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.

Elections 2021 - Prioritizing the health of children & youth in Canada

By Leah Sarah Peer (General member, The Young Canadians Roundtable on Health)

With the federal election around the corner, it is time we reflect on the COVID-19 pandemic and how it has exacerbated numerous health inequities and the inadequacies of our current healthcare system. The pandemic has laid bare the need for urgent action and for our country’s officials to do better.

As a medical student, Canadian Medical Association (CMA) Ambassador, the Executive Director of the Peer Medical Foundation (PMF), and a fellow citizen, I am urging all candidates to commit to real action that improves the health and well-being of children and youth in Canada.

Approximately eight million Canadian children and youth will not be able to vote in this federal election but will be directly impacted by its result and policies. Below are a few urgent areas in the child and youth sector that leaders should prioritize:

Research for Childhood Illnesses and Medication

Canada is the only country with a universal public health system that excludes drug coverage. It is outrageous that there is a lack of access to essential medications. This not only undermines the physical and mental health and well-being of all Canadians, but places children and youth at additional barriers accessing affordable and effective medications of appropriate formulations.

Research often prioritizes funding for adult diseases over childhood illnesses, neglecting the importance of recognizing and respecting that children deserve the same standards for  drug safety, efficacy, availability, and access. It is time for robust policies governing the development, approval and use for drugs in the paediatric population and that a national pharmacare program be implemented.

Research must provide paediatric-specific data that guides clinicians. 1 in 15 children are born with rare diseases. This means that over 70% of all rare diseases manifesting in childhood translates to 1 in 4 paediatric hospital beds that will be occupied by a child with a rare disease. It is crucial that children with rare diseases are not neglected nor forgotten in this election.

Address Historic & Systemic Barriers to Care for BIPOC Youth & Children

The atrocities of the residential school and the discovery of the unmarked graves serve as a reminder of the colonial trauma endured by Indigenous peoples, and the importance of prioritizing cultural practices (e.g. Elders looking after children) that are core to resilience and wellness. It is imperative that steps be taken to ensure that residential schools are not a forgotten chapter in our history.

Without coordinated action between communities, Indigenous leaders, health providers, and governments, gaps in health outcomes will widen. It is time that policies and practices address historic and systemic barriers to care and living conditions that have unfairly affected BIPOC children and youth in Canada. We must promote a culturally-safe and trauma-informed care environment, and ensure patients and families are confident in the care they receive.

Providers must learn about and address the structural inequalities and impacts of colonialism that undermine child and family wellness. We must learn about each patient and family’s background and understand interconnected factors affects their health needs. Providers must screen children and their families for social determinants of health such as poverty, housing, and clean water availability It is time to partner with BIPOC community organizations to support high-risk families through measures such as phone check-ins, mental health counselling, food delivery or grocery gift cards, or even ensuring the availability of technology and the Internet to maintain healthy relationships with isolated family members.

Prioritize Children & Youth Access to Mental Health Care Services

Lastly, even before the pandemic, long wait times, a lack of access to quality mental health services, and support for children and youth were issues of serious concern. The effects of the pandemic have eroded mental health. Wellness centres are seeing unprecedented numbers of youth reporting to the emergency room with anxiety, depression, suicidal thoughts, substance misuse and eating disorders. It is time to implement a nationally funded system that is transparent, accountable, and supports improvements in mental health outcomes in children, youth and their families. It is time to fund evidence-based mental health care for children and youth as well as educational resources, training and programs that increase professionals’ competencies in paediatric mental health care.

It is time we do better for children and youth in advocating for their health and well-being. Our health system should support access not only to high-cost medications but to equitable, comprehensive care that ensures optimal outcomes for all children and youth in Canada.

Leah Sarah Peer is a medical student at Saint James School of Medicine in Chicago, USA. She holds a Bachelor of Science with a Specialization in Biology and a Minor in Human Rights from Concordia University in Montreal, Canada. Mingling her passion for medicine with her human rights endeavours, Leah aspires to serve humanity beyond the bounds of medical knowledge.

Coping with grief: The role that schools can play in supporting children and youth after the loss of a parent

Photo by Rubén Rodriguez on Unsplash

By a General Member (name withheld), the Young Canadians Roundtable on Health

It's been almost a year since I lost my father and though things do get easier, the wound never fully heals. Undoubtedly, the loss of a parent is traumatic and greatly impacts the family as a whole. Being an older brother, I naturally find myself trying to ease the pain and stress of my three younger brothers while simultaneously attempting to cope with my own. As I dwell on the well-being of my younger brothers, I am drawn to consider the larger picture—that so many of Canada's youth are facing a similar struggle. I empathize with these youth as I know that pain is associated with the loss of a parent, but unlike myself, these children and adolescents may not have developed the coping strategies that can at least slightly alleviate the anguish. In developed nations such as Canada, roughly 4% of children experience the loss of a parent. This loss is associated with an increased risk of mental health problems and threats to the emotional wellbeing of affected children such as anxiety, depression, and learned helplessness. I believe more can be done to support Canada's youth who are experiencing loss, and I believe that school is where this support can be obtained. 

Following the death of a parent, children often experience distress, anxiety, depression, and difficulty focusing in school. Academic struggle is something that resonates with me. I can recall being in high school when my father was first diagnosed with stage 4 lung cancer. I remember carrying this enormous weight with me to every one of my classes and it undoubtedly influenced my productivity in school. I also remember how long it took for me to seek help from teachers and guidance counselors. Reflecting on that time, I think that I can attribute my hesitation in seeking help to not feeling that my mental health and overall well-being were of concern to anyone at school. This, of course, was not accurate; however, this can be representative of the need for schools to make mental health a priority and convey to students that help can be obtained at school. Without this, Canada's youth are at risk of facing long-term detriments to their mental health. Following the death of a parent, 50% of children report becoming depressed in the year following their loss, and 16% report remaining depressed years later. This is no small proportion of children as it translates to thousands not receiving the care they need. 

The importance of school being a safe place where children coping with loss can receive help goes beyond what teachers and counselors can provide. Peer support during these times is absolutely crucial for youth experiencing the death of a parent. For many Canadian adolescents, peers were the most helpful source of emotional support after the loss of their parent—time spent with friends allowed them to feel normal and less isolated. I believe that school has the potential to provide something beneficial to youth facing the loss of a parent. These youth can learn coping strategies from adults who likely have more experience with traumatic events, while also being granted services and accommodations that they may need to succeed academically. They are also able to benefit by being in an environment where peer support is readily available. The ability to receive support from academic personnel and peers in an environment where children spend so much of their time throughout the year demonstrates how important school is for youth in mourning. 

The last aspect of coping with the loss of a parent which I believe schools may be able to help with is the financial issues that these families face. Children from families who lost a parent who the household’s sole source of income reported being under significantly more stress than those who were financially secure. Since my father was the only one of my parents who was working, I can relate and empathize with youth facing similar situations. I see this every day when I look at my mother and brothers. I watched as a sense of urgency to find employment consumed my 14-year-old brother. Being so young and previously relying on my father for financial support, he had no prior work experience. This made it increasingly difficult to find a job. This is an area where I think schools can help such students facing financial distress. I have noticed that schools have begun to teach financial literacy and how to approach the employment process, but I think further steps can be taken. I think that these schools could potentially offer employment opportunities to students such as working during school athletic and extracurricular events or working as teachers' assistants. These schools may even consider communicating with companies who act as suppliers or sponsors to see if a program can be implemented which functions to provide employment to students facing difficult financial situations. This would allow schools to further support their students coping with loss and lessen their financial burden and stress.

Schools can play an important role in support youths’ grieving following the loss of a parent to not only academic success but overall well-being. More needs to be done by individual schools and school boards to ensure youth facing a difficult period of their life are not falling through the cracks.

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. 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 two-thirds of children with ADHD also have a co-existing disorder. 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.

Looking forward: Executive Director Stacie Smith reflects on what's next for the YCRH

My name is Stacie Smith, and I have the amazing privilege to be coming into the role of Executive Director of the Young Canadians Roundtable on Health, the first based in Atlantic Canada. I am originally from Saint John, NB, but have called Halifax, NS my home since 2013. I have been with the YCRH since January 2020, starting off as the Director of Relations and Outreach. This role has allowed me to develop my leadership and communication skills, thus being able to take on this larger role as Executive Director. This is my first leadership role with a national organization with youth spanning across the country, but I am excited to keep the momentum going that began in 2019. 

My passion for youth health and well-being began during my undergraduate degree at Dalhousie University in Halifax. I graduated with my Bachelor of Science in Kinesiology, with a keen interest in getting children and youth physically active. It is well known that children and youth in Canada are not getting the adequate activity they need. Less than one in five children and youth in Canada are meeting national movement guidelines for physical activity. My goal is to improve this through the work we do with the YCRH.  

I was President of both the Dalhousie Kinesiology Society and the Student Association of Health and Human Performance during my degree, which allowed me to develop my leadership and advocacy skills that are needed to be successful in this role. I am very excited to be taking my skills back to school this Fall, attending the University of New Brunswick in Fredericton in their Bachelor of Education program. I am hoping to use the knowledge I learn throughout the year with the work we are doing on the YCRH.

I have also had the opportunity to work with many organizations on youth engagement initiatives, such as Children’s First as a Facilitator during their Young Canadians Parliament, Wisdom 2 Action as a member of their Youth Advisory Council on Youth Suicide Prevention, and with Frayme as a Youth Partner. These roles have given me the opportunity to connect with amazing advocates from across the country, while being able to take away what I have learned from them and apply it to the YCRH.

I have also been a strong advocate for children and youth mental health over the past 3 years. As someone living with depression and anxiety, I want to advocate for those who may not have the ability to do so and give them the hope for change in our mental health system. Many young people are afraid to come forward, as equitable access to mental health services can be hard to find.  This led to my involvement as Co-Chair of the New Brunswick Youth Advisory Council on the Review of Youth Mental Health Services, which is being conducted by the New Brunswick Child/Youth Advocate.

We are slowly coming out of the pandemic, and children and youth will need our support more than ever. The YCRH is declaring #codePINK and raise the alarm about the current mental and health crisis facing children across the country. The campaign is calling on the federal and provincial/territorial governments to act immediately to address this emergency. We joined Children’s First in making this call and look to support children the best we can during this time of dire need.

I want to ensure the YCRH continues to have an equitable lens to its work moving forward. I am looking forward to bringing forward a plan to work with members to ensure this is achieved and that the YCRH has a good balance of members from various cultural and diverse backgrounds from across the country. We need all voices at the table to ensure no youth feel left out of the conversation.

We have many exciting initiatives and partnerships coming up over the next several months, including:

• The creation of and leading of youth focus groups conducted in partnership with The Coalition of Healthy School Food, who have been advocating for a federally funded National School Food program since 2018. We will be gathering feedback on their experiences in accessing school food.

• We are partnering with Healthy Debate to provide a platform for youth across Canada to share their different experiences regarding their physical, mental, and emotional well-being throughout this pandemic. We will be asking youth to share their experience through multi-media content including writing, art, music, video, audio etc.

• Our continued partnership with the Inspiring Healthy Futures: WeCanFor Kids initiative, in collaboration with Children’s Healthcare Canada, the CIHR Institute of Human Development, Child and Youth Health, Pediatric Chairs of Canada and UNICEF Canada.

I want to end off by thanking the outgoing Executive Director, Umayangga Yogalingam, for her dedication and hard work in taking the YCRH to where it is today. We would not be where we are without her tireless efforts at putting us on top. I look forward to continuing the amazing work and collaborations she has started over the next year to advance the child and youth health sector forward, so that they are not left behind.

Stacie Smith is the Executive Director of the YCRH. She is also founder of the COVID-19 Student Support Network and the Director of Relations and Outreach for the YCRH. She is a recent graduate from Dalhousie University's Kinesiology program.

Reflecting on my time as Co-Executive Director of the YCRH

The day is finally here to hang up my Co-Executive Director of the Young Canadians Roundtable on Health hat. It was a hat that I have worn since September 2019, at the tail end of my Sandbox Project internship which I completed as part of my Master of Public Health degree. I had never held a leadership position for an organization that had such a diverse group of individuals across Canada. I was a little nervous, but mostly I was excited to making interesting connections, meet amazing youth across Canada and do the work to help advance youth health and well-being in Canada.

Taking on this role was difficult at first, as I was trying to get through the last few months of my degree and then the pandemic hit. I felt a little bit like a headless chicken but came to realize there are so many others out there who are already doing the work. So I decided to reach out to youth advisory committees (YACs) in health spaces across Canada for some guidance and have conversations to see what practices they implement to meaningfully engage their youth and how they address challenges within their committees. I learned so much and was struck by how selflessly everyone provided their ideas and the strategies that worked for them.

Using the strategies and suggestions of other YACs, I spent most of my tenure as Co-Executive Director creating internal processes and implementing strategies that would meaningfully engage our members and empower them to make decisions related to the YCRH’s agenda. This included holding monthly meetings instead of quarterly meetings to keep the momentum going, creating a monthly internal newsletter for members for updates, external opportunities, and self-care tips, implementing an honorarium policy to recognize members for their hard work, creating an internal database of all our partners and collaborators, and collecting feedback and demographic data from our members to ensure that the YCRH members are able to shape how the Roundtable is run and that we are not missing voices from the table. The last six to eight months was the most engaged I have seen the YCRH, both within the organization and in collaborations with external organizations over the last two years. It has been so refreshing to see YCRH members actively participate and provide new, innovative ideas that would ultimately play a role in improving youth health and well-being across Canada. The YCRH would not be where it is today without the tireless efforts of its members. Seeing them in action makes me so hopeful for the future of Canadian youth.

Building up the YCRH was not easy but it was a labour of love. Youth engagement during the pandemic was slightly difficult to navigate but it was much needed. The pandemic has had devastating consequences that will last for years to come. Canadian youth were already doing fairly terribly compared to their counterparts in other wealthy countries, according to the UNICEF Report Card 16. Post-pandemic, inequities in youth health will continue to be exacerbated, barriers to youth services and programs will continue to be an issue, and youth will continue to experience economic impacts such as job loss, precarious employment and low wages. Youth engagement and partnership to advance youth well-being is important now more than ever. Organizations must meet youth where they are at to address these issues and jointly work towards improving youth health and well-being. The YCRH, in collaboration with youth-focused organizations, is dedicated to making this happen.

I’m happy to say that it’s not a final goodbye to the YCRH! I will continue in my role at The Sandbox Project where I will provide the YCRH with high-level mentorship. I know this summer and beyond will see an exciting chapter of the YCRH, as it turns outward and becomes a more prominent voice in the youth health landscape in Canada. Here’s a sneak peek of what the YCRH has got planned for the rest of the year:

• Continuing the YCRH-created webinar series which will be renamed to “Recovering from COVID-19.” The webinar series will continue to equip youth and families with strategies from experts on a variety of topics that impact health including financial well-being, employment, and more

• Rebranding the YCRH, including creating a new logo, creating a new communications strategy that prioritizes accessibility, and trying out innovative ways and platforms to communicate pertinent information to youth and the general public

• Conducting a workshop at the One Young World Munich Summit happening July 22 – 25, 2021. In partnership with Frayme, the YCRH will be presenting on youth mental health, financial literacy and engaging youth in a digital world

• Joining Senator Rosemary Moodie’s office to advocate for a federal Child Commissioner through conducting focus groups to get the youth perspectives and assisting with creating a report to outline what children and youth across Canada want to see

• And many other exciting partnerships and collaborations still in the works!

Finally, there are many people to thank – individuals who made it possible for the YCRH to do the work and made my life easier in the process:

• Mary-Ellen Rayner, Christine Hampson, and Lauren Hamill at The Sandbox Project, who always provided excellent guidance and supported us in the operations side of the YCRH

• The amazing YCRH leadership team (Akosua Bonsu, Erika Dupuis, Melanie Asselin, and Mobeen Lalani) whose expertise and ideas I can always count on

• The amazing YCRH members (over 50 individuals across Canada) who are dedicated advocates and instill me with so much hope for our future

• The Sandbox Project board of directors with a special shoutout to Paul Brown for always amplifying our voices

• The many partners and organizations that the YCRH got the opportunity to collaborate with

• The youth advisory committees who graciously told me about the ins and outs of their committees which helped make improvements to the YCRH

• Victoria Moore, the previous Co-Executive Director and my practicum partner-in-crime

• Stacie Smith, the current Co-Executive Director, whose passion for child and youth health and hard work will take the YCRH to a whole new level

Umayangga Yogalingam is a graduate from the Master of Public Health program at the University of Toronto and is passionate about mental health, health equity, environmental health, and the impact of race, culture and ethnicity on health. While she is the outgoing Co-Executive Director of the YCRH, she will be continuing her role as Research and Knowledge Translation Lead at The Sandbox Project.

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.

Youth Mental Health During and After the COVID-19 Pandemic

Photo by  Anthony Tran on Unsplash

By Devanshi Desai, (General member, The Young Canadians Roundtable on Health)

The COVID-19 pandemic has brought a sense of fear and anxiety which has led to short-term and long-term psychological and mental health implications for children and young people. Removal from school and daily routines, social isolation  - and sometimes loss associated with illness – have increased the stress in children’s lives. Youth are experiencing similar effects too. The perceived mental health of Canadian youth has declined during the pandemic, with over half of the participants aged 15-17 reporting that their mental health was somewhat worse than before the implementation of physical distancing measures. In an Association for the Canadian Studies survey conducted in mid-May 2020, more than one-third (37%) of respondents in the youth survey reported that they experienced adverse impacts to their mental health. 

Youth aged 12 to 17 were more likely to report feeling sad and irritable than adults and were more likely to report having trouble sleeping. Another survey of youth and young adults aged 14 to 27 was done in April 2020 by the Centre for Addiction and Mental Health (CAMH).It also found a decline in reported mental health early in the pandemic, both for youth and young adults with pre-existing mental health issues and for those without.

Many younger people feel more vulnerable to the pandemic's specific economic impacts, such as job loss. And for those who do not have access to virtual mental health care, disruptions in care and supports due to physical distancing measures may worsen their mental health challenges. A potential solution is the accessibility of more virtual mental care programs; free and confidential crisis resources can also help you or a loved one connect with a skilled, trained counsellor in your area.

COVID-19 and the Impact on Children’s Mental Health, a report by Simon Fraser University’s Children’s Health Policy Centre, reviews several studies on mental health outcomes for children and youth after earlier pandemics and natural disasters. This research identifies the mental health challenges children and youth can be expected to experience during and after COVID-19, including anxiety, post-traumatic stress, depression and behavioural problems. The report indicates that because untreated mental health problems can persist, even extending into adulthood if left untreated, supports for children and youth will significantly reduce future costs.

The study further finds that some adolescents and teens could be adversely impacted, including those with neuro-diverse needs, pre-existing mental health problems, youth in foster care and those influenced by adversities such as social deprivation and prejudice. It also finds that COVID-19 may have a particular effect on Indigenous peoples, who have unduly experienced co-related damage.

Overall, the pandemic is taking an exhausting toll on mental health of youth across every population in Canada. With the uncertainty over when life will go back to “normal,” it’s imperative that youth have barrier-free access to ample mental health supports for the remainder of the pandemic and beyond, to ensure that Canadian youth are able to lead healthy lives.

Devanshi Desai is currently completing her Master of Science in applied human nutrition at Mount Saint Vincent University in Halifax, Nova Scotia. She is passionate about improving health standards by providing quality of food to every individual, reduce food insecurity, mental health, and safety.

Reflecting on the YCRH’s 2020 and Looking Ahead

Photo by Priscilla Du Preez on Unsplash

By Umayangga Yogalingam, (Co-Executive Director, The Young Canadians Roundtable on Health)

2020 was an interesting year for the Young Canadians Roundtable on Health (YCRH). We were in the midst of planning the annual Sandbox Summit when the pandemic was declared in March 2020 and the Summit had to be postponed. Soon came the ever-familiar lockdown and work-from-home orders, daily COVID-19 case counts, Zoom fatigue, and anxiety about the future.

As a national youth advisory committee, we didn’t have to significantly adjust our processes as the YCRH has always relied on virtual means of meeting and planning, but it was still challenging. During the pandemic, Canadian youth have had to adapt their lifestyles, routines, and relationships in unprecedented ways to ensure the safety of themselves and their loved ones. These adjustments have been difficult. Youth have had their schooling moved online, have had difficulty obtaining meaningful employment, and some have had to navigate various means to meet basic needs to support themselves and their families. Many surveys have found that many youth reported a decline in mental health resulting from burnout, feeling isolated, and worrying about the pandemic’s impact on the health of themselves and their families, education, job prospects, and social life.

It has been a difficult time for youth but despite these challenges, the members of the YCRH demonstrated tremendous leadership in the work towards bettering the health and well-being of Canadian youth, families, and communities through various initiatives. Some highlights include:

• Launching the first webinar of our webinar series called The YCRH Webinar Series: Coping with COVID-19 as a Family in September where families across Canada got to learn more about physical activity, healthy eating, and mindfulness meditation during the pandemic.

• Presenting at the Students Commission of Canada’s #CanadaWeWant Knowledge Exchange Event and at Children’s Healthcare Canada’s annual conference on the importance of meaningful youth engagement in health spaces across Canada

• Partnering with the Students Commission of Canada to facilitate three discussions with youth on health and well-being, employment, and the environment and climate change in order to inform the federal-level State of Youth report

• Organizing and hosting two national youth forums as part of a new initiative called Inspiring Health Futures: WeCANforKids, in collaboration with Children’s Healthcare Canada, the CIHR Institute of Human Development, Child and Youth Health, Pediatric Chairs of Canada and UNICEF Canada.

The YCRH is a microcosm of the amazing work that Canadian youth have been doing during the pandemic to protect, serve, and build their communities. Youth health and well-being have been significantly impacted during the pandemic and as such, it is important now more than ever to incorporate youth into decision-making as we all make steps towards pandemic recovery and beyond. Youth have proven themselves time and time again that they are resilient in the face of adversity, knowledgeable about the issues that affect them, and dedicated to bettering their communities. It’s time to listen to them and act.

Umayangga Yogalingam is a recent graduate from the Master of Public Health program at the University of Toronto and is passionate about mental health, health equity, environmental health, and the impact of race, culture and ethnicity on health. In addition to being the Co-Executive Director of the YCRH, she is also the Research and Knowledge Translation Lead at The Sandbox Project.

The effect of COVID-19 on the mental health of Canadian post-secondary students

Photo by Tim Gouw on Unsplash

By Stacie Smith, (Director of Relations and Outreach, The Young Canadians Roundtable on Health)

The COVID-19 pandemic has brought on many challenges for post-secondary students. The transition to at-home learning has not been an easy one, which in turn has affected many students’ mental health. A large proportion of young people in Canada attend some form of post-secondary education, which is considered challenging even in the best of times. While many have acknowledged the struggle students are facing, there have been limited supports in place to address these issues.

Students are facing social isolation and a loss of social support. Mandatory physical distancing and reductions on social gatherings have left many students feeling disconnected from their campuses where support and services are available. A survey by the Ontario Confederation of University Faculty Associations (OCUFA), an advocacy group that represents faculty and librarians at universities across Ontario, found that COVID-19 has had a negative impact on the quality of postsecondary education. This has led to a decrease in positive mental health in these students, along with concerns that they will graduate later than anticipated, or that they will not be adequately prepared for the workforce.

A survey by The Canadian Alliance of Student Associations administered to students across Canada in May found similar results. Over 70% of respondents reported they have felt stressed, anxious, or isolated due to the pandemic. 82% reported worry about their futures beyond the pandemic. Students are reporting more stress about everything from their health to their finances and the future.

The pandemic is taking a major toll on the health and well-being of students and it will likely be exacerbated by the upcoming winter semester. With another term being completed virtually, it is important to consider how the stressors associated with the COVID-19 pandemic and social isolation will further impact these students. Now more than ever, creative solutions are needed to bridge the gap between the demand for relevant supports that help students manage the transition, and the available resources.

After hearing from many post-secondary students of their struggles with online learning, I knew there was a gap to fill. I also felt that many post-secondary students are struggling to access mental health support from home with many institutions being online this year. I wanted that peer-to-peer connection to stay intact while being physically apart.

The COVID-19 Student Support Network was created to support the current mental health needs of post-secondary students in Canada. Designed using lived experience during the pandemic, this virtual, peer-to-peer support model helps students struggling with virtual education. Our mission is to promote the mental health and wellbeing of post-secondary students across the country, and to help ensure adequate supports are available for their use. Our vision is to give post-secondary students across the country the opportunity to support one another through the COVID-19 pandemic.

The COVID-19 Student Support Network provides post-secondary students in Canada with space to share their thoughts and feelings about their post-secondary experience during the pandemic, access mental health resources, and find volunteer opportunities. Our combination of peer-to-peer social support and digital platforms allows for an efficient and scalable means to provide support to students struggling with the transition to virtual education.

For more information on the COVID-19 Student Support Network or to sign up for the support network, visit https://www.covid19mentalhealthawareness.com/ 

Stacie is the founder of the COVID-19 Student Support Network and the Director of Relations and Outreach for the YCRH. She is a recent graduate from Dalhousie University's Kinesiology program.

The YCRH Blog: Three Meaningful Ways to Increase Youth Engagement

Photo by Priscilla Du Preez on Unsplash

A Guide for Public and Private Sector Organizations 

By Mobeen Lalani, (Member, The Young Canadians Roundtable on Health)

Traditional forms of youth engagement have limited youth to be members of society who need to be guided, controlled, and told how to live a more “positive” lifestyle. Through tokenized and invitational forms of engagement, youth voices have been limited to what governments, organizations, or companies want to hear, rather than truly working to understand the reality. These forms of youth engagement have disengaged and disconnected youth, making them feel powerless, voiceless, and incapable of contributing as active citizens to the communities in which they live. Furthermore, institutional barriers including social inequality and a lack of access to education have dramatic impacts on youth’s quality of life, which in return have downstream impacts which include limited access to opportunities for youth, and ultimately, limited ability to be active members of society. 

Over the past few years, there has been a shift – a generational shift in how youth participate in civil engagement and voice their concerns. With the advancement of technology and innovation, youth have taken participatory action into their own hands. Starting a hashtag, creating a Twitter thread, speaking at poetry slams, and boycotting products are examples of ways through which youth have attempted to amplify their voices and be a part of youth-led movements. 

With a strong sense of disconnect between youth and governments and organizations, where youth feel unheard and misunderstood, they have sought unique ways of engaging themselves in matters that mean the most to them. Through podcasts, video and audio production, visual art, among others, to organize community outreach and participate in lifestyle politics, youth have attempted to disrupt traditional forms of engagement which has limited their participation. The impact seen over the past few years has motivated youth to challenge the traditional models of engagement and ask for equal distribution of power at decision-making tables. 

With youth-led innovation growing and speaking for itself, private and public sector organizations must shift their priorities to increase youth engagement and governance within their structures. If the objectives of organizations are to speak to youth needs, then youth must be at the forefront of guiding the policies and programs proposed by the organizations.

This post shares three meaningful ways through which public and private sector organizations can work with youth and support a “for the youth, by the youth” approach, instead of continuing to work on behalf of youth. These include:

1. Organizations should have youth governance models integrated within their decision-making platforms. This starts when organizational culture, values, and bylaws support youth and their engagement within their institutions. Recognizing young people’s right to participate in decisions that impact them is one way towards a path to allyship. 

2. Youth must be engaged in both evaluations and research practices within organizations. Organizations can practice youth integration by keeping up-to-date with regular feedback from those that they serve and addressing the challenges that may arise. Having youth lead the evaluation processes of programs and policies is one way to involve youth in making quality decisions for their communities. 

   This is also a way to build capacity within organizations. By providing youth with the resources, mentorships, and support systems to leverage their own skillsets, this can lead to strengthened organizational hiring and recruiting processes. 

3. Integrate a “youth-led innovation” incubator or sandbox within your own organization. Youth face many issues in leveraging their own ideas due to the absence of support systems and resources, whether it be networks and connections, monetary resources, or project management. Your organization can support the development of youth-led innovations to boost impact and build on youth allyship. 

   This is a forward-thinking approach to build on your own organization’s goals and objectives, while also supporting youth-innovation.

Youth are the decision-makers of the future. They will be individuals who will guide, support, and take the organization to the next level. Disengaging with them is a direct miss. 

If it is for the youth, it should be guided by the youth. 

Mobeen is a member of the YCRH and a Youth Leader on the #WeCANforKids Core Engagement team with the CIHR, UNICEF Canada, Pediatrics Chairs of Canada, and Children’s Healthcare Canada. He is a Founder and Consultant with Emerging Youth Consultancy (EYC). EYC focuses on increasing inclusion of youth and young adults on decision-making tables, which work to serve them. To learn more about EYC, follow @YouthEmerging on Twitter, Instagram, and Facebook or email emergingyouthconsult@gmail.com.

The YCRH Blog: Autism in a Pandemic

A Spectrum of Complications

Interview with an ASD Personal Support Worker

By Nik Jelicic, (Member, The Young Canadians Roundtable on Health)

Even on good, “normal” days, life with Autism Spectrum Disorder (ASD) can be a challenge. For youth with ASD, sudden or unplanned changes - be it a sudden change in the weather or having a different brand of juice box than their usual go-to for lunch - can lead to debilitating confusion, distress, irritation, and even trauma. For lower-functioning children, transitioning from performing one activity to another without proper priming, communication, and strategy can significantly undermine their day.

Within the span of mere weeks, COVID-19 took away outdoor activities, social engagement, and learning opportunities heavily relied upon by children with ASD and their families. In some lucky cases, virtual offerings replaced this programming, although their effectiveness likely cannot compete with the real deal. There is no doubt that the swift and widespread sociological transitions experienced by the entire planet have thrown a pandemic-sized wrench in the routine-based and often meticulously-planned daily lives of youth with ASD, whose wellbeing already lies in a delicate balance.

In the best cases, youth affected by ASD understand the bases of new COVID-related policies and respect the concept of a worldwide pandemic. They may transition from in-person to online schooling with some success, continue to develop social skills through interactions limited to family members only, and persevere through this unparalleled chapter of history. In other cases, youth may be unable to grasp the reasons for what may feel like a prolonged detention or punishment. These children may become increasingly irritated and aggressive with limited time outdoors, rendering a safety risk to themselves and others. Regardless, COVID-19 has placed a far more taxing burden on this population and their families than that placed on typically-developing youth.

As a consequence, with group services and respite programs being moved online or completely repealed, demands have increased for personal support workers (PSWs). These individuals, who are often required to “bubble” with their client and respective family rather than their own, care for youth with ASD on a one-on-one basis for days or weeks at a time. This allows family members to refocus attention to their work, tending to other children, and other responsibilities.

I interviewed Annie Douglas, an experienced ASD youth personal service worker, over the phone. We discussed some of her experiences working with youth and families during the COVID-19 pandemic:

For those who don’t know, what exactly are the responsibilities of a PSW for youth with ASD? What would a day on the job look like?

Generally, PSWs dedicate their time to providing hands-on direct care for anyone that might need it. As a PSW, your job can consist of a strict regimen of various healthcare and personal hygiene tasks to keep your client healthy and functioning. Or, it can really just be a supervisory or companionship role for clients who are relatively independent but require more assistance than what can be provided by public services or daycares. Since autism is such a diverse spectrum, no two PSW jobs for clients with ASD will look the same.

This summer, I worked with John [true name and identity retained to maintain confidentiality], a young man whose symptoms place him somewhere around the middle of the spectrum. He was relatively verbal, was very energetic, and I quickly found out he had a fascination for trains and buses. His parents wanted someone around to keep him calm and safe while completing his daily tasks since his excitement often led to loud yelling, running, and sometimes aggressive head-pumping. His parents were great and they gave him a checklist with daily chores to complete, so I’d try to fill any gaps with excursions or other engaging programming based on his attitudes that day and how much sleep he had the night before.

How would you describe your time as a personal care worker this summer relative to other experiences in such placements outside of a worldwide pandemic?

At first while restrictions were pretty intense, it was definitely an adjustment. John understood that it was unsafe to go out in public but would get really concerned and agitated when his mom would leave to go to her office downtown. It took him a bit of time every day to calm down after his mom left, and then things would be pretty normal. I couldn’t take him on any excursions around town and he was getting more aggressive the more we were cooped up at home. I tried some train-related crafts that took up some time.

Once restrictions were slightly lifted, about a month into working with him, we went to his favourite train station and we hung out there for a few hours making sure to obey distancing regulations and wear masks. His mood immediately lifted and from then on, we went outside every day which helped a lot. His weekly group social skills lessons have been cancelled, which was a big blow since they were really valuable, and he especially benefitted from the - albeit forced – social interactions with his peers

In terms of my bubbling, John and his family were my bubble, so when I wasn’t with them I was isolating for most of the summer, which was really tough. Last month things got a bit more relaxed so I could see my family and some close friends.

Like you mentioned, programs are getting cancelled. Do you think more families are looking for personal care workers this year than previously?

Definitely. I actually had four families that I knew previously reach out to me within a span of eight days this spring asking for me to be a PSW for their children after their different planned programming had been cancelled. Since it’s a full-time commitment, I only took on the first family that asked me. Families really rely on governmentally-funded programs for their children, and most, if not all, programs were halted in their tracks.

Things were looking kind of desperate for a bit right after COVID hit Canada. Since these families need more than just babysitters, not only did the cancellation or postponement of these programs prevent them from being able to work, but it also increased the cost of child care. From what I know, 3 of the 4 families ended up finding a PSW, while the father of the other child had to take an official leave from work since there was no one in their area able to provide the care they needed.

How would you suggest someone interested in getting involved with youth with ASD does so during this pandemic?

In Ontario, becoming a PSW requires a college certificate, so there’s less of short-term option. But if people are interested in caring for ASD clients specifically, many families and programs don’t require you to have a diploma. In fact, I got most of my experience caring for children with ASD without my PSW certificate. There are many ASD-specific certifications including Applied Behaviour Analysis (ABA) and Crisis Prevention Intervention (CPI) that are generally enough to get your foot in the door, along with some experience working with vulnerable populations.

Ms. Douglas ended the conversation noting that although PSWs are in demand now, resources for families impacted by ASD in Ontario had major gaps in both availability and accessibility long before the COVID-19 pandemic.

Nik is a senior at Dalhousie University, and will be completing his Hons.B.Sc in Kinesiology in 2021. He is involved in the Autism Canada community, having worked full time as a respite worker at the Geneva Center for Autism, and volunteering for numerous Special Olympics organizations. Nik aspires to be attend medical school in the future.

The YCRH Blog: Environmental Injustice in Canada

Photo taken from https://globalnews.ca/news/6744430/ellen-page-environmental-racism-documentary-netflix/

Canada’s long history of racism is still affecting youth today

By Kathleen Dolan (Member, The Young Canadians Roundtable on Health)

Environmental racism is a term that may be unfamiliar to many Canadians. However, for others, it remains an issue that they have dealt with their entire lives. Environmental racism refers to the disproportionate exposure of hazardous waste sites to marginalized neighbourhoods. Racial and ethnic background, along with socioeconomic status, play an important component for those affected by this injustice. Environmental racism also includes racial discrimination that takes place when creating environmental policies. Consequently, the heavy exposure from toxic waste, garbage dumps, and other air, water, or soil pollutants lead to many adverse and preventable health issues.

Before we can understand why there is such a prevalence of environmental racism in Canada, we must consider the long and brutal history that predominantly Black and Indigenous communities have faced. Throughout history, marginalized populations have been displaced, relocated, and discriminated against by a lack of environmental regulation and policy. In many instances, corporations are manufacturing products close to lower socioeconomic and minority communities and releasing their toxic by-products into the surrounding environment. You may be surprised to hear that provinces as small as Nova Scotia have had long-term problems, dating back decades when considering environmental inequity. 

A map of Nova Scotian communities affected by environmental racism from the documentary “There’s Something in the Water” directed by Ellen Page, originally written by Ingrid Waldron. https://www.halifaxexaminer.ca/environment/ellen-page-the-more-we-filmed-the-more-incredible-women-we-met/

The youth of these communities are particularly at risk due to their extreme vulnerability to these hazardous materials. As fetuses and children are still growing and going through critical developmental stages, environmental toxin exposure leads to much higher disease, disability, and death rates. Children are unique as they breathe more air, eat more, and drink more water per body weight than adults, making them more likely to consume higher levels of environmental contaminants. Their bodies are also unable to break down and filter out pollutants, leading to higher rates of health issues such as asthma, heavy metal poisoning, and obesity. As they are still young, long-term exposure allows these toxins to build up in the body, resulting in adverse health conditions in adolescence and adulthood. The exposure to compounds such as methyl mercury, furans, dioxin, and other harsh elements may even lead to premature death. The Canadian Pediatric Society has excellent resources for monitoring a child’s development to ensure that children are reaching milestones and identifying whether there may be any concerns.

The Asubpeeschoseewagong Netum Anishinabek, also known as the Grassy Narrows First Nations community in Ontario, has experienced some of the worst environmental racism in Canadian history. In the 1960s, a chlor-alkali plant dumped 10,000 kilograms of mercury into the waters of this community, having cascading effects to this day. This environmental contamination devastated and destroyed the town, which had strong cultural and economic ties with this body of water. Children and adults have been recorded as having higher mercury rates in their bodies, affecting neurological and immune development in children. The mercury contamination has caused health issues such as numbness, coordination problems, loss of vision, learning disabilities, and anxiety in the Grassy Narrows children. After authorities abandoned this community and attempted to hide this disaster from the rest of the country, the youth are fighting back for environmental justice. They are fighting for what they deserve, to restore their cultural identity, and pave a healthy path for future generations of the community. 

Chemical Valley is another example of environmental racism. It is a moniker for the Sarnia-Windsor-London area in Ontario. The name is as haunting and accurate as it sounds. Home to the Aamjiwnaang First Nations, it also houses 62 industrial facilities within a 25-kilometre radius and releases millions of kilograms of toxic chemicals into the environment, some of which are banned in Canada. For children living on the reserve, 23 percent aged 5 to 16 struggle with learning and behavioural problems, 13 percent struggles with ADHD, and 27 percent suffer from skin rashes (including eczema and psoriasis). All of these incident rates remain well above national averages for Canadian children, making it hard to deny that excessive pollution and toxins in their environment play a key role.

Furthermore, community members and many researchers have also discovered that male birth rates have declined. The human sex ratio can be altered when populations are exposed to certain toxin chemicals. In this community, males are born at lower rates, and women experience more male fetus miscarriage. When male children are born, they are affected at higher rates by developmental issues and disabilities. The cultural life of the Aamjiwnaang people, including fishing, hunting, medicine gathering and ceremony, has been impacted by these environmental pollutants. The children live in a world of fear—scared to go outside, scared of hearing warning sirens, and scared of unreported chemical spills.

Unfortunately, the Grassy Narrows and Aamjiwnaang First Nations are only a small fraction of the many communities suffering from environmental injustice. There remain 61 long-term water advisories on Canadian reserves. That number does not even begin to include toxins that stay in the soil and air of these communities, nor does it account for predominantly Black, Indigenous off-reserve lower socio-economic districts across this country. We must begin to treat this like the crisis that it is. The health of Canadian youth--our future leaders--is at stake.

To learn more about environmental racism, visit the following links to access an interactive mapping of environmental racism in Nova Scotia, along with information about the communities affected.

• https://www.arcgis.com/apps/MapJournal/index.html?appid=06f534a113644200afa6b49e572299a9

• http://www.arcgis.com/home/webmap/viewer.html?webmap=d12d5f8cc46f40e5918f6072ab0e4d7c&extent=-63.6247,45.1665,-62.6105,45.5669

Kathleen Dolan is a 19-year-old outdoor enthusiast in the Bachelor of Arts and Science in Health at St. Francis Xavier University in Nova Scotia. She is passionate about advocating for environmental awareness, and health equity and resources amongst youth who may be from vulnerable communities or whose voices are yet to be heard.

The YCRH Blog: Greener on the other side – inequitable access to green spaces impacts children’s health

By Umayangga Yogalingam (Co-Executive Director, The Young Canadians Roundtable on Health)

Restrictions under the COVID-19 pandemic are forcing more and more Canadians to discover the public green spaces in their neighbourhoods, cities and beyond. Green spaces are areas with vegetation that is specifically for aesthetic and/or recreational purposes and include parks, gardens, public facilities, and ecological reserves. Green spaces can offer a sense of respite from the newfound stressors associated with school and community centre closures, social isolation and the tedium of being stuck at home, mitigating the pandemic’s negative impact on health and quality of life. For children especially, green spaces can be a blessing as it is a space to engage in physical activity and access learning related to nature and the environment, all while maintaining physical distancing.

The link between green spaces and positive health has been well-established. Increased access to green spaces has been associated with decreased risk of death from common illnesses such as heart diseases, diabetes, and respiratory illnesses, according to a national cohort study in The Lancet. The pathways through which green spaces impact children’s health are numerous. Green spaces enhance physical activity which is a protective factor against the development of illnesses in childhood such as obesity, diabetes and cancer. In urban settings, green spaces can mitigate air pollution, noise and heat, all of which can lead to adverse, long-term health consequences especially during fetal growth and childhood. Green spaces can also improve immunological functioning due to exposure to beneficial microbiota.

A review in the Journal of Pediatric Nursing has highlighted a body of research that shows how green spaces can positively impact mental health, reduce behavioural problems and improve academic performance within children. Specifically, it can lead to improved mental well-being, positive behaviours, improved attention deficit hyperactivity disorder (ADHD) symptoms, and better standardized test scores. It can also protect against high stress levels, depression, and mood disorders via increased physical activity, increased social contact and the change in environment that green spaces provide.

However, not all those who live in Canada are able to reap the benefits of high-quality green spaces. According to Statistics Canada’s 2017 Households and Environment Survey, Canadian households (85%) indicated that there is a park ten-minutes away from their home. However, there are many factors that impact access to these green spaces including walkability, availability of play facilities, perceived safety, and aesthetics. Several studies have shown that individuals and families with higher income and higher education levels are more likely to have greater access to high-quality green spaces. As such, wealthier neighbourhoods are more likely to benefit from green spaces in comparison to underserved neighbourhoods.

Inequities in access to green spaces have been reinforced during the COVID-19 pandemic. The pandemic saw the closure or the restricted use of green spaces, namely parks and play facilities, in Canada. For many low-to medium-income households and may be unable to leave cities to access nature, parks offer a way to access green space and its benefits. The lack of access to green spaces further limits the options of activities that underserved populations can engage in during the pandemic, exacerbating stressors and other inequities these populations may already be experiencing.

Unsurprisingly, studies have found correlations between children who have limited access to green spaces and poor health outcomes such as increased risk for neurodevelopmental disorders such as ADHD, and behavioural problems such as aggressive behaviour and conduct problems. Impacts on health include increased sedentary behaviour due to lack of spaces to engage in moderate-to-vigorous physical activity, higher blood pressure, and increased risk of developing psychiatric disorders.

The COVID-19 pandemic has highlighted the importance of green space for children’s health and broader public health. As Canada slowly loosens restrictions, observations and data collected on green space use during the pandemic can be used to equitably invest in green spaces. It is important to apply an equity lens and actively engage community members, families, children and youth across all populations in planning, implementing and enhancing green spaces. High-quality green spaces can serve as an upstream, preventative measure against many negative health outcomes, especially among children. As such, the importance of investing in green spaces must not be understated.

Umayangga Yogalingam is a recent graduate from the Master of Public Health program at the University of Toronto and is passionate about mental health, health equity, environmental health, and the impact of race, culture and ethnicity on health. In addition to being the Executive Director of the YCRH, she is also the Research and Knowledge Translation Lead at The Sandbox Project.

The YCRH Blog: Child and youth well-being during the COVID-19 pandemic

By Stacie Smith (Director of Relations and Outreach, Young Canadians Roundtable on Health)      

The COVID-19 pandemic has had a major impact on many people’s lives, especially children and youth. There are many uncertainties for them, such as wondering when they might be able to play with their friends again and what the upcoming school year may look like. Their fears and worries are just as important as anyone else’s and need to be remembered during this time of uncertainty.

Every single child in Canada deserves the best start in life, no matter where they live in the country. There can be long-term mental health effects of the closures and distancing measures, especially in infants and toddlers who have had their day-to-day routines disrupted and changed. One way of keeping things normal is to always have structured days with regular mealtimes and bedtimes, as they are an essential part of keeping kids happy and healthy. Planning daily walks can be a good way to create structure and ensure physical activity. Overall, children do better when their activities are predictable and therefore, whenever possible, inform them about any change in routine ahead of time.

Kids feel inspired when they know what to do to keep themselves safe. It is always a great step to let children make their own decisions when it comes to staying safe and healthy. It gives them a sense of pride that they made a decision that kept them protected within their limits. Teaching kids that staying healthy and having good hygiene habits can help them stay strong and well. It’s also necessary to set limits. For example, some may need structured and unstructured time, as well as supervised and unsupervised time.

With the most recent release of the ParticipACTION Report Card giving a grade of D+ to Canadian Youth for Physical Activity, it is more important than ever to ensure children are getting enough physical activity during a time when children are not playing with their friends or getting outside as often. We can still do everything we can to ensure our families’ bodies and minds are strong, their moods are boosted and energy levels are prime. ParticipACTION has some great resources to keep everyone moving.

There have also been many questions about how thousands of children who rely on food programs will be able to access those critical meals safely. For example, the Government of Nova Scotia funds school healthy eating and breakfast programs, but some fall short of meeting the needs of students and they rely too heavily on support from volunteers to deliver them.

Since classes ended early in March, Feed Nova Scotia has been delivering meals to students who would normally get them at school through its annual After the Bell program. This year, it received more than 9,000 food packages for kids. It is still unclear how school food programs will look this fall, but there are many factors at play when considering what changes need to be made.

There will need to be changes to communal eating spaces to accommodate for physical distancing, personal protective equipment provided to those who serve food to students, as well as how to best prepare food that may not be prepackaged.

It will become very important to keep children safe and comfortable when coming back together in childcare settings, summer camps, on the playground, and ultimately, back to school this coming fall. While most provincial governments have released their reopening guidelines for schools this fall, Nova Scotia has not. They have indicated that they want to take their time, but many parents and other government parties are calling on the government to provide a plan sooner rather than later. Kids are already worried about what the fall will look like; it doesn’t make sense to make them worry longer than needed.

Stacie Smith is a recent Kinesiology graduate from Saint John, New Brunswick and the founder of the COVID-19 PSE Support Network. She is also the Vice President of the Kinesiology Association of Nova Scotia. She was the recipient of the PHE Canada Student Leadership Award in 2018-2019 for her leadership role in the School of Health & Human Performance.