Affordable Mental Health Services in Toronto

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It’s not always easy to find low-cost mental health services in Toronto. Even as someone who has worked in the health sector for some time now, it can be challenging to find a reliable, affordable and up-to-date list of available mental health services in the city, unless I get it from a service provider directly. After all, providers tend to stay most on top of these things (service changes, fees, availability, etc.) as this is a central part of their job.

I’ve had a few people ask me about affordable, Toronto-based counseling services over the last few weeks, so I wanted to share a list of resources that I feel not enough people know about. I got this list of organizations from a trusted provider I know. I have not personally vetted nor do I necessarily endorse these resources, but I share them here as they may be great starting points for people who are exploring their options. It would be devastating to think that someone would not pursue mental health help for reasons of cost, and I hope that this helps bring some level of awareness to services that are making help more accessible.

Please feel free to download and print the list of resources as a Word file here: Mental Health Resources

I find that not enough of these resources/lists are available digitally (especially from providers) so they can be shared easily and enable people to make notes, changes, and additions. I restructured and digitized the above file from a paper copy of resources I received and hope it’s usable and helpful in this format.

There are many, many great resources out there and some hidden gems among them. A trusted physician is one of the best starting points for seeking support as she/he can help a person create a personal health plan and refer an individual out to community programs (e.g., CAMH), other organizations, or specialists (e.g., psychiatrist) based on their own assessment of a patient. Either way, seeking support is a big and important first step.

 

‘Public Health Iconathon’ at Insight2

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If you look through my most recent posts on this blog, you’ll notice a recent explosion of public health related icons I created back in October during my self-hosted Iconathon.

A summary piece of the Iconathon (above) will be featured at Insight 2: Engaging the Health Humanities at the University of Alberta in May. I mention this because not only am I delighted to take part, Insight 2 is one of the few exhibits that I know of that is exploring the intersections of design, art and health promotion. Moreover, Insight 2 is based in Alberta and, generally, I find that the conversation around design+art+health is limited here in Canada. Here is a quick blurb from their website about the aims of this project:

InSight 2 explores how we can engage the health humanities to help us work collaboratively across disciplines 
and communities, to imagine and design innovative and transformative processes, communications, products, environments, services and experiences that can help to promote our health and well-being.

Based on this description and my goals with the Iconathon, I thought it would be an appropriate addition to the exhibit. Here’s my explanation of how it aligns with this greater mandate:

“Public Health Iconathon” is a visual summary of an ‘icon marathon’ completed in October 2012 in response to the lack of recognizable, universal and usable imagery conveying complex public health concepts. Over a one-month period, twenty-five public health concepts were iconized, with personal Twitter followers and peers of the illustrator involved in helping brainstorm terms to visualize. Icons were created in less than one hour in order to encourage rapid ideation, iteration and prototyping.

The iconathon represents a type of visual design ‘jam’ or ‘charrette’ that I believe is important to incorporate into public health practice. Through ongoing and creative collaboration and a participatory co-design process, we can create new visual imagery in order to expand the public’s understanding of health and wellbeing, and improve health literacy, signage, and wayfinding. The ultimate goal is to create a more robust visual vocabulary for health.

Anyhow, if you’re in Edmonton AB in May, I think this showcase will be a great opportunity to see how practitioners, healthcare users, artists and designers are promoting health through creative and less conventional means. I look forward to seeing the other submissions!

A little mental help: Action cards

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Depression.

I know many who have and continue to experience it on a day to day basis. Given my training and work on mental health initiatives, I’ve had people approach me to ask about recommended resources on depression (websites, trusted literature, etc.) and tools that inspire motivation and action. And generally speaking, there are some great, evidence-based self-help resources out there:

While there isn’t a shortage of accessible and reliable content, it seems that the bulk of existing resources tend to be extremely text-heavy, look and feel somewhat dated, and come across as a bit dry, drab and ‘clinical’ in nature (e.g., included images are limited to charts and surveys or photo stock images like this). This is not to criticize any particular resource, including the ones I’ve mentioned. Rather, it’s more of a commentary on what I’ve seen and would expect to receive from my own health care practitioner.

To me, managing depression is about bettering one’s own mental health with the support of trusted friends/family and professionals. At the same time, I believe that this process shouldn’t have to feel like undergoing an academic or clinical exercise. It can be daunting enough to acknowledge the need for change, to seek out supports and embark on a treatment plan. Doing so within a clinical context while supporting yourself with dense and somewhat sterile resources probably doesn’t help minimize the overwhelming and uncomfortable feelings that can arise. Perhaps this is a common experience among those who go through the medical system to ‘fix a health problem’, but I think that addressing a mental health issue also comes with unique layers of stigma, challenge and complexity.

I have found few tools that are visual, colorful or feel friendly and personalized to my interests. While it’s actually quite exciting to see soft/hardware being developed that can help track mood and behaviour and enable us to interact with mental health issues in new ways, I think that the existing ‘old-school’ resources out there deserve a re-vamp too — in reality, these are the resources that the majority of care professionals continue to use and recommend in practice.

I decided to make some ‘action cards’ that suggest tangible steps one can take to help overcome depressive feelings. These cards are informed by cognitive behavioural therapy approaches to treatment and aim to be quick, ‘on-the-go’ actions that someone can print out, shuffle through, and carry around. They were also designed for someone familiar with CBT concepts and would probably play a more supportive role to someone undergoing treatment. These were created with a personal intent but are shared here if they (or the idea of them) can be helpful to someone else. Inspired by my own deep dive into the world of animation and cartooning, I decided to create a character who would accompany the cards and (hopefully) can appeal to a general audience. My hope was to create something more playful, personable, less ‘institutional’ feeling, and appealing to adults.

At the top, you can see ‘side 1’ of the cards with the “problem” being faced. ‘Side 2’ below offers a practical action response. I welcome your feedback and ideas on how to improve these cards.

 

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Health Promotion in Canada, A History

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Earlier this year, I decided to create a graphic in order to map out the history of Health Promotion in Canada — key milestones and movements from the 1970s onward. In many ways, this is a response to the lack of visuals and timelines I’ve found documenting health promotion activities. For a country that is internationally recognized for its leadership in this space, it surprises me that I haven’t found too many sharable graphics on this.

Here’s the full PDF draft: HP History_DRAFT3_AYIP

The timeline is unfinished and still in progress. Nonetheless, it serves as a starting point for documenting key moments for the health promotion movement in Canada. I realize that not everyone will agree with the relative importance of events in the timeline and that there are certain pieces that are missing (and only goes up to 2010), but I welcome your feedback. Please comment below with suggestions on what needs to change, stay or be added.

Below, you can find some of the references I used to populate the timeline. Many thanks to Dr. Suzanne Jackson for sharing her health promotion resources with me so this document could be created!

References

Health promotion in Canada: 1986 to 2006 by Suzanne F Jackson and Barbara L Riley

Health promotion in Canada – a case study by Health Canada

The Pre-Flight Safety Demonstration



During the flight if the cabin pressure changes, an oxygen mask will drop automatically from the panel above you. Remain seated. Pull the mask toward you. Use the support strap to hold the mask over your mouth and nose. Adjust your mask. Breathe normally.

Air Canada Safety Video

My mom always gives good advice. She is a very thoughtful and intelligent woman. She has also worked incredibly hard her entire life and, having moved to Canada from Hong Kong during her teenage years, she learned at a young age how best to take care of herself and her loved ones, even as she faced adversity as a woman, a woman of color, and a newcomer. Not surprisingly, she trained as a social worker and has spent her life supporting and counseling others in need of help. I love talking to her because she has the ability to be amazingly compassionate while being completely honest and up front with me. She can always cut through what I call the “fluffy bull****” (getting too entangled and debilitated by emotions) and just get straight to the point.

I have always turned to my mom for advice on love, life and relationships. And more recently, I reached a point at which several seemingly unrelated and rather problematic issues in my life became entangled with one another into a gigantic, messy knot. I was burnt out, overwhelmed, and felt powerless to create any change in my life. In other words, I wasn’t at my healthiest, physically, mentally, or emotionally. It wasn’t good. Despite this, I had deadlines to meet, work to finish, and projects I wanted to press forward with. I tried to find distractions and things I could work on, but I couldn’t find my focus…or motivation. But then I remembered some valuable words that my mom once shared with me a while ago when I was in a similar situation.

She gave me the analogy of flying on an airplane. As in the quote above, when the cabin pressure drops in mid-air, oxygen masks will drop from the upper panel and you’d better put one on. Most importantly though,

Always secure your own mask before assisting another person.

That last point was key: If you aren’t minding your own health and safety first, you are not going to be in a position where you can help others.

I was at a training with Anima Leadership last week on conflict resolution and brought up this point. It became a useful and logical reminder to myself and other participants to make sure that we are in position to be ready and as healthy as possible to approach conflict. Otherwise, it may turn into this sort of situation. It’s also a point that came to mind when I was at a Conference last week listening to Robin Sharma speak. He was talking to an entrepreneurial-minded crowd, and reminded us that we had to take care of ourselves first: Our state of health and wellbeing would translate into our work, our relationships, our start-ups and/or our companies. If we are a reflection of our business and vice versa, how could we expect people to engage with either if we are unwell? I think this is true for design too. If we neglect our health and identity within the design process and we forget to breathe (something so very basic and essential to our survival), we cannot produce “good” design.

This advice has helped me get through murky waters time and time again. I’ve learned that sometimes I need to be a little selfish and take care of me first, but that in the end, this is to the benefit of the work that I do and the people around me.

The next time I’m sitting through the pre-flight safety demonstration, rather than roll my eyes and think “I’ve seen this a million times before!”, perhaps getting a reminder won’t be so bad. After all, turns out it’s pretty useful advice.

Thanks mom.

The Health Promotion Font

Fonts have their own stories and personalities, and have the potential to amplify, diminish, or subvert the message(s) that they are intended to communicate. There is also an incredible power fonts have in their layout, colour, sizing, and overall organization in evoking a particular set of senses or feelings from its viewer.

As a growing and ever evolving health promoter, my experience as a practitioner and researcher has grown over the years: I have learned a lot, have been humbled to work with some amazing folks, and have been thrown into various contexts where I have co-designed health in communities in Canada and abroad. Channeling these experiences and thoughts into some thinking about fonts, I have decided that health promotion as a field is well represented by Papyrus.

According to Linotype,

Papyrus® is the work of American designer Chris Costello, an unusual roman typeface which effectively merges the elegance of a traditional roman letterform with the hand-crafted look of highly skilled calligraphy. It includes an extra set of initialing capitals to enhance its unique style.

If you’re curious, here is an intro to Papyrus, courtesy of Costello. I personally do not tend to use Papyrus (and there are many criticisms of it…yes, there was the whole Avatar debate too), but its textured, rough edges, irregular and wide curves have a very elegant, natural and ‘Earthy’ look that I think suggest something that originated from the ground-up, if you will. The spacing, curves and inflections suggest a calm and collective demeanor. Would you agree?

The Re-Imagined Ottawa Charter for Health Promotion

The Ottawa Charter is a seminal document in Health Promotion that was birthed at the First International Conference on Health Promotion twenty-five years ago in Ottawa, Ontario, Canada, November 1986.

The Charter was a way of legitimizing the vision for health promotion, describing key concepts, the prerequisites for health (conditions and resources needed for health), and outlining strategies and actions in order to achieve ‘Health for All’. The Charter highlighted individuals, communities, organizations, and systems as key players in improving health and wellbeing and frames the value systems and practices of health promotion. For the field, it represented the “move towards a new public health”. An original image of the charter can be found here — it is basically the same as the image you see above on the left (sans the Francais and colour).

While the state of health promotion and public health has evolved since 1986, the Ottawa Charter still remains a highly relevant, powerful, and inspirational document in the world of health promotion. This has been important in informing my own work as a health promoter, but I find it interesting that in 25 years, the logo has remained unchanged. Certainly, subsequent health promotion conferences have reinforced their support for the Charter and noted new and evolving issues for health promotion to take into consideration in this day and age (e.g., acknowledging rapid globalization and the role of information technologies in transforming our world) but no visuals have been created to reflect these considerations or even simply try to re-imagine different ways of visualizing these fundamental concepts in health promotion.

The original description of the Charter logo is here. I’ll just bring up a few points from this text so you have a bit of context:

The logo represents a circle with 3 wings. It incorporates five key action areas in Health Promotion (build healthy public policy, create supportive environments for health, strengthen community action for health, develop personal skills, and re-orient health services) and three basic HP strategies (to enable, mediate, and advocate).

The outside circle, originally in red colour, is representing the goal of “Building Healthy Public Policies”, therefore symbolising the need for policies to “hold things together”. This circle is encompassing the three wings, symbolising the need to address all five key action areas of health promotion identified in the Ottawa Charter in an integrated and complementary manner.

The round spot within the circle stands for the three basic strategies for health promotion, “enabling, mediating, and advocacy “, which are needed and applied to all health promotion action areas.

[The upper] wing is breaking the circle to symbolise that society and communities as well as individuals are constantly changing and, therefore, the policy sphere has to constantly react and develop to reflect these changes: a “Healthy Public Policy” is needed;

Based on this original explanation, I thought it might be a useful exercise to re-imagine the Charter. In doing so, my point is to play with these concepts, particularly since I see so much dynamism, synergy, and relationships amongst them that I do not think is currently expressed in the logo. I also wonder if policies are the binding concept that “hold things together” as suggested above — policy is powerful, but I think about it as another component of the greater Health Promotion (HP) system. To me, there are two main ways I’d like to change the logo: (1) visualize the HP concepts to demonstrate how they are constantly reacting, responding and adapting to one another and (2) illustrate the forces that shape, design, and manipulate these concepts (aka the Health Promoter).

So allow me to throw out some alternative visuals. And yes, they are all very nerdy (I think in very scientific ways), so please bear with me.

1. The Health Promotion Molecule: I have been talking about elements and molecules a lot lately, so I tried making a health promotion (HP) molecule using the five action areas. I changed the language of these actions slightly but I like this visual because it implies that HP must function as a whole and is comprised of several integral concepts. This was a start, but I didn’t really like the linear connectivity using the chemical bonds between the atoms. I think that the concepts relate to one another in dynamic and complex ways, and this is not illustrated here. Also, it’s not clear where the health promoter fits into this picture.

2. Health Promotion molecules: Based on the last logo, I thought it might be helpful to break off the action areas into different molecules to show that they can freely move around and interact with one another in different ways (if you can imagine, in a 3D space). Inspired by H2O molecules, you can think of the action areas having an attraction for one another (e.g., H2O polar bonds), enough so that together they have fluid qualities (highly interweaved). The dotted lines can represent motion (molecules are in constant motion and vibrate) and may even indicate the level of intensity of a particular action area depending on whether it is located closer to the centre or to the outer rings. Again, it’s not clear where the health promoter fits into this logo.

3. The Health Promotion Atom: I like the idea of orbitals and putting concepts into orbit around some sort of central component that brings all the concepts together, and so, I give you the atom. The atom here shows the HP concepts along different pathways of orbit. Like electrons orbiting a nucleus, the HP concepts occupy and move within a particular space (or energy cloud if you will). There are different ways these HP concepts can relate to each other or their central “nucleus” (they can be drawn closer together or repelled further away), a quality I like about this logo. The nucleus represents the health promoter who can act upon these various action areas/concepts.

4. The Health Promotion Galaxy: This logo is inspired by the original Charter as the formation of the wings in the Charter remind me of a galaxy. The “wings” here start to swirl into each other and gravitate around the centre. The wings also appear to originate from the same central space that the health promoter occupies. This is a gravitationally bound system.

So, does design fit anywhere in these re-imaginations?

I think so. The action areas outlined in the Charter are inherently designed: We design environments to be supportive, interventions to help people build personal skills, public policy, health services, opportunities and processes for community action, and the greater system in which these operate. It seems that the health promoter is akin to a designer: someone who is aiming to change an existing situation into a healthy or preferred one, and essentially designing health.  The designer/health promoter is centralized in the last two logos, suggesting their importance and power (e.g., gravitational pull) within the greater health promotion system.

These may not be the best visual representations of health promotion, but it’s nice to have alternatives and options that can stimulate new or different thinking and ways of understanding the field. I wonder if we (as a field) will test out some new visualizations in the future, but in the meantime, I hope this is a starting point!

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NOTE: I should also mention that after chatting with some of my health promotion professors and consulting Google, I had a difficult time finding any versions of the Ottawa Charter that had been visually modified. Other than the logo for the Jakarta Declaration (which is really more of an artful than conceptual representation), I could not find much out there…if you can point me in the direction of any others, I’d appreciate it!