2016 (View original PDF)

Appendix A – Mental Health Commission of Canada Complementary PTSD related programming

National Standard for Psychological Health and Safety in the Workplace (the Standard)

Most adults spend more waking hours in the workplace than anywhere else (60% of our waking hours) and therefore workplace plays an essential part in maintaining positive mental health. Prevention and promotion are broad-based public health initiatives in which the workplace can play a key role, as we know the health or harm created in workplaces can migrate into families, communities, and society as a whole. This is particularly true when the workplace may be inherently stressful – for example, for public safety officers and soldiers.

The MHCC recognizes the importance of proper treatment and care for first responders and their families, and is already working with first responder organizations across the country to advance psychological health and safety in the workplace.

MHCC also recognizes that stigma is a major barrier preventing first responders from seeking help for mental health problems, and this fear, often delays diagnosis and treatment. It is important to build workplaces that are inclusive and eliminate stigma; that provide supportive programs and training, and have policies in place that support first responders being aware of their mental wellness and seeking care if necessary. Workplaces themselves can help raise awareness of the issues, build resiliency and coping skills and help prevent many of these psychological injuries from progressing. And for those responders who are struggling and need care, workplaces can promote help seeking behaviors and try to keep them at work.

The National Standard for Psychological Health and Safety in the Workplace (the Standard) has been developed to prevent and respond to psychological injuries in the workplace, including PTSD. It is a framework of tools that any workplace can use to help guide its efforts in promoting psychological wellbeing, and preventing psychological harm. Like occupational health and safety standards, it helps provide a road map for continual improvement in mental wellness. It is free and voluntary. Police, corrections officers, and other first responder groups are using it across the country to try to bring about systemic and cultural change at the organizational level. MHCC launched a case study project in 2013, and the Commission is now following more than 40 organizations across Canada as they apply the Standard and assess their experiences. Those include the RCMP and Canadian Security Intelligence Service, and first responders employed by a variety of municipalities.

Workplace Mental Health Training Programs for First Responders ROAD TO MENTAL READINESS (R2MR)

R2MR is an evidence-based program designed to reduce stigma and address and promote mental health and resiliency for First Responders. R2MR is based on a program initially developed by the Department of National Defence and adapted for the special needs of a first responder audience. The main objectives of R2MR are to reduce the stigma of mental illnesses, increase awareness of mental health, and offer resources to maintain positive mental health and increase resiliency. It has been adapted for use by a variety of first responder groups including police, fire, EMS and corrections.

R2MR training includes the mental health continuum model. This is a self-assessment tool which provides participants with various indicators of positive, poor, and declining mental health. The program helps First Responders in creating a supportive environment, strengthening the organizational culture, and contributing to a healthy workplace.

It is offered as an 8-hour training session for supervisors and leaders and a 4-hour training session for those on the frontlines. R2MR teaches participants how to use the “Big 4” — a set of evidenced-based, cognitive behavioral therapy techniques that help individuals cope with stress and improve their mental health and resiliency. In an effort to promote sustainability, R2MR can be delivered as a 5-day, train- the-trainer model where participants become facilitators and deliver both training packages (8-hour and 4-hour) to their co-workers.

THE WORKING MIND (TWM)

TWM is an education-based program designed to address and promote mental health and reduce the stigma of mental illness in a workplace setting. It is also based on the Department of National Defence’s program called Road to Mental Readiness (R2MR). TWM has been used in healthcare settings and the evaluation results have been very positive. It has similar goals and objectives as R2MR, but it has been specifically adapted for the general workplace.

Goals

  • To support the mental health and wellbeing of employees
  • To enable the full productivity of employees
  • To ensure the workplace is respectful and inclusive of all employees, including those with mental health problems and mental illnesses
  • To encourage employees to seek help for mental health problems and mental illnesses

Results to Date

  • Total individuals who have received training (R2MR/TWM) to date: ~12,500
  • We estimate that about 80% of these individuals are first responders
  • Projections for 2016:
    • We plan to deliver a minimum of 36 train-the-trainer courses which will create 864 new trainers
    • In 2016, we estimate that a minimum of 20,000 individuals will receive either R2MR or TWM training
    • Of the 20,000, we estimate that about half will be first responders

Mental Health First Aid for Veterans

The Mental Health First Aid (MHFA) for members of the Veteran Community Project aims to improve the capacity of members of the Veteran community to address mental health problems and illnesses by providing MHFA, an evidence-based training course. MHFA was developed to increase mental health literacy, decrease stigma, and increase helping behaviours in participants.

Mental health first aid is assistance provided to a person who is first developing a mental health problem, or who is in a mental health crisis, until appropriate professional treatment is received or until a crisis has been resolved. The MHFA course achieves these goals by improving participants’ knowledge

about mental health, including disorders and treatments; building skills for recognizing and responding to mental health issues through the use of a tested, evidence-based action plan (ALGEE); and increasing helping behaviours.

The Mental Health First Aid (MHFA) for members of the Veteran community Project has the following objectives:

  • To customize case study and resource sections of the MHFA BASIC course to make it relevant, appealing and effective to members of the veteran community.
  • To train up to 48 Instructors across Canada in both official languages
  • To train up to 3000 members of the Veteran community across Canada in the customized MHFA course, in both official languages
  • To conduct a process and short-term outcome evaluation throughout the term of the project with a results report submitted by March 2020.

These objectives will facilitate the achievement of the following outcomes:

  • Improve the capacity (increased knowledge and helping behaviours; decreased stigma associated with mental illness) of the members of the Veteran community to recognize and assist with addictions and mental health problems and illnesses;
  • Support the members of the Veteran community to apply evidence-based practices in service delivery, workplace and personal interactions;
  • Build capacity within members of the Veteran community to offer the MHFA course to members of the veteran community across Canada

MHFA – First Nations

Mental Health First Aid First Nations is designed to encourage open and honest conversations about mental health with family, friends, and others. It is part of a larger journey that helps strengthen the connections within communities. It was developed by First Nations people for First Nations people. This course is for everybody who takes it in a First Nations community setting. It is designed to speak to First Nations participants about mental health, where participants reflect on their life experiences and acknowledge the historical context of that experience. And from this, explore ways to restore balance on their journey to wellness.

Mental Health First Aid First Nations is a 20-hour course that aims to:

  • Increase awareness of the signs and symptoms of the most common mental health problems
  • Increase awareness of the pathways to recovery
  • Increase confidence and skills to help those developing a mental health problem or in crisis
  • Decrease stigma about mental illness

Facilitated from a First Nations Perspective where:

  • Sharing is an important part of learning
  • Every First Nations community is unique
  • Support looks different in every community
  • Communities explore First Nations and western practices in the pathways to recovery

MHCC Suicide Prevention Training Police

The Mental Health Commission of Canada is supporting the Canadian Police Knowledge Network (CPKN) in the development of a Suicide Awareness Program to be delivered to police members across Canada.

The online learning modules cover suicide awareness; risk assessment; suicide prevention; and the supervisor’s role. It is anticipated that the modules will be launched in early May 2016.

First Nations Police

The Mental Health Commission of Canada is looking to expand the suicide prevention training currently in development with the Canadian Police Knowledge Network (CPKN) to First Nations police. Our intent would be to co-develop a First Nations Police Suicide Awareness program with partners such as the First Nations Chiefs of Police Association, various provincial First Nations Police associations, and the First Nations and Inuit Health Branch among others. There are unique challenges for First Nations police and often the availability of resources (e.g. access to mental health professionals, presence of peer supporters, etc.) is limited or lacking. Services may need to be accessed from far away or through alternative forms of delivery. This makes training on suicide awareness and prevention even more critical.

Training for Physicians on Suicide Prevention

The Mental Health Commission of Canada, in partnership with the Canadian Association for Suicide Prevention, is developing an online learning module to enhance the capacity of physicians to identify, assess, and support those at risk of suicide, those who have attempted suicide and those bereaved by suicide. The learning modules will be presented to the College of Family Physicians and the Royal College of Physicians and Surgeons for certification.

Appendix B – Mood Disorders Society of Canada

MDSC has emerged as an effective national organization dealing with issues related to PTSD/Trauma in Canada. MDSC has also surfaced as one of the most well-connected organizations in Canada. A review of the resources that MDSC has brought to bear on PTSD over the years is impressive and has received recognition across the country. MDSC has a track record in collaborating with professional associations, governments, private industry and NGOs whom share its goal of improving the lives of Canadians living with or suffering from mental illnesses; as well as the lives of their families and caregivers. All mental health care professional associations and providers are valued collaborators and partners in this regard.

Since partnering with the Public Health Agency of Canada to produce the Government’s first report on mental illness in 2002 and another subsequent study in 2006, MDSC has remained at the forefront of many successful programs to change the way mental health issues are dealt with in society and treated in the healthcare system. Today, in co-operation with prominent partner organizations and agencies, MDSC continues to be a leader in innovative and successful programs aimed at helping those afflicted with PTSD and depression. Programs include:

Training:

  • The development and deployment of leading educational materials and training programs aimed at improving the diagnosis and treatment of PTSD and depression, and which are already used extensively by the Canadian Medical Association and physicians across Canada.
  • Providing PTSD diagnostics and other training to family healthcare teams involved in the Shared Care Program that promotes primary healthcare delivery through multi-disciplinary teams;
  • In partnership with the Mental Health Commission of Canada (MHCC), Canadian Nurses Association (CNA) and Bell Let’s Talk, developed a national stigma training program for nurses and other health care providers, to reduce the stigma found within the nursing profession
  • Developed a mental health training program and associated supports for front line staff of the Correctional Services of Canada (CSC). The project developed training curriculum and resources to assist CSC front line staff, case managers and mental health professionals to identify and find strategies to address the many barriers that ex-offenders face when re-integrating back into society.
  • MDSC, the Canadian Bar Association and Bell Let’s Talk recently completed the development of a Mental Health and Wellness in the Legal Profession, an online educational course that raises awareness and gives lawyers, judges and law students information about mental health and addiction issues, their causes and symptoms, as well as prevention treatment options. Over 1,000 lawyers, judges and other legal professionals have already completed the program. The curriculum is designed to give the profession factual information about mood disorders, their causes, symptoms, as well as prevention and treatment options. It offers support and resources for recovery and maintaining wellness.

Breaking the Stigma:

  • Creating and deploying the popular “Elephant in the Room” program aimed at reducing the stigma of mental health through public education and by stimulating an informed national conversation about mental illness. The program is already being used in schools, colleges and universities, police departments, and various government agencies.
  • Participation as one of the leading partners in Bell Canada’s “Let’s Talk” campaign also aimed at breaking down the stigma of mental health;
  • Leadership in the creation and operation of the “Champions” network of prominent Canadians whose influential voices continue to raise awareness of PTSD and other mental health issues;

Research:

  • Leadership in the establishment of a national network of mental health research centres. The Canadian Depression Research and Intervention Network (CDRIN) is a partnership among the Mental Health Commission of Canada, Mood Disorders Society of Canada and The Royal’s Institute of Mental Health Research that was established by an investment of $5.2-million from the Government of Canada. CDRIN is mobilizing Canada’s mental health community, including people with lived experience, to address important issues associated with mood disorders and post-traumatic stress disorder (PTSD) through research, capacity building and knowledge translation in order to improve the lives of people with mood disorders and their families. CDRIN has made tremendous progress in establishing a network currently consisting of seven Depression Research Hubs across Canada, spanning from British Columbia to the Maritimes and bringing together the top scientific minds in depression research and treatment, the community of people with lived experience of depression and the next generation of researchers. CDRIN, through its network, is currently affiliated with 53 partnering institutions and organizations across Canada. CDRIN also collaborates with other national and international networks. These include CANMAT (Canadian Network for Mood and Anxiety Treatments); CIMVHR (Canadian Institute for Military and Veteran Health Research); NNDC (the U.S. National Network of Depression Centers); and EAAD (the European Alliance Against Depression).
  • On October 26, 2011, over 70 experts, thought leaders and parliamentarians came together to discuss the issue of Post-Traumatic Stress Disorder (PTSD) at a special meeting hosted by the Mood Disorders Society of Canada at the Canadian War Museum in Ottawa. This innovative initiative gathered some of the most experienced and brightest minds in Canada. Particular emphasis was placed on experiences and outcomes for soldiers and veterans. The discussion topics included Enhancing PTSD Research; Family Supports; De-Stigmatizing PTSD; and System Capacity.

Indigenous Peoples:

  • A partnership with the Government of Canada and indigenous groups to create the first mental health policy specifically for indigenous communities.
  • Building Bridges I in 2008, MDSC and the Native Mental Health Association of Canada in a joint research and national consultation initiative, the first of its kind in Canada, centered on cultural safety, relational practice and social inclusion. We continued our partnership in 2009 – 2011 in the Building Bridges Two (BB2) project by collaborating with the First Nations, Inuit, and Métis Advisory Committee of the Mental Health Commission of Canada. Over 500 researchers, policy makers, service/health care providers, consumers and caregivers from every province and territory in Canada took an active role in this groundbreaking initiative.

First Responders:

  • Working with the Peer & Trauma Support Systems Team to provide early peer intervention for police officers and other first responders involved in traumatic situations which typically might lead to PTSD.