“Bell Let’s Talk Day,” an annual event that takes place today, has brought much-needed attention to the stigma of mental health and the funding gaps in our system. But the conversation has yet to include the state of mental-health workers.
As the number of Canadians willing to talk openly about their mental health has grown, so has the number of people in mental distress and the overall demand for services. Half of Canadians polled in an Angus Reid survey last April reported a worsening of their mental health since the start of the COVID-19 pandemic. Data from the Centre for Addiction and Mental Health demonstrates that the trend of worsening anxiety and depression mirrors the increase in COVID-19 cases. That trend has not spared mental-health workers. While burnout is a difficult concept to measure, research indicates that anywhere from 21 per cent to 67 per cent of mental-health workers experience high levels of burnout.
Many of the challenges faced by mental-health workers are “longstanding and unresolved” and predate COVID-19, says a preliminary report by the Mental Health Commission of Canada. “Frontline providers who serve populations with serious mental illness or substance use disorders – including shelters and residential or inpatient facilities who rely on face-to-face service provision – confront the greatest challenges from the added constraints of COVID-19.”
Mental-health services in Canada have historically been underfunded and understaffed and while COVID-19 has sped up the implementation of newly funded mental-health support programs, many of them rely on technology to align with physical distancing requirements, which is not an option for everyone.
Working in mental health can be a deeply rewarding job, says Francoise Mathieu, executive director of Tend Academy, a company focused on training high-stress, trauma-exposed workplaces. “But it can’t be …a mental-house mill where we are just seeing this incredibly high volume of folks without proper resources to offer them.”
Mary Ann Baynton, director of strategy and collaboration for Canada Life’s Workplace Strategies for Mental Health, says the mental-health field is “ripe for burnout,” due in part to the “unlimited demands” placed on mental-health organizations.
The job requirements of most frontline mental-health roles include three main components:
- Being good at technology, which is often not taught in school and has to be learned on the job;
- Being detail-oriented in documentation and reporting;
- And being people-oriented.
“Usually, people are good at one of those three,” says Baynton, “but in this role, people are expected to do all three.”
This is on top of the exposure to difficult or traumatic stories, which is often what leads people to seek services in the first place.
In addition to job demands, Baynton says, the personality types who are attracted to this field are also ripe for burnout. “So many bright, enthusiastic people go into this field thinking that they’re going to make the world a better place. And when they find out that they can’t fix or save people … (they) feel like a failure.”
Samantha Lamont, an addiction medicine physician in Guelph, says of this double-edged sword: “The more empathy you have for your patients, the more compassionate you are, the deeper the cut is in your soul and in your psyche.”
Lamont illustrates her point by sharing an experience she had supporting a young mother who was in an abusive relationship and “escaped with her life and the clothes on her back.” She secured a three-month stay in a women’s shelter but she is quickly running out of time, with no follow-up plan. “That is the injustice that breaks my heart.
“It invokes feelings of frustration and rage and powerlessness. That’s certainly going to affect your mental health, right?”
The stigma surrounding mental health, the very thing that “Bell Let’s Talk” aims to address, is common among mental-health workers, though it shows up in a unique way, says Stephane Grenier, founder and lead innovator of Mental Health Innovations.
“We can’t forget that self-stigma, the ability for human beings to judge themselves, even before they go to work, is huge with mental-health issues,” says Grenier. “I believe it is even more true of clinical workers. Why? Because they are exposed to the worst cases every day… so if they start slipping a little bit, if they start losing it a little bit, feeling stressed or having a hard time concentrating, they imagine the worst-case scenario…” and will dismiss their own experiences, instead of looking for support.
Even when mental-health workers do gather the courage to seek support, they face many of the same barriers as their clients. Vithieyah Atputharajah, a Toronto-based social worker, recalls having to overcome the stigma embedded in her culture to get support in the first place, followed by prolonged wait times spent in crisis centres, limited referral resources and then a lack of support from employers. Throughout her career in community mental health, Atputharajah says, she has consistently had little to no access to mental-health benefits – something that has changed only recently as a result of COVID-19 and the widespread recognition of its impact on mental health.
Support from employers is essential, says Atputharajah. Without it, “it makes it really hard. It feels like the people you work for, the people that you do all this fantastic, phenomenal work for, don’t essentially care or have not attended to some of your own struggles.”
Mathieu echoes the importance of employer supports. Going forward, she says, what is needed is quality training on secondary traumatic stress, flexible work environments and thoughtful caseload allocation as low-cost, evidence-based strategies to support employee mental health.
“And then of course,” says Mathieu, “if we eliminated poverty and addressed some of our much bigger social, cultural issues… like eliminating racism, discrimination and oppression, the burden on all (including mental-health providers) would be reduced.”