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Serving the Mental Health Legacy of the Late Honourable Michael Wilson

September 13th, 2021

Being Seen, Being Heard, Being Helped: Atlantic Youth Come Together

MHI is pleased to post this report on an extraordinary discussion among young people from Atlantic Canada and encourage everyone to examine their insights.

For Young People in Crisis, Mental Health Care in Atlantic Canada is a ‘Closed Door

Jillian Stringer, Co-Chair, Youth Advisory Council,
Mood Disorders Society of Canada – jillstringer3@gmail.com

Children shouldn’t have to die for mental health to get attention. Yet, many communities find themselves spurred into action in the wake of the preventable loss of young lives.

Two young women - one, 24, the other, 16 – died from suicide in New Brunswick, recently and questions arose as to whether the healthcare system failed them both.

Mental Health International Executive Chairman Bill Wilkerson – who looked into these tragedies and worked with families affected by mental illnesses in that province - picked up the phone and called 24-year-old public health student - Jill Stringer back in July.

Jill co-chairs the National Youth Advisory Council for the Mood Disorders Society of Canada and was keen to reach out to her peers in Atlantic Canada to examine the level and quality of mental health services from the perspective of young people in that region.

The result was a roundtable of young people - students and community members - which examined the question and found mental health services for youth inexact, incomplete, often out of reach, and for those in crisis, a closed door.

The discussion centered on what many patients, caregivers, friends, and families already know - that we can do better.

Most young people at the Roundtable described the barriers they faced when seeking treatment. Even those who described “okay” experiences attributed this to their advantages of family and income, recognizing for others, the struggle for care runs deep.

The experiences of the participants in the Roundtable were supplemented by community feedback collected prior to the event, bringing to light barriers including steep price tags, inconsistent medical coverage, far distances to travel, and seemingly endless wait times - over a year in some cases.

One said this:

“I’ve personally been lucky in my receipt of services, but it shouldn’t come down to luck or privilege. As Canadians we tend to pride ourselves on our healthcare yet we continue to further a dangerous divide between the private and public sectors in the mental health sphere. Counselling, or psychotherapy, despite generally being one of the ‘gold standards’ for treatment, is still not universally covered for Canadians.”

Through the Newfoundland Premier’s Youth Council, Julia White (23, NL) advocates for affordable psychotherapy, knowing that it is one of the most effective treatments for mental health concerns. Working as a psychiatric emergency nurse, Julia sees the evidence of this first-hand, where wait times are onerous and services unaffordable for so many.

The Roundtable called for Canada-wide financial support for mental healthcare for those on social assistance, those with part-time employment, and anyone who can’t afford to pay $200 out of pocket for an hour of counselling each week.

At the same time, the group highlighted how local and provincial mental health services can still learn a lot from each other about what works and what doesn’t for youth in need.

Shaina Harvey (23, NB), spoke about Saint John’s desperate need “for proper (and appropriately-timed) access to healthcare and education”.

An observation about her own community that is echoed by New Brunswick’s poor track record for mental health on the national and international stage.

The province’s suicide rate has exceeded the national average for the sixteen of the past twenty years (Centre for Suicide Prevention). They also currently find themselves in a shortage of staff for their hospital emergency rooms - a fact that Shaina worries might discourage youth in crisis from seeking help altogether.

However, rather than depending on emergency rooms that are already understaffed with professionals who are overworked and often not trained in psychiatric care, we need investments in appropriate psychological emergency services.

St. John’s, Newfoundland for example, has a mobile crisis response team made up of specially trained nurses, social workers, and de-uniformed police officers. This travelling response team has been relatively well-received by the community and has been good at preventing hospitalizations of community members experiencing mental distress.

However, in order to effectively help folks in distress, we need sufficient resources and proper training to ensure the competency not only for these crisis teams but for other professionals like police and emergency room staff who respond when the crisis team is busy.

Unfortunately, as Amelia Jones (21, Labrador) pointed out - it’s not really feasible to provide the same type of service in rural Labrador for instance, where crisis responders would have to drive long distances to make contact with patients in need.

Amelia’s community has been using telehealth and eHealth services and she described that patients can have virtual visits with practitioners or mental health specialists from a private space in a local clinic set up with internet access and video conferencing.

Of course, potentially life-saving conversations about mental health and mental illness are often still precluded by overwhelming stigma.

While the group tended to feel that overall attitudes towards mental health have improved, particularly amongst their own generation, it is apparent that stigma is still prevalent.

Julia notes that in her practice as a nurse, second only to financial constraints, negative perspectives about mental health are still one of the most common barriers she sees to folks getting care, especially for patients over the age of 40.

Importantly, unique communities have unique needs. Different communities too, continue to have different attitudes towards mental health and mental illness themselves.

As Shirin Mehrpooya (19, NS) notes - “There still seems to be a stigma among students and professionals pursuing healthcare”, especially.

“From my own academic experience in a healthcare-driven program, speaking about mental illness is discouraged in the community because it shows ‘weakness.’"

Heartbreakingly, other Roundtable participants in health studies echoed this perspective – noting that mental illness is consistently perceived negatively when applying to health professional degrees.

Julia herself, also explained that she has faced backlash for being open about her own mental health journey throughout her nursing career.

“My mental illness doesn’t define who I am, but it is a big part of what drew me to healthcare. My experience allows me to empathize with patients and better understand their concerns. I think it is valuable for someone with lived experience to help others navigate their path to wellness by showing that their concerns can be worked through, and that mental health challenges don’t have to limit you”.

“Continuing to expect that our healthcare professionals do not experience mental health problems is not viable for the future of our mental healthcare system” says Shirin.

The group tended to agree that the knowledge base of mental health care providers has been getting better, with Julia even noting that people with lived experience of mental illness were brought in to speak about mental health during her time at nursing school.

But there is still a need to reconcile physical health care with mental health care. Both depend on the other. Often a family physician is a patient’s first (or only) point of contact with the healthcare system for their mental health concerns, but patients may feel that doctors don’t have enough specialized knowledge or even time to effectively help someone with a mental illness.

One of the biggest shortcomings that came up was the discrepancy between textbook knowledge and empathic practice.

Amelia wondered “if the problem is not with the practitioners themselves but with our system that is producing the doctors, nurses, and professionals in the first place”.

How can physicians, nurses, or therapists be expected to have compassion towards others seeking help for mental illness if they were never afforded empathy or flexibility themselves?

What kind of tone does it set to tell aspiring professionals that they shouldn’t be open about their own mental health for they’d risk hurting their chances of becoming a doctor at all?

How can frontline workers be patient and caring towards someone with mental illness if they don’t have the time to be? Or if they’re overworked, burnt out, and compassion-fatigued?

Of course, the answers to all these complex questions aren’t found in just one roundtable, but being willing to have the conversation is a crucial first step.

In considering what the group wanted to come of their discussion, everyone agreed on the importance of advocacy - something many representatives at the roundtable already do so readily in their communities.

Amelia has been working with a local representative in Labrador to reach out to community Elders and provide mental health education.

Shirin brings equity-seeking youth together from around Nova Scotia to attend meetings of local government and amplify the youth voice in the discussion surrounding mental health.

Importantly, this Roundtable falls against the backdrop of our COVID-19 recovery efforts and a federal election campaign that officially began just a week or so earlier.

And for the first time, all three major national political parties claim mental health as a priority.

An opportunity.

“Bring your concerns to your local representatives. Let them know what you need from them and work with them to get it. If they won’t work with you, make them work for you. As your elected representative, that’s what they’re there for.” - Amelia

About

Contributing their insight to the conversation were students Shaina Harvey (NB), Amelia Jones (Labrador), Shirin Merhpooya (NS), and psychiatric emergency nurse Julia White (NL). The roundtable was hosted by Jill Stringer (ON) with supported from Stacie Smith (NB) and Bill Wilkerson (ON).

Jillian Stringer (She/Her) (ON) is a second year Public Health Masters student at the University of Guelph and co-chairs the National Youth Advisory Council with the Mood Disorders Society of Canada (Refer: jillianstringer3@gmail.com).

Shaina Harvey (She/Her) (NB) is a fourth-year biopsychology student at the University of New Brunswick Saint John. Shaina is a member of the Saint John Suicide Prevention Committee and an active mental health advocate.

Amelia Jones (She/Her) (Labrador) is studying biology and neuroscience at Memorial University in St. John’s, Newfoundland where she is also a member of the Premier’s Youth Council.

Shirin Merhpooya (She/Her) (NS) is currently living in Halifax, studying medical science and health studies at Dalhousie University. She is also the president of AMPLIFY NS, youth-led, grassroots organization that connects equity-seeking youth with mental health professionals and local decision makers.

Julia White (She/Her) (NL) is a psychiatric emergency nurse in St. John’s Newfoundland and graduate of Memorial University. She is an active member of the Newfoundland Premier’s Youth Council and the 2021-2022 Newfoundland and Labrador Network Representative for Jack.org.

News Release

September 13, 2021

ATLANTIC CANADA YOUTH CITE GAPS IN ACCESS AND AFFORDABILITY OF MENTAL HEALTH SERVICES

Youth Services “A Closed Door” for Many

An Atlantic Canada Youth Roundtable on Mental Health has concluded that mental health services for youth in that region are “inexact, incomplete, often out of reach and for those in crisis, a closed door.”

A Report on the Youth Roundtable - organized and led by the Co-Chair of the National Youth Advisory Council for the Mood Disorders Society of Canada, Jillian Stringer - has been circulated among communities and government leaders in the Atlantic provinces.

Even young people who described “okay experiences” with mental healthcare in Eastern Canada attributed this to their own family and income advantages, while, for others, the struggle for care runs deep.

The Roundtable was the centerpiece of fact-finding by young people. Community feedback was collected prior to the event “bringing to light steep price tags for prescription drugs, medical insurance, far distances to travel for care, and seemingly endless wait times.”

Meanwhile, the Newfoundland Premier’s Youth Council, calls for “affordable psychotherapies -one of the most effective treatments” and “Canada-wide financial support for mental health care among Canadians on social assistance, working only part-time, and who find $200 per therapy session out of reach.”

Saint John, New Brunswick, is in “desperate need for proper and appropriately-accessible mental health care and education. This shortage is compounded by a provincial suicide rate in that has exceeded the national average for 16 of the past 20 years (Centre for Suicide Prevention) and staff shortages in hospital emergency rooms - factors that will discourage youth from seeking help.”

The Roundtable also heard that students pursuing health education are discouraged from mentioning their own experience with mental illness because they will be looked upon by professional schools as “weak.”

Roundtable chair Jillian Stringer said “the group reached a clear-cut consensus, that continued advocacy by young people for an accessible, empathic, and affordable mental healthcare system is essential. Youth are beginning to accept mental health and mental health problems - as a natural part of the human experience.”

Refer: Jillian Stringer, Co-Chair, Youth Advisory Council, Mood Disorders Society of Canada (jillianstringer3@gmail.com) or Bill Wilkerson (bill.wilkerson@mentalhealthinternational.ca)

August 26, 2021

A Milestone. Mental Health as a Canadian Election Issue

Canada’s national newspaper, the Globe and Mail, today declared ‘mental health’ a surprise election issue in Canada’s current federal campaign.

A first.

And to everyone who has worked hard in whatever capacity to “normalize” our ability to discuss, learn about and understand that mental health problems are part of the human experience, I say bravo to all of you.

The three major national parties all claim mental health as a priority. This means it should stay high on the leader board no matter the result of the vote.

That said, we need, all of us, to be very careful not to interpret a federal political embrace of mental health in a political contest to mean the leader of the next Government will have a clear idea about what spending more money on mental health actually means.

The point is this: more money will not solve with what’s fundamentally wrong with mental health care in Canada.

We will need a new, more informed, more compassionate approach as to reining-in the effects of what mental health conditions across Canadian life.

We will need a clearer picture of how so-called ‘general hospitals’ are accredited to provide psychiatric services through a dedicated unit and how emergency services are accredited to deliver informed mental health care under those circumstances.

I will comment on this in the next few days.

Thanks, Bill

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Bill Wilkerson, Executive Chairman, Mental Health International
bill.wilkerson@mentalhealthinternational.ca – 001-905-885-1751

August 19, 2021

New Brunswick in Crisis of Conscience
“Citizens Cabinet” Needed to Drive Urgent Mental Health Care Reforms

Statement by Bill Wilkerson, LL. D. (Hon)
Executive Chairman, Mental Health International

“It was 36 Wednesdays ago today, at this exact time, 10.52 a.m. that we were shutting off the life support. I miss my girl. I will get answers. I will get justice. I will never go quietly.”
Patricia Borthwick, Wednesday, August 18, 2021, 10.52 a.m.

New Brunswick is in crisis and one observer says “the people are at the point of revolution.”

This a crisis of conscience, a crisis of confidence and faith in the leadership and overall management of mental health care services.

Newly revealed stories of suffering, frustration and fear provide deeper anecdotal evidence of Horizon Health Network as a source of telling and troubling public experience New Brunswickers have reached out to me by email and telephone.

This is a crisis that permeates the mental life of a liveable and loveable province of Canada that is also, in a sense, a suicide capital in a world where suicide is now the leading cause of violent death and principal cause of death of adolescents.

In 2011, sixteen suicide deaths per 100,000 of the New Brunswick population was the 5th worst among any jurisdiction in the entire world. Consistently, the suicide rate in New Brunswick has exceeded the national average. Women try the most. Men die the most.

There are concerns about murder-suicides. Men killing women. Is this a mental health care system that is broken, or one that simply does not exist at all?

This is also a crisis of leadership within the Government of New Brunswick – and the answer to this crisis does not lie in the stuff government usually does: reports blueprints, strategies.

New Brunswickers are owed an agenda of conscience in the here and now – not a youth drop-in centre in 2024, after ruthless delays already, but one now.

New Brunswickers are owed an examination of conscience within their body politic, among their politicians and leaders broadly.

Why is it that elected officials, hospital officials, public servants are either unable or unwilling to break-into the management culture of Horizon Health and root out the reasons for the “horror stories” that I am told about directly?

It is apparent to me that politicians in this province have effectively turned their back on New Brunswickers perhaps through their own bewilderment as to what to do or through an innate compact of behaviour that transfers this duty to care to the health care professionals and administrators.

New Brunswickers must now must speak and act for themselves. In Charlotte County, a Facebook page says the voice of the people will not be silenced on these matters. This is start.

But to reach “Beyond the Horizon” – which is a timely, pertinent slogan - we advise New Brunswickers to come together as a “Citizens Cabinet for Mental Health Reforms,” and ask your elected representatives and their officials to lead, follow or get out of the way.

Use this election to ask both federal candidates and provincial politicians the following:
Have you spent any time working on mental health care?

Have you learned lessons in life that will help you appreciate the mental health needs of people? Do you understand what it is like to suffer the effects of mental disorders?

If you do, tell us, if you don’t, will you find out and tell us then?

Meanwhile, the stories of real people emerge:

Video of Abuse
A young woman in New Brunswick writes me: “I have been abused, ridiculed, injured, ignored and have received zero aid towards both my physical and mental health from several hospitals in Charlotte County and Saint John.

“I have a video recording of doctors outside of a mental health room mocking me and laughing when I told the hospital advocate I was a rape victim.

“I am still suffering immensely and it is not even because I’m suicidal anymore but it feels like there is no other way to stop all this. I have gone to the hospital – duffle bag and pillow in tow – and told them that if I left I would jump off the reversing falls bridge. They called me a cab.

Concerned about an internal discomfort, she says “Just last week ... the doctor was going to examine my stomach and an ICU nurse said, ‘don’t let her lay on the bed, she‘s a psyche patient and we will never get her out of it.’”

Heart-breaking stuff.

Horizon Health Network demonstrated an extraordinarily harsh manner in responding to the families of young women who took their own lives, one while in Horizon’s care, the other, who I am told sat 8 hours in a Horizon emergency waiting room in suicidal thought. She was ignored. She left without seeing anyone. And killed herself.

Hooks Held for Hanging

In another case brought to my attention, a Horizon hospital said they would “investigate” the possibility the hooks on the bathroom in the psychiatric unit were weight-bearing, thus holding while a 27-year-old daughter hanged herself. Horizon says they will also “investigate” problems affecting their capacity to be watchful and observe this young woman.

Consider this: the Horizon hospital sought and received the mother’s consent to remove her adult child from life support ending her life, accepting the mother’s ‘next of kin’ legal and moral authority to take that fateful step.

Then, this bunch turned around and rejected the mother’s request for information based on the “privacy” of her now-dead daughter. This breath-taking absurdity quickly gave way to more standard bureaucratic excuses.

Months went by – Horizon management frustrating a woman consumed in the kind of grief that is unimaginable to others;

Months went by, time eaten up by a health care company that apparently ignored or was unaware of the higher risk of suicide among family members who lost their kin in this way, deepening her frustration and closing the door to her search for meaningful information.

The mother - a courageous and resolute Patricia Borthwick who grieves her daughter with a ferocious kind of humility - emailed me on August 18, at 10.52 a.m. “It is 36 Wednesdays. At this exact time, 10.52 am., we were shutting off the life support. I miss my girl. I will get answers. I will get justice. I will never go quietly.”

The Horizon people finally released a document concerning her daughter to the media, a heavily-redacted, impenetrable form of bureaucratic evasion. Patricia got a copy from the news media, not Horizon who committed an awful violation of competent common sense and common decency

Later, a 2nd family asked Horizon for information about their daughter’s care after the girl took her own life. At first, the hospital managers said, no, she had turned 16. She was, technically, an adult. Parents had no right to the information. Then, relenting, they forced the parents to sign a legal, non-disclosure agreement for pages of information that may or may prove informative.

Other stories have come to me.

A Student

A student told me, ”this is something very personal and passionate to me ... I suffer mental illness ...

“At one point I felt so overwhelmed from my own fear of doing physical harm to myself, a friend drove me to the emergency room of Saint John Regional Hospital. She waited with me for hours.

“A nurse practitioner finally saw me. He asked if I was overwhelmed with my job, I said, of course ... but that was the extent of his interest ... he offered to write me a sick note for work, gave me an Ativan and told me to come back in the morning if I felt the same way.

“Later that year, I had a friend in a similar situation ... I drove her to the same ER at 11.00 pm ... no one saw my friend until 4.00 a.m. ... she was admitted ... but the nurse kept trying to convince her she had no need to stay.”

A Young Married Couple
A 28-year-old working professional, living in Fredericton, tells me of her husband’s struggle with mental illness, saying: “In the past five years, I have become all too familiar with the mental health system in New Brunswick and if there is any way that I can share our story and help improve it, I will do just that.”

Since He Was a Child
A New Brunswicker who has tried to take his own life “several times since I was a child” and who has yet to receive coherent care across the span of his life, wrote to me about Saint John Regional Hospital: “I have nothing but horror stories from Horizon. I tried to kill myself and at the Regional they left me in a room for hours, and finally someone came in and said you have a drug problem not a mental health problem.”

Doctor Said a Prayer

A New Brunswick man with PTSD as a result of childhood abuse, speaks of turning to a Horizon hospital for help when he felt that he might harm himself. The doctor at Horizon told him it was “the devil in me,” launching into a prayer. This was five years ago, in modern New Brunswick.

Brother on a Bridge

The sister of a man finds him on a bridge, ready to jump, giving up on his gambling addiction. She convinces him to go to Saint John Regional Hospital with her. It was after midnight. A nurse said – “with attitude” – that no doctor was available to see him until the morning. They left.

A young mother and wife writes me, her husband suffers a severe mental disorder and she is “totally blown away by the lack of compassion, organization, and accountability of the health care system” in New Brunswick.

A psychologist practicing in New Brunswick speaks of a shortage of mental health practitioners and staff at Horizon Health, and one is drawn to that observation as prescient.

A concerned grandmother asked me “to call me if you think you can help. I need to rescue my grandchildren.”

These are stories of ‘life and death’ - the very words that appear on the cover page of an interim report by the Child and Youth Advocate on youth suicide prevention. One must applaud this initiative. I have these suggestions:

Training emergency department personnel will not work without a reconciliation of the need for attitudes that embody compassion, willingness to listen and empathy.
Public cynicism isn’t about good reports, it is about reports providing cover for delayed action or inaction. Priority one: if the minister or her staff try to water down the commentary or recommendations, push back – push back hard.
Give New Brunswickers the truth as you found it.

That said, a report will not be enough. What I have seen over the past four months is a mental health care system represented by Horizon bureaucrats who seem to behave as if they are afraid of liability for actions taken or not taken in these matters. One lawyer said this about that: “it is lawyers who made them the way they are.”

Without the voice of the citizens of New Brunswick, change will be hard-won and let us also remember, a crisis of conscience forms a moral basis for a fundamental re-examination of the culture-and-capacity of the Horizon organization to provide compassionate, psychiatric-based care at times of crisis in particular.

The citations in this statement project the stigmatization of mental distress and disorder, not the values of love and compassion for those who come their way. Yes, human love. Most of all, that is what I saw missing in the response by Horizon to the parents of two young women who lost their lives, and in the stories given me by brave people who are willing to make their troubles known to help others avoid their own.

As for a way ahead, I believe the following steps are called for: a Citizens Cabinet drawing on the population of New Brunswick to set forth the following steps by government:

An independent investigation of the management of the psychiatric units of Horizon general hospitals in the province. Horizon cannot investigate itself at Saint John Regional Hospital as is their current intent in the wake of the tragedies under discussion here.

The objective: to uncover, expose and extract management and clinical attitudes, behaviors and practices that diminish, harm, and stigmatize the needs of those who suffer mental disorders and seek care at times of crisis.

A second principal objective is to put lawful and responsible citizen pressure on the Government of New Brunswick to recruit adequate numbers of mental health professionals in mental health, and in allied fields of specialized care wherein depression is linked to other illnesses including cardio-vascular disease, diabetes, Parkinson’s Disease, and eczema.

In this modern era, with clinical sciences leading clinical care, New Brunswickers must demand an informed response by government, taking into account the following pressing factors:

Depression increases the risk of sudden death among heart patients by 500%.
Depression increases the risk of early death among those living with diabetes and cardiovascular illness;
Depression increases the risk of stroke among women;
Bipolar disorder has been found to increase the risk of vascular diseases – including cardiovascular disease – among young people and has been cited as a pediatric health risk factor.
Severe, chronic stress has been described by scientists as the “overwhelming cause” of mental disorders, the kind of stress reported to me by New Brunswickers and chronicled in this statement.

If there are shortages among mental health care professionals, then that part of this ’crisis of conscience’ must also be addressed – but not without re-creating the culture within the Horizon organization.

In fact, a Citizens Cabinet could realistically pursue the question of whether the current Horizon board has exercised adequate due diligence in the governance of this organization.

Citizen-based leadership and channels of communication on mental health reforms is a must, in my estimate. A “Citizens Cabinet” can advocate for change if widely-representative of the population of the province.

A ‘Citizens Cabinet’ can help answer the question of those who suffer, those who are in urgent need, those who are asking themselves, “where can I turn?” – a question unanswerable in the present mental health care environment of New Brunswick.

A ’Citizens Cabinet’ must be willfully dedicated to making change, to reaching out to those who suffer to alleviate their burden through contact with others who will show them the basic tenets of dignity, respect, and human love apparently deficient in the province’s attempts at mental health care presently.

A ‘Citizens Cabinet’ can mobilize the best form of community spirit and give an expression of solidarity and voicing and presenting the kind of value system and professional services that you insist must define this otherwise Great Province.

A “Citizens Cabinet” can organize a Firm Team of Pro Bono Lawyers to assess and, if possible, act upon a defense of the rights of the people of New Brunswick in the protection, protection and survival of their mental lives against the government indifference and Horizon.

Individual cases can “stand in” for broad litigation aimed at the “system” and that is where focus should be trained first.

Government – at least this government – will not, it appears, do anything of that nature unless New Brunswickers unify and act on your behalf and in your right and to share the pain and embrace the opportunity to be one for all and all for one, as the qwords of a classic proclaim.

Perhaps as a model for the country, argue for and create Citizen Standards to spell out that New Brunswick is a ‘Mental Health Province” not an incompetent uncaring jurisdiction where too many die in violent circumstances, both self-inflicted and otherwise.

Establish channels to university leaders and scientists and secure a lay person briefing of what science now knows about what causes mental disorders and what new treatments are in the offing.

Engage the business community and raise the funds from within the community to create youth-centred programs, do not rely on government, do not wait for government, act on your own initiative in an orderly, lawful, determined way. Use Patti Borthwick as your inspiration.

Reach out to the members of the board of directors of Horizon Health, ask questions, ask why they are serving in that role if they do not know about these concerns as expressed or, if they do know, why are they not taking action? Ask questions of the board, I urge you. Seek resignations if necessary.

Remember, taxpayers/citizens own the health care system, not a management company and government-appointed board or Minister of Health or even the Premier and the Cabinet.

If you feel they have turned their back on you, bring that to their attention. And ask why. Ask for a lot better. Ask for it now.

This government may eventually learn to listen. I suspect, right now they operate between two poles – careless and clueless when it comes to the mental health of New Brunswick.

So, make your voice heard in your call for an independent, arm’s length, investigation of Horizon Health and question why Horizon has the authority and power it now possesses given the stories now being told.

Two final points:

New Brunswick recently lost its health transfer payments given its approach to abortion services for women. Does the same remedy apply to the way this province cares for those in need of mental health services? A question citizens should ask – with intent.
Horizon is looking for a new CEO. I am told. New Brunswickers, get involved in that decision. Do not stand by. The Citizen’s Cabinet should meet with the favored candidate before a final hiring decision. This individual must understand the frame of mind and the conscious expectations of the people of New Brunswick for real changes in how Horizon manages it psychiatric duties.

The mission, as I see it, to be stated and to undertake is to go “Beyond The Horizon” in every way possible to ensure meaningful reforms in mental health care in New Brunswick.

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Bill Wilkerson, Executive Chairman, Mental Health International
001-905-885-1751 bill.wilkerson@mentalhealthinternational.ca

August 9, 2021

A Young Mother Finds Her Way: “I am Loved, I am Worthy.”

By Ashly Smith, Registered Pharmacy Technician

Saint John, New Brunswick
Special for Mental Health International

There was a time in my life when I felt I had nowhere to turn. I felt alone, helpless, and desperate for someone - anyone - to hear me. I was suicidal, and while I didn't have a concrete plan, I found myself in many situations where I imagined the ways in which I could end my life.

On a beautiful fall afternoon in 2019, after spending the day apple picking with my husband and then six-month-old daughter, it took all the strength I had, not to open the car door on the highway. On another day, I imagined myself closing my eyes and free-falling from a great height, just feeling the wind in my hair one last time before ending my suffering.

All I needed was for one person to notice my cries for help - just one tiny shred of a connection to grasp onto to pull myself from the depths of darkness. What I encountered were several people and organizations that were ill-equipped to understand and support someone struggling with mental illness. I was truly alone - or so I thought.

I've struggled with my mental health for as long as I can remember. The first notation in my medical records is at the age of nine - anxiety. I was a shy, timid child and this continued into early adulthood.

I began my career in Pharmacy in 2010 at the age of twenty. I graduated from a one-year Pharmacy Technician program taken at the Saint John campus of the New Brunswick Community College. Back then, there were two main roles within the pharmacy – a Pharmacist and a Pharmacy Technician. Pharmacy regulations are often shifting as the scope of practice of pharmacy professionals continues to grow, and in 2015 New Brunswick saw the first Pharmacy Technicians become registered in the province.

This change resulted in all Pharmacy Technicians employed at that time having their title changed to Pharmacy Assistant. To become a Registered Pharmacy Technician, a Pharmacy Assistant would have to continue their education via a bridging program, complete a Jurisprudence exam at the provincial level and two other exams at the national level. In addition, a practical training component required the completion of five-hundred consecutive prescription checks without making an error. One mistake would reset the number of checks completed back to zero.

Registered Pharmacy Technicians are pharmacy professionals registered with their provincial governing body, or “College.” They are required to be licensed, to maintain professional liability insurance, and are bound by the Act, Regulations, and Code of Ethics of the profession of pharmacy. They are also required to ensure their continuous professional development by completing a minimum of fifteen Continuing Education (CE) credits annually.

This new role was created to relieve Pharmacists of the more technical aspects of their jobs so they can focus their time, attention, and pharmacologic expertise on the ever-growing clinical duties of their profession. Registered Technicians have taken on the technical checking portion of prescription preparation – ensuring the correct patient is getting the correct medication, that the directions on the label accurately reflect what is written on the prescription, and the correct drug is in the vial.

They also receive and transcribe verbal prescription orders from Physicians, demonstrate the correct use of different devices to patients, and send and receive prescription transfers between pharmacies. These are all duties that were once only performed by a Pharmacist. In 2018, I completed my training and became a Registered Pharmacy Technician.

Over the years I developed incredible relationships with my colleagues and patients.

I grew exponentially, and as I gained confidence in my abilities; the shy, timid little girl became a professional young woman. I spent ten years in my first job as a pharmacy technician. I took great pride in my work, often starting early or staying late. I got the job done and could always be counted on to have it done efficiently and accurately.

I took on additional responsibilities, no questions asked, and often found myself working in excess of sixty hours per week. I loved every minute of it. My work gave me a sense of purpose and I gave it my all.

In mid-2019, everything came crashing down when unfortunate circumstances caused me to leave my job. For so many years, my job was my identity and suddenly I didn't know who I was anymore. The sense of purpose my job gave me was gone and I didn't know how to live my life without it. How was I supposed to go on? The answer I would have given myself back then was "you're not."

This past July, I came across a Facebook page for the "All Ears Reach Out Campaign." A man local to my area, Gary Brown Sr., created this page to promote a t-shirt campaign he had started, in which he sells t-shirts to raise money to sponsor people interested in taking the ASIST course.

ASIST stands for Applied Suicide Intervention Skills Training. The course was founded in Calgary in 1983 by four men with backgrounds in social work, psychiatry, and counseling. Today, it is a two-day workshop offered by Living Works, which teaches participants the skills to recognize signs, provide intervention, and develop a safety-plan to keep someone alive.

I decided to inquire about the course and was given the opportunity to take one of the seats sponsored by All Ears Reach Out. After rearranging my work schedule, I was ready to go.

HOW CLOSE TO SUICIDE
The first day of the two-day workshop focused on the personal experiences of the participants, as well as three fictional characters who have died by suicide. We started by filling out a questionnaire to determine how closely each of us has been affected by suicide.

The results of this questionnaire served as an icebreaker in a sense, as it was our first glimpse into the experiences of the other participants. As a group of twenty-one strangers, we realized for the first time that we were all connected.

After watching a video depicting three different scenarios involving fictional characters who ultimately end their lives, we were divided into two workgroups. In our respective workgroups, we explored our feelings, personal experiences, and beliefs about suicide, and learned how our attitudes can have an impact when providing suicide first aid.

Each of us shared details of our personal experiences, then we moved on to explore the story of one of the characters from the video we watched. As a group, we engaged in role play to alter the course of the character's life, using the PAL (Pathway for Assisting Life) model. The PAL model has three phases:

Connecting with Suicide;
Understanding Choices;
Assisting Life

In the Connecting with Suicide phase, we were taught to recognize and explore invitations, and to ask if the person at risk is considering suicide. Once engaged with the person at risk, we move to the second phase, which is Understanding Choices. In this phase, we hear the story of the person we are assisting, and actively listen for a turning point.

A PART OF THEM DOESN’T WANT TO DIE
A turning point is a moment of awareness in which the person at risk realizes there is a part of them that does not want to die. After identifying the turning point, we move to the Assisting Life phase, which involves incorporating the turning point into developing a safety-plan to keep the person safe for now. We do this by determining specific actions the person at risk can commit to, with or without assistance, in order to ensure their safety.

After leaving for the day, I was mentally exhausted. The content was informative and relatable, but also triggering. In my mind, I was taken back to that time when I felt desperate and alone. After day one was completed, I drove straight to work. There was no time to process the impact the day had on me prior to my shift, so I shed a few tears in my car before heading inside to start my shift.

On day two, we focused on the Assisting phase of the PAL model. We spent time as a whole group, and in our small groups, practicing our skills by acting out various scenarios.

All in all, the training was a wonderful experience. I was able to meet some incredible individuals who are passionate about mental health. I learned that I am not alone in my struggles. Our healthcare system is broken when it comes to mental health. Getting as many individuals trained in the ASIST course as possible can have a major impact by improving access to people who are ready, willing, and able to intervene when someone is at risk of suicide - someone I needed when I was consumed by darkness less than two years prior.

NEW JOB NOW
I have a new job now, and a much healthier work-life balance. My work no longer defines me, but is just one piece of a larger purpose. I am a mother, a wife, a sister, a daughter, a friend. I am loved. I am worthy. Though the depression and anxiety are still very much a part of who I am, my experiences have only strengthened my ability to fight back and continue to live one day at a time.

I often ask myself what I can do to make a difference. I'm not a profound speaker with the ability to move an audience. I'm not a business executive. So, how can I make an impact on the mental health crisis we are currently facing?

Taking the ASIST course is one step in the right direction. Taking my personal experiences with facing adversity, and using those experiences as motivation to continue the fight to end the stigma surrounding mental health issues is another step. I've only just begun.

MAGGIE KUHN tells us this and I heard her:

“Leave safety behind. Put your body on the line. Stand before the people you fear and speak your mind – even if your voice shakes. When you least expect it, someone may actually listen to what you have to say. Well-aimed slingshots can topple giants.”

July 2, 2021

Mental Health International’s Bill Wilkerson, appeals to New Brunswick Premier Blaine Higgs to Order Independent investigation of Saint John Regional Hospital.

Posted below is a letter by Bill Wilkerson to Premier Higgs of New Brunswick asking for a provincial investigation into the suicide death of a patient in the psychiatric care of Saint John Regional Hospital last December.

Also, posted is a news release put out today. Wilkerson underscores that the Saint John Hospital, operated by Horizon Health Network, also mentioned, has itself found deficiencies in the operation of its psychiatric unit. New Brunswick has a suicide rate higher than the national average, it was the highest among the ten provinces as recently as 2016, and in light of this, “hospitals in that province should be on alert not asleep at the switch.”

Bill is encouraging general hospitals that provide “side bar” psychiatric care in Canada to audit the the status of their practices to protect in-patients from harming themselves, especially those on suicide watch as in the New Brunswick case.

July 2, 2021

To: Honourable Blaine Higgs, Premier of New Brunswick
From: Bill Wilkerson, LL. D. (Hon)

Re: Horizon Health Network’, Patricia Borthwick and her daughter’s death in the care of Saint John Regional Hospital

Premier, on April 28, you kindly wrote me to advise that that you are “listening and taking action” with respect to our concerns as to how Horizon Health failed to respond in a courteous, compassionate and timely manner to the questions for information posed by Patricia Borthwick, a resident of Utopia, N.B., pursuant to the death by suicide of her daughter while in the care of Saint John Regional Hospital. Your letter was in reply to mine of April 6, 2021.

As you may recall, I am a national and international mental health advocate and proponent of suicide prevention, I am advising Patty on a pro bono, personal basis as I do from time to time in support of families contending with mental health crisis and, frequently, the liability-aware nature of how health care institutions communicate with families of patients.

In the matter of Patty’s daughter, the first response she got from the regional hospital person is that they couldn’t answer her questions because of privacy rules. The privacy of her deceased daughter. This absurdity triggered my serious concern about the competence and integrity of this hospital relative to psychiatric care.

True to form, through its Vice-President, Quality and Patient-Centred Care – an ironic ‘corporate title’ for the executive corresponding with Patty in this matter – Horizon sent a June 22nd letter to Patty, the salutation referencing ‘”Ms. Patricia Borthwick,’ a clear signal of a form letter, in which they give this grieving mother a powerfully-arrogant and detailed explanation of the legal reasons they cannot respond to her mother’s questions about her daughter’s violent death.

For one thing, they differentiate between the mother of the deceased young woman and who purportedly qualifies as a “personal representative” of Hillary’s estate with or without a will. Superbly ironic, since the hospital accepted Patty as sufficiently “personal” and sufficiently “representative” to be the source of next-of-kin permission to remove her daughter from life support.

But the organization sees her as too distant to qualify for information that would be otherwise and legally available to some “personal representative.” This legalistic, bureaucratic, fearful (liability concerns, no doubt) and cruel letter merely sustains the tone and demeanour of how the hospital and Horizon have treated this woman and her grieving family.

On March 30, 2021, the Minister of Health said in a letter to Patty that “in light of these tragic events, I have directed the Department of Health staff and the regional health authorities to address crisis care in emergency departments and in communities. Furthermore, I have asked for recommendations within 30 days.”

The Minister also said “I have asked the Executive Director of the Addiction and Mental Health Branch at the Department of Health, Annie Pellerin, to ensure that someone from the Department reaches out to you directly.” I can tell you, despite the Minister’s promise, Patricia Borthwick heard from no-one.

Therefore, six months after Hillary’s death and several more months of trying to get information about her daughter’s death plus two months after the Minister of Health’s letter to Patty, she received a MAY 21ST letter from Horizon’s Vice-President of Community, Jean Daigle in which she is advised that:

“The following two recommendations were approved by our quality-of-care committee and action plans are being developed for their implementation.” That is, the hospital will:

“Investigate procuring ligature resistant door frames, designs or door design for inpatient psychiatry units.”
”Investigate the establishment of a Crisis Stabilization Unit for increased structure and observation for patients in crisis requiring short-term intervention.”

Horizon Admission and Revelation Justifies Provincial Supervision

This is a revelation: the hospital knows that certain deficiencies likely contributed to Hillary’s death and, to the outside observer, these deficiencies seem so fundamental, so basic to the safety of psychiatric services as to warrant a provincial investigation into Horizon’s capacity to provide such services. I encourage you, Premier, to consider putting Saint John Regional under supervision,

Further, neither the hospital management nor Horizon should be left to their own devices in carrying out the “investigations” of which Daigle speaks. I would encourage you to oversee these inquiries and to audit the Horizon Health Network ‘s competence and informativeness in managing psychiatric crisis.

Suicide Risk for the Family

It seems entirely plausible that Horizon and the Saint John Regional Hospital management – given the distant and evasive manner in which they have treated Patty Borthwick – is unaware that high on the list of suicide risk factors is losing to suicide a family member or a person close to you. The frustration generated by their behaviour compounds such a risk

Suicide Risk for the Province

As of 2012, as you also know, New Brunswick had the highest ‘per population’ rate of suicides among Canada’s ten provinces and was the 6th worst jurisdiction in the world after Japan, Belgium, Finland, France and Austria. New Brunswick also experiences high rates of domestic violence.

Suicide Prevention: A Priority in New Brunswick?

Under these circumstances, one would presume that suicide prevention and suicidal crisis management would be at the top of the list in all mental health clinics and services in New Brunswick but especially acute care general hospitals which provide side-bar psychiatric care.

At the very least, I would question whether you can rely on the Saint John Regional Hospital and other Horizon facilities to master these requirements based on this experience and perhaps other incidents of which I have become aware.

The number of suicides in N.B. have topped the national average consistently, nearly 16 deaths per 100,000 persons at its worst, based on data I have seen, thus establishing your otherwise lovely province as a world-scale suicide capital.

And now, years after the province emerged as a leading jurisdiction in suicide incidence, we have a major urban hospital and health management company “investigating” whether the basics of door design and observational capacity are suitable for their psychiatric wing.

This certainly supports the Minister of Health’s directive for a review of emergency psychiatric services. I understand the Minister announced a strategy but, again, no one – zero – reached out to Patty despite the Minister’s promise they would do so.

Therefore, sir, I strongly recommend – and will be making a public statement along these lines -- that you convene an investigation into the policies, practices, training and competencies of the Saint John Regional Hospital in their handling of this particular suicide and the tragic circumstances surrounding it.

I submit, sir, that New Brunswick could lead Canada toward an effective, solid model of suicide prevention. This is not beyond reach.

A personal note if I may: it would be very nice – thoughtful and welcomed – if you were to call Patricia Borthwick at 506-755-0881. The family would welcome hearing that you are taking steps so that Hillary will not have died in vain, that her death will bring about changes that will save the lives of others.

Meanwhile, Patty has just received the coroner’s report officially advising that her daughter’s death was asphyxiation at her own hand. This is, on one level, a step toward closure. On another, it is the cold re-confirmation that her daughter is never coming home.

Best Regards,

Bill Wilkerson, LL. D. (Hon)

Executive Chairman, Mental Health International

001-905-885-1751

bill.wilkerson@mentalhealthiinternational.ca

Full Text and accompanying News Release

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Bill Wilkerson continues his analysis of mental health in the era of artificial intelligence. He kicked off this dialogue in May 2019 with his now widely-travelled report: Of Two Minds - One Human, One Not - Mental Health in the Era of Artificial Intelligence.

‘BRAIN CAPITAL’ in the era of AI

HR Reporter

By Bill Wilkerson
October 5, 2020

"Unless we prepare for tech revolution, AI could trigger superstorm of chronic workforce stress."
Read the article >

Mental Health In The Workplace
Michael Wilson Led Canada, Canada Led the World.

As appears in The Globe and Mail, Saturday, July 18, 2020

Bill Wilkerson, LL. D. (Hon), Executive Chairman, Mental Health International, reflects on his 20-year partnership with the Late Michael Wilson in workplace mental health and, with acclaimed University of Toronto physician-scientist Roger McIntyre, projects Mr. Wilson’s legacy into the future.

Enduring Milestone

A great Canadian, Michael Wilson’s smile lit up every horizon he crossed. He was a man of his nation whose memory and legacy now belong to all Canadians.

Michael was the chairman of the Global Business and Economic Roundtable on Mental Health, succeeding Co-Founder, Tim Price, Chairman of Brookfield Funds. Tim is a powerful mental health advocate and a great Canadian in his own right.

This is the 20th anniversary of the first Business Plan to Defeat Depression that Michael signed and took to the world on July 20, 2000, setting in motion a chain of events resonating across decades.

International Leadership
In Michael Wilson’s words: “We are poised, as Canadians, to show international leadership by opening a new front — the workplace and economy — in the old war against mental illness.’

The Business Plan to Defeat Depression was rooted in CEO leadership and top Canadian executives stood with Michael, putting mental health where it had never been before. That is, on the agenda of big banks and major companies across this country and eventually beyond our borders.

Through these corporate pioneers:

Canada brought North America the US/Canada Forum on Mental Health and Productivity.
Canada introduced a series of CEO Mental Health Summits hosted by our major banks whose boardrooms became, symbolically, original housing for a new era of workplace mental health.
Canada produced CEO, CFO, investor and boards of director Guidelines for Mental Health and Productivity, innovations exported to target depression in the workplaces of Europe
Canada was home to the first website devoted to strategies, guidance and tools for employers to manage mental health in the workplace, the initiative of Great West Life Assurance Company, now Canada Life.

Into the Future
As noted, the Business Plan to Defeat Depression, was an act of corporate leadership. The question: is that leadership energy still there? Some say it is not. If true, it must be rediscovered. Here’s why:

Scientists (McIntyre et al) have linked unemployment rates with suicide. One percentage point up, one life lost. Companies continue to end the employment of people as the first not last resort of adjusting to economic pressure. Michael Wilson decried this publicly.
Loneliness is now a public health concern fast-forwarding into millions of lives including young people entering early adulthood more stressed and depressed than generations before them.

Michael Wilson 2020
Looking to the future, might we see a new ‘Business Plan to Defeat Depression’ and might we call it Michael Wilson 2020 to capture the spirit of aspiration and action that Michael embodied.

In years past, there were obvious mental health and workplace issues for business to target — issues affecting business costs, productivity, innovation and lost work time.

But these are different times — the pandemic, job loss, climate change, pursuit of justice in the streets. In this context, the mental health goals of business must serve broader societal purposes.

For this reason: the environments in which we live and work are part of the “gene + environment” dynamic causing mental disorders across whole lifetimes from one generation to the next.

Michael Wilson pointed to the “flesh and blood of capitalism” as the property through which business can help reduce these environmental risks.

From this vantage point, business leaders can help achieve a series of Great Societal Goals leading toward the prevention of human misery and economic cost associated with mental illness.

To prevent suicide including children coping with despair delivered by social media;
To prevent depression’s dangerous effects on the course of heart disease, cancer and diabetes;
To prevent workplace and marketplace spread of misogyny, racism, hate and chronic stress;
To prevent abuse of the elderly in all places at all times;
To prevent eco-anxiety among youth apprehending a future of climate change;

And

To declare and explicitly and value inherently all people of colour as stakeholders to whom business is accountable.

The Unmet Need of 500 Million People
In his efforts to embed mental health in the workplace as a corporate priority, Michael Wilson expressed a strong view that business and science must work together in common cause.

Michael envisioned “an international, workplace-centred, business + science alliance to reverse the tides of brain-based mental disorders and to press for new science to be translated more quickly into innovative clinical care to meet the unmet needs of a half billion people.”

A formula was developed ‘brain health + brain skills = brain capital’ to unify business and science, advancing Michael’s vision.

Flying on the wing of closer synergy between business and science are these clinically-significant priorities for the next three to five years brought into view by Dr. Roger McIntyre:

Priority: strengthen human resilience: our capacity to deal with life.

Priority: discover treatments that alleviate depression symptoms in a day.

Priority: develop treatments specifically aimed at preventing suicide.

Priority: make mental health care accessible for all.

Priority: advance ‘precision medicine’ to identify who will respond to treatment, and who will not.

Priority: expand technology for early detection, improved treatment and medical home care.

These clinical priorities and the societal goals for business will enhance the asset value of human capital in the workplace and in the marketplace — that is, the productivity of employees and the purchasing power of consumers.

An acutely well-timed revolution. Today, so-called ‘intangible’ assets — people — constitute 80% of the reported asset value of corporations. Not technology. Not things. Human beings.

The priorities and societal goals set out here, therefore, will sustain these vital human assets and, in doing so, represent an historic opportunity for business.

A Moment in Time
When Michael Wilson passed away, a large cloud rolled-in from another place. But it didn’t last all that long. In death, as in life, Michael‘s optimism shone through. He would have loved the findings of a recent survey:

Even while they contended with the effects of COVID-19, young people — more than any other age group — “feel the most hopeful about the future.”

Let this nourish our soul. Just as Michael Wilson would want us to.

The Unheralded Business Crisis In Canada, Depression at Work
12 Steps To A Business Plan To Defeat Depression
July 20, 2000 (www.mentalhealthroundtable.ca)

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Original First-Ever Business Plan to Defeat Depression, Launched in Toronto and Geneva in Year 2000:

20 Years Ago, Words of Change
CEO-Led Business Plan to Defeat Depression

On July 20, 2000, the Global Business and Economic Roundtable on Mental Health released the first Business Plan to Defeat Depression in a news conference in Toronto and Geneva. The entire plan is posted on this site.

One of the features of the plan at the time, two decades ago, what the new language used to describe how business should go about promoting mental health in the workplace. Here are examples:

BUSINESS URGED TO HELP ACHIEVE MAJOR SOCIETAL GOALS THROUGH “FLESH AND BLOOD CAPITALISM.”

Tribute in the Globe and Mail to the Late Michael Wilson draws on one of his privately-stated ideas to get business to fight ‘great societal’ questions.

July 16, 2020 – The Late Michael Wilson was famous as Canada’s Minister of Finance who introduced the GST and was, in the words of former Prime Minister Brian Mulroney, “the greatest finance minister this country ever had.” Read news release>

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Newsroom

June 9, 2020

‘OF TWO MINDS’ – One Human, One Not
“Can we keep them both healthy? That is unclear.”
Mental Health in the Era of Artificial Intelligence

By Bill Wilkerson, LL. D. (Hon)
Executive Chairman, Mental Health International
‘National Accessibility Awareness Week’
Nova Scotia Reachability Association,
Halifax, N.S.
June 5, 2020

April 15, 2020
THE COVID-19 LEGACY: PREPARING FOR GENERATION ONE

” Yours is the first generation that will prevent suicide, stop the spread of the disabling effects of mental disorders and support each other’s mental health and wellbeing openly and naturally, setting aside discrimination and denial of our shared vulnerability. Yours is the first generation that will explicitly imply human love in caring for distressed and disordered minds.”

Extracted from the 2015 McMaster University Convocation Speech by Bill Wilkerson to a graduating class that lost four of its own to suicide in that same academic year. Their parents were in the audience for his remarks. Bill addressed them directly and based on these remarks, the term ‘Generation One’ is herewith introduced.

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We call the children, adolescents and young adults of the 21st Century Generation One -

The first generation born into an era foretelling climate change as part of their burden;
The first generation exposed to a virus pandemic with mental health a known casualty;
The first generation since the Great Depression to face a momentous global economic downturn;
The first generation born into an era of new vulnerability: school shootings, street terrorism;
The first generation born into the chronic stress of the post-truth world;
The first generation to know the iPhone as an appendage not an accessory;

Generation One is graduating into uncertain economic prospects while embracing many social causes in great numbers—equality, climate, same-sex marriage, female empowerment, gender identity and mental health.

Generation One is the first to move into workplaces facing vast change portended by artificial intelligence and Generation One is described by the Economist Magazine as the ‘best educated, best behaved, most stressed and depressed generation than those who came before it.’

After 20 years of awareness-raising, Generation One is growing up at a time when mental health sensitivities, for them, are a given, talked about openly. Generation One prioritizes emotions and their ‘personal brand,’

On this basis, it will be important for business and economic policymakers to understand what an ‘emotion priority’ means and how the promotion and protection of mental health in an economy that put a premium on cerebral skillsets, noting that Generation One will expect:

Mental health care that is accessible, that works and that is attached to every existing acute and medically-specialized health care service;
Mental health care delivered in the community by an expanded cohort of professionals and laity trained in the art of active listening (the grand-mother model);
Prevention as a global priority, new technologies as tools of prevention and a new language for mental health to reference/infuse as common knowledge links between the body and the brain,

Refer: bill.wilkerson@mentalhealthinternational.ca

February 21, 2020

Bill Wilkerson launches unique Cobourg Rotary Club series on mental health called Four Fridays in February. His speech provides broad and, yet, detailed context for discussion and understanding of questions about what mental health is, what mental illness is, what mental illness is not, are those with mental illness prone to violence, are words like “crazy and insane” still used and if so, why?

Read the speech here

Notes for Remarks by Bill Wilkerson, LL. D. (Hon),
Executive Chairman, Mental Health International
Launching The Rotary Club of Cobourg Series
‘FOUR FRIDAYS IN FEBRUARY’
A Conversation on Mental Health
February 7, 2020

December 31, 2019

BILL WILKERSON AND MENTAL HEALTH IN THE INTERNATIONAL WORKPLACE

These are cities in North America, Europe, South America, Asia and the Middle East where Bill has taken his workplace mental health message through speeches and business roundtables between 1999-2019.

Canada (many cities multiple times)
Whitehorse, YT
Yellowknife, NT
Victoria, BC
Vancouver, BC
Calgary AB
Edmonton, AB
Regina, SK
Saskatoon, SK
Winnipeg, MB
Thunder Bay, ON
Sudbury, ON
Barrie, ON
Niagara Falls, ON
St. Catharines, ON
Toronto, ON
London, ON
Kitchener, ON
Hamilton, ON
Ottawa, ON
Guelph, ON
Quebec City, QC
Montreal, QC
St. John, NB
Fredericton, NB
Moncton, NB
Halifax, NS
Sydney, NS
Charlottetown, PEI
St. John ‘s Newfoundland

US
Los Angeles, California,
San Francisco, California (x3)
San Diego, California
Seattle, Washington (x2)
Portland, Washington
Las Vegas, Nevada,
Denver, Colorado
Dallas, Texas,
San Antonio, Texas
St. Louis, Missouri
New Orleans, Louisiana
Chicago, Ill.
Baltimore, Maryland,
Richmond, Virginia
Washington, D.C. (x4)
New York, N.Y. (x2)
Albany, N.Y.
Providence, Rhode Island
Boston, Mass., (x3)
Atlanta, Georgia (x2)
Orlando, Florida

Europe
Porto, Portugal
Bruges, Portugal
Madrid, Spain
Geneva, Switzerland (x2)
Paris, France,
Frankfurt, Germany
Berlin, Germany
Rome, Italy (x2)
Brussels, Belgium ( x2)
London, England (x3)
Dublin, Ireland
Kristiandsan, Norway
Copenhagen, Denmark (x3)
Athens, Greece (x2)
Thessaloniki, Greece
Rotterdam, Netherlands

Santiago, Chile
United Arab Emirates
Dubai
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September 25, 2019

New Podcast Interview with the Canadian Centre for Occupational Health and Safety and Bill Wilkerson

Artificial Intelligence: Managing the Positive and Negative Implications for Workers

The spread of artificial intelligence (AI) into science, society, and the workplace is a revolutionary change that will have profound impacts on not only jobs but also the well-being of workers. Bill Wilkerson, Executive Chairman of Mental Health International, authored a recently published report entitled One Human One Not: Mental Health in the Era of Artificial Intelligence. In this episode Bill shares his views and findings from the report and recommends that AI be managed carefully to prevent it from becoming a major intruder into the mental health and well-being of workers and families. Listen Now www.ccohs.ca

‘MENTAL HEALTH IN THE ERA OF ARTIFICIAL INTELLIGENCE’

Statement by Bill Wilkerson, LL.D. (Hon)

Executive Chairman, Mental Health International
Industry Professor, International Mental Health, McMaster University

August 9, 2019
‘OF TWO MINDS – One Human, One Not Mental Health in the Era of Artificial Intelligence’

The world is crossing an historic bridge between human and artificial intelligence, bringing together two minds, one human, one not. Can we keep them both healthy? This is unclear.

But this much is clear. The revolution in artificial intelligence is a vivid and present danger to the livelihood and health of hundreds of millions of working people and their families worldwide, threatening to displace and replace human beings in whole jobs and specific tasks on an unprecedented scale.

Even the most informed proponents of AI worry about this. According to Dr. Alan Bernstein, CEO, Canadian Institute for Advanced Research (CIFAR), “AI will force us to challenge our cherished views of what it means to be human.”

The World Economic Forum forecasts that individuals in some 375 million jobs will be rotated out of those jobs. According to consulting giant McKinsey, 60-90% of all jobs now in place will be affected by artificial intelligence.

Unless employers and governments prepare for this revolution by retraining workers, creating replacement jobs that demand distinctly human traits, and forging new education and career models, social unrest and public alienation will intensify in a world already fractured by income inequality.

Dr. Bernstein, who leads the Pan-Canadian Strategy on AI, sees “AI as such a powerful platform for analyzing data in new ways that its applications will extend into every aspect of our lives.”

If AI feeds human mental unrest, disquiet and disorder, then it will damage society and if it is cloaked in confusion and lack of transparency, then it will de-humanize the environments in which people live and work.

If the sole driving purpose of AI is to displace employees to cut costs, then it will not only cheapen the cost of producing goods and services, it will cheapen our way life.

Generating invasive, job uncertainty, the deep learning of machines could be a super-power of deep stress for human beings if its infusion is careless and unmanaged. Deep stress is at the root of frustration, fear, anger and rumination which predicts depression

Deep, chronic stress can move us toward depression and just as cancer is a malignant growth, depression – in the words of author Lewis Wolpen - is malignant darkness.

It is also the trigger of 90% of suicides, now the leading cause of violent death. Human beings are killing ourselves faster than we are killing other people. Guns kill more Americans through suicide than homicide.

In late 2018, according to the Economist, suicides in the United States skyrocketed by 18% while globally, suicide declined by nearly 29%, saving nearly three million lives.

Across their lifetime, 50% of populations are symptomatic of mental illness and, in any given year, 20% of the population is afflicted. And these human beings are the faces of the troubled, turbulent times in which the effects of artificial intelligence will be felt.

On a promising note, just as AI may increase the stress-born burden of mental illness, AI apps are being developed to help us better manage depression and anxiety disorders – and even to prevent suicidal risk.

Artificial intelligence is being developed to diagnose and treat schizophrenia more effectively, model psychiatric illness to test new methods of treatment, improve the diagnosis of schizophrenia and improve understanding of autism.

To improve internal decision-making, the Government of Canada has invested heavily in AI systems for internal use, introducing a ‘Directive on Automated Decision-Making’ and an “algorithmic assessment” to spell out ethical responsibilities for the use of AI,

The inevitable ‘but’ surfaces, though, when we consider time frames. The potentially oppressive nature of artificial intelligence as a source of job loss is imminent while counter measures usually take time.

Therefore, my report on mental health in the era of artificial intelligence calls for the “human capitalization” of the AI workplace and digital economy to help balance the billion-dollar investments in machines with billion-dollar investments in people to ensure the supremacy of human beings in the AI workplace.

Human capitalization of the AI workplace should start now with the introduction of workplace protocols or standards - mandated by law, if necessary – to establish the values that will govern entry of AI into the workplace, assess the threats to those values and take steps necessary to neutralize those threats.

On reflection, the ‘human capitalization of AI workplace’ might be stated as the ‘humanization of artificial intelligence in the workplace, this, to eliminate the risks of a troubling ambiguity between the role of people and machines.

In fact, it is clear that the AI revolution is not just a technology event, it is a human event. Surely, it can be leveraged into a positive and transformative, ‘new job’ and ‘new career’ experience for the people who otherwise are written off as short-term pain.

Key to this will be a major transition – from an economy where employees are generally seen as a cost to cut rather than an investment to make.

The AI era will produce technology that will be deployed to valuate people as financial assets, monetizing the human factor in productive capacity, innovation and competitiveness.

In this context, expenditures by employers on employee retraining, reskilling incumbent workers and supporting mental health and well-being is an investment with a calculable and reasonable return.

Investments in people as a defining asset of the 21st century economy also means fostering employment opportunities that demand uniquely human qualities and a focus AI on taking over specific tasks not whole jobs.

The AI revolution is now, and a look into the more distant future is also called for. Perhaps, in Canada, through a Royal Commission on the ‘Prospects for Human Dignity, Development and Health in the 21st Century.” Such an endeavor could be far-reaching in complex times.

To request additional information, schedule an interview, or receive copies of media releases and advisories, please contact us.

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THE ESSENTIALS OF MENTAL LIFE

2019-2020

Our report, Mental Health in the Era of Artificial Intelligence, is the first is a series of discussions about the mental health and well-being of people in the face of serious public issues now confronting the world. First up, the revolution in artificial intelligence.

From this series, ultimately, we will paint a picture of what the ‘essentials of mental life in the 21st century are and must be. Scrolling down, you will find not only the full report on Mental Health in the Era of Artificial Intelligence in PDF that can be downloaded, but a series of extracts recapping the Report.

The report, as a booklet, is being distributed among leaders and organizations in business, science, health care, government and NGOs across North America and Europe.

Comments are welcome.

bill.wilkerson@mentalhealthinternational.ca

Extracts

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July 25, 2019

The Real World Forces Causing Mental Illness

Bill Wilkerson, LL. D. (Hon) Executive Chairman, Mental Health International,
Industry Professor, International Mental Health, McMaster University

Efforts to create greater public understanding and acceptance of mental illness as a ‘natural’ part of the human experience have had some success in recent years.

But, still, the results are incomplete. This, for several reasons.

For one thing, allied sciences investigating internal/external causes of mental disorders have yet to produce an unambiguous, public-consumable statement as to what science knows as to what these invasive conditions are – and are not.

Over the past number of years, my job as a mental health advocate has been, among other things, to ‘translate’ what I come upon in various research reports and studies that I read on behalf of the people I claim to serve in my self-appointed mission.

Our report – Mental Health in the Era of Artificial Intelligence – is part of that process. As lay people, we can now make several deductions based on what science has reported.

Genes play an important role in the development and onset of mental illness but not without the influence and impact of the environments we are born into and in which we live, work, and co-relate with others.

The simple equation is this: gene + environment is the dynamic that produces the risk and the symptoms of mental illness.

The branch of science where this equation stems from is called ‘epigenetics’ – but, funny-enough, researchers are not always clear what they mean about ‘environment.’

Some refer to environment as the period prior to birth. Some refer to natural environments – air, land, water – despoiled by pollution, a reference not necessarily relating to mental disease but to disease more generally, respiratory being one.

Generally, though, it is fair to say that the environment is an active ingredient in shaping our vulnerabilities and all human beings are vulnerable to the gene + environment dynamic but not all of us are made ill by it. Notably, however, the G + E equation embodies the human factor.

Mental illness has physical properties and physical origins in brain cells, it can be triggered by physical trauma, abuse, deprivation, isolation and other experiences, some gradual, a lifetime in the making, others sharp, pointed factors.

This means how we treat each other contributes to the development and onset of mental illness. How we treat ourselves is also a factor including, very significantly, diet.

In our report on Mental Health in the Era of Artificial Intelligence, and the supporting summaries, we cite this finding: the human brain never functions without reference to the environment outside.

In effect, therefore, the seeds of mental illness are sown in our genetic selves combined the environments and experiences we inherit, create and go through. In effect, the accumulative effect of human affairs one unto the other.

bill.wilkerson@mentalhealthinternational.ca

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Question: MENTAL ILLNESS IS WHAT?

Bill Wilkerson, Executive Chairman, Mental Health International, believes the nomenclature of mental health contributes to public misunderstanding of what mental illness is.

His answer to the question above was reviewed by Dr. Bruce Cuthbert, U.S. National Institute for Mental Health and Dr. Roger McIntyre, University Health Network, University of Toronto

Answer: MENTAL ILLNESS IS biological unrest in a person’s brain that upsets the brain’s machinery for thinking, feeling and perceiving. Brain circuits are working improperly. Mental Illness has physical properties and physical effects.

Mental illness is caused in some combination by what we’re born with (our genes) and what we experience in birth and in life, what we might call our collisions with life. In that light, mental illness is more like an injury.

Mental illness can be both inherited and experienced. In either case, mental illness is involuntary, uninvited, unwanted, is not a form of personal weakness and is not the fault of those who suffer.

The Canadian Armed Forces describe post traumatic stress disorder (PTSD) as ‘operational stress injury” and have dropped the word ‘disorder’ altogether.

In remarks to Canadian war veterans and their families, I described PTS(D) as a “the normal brain’s response to an abnormal event … like a severe concussion from the inside out.” Getting accidentally hit on the head is not your fault, neither is mental illness.

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OF TWO MINDS - One Human, One Not
Mental Health in the Era of Artificial Intelligence
JUNE, 2019

The world is crossing an historic bridge spanning human and artificial intelligence and the result is a meeting of two minds – one human, one not. Can we keep both healthy? That is unclear.

By Bill Wilkerson, LL. D. (Hon), Executive Chairman, Mental Health International and
Industry Professor, International Mental Health, McMaster University, Hamilton, Ontario, Canada

Read Here and/or Download PDF

Artificial intelligence could have damaging effects on our mental health

BILL WILKERSON
CONTRIBUTED TO THE GLOBE AND MAIL
PUBLISHED MAY 26, 2019

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In 2015, MHI and Lundbeck Canada partnered with Post Media to produce a 10-month, national advertising campaign building the case for an International Business-Science Partnership for Brain Health in a Brain Economy. The campaign attracted significant interest, especially online, and we invite readers to have a look at the campaign by visiting http://business.financialpost.com/category/brain-health or clicking the Brain Health link below.

BRAIN HEALTH

Business and science hold the key to unlocking the door to brain health in a brain economy.

The goal of an International Business-Science Partnership for Brain Health is to hasten the transfer of vital brain discoveries into vital clinical benefits for everyday people, thus changing the world’s experience with brain-based mental disorders over the next 10 years.
Visit the Financial Post website for articles and resources.

Shannon’s Story – A Personal Account of Balancing Mental Wellness in the Workplace

These insights were prepared by Shannon McCoy, an employee of the Government

of Canada, at the request of Mental Health International and its Executive Chairman,

Bill Wilkerson, LL. D. (Hon), to post on www.mentalhealthinternational.ca and

www.targetdepression.com to share with employees and their employers in

managing the effects depression and anxiety. Read now >

January 10, 2019

Can International Business and Science Unite to Advance Global Mental Health in a Global Brain Economy?
Embassy of Canada to the United States of America
October 6, 2016

Making Mental Health a Global Development Priority

Global Mental Health & Psychiatry Newsletter: Career, Leadership and Mentorship Program
By Eliot Sorel, MD

Newsletter Volume II, No. 2 June 2016

Global Mental Health: A Powerful Investment in the Economies and Peoples of the World
In 2007, Canada’s Ambassador to the United States, Michael Wilson, the country’s onetime Minister of Finance and an international business leader, said major issues such as “energy, security and trade demand international solutions and I absolutely include mental health in that.”
By Eliot Sorel, MD, Senior Scholar in Healthcare Innovation and Policy Research, Clinical Professor of Global Health, Health Policy & Management, and of Psychiatry & Behavioral Sciences at the George Washington University, Washington, D.C.
And
Bill Wilkerson, L.L. D. (Hon), Founding Fellow, Institute for Mental Health, University of British Columbia, Chairman, Mental Health International, London, England and Port Hope, Canada

July 12, 2016

Breaking Through: Advertising Campaign Attracted Millions of Readers in Promoting Brain Health in a Brain Economy

In March, 2013, the 5th US/Canada Forum for Mental Health and Productivity convened by Mental Health International at the prestigious Centre for Addiction and Mental Health in Toronto produced a powerful consensus among leaders in science and business that steps are called for to accelerate the translation of brain knowledge into improved treatments for brain-based mental disorders.