauma, can have serious negative consequences on that child’s life and future. A traumatic childhood can critically affect adult life.  

    Children are learning how to regulate emotions, problem-solve, and acquire basic skills. Further science has shown us how trauma and stress impact children’s developing brains, affecting how they react to day-to-day situations. (1) If natural processes of child development are interrupted, they can have lasting outcomes as an adult. A child that is never spoken to will not acquire a language (2); a child that is never loved will struggle to love. The main caregivers are usually the child’s role models, and whatever they do or not do impacts what the child learns about life and their behaviour. (3) A supportive adult figure, whether caregiver or not, in a child’s life can help them excel and overcome hardship through the development of resilience.  

    How Childhood Trauma affects adults? 

    In Canada, 1 in 3 people has experienced traumatic childhood experiences. (4) How does this affect later life? Adults with a past of childhood trauma can have heightened rates of anxiety, depression, suicidal thoughts, PTSD, difficulty regulating emotions, substance use, experience being unhoused, and live in poverty or with low income. (5) Early chronic life stress, which can be caused by abuse or trauma, can cause the body to not be able to regulate stress properly. (6) Stress management is important because stress affects almost every aspect of a person’s life. Chronic or unhealthy stress can cause negative health impacts including heightened rates of mental unwellness, heightened blood pressure, heart disease, substance use and more. Chronic or unhealthy stress can impact people emotionally and socially including difficulty maintaining relationships, or adhering to social norms (7)  

    The lasting effects of trauma can also be seen through generational and historical trauma, defined as transmitting the impact of traumatic events to younger generations.  Older generations not being able to receive the help they needed, can transfer negative emotions to the younger generation, unintentionally contributing to a continuation of a trauma cycle, or cannot help the new generation deal with traumas they are experiencing. (8) Usually, this trauma is caused by recurring systemic oppressions, colonization and violence. (9) It can be hard for those that experienced generational/historical trauma to search for the help needed, because of, discrimination, cultural barriers, or unavailability.  

    Resiliency 

    A traumatic childhood does not have to equal a bad adulthood. Children that have at least one supportive figure in their life are more likely to have reduced stress and clear goals for their future. Even if that figure is not a parent, the support can highly affect the child’s life positively. (10) Children that have experienced abuse and trauma need a healthy adult role model, someone that is by their side, does not give up on them, and is someone they can trust, for this marks a significant difference in their lives helping them build relationships and confidence.  Early intervention can foster resilience in children, which is defined as the capacity to utilize holistic resources to maintain one’s well-being during challenging times. Resilient children can manage external stressors positively and develop a problem-solving mind. (11) 

    What can be done? 

    Awareness of the impact of childhood trauma on adult mental health is the first step as every person can start to make a difference in the lives of future generations. You can help support organizations that help families grow together. You can help impact a person’s life, consider volunteering at these organizations: Boys and Girls Club, Bent Arrow, Africa Centre, and Terra Centre. 

    Here are three agencies in Edmonton, Alberta that can help children experiencing trauma or learn more about how to take action: Little Warriors, Zebra Centre, and Metis Child & Family Services.  

    If you suspect a child is experiencing abuse or neglect, please call the crisis line at 2-1-1.  

     

    Alejandra Hasbun (she/her), an international student from El Salvador, possesses a strong interest in the field of human behavior and mental health advocacy. In her spare time, her passion lies in travelling and exploring the world, immersing herself in new cultures, and gaining a different understanding of the world through meeting new people. 

     

    REFERNCES:  

    1- Perry B. (2005), Maltreatment and the Developing Child: Early Childhood Experience Affects Child and Culture. https://www.lfcc.on.ca/mccain/perry1.html 

    2-  Linguistic Society of America, FAQ: Language Acquisition |. (n.d.). https://www.linguisticsociety.org/resource/faq-how-do-we-learn-language 

    3- CDC (2021, September 23), Child Development Basics |.. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/childdevelopment/facts.html 

    4- McGill University. (2023). Too many Canadian children and youth are impacted by trauma. Canadian Consortium on Child and Youth Trauma. https://www.traumaconsortium.com/en/ 

    5- ISTSS – Childhood Trauma. (n.d.). https://istss.org/public-resources/trauma-basics/what-is-childhood-trauma/effects-of-childhood-trauma 

    6- Carpenter, L. L., Shattuck, T. T., Tyrka, A. R., Geracioti, T. D., & Price, L. H. (2010). Effect of childhood physical abuse on cortisol stress response. Psychopharmacology, 214(1), 367–375. https://doi.org/10.1007/s00213-010-2007-4 

    7- Mayo Clinic Staff. (2021, July 8). Chronic stress puts your health at risk. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037?reDate=31012023 

    8- Ryder, G. (2022, April 15). How Intergenerational Trauma Impacts Families. Psych Central. https://psychcentral.com/lib/how-intergenerational-trauma-impacts-families 

    9- Resource Guide to Trauma-Informed Human Services. (n.d.). The Administration for Children and Families. https://www.acf.hhs.gov/trauma-toolkit 

    10- Harvard University. (2021, April 23). Three Early Childhood Development Principles to Improve Child Outcomes. Center on the Developing Child at Harvard University. https://developingchild.harvard.edu/resources/three-early-childhood-development-principles-improve-child-family-outcomes/ 

    11-  Ungar, M. (2021, July 19). U is for Michael Ungar: Developing Resilience In Children. The Positive Encourager. https://www.thepositiveencourager.global/michael-ungar-talks-about-developing-resilience-in-children-video/ 

     

     

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                                                                          1. Research Review: Addressing Indigenous Mental Health: a Journey to Reconciliation

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                                                                            The article aims to develop strategies to improve mental health systems in Indigenous communities through a two-day forum in the Regional Municipality of Wood Buffalo. The forum gathered information on what the mental health needs are for this community, and performed interviews with relevant stakeholders to understand what their concerns were. This allowed the authors to develop four key themes that would provide directions and strategies to be followed in order to improve these systems and the Indigenous lives that could benefit from them. 

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                                                                          2. Blog: Mental Health Struggles as a Newcomer to Canada: Finding a Sense of Belonging 

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                                                                            Immigrants suffer from loneliness and shock when moving to a new country. It is important to know why this happens and understand some of their experiences firsthand.

                                                                            By Alejandra Hasbun, Practicum Student

                                                                             

                                                                            Adjusting to a new culture, environment, and language is not always easy for newcomers to Canada. Moving away from one’s home country can be as exciting as it is terrifying, and navigating an unfamiliar society takes time to adapt. Homesickness, culture shock, and language barriers are just some of the many things newcomers experience when immigrating to a different country and it is important to recognize that their mental health can be affected.  

                                                                            Homesickness 

                                                                            Homesickness can be described as the feeling of loneliness and/or anxiety when a person is far away from their home. As an immigrant, it is not unusual to feel homesick when moving to a completely different country by yourself. Feelings of loneliness and isolation can increase when being away from family and friends (WebMD, 2021). In my experience, when moving to Canada from El Salvador, this new country seemed exciting until I had to say goodbye to my family and felt fear of uncertainty about when I would see them again. Most immigrants move to Canada because they need to find a better quality of life that their home country could not provide them due to low employment opportunities, violence, or political conflicts (Statistics Canada, 2006). The choice of immigrating does not feel like a choice anymore, it feels like a necessity for a better life. When moving back home is not an option, it can make a person feel like they do not belong anywhere (Kitchen et. al., 2015). Accepting that Canada was my new home felt in some way as if I were betraying my country, I never appreciated my country so much until I had to leave it. This creates a conflict when trying to adapt to this new society because nothing measures up to the customs of the country that is left behind. The food now tastes wrong, the cars drive too fast or too slowly, and even the air tingles differently, everything feels out of order. Even if these things are an exaggeration of reality, they feel this way because of the unfamiliarity of this new society, this new place.  

                                                                            In my experience, homesickness would come in different ways: seeing pictures of my family members celebrating a birthday without me, missing my mom’s home cooking, experiencing an extreme change in weather, or having to spend Christmas without my parents. If a person immigrated by themselves, they are lacking physical closeness with their main support system, especially if they come from a collective culture. A collective culture refers to people who value working as a group rather than alone, the feeling of belongingness comes from being included in a collective (Nickerson, 2021). Changing from a collectivistic to an individualistic culture, like Canada’s, can be a substantial change because one must fend for themselves without being able to ask for help or feeling weak if help is asked (Evanson, 2016). Owais Memon, an Indian international student with Concordia University of Edmonton, responded when asked how he experienced homesickness, “I felt trapped. I missed my family, but I could not help myself because I could not see them until I went back, which would be a while.” (O. Memon, personal communication, November 21, 2022). Family helps cope with the stressors that come with moving to a new country. Not having anyone to reach out to when experiencing homesickness can make the feeling of loneliness worse and affect the person’s mental health negatively (Dumon, n.d.). In fact, homesickness has many depression-like symptoms and can develop into a formal diagnosis in the long run (WebMD, 2021). 

                                                                            Culture Shock 

                                                                            Culture shock are feelings of disorientation and anxiety people feel when experiencing a new culture (Segal, 2022). How does culture shock relate to homesickness? When arriving in a new country, a lot of things can be different including language, customs, greetings, food, weather, etc. As a newcomer, experiencing all these things at once can be overwhelming. For the social aspect, some people might feel like they need to relearn how to socialize so they can integrate into their new society. Newcomers need to change their habits to fit into what is more socially acceptable in the new country. For example, coming from El Salvador, it is common to say hello by kissing people on the cheek, which is not the case in Canada. This simple act made such a difference for me, I felt distant from others, unable to feel familiar and warm. It is common to feel “strangeness” in the host country, it is hard navigating a completely different environment (Belford, 2017). Human beings are all trying to find a sense of belonging, which can be particularly hard to find as a newcomer to Canada if your culture differs from the Western culture. Immigrants try to find groups of people whom they relate to, feel belonging and acceptance. Thus, this is why there are so many centers or resources for immigrants in Canada to help with this issue like the Multicultural Family Resource Society. Finding groups that can give you a feel for home can be extremely helpful when dealing with culture shock and homesickness.  

                                                                            Language Barriers 

                                                                            Language barriers can be distressing for immigrants. Some immigrants to Canada do not speak English as their first language. Language is integral to being understood and feeling belonging. Being unable to communicate can be extremely frustrating, it is like the “tip of the tongue” phenomenon but through most of the conversation. Jingyi He, a nursing student with the University of Alberta, came to Canada from China as a young girl, but she did not know how to speak English when she arrived. This was her experience: 

                                                                             “People were distancing themselves from me. When I was trying to make friends, I didn’t know what to say. I saw kids playing and I did not know how to express myself and they would ignore me, I felt abandoned…it created a lasting memory.” (J. He, personal communication, October 26, 2022).  

                                                                            Even if an immigrant’s second language is English, it can still be hard to communicate with others. The English that a person learns in their home country can utilize different words, slang, and could also be combined with their native language (Spanish + English = Spanglish). When a newcomer enters the host country and tries to communicate with the English they were taught and realize it is not the same, it may affect the way they hope to socialize and possibly be a deterrent (Pryce et.al., 2019). My struggle with language when moving came from not being able to communicate without throwing Spanish words into the conversation, which made it hard for others to understand if they did not know Spanish. People with a non-Canadian or non-native accent also struggle because sometimes locals believe that a different accent makes someone less intelligent and treat them as such (Ro, 2021). It takes time to get used to socializing in a new language and being able to convey humor and dialect using a new vocabulary. Speaking from experience and a lot of awkward silence, most jokes do not translate from one language to another. If a person is not able to relate with others, share some laughs, and have a common conversation topic it causes a disconnect between the person and their society, and this connection begins through language.  

                                                                            Takeaway 

                                                                            Feeling homesick is common as an immigrant, and yet it is not talked about enough. With the loneliness also comes a sense of guilt. Why would someone feel sad about living in a country with so many opportunities? It can feel as if one is being ungrateful for the chance of living in such a great country. However, that is not the case, it is okay to feel sad about missing family or friends, it is normal to miss one’s culture and norms, and it is natural to experience homesickness or culture shock. It is also okay to accept the new environment and genuinely enjoy a different culture. Being happy about moving and sad about leaving are not mutually exclusive feelings, it is normal to feel both. Allowing people to feel heard when experiencing everything that comes with immigrating is particularly important as a society as it helps people feel supported. Canada has organizations with support groups for newcomers which are amazing for finding relief. In Edmonton, these organizations include: Edmonton Immigrant Services Association, Edmonton Mennonite Centre for Newcomers, and  Catholic Social Services.  

                                                                             

                                                                             

                                                                            References: 

                                                                            Belford, N. (2017). International Students from Melbourne Describing Their Cross-Cultural Transitions Experiences: Culture Shock, Social Interaction, and Friendship Development. Journal of International Students. https://www.ojed.org/index.php/jis/index/  

                                                                            Dumon, W. A.  (n.d.). NCBI – https://pubmed.ncbi.nlm.nih.gov/12315897/  

                                                                            Evanson, N. (2016). Canadian Culture – Core Concepts. Cultural Atlas. https://culturalatlas.sbs.com.au/canadian-culture/canadian-culture-core-concepts  

                                                                            Kitchen, P. (2015, August 20). Sense of belonging to local community in small-to-medium sized Canadian urban areas: a comparison of immigrant and Canadian-born residents – BMC Psychology. BioMed Central. https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-015-0085-0  

                                                                            Multicultural Family Resource Society (n.d.). What We Do. https://mfrsedmonton.org/programs  

                                                                            Nickerson, C. (2021, July 21). Understanding Collectivist Cultures – Simply Psychology. https://www.simplypsychology.org/what-are-collectivistic-cultures.html  

                                                                            Pryce, J. M., Kelly, M. S., & Lawinger, M. (2019). Conversation Club: A Group Mentoring Model for Immigrant Youth. SagePub, 51. https://edmspc-my.sharepoint.com/:b:/g/personal/amandal_edmontonsocialplanning_ca/EWMhLSdjEMFKghV-erVD-BEBtixCo96wOBB8qDpI9wObIA?e=x1DWLA  

                                                                            Ro, C. (2021). The pervasive problem of “linguistic racism.” BBC Worklife. https://www.bbc.com/worklife/article/20210528-the-pervasive-problem-of-linguistic-racism 

                                                                            Segal, T. (2022, July 25). Culture Shock Meaning, Stages, and How to Overcome. Investopedia. https://www.investopedia.com/terms/c/culture-shock.asp  

                                                                            Statistics Canada. (2006, October 30).  Table 4 Reasons for staying in Canada cited by immigrants who plan to settle here permanently, by immigration category (Cited 4 years after arrival). https://www150.statcan.gc.ca/n1/pub/11-008-x/2007000/t/4097873-eng.htm  

                                                                            WebMD. (2021, March 30). What to Know About Homesickness and Mental Health. https://www.webmd.com/mental-health/what-to-know-about-homesickness-and-mental-health 

                                                                             

                                                                             

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                                                                                                                                                  1. CM: Job Burnout: Why We Need Equitable Access to Mental Health Services 

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                                                                                                                                                    By Sydney Sheloff

                                                                                                                                                     

                                                                                                                                                    Defining Burnout  

                                                                                                                                                    “Burnout is a state of emotional, physical and mental exhaustion caused by excessive and prolonged stress” (CAMH, n.d.). While burnout is often associated with work, it is exacerbated by compounding stresses in all aspects of one’s life. Burnout has always existed, but it has been heightened by the pandemic. Work responsibilities have increased during the COVID-19 pandemic, but individuals and families have also had to deal with the stress of school and child care closures, fears surrounding the virus, increases in the cost of living, and many more stresses. All these factors compound and may lead people to feel helpless, emotionally drained, and unable to function. If not taken care of, burnout can morph into more serious mental health disorders such as anxiety or depression (CAMH, n.d.). 

                                                                                                                                                    Incidents of burnout vary greatly source-to-source, and as such we do not have reliable numbers on this phenomenon. This variation likely comes from the different ways in which different studies define and measure burnout. A study by Mental Health Research Canada found 35% of Canadians are experiencing burnout at work (MHRC, 2021). Another found that 47% of Canadian workers feel exhausted on a typical workday. Yet another study found 84% of workers at Canadian organizations with 100 or more employees are suffering from career burnout, and 34% of those workers report high or extreme levels (Moore, 2022). While the numbers themselves vary considerably, they all show that burnout is prevalent in Canadian workplaces. 

                                                                                                                                                    Burnout in different sectors 

                                                                                                                                                    Experiences of burnout varies by occupation. Folks working on the frontlines during the pandemic face considerable stress. They are dealing with the pandemic head-on as they care for patients with COVID, while dealing with staffing and hospital bed shortages. According to Mental Health Research Canada (2021), 53% of people working in health and patient care, and 66% of nurses reported experiencing burnout. Almost a fifth (17.9%) of health care workers intend to leave their job within the next three years, 63.2% of those workers want to leave due to stress or burnout (Statistics Canada, 2022). Many folks in other caring positions struggle with burnout as well. For example, 38% of people working in education and child care reported experiencing burnout (MHRC, 2021). Teachers had to quickly adapt to teaching children online with little training, and child care workers have faced precarity in the face of centre closures. Women are overrepresented in these roles, making them more vulnerable to all these issues (Canadian Women’s Foundation, 2022). 

                                                                                                                                                    Parents working from home had to work a full day while simultaneously supporting their children in online learning. Women have had to take on more of the responsibility to manage this situation during the pandemic. In a 2022 poll, almost half (48%) of mothers stated they were at their ‘breaking point’ (Canadian Women’s Foundation, 2022). In addition, having work and home in the same space blurred the boundaries between work and home life, with many people unable to “turn off” and relax at the end of the day. While reasons for and experiences of burnout vary from occupation to occupation, and situation to situation, this is an issue prevalent for almost everyone.  

                                                                                                                                                    Burnout by demographics 

                                                                                                                                                    Burnout also varies by demographics, with marginalized communities more likely to experience burnout. 41% of Black Canadians and 37% of South Asians reported experiencing burnout, compared to 17% of non-visible minorities (MHRC, 2021). Black and South Asian peoples were more likely to be working in ‘essential’ occupations such as nurse aides, orderlies and patient service associates (Turcotte and Savage, 2020). At the same time, Black, Indigenous, and People of Colour (BIPOC) must also contend with discrimination, feeling invalidated at work, and a pressure to do more than their coworkers (Washington, 2022). In other words, BIPOC folks working in healthcare are deemed “essential” yet continue to be treated as less-than, which has large impacts on their mental health. 

                                                                                                                                                    Impacts of Burnout 

                                                                                                                                                    Burnout has significant impacts on an individual’s work. People experiencing burnout feel dissatisfied with their jobs and achievements and miss more work (Salvagioni et al. 2017). They may face a lack of motivation and find it difficult to get tasks done, which impacts their effectiveness on the job (CAMH, n.d.). In more serious cases, affected individuals may want to leave work altogether. However, the impacts of burnout are not isolated to work, but reach into every facet of the lives of those effected. 

                                                                                                                                                    53% of Canadians report they are unable to reasonably balance the demands of work and personal life (MHRC). In other words, Canadians are overwhelmed with the number of responsibilities they have. They may not have the time or energy to devote to their home and family lives. Being emotionally drained is a symptom of burnout (CAMH, n.d.), so this may mean that people have a hard time connecting with loved ones and relationships can get strained. Furthermore, people simply do not have the time or energy to engage in the activities that bring them joy. 

                                                                                                                                                    A meta-analysis of studies about burnout found that burnout was a predicator of many physical and mental health conditions. Physical health conditions included type 2 diabetes, heart disease, prolonged fatigue, and gastrointestinal issues. Mental conditions included insomnia, depressive symptoms, and hospitalizations for mental disorders (Salvagioni et. Al. 2017). Burnout is literally making us sick.  

                                                                                                                                                    A Lack of Support 

                                                                                                                                                    Often, solutions for burnout focus on individual level self-care techniques. People experiencing burnout are told to socialize more, exercise, eat healthy foods, engage in relaxing activities, and disconnect after work (CAMH, n.d.., Dene, 2022). However, it isn’t that simple. In modern ‘hustle’ culture, taking time for oneself can make people feel worse, as they’ve been conditioned to think they should be productive all the time (Healthline, 2022). Some professions, such as nurses, work long, demanding hours and do not have the time or flexibility to engage in self-care activities. Encouraging people to take care of their own mental health downloads more responsibility onto already overworked people. What is truly needed is accessible and affordable mental health care. 

                                                                                                                                                    Edmontonians face several barriers to accessing mental health care. A survey from the Canadian Mental Health Association found that almost a quarter (23%) of Albertans needed help for problems with their emotions, mental health, or substance use, but did not receive it. Of those who did not receive help, 47% did not know where or how to access help, 54% could not afford it, and 26% reported their insurance would not cover it. Canadian workplaces are both creating the conditions that produce burnout, and not giving employees the resources, they need to deal with it. All Canadians, regardless of their employment status, should have access to robust mental health care. Perhaps it is time we consider folding mental health care into the universal health care system. 

                                                                                                                                                     

                                                                                                                                                    Note: This is an excerpt from our December 2022 Community Matters, you can read the full publication here

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                                                                                                                                                    Resources 

                                                                                                                                                    Canadian Women’s Foundation (2022). The facts: Women and pandemics. https://canadianwomen.org/the-facts/women-and-pandemics/  

                                                                                                                                                    Center for addiction and mental health (CAMH) (n.d.). Career Burnout. https://www.camh.ca/en/camh-news-and-stories/career-burnout  

                                                                                                                                                    Canadian Mental Health Association (2022). Summary of Findings Mental Health Impacts of COVID-19: Round 4. https://cmha.ca/wp-content/uploads/2022/02/Key-findings-summary-UBC-round-4-Final.pdf  

                                                                                                                                                    Environics Institutes (2021). Making up time: the impact of the pandemic on young adults in Canada.  

                                                                                                                                                    Healthline (2022). For Many People with Anxiety, Self-Care Just Doesn’t Work. https://www.healthline.com/health/mental-health/self-care-is-hard#1  

                                                                                                                                                    Mental Health Research Canada (MHRC) (2021). Psychological Health & Safety in Canadian Workplaces 

                                                                                                                                                    Moore, Dene. (2022). Worker burnout is becoming endemic and it’s everyone’s job to treat it. The Globe and Mail. Worker burnout is becoming endemic and it’s everyone’s job to treat it – The Globe and Mail 

                                                                                                                                                    Salvagioni, D., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PloS one, 12(10), e0185781. https://doi.org/10.1371/journal.pone.0185781  

                                                                                                                                                    Statistics Canada (2022). Experiences of health care workers during the COVID-19 pandemic, September to November 2021. https://www150.statcan.gc.ca/n1/daily-quotidien/220603/dq220603a-eng.htm  

                                                                                                                                                    Turcotte and Savage (2020). The contribution of immigrants and population groups designated as visible minorities to nurse aide, orderly and patient service associate occupations. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00036-eng.htm 

                                                                                                                                                    Washington, K. (2022). Why BIPOC Employees Are Burning Out—and What People Leaders Can Do About It. Spring Health. https://springhealth.com/blog/help-bipoc-employees-reduce-burnout/  

                                                                                                                                                     

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                                                                                                                                                    1. Blog: Intersection of Mental Health and Substance Use

                                                                                                                                                      [et_pb_section fb_built=”1″ _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row column_structure=”3_4,1_4″ use_custom_gutter=”on” _builder_version=”4.16″ _module_preset=”default” width=”100%” custom_margin=”0px||||false|false” custom_padding=”0px||0px||false|false” border_width_bottom=”1px” border_color_bottom=”#a6c942″ global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”3_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_post_title meta=”off” featured_image=”off” _builder_version=”4.16″ _module_preset=”default” title_font=”||||||||” custom_margin=”||3px|||” border_color_bottom=”#a6c942″ global_colors_info=”{}” theme_builder_area=”post_content”][/et_pb_post_title][/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_image src=”https://edmontonsocialplanning.ca/wp-content/uploads/2020/12/COLOUR-BLOCKS_spaced-300×51.png” title_text=”COLOUR BLOCKS_spaced” align=”center” _builder_version=”4.7.7″ _module_preset=”default” max_width=”100%” max_height=”75px” custom_margin=”0px|0px|0px|0px|false|false” custom_padding=”10px|0px|20px|0px|false|false” global_module=”96648″ global_colors_info=”{}” theme_builder_area=”post_content”][/et_pb_image][/et_pb_column][/et_pb_row][et_pb_row column_structure=”3_4,1_4″ use_custom_gutter=”on” make_equal=”on” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” width=”100%” custom_margin=”0px|auto|0px|auto|false|false” custom_padding=”30px|0px|0px|0px|false|false” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”3_4″ _builder_version=”4.16″ custom_padding=”0px|0px|0px|0px|false|false” global_colors_info=”{}” custom_padding__hover=”|||” theme_builder_area=”post_content”][et_pb_text _builder_version=”4.16″ _dynamic_attributes=”content” _module_preset=”default” text_font=”|600|||||||” text_text_color=”#2b303a” custom_padding=”||32px|||” global_colors_info=”{}” theme_builder_area=”post_content”]@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9kYXRlIiwic2V0dGluZ3MiOnsiYmVmb3JlIjoiIiwiYWZ0ZXIiOiIiLCJkYXRlX2Zvcm1hdCI6ImRlZmF1bHQiLCJjdXN0b21fZGF0ZV9mb3JtYXQiOiIifX0=@[/et_pb_text][et_pb_text _builder_version=”4.19.5″ text_text_color=”#2b303a” text_line_height=”1.6em” header_2_font=”||||||||” header_2_text_color=”#008ac1″ header_2_font_size=”24px” background_size=”initial” background_position=”top_left” background_repeat=”repeat” text_orientation=”justified” width=”100%” module_alignment=”left” custom_margin=”0px|0px|0px|0px|false|false” custom_padding=”25px||||false|false” hover_enabled=”0″ locked=”off” global_colors_info=”{}” theme_builder_area=”post_content” sticky_enabled=”0″]

                                                                                                                                                      Mental health and substance use often co-occur and are complications that require trauma-informed and person-centred care. Destigmatization and harm reduction approaches are important in these circumstances.   

                                                                                                                                                      By Amethyst Zapisocky, ESPC Volunteer

                                                                                                                                                       

                                                                                                                                                      Substance use and mental unwellness can be interlinked. When they are co-occurring they typically reinforce each other which has many adverse effects on well-being and life functioning. (1)  It is indeterminable if mental health complications or substance use comes first for many reasons: drugs may be used for self-medication purposes, they have common risk factors (such as genetic predisposition, stress, and/or trauma), and the substance(s) may heighten/awaken preexisting mental illness or even cause them by altering brain structure. (1) (2) Nonetheless, substance use and its interaction with mental health is a grave and serious reality in Canada, as reflected by the ongoing opioid crisis. (3)  

                                                                                                                                                      There have been 1443 deaths from drug poisoning (any substance) in Alberta between January and November 2022, with 556 occurring in Edmonton. (4) Furthermore, more than 1 in 4 adults living with a mental health diagnosis also struggle with substance misuse, (5) and people with mental illness are twice as likely as other Canadians to engage with substances. (6) Common susceptible mental disorders include ADHD, depression, anxiety, schizophrenia, bipolar disorder, and personality disorders. (2) (5) For example, those with major depressive disorder (MDD) are twice as likely to use alcohol harmfully, with drug dependence being four times as likely. (7) Those with both substance dependence and MDD are less likely to seek treatment while more likely to have heightened suicidal thoughts and psychological distress. (7)  

                                                                                                                                                      Stigmatization 

                                                                                                                                                      Despite a need for respectful and effective intervention, mental unwellness and substance use are frequently marginalized and stigmatized – much to the detriment of impacted individuals. (3) (8) This negatively affects how the (opioid) crisis is perceived, hinders the establishment of necessary help-giving services, perpetuates misinformation on mental and substance use disorders, and poses a barrier to accessing treatment. (3) These negative effects are further complicated when judgment comes from medical professionals, which can result in inadequate care and system mistrust. (3) Destigmatization is paramount. It involves challenging the misconceptions that people who struggle with mental health and/or substance misuse are morally corrupt or unworthy. (3) (8) It also requires addressing systemic gaps, training for trauma-informed care in healthcare (and other front-line services), establishing contact, and educating on substance use and recovery. (3) (8)  

                                                                                                                                                      Because abstinence from substance use is not always possible, harm reduction is a beneficial approach to addressing the use of substances. (8) (9) Harm reduction aims to minimize harm from substance use by providing care that is inclusive, trauma-informed and person-centred. (8) (9) Rather than focusing on abstinence, this approach meets individuals where they are, listens to them, and recognizes the person’s particular circumstances and needs. (8) (9) It serves those who use substances by providing them with information on the potential risks along with informing them on safe use. (8)  

                                                                                                                                                      A substantial percentage of people who experience mental and/or substance use difficulties do not seek treatment or services, which is heightened in street-involved populations. (10) Studies conducted in Edmonton have found that such populations have complex circumstances, enduring trauma and facing both social and care exclusion. (10) (11) According to a study published in 2022, Edmontonians in this situation often perceive a need for health services (89%) and do pursue them (73%). (10) However, only 8% of respondents who sought help had their needs met. (10) This percentage of unmet care is much higher than what is reported in the general population, indicating a care system in need of improvement for this underserved community. (10)  The reported reasons for not accessing care were wanting to manage care by oneself (most common), not wanting help at the time, not knowing where to find help, and being allowed a limited amount of time (least common); this could reflect mistrust in the system, based on intersectional negative biases/discrimination that persons who are unhoused experience. (10) 

                                                                                                                                                      Finding Help and Responding to Drug Poisoning 

                                                                                                                                                      Challenging misconceptions about mental illness and substance dependence is important in minimizing harm and destigmatizing these serious (and often co-existing) conditions. Further, recognizing and knowing the signs and symptoms of mental unwellness and substance misuse can be the first step in initiating healing (HelpGuide lists some indicators). (1) If a mental or substance use disorder is suspected, professional advice should be sought.  

                                                                                                                                                      Preventing overdose and minimizing harm from substance use is crucial. If you suspect an overdose is occurring call 911 immediately. (12) Signs of drug poisoning, as outlined by Alberta Health Services (AHS) are (12): 

                                                                                                                                                      • Slow or no breathing 
                                                                                                                                                      • Lack of or no responsiveness 
                                                                                                                                                      • Pale face 
                                                                                                                                                      • Blue lips/nails 
                                                                                                                                                      • Gurgling sounds 
                                                                                                                                                      • Choking  
                                                                                                                                                      • Vomiting 
                                                                                                                                                      • Cold/clammy skin 
                                                                                                                                                      • Narrow pupils 
                                                                                                                                                      • Stiff body or seizure-like movement 

                                                                                                                                                      For opioid overdose, Naloxone Kits are vital and are available here. (13) For other drug poisonings, stay with the person and call 911. (13) Placing the individual in the recovery position may also be helpful–especially for alcohol poisoning. (13) Avoiding overdose can also occur by not using substances alone, and by utilizing supervised consumption sites. (14) (15) AHS educational tools are available here, along with their information on drug safety available here. Further supports available are as follows: 

                                                                                                                                                       

                                                                                                                                                      Amethyst Zapisocky is working towards a BA in psychology at the University of Alberta. A fourth-year undergraduate student, her career focus is on research and social development. She values equity, learning, and philanthropy. Personally, Amethyst enjoys statistics, mindfulness and jazz music. 

                                                                                                                                                       

                                                                                                                                                      References 

                                                                                                                                                      1. Robinson, L., Smith, M., & Segal, J. (2023, January 4). Dual diagnosis: Substance abuse and mental health. HelpGuide. https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm  
                                                                                                                                                      2. National Institute of Mental Health. (2021, March). Substance use and co-occurring mental disorders. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health  
                                                                                                                                                      3. Mental Health Commission of Canada. (2020, October 14). Stigma and the opioid crisis: Summary. https://mentalhealthcommission.ca/resource/stigma-and-the-opioid-crisis-summary/  
                                                                                                                                                      4. Government of Alberta. (2023, January). Acute substance deaths overview. Alberta Substance Use Surveillance System. Retrieved January 24, 2023, from https://healthanalytics.alberta.ca/SASVisualAnalytics/?reportUri=%2Freports%2Freports%2F1bbb695d-14b1-4346-b66e-d401a40f53e6&sectionIndex=0&sso_guest=true&reportViewOnly=true&reportContextBar=false&sas-welcome=false  
                                                                                                                                                      5. MentalHealth. (2022, March 10). Mental Health and substance use co-occurring disorders. https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders  
                                                                                                                                                      6. Mental Health Commission of Canada. (n.d.). Mental health and substance use. https://mentalhealthcommission.ca/what-we-do/mental-health-and-substance-use/  
                                                                                                                                                      7. Currie, S. R., Patten, S. B., Williams, J. V., Wang, J., Beck, C. A., El-Guebaly, N., & Maxwell, C. (2005). Comorbidity of major depression with substance use disorders. The Canadian Journal of Psychiatry, 50(10), 660-666. https://doi.org/10.1177/070674370505001013  
                                                                                                                                                      8. Danda, Michelle. (2022). Meeting substance use patients where they are. American Journal of Nursing, 122(4), 11. https://doi.org/10.1097/01.NAJ.0000827256.97267.59  
                                                                                                                                                      9. Alberta Health Services. (n.d.). Harm reduction: Harm reduction services. https://www.albertahealthservices.ca/info/Page15432.aspx  
                                                                                                                                                      10. Hyshka, E., Anderson, J. T., & Wild, T. C. (2017). Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs. Drug & Alcohol Review, 36(3), 295–304. https://doi.org/10.1111/dar.12427  
                                                                                                                                                      11. Addorisio, S., Kamel, M. M., Westenberg, J. N., Heyd, A., Maragha, T., Abusamak, M., … & Krausz, R. M. (2022). Unmet service needs and barriers to care of individuals experiencing absolute homelessness in Edmonton, Canada: a cross-sectional survey. Social Psychiatry and Psychiatric Epidemiology, 57(2), 387-395. https://doi.org/10.1007/s00127-021-02080-2  
                                                                                                                                                      12. Alberta Health Services. How to spot an overdose. https://www.albertahealthservices.ca/info/Page16025.aspx#symptoms  
                                                                                                                                                      13. FraserHealth. (n.d.). Information, resources and tips on how to respond to an overdose. https://www.fraserhealth.ca/health-topics-a-to-z/mental-health-and-substance-use/overdose-prevention-and-response/responding-to-an-overdose  
                                                                                                                                                      14. Alberta Health Services. (n.d.) Supervised consumption services. https://www.albertahealthservices.ca/info/Page15434.aspx 
                                                                                                                                                      15. Alberta Health Services. (n.d.). DrugSafe. https://www.albertahealthservices.ca/info/Page12491.aspx  
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                                                                                                                                                                                                                            1. CM: Poundmaker’s Lodge and its Role in Combatting The Fear of ‘Stigma’ and its Social Violence 

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                                                                                                                                                                                                                              By Siobhan Dreelan and Virginia Duran

                                                                                                                                                                                                                               

                                                                                                                                                                                                                              Mental Health and Wellness can have both positive and negative effects on the individual, family, community, and Nation. In today’s society, you can see people struggling with Mental Health and Wellness negatively – suicides, addictions, homelessness – however what fails to be recognized and/or addressed are the ‘stigmas’ around mental health that limit the possibilities for effective services. These existing stigmas put fear and blame on the individual, while society distances itself from those who are suffering. This is quite problematic because people don’t understand mental health and wellness, although they are quick to judge, deny, and create barriers. 

                                                                                                                                                                                                                              Studies have proven that trauma has lasting impacts on people’s mental health, and trauma is experienced every day. For example, losing a job, breakups, losing a loved one, or injuries. Further, we know that intergenerational and historical traumas continue to impact the lives of Indigenous Peoples. The lasting impacts of trauma play out though addictions, chronic negativity, mental unwellness, hopelessness, poverty, violence, and more that continue to plague many people.  

                                                                                                                                                                                                                              What is Poundmaker’s Lodge?  

                                                                                                                                                                                                                              Poundmaker’s Lodge is a residential treatment service provider that offers two treatment programs, a 42-day program and is open to anyone over the age of 18 and a 90-day program that is structured and guided by Alberta Health Services, which focuses on life skills and is tailored for persons ages 18-24. Poundmaker’s Lodge has a medical detox centre onsite and has some harm reduction strategies particularly in the opioid dependance program. It also offers the Iskwew women’s healing lodge, where women can stay for 3 months to a year where they learn life skills, and gain support, skills and access to counselling, school, volunteer opportunities and employment.  

                                                                                                                                                                                                                              Programming at Poundmaker’s Lodge is a combination of Indigenous and Western modalities, a blend of perspectives that provides a unique approach that can start where people are comfortable, provide wrap around care and involves collaborative teamwork.  

                                                                                                                                                                                                                              Poundmaker’s Impact 

                                                                                                                                                                                                                              Poundmaker’s Lodge works with numerous Indigenous communities who might not otherwise have access to help with substance use. These folks come from all over Treaty 6, including Saskatchewan as Treaty 6 crosses provincial borders. Folks also come from Treaties 7 and 8. Poundmaker’s Lodge offers culturally competent programming including bringing in Indigenous Elders from various different tribes and communities, recognizing that the Indigenous umbrella is broad and encompasses many different groups of people with unique perspectives, experiences and ways of knowing.  

                                                                                                                                                                                                                              The idea of representation is incredibly important at Poundmaker’s Lodge, where a person can feel at home around others like themselves. Having people who walk with, and role models recovering from addictions and who talk about mental health is integral to the work of connecting with folks at Poundmaker’s Lodge as a community. As well those at Poundmaker’s Lodge advocate for reducing stigma associated with Indigenous Peoples.  

                                                                                                                                                                                                                              Challenges 

                                                                                                                                                                                                                              Where there is trauma, healing is the answer. Those who work at Poundmaker’s Lodge find it very difficult for the clients they serve and support to access assessments (psychiatrist), get identification, receive Alberta healthcare, obtain safe and affordable housing, access affordable therapy and medications, peer support, community, follow-up and transition support, and services for those who are hearing and visually impaired.   

                                                                                                                                                                                                                              When clients come for intake, Poundmaker’s Lodge admissions team has been noticing that many of the clients are struggling with mental health, and clients have disclosed that it is difficult to get a bed at the Alberta Hospital and the Royal Alexandra Hospital for their mental health needs. It can take months for someone to see a psychiatrist, and for clients that have co-occurring disorders it is very challenging for them to address addictions when their mental health isn’t stabilized. Mental health should come first and then addiction treatment.  

                                                                                                                                                                                                                              Funding continues to be a challenge. In part this is because Poundmaker’s Lodge is not recognized by funders as a cultural program. This creates barriers for folks on the Saskatchewan side of Treaty 6 gaining funding to access Poundmaker’s Lodge, because while Treaty 6 extends into Saskatchewan, the funding does not. Another example is the challenge of accessing places where Indigenous medicines can be picked when funders do not have the cultural understanding and competency to understand this is an important part of the healing process.  

                                                                                                                                                                                                                              When folks leave treatment at Poundmaker’s Lodge or other community supports, there are not enough resources like housing. Often times the individual is blamed as if they are lacking or should be responsible for the entirety of their situation. The reality is it is societal pressures and factors that contribute to the continued struggles. Poundmaker’s Lodge has recovery coaches who help get people started once they leave the treatment centre and provide the bridge of support for people on their path of recovery as they reintegrate into society. 

                                                                                                                                                                                                                              Indigenous Ways of Knowing 

                                                                                                                                                                                                                              There are four parts to every person, the mental, emotional, physical and spiritual. Mental wellness and how it intersects with substance use can be seen in all four dimensions, and so healing must happen holistically in all four dimensions. All the quadrants are worked on during programming where clients learn to understand that there are root causes to addiction, including the numbing of trauma.  

                                                                                                                                                                                                                              In addition to recognizing and incorporating the 4 quadrants, on the spiritual level the 7 directions are incorporated. Each has a value system, medicine and connectivity with things outside the self. The goal is to work towards the centre, which is the love component – where healing can happen. This further develops into a focus on the self and how actions such as a choice of kindness are the responsibility of the individual and relate to how they can connect to recognize their place and role in the community. 

                                                                                                                                                                                                                              Through the Indigenous Ways of Knowing people learn to cope and co-exist with their mental health challenges, because these can continue well after substance use has been addressed.  

                                                                                                                                                                                                                               

                                                                                                                                                                                                                              Note: This is an excerpt from our December 2022 Community Matters, you can read the full publication here

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                                                                                                                                                                                                                              To learn more about Poundmaker’s  Lodge or if you are in need of help:  

                                                                                                                                                                                                                              Phone: (780) 458-1884 Toll Free: 1-866-458-1884 Fax: (780) 459-1876 

                                                                                                                                                                                                                              Intake : admissions@poundmaker.org  

                                                                                                                                                                                                                              Medical Detox : detox@poundmaker.org         

                                                                                                                                                                                                                              General : info@poundmaker.org 

                                                                                                                                                                                                                               

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