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Welcome to HC Link's blog! Our blog will provide you with useful information on healthy community topics, news, and resources, as well as information on HC Link’s events, activities, and resources. Our bloggers include HC Link staff and consultants, as well as our partnering organizations, clients, and experts in the health promotion field.

Please note: opinions in posts are those of the author and are not necessarily the opinions of HC Link or our funder.

We look forward to engaging in thought-provoking conversation with you!

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Seher joined PAD in 2014 as the Communications and Projects Coordinator for SFPY. Her work at the UN Population Fund in Geneva, Switzerland exposed her to global health and women’s health issues, which furthered her interest in health promotion. Now, she is excited about working on health promotion issues at a more local level through PAD’s work in Canada. Seher holds a Master of Global Affairs from the University of Toronto’s Munk School, which is a policy degree focused on international issues. She enjoys staying up to date on the latest news on social innovation, trying new restaurants, and exploring different parts of Toronto.

PAD’s SFPY program featured in United Nations commissioned study on global “good practice” programs

By Seher Shafiq, Parent Action on Drugs


After a long process, PAD’s Strengthening Families for Parent and Youth (SFPY) program has been selected as a global good practice in a report published by the American University of Beirut (AUB).

Background

In March 2014, the UN Inter Agency Technical Task Team on Young People (UNIATTTYP) for the Middle East and North Africa/Arab States, began a process to document good and promising practices in adolescent and youth. The geographic focus was the Middle East and North Africa (MENA) region, but the project also looked at programs globally in order to recommend some “best buys” in adolescent programming that could be applied in the MENA region.

This project was spearheaded by UNICEF MENARO, who had partnered with the Outreach and Practice Unit (OPU) of the Faculty of Health Sciences at the American University of Beirut. The age group the project focused on was 12-24 year olds, and thematic areas included employability, social protection, civic engagement, and health (among many others).

The process

The first phase was research on the part of AUB, who selected a few of PAD's programs that could be considered good/best practices for youth aged 12-24. PAD’s programs were among the 169 potential good practices that the AUB had found regionally and globally. After looking at several of PAD’s programs, the AUB decided to focus on PAD’s SFPY program.

Second, the programs were rated based on a number of criteria: Effectiveness, Sustainability, Replication, Equity Analysis, Evidence-based, Innovation, Values Orientation, Youth Involvement. The SFPY program met this criteria and was selected as a potential good practice.

To validate the research made by AUB to this point, PAD participated in an in-depth interview about the SFPY program, where we shared more details with the researchers.

After the interview, the SFPY program was deemed by AUB to still meet the criteria listed above, and the researchers completed a report that explained the various aspects of the program.

The entire process above took around 8 months. After 8 months, the final stage of the process was for PAD to “validate” the write-up by the researchers. PAD and AUB had a back-and-forth consisting of report edits, and a few months later we were asked to provide some photos of the program.

Results

Last month, we were contacted by AUB who had finalized the report. After such a long process, it was exciting for us to see the final result. The AUB did a great job at summarizing the key aspects of the program and why it is considered a “good practice”. It’s interesting to see that a Canadian-based program has potential for global audiences as well!

To read the full report, click here.

To see the other programs featured by the AUB, click here.

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Policy Talk: An ounce of prevention is worth a pound of cure

By: Seher Shafiq, Parent Action on Drugs

This blog post is part of a series on the topic of developing health public policy written by HC Link and our partner organizations. If you would like to contribute to this series, please contact This email address is being protected from spambots. You need JavaScript enabled to view it.

The Canadian Centre on Substance Abuse recently released a free online learning module to help better understand the Portfolio of Canadian Standards for Youth Substance Abuse Prevention — a resource that guides teams on how they can improve their prevention work in the area of substance abuse.

I had the opportunity to go through the online learning module, and found it concise, informative, evidence-based, and interactive.

The module provides tools to help professionals in various sectors prevent youth substance abuse. It encourages the user to recognize that regardless of what sector they are working in, the work we all do as community service providers plays a role in substance abuse prevention. The module recognizes the importance of setting a strong foundation in the “youth years”.

The module also explains risk factors that youth are exposed to when growing up (ex. Conflict with the law, relationship issues, mental illness, etc.), as well as protective factors, noting the importance of minimizing the former and promoting the latter. CCSA also notes that substance abuse prevention does both of these things.

I have to admit, the discussion about risk and protective factors reminded me of Parent Action on Drugs’ Strengthening Families for Parents and Youth program, which is an evidence-based, preventative program that promotes youth resiliency.

What interested me the most in the module was the data on costs associated with substance abuse. In 2006, Canada spent almost $40 billion on substance abuse. These costs were often associated with healthcare, law enforcement, and the court system. I also found it interesting that 30% of charges in violent crimes are associated with alcohol abuse use.

However, the most surprising data for me was that for every dollar spent on substance use prevention, the government saves $15-$18 dollars. This data should be eye-opening for policymakers. Two years ago, I did a project for the MaRS Centre for Impact Investing and similarly found that reducing recidivism rates (i.e. people going back into jail after they’ve been released) through promoting preventative interventions like mental health counselling, affordable housing, and employment skills workshops can also produce similar cost savings for the government.

I can’t help but think of the billions of dollars the government could save if it prioritized prevention initiatives. Policymakers need to recognize that prevention initiatives work and show results – not just in dollar terms, but also through the positive impact on society.

As the saying goes “an ounce of prevention is worth a pound of cure”.

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Peer-led health promotion interventions: The importance of collaborative, multi-sectoral approaches

By Seher Shafiq, Parent Action on Drugs

On March 7th 2016, Parent Action on Drugs (PAD) and HC Link hosted a webinar titled “Effective peer programming on substance use for the transitional years”. Peer education is defined as “the teaching or sharing of health information, values and behaviours between individuals with shared characteristics”.

To my knowledge, PAD has the longest standing peer education programs (in the area of substance use) in all of Canada! The numbers don’t lie: over the past 30 years, PAD’s peer education programs have reached 3000 classes, trained 10,000 peer educators, and had approximately 90,000 youth involved overall. Having done a backgrounder on peer education effectiveness before the webinar, I was excited to hear the diverse, real life experiences from our webinar presenters.

Suzanne Witt-Foley (Consultant, PAD/HC Link) and Patricia Scott-Jeoffroy (Consultant, PAD/HC Link) opened the webinar by noting that it’s important for educators to focus on ‘health literacy’, and that PAD’s Challenges, Beliefs and Changes (CBC) program has information that is balanced, accurate and promotes skills practice. Patricia did an overview of PAD’s peer education programs, recognizing that the Masonic Foundation of Ontario has provided almost 30 years of support to these programs.

Next up was a panel presentation from diverse voices that have been involved in the CBC program. Both Allison Haldenby (Guidance Counsellor, East Elgin Secondary School) and Jacky Allan (Public Health Nurse, Elgin-St. Thomas Public Health Department) emphasized the importance of a collaborative approach to coordinating a peer education in schools, and discussed how they worked with school nurses, public health units, elementary schools, high schools, and students to organize, promote and deliver the CBC program.

As a Youth Addictions Counsellor at the Canadian Mental Health Association of Muskoka Parry Sound, Brittany Cober provided an interesting mental health perspective. Brittany mentioned that she often notices the youth in peer education programs form an “automatic bond with each other” in a way that they don’t with adults, and this is what makes peer education programs so successful. Brittany was speaking anecdotally from her own personal experience, but I couldn’t help but think how similar her experience was to the research on peer education effectiveness. For example, a 2009 study on peer education found that “peer educators were...seen as very credible by the majority of the participants...with the experimental group significantly more likely to find the peer educator more credible than the control group”.

The most interesting part of this webinar was that the audience was able to hear from two students who participated in the CBC program for three years: Jack Gaudette and Kennedie Close from East Elgin Secondary. Jack shared a powerful story about how he was “pushed around” in elementary school and was worried about starting high school. However, high school wasn’t what he expected – in a good way! Being involved in the peer education program helped both Jack and Kennedie “fit in”, get involved, and have fun. Jack and Kennedie keep participating in the program each year because it’s “been a blast every year”, and I’m sure their enthusiasm motivates other students to join the program. Having helped develop PAD’s youth engagement model as part of our strategic plan, I was particularly happy to see that youth voices were represented in this webinar!

Overall, it was a great webinar that illustrated the importance of taking a collaborative, multi-sectoral approach to a preventative health intervention. With drug policy staying high on our new government’s policy agenda, I am sure PAD’s peer education programs will be even more important moving forward.

Webinar slides and recording

 

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Toronto Drug Strategy Prevention Working Group

Guest post by Chidinma Nwakalor, an undergraduate placement student at PAD

On November 5th 2015, a Toronto Drug Strategy Prevention Working Group meeting was held at Metro Hall. The monthly meeting brings together representatives from community stakeholders around Toronto such as the YMCA, CAMH, Loft Community services, Toronto School District Board, Parent Action on Drugs, and Toronto Public Health.

The highlight of the meeting was a presentation by Erika Kandar, an epidemiologist with Toronto Public Health (TPH). She presented findings on a Toronto Public Health Survey of students from grade 7 – 12.

The survey showed that most students had a positive view of their self-esteem (80%) and school connectedness (85%). Unsurprisingly, there was a strong, consistent link between mental health and substance use.

The good news for Toronto, is that compared to students in Ontario, Toronto students are less likely to binge drink and use drugs like marijuana, cough medication and pain pills (without prescription). However, 26% of secondary school students still reported risky behaviors like binge drinking and mixing alcohol with energy drinks. Sub-groups of youth at risk for alcohol and drug use included: females, older students, students from low socio-economic backgrounds and LGB+ students. Canadian-born students were more likely to use alcohol compared to new immigrants.

Alcohol and drug use is concerning because these behaviours can affect the development of teenagers and may also lead to substance misuse. The responses on suicidal attempts and incidents of self-harm were even more worrisome. 11% of students reported engaging in self-harming behaviours like cutting or burning themselves on purpose within the past year. Around the same percentage (12%) also reported that they had seriously considered suicide within the past year.

At the meeting, the representatives from the Toronto District School Board and Toronto Public Health (who interact with high school students frequently) agreed that the numbers around suicidal attempts and self-harm from this survey might even be an underestimation.

Self-harm and suicidal attempts are signs of poor mental health and inadequate social support. These two factors need to be addressed to ensure that the incidents of self-harm, suicidal attempts, substance misuse and other risky behaviours are reduced among Toronto students.

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Looking Back, Moving Forward: The 10th Anniversary of the Toronto Drug Strategy

 

On November 9th, 2015, the City of Toronto hosted an event honouring the 10th anniversary of the Toronto Drug Strategy (TDS). The event brought together community workers, activists, policy makers and members of the public to discuss the work of the TDS over the past 10 years, and the future of drug policy in the City of Toronto.

TDS1

Toronto City Councillor Joe Cressy opened the event stating that preventing harms associated with substance use has been the main goal of the TDS.

The introductory remarks noted the TDS’ work on reducing the lives taken through drug overdose. Former City Councillor Kyle Rae mentioned that in 2010, the City of Toronto became the first municipality to endorse the Vienna Declaration, which seeks to improve community health and safety by calling for the incorporation of scientific evidence into drug policy.

Kyle went back in time to when the area surrounding St. Stephen’s House in Toronto was “disruptive” due to drug activity in the area. Kyle went to Europe to see how similar situations were dealt with in different cities, and found that safe injection sites were particularly helpful in decreasing the number of break-ins, decreasing property violence, and improving health. After bringing these learnings back to Toronto, this issue moved forward on Toronto’s City Council and has played a significant role in Toronto’s drug policy work since then. City Councillor Gord Perks also added the importance of working with the “different hands that make our society” to end the stigma surrounding drug use.

Susan Shephard, Manager of the Toronto Drug Secretariat spoke next about the detailed work of the TDS. When discussing prevention initiatives, Susan noted Strengthening Families for Parents and Youth program, which is an initiative of Parent Action on Drugs. Other work of the Implementation Panel includes workshops for service providers on building youth resilience, workshops on teen brain development, a prescription drug drop-off day, the promotion of safer nightlife/partying, and other harm reduction services. The overall theme of the presentation was the reduction of stigma and discrimination towards drug users.

Next to speak was Zoe Todd, a Harm Reduction and Drug User Advocate from the South Riverdale Community Health Centre. Zoe’s presentation was by far the most moving, as she discussed her personal experiences losing people to drug overdose. Zoe delved deep into the policy context that she feels contributes to the stigma and eventual deaths of drug users, noting the criminalization of drugs as a main barrier to safer drug use. Zoe also emphasized that cuts to health care, gentrification, homophobia, inadequate housing, and racism all contribute to a loss of community, which eventually leads to drug overdose deaths.

I was personally shocked to learn that between 2003-2014, the City of Toronto saw a 41% increase in reported overdose deaths in Toronto. What causes this? Well, one reason is that when drug use is heavily criminalized, drug users are scared to call 911 when overdosing. Zoe advocated for Good Samaritan Legislation, which would allow drug users to call 911 without fear of being arrested for drug use or possession. Zoe brought the audience to tears when she powerfully closed her presentation with a moment of silence for those that have died due to drug overdose.

Senator Larry Campbell was the final speaker of the event, and also emphasized the need for a Good Samaritan Legislation, as well as drug policy that is based on science. He stated that in his ten minute walk to City Hall, he saw 10 homeless people, many of which were probably mentally ill, experiencing addictions and experiencing abuse. “This is unacceptable”, Larry exclaimed.

After the event, there was an information fair in the members’ lounge, where the audience was able to learn about the wide range of Toronto Drug Strategy community initiatives. It was a great opportunity for those in the drug policy and prevention community to learn about each other’s work and further reflect on the presentations made earlier.

Congratulations to the Toronto Drug Strategy for an impactful 10 years, and we look forward to seeing what the next 10 years will hold!

TDS2

 

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YouthREX: When Asset-Mapping for Communities, Focus on Opportunities…not Problems!

On October 21st, YouthREX hosted a webinar titled “Reframing Need: Asset-Driven Youth Program and Community Development”. It’s not often a webinar is jam-packed with new, practical information, but YouthREX never fails to impress me. This webinar was no different.

The webinar kicked off with a presentation by Alexander Lovell, Director of Research and Education at YouthREX. His presentation included a literature review on approaches to community development and youth engagement, starting from the 1970s until today. The main takeaway of this literature review was that youth engagement today focuses more on assets than it used to, and that the concept of “positive youth development” is quickly gaining popularity.

Alexander also highlighted six main principles to remember when asset mapping:

  • Everyone has gifts/strengths/assets
  • Relationships build community
  • People are actors
  • Leaders involve others
  • People care about their community 
  • Research matters and involves listening/asking/learning 

He also highlighted key steps in the asset-mapping process, such as defining boundaries, finding partners, determining what assets to include (both for groups and individuals), organizing the assets through visual means, and determining steps for action. He noted the importance of recognizing different levels of analysis when asset mapping, such as the system, community and individuals.

To demonstrate some of the concepts in his presentation, Alexander used the example of youth unemployment. Focusing on the negative aspects of this problem would be a normal part of a needs assessment. However, an asset-based approach would consider the local resources available in an area with youth unemployment, such as opportunities available for youth and the broader community.

Next up was Katie Elliot of the NORDIK Institute. Katie works in the area of youth social entrepreneurship with Social Entrepreneurship Evolution (SEE). SEE is rooted in a holistic community approach, and aims to promote social entrepreneurship to support young change-makers in promoting resilient communities.

For this project, SEE used a strengths-based approach to identify assets that can support young social entrepreneurs in northern Ontario. Instead of looking at problems negatively, SEE identified gaps as opportunities to help youth realize how they can make positive change. In doing so, Katie and SEE learned why it is important for the community to lead the discussion of their own asset-map, and that this should be done in a safe environment conducive to knowledge sharing. Katie also noted something that many of us in the non-profit world are aware of: lots of community work happens in silos, and it is important to be aware of all the initiatives happening in your community so we can collaborate.

As usual, the YouthREX webinar had tons of practical information for non-profits seeking to improve their community and youth engagement practices!

 

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SFPY in French: A delicate balance between cultural adaptations and program fidelity

Last year, PAD and Health Nexus (two members of HC Link) received funding from the Ministry of Health and Long-Term Care to adapt the Strengthening Families for Parents and Youth (SFPY) program for Francophone communities across Ontario. The project, titled “Strengthening Francophone Youth and Families” (SFYF), includes consultations with Francophone organizations across Ontario, a Francophone Advisory Committee, and pilots of SFPY in French. The collaboration between Health Nexus and Parent Action on Drugs has so far been very successful, and the project findings are currently in the process of being disseminated across Ontario.

When done properly, cultural adaptations of family-based programs can help recruit and meaningfully engage participants, with increased participant retention of up to 40%. However, the process of cultural adaptation of a family-based program requires a delicate balance between making changes to the curriculum while maintaining program fidelity to ensure that the positive outcomes of the program are not compromised.

The SFPY program is an evidence-based, best practice program for youth aged 12-16 that has shown positive results in 21 outcome areas. SFPY is a shortened, adapted version of the 14-week Strengthening Families program by Dr. Karol Kumpfer of the University of Utah. Since SFPY was already adapted and shortened by PAD once, further adapting it to a Francophone audience was a daunting task.

Here are some of the major steps involved in culturally adapting a family skills program, which PAD and Health Nexus incorporated when adapting the SFPY program for a Francophone audience:

  1. Create a cultural adaptation advisory team to help determine how to balance the needs of the community with fidelity to the program.
  2. Translate and adapt the program curriculum to French language and culture (for example, use ideas/concepts that are more familiar or meaningful to that particular community).
  3. Translate monitoring and evaluation tools, and then measure baseline data on targeted outcomes to compare with outcomes after program completion.
  4. Ensure a strong monitoring component, which includes attendance records, feedback from program participants, fidelity to the original program, and successes/challenges.
  5. Evaluate the adaptation and incorporate lessons learned into the program to further improve it.

Interested in learning more? Sylvie Boulet (the project's coordinator at Health Nexus) will be delving deeper into this topic in a workshop titled “Applying Evidence-Based Strategies to Adapt a Program in French” at this year’s HC Link Conference. The conference theme this year is Linking for Health Communities: Action for Change. Register for the conference.

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Election Talk – Why Health and Wealth are Inextricably Linked

A recent Ipsos poll asked Canadians what issue areas they felt party leaders should have a very clear plan on. Unsurprisingly, party leaders’ plans for the economy was a top issue that Canadians said they would consider before casting their ballot, but tied for second were “creating jobs” and “addressing the problems facing Canada’s health system”.

Although the economy scored first in the poll, and healthcare second, the two are inextricably linked. This week, the Toronto Star published a great opinion piece by Alex Munter about the importance of considering healthcare and economy together in the context of an upcoming federal election. We all know that healthcare has significant costs on government spending, but some of the points Munter made really made me realize that healthcare policy really is a bigger issue than party leaders are giving credit for.

Munter argues there are “worrisome signs that this generation might become sicker adults, not healthier, than us”. For example, if current trends continue, obesity, mental illness, and premature births will cost Canada $35.5 billion, $423 billion, and $27.8 billion over the next 10-20 years, respectively. I knew that mental health in Canada was a growing concern, but I had no idea that it has the potential to cost the country a whopping $423 billion. If 70% of today’s children really will be overweight or obese adults by 2040, then we are headed for trouble.

The return on investment for prioritizing healthcare is huge – preventing or delaying the onset of chronic illnesses saves time parents spend on caring for sick children, while promoting higher productivity and lower absenteeism. Further, as healthy youth age into healthy adults, they will be able to remain independent longer if they maintain strong health.

Just as investing in early childhood education has been proven to benefit the economy, a long-term investment in young people’s health today means preventing illnesses and saving tax dollars tomorrow.
With less than 60 days left until Election Day, it will be interesting to see if and how healthcare is presented during the election campaign…

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Is Full Reconciliation with Canada’s Indigenous Peoples Even Possible?

Let me start by saying this: I am embarrassed that I indirectly benefit from the oppression of our country’s indigenous people.

As many know, just over a month ago, the Truth and Reconciliation Commission (TRC) published a scathing report about the impact of 150,000 First Nations, Metis and Inuit children that were forced to attend residential schools for over a century. The TRC found that the practice of residential schools amounted to “cultural genocide”, whereby the Canadian government intentionally destroyed the social and political structures and practices of Canada’s indigenous peoples in an effort to assimilate them. The list of policies by the government which allowed this to happen can be found in the TRC Report’s summary.

Reading about the physical, mental and sexual abuse of residential schools is painful - in some residential schools, the death rate was up to 75%.

What’s even more painful is this colonial history has meant that poverty, unemployment, abuse, and poor health are all rampant in Aboriginal communities today. Aboriginal families have over double the unemployment rate compared to non-Aboriginal families, and over half of First Nations children living off reserve live in low-income families. It comes as no surprise that low-income and inadequate housing is a risk factor that is linked to poor mental health and a disproportionately high number of Aboriginal children in the child welfare system.

Aboriginal people are also almost 9 times more likely than other Canadians to end up in the criminal justice system. As of last month, over one third of all women in prison are Aboriginal, while Aboriginals represent a tiny 4% of the overall Canadian female population. For First Nations children, this has significant implications, as the majority of Aboriginal inmates are parents, and often single parents.

In designing health-related interventions for Aboriginal communities, it is important to keep in mind the historical impact of colonization and trauma. Meaningful engagement with Aboriginal communities requires processes to be Aboriginal-led, where Aboriginal communities have decision-making authority. It is also important to recognize holistic approaches rooted in Aboriginal culture, which hold that, “Aboriginal people live and grow in families and communities with needs that span the full spectrum of spiritual, mental, physical, and emotional realms”. These are just a few of the recommendations I have found online, and I encourage anyone who is designing a health intervention for the Aboriginal community to consult with all relevant stakeholders on the best way to do so.

The report Open Hearts, Open Minds by the Best Start Resource Centre at Health Nexus notes the importance of ‘cultural safety’, which “recognizes power imbalances, political ideals and de-colonization efforts. It involves an understanding that the cultural values of the client are affected by their political past”. I think this is the most important aspect of working in Aboriginal communities – recognizing past traumas and putting Aboriginal stakeholders in a decision-making capacity.

While health interventions may improve outcomes in Aboriginal communities, the TRC Report details 94 “Calls to Action” to help the process of reconciliation. Even if we fulfill those 94 recommendations to redress the legacy of residential schools, will that make up for the dire situation of our indigenous peoples today? Clearly, we have a long way to go.

“Reconciliation is not an Aboriginal problem. It is a Canadian problem and involves all of us.”
– Justice Murray Sinclair, TRC Chairman

 

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Webinar Recap: YouthREX’s 10 Ways to Meaningfully Engage Underrepresented Youth

On May 28th, YouthREX hosted a webinar titled “10 Ways to Meaningfully Engage Underrepresented Youth”. It was a great learning event that included perspectives from service providers, social enterprises (such as Spoke N’ Heard), academia, and of course, youth!

Without further ado, here are YouthREX’s top 10 tips for meaningfully engaging underrepresented youth:

  1. Let youth self-identify. Labels like “marginalized”, “at-risk”, “vulnerable” can be strong words, and these labels are all circumstantial.

  2. One-off consultations with youth don’t create youth leaders. We need to embed youth in decision making, advising and brainstorming processes.

  3. Create the sandbox from the get-go. Give youth creative freedom to express themselves       

  4. Recognize your power and their power. Three powers are always at play – personal, local, and global. Power can come in the form of speaking English, being Caucasian, living in a developed country, and how you carry yourself. Be aware of micro-aggressions
  5. Experience is not a form of payment. Compensate youth for their time (ex. Public transit, food, snacks). Don’t expect young people have the time and resources to commit to meetings.

  6. Silence is a part of the conversation. Sometimes young people only speak when ask or are prompted to. So, ask for youth contributions. It can be intimidating to bring new ideas when you are the only young person in the room.

  7. Make all resources known. Marginalized youth may not always feel safe because of various forms of violence they have experienced in the past. Make them aware of the available resources before they have to ask, so it’s as safe a space as possible to work optimally. For example, tell youth if you will be paying for lunch or subway fare.

  8. Give a job title to youth who are involved in your organization. This clarifies responsibilities and helps youth in future jobs if they are able to say exactly what they did while working with you.

  9. Get to know the youth’s interest and goals. If they enjoy what they are doing, they will offer more to the organization.

  10. Appreciate and foster their intangibles. Marginalization prompts skills that may not be tangible, such as a distinct world view, knowledge of neighborhood experience, youth perspective, or creativity they may have developed due to lack of resources.

The second part of the webinar focused on an academic perspective on youth engagement, and was presented by Rebecca Houwer. Rebecca has produced a model of youth engagement on promising, evidence based practices to build leadership capacity of marginalized youth. She noted that structurally marginalized youth want opportunities to be part of their communities and have access to share in the work of addressing root causes of marginalization. When developing models for youth engagement, there is a danger of reproducing a patriarchal, euro-centric, adult-centric model that is exclusionary. Youth engagement needs to focus on skill development that moves young individuals, and although we may aim for a collaborative approach to leadership development, we also need to integrate personal and social development needs. Equally as important, Rebecca noted that it is important to contextualize programs within youths’ individual, cultural, political and gendered experiences. Lastly, I found it interesting that Rebecca mentioned the need to cultivate 21st century skills when working with youth, such as collaboration, innovation, and participatory practices, among others. With the world of work changing, developing these skills is crucial.

Overall, it was a great webinar jam packed with tons of resources and information. I’m definitely looking forward to attending YouthREX’s next webinar! 

You can watch a recording of the webinar here 

 

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Mental Illnesses in Canada: Can Mental Health First Aid Training Help?

Did you know that in any given year in Canada, one in five people experience a mental illness? Further, one in three people will experience it at some point in their lives. Here’s something equally as shocking: according to CAMH, in 2013, 2.2% of Ontario adults seriously considered suicide, which is roughly 230,000 people a year. These are just some of the statistics that show the increased need for understanding mental illness, as well as public education around mental health. To address this need, Mental Health First Aid training is becoming increasingly common in Canada.

To learn more about this topic, I listened to Suzanne Witt-Foley’s radio interview (https://www.youtube.com/watch?v=_WYt6Hg_lQI) about mental illnesses in Canada, and her experience running Mental Health First Aid training. Here’s what I learned. 

Public education about mental health is extremely important. Mental illness is common, and many times it begins during adolescence. Early interventions can produce stronger mental health outcomes in later years. If treatment comes too late, then ingrained brain pathways are developed and are much harder to change. Early intervention makes those pathways easier to shift, so it is easier to address mental health symptoms when they arise. Public education on mental health also reduces stigma. There are a lot of myths, and when we don’t understand something we tend to fear it. Suzanne believes that if we don’t understand mental illness, we fear, and that means we avoid it.

There are many strategies that exist to address mental health issues, and Suzanne believes these strategies are like ingredients for soup; you need a whole tool kit, and strategies that work for some people don’t work with others.

Mental Health First Aid training is one such “ingredient”. Mental Health First Aid training is a 12 hour course developed to help provide initial support for someone experiencing a mental health problem. It was developed in Australia in 2001, has been extensively evaluated, and is an evidence-based course with a certificate for participants at the end. The course has been shown to improve participants’ knowledge of mental health, and has also contributed to a reduction in stigma.

We take a physical first aid course so why not mental health course? When we think of prevalence of mental illness in Canada, it makes sense to learn about it. Topics in the Mental Health First Aid Training include:

  • Introduction to health and mental health
  • Substance related disorders, addictions, mood disorders, anxiety, psychotic disorders
  • Signs, symptoms, and risk factors for mental illnesses
  • Overdose, panic attacks suicidal behaviour, psychotic episodes
  • Action steps
  • Information about treatment and current resources

To learn more about Mental Health First Aid training in Canada, visit http://www.mentalhealthfirstaid.ca/.
Suzanne Witt-Foley is an HC Link Consultant. To learn more about HC Link Consultants or to request a service, visit http://www.hclinkontario.ca/consulting-services/consultants.html

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Community Forum: Breaking Down Barriers

On March 31st, the San Romanoway Revitalization Association held a community forum through their “Pathways to Health Choices” project funded by Health Canada. The event was titled “Breaking Down Barriers: Mental Health and Drugs Among Marginalized Youth”.

The keynote for the forum was Dr. Akwatu Khenti, the Director of Transformative Global Health at CAMH. Dr. Khenti’s presentation was titled “Drugs, Social Construction and Policing Unequal Justice and Health for Racialized Youth”. He started off his presentation by stating that race and the perception of race matters, because it drives public policy and the public agenda. He noted that racism impacts everyone, and that we are all part of the solution.

He spent much of his presentation going through Canada’s history with racism, and then discussed the history of Canada’s national drug strategy which started in the late 1980s. Because of the drug strategy, by the 1990s, Canada was number 2 in the worlds in terms of drug arrests. He made the point that the harms of cannabis in particular are negligible to the harms of incarceration. Dr. Khenti noted that between 2002-2012, Black incarceration increased by 75%, and “white incarceration went down… even though blacks and whites use the same amount of drugs” in Canada.

He argued that most people age out of cannabis use as they get older and take on more responsibilities such as jobs, university, marriage and children, but that Black people are more likely to get arrested before they “age out” of drug use. Further, Dr. Khenti argued that Black people are also perceived as older by the police, so if a 13-year-old is caught doing drugs, he (and Dr. Khenti noted that it is most often Black men who get stopped by the police) is more likely to be seen as age 16 and thus having more responsibility. Dr. Khenti repeatedly made the point that in order to make strong policies that help racialized youth, more race-based police data is needed.

After a Q&A, there was a panel discussion on Strategies to Reduce Drug Use and Enhance Youth Mental Health. There were five discussants from very different backgrounds ranging from a mental health/addictions case manager, a police officer, a lawyer, and youth outreach workers. The panel touched on issues relating to youth engagement, the importance of accessing resources for racialized youth, and a heartfelt story about one panelist’s experience in the incarceration system and how he changed his trajectory after being released.

The event closed off with a networking session and lunch. It was a great forum to bring together those working in the mental health and addictions sector, and a great learning event!

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Strengthening Families for Parents and Youth: All Partner Forum in Toronto

On March 23rd, 2015, Parent Action on Drugs (PAD) was fortunate enough to have all our provincial partners for the Health Canada project come to Toronto for a face-to-face all-partner forum. The day was full of collaboration, networking, and information sharing about how to make Strengthening Families for Parents and Youth (SFPY) deliveries as successful as possible in the coming years.

 Diane Buhler, Executive Director at PAD opened up the day by discussing the objectives of the Health Canada project, and what has been achieved so far. After discussing what the goals for the all-partner forum were, Diane passed the floor to Suzanne Witt-Foley (Consultant at Making Connections 4 Health), who was the facilitator for the day.

 After leading an activity to help partners get acquainted with one another, Suzanne facilitated a discussion about where each partner is at in terms of delivering an SFPY cycle. Following this, the Peterborough Drug Strategy shared a presentation about their experience running SFPY in Fall 2014, and how they achieved such strong successes with 11 families.

sfpyforumNext, Suzanne facilitated a community mapping exercise, where all participants were asked to identify the assets in their community, the need for SFPY, the service gaps SFPY can fill, how SFPY can benefit the organization, and what individuals, businesses, funding sources, and organizations may help in delivering a successful SFPY cycle.

After a fun activity from the SFPY curriculum, the group participated in an interactive activity about how to engage youth successfully in SFPY. Participants were given post-its and were asked to write down what works, successes, challenges, and barriers to running SFPY. The post-its were then posted on the wall, which had a continuum showing different stages of the SFPY cycle. See the attached for a photo of the continuum and a list of the ideas and lessons learned that were raised during this session.

After a nutritious lunch, the group came back to a presentation by Suzanne about how 14 years of running the Strengthening Families Program has transformed the community in Muskoka. Suzanne touched on funding sources, how stigma associated with the program has almost disappeared over the years, and tips on how to make families feel as comfortable as possible when they are participating in the program.

The group then had a discussion about where each partner is at in terms of capacity building, and how the project has contributed to an increased sense of community. The day closed off with a discussion and sharing of each partner’s community map (see some examples attached), and a roundtable discussion about what each participant gained from the day.

It was a wonderful day full of rich discussion, knowledge exchange, networking and capacity building. We are very thankful to our partners for making the trip to Toronto for the all-partner forum, and also to Health Canada for providing the funding to make this all-partner forum possible.

For more information about SFPY, go to www.sfpy-pad.org 

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Parent Action on Drugs (PAD) presents at the 2014 Children Mental Health Ontario Conference

By Seher Shafiq, Parent Action on Drugs

On November 25th, PAD attended the 2014 Children Mental Health Ontario (CMHO) conference titled "Getting it Right for Kids and Families" at the Marriot Hotel in Toronto. I attended on behalf of PAD, and we had a poster presentation on display titled Strengthening Families for Parents and Youth: Engaging Diverse Youth in a Family-Based, Skills-Building Approach. I got there bright and early for 7:30am, and before the conference started was able to chat with many delegates about our best-practice program for at-risk teens aged 12-16. You can learn more about our SFPY program at www.sfpy-pad.org.

CMHO Seher Nov 25

After the conference breakfast and poster presentations, the day opened with a speech by Mr. Aryeh Gitterman, Assistant Deputy Minister for Policy Development and Program Design at the Ministry for Children and Youth Services. Gitterman emphasized the importance of "shared responsibility", as well as collaboration at the local level. Recognizing that a lack of knowledge and lack of planning is a hurdle, he suggested that lead agencies should reach out to the LIHNs, as the two have a common objective and work together. Gitterman discussed the education system at length, stating that all 72 school boards in Ontario have a superintendent with responsibility for mental health, a mental health leader, and mental health teams. He noted that school boards now have a Mental Health Strategy and Action Plan in place, which is a big change from the past. Gitterman also touched on data, measurement and public reporting about performance indicators, stating that the public should know how the system is working.

After Gitterman's speech, I attended the morning session on youth engagement titled How to Give Youth an Opportunity to Speak Up, Speak Out! We talked quite a bit about the National Youth Advisory Committee – a group of 110 youth aged 12-24 from across Canada, who work on their own projects while also playing an advisory role for projects within and outside CAMH. The discussion focused around how to best engage youth and make them feel comfortable and welcome while doing so. We discussed that accountability means many things: being accountable to the process, letting youth know how their input will be used, encouraging diverse voices, and allocating money and staff into youth engagement. Integrity was also discussed as being key to youth engagement, and organizations should not just participate in youth engagement to "check the box"; they should do it wholeheartedly or not at all. We also touched on the importance of trust and respect, and talked about concrete ways to engage youth effectively: have food and incentives that youth will like, have more youth than adults in the room, support conversations rather than directing them, and ensure that the environment is comfortable, flexible and accessible. The best part about this session was the play-doh, pipe cleaners and pom poms on each table that participants were encouraged to play with!

play dough

After a healthy lunch and great keynote about mental illness and stigma by Professor Patrick Corrigan of the Illinois Institute of Technology, I headed over to another session on youth engagement titled Youth-Adult Partnerships: Working Together to Achieve Desired Outcomes and Impact System Change. A youth-adult partnership (YAP) is a relationship between adults and youth that focuses on joint work, common values, shared power and works on collective issues. The principles of a YAP include authentic decision-making (active participation of youth), community connectedness (increases community engagement, fosters relationships), natural mentorship (support without taking over), reciprocal activity (everyone is a teacher and student). The session discussed how youth can join an organization, as well as the challenges and solutions associated with YAPs. We ended with a short workshop where we discussed in groups what our organizations are currently doing to engage youth, and what we hope to do in the future.

Pyramid

The conference closed with a panel discussion and another engaging workshop. Overall, it was a great day!

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2014 Launch of Best Practice Guidelines for Mental Health Promotion: Children and Youth

By Seher Shafiq, Parent Action on Drugs

On October 7th, 2014, the CAMH Health Promotion Resource Centre held a webinar to launch the latest version of the Best Practice Guidelines for Mental Health Promotion: Children and Youth. The Guidelines were launched by CAMH, Toronto Public Health, and the Dalla Lana School of Public Health at the University of Toronto. With four presenters representing each of the three organizations, the webinar was a rich discussion involving knowledge exchange and new ideas.

BPGSpic

Marianne Kobus-Matthews, a Senior Health Promotion Consultant at CAMH's Provincial System Support Program started the webinar by discussing the history behind the Guidelines. In 2003 a report called the Analysis of Best Practices in Mental Health Promotion across the Lifespan was commissioned. Over the years, the project got narrowed to children and youth, because it was seen that most studies with a lot of evidence focused on children (7—12) and youth (13-19). In 2007, the online tool Best Practice Guidelines for Mental Health Promotion was launched. Now in 2014, many developments show the momentum of mental health promotion:

For example, there now exist national and provincial mental health strategies that focus on the mental health of children and youth. This meant that 2014 was a good year to refresh the guide and include new literature that has emerged since 2007. The goal of the Guidelines is to eliminate risk factors and promote resiliency. Practitioners are also encouraged to take a modified approach that considers social determinants of health.

Marianne discussed how youth that belong to groups that face social and economic exclusion (such as Aboriginals, LBGTQ youth, newcomer youth, and street-involved youth) have greater problems when it comes to health. She highlighted that resources in the guidelines include a worksheet that asks an organization questions based on the Guidelines. This includes a checklist of actions that can be taken to ensure your organization follows the Guidelines as much as possible. Marianne also mentioned that the guide has outcomes and indicators to help your organization gauge the success of an initiative.

Suzanne Jackson, an Associate Professor in the Health Promotion Program at the Dalla Lana School of Public Health (University of Toronto) spoke next about the evidence base of the Guidelines. She highlighted the relevance of risk factors and protective factors, such as optimism, attachment to school or work, family harmony, etc, noting that the presence of more protective factors over risk factors lowers the risk of mental illness. We should therefore be pushing protective factors, she argued. Suzanne also went into the literature that helped provide the evidence and information to inform the Guidelines. For example, Keleher & Armstrong, 2006 have concluded that the most significant determinants of mental health are: social inclusion, freedom from discrimination and violence, and access to economic resources. She discussed the criteria for best practice program examples, some of which are: identifying at least 5 guidelines, and having an evaluation tool.

The last presenters were Claudette Holloway (Toronto Public Health, Acting Director, Healthy Communities), and Patricia Stevens (Toronto Public Health, Health Promotion Specialist, Investing in Families). Investing in Families (IIF) is "an initiative designed to improve the economic, health and social status of families receiving Ontario Works benefits in several high-needs communities across Toronto". IIF provides families: employment related services, health services, computer/literacy/homework help, recreational activities, and opportunities to be socially involved in the community (1). Claudette and Patricia discussed how the IIF project began and expanded, how Toronto Public Health formed a partnership with CAMH, and where the project is at now. They also shared how their project follows the CAMH Guidelines, as well as lessons learned. One 'lesson learned' was through using phase III of the Worksheet in the Guidelines to develop a transparent and resilient approach to their project. Toronto Public Health strongly felt that the Guidelines and the Worksheet provided a systemic approach and a framework for mental health focus, as well as an ability to incorporate organizational thinking into their project.

Questions after the presentation included topics relating to social media, mental health in the LGBTTQ community, working with vulnerable populations, and other mental health promotion initiatives for children and youth.

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information regarding the Guidelines (the CAMH Health Promotion Resource Centre has a limited number of hard copies of the Guidelines resource available by request). 

The webinar recording and slides are available for viewing.

Summary of guidelines

  1. Address and modify risk and protective factors, including determinants of health, that indicate possible mental health concerns
  2. Intervene in multiple settings
  3. Focus on skill building, empowerment, self-efficacy and resilience
  4. Train non-professionals to establish caring and trusting relationships with children and youth
  5. Involve multiple stakeholders
  6. Help develop comprehensive support systems
  7. Adopt multiple interventions
  8. Address opportunities for organizational change, policy development and advocacy
  9. Demonstrate a long-term commitment to program planning, development, and evaluation
  10. Ensure that information and services provided are cultural appropriate, equitable and holistic

(1) https://www1.toronto.ca/wps/portal/contentonly?vgnextoid=eaa9707b1a280410VgnVCM10000071d60f89RCRD

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