Talking mental health with Queen’s Bell Canada Chair

Heather Stuart reflects on how the conversation around mental health has changed since the start of Bell Let’s Talk Day and previews where her research is going next. 

For more than 10 years, Bell Let’s Talk Day has been putting a spotlight on mental health in Canada. As Bell Canada Chair in Mental Health and Anti-Stigma Research since 2012, Queen’s professor Heather Stuart has had a unique vantage point to see how the conversation has evolved since the annual day began. She’s also conducted significant research that continues to change understandings of mental health and influence approaches to stigma in workplaces, healthcare settings, and other areas of Canadian society.

Leading up to this year’s Bell Let’s Talk Day on Jan. 25, the Queen’s Gazette connected with Dr. Stuart to learn about her current research projects, hear her insights on the current state of mental health in the country, and find out how far Canada still has to go to recover from the psychological toll of the pandemic.

Now that Canada is gradually moving out of the COVID-19 pandemic, people are increasingly able to resume activities they had to give up. But there’s also a keen awareness of the toll that the past few years have taken. How would you characterize the state of mental health in Canada at this moment?

The pandemic really did cause a lot of distress to people. Mental Health Research Canada has been conducting population polls since the beginning of the pandemic, and they are monitoring things like frequency of symptoms of depression and anxiety. Before the pandemic, about seven per cent of people reported feeling symptoms of anxiety. That went up to 23 per cent during the pandemic. That’s a huge increase. In the most recent poll, it’s back down to 11 per cent of people. So it’s coming back to normal, but isn’t quite there yet. Since the pandemic, it seems to be easier for people to talk about mental health issues and have conversations around anxiety and burnout. Especially since many of us know someone who has been struggling, maybe even ourselves.

On the Bell Let’s Talk website, there are statistics related to several common mental health topics. Among them is a statistic saying opioid overdoses increased by a shocking 90 per cent during the pandemic. Is more attention being paid in recent years to potential connections between addictions and mental health?

There’s more recognition now that there’s a high degree of overlap between mental illnesses and substance use disorders. You can’t treat one in isolation of the other for a large proportion of clients. You have to treat them both together, but we used to treat them quite separately in separate systems. What you’re starting to see now is organizations integrating their services. In Kingston, for example, we have the Integrated Care Hub on Montreal Street, which provides wraparound care. That means they’ll help with everything somebody needs, including connecting them with mental health services, if that’s what they want to do.

As the Bell Canada Chair in Mental Health and Anti-Stigma Research, you work on a range of important topics relevant to Let’s Talk Day and with a variety of prominent organizations promoting mental health. What is your research most focused on currently?

I’ve got a number of different projects on the go related to stigma. In every case, I’m working with an agency or organization outside of Queen’s and doing work with real-world applications.

With the Mental Health Commission of Canada, I’m doing some work on structural stigma in healthcare settings. By structural stigma, I mean the policies and practices of an organization that embed inequities for people with mental health problems.

I’m also analyzing the data from a national survey of people who have experienced stigma because of a mental health or substance use disorder. We’re hoping we can administer the survey every five years or so to use it as a monitoring system to see if progress is being made.

I’m working with the World Psychiatric Association to provide webinars on how to reduce stigma. We used to have in-person conferences on this topic every two years, but we found during the pandemic that we could attract a wider audience with online sessions, particularly from people in low- or middle-income countries.

With an organization called Workplace Strategies for Mental Health, I’ve worked to review a survey they provide to employers looking to improve mental health for their employees. We revised the questions to make them more accessible and easier to understand, then tested them and found the new versions worked very well. The revised survey has been adopted and will be used by employers across Canada.

Bell Let’s Talk Day has been recognized for more than ten years now. How have things changed since it began, for both the day and conversations about mental health in general?

In the early days, the point was to start a conversation – because there weren’t many conversations about mental health going on. Now, the conversation is well underway, and we can see that through how much interaction there is with Bell Let’s Talk Day each year. This year, Bell is focusing more on statistics and challenging us to improve mental health systems and increase access to care. It’s a big change, but I think it’s a natural progression from where we were ten years ago.

Bell has also supported the creation of two voluntary standards. One pertains to mental health in the workplace and the other to mental health in postsecondary institutions. Increasingly, this is provoking organizations to think more seriously about mental health. At Queen’s, for example, we’ve signed onto the Okanagan Charter, which lays out a path for promoting health and wellness, including mental health.

In recent years, there’s been an explosion of digital applications to support mental health and help people with self-care related to mental illness. On the positive side, now people don’t have to wait in line to get some help. They can even use online screening scales and programs to understand whether they need help, or how much and what kind. The downside is that a lot of these programs have not been evaluated yet, so we don’t know for sure how well they work. Some may work very well, but some others might not or could even be doing harm. So many digital programs have come out so fast that we’ll have to wait for the research to catch up.

Note: This article originally appeared in the Queen's Gazette.