Click here to view the Call to Action banner that was developed in March 2018

 

Promoting Child and Youth Mental Health in Atlantic Canada: Call to Action

“When we think of mental health we often think of emotional difficulties and mental health problems and how we can resolve a crisis once it has occurred. This thinking demands an investment after the fact or ‘downstream’. ‘Upstream’ thinking means investing wisely for future success and addressing the broader determinants of mental health at a population level. We view mental health as a resource for all that requires a whole-of-government and whole-of-society approach. Although there is evidence to support an ‘upstream’ view, our current investment in policies and practice is ‘downstream’ and we will need a change in public and political support to think and invest differently.”  – ASI 2017 keynote speaker, Professor Margaret Barry, WHO Collaborating Centre for Health Promotion Research, National University of Ireland, Galway.

INTRODUCTION        

Raising healthy children is a responsibility of all Canadians. Supporting and promoting child and youth mental health is central to enabling them to become life-long, positive contributors to their communities and society. Strengthening policies and programs that support positive mental health for children and youth is vital to creating a sustainable and inclusive Atlantic Canada.

The Atlantic Summer Institute on Healthy and Safe Communities (ASI) has provided an Atlantic platform for inter-sectoral collaboration to promote child and youth mental health in the region. ASI hosted a Symposium on Child and Youth Mental Health Promotion in 2015 to bring together a broad range of groups – public, non-profit, academic and private sectors, including education, health, community services, justice and community organizations – to find ways to have a collective impact to improve child and youth mental health. The emphasis is on mental health promotion, through upstream investment for downstream benefits.

Building on the momentum from the past 2 years of ASI programming, which focused on emerging evidence and best practices that promote positive child and youth mental health in schools and communities, ASI 2017  was designed to generate a Call to Action based on evidence for polices, programs and best practices discussed and showcased at the event. Two documents have been developed to inform discussions, an Atlantic Profile of Child and Youth Mental Health and a Backgrounder on Child and Youth Mental Health Promotion that has compiled research and evidence from a variety of sources to inform policies, programs and practices that support child and youth mental health.

This draft Call to Action emerged from the planning for ASI 2017 and offers a framework that can be filled in before the August event and at the event. The first public draft was posted on the ASI website in mid-July, with communications going out to draw attention to it. The final version of the Call to Action will be released at the end of September, 2017.

The success of this Call to Action will be in the hands of diverse stakeholders from Atlantic Canada, other provinces and territories, the federal government, and pan-Canadian organizations. Below we set out clear actions that can be taken up by various stakeholders to implement a more sustainable approach to promoting child and youth mental health.

 

 GOAL AND OBJECTIVES

The goal of the Call to Action is to build on existing efforts to create a more sustainable approach to promoting child and youth mental health in Atlantic Canada.

The objectives of the Call to Action are to:

  1. Catalyze concrete, cross-sectoral responses for mental health promotion.
  2. Influence decision making in Atlantic Canada and across the country.

PRINCIPLES

We are using these principles as guideposts to action. Detailed definitions are in the Backgrounder.

  • Equity
  • Inclusion
  • Cultural Safety
  • Life-course Perspective
  • Respecting Rights of Children
  • Respecting Voices of Lived Experience
  • Respecting Truth and Reconciliation Commission
  • Mental Health in All Policies
  • Evidence-based Decision Making
  • Sustainability of Policies and Programs
  • Whole-of-government approach
  • Whole-of-society approach

ENABLING CONDITIONS

These conditions are required to achieve our goal.

  • Common Language
  • Population Health Approach
  • Cross-sectoral Collaboration
  • Partnerships Committed to Common Goal
  • Capacity Building for Success
  • Policy and Program Integration
  • Outcome and Process Evaluation
  • Collective Impact
  • Return on Investment
  • Knowledge Sharing, Translation and Mobilization
  • Data Infrastructure to Inform Policy and Program Development
  • Two-continuum model – Wellbeing and Mental Health

 

THE EVIDENCE FOR IMMEDIATE ACTION ON MENTAL HEALTH PROMOTION

This year is a defining moment for Canada and its many nations. The Report of the Commission on Truth and Reconciliation is the ultimate call to action, and perhaps the most pressing. There are many other organizations at the national, regional and provincial levels that are focusing on child and youth mental health. This Call to Action builds upon and makes strategic links to many existing provincial, territorial, and pan-Canadian strategies and policy reports. The Backgrounder prepared for this event provides a comprehensive overview of the evidence base that we are drawing on for this Call to Action. A few highlights are presented here as context for the actions outlined below.

  • First Nations Mental Wellness Continuum Framework (2015) – Assembly of First Nations, Health Canada’s First Nations and Inuit Health Branch, the National Native Addictions Partnership Foundation, Native Mental Health Association, and other community mental health leaders.
  • Mental Health Summit: Mental Health Promotion and Mental Illness Prevention for All (2012). Hosted by Government of Manitoba and Healthy Child Manitoba.
  • Mental Health Summit Follow-up: Think Tank Proceedings Report (2013). Public Health Agency of Canada, Mental Health Commission of Canada, Manitoba Mental Health and Spiritual Health Care, and Healthy Child Manitoba.
  • Maximizing Social Impacts and Returns on Investment: Towards a Sustainable Prevention Infrastructure for Population Mental Health Promotion and Mental Illness Prevention in Canada (2014). Mental Health Summit Network.
  • Population Mental Health Promotion for Children and Youth – Topical Papers and Resources (2017) National Collaborating Centres for Public Health.
  • Positive Mental Health Toolkit, 2nd Ed. (2016), Pan-Canadian Joint Consortium for School Health.
  • The SEAK (Social and Emotional Learning for Kids) Project, funded by the Public Health Agency of Canada.
  • Positive Population Mental Health Surveillance Indicator Framework for Youth (2017). Public Health Agency of Canada.
  • State of the Child Report 2016 – New Brunswick: Office of the Child and Youth Advocate

All of these reports are pieces of the puzzle of child and youth mental health promotion. Taken together, a clear picture emerges. The Backgrounder puts them all together in one place for all to view.

 

ACTIONS

This Call to Action builds on the Mental Health Summit Network report, which outlines ways of building capacity for collective impact, choosing approaches for sustainable system transformation, advancing evidence on returns on investment for mental health promotion, promoting existing best and promising practices upon which future efforts can build, and implementing and sustaining programs, practices, and policies for promoting child and youth mental health.

The success of this Call to Action will be in the hands of diverse stakeholders from Atlantic Canada, starting with the premiers of the four Atlantic Provinces, the Council of Atlantic  Premiers (CAP), other provinces and territories, the federal government, and pan-Canadian organizations. Below we set out clear actions that can be taken by governments, NGOs, researchers, and other stakeholders to implement more sustainable policies and programs for promoting child and youth mental health.


ACTIONS – What and Who

Policy

ACTION 1: For effective implementation of effective SEL programs, integrate them into school curricula
Who: Council of Atlantic Ministers of Education and Training (CAMET), Ministers and Departments of Education.

ACTION 2: Increase accountability by using health economics modelling to assess health impacts and related costs of all policies.
Who: Council of Atlantic Premiers

ACTION 3: Have a dedicated, fully financed Health in All Policies Unit within departments responsible for mental health and hold departments responsible for managing health impacts.
Who: Council of Atlantic Premiers, Ministers of Health, Education, Justice and Social Services.

ACTION 4: Educate policy makers to use the mental health continuum model (prevention, promotion, treatment, recovery) to support intersectoral policies and resourcing, linking upstream with downstream services.
Who: Mental Health Commission of Canada, Public Health Agency of Canada, Young Lives Research Lab, NGOs and Academic Researchers

 ACTION 5: Monitor health impacts research related to the legalization of cannabis.
Who: Young Lives Research Lab, Academic researchers.

 

Program

ACTION 1: Find ways of linking evidence for mental health promotion and mental illness prevention with front-line mental health services.
Who: Mental Health Commission of Canada, Young Lives Research Lab, Canadian Mental Health Associations, national and provincial.

ACTION 2: Create and promote system navigation services/supports to help children, youth, and families to access and navigate programs and services across the continuum.
Who: Ministers of Health and Social Services, Young Lives Research Lab.

ACTION 3: Support youth voice and insist on youth participation in program and/or research design.
Who: Young Lives Research Lab, All of us!

ACTION 4: Increase funding and build capacity for not-for-profits to conduct program evaluation and impact research.
Who: Council of Atlantic Premiers, Canadian Institutes for Health Research, provincial health research councils.

 

Practices

 ACTION 1: Advance the whole-of-person approach for the promotion of healthy and safe communities, situating children and families in their social, political, economic, and environmental contexts.
Who: Joint Pan Canadian Consortium on School Health, Young Lives Research Lab, All of us!

ACTION 2: Improve outreach of prevention and services to marginalized children, youth, and families.
WhoMinisters of Health, Social Services, local health authorities, Young Lives Research Lab.

ACTION 3: Invest in paid peer support
Who: Ministers of Health and Social Development, NGOs.

ACTION 4: Build a Community of Practice for promoting child and youth mental health.
Who: Young Lives Research Lab, NGOs, practitioners.

ACTION 5: Be humble, create safe spaces for learning, be careful not to shut people down, and be comfortable asking questions.
Who: Young Lives Research Lab, All of us!

ACTION 6: Ground the education and training of professionals in the lived experience of the social determinants of mental health and sustainable development goals.
Who: Universities and Colleges, Young Lives Research Lab.

 

Research and Knowledge Exchange

 ACTION 1: Bridge Western and Indigenous knowledge through two-eyed seeing; honour, respect, value, make space for other ways of knowing; need practical understanding of two-eyed seeing
Who: Researchers, funders, policy makers.

 ACTION 2: Value narratives and stories as evidence, being open to what constitutes knowledge and evidence and what gets privileged in certain contexts
Who: Researchers, funders, policy makers.

ACTION 3: Work alongside children and youth as experts of their own lives.
Who: NGOs, practitioners.

ACTION 4: Develop and promote multi sectoral indicators of mental health and its determinants.
Who: Mental Health Commission of Canada, Canadian Institute for Health Information (CIHI), Public Health Agency of Canada (PHAC).

ACTION 5: Use common indicators to measure short term and long term collective impact.
Who: Mental Health Commission of Canada, Provincial and Territorial governments, local health authorities, municipalities, data holders).

ACTION 6: Create and report on common indicators for child and youth mental health and frame outcomes within a rights-based approach.
Who:  Mental Health Commission of Canada, Provincial Departments of Health, Children’s Advocates, provincial health research councils.

ACTION 7: Create interdepartmental and inter-jurisdictional agreements to share data and indicators that illustrate factors that contribute to mental health.
Who: Council of Atlantic Premiers, Canadian Institute for Health Information, Public Health Agency of Canada.

ACTION 8: Increase support for diverse research methodologies, including community-based and participatory action research.
Who: Canadian Institute for Health Research, Social Sciences and Humanities Research Council, provincial health research councils.

ACTION 9: Promote economic literacy for people to better understand macro-economic, structural issues that impact mental health.
Who: NGOs, community groups.

ACTION 10: Create a clearinghouse and a sustained infrastructure and funding to maintain the sharing of data and knowledge in the Atlantic region and beyond. Work with other models and existing networks.
Who: Mental Health Commission of Canada.

ACTION 11: Educate the public about child and youth mental health promotion and illness prevention and the long-term benefits to communities and society.
Who: Council of Atlantic Premiers, Canadian Mental Health Associations, national and provincial, and other NGOs.

ACTION 12: Improve data sharing across jurisdictions by enhancing training, increasing funding, building infrastructure in adherence with reference to national and global standards.
Who:  Public Health Agency of Canada, Heath Canada, provincial Departments of Health.

ACTION 13: Improve public reporting on child and youth mental health indicators, including positive mental health indicators, on a regular basis.
Who: Mental Health Commission of Canada, Public Health Agency of Canada, Canadian Institute for Health Information, provincial health councils.

ACTION 14: Enhance partnerships between academia, communities, and the public sector to strengthen data collection and research
Who: Council of Atlantic Premiers, Public Health Agency of Canada.

ACTION 15: Read and support Truth and Reconciliation Commission Report, articles #57, #62, and #66.
Who: All of us!

 

Networks

ACTION 1: Introduce yourself to someone you don’t know in another sector that can contribute to your work.
Who: All of us!

ACTION 2: Seek opportunities through networks activities to advance a shared agenda.
Who: Council of Atlantic Ministers of Education & Training and Health, National Collaborating Centres Forum,  NGOs.

ACTION 3: Use network mapping tools to understand and expand your network.
Who: All of us!

 

 

APPENDIX 1 – CONTEXT

First Nations Mental Wellness Continuum Framework (2015) was developed through collaboration between the Assembly of First Nations, Health Canada’s First Nations and Inuit Health Branch, the National Native Addictions Partnership Foundation, the Native Mental Health Association, and other community mental health leaders.  The Framework identifies ways to improve service delivery to First Nations and provide culturally-safe supports. We can learn from First Nations and use this framework for working together to promote child and youth mental health for all Canadians. Key themes from this framework woven into the ASI program are: leadership, cultural ways of knowing, resilience, strengths-based, across the life span.

Mental Health Summit: Mental Health Promotion and Mental Illness Prevention for All (2012) led by Healthy Child Manitoba, the summit drew more than 300 delegates from across the country, including service delivery, policy and research, as well as representatives from provincial, territorial, Indigenous, federal governments, and national organisations. The post-summit report proposes a blueprint for a “pan-Canadian framework for the collaboration, implementation, scale up and sustained commitment to evidence-based mental health promotion and mental illness prevention.” Key concepts and themes from this report woven into the ASI program are; life course approach, collective impact, evidence-based implementation, and equity.

Mental Health Summit Follow-up: Think Tank Proceedings Report (2013).  Public Health Agency of Canada, Mental Health Commission of Canada, Manitoba Mental Health and Spiritual Health Care, and Healthy Child Manitoba. The goal of the Think Tank was to identify and recommend those mechanisms which not only facilitate the exchange (communication) of evidence among and between jurisdictions, but which also provide support for the development and scale up (“the how”) of MHP-MIP innovation and best practices within and across respective Canadian jurisdictions. It provides a blueprint for successful scale-up of effective mental health promotion-mental illness prevention innovations and best practices.

Maximizing Social Impacts and Returns on Investment: Towards a Sustainable Prevention Infrastructure for Population Mental Health Promotion and Mental Illness Prevention in Canada (2014). Mental Health Summit Network. Provides a pan-Canadian framework for the collaboration, implementation, scale-up, and sustained commitment to evidence-based mental health promotion and mental illness prevention.

Population Mental Health Promotion for Children and Youth – Topical Papers and Resources (2017) was published by the National Collaborating Centres for Public Health (NCCPH). This project addresses a need for resources to help clarify terms, concepts, roles and responsibilities related to population mental health promotion.  Key concepts from this series woven into the ASI program are: life course approach, health equity, indigeneity and diversity, population health promotion.

Positive Mental Health Toolkit, 2nd Ed. (2016), developed by the Pan-Canadian Joint Consortium for School Health, is comprised of five online modules that have been updated to reflect recent Canadian research, and to identify promising practices occurring in diverse contexts across the country.  The PMH Toolkit also provides a means of measuring positive mental health practices.  Key concepts from this toolkit woven into the ASI program are: strengths-based approach, social and emotional learning, resilience, connectedness.

The SEAK (Social and Emotional Learning for Kids) Project, funded by the Public Health Agency of Canada (PHAC), has created a vision document that represents the input of a cross-section of leaders, decision-makers, and practitioners who share a commitment to social and emotional learning (SEL) programs across Atlantic Canada.  Building on the PHAC Innovation Strategy’s program design, the document offers a detailed strategy for inter-provincial collaboration to scale up SEL programs in Atlantic Canada. Key themes from this report woven into the ASI program are: leadership, scale up, whole school approach, strengths-based, equity, partnerships, teaching and learning.

Positive Population Mental Health Surveillance Indicator Framework for Youth (2017), produced by PHAC, provides a comprehensive national framework captures high quality information about risk and protective factors affecting mental health outcomes for youth (12-17 years) across four related domains.  The 26-indicator framework was developed in consultation with stakeholders working in mental health surveillance, programs and policy. It will continue to evolve as new data becomes available.

State of the Child Report 2016 – New Brunswick: The eighth annual report is the undertaking of the Office of the Child and Youth Advocate.  It contains more than 200 data indicators, based on a child rights and well-being framework.  The 2016 report focuses on children’s mental health.  It is notable for its comprehensive look at factors that build resilience, while also examining persistent gaps and risk factors for positive mental health in children.  It is a strong example of a good practice.

 

Drafted by the Writing Team: Malcolm Shookner, Christopher Canning, Lara di Tomasso, Patsy Beattie-Huggan, Barbara Broom, Andrea Simpson, Joanne Elliott, Kathleen Murphy, Christian Whalen, with input from ASI 2017 participants.

September 26, 2017

 

APPENDIX 1 – CONTEXT

BACKGROUNDER