Mental Health Week in Canada: De-Stigmatizing Eating Disorders

Image by Hannah Baillie

By Hannah Baillie (General member, The Young Canadians Roundtable on Health)

October 3 – 9 is Mental Health Week in Canada, a time to reflect on the aspects of our wellbeing that aren’t tangible or physical, but are nonetheless an important part of our health and wellness. Even with initiatives like Mental Health Week, Bell Let’s Talk Day, and individual days of recognition, mental health is still a heavily stigmatized topic in Canadian society.

While these days and weeks of recognition do an excellent job of raising awareness and educating the public about mental health, we need to keep the conversation going to truly work towards de-stigmatizing mental illnesses. But how do we do that? How do we keep the conversation going? It can be pretty simple – we can share our stories. In the spirit of practicing what I preach, I will start by sharing my own.

I was diagnosed with an eating disorder when I was 16 years old. At the time, I didn’t understand what was happening inside my mind and body. From the outside, I was what most people would call “the picture of health,” I played a variety of sports, enjoyed spending time with friends, and did well in school. Things were going well for me, or so it seemed. What many people, including myself, didn’t realize is that I was falling into dangerous patterns of coping that were impacting my mental and physical health.

Eating disorders are one of the most common and deadliest mental illnesses an individual can suffer from. In fact, the mortality rate associated with Anorexia Nervosa is 12 times greater than that of all other causes of death combined for girls and women aged 15 to 24. In Canada, it is estimated that one million people are currently struggling with an eating disorder. Unsurprisingly, this demand for eating disorders support and services has spiked since the onset of the COVID-19 pandemic – up to 400% in some areas.

As is often the case in eating disorder recovery, I went through various ups and downs along the way to regaining my health. Admittedly, the COVID-19 pandemic was tough. While I had been in a stable position for many years leading up to this point, the lack of certainty, control, and sheer isolation of the pandemic caused me to fall back into old habits that deteriorated my health quickly.

There is no “one size fits all” in any area of life, least of all in eating disorders. Individuals with  all body types, from any socioeconomic background, and of any gender or sexual orientation can experience an eating disorder. Eating disorders don’t discriminate. Unfortunately, our health systems and diagnostic criteria are just catching on to this fact. Where eating disorders were once seen as a “thin, white woman’s disease,” they are now being recognized as a biological, brain-based illness that can impact anyone, at any time.

I consider myself very fortunate to have received timely access to treatment and care in my home province, but this experience also opened my eyes to the state of the healthcare system in my region (and others) that left me feeling deeply uncomfortable. For instance, let’s start with the numbers. In Atlantic Canada, there are approximately 1,917,316 people. Yet there are only three inpatient beds dedicated to treating eating disorders. Just three beds. As our health systems struggle to keep up with demand for services, many people are left waiting. And when it comes to eating disorders, waiting can be deadly.

My time as a patient in the healthcare system showed me that treatment can be life-changing. People canrecover from eating disorders, despite many people referring to them as a “chronic illness”. I am now recovered, working towards my education, and taking on new roles with organizations like the YCRH that aim to improve healthcare services for youth in Canada. But I also wish that I didn’t have to consider myself “lucky” to have reached this point. I wish that timely access to care was the standard in this country and not an anomaly. I wish that individuals with eating disorders didn’t have to leave their province, their friends, or their families to get life-saving treatment. Most strongly, I wish that Nova Scotia could have a residential treatment centre for people with eating disorders. These are lofty wishes with no “quick fix,” but as we talk more about mental health, and in particular about eating disorders, we move closer to making them a reality.

I would be remiss if I didn’t recognize the role that community-based organizations like Eating Disorders Nova Scotia, and their sister organizations around the country, play in promoting recovery and advocating for mental health in Canada. As the demand for mental health services continues to rise, these organizations have stepped up to the challenge by offering new services, supports, and programs so that no one has to face their mental illness alone. Eating Disorders Nova Scotia’s professional services, peer support networks, and virtual workshops, bridge the gap between reaching out for help and accessing treatment.

So, as we take the time to reflect on our own journeys with mental health and wellness this week, let’s think about what we’re doing well, but also what we’d like to improve. Every day – not just those dedicated to national awareness and recognition – is an opportunity to build a future that is less stigmatized and more supportive of those with mental illnesses. Start by sharing your story, donating to your local non-profit mental health organizations, or reaching out to a friend who might be struggling. I’ve learned over the past few years that these actions do not go unnoticed. They make a difference for us, personally, as well as for others. Together, we can make mental health in Canada a less stigmatized experience.

Hannah Baillie is Public Relations student at Mount Saint Vincent University in Halifax, Nova Scotia. A natural writer, Hannah uses storytelling to advocate for a wide variety of healthcare topics. She is looking hopes to use her personal and professional experience in the healthcare system to advocate for improved mental health policies, services, and initiatives.

The transition back to in-class learning: Considering youth with ADHD

Photo by Deleece Cook on Unsplash

By Christine O’Meara (General member, The Young Canadians Roundtable on Health)

As Canadians receive their second dose of the COVID-19 vaccine and COVID-19 cases steadily decrease, many are hopeful of a normal return to in-person classes in the fall. The abrupt upheaval of everyone’s routine in March 2020 was a difficult transition, causing stress and anxiety on students burdened with multitasking a changing schedule, cancelled graduation ceremonies, reduced study spaces, exam preparation, and most importantly, newly-introduced online learning tools. As we transition back to in-person classes and adapt to a new environment, we should consider the effects the pandemic and remote learning may have had on youth with Attention Deficit Hyperactivity Disorder (ADHD).

ADHD is a neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity symptoms. It impacts an individual’s learning ability, relationships, emotions, and confidence (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195413/). Beginning in childhood, it is estimated that between 5% and 12% of children have ADHD in which approximately two-thirds will continue to exhibit impairing symptoms into adulthood. Due to a difference in symptom presentation amongst boys and girls, girls are repeatedly underdiagnosed. Boys are diagnosed with ADHD at a ratio of 3:1 compared to girls, likely due to the fact that boys depict the more outwardly visible, hyperactive symptoms whereas girls depict the subtler, inattentive symptoms of ADHD. ADHD can have a substantial impact on an individual’s daily life. Approximately twothirds of children with ADHD also have a co-existing disorder (https://chadd.org/about-adhd/overview/). It affects executive functioning, a mental process that enables us to plan, reflect, and time manage, as well as begin and finish tasks. It also impacts the ability to regulate emotions, appropriately process information, pay attention, and utilize working memory in the same capacity as non-ADHD folks. Impaired levels of sustained focus and attention coupled with the many other symptoms of ADHD puts ADHD students at a higher risk of performing worse academically than students without it. As assignments, concepts, and schedules become harder to learn and self-manage, ADHD can make coping with these changes more challenging.

Photo by Thomas Park on Unsplash

The uncertainty of the pandemic and the abrupt switch to remote learning and isolated living has negatively affected the mental health of youth and adolescents with ADHD. A study examining the effects of remote learning during the pandemic found that 31% of parents of adolescents with ADHD and an Individualized Education Program (IEP) had a harder time supporting and managing remote learning. Out of the parents with an adolescent that had no ADHD or IEP, only 4% reported difficulty managing remote learning.

As we transition back to in-person learning, educators, peers, youth, and guardians must recognize the effects the pandemic may have had on youth with ADHD. It will be more important than ever to ensure that youth with ADHD feel equipped and supported socially and academically. Additional resources and attention may need to be allocated to these youth to help ensure they do not fall behind in class and can feel confident in themselves to persevere. Here are four ways to help youth with ADHD this upcoming academic year:

1.     Don’t overlook students with high grades

• ADHD can easily go unrecognized in students who appear, on paper, to be successful academically. The transition to higher education increases demands on school and life, challenging an individual’s executive functioning skills. Without proper coping mechanisms and tools, this can have an impact on one’s mental health, grades, and self-esteem. Additional pressure from others including phrases such as, “you’re not trying” or “you’re being lazy” can lead to feelings of anxiety, shame, doubt, and frustration for the student.

2.     Explore different educational tools and approaches in the classroom

• Whether it is speech-to-text apps, regular walks, quiet spaces, one-on-one study time, remote/hybrid learning, or personalized projects, there are endless tools and approaches that can be used in educational settings to help students with ADHD stay focused, motivated, and interested. There is no “one size fits all” technique for students with ADHD. It is important they have time and space to explore options that complement them best.

3.     Personalize schedules to align with medication peak

• A study found that learning from home decreased levels of anxiety and stress in some youth with ADHD caused by the structured rhythm of school. Having the freedom to design a schedule can be beneficial for ADHD students. Difficult projects can be scheduled to align with the medication’s most effective period.

4.     Show empathy

• Most importantly, be kind and patient to others and to yourself if you have ADHD.

Christine is a graduate from the Bachelor of Science in Kinesiology program at Dalhousie University. As someone who received her ADHD diagnosis after completing university, she understands how difficult it can be to cope with the pandemic and educational challenges without the appropriate resources nearby. She is passionate about environmental health, food insecurity, and advocating for improved and accessible mental health resources for youth and adults.

Spotlighting Children and Youth with Disabilities and How You Can Be an Ally

Photo by Greg Rosenke on Unsplash

By Emily Chan (General member, The Young Canadians Roundtable on Health)

In 2017, Statistics Canada found that one in five (22%) of the Canadian population had one or more disabilities – or around 6.2 million Canadians. Of this number, over 200,000 are children and youth, many of whom live with multiple disabilities. The Canadian Survey on Disability conducted by Statistics Canada categorized ten disability types: seeing, hearing, mobility, flexibility, dexterity, pain, learning, developmental, mental/psychological, and memory. Although this is not an exhaustive list, it illustrates an important point: some disabilities are visible, others are not. The Learning Disability Association of Canada estimates that one in ten Canadians has a learning disability and Statistics Canada estimates mental health-related disabilities are the most prevalent type of disability in youth ages 15-24.

A prominent issue faced by children and youth with disabilities is ableism. The term is defined as a form of discrimination and a way to exclude individuals with disabilities on the basis that typical abilities are superior. Ableism takes many forms and poses significant challenges and barriers for children and youth with disabilities.

• Ableism looks like bullying. According to the Canadian Survey on Disability, 42% of youth with a disability have experienced bullying at school because of their condition. This number increases to 62% among youth with a severe disability or multiple disabilities. This leads to feelings of isolation, exclusion, and loneliness. Much of the bullying stems from the fact that children and youth with disabilities can have different ways of navigating the world (e.g. using a wheelchair), communicating (e.g. using sign language), and expressing themselves. The problem of isolation and exclusion has only worsened with the COVID-19 pandemic.

• Ableism looks like discriminatory hiring practices. Statistics Canada found that the employment rate for individuals with disabilities is significantly lower compared to non-disabled employees. Many youth seeking employment are confronted with the challenge of finding a role they can perform with their disability and finding an inclusive organization to work for. There is an additional challenge of determining when and how to disclose a disability during an interview with a potential employer. Many youth worry about facing stigma and discrimination if they disclose their disability to an employer. The fear becomes, ‘they do not think I am capable of performing this job because of my disability.’ Yet, not disclosing prevents youth from asking for workplace accommodations which may help them perform the job tasks to the best of their ability. This internalized form of ableism prevents many youth with disabilities from pursuing exciting careers or deters them from seeking employment entirely.

• Ableism looks like inaccessible environments. From the lack of curb cuts and working elevators to the lack of closed captioning and ASL interpreter supports available in classrooms, society is not built in a way that supports children and youth with disabilities.

Ableism is pervasive in our everyday lives. However, you can be part of the change. Here are four tips on how you can be a youth ally and stand in solidarity with children and youth with disabilities.

1. Never assume that someone with a disability needs help.

   • Although your intentions to help are good, it is not always needed. Always ask and wait until an invitation to help has been extended before taking action, and respect that your invitation may be declined

2. Ask the child/youth with a disability if they prefer person-first or identity-first language.

   • An example of person-first language is saying ‘youth with a disability’ and an example of identity first language is saying ‘disabled person.’ Although referring to a person with a disability (PWD) by name is the best option, if you are talking about a PWD, always check to see which language a person prefers as not everyone prefers person-first language.  

3. Keep accessibility at the forefront of your mind when creating spaces.

   • Whether it be online spaces or physical spaces/events/forums, always ask yourself if this space is accessible and inclusive and if not, what modifications would you need to put in place? This may include closed captioning, ASL interpreters, and documents available in alternative formats. If you are not sure if a space you are creating is accessible, ask.

4. If you witness a form of ableism taking place, and you feel comfortable, say something.

Emily Chan is a recent graduate of the Master of Social Work Program at the University of Toronto and identifies as a young person with a disability. As a passionate advocate for disability rights and leader in her community, Emily has lent her lived experience to several disability justice and health equity organizations. She is also an active stakeholder on many community committees including the Holland Bloorview Youth Advisory Council, the Young Canadians Roundtable on Health, and the March of Dimes Strategic Planning Committee. Emily also hopes to continue being a champion for change and advancements of disability rights.

The time is now to advance girls’ rights and health in Canada

Photo by Priscilla Du Preez on Unsplash

By Lauren Hamill (General member, The Young Canadians Roundtable on Health)

Content Warning: sensitive topics including gender-based violence and sexual abuse

As we reach the end of Women’s History Month, it is important to consider what we can learn from the history of women’s rights and health to ensure that future generations of girls and women can realize their right to health. In order for this to be a reality, girls’ health must be a priority in Canada’s post-pandemic recovery plan. Since the pandemic began in Canada, the impacts have exposed gaps in our systems and highlighted existing inequalities for women and girls.

Even before the pandemic, girls faced many additional challenges and barriers. When girls start school they are generally more likely to do well in reading, writing, and forming friendships, yet as girls approach adolescence, things begin to change. Indigenous girls in Canada are especially at risk and experience even higher levels of mental illness, suicide, gender-based violence, and poverty. Other girls who are systemically disadvantaged include those of lower socioeconomic status, racialized and immigrant girls, and those that live in rural areas.

Girls experience high levels of sexual assault and other forms of violence, with over 11,000 sexual assaults of girls under the age of 18 being reported to police in Canada in 2016. This number is likely much higher, due to the underreporting of such offences. Girls also experience sexual assault at much higher rates than boys, with 83% of all sexual assault victims under the age of 18 being female in 2016.

Girls also experience serious declines in mental health and wellness when entering adolescence, with 36% of girls saying they are self-confident in Grade 6, but only 14% saying the same in Grade 10 according to a Public Health Agency of Canada report. More girls aged 10-17 are hospitalized for mental disorders than boys the same age, and Canadian girls are 15 times more likely to be hospitalized for an eating disorder than males. Alarmingly, suicide remains the third-leading cause of death for girls aged 10-14, and the second-leading cause of death for girls aged 15-19 in Canada.

Photo by Jeffrey F Lin on Unsplash

Women and girls also participate in sport and recreation less than men and boys as athletes, coaches, and leaders in Canada across all demographic categories. Period stigma and period poverty can also further limit participation of girls in activities. Plan Canada’s 2019 Gender Study found that 68 per cent of women in Canada felt that their period prevented them from full participation in an activity, with the number even higher for women and girls under 25 years of age. A third of women under 25 also reported struggling to afford menstrual products for themselves or others.

The COVID-19 pandemic has added an additional layer to the barriers girls and women face, due to lockdowns, school closures and unequal access to virtual learning. While the impacts of the pandemic on women are being highlighted, these impacts are less known for girls. Women have seen increased job losses, reduced hours of work, and are responsible for the majority of unpaid care responsibilities at home. There have also been higher reports of intimate partner violence and other forms of gender-based violence. These impacts have been increased for Indigenous women, racialized women and other underrepresented groups of women.

These challenges and barriers have long existed for women, but were made far worse due to the pandemic, resulting in more attention. It can then be expected that the inequalities girls face will also be exacerbated. Let’s not wait until these impacts are at their worst and most obvious before we bring attention to them and respond.

Photo by Omar Lopez on Unsplash

We must act now to ensure that the girls of today and women of tomorrow do not face the same inequalities of the women of history and today. Through highlighting these gaps, the pandemic has given us a unique opportunity to ensure that the next generation of women will not face the same challenges and will come out stronger in the progress towards gender equality. This will require systemic change that looks at the unique needs of diverse girls across the country.

This requires us to ask questions and learn about the plight of girls in Canada, and to bring awareness to these issues, sign petitions, and advocate to government for change. We must demand more data related to the impacts of the pandemic on girls so that we can respond effectively. We must ensure girls are involved in the recovery and are encouraged in leadership and decision-making positions. This must act as the catalyst for systemic change that improves women’s and girls’ economic security and prosperity.

We must also address the other hidden pandemic that has long plagued our country: gender-based violence. This can only be done through the erasure of stigma and attitudes in our society that prevent girls from reporting and that protect perpetrators. We must also demand improved supports and services for victims.

We cannot address these issues in isolation. The pandemic has shown us that these various inequalities are interconnected – when one worsens, others will also magnify. We need intersectional approaches that recognize the diverse needs of different groups of women and girls and the intersecting barriers they may face.

No matter what we do, we must start now. We cannot let a whole generation of girls fall behind, or else repeat the plights women have faced throughout history and lose progress gained in the fight for gender equality.

Lauren Hamill is a Master of Public Health student at the University of Toronto. She is currently specializing in women’s health and global health and hopes to pursue medicine or to work in maternal and child health programming. She has various experience with non-profits, and in the global health field especially in regard to women’s health programs and monitoring. In her free time, she runs BloomiBox, an organization working to provide vulnerable mothers and babies with essentials.

Registration for the second YCRH Series webinar is open!

The Young Canadians Roundtable on Health will be hosting their second webinar! Registration is now open for The YCRH Series: Coping with COVID-19 as Youth which will be happening on Monday, March 1, 2021 at 5 p.m. EST and will primarily feature organizations and youth speakers from Ontario including YouthNet/RéseauAdo and mindyourmind.ca. Our speakers will be going over strategies on stress management, productivity, self-care, and self-compassion that Canadian youth can implement in their lives during the pandemic.

The webinar will feature the following speakers:

1. mindyourmind is a non-profit mental health program that engages youth, young adults, and the professionals who serve them to co-create tools and resources to build capacity and resilience. In this workshop, you will learn about coping strategies, tools, and mental health resources you can incorporate into their daily lives during the COVID-19 pandemic.

2. Emma Hamill grew up in Northern Ontario and has since settled in Victoria, BC to attend the University of Victoria. She is currently completing her Masters of Community Development where she hopes to marry her passion for non-profits with her appreciation for art. In this workshop, you will learn more about using art as a tool for coping, stress management, and advocacy.

3. Zaamilah Balasubramaniam is the founder of Zen with Zaam and is a Hatha Yoga Teacher. Hatha yoga includes a flow of Asanas (yoga poses) and Pranayama (breathing techniques). The skills you acquire from this practice allow you to connect your body, mind and soul, ultimately preparing you for a deeper spiritual practice.

4. YouthNet/RéseauAdo (YNRA) is a for-youth-by-youth mental health promotional organization run through the Children's Hospital of Eastern Ontario (CHEO). YNRA's two awesome Youth Facilitators (Madison and Tessa) will test your knowledge with some trivia. Get up and move along to practice what we've learned, and challenge yourself to explore ways to take care of your mental health!

The webinar will also have a youth panel who will talk about their experiences during the pandemic and what they’ve been doing to cope.

Attend our webinar for your chance to win some great door prizes! Please register here: https://bit.ly/2OPkNcO. The YCRH Webinar Series is generously sponsored by TELUS.

If you would like more information or have questions about webinar series, please contact the YCRH at ycrh@sandboxproject.ca.