Study: As Global Suicide Rates Rise, Innovative Prevention Efforts are Needed

See Author Article Here
By Sarah Sloat – video in link

The number of deaths from suicide increased by 6.7 percent globally between 1990 and 2016, a study published Thursday in The BMJ shows, making an ambitious goal to reduce suicides worldwide only seem achievable if global efforts are made now, urge the study’s researchers.

The World Health Organization’s goal to decrease global suicide mortality by one-third by 2030 is well-documented, but the latest statistics shows that suicide prevention frameworks and study are needed on a global scale.

Suicide, as a global public health concern, is more complicated than a single statistic, and trends vary substantially across countries and between groups. The complex web of factors that underlie suicide mortality can be drastically different per region.

While this study, which was produced by the Institute for Health Metrics and Evaluation, determined an overall uptick in suicides, the years of life lost globally have actually decreased when everything is averaged out.

Also, when the researchers adjusted for the age of the individuals when they died from suicide, they realized that the years of life lost rate from suicide has decreased by a third between 1990 and 2016.

These conclusions all came from analysis of data collected from the 2016 Global Burden of Disease Study, which reflects patterns of suicide mortality by age, sex, and sociodemographics across 195 countries. Overall, rates of suicides committed by men were higher than that of women across the world, save for when it came to the 15 to 19-year old age group. Suicide deaths are higher among men than women, but the ratio is much lower in the countries that stretch from southern India to China.

This map shows the suicide rate per 100,000 people.
This map shows the suicide rate per 100,000 people.
Ellicott Matthay, a University of California San Francisco postdoctoral scholar, writes that global improvements in suicide prevention are needed.

Determining the means of suicide is crucial.”
“This study … lays the groundwork for future suicide studies to incorporate such factors and inform prevention efforts,” Matthay writes. “For example, determining the means of suicide is crucial to evaluate and inform means related interventions, historically one of the most successful avenues for suicide prevention.”

Other varying trends also emerged from the data:

In Western countries, there is a strong relationship between mental illness and suicide, but that link is less pronounced in Asia.

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Some countries have exceptionally high rates — like Lesotho and Lithuania — and other countries have especially low, like Lebanon and Syria.
Suicide is the leading cause of years of life lost in the area known as “high income Asia Pacific” and is among the top 10 leading causes of death in eastern Europe, central Europe, western Europe, central Asia, Australia, southern Latin America, and high income North America.
Importantly, this analysis, like many suicide studies, lacks information about the drivers behind these suicides.

Because of the “sensitive and illegal nature of suicide” in many countries, the results could reflect issues like under-reporting and while uniform metrics are helpful in generating comparable estimates of death, it doesn’t reveal crucial insights that could perhaps prevent those deaths.

In the United States, researchers from the University of Michigan have determined that, when it came to American teenagers, one of the best ways of reducing the likelihood of teen suicide was building a circle of trusted adults around a young person at risk. On Wednesday, they published a paper in JAMA Psychiatry showing that young people — previously hospitalized for suicidal thoughts — randomly assigned to receive extra support from trained adults were more likely to survive in the future.

Whether similar approaches would work across populations and regions, remains to be seen. Suicides are preventable and public health advocates and scientists are working together to develop the strategies that can be deployed.

Partial Abstract:

Objectives — To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016.

Design — Systematic analysis. Main outcome measures — Crude and age-standardized rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education).

See abstract in full here.

Media via WHO, CDC, Unsplash / Verne Ho

Five Enlightened Ways To Think About Mental Health

See Psychology Today Article Here
By Hilary Jacobs Hendel 

It’s time to eradicate stigmas.

Life is hard even under the best of circumstances. Without physical and mental health, it’s difficult to enjoy life and to thrive. It makes good sense to take care of ourselves and that includes getting help when we suffer physically or psychologically. When we feel sick we get ourselves to the doctor. And when we feel so bad that we think about hurting ourselves or others, or when we cannot engage positively in work or in relationships, or we cannot accomplish what we want, we should seek help to feel better. That is what all of us deserve.

Mental health shouldn’t be a dirty word. Still damaging stigmas prevail allowing ignorance to end lives. Judging others or ourselves for our suffering is just plain harsh, not to mention counterproductive. When was the last time telling a depressed person to “get over it” worked? Try never! And using shame as a tactic to “encourage” someone to be what you think they should be only adds to a person’s suffering.

Mental health problems should be thought of no differently than physical health problems. In fact, they are completely related: mental health problems affect physical health and physical health problems affect mental health. We need a world where no one feels embarrassed or ashamed about their suffering. We need a world where suffering evokes only kindness, compassion, and a desire to help.

Here are 5 enlightened ways to think about mental health:

1. Everyone suffers.

I have never met anyone who is happy and calm all the time. It’s just not possible, no matter how good someone’s life looks like from the outside. Most people suffer at some point in their life from anxietydepressionaggressionPTSDshamesubstance abusedisorders, and other symptoms. And, if a person is lucky enough to never suffer psychologically, they surely love someone who does suffer in these ways. Instead of living lives of quiet desperation, to paraphrase Henry David Thoreau, let’s encourage honest talk. If someone gets uncomfortable with honest talk, we can talk about that too.

2. Mental health checkups are an important part of wellness.

Do you feel ashamed when you go for a check-up at your internist? Probably not. On the contrary, you’re likely to feel proud that you are taking care of your health. Yet most people are ashamed to call a psychotherapist for a consultation. This makes no logical sense. A mental health checkup is a great idea especially if you are suffering and not able to function the way you want. You should feel very proud for taking care of your mental health.

3. Gym for the brain.

That’s exactly how I describe therapy for my patients who come in feeling bad that they “have to come to therapy.” In our society, we praise people for working out at the gym. We think of them as maintaining their health and taking good care of themselves. Well, that’s no different for a person wanting to enhance their psychological wellbeing. Therapy grows new brain cell networks, calms the mind and body, makes it easier to meet life’s challenges, and helps us thrive as we become the best versions of our self that we can.

4. Education in emotions is a game-changer.

We live in a challenging society because it is not very nurturing. That’s why rates of anxiety, depression, and substance abuse disorder have skyrocketed. According to a new disturbing report from the CDCsuiciderates are steadily increasing. At the very least, our society could provide an accessible and understandable education on emotions. This would help us all understand how our childhood experiences translate to directly affect our adult mental health (for better and for worse). Emotion education debunks myths like “emotions are just for weak people” and we can control our suffering with “mind over matter.” Our schools should be teaching us trauma-informed tools like the Change Triangle. Our educational institutions should be teaching skills for managing relationships and interpersonal conflicts constructively so bullying, for example, would become a thing of the past. Parents should be taught about emotions so they don’t unwittingly create shame and anxiety in their children. Education on emotions and how emotions affect the brain, body, and mind depending on how we work with them, has great power to change society for the better and even reverse the current epidemic in depression, anxiety, and addictions.

5. Question assumptions, judgments, and fears around mental health and mental illness.

Many of us fear difference. When people feel, act or look different than we do, we tend to judge them. Judgment, while a form of misguided emotional protection achieved by distancing ourselves from those we fear or don’t understand, is destructive for all of us. Judgment is the basis of stigma and justifies the horrible way we treat people who suffer mental illnesses and substance abuse disorders. Judgment shames those who suffer, and that is all of us. No wonder shame-based depressions are rampant in our society. Instead of judging others for emotions and suffering, can we instead be curious about our assumptions and question where we learned to judge or fear people who struggle psychologically?

Most suffering can be eased with support, proper treatment, and a variety of resources. Let’s be proud to grow our collective and individual mental health. What a difference it makes to wholeheartedly say to someone seeking help, “Good for you! I could use some help for myself too!” Because we all can.

30 Things To Keep In Mind When You’re Struggling

See ThoughtCatalog Article Here
By Brea Johnson

No matter your age we all struggle and sometimes that struggle feels like it’ll last forever but it doesn’t. One thing that I always remember for myself is that my pain is inevitable but my staying in suffering is a choice. Let’s talk about the 30 things to remember when it feels the world is crashing around you.

1. I always say this, ITS OKAY NOT TO BE OKAY. Don’t guilt yourself for how you feel, it’s valid. You have no issues accepting yourself in a happy space, the dark spaces are a part of you too. Embrace it little by little (I can discuss how in another post, no worries).

2. Eat, this really just popped in my head. I have a tendency to forget to eat when I’m upset but it only makes things worse. Your body needs fuel and when you neglect that, it only worsens your mental space.

3. Don’t decide for your friends or loved ones that they can’t handle you. There are going to be people you hold dear that don’t understand or can’t provide support but don’t judge everyone because of that one person. People will surprise you and let’s be real you need the support in this time.

4. Don’t isolate. This means avoiding calls, text, and all contact. Inevitably it makes you feel more alone. Let people in.

5. Your family loving you counts, don’t count them out because they’re family. I can remember saying to my mom “you have to love me I’m your child”, but I’ve learned through my Mental Health practice…. that’s not so true.

6. There is something to be grateful for, even if it’s as small as the warmth your covers give you. Try to say one thing a day you’re grateful for it goes a long way.

7. Having a day where you stay in bed and watch your favorite show is okay. It doesn’t mean you are less than, it just means you need a day. Take it.

8. Self-sabotage is real when you’re feeling sad. We as people want to prove ourselves right that we aren’t good enough or that person doesn’t love us. Learn to recognize any self-sabotaging behavior you possess.

9. You’ve got something special to offer the world, I know it sounds corny but in suffering we don’t see ourselves as we truly are. Don’t let this time of suffering take that away from you, instead let it help you grow more into the person you’re meant to be.

10. You’ll find your way back to yourself but understand it’ll take the 3 p’s, patience, persistence, and pain (acceptance of).

11. That heartbreaking thing that person said to you a long time ago or yesterday doesn’t have to be your reality. You decide always who you are, some contribute but you’re the CEO that approves the message.

12. Avoiding pain only makes it come back stronger. The sooner you learn to process pain the sooner you’ll be able to navigate it and let it teach you something.

13. Drinking or using drugs will not make it better. Alcohol is a depressant that should tell you enough and drugs will mask it and act like it’s gone but come knocking on your door at 2am asking where you’ve been. I’m not against a wine night with your friends and crying it out BUT every day no, no, and no.

14. Put your favorite song on and dance it out. Studies suggest moving the body is good for those that suffer from anxiety, depression, etc. LOL I’m such a “studies suggest” person…bear with me.

15. Crying is not for the weak, holding all that in can be damaging let it out.

16. When you feel somewhat ready, identify why you’re suffering.

17. You know it was coming…. seek out therapy. Talking to someone that is non-judgmental can be refreshing.

18. You are stronger than you’re giving yourself credit for.

19. It’s okay to feel wronged and disappointed, we just can’t stay in that space, love…It at times can breed self-loathing and that’s not you.

20. If you have children it’s okay to let them see you be a human. I’m not suggesting breaking things and so on but it’s okay to let them know mommy’s going through a hard time but she’ll be okay. Kids can be the best comforters by just giving you a hug

21. You matter, simple.

22. Getting creative can help to express the pain you’re unable to put in words. Grab a paintbrush or some clay.

23. Someday you’ll look at this period of time in your life and wonder how you got through it AND you’ll be proud of yourself.

24. No one person is worth you staying in suffering unless you deem it so.

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25. You’re in control, don’t forget.

26. There’s a light at the end of the tunnel but you gotta walk towards it; it’s not coming to you.

27. Learning radical acceptance will change your life.

28. Did I mention you matter and you have something to offer the universe? okay cool.

29. I’m rooting for you. Sending positive vibes your way always.

30. CHIN UP!

35 Quotes For Introverts

See ThoughtCatalog Article Here
By Christopher Hudspeth
*click link for all 35 quotes

Oregon Lawmaker Seeks $2 Million For Mental Health Centers

See Author Article Here
By Elliot Njus

The Oregon Senate’s Housing Committee advanced a bill that would enact a statewide rent control policy and restrict evictions, sending it to the full Senate for a vote.

Lawmakers heard nearly four hours of testimony from renters and landlords as Senate Bill 608 had its first hearing in the Senate’s Housing Committee. It’s poised to cruise through the Legislature, with support from leaders of the Democratic majority in both the House and Senate.

Oregon lawmakers propose unorthodox approach to rent control

Oregon lawmakers propose unorthodox approach to rent control

Their proposal attempts to sidestep longstanding criticism of the polarizing policy, but it’s also drawn some misgivings from rent control supporters.

Two landlord groups, the Rental Housing Alliance Oregon and the Oregon Rental Housing Association, are both remaining neutral, with their leaders saying the bill is palatable, if not appealing.

That’s a relatively friendly position for their constituency – both statewide advocacy groups geared toward small landlords.

“There’s a lot here for landlords to dislike,” said Jim Straub, the legislative director for the Oregon Rental Housing Association. “But I’d also like to recognize it for what it isn’t: an industry killer. As written, I do not believe it will be catastrophic to our livelihood.”

The larger Multifamily NW, whose Portland-area membership includes larger landlords and property management companies, opposes the bill, as did many landlords who testified on their own behalf. They argued it would hurt business and discourage investment, resulting in substandard housing.

They pointed to a large body of academic research that’s found rent control policies in other states have resulted in a reduced housing supply and higher rents.

“At best, Senate Bill 608 will have no effect,” said Deborah Imse, the executive director of Multifamily NW, “but at worst it will make housing less affordable in the long run.”

Renters and tenants’ rights activists largely argued the bill would help protect against eye-popping rent increases that have frequently grabbed headlines across the state.

“It doesn’t solve the entire problem,” said Katrina Holland, the executive director of the Community Alliance of Tenants. “It certainly does take a giant leap forward by giving a measure of predictability for hundreds of thousands of renters in hundreds of cities across the state.”

Senate Republicans on Monday released statements in opposition to the proposal.

The bill would cap annual rent increases to 7 percent plus inflation throughout the state — a rate that’s much higher than most municipal rent control policies in other states. In many California communities with rent control, for example, affected apartments see their rents climb only by the rate of inflation, or a fraction of it, each year. (Annual increases in the Consumer Price Index, a measure of inflation, for western states has ranged from just under 1 percent to 3.6 percent over the past five years.)

The rent increase restrictions would exempt new construction for 15 years, and landlords would be free to raise rent without any cap if a renter left of their own accord. Subsidized rent would also be exempt.

The bill also would require most landlords to cite a cause, such as failure to pay rent or other lease violation, when evicting renters after the first year of tenancy.

Some “landlord-based” for-cause evictions would be allowed, including the landlord moving in or a major renovation. In those cases, landlords would have to provide 90 days’ notice and pay one month’s rent to the tenant, though landlords with four or fewer units would be exempt from the payment.

The bill would not lift the state ban on cities implementing their own, more restrictive rent control policies.

Sen. Fred Girod, R-Stayton, the ranking Republican on the Senate Housing Committee, said Senate Democrats flatly rejected a suite of amendments, including the removal of an emergency clause. With the clause, the bill would take effect when it’s signed by the governor; if passed without it, the bill would take effect next year. Girod abruptly left the hearing after it became clear the amendments would not pass.

Sen. Tim Knopp, R-Bend, the only Republican remaining after Girod left, cast the lone “no” vote.

“We’re making policy that ultimately going to be counterproductive to hat all the people who testified said they actually want,” Knopp said.

Sen. Shemia Fagan, D-Portland, who chairs the housing committee, said she shared concerns from people who testified it doesn’t go far enough.

“I wish this bill would do more, and I would be willing to go further,” she said.

— Elliot Njus

Why Mental Illness Is Surging Even In The World’s Happiest Countries

See Author Article Here

In recent decades, economists studying life satisfaction have noticed a pattern – one that is remarkably persistent across different countries and cultures. Most people’s happiness levels begin dipping in adulthood, bottoming out when they reach their forties and fifties, before rising again.

This link between age and life satisfaction is known as the happiness curve. For discontented Generation Xers, it may provide relief to know that the midlife crisis is real but temporary, and that things will most likely get better. Young people might think rather differently, however. Could they feel any worse?

In both the US and the UK there has been a disquieting rise in depression, anxiety and other forms of distress among young people. Last April, a survey of more than 2,000 Britons aged 16-25 conducted by the youth charity the Prince’s Trust found that half had experienced a mental health problem, one in four said they felt “hopeless” and almost half felt they could not cope well with setbacks in life. The number of students dropping out of British universities because of mental health problems, and the number of campus suicides, have reached record highs. Similarly, a 2017 survey of 63,500 US college students found that 39 per cent had felt “so depressed it was difficult to function”. Between 2008 and 2015, the number of hospitalisations of suicidal teens doubled in America.

There are many economic and structural reasons why American and British teens might be struggling to cope. Inequality is rising, social mobility is stalling, competition for high-ranking universities and well-paid jobs is becoming fiercer. Yet this remains an insufficient explanation.

Last year, the Nordic Council of Ministers, an inter-parliamentary group comprised of representatives from Denmark, Finland, Iceland, Norway, Sweden, as well as several autonomous islands, released a report titled In the Shadow of Happiness. The Nordic countries consistently top the United Nations’ world happiness rankings, which is often attributed to their egalitarianism, extensive welfare states and work-life balance. But the Council wanted to examine a population that is overlooked in glowing UN reports: in the happiest countries in the world, who is sad?

It transpired that the populations most likely to be suffering or struggling emotionally were the very old (those over 80) and the young. The report found that 13.5 per cent of 18- to 23-year-olds in the Nordic states rated their life satisfaction as less than six out of ten, which means they are either struggling or suffering. The primary cause of this discontent, the authors concluded, was the rising rate of youth mental illness. In Norway, the number of young people seeking help for mental illness increased 40 per cent in five years. In Finland, named the happiest country in the world for 2018, suicide is responsible for a third of all deaths among 15- to 24-year-olds.

In her 2017 book iGen, Jean Twenge, an American psychologist, attributed the sharp increase in mental illness among young people to the proliferation of smartphones and the rise of social media. She noted that in the US, youth mental illness rose steeply from 2012 onwards, the year that more than half the population gained access to a smartphone. Perhaps the use of smartphones helps explain the similar trends observed among Nordic teens.

Twenge’s research found that the more time teenagers spend on social media, the more likely they are to report feeling unhappy or depressed. One of her studies found that teens who spend more than three hours a day using electronic devices were 35 per cent more likely to present a risk factor for suicide (such as having made plans to end their life). If modern technology is a prime culprit, then researchers should be worrying about teens in poorer countries too, where smartphone use is spreading but people are often less likely to report mental illness.

Mental illness is complex and there is unlikely to be merely one reason so many young people worldwide are miserable – or any simple solutions. Banning smartphones and social media would be neither practical nor effective: research shows that social media can also increase happiness. Yet finding ways to protect young people from the harmful effects of digital culture could save lives – and might benefit miserable middle-aged people too.

5 Morning Habits That Help You Wake Up In A Good Mood

Preparing The Night Before*

See Habits Here (source: powerofpositivity)

Forbes: How Can We Help Solve The Global Mental Health Crisis?

Forbes Article Here
Today, 450 million people worldwide live with a mental illness. According to the World Health Organization, one in four of us will experience a mental or neurological disorder during our lifetime. Depression is the leading cause of disability around the world. Yet low-income countries generally lack the human resources necessary to provide adequate care for the mentally ill, resulting in an astonishing treatment gap. Pavel Reppo founded a non-profit called mindfullwe in order to address this problem, and just finished his pilot program of community-based mental health support in Uganda.
Pavel Reppo is the founder of mindfullwe, a non-profit supporting mental health.BENJAMIN NSUBUGA

“ We recruit, train and employ local community members to provide basic therapeutic support services to individuals struggling with depression ,” Pavel says. The work is steeped in task-sharing, whereby the few specialists on-the-ground in the country are reallocated to offer oversight, quality assurance, and supervision so that lesser-trained workers can be empowered to act as the frontline in mental health support. The stepped care these workers provide includes 1) psychoeducation: offering practical advice in coping with problems, 2) antidepressant drug therapy, 3) interpersonal counseling: which focuses on understanding the relationship between symptoms and triggers, and if necessary, 4) referral to a mental health specialist.

Moving forward, mindfullwe intends to partner with vetted organizations around the world to run similar programs, sharing a functional playbook detailing the steps to effectively replicating the program in other geographical locales. Their hope is to catalyze a shift towards community-based mental health services.
Community members offer mental health services through mindfullwe.BENJAMIN NSUBUGA

Reppo says he was inspired to pursue his life purpose of facilitating groundbreaking work in mental healthcare by Tom Chi, a pioneer in rapidly prototyping solutions to different problems. But also, he was inspired to found mindfullwe based on his personal experience with mental illness. “At 13, I found myself washing my hands for 45 minutes at a time. My hands began to crack and bleed, and yet I could not stop. I was in the cold grip of obsessive-compulsive disorder (OCD). Since that fated day, I’ve had an outpouring of support to reclaim my life. Even so, it has been far from easy. I’m rounding the corner on five years of behavioral therapy, a year with an OCD expert, several bouts of medication, and keeping up-to-date with the latest literature and research in OCD management. And I’m one of the lucky ones.”

The global mental health landscape is bleak, Reppo reports. On average, there is only one psychotherapist for every 200,000 or more people in the world. In Africa, most countries spend less than 1% of their health budgets on mental health care. The World Health Organization posits that one of the most important recommendations for improving healthcare globally is integrating mental healthcare into primary care settings, which includes screening, assessment and treatment. One simple and effective solution is task-sharing: using non-professionals trained in brief, intense therapies to offer services. “By no means did I ‘invent’ this solution,” Reppo explains. “However, I am undaunted in applying task-sharing to bridge the global mental health treatment gap.”
Reppo has a personal and professional passion for solving the mental health crisis.BENJAMIN NSUBUGA

Reppo shares the story of a patient, whom we’ll call Jane, who came into a Uganda health clinic for a check-up for her one-year-old daughter. After sitting down with a health worker trained by mindfullwe, Jane confessed that she had been struggling with severe stress for months, stemming from her separation from her husband, taking care of three children as a single mother, and being the sole provider for her family, including her mother and sister. On top of that, she recently had lost her job. The night before, she had made the decision to take her life. She had cooked a local Ugandan dish and planned to purchase rat poison to mix with the food.

Luckily, the mindfullwe health worker was able to understand the diagnosis of depression, manage Jane’s suicidal risk, and offer practical advice. This timely intervention may have saved Jane’s life, and saved her three children from growing up without a mother.
With support from trained professionals, community members provide basic screening and treatment for mental illness.BENJAMIN NSUBUGA

“This anecdote shows just how meaningful our work is,” Reppo says. While he finds the constant travel back and forth between Colorado and Uganda exhausting, he is passionate about what he does. “We literally save lives. Other patients report having more interest and pleasure doing things. Most are more upbeat, resilient, and hopeful.”

Nevertheless, pursuing this career path takes its toll on Reppo’s own physical and mental health. “I’ve noticed that I am willing to give everything I have in order to see mindfullwe flourish. In doing so, I subject myself to ungodly work hours, expectations, and standards. I don’t extend compassion to me, and end up hurting myself. I’m learning to understand that it is not okay to give up my health for another pursuit,” he says.

In pursuing your life purpose, Reppo recommends “a horizontal approach where you experiment doing things that may be completely unrelated. Listen to what grips and interests you, what sours you and pushes you away. A close cousin of this is, be willing to look silly or foolish in new endeavors. Frankly, if you are focused on tapping into your life purpose, it’s not going to matter in the long run how it appears to someone else.”

MeiMei Fox is a New York Times bestselling author specializing in health, wellness and positive psychology. As a writer and life coach, she helps people align careers with their life purpose.

People With Mental Illness Need More Than Just Talk

See Author Article Here

Philip Moscovitch writes frequently on mental health and mental illness. He is working on a book about life with psychosis – for those experiencing it and those around them.

It’s nearly Bell Let’s Talk Day. You know, the one day of the year when social media is flooded with messages urging us to talk about mental health and to feel good about doing it.

But as the father of a young adult who has experienced mental illness, campaigns like this make me want to scream.

On its Let’s Talk website, Bell boasts about donating money to “mental health” – the words “mental illness” rarely appear – and uses inane slogans such as “Mental health affects us all.” Money from the campaign goes to causes including “fighting the stigma”, a vague-sounding goal that puts the onus on people facing prejudice to end the discrimination against them.

Canada has no shortage of mental-health advocacy and awareness groups. In my province, the Mental Health Foundation of Nova Scotia holds an annual gala fundraiser, complete with local celebrities and politicians. The organization’s key platitude: “#changingthewaypeoplethink.”

And in late November, the Canadian Mental Health Association published a blog post encouraging readers to “keep your mental health top of mind” by putting together a “workplace wellness box including things that help reduce stress and put an accent on feeling well.” What kinds of things? Oh, you know: colouring books, essential oils, fidget spinners, tea. Leading mental-health expert Stan Kutcher, who has since been appointed to the Senate, tweeted in response: “You got to be kidding. Right?… Please tell us that this is not what our mental-health advocacy has become.”

It’s hard to argue with raising awareness and fighting stigma. But those things don’t do much to help people who are living in precarious housing or trying to find a way to pay for anti-psychotic medication, which can cost thousands a year.

There is little evidence that these kinds of campaigns have any significant effect on changing people’s beliefs or behaviour. A study published in the medical journal The Lancet in 2015 said that when it comes to medium- and- long-term effectiveness of anti-stigma campaigns, there is “some evidence of effectiveness in improving knowledge and attitudes, but not for behavioural outcomes.” In other words, people might change the way they think – but not how they behave.

Even worse, the campaigns could be counter-productive. “The more we emphasize how widespread the stigma of mental illness is,” said psychiatrist Ross Norman at a 2013 conference in Montreal on early psychosis treatment, “the more we may be reinforcing people’s stigmatizing responses.”

My son, who has been open about his recovery from psychosis, knows this flipside of fighting stigma and how appearances are inherently built into how people respond to someone else’s mental illness. “Even as a privileged person, you are marginalized when you have a mental illness,” he said at a 2017 talk at a coffee house in Nova Scotia organized by a group advocating for better funding, community support and more creative solutions in mental-health care. “There were nights when people I thought were my friends wouldn’t let me sleep at their place, I thought I was alienated from my family, it was minus-15, and I was just walking down the streets of Halifax with jeans that were frozen to the bone, unable to go anywhere and sleeping in underground parking lots.”

One mental-health professional – who has a diagnosed mental illness and asked to remain anonymous because of potential career repercussions – told me she used to appear at awareness fundraising galas but doesn’t anymore. “You become kind of a dancing monkey.” she said. “I’m there representing people with mental illness because I can put on a dress, look like a middle-class person, speak at a fancy event and not make people uncomfortable … Meanwhile, people who are not being served well by the system would not even be allowed into the room.”

Indeed, despite years of anti-stigma campaigns, most of the people I have interviewed about psychosis don’t want to use their real names, for fear of the personal and professional consequences. Asking people with mental illness to reduce stigma by telling their stories potentially exposes them to more discrimination.

I’m not suggesting groups devoted to raising awareness don’t also fund worthwhile programs and services. They do. But they don’t emphasize the kinds of fundamental change we need.

It does no good to raise awareness if you have an underfunded mobile crisis team that only has the capacity to go out on calls for 12 hours a day, or if patients wait months for assessment, or if you can’t provide stable, supportive housing for those who need it so they can recover and carry on with happy and productive lives.

Let’s talk about that.