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In Conversation with Pamela Magee, Executive Director of the Canadian Mental Health Association NS Division

How would you describe the state of the mental health services in HRM and more broadly speaking, in Nova Scotia?

There is a lot of fragmentation in our formal health care system that needs to be addressed and supported as a province. The issue is not unique to HRM. In some ways, we share more coming out of HRM because of the volume of care sites and population size. But the lack of services and support that we see in the formal health care system in HRM is actually double to quadruple in rural areas of Nova Scotia.

What do you think needs to change so that we can improve the quality of mental health services in Nova Scotia?

The government has taken steps to create change by unifying health care across the province. But our healthcare system is too slow; we need to be more responsive. There are other methods and approaches that we can use to better our health system. In provinces that have fluid, functioning health systems and lower wait times, community actually plays a major role in the health system. The primary care model in Nova Scotia isn’t inclusive of community supports and services. Our definition of community is limited to clinicians and those trained and licensed in health care provision. I think that if we want to improve the quality of mental health services in Nova Scotia we need to expand our health system so that it is not solely reliant on clinical support.

Do you think that there is sufficient funding being put towards mental health services in Nova Scotia? 

Nova Scotia actually has the lowest percentage of funding for mental health services per capita in Canada. We don’t even meet the national standard for what should be going towards mental health and addiction services in the province. At a community level, there is no core selecting. Nova Scotia is one of two provinces in this country that does not core fund community based NGOs and the work that they do. This problem that we are facing can largely be attributed to our reliance on a traditional health model that back in the 60s was proven around the world to be ineffective. This is also when the population health approach was introduced in Canada. Nova Scotia led the way in its implementation during the late 60s to early 70s, but we seem to have fallen off that track and receded into a traditional health model of care and support. This model is very costly and one-on-one based. There are more cost effective and quality of life centered approaches that we can implement. Australia and Finland have created new models and approaches that are highly effective and keep people healthy. Nova Scotia’s current health system is built on illness; we wait for people to  become unhealthy and then we intervene. Right now we can’t even intervene. 

What sort of feedback is CMHA receiving from people across the province about the quality of our mental health services? 

Our branches receive feedback from people in their communities on a day-to-day basis. Everyone is frustrated. I personally receive numerous calls a day of people in need of support and care. People are falling through the cracks of our healthcare system as we speak. Even within emergency units, people who are struggling with their mental health are told that unless they’re immediately suicidal they will not receive any care. So there is a lot of frustration across the province, but there is also a lot of hope. 

What steps is CMHA taking to help de-stigmatize the topic of mental health or mental illness, particularly in marginalized communities? 

I think it’s beyond stigma because stigma is an educational piece, where you help people understand why and how mental health impacts us all. We all have mental health, just like we have physical health. At CMHA, that is the mantra that we live and breathe daily to help people understand that this affects all of us. It isn’t an us and them situation. We all have mental health and which means that we are all at risk based on circumstances that are sometimes within our control but a lot of the time outside our control. So if we aren’t given the right tools, techniques, and resources to keep ourselves healthy and to handle what life throws at us then we are more likely to give into our struggles. CMHA specializes in keeping healthy people healthy but also helping people that have experienced illness stay in that ideal space of health and recovery. We do try to tailor our approaches and techniques to certain groups of people. For example, at a divisional level, we have created virtual hubs with unique and tailored resources that marginalized communities are encouraged to use. Our Halifax-Dartmouth Branch yields the largest hub of the population in Nova Scotia so there is a lot of support available for a broad range of issues and individuals. The Halifax-Dartmouth Branch is always looking for tools that can meet people where they are and ways to educate members of their community support system and beyond when there are unique needs within subsets of the population. Considering the limited funding and staff that the CMHA has, I would have to say that our Halifax-Dartmouth Branch is leading this area of concern for our province. 

Do you have any advice for organizations such as Engage Nova Scotia on how they can work towards de-stigmatizing the topic of mental health in the workplace, as well as how they can help support their employees in their mental health journey?

I think that having peer care and support is key. You should also ensure that there are mechanisms and standards in place that support everybody within the organization.

How can people in the community create safe spaces for others to discuss mental health?

The CMHA website is a great starting point for learning how to create safe spaces for others to discuss mental health. Our website includes tools, literature, and resources to help people educate themselves on the topic of mental health. For example, you can learn about how to have a healthy conversation around mental health and when you should recommend support from the formal system. Communities may not be clinical in nature but they can be great navigator-support mechanisms.

Why is it important that we talk about mental health?

If we want to normalize and de-stigmatize mental health, it is crucial that we acknowledge it to the same degree as we do with physical health. This will allow us to work together to break down all the barriers to mental health care and support. It is important that we take action now because without mental health there is no health since it is connected to every other aspect of our wellbeing. So really mental health is an ecological issue, which means that we have to take an ecological approach. This involves educating people and providing them with the right tools and support to be able to navigate and function within the system. If we don’t do this, we are going to end up in a crisis. The data shows that mental health, if unsupported, can lead to various physical health issues. So when we care for our mental health we’re also caring for our physical health. 

In what ways do you think that the Nova Scotia Quality of Life Survey might be able to help organizations such as CMHA address the state of mental health in Nova Scotia? 

The Nova Scotia Quality of Life Survey and other surveys alike that have been circulating recently is bringing to our attention that youth in the province are more likely to report their mental health adequately. This is not as pervasive in other provinces, which I think is indicative of the work that’s being done within our communities to help people understand that mental health is an issue and not a disease, and that it impacts us all. If we don’t support mental health and well-being, we are going to become ill. I think that the data coming from the Nova Scotia Quality of Life Survey could help government understand the importance of mental health promotion.