May 1, 2023 • 33 mins
Years on the ground gave Louise a view into the challenges facing mental health care delivery but also the crucial role that workplaces can play in fostering - or harming - mental health.
As past president and CEO of the Mental Health Commission of Canada, Louise led the development of the country’s first Mental Health Care strategy. In this episode, Diane and Louise talk about stigma, the workplace, and being vulnerable.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
I found out that no matter how often I told it,
it didn't get easier.
So I think it has,
I've had people tell me that it has inspired them that they have tried it out themselves.
And so if there's a super power to be had,
it's not so super but being vulnerable and showing that uh you are human,
(00:25):
but yet in a leadership position,
I think is one of the most powerful things that I have ever experienced in all my years in leadership positions.
Today,
I'm speaking with Louise Bradley and I just have so much respect for what Louise has accomplished.
She recently stepped down as president and CEO of the Mental Health Commission of Canada,
(00:49):
which was a post she held for 12 years under her leadership.
Louise advanced many important issues,
improved psychological safety in the workplace,
as well as addressing issues around homelessness and driving people centered care.
In 2019,
Louise was presented with the Order of Canada in recognition for the outstanding achievement and service to the nation in the field of mental health.
(01:15):
Personally,
Louise and I not only share our love of Atlantic Canada,
but also many of the same views and concerns on the state of Canadian mental health care and what needs to happen to create meaningful desperately needed change.
Today,
we talk about stigma,
the workplace,
being vulnerable and we also talk about kindness.
(01:36):
Now,
let's get to my conversation with Louise early in your leadership,
you developed the first mental health strategy for all Canadians called changing directions,
changing lives.
And this was published in 2012.
Thinking back,
What did Canada look like?
10 years ago before this strategy was developed?
(01:59):
And what do you think Canada looks like?
Now,
10 years later after the strategy was published?
Well,
I'm happy to say that it does look different.
So back in 2012,
we were just beginning to talk about stigma and you know,
talking about the workplace where we spend most of our waking hours,
(02:20):
talking about mental health and workplace simply was not happening.
And if you needed time off to go for help to a psychologist or any kind of mental health assistance,
you didn't say,
I mean,
you lied about it.
You said I have to go for,
(02:41):
you know,
something physical,
you could talk about having cancer,
but you couldn't talk about having a mental health problem and certainly not in the workplace.
It was a time when if you were off for surgery,
you got all kinds of cards and flowers and well wishes.
If you were off because of a mental health problem,
(03:03):
there was radio silence and you didn't want to talk about it and people quite frankly didn't know how to talk about it.
So,
in that regard,
I'm actually happy you asked that question because now that I think about it,
yes,
there is a big difference in that period of time.
And notwithstanding,
(03:23):
we have a ways to go.
As I said,
we have made some progress and the commission at that time started a 10 year anti stigma initiative.
And I don't think there's a day goes by now that you turn on the radio or listen to TV,
that you don't hear mental health talked about.
That's improvement.
(03:44):
I am personally a glass half full kind of girl.
I'm always looking for the win.
What's the solution?
But I do find myself feeling quite negative about where we are now.
But in that context,
a lot has changed,
particularly around talking about mental health,
mental illness and around stigma.
(04:05):
I guess your follow up to that was in 2013,
your MHCC team developed the standard for psychological health and safety,
which really has become known internationally as the standard and really a framework for employers to use towards creating a healthier,
more psychologically safe work space that's used in all sectors and all kinds of different business.
(04:31):
What was going on then?
That made you think employers,
that's where we need to go.
Why the focus on employers and what role do you feel that they have in improving the mental health and well being of their teammates.
I think they have a very big role and an important one.
But also to,
it's important for them to realize that it's a huge return on investment.
(04:53):
And there have been many workplaces that have shown that I have spent most of my career in mental health and but I did take a little time away for a couple of years where I worked in a very large tertiary care hospital.
And I began to see that hospitals as ironic as it may sound can be in our very toxic places to work in.
(05:21):
And,
you know,
I was feeling a little bit out of a whole lot out of my depth in a tertiary care setting where I had responsibility for everything except mental health.
And I soon discovered the real reason why I was asked to go there to work was not to tell people how to do surgery.
(05:42):
But the work environment,
the culture there really did need changing.
And I worked hard on that.
And I like to think there was some improvement,
but I think it lit in me of passion that you know,
(06:02):
this was happening in this one place.
It had to be happening everywhere else.
And you know,
like I said,
I was feeling a bit out of my depth.
But I think I was also looked upon as being not a real clinician because I worked in mental health.
And so when the opportunity came to do something new and innovative,
(06:28):
I thought,
wow,
this is where we have to go and just think about it,
the domino effect of having a psychological safety standard for the workplace probably makes it a little more likely that you will go home at the end of the day and talk about it around the dinner table to family,
(06:51):
to friends.
And I think that in places where we have looked at where the standard has been implemented,
it's a wonderful place to begin with because my belief is that the only way we're going to improve the health care system is to develop strong healthy prevention programs.
(07:11):
And what better place to do that than in the work environment who wants to have staff who are,
Are stressed out tired.
There's no way that you're getting the best out of a person.
So the employer suffers and the employee suffers.
So I am really happy to see mental health being talked about plans being developed and actually implemented in places that,
(07:43):
you know,
back in 2012 simply would not have occurred to them,
let alone happened.
I completely agree.
And as a leader of a team now I've learned so much particularly and I have my list.
So this is what I'm going to ask you.
I have this list in my brain.
Now what I consider to be leadership superpower.
So for me,
there are things like integrity compassion,
(08:06):
vulnerability,
courage,
grit,
and maybe one of the most important is your ability to listen.
We all have the attention span,
not of a goldfish,
but of a dead goldfish.
Now it appears and actually people listening silently with intention is to me,
a leadership superpower.
So what I'd like to ask you is what are your leadership superpowers?
(08:30):
And also how do we engage leaders in order to create this change?
Because the change in my mind has to come from the top.
If the CEO doesn't buy it,
it ain't happening.
So what are your powers?
What do you encourage in other people?
And how do you get the C E O s to buy in?
That's a very good question.
And if I had a complete,
(08:50):
you know,
failed proof answer,
I'd be very happy.
I don't,
but I encourage leaders to do something that I've done myself.
And so I can say to them,
I know this isn't easy,
but here has been my experience and what I'm talking about is being vulnerable.
(09:13):
And so I always encourage leaders to tell their story.
We all have a story.
Uh There's not one of us that hasn't been impacted by mental health,
whether it's yourself a family member,
a good friend.
But in talking about it,
it empowers other people.
And my experience has been like,
(09:37):
I've been,
I was blown away.
It was actually a young woman who worked at the commission used to help me with writing speeches,
articles.
And so when I would talk to her about the messaging that I wanted to get across,
I would share a story with her.
Well,
lo and behold,
I started seeing these stories verbatim showing up in what she was writing.
(10:02):
And I was like Suzanne,
I can't talk about this in public and she pushed me out of my comfort zone.
And I did,
I shared the story of growing up here in ST John's actually where I am today.
And growing up in a,
I don't think you could even call it a system,
(10:23):
but we'll call it the foster system And talking about the impact that that had on me,
talking about losing my best friend to suicide in her 30s.
And one of the first times I did that,
I remember somebody coming up to me,
which always happened afterwards.
(10:43):
And she said,
Well,
she said I was just looking at my phone and starting to read Twitter.
And suddenly she said,
I thought,
oh wow,
this is not just another CEO type.
This is actually a real person.
And so she said,
I put my phone away and listened to every word and she had tears in her eyes.
(11:04):
And I have had that experience similar to that so many times.
And so,
but it's not easy,
as I said,
it was very difficult to talk about something that's deeply personal.
And it's,
I found out that no matter how often I told it,
it didn't get easier.
(11:25):
So I think it has,
I've had people tell me that it has inspired them that they have tried it out themselves.
And so if there's a superpower to be had,
it's not so super but being vulnerable and showing that uh you are human,
(11:45):
but yet in a leadership position I think is one of the most powerful things that I have ever experienced in all my years in leadership positions.
We did mention it was a young woman who was pushing you.
And it's interesting when I'm meeting young people now,
whether it's looking forward to maybe employing them or,
(12:09):
you know,
they're working as contractors,
how open they are.
And even starting once they know,
um a psychiatrist starting a conversation,
talking about their own mental health journey,
about their own experience so openly.
So I think they're going to change the world from a stigma perspective.
We've got a long way to go.
(12:30):
I guess I'd like to understand why creating national standards for psychological health and safety for post secondary students was important to you.
Well,
you know,
having,
well,
I'll share another story uh in,
I've had the immense privilege of being in every corner of this country through my work with the commission.
(12:52):
And so there were post secondary institutions as well where I would get invited to speak or just to talk about.
Was there anything that they could do?
And this one particular time I was visiting a very well known university and one that has a hugely high reputation and they were talking about,
(13:15):
um,
the fact that they lost 3-4 students every year to suicide.
And,
and it was almost as if,
you know,
as long as we don't go over that number,
then we're okay.
And I'm like,
how could 3 to 4 young people dying each year be normalized?
(13:38):
I,
I,
I was absolutely shocked and it hit the core of my being,
it really did.
And I was in a meeting shortly after that with a group of academics at the university and it was actually a group of deans.
(13:59):
And when I was talking about,
you know,
would you be interested in participating in something like this?
They said,
oh no,
we don't have any problems here.
You know,
this university is just fine.
And I said,
what about your faculty and your staff?
No,
no,
just fine as I was leaving,
(14:20):
I had no less than four deans come to me and talked to me about how difficult it was to work there.
So I thought Holy Anna,
this is like second only to hospitals in terms of toxicity.
And so there I really and truly came to understand that this was something that desperately needed to be addressed.
(14:47):
It was the,
you know,
the incidents around suicide rates that really triggered it for me.
But there were all of these other conversations that I that I was having and,
you know,
I don't think universities would want me to say this or many of them,
but it's a workplace like anywhere else,
but it has the impact of influencing so many people and so many lives that I really felt strongly that and there are other places that I'm pretty sure the commission will go on to expand and offer specialties in other situations as well.
(15:26):
So,
which would be great.
Well,
you demonstrated some vulnerability louise by talking about growing up in the foster care system.
And I wonder how those experiences have shaped you professionally in your approach,
going to post secondary students or just in general,
how have they shaped you professionally?
That experience?
(15:47):
I'm sure it has.
I mean,
I there was never an aha moment for me,
it was more organic,
it kind of just happened.
But finding somebody after you come through a situation like that and feeling so alone and feeling so abandoned and being abandoned.
It showed me the importance of somebody believing in you.
(16:12):
It has a huge impact.
I think it is an important thing.
And I believe that with my whole heart,
I do too.
And I think the loss of kindness and compassion in our health care system and particularly when someone is really struggling and they're going into what is an overloaded health care system,
(16:34):
you know,
going to an emergency department.
The kindness and compassion are so often missing and I don't think we think enough about the downstream consequences of someone asking for help and being treated so horrendously,
it's so impactful.
So I wonder when we think about the system we have now and the great challenges that we're facing with our public system.
(17:00):
Do you see a role for a private sector in mental health care delivery in Canada?
Could that be an added benefit for our health care system?
Do you imagine?
I think it does.
I really do.
I have seen,
you know,
wonderful examples of because I do believe corporate Canada has a big role to play in providing mental health services,
(17:28):
be it in their own individual workplaces or giving back to the communities that are so generously funding them and giving them their business.
And so I do think,
and I also think that there's probably more of a chance of more innovative ways of doing it instead of those of us who grew up in the system where,
(17:54):
you know,
I was used to.
But I want to see somebody,
I had to go in an office and sit in a waiting room and physically walk in.
There's private companies that are developing new and different innovations and I really do believe that they are doing really good things.
And so I do feel there is a role and that's not to diminish in any way or public health care system because I'm quite proud of it.
(18:21):
But I do believe that just to stick to that is actually depriving people of something that they could have just started carrying on from that last point that you made,
you said earlier that you were spoken to or perceived perhaps as not being a real clinician because you worked in mental health.
(18:42):
And I will say that really did influence my choice of a specialty.
I went into pediatrics when my passion was in psychiatry.
Then I figured out I didn't really like parents all that much and had to give in and become a psychiatrist.
But it was,
you know,
the losers in the class go into psychiatry,
the people that,
that can't get into anything else.
(19:02):
This was the stigma and I think it has a massive impact on funding.
It has a massive impact on perpetuating the stigma that people living with mental illness face within the health care system.
Why do you think that that stigma continues to exist in mental health care?
I think,
(19:23):
you know,
this is not something that you change overnight,
it's improving,
but this is decades,
if not hundreds of years in the making,
you simply don't change it by saying it's wrong.
I mean,
look at how hard it was for you and I as individuals to come to grips with that.
(19:44):
So it's a very difficult thing to overcome,
very difficult.
And I think that that's why the 10 year anti stigma initiative that the commission did was so important and so powerful and it looked at the issue of self stigma because that's extremely important and it's really,
(20:05):
really complex and it's difficult to deal with.
I bet you if I stopped and was really honest with myself,
there's still a little tinge of that belief roaming around inside this head of mine.
And so I think we need to be kinder to ourselves and accept that we're human beings and This was created over time and we were doing the best that we can,
(20:34):
but it's really complex and really difficult to shake.
I would fully agree.
Louise in 2019,
you were invested as a member of the Order of Canada,
which of course is our country's highest civilian honor.
And that was for your contributions to advancing mental health.
I want to start by saying that as a Canadian,
(20:54):
I just feel so proud of winners of the Order of Canada because they represent our best and brightest with all of your accomplishments.
What are you proudest of?
I would have to say that its workplace,
the psychological safety standard.
I really am so proud of that.
I'm proud of the team who put in so many countless hours,
(21:18):
the Canadian Standards Association.
It was a collaborative effort unlike anything else.
But when I see the aviation sector wanting me to be on their board because I have a background in mental health,
then by God,
we've done something,
right?
And so I'm very proud of that.
(21:39):
Now,
you know,
as a true blue Newfoundland or the flip side of that,
my greatest disappointment was having left the commission with the suicide rates not being touched.
It breaks my heart.
And particularly when I believe that almost every one of them were,
are preventable every year.
(22:01):
So,
you know,
we're going in the right direction,
but I also wish we could speed it along.
But I think that doing things in the workplace is a place where we can prevent things because we've learned that,
you know,
if you can get seen,
when you need to be seen,
it's the timing and that maybe once or twice is enough.
(22:23):
Whereas there was a lovely young woman when we Released the report here in ST.
John's who said that before stepped care,
she would call and ask for help and they put her on a wait list of 18 months for a backhoe when she said that very day,
if someone had offered her a shovel,
she would have been perfectly fine.
(22:45):
And I thought that example was just great.
And so I think that in looking at the standard which has,
I think influenced things like virtual and e mental health that it has had a broader reach than we actually expect.
(23:06):
And so I'm very proud of that and so proud of the team that put so much effort into it.
Well,
rightfully so for my part,
as a psychiatrist,
my focus has always been on supporting primary care providers,
nurse practitioners,
family doctors who I believe really bear most of the weight of mental health care delivery in this country.
(23:32):
We're never going to have enough psychiatrists.
But if we keep going the way we're going,
we're actually going to bankrupt our country from a healthcare perspective.
How do we better support these clinicians?
What innovations have you seen or do you imagine might make a difference when supporting our primary care providers to improve access for people when they're struggling?
(23:54):
I would agree with you with regard to primary care positions.
But I think expanding that and utilizing other disciplines as you know,
my background is nursing.
And I said,
I'm a staunch believer in peer support.
I have seen the impact that it can have and it is so hugely helpful.
(24:17):
And when I say peer support,
I mean,
trained peer supporters so that you're just not putting a hat on and saying I can talk to you and that's all you need.
But not everybody needs a psychiatrist or a psychologist,
it could be someone else who has walked a mile in their shoes and nose has learned some ways of being able to talk and help.
(24:39):
And so I think that we're going to have to start thinking differently about who mental health practitioners are and think myself included that,
you know,
just because I became an RN doesn't mean that there aren't other kinds of nurses who can offer and provide care every bit as good,
(25:00):
if not better than me.
And that was,
you know,
it took me a while to accept that because I was hanging on to that image that,
that role that I thought was so important.
And so I think that when we,
we think like that it closes us,
closes our minds to looking at other ways of doing things.
(25:24):
And so I think we've really got to start thinking differently about where and who provides mental health care.
I would agree with you.
And before medical school,
I was a pharmacist and I know now pharmacists are amongst the most trusted health care professionals as far as the general public viewing them with,
(25:47):
with a huge amount of trust.
I think one of the critical piece is,
is making sure that the education is aligned with the opportunity to make sure that pharmacists understanding of mental health care,
not just from a pharmacy perspective,
knowing how the drugs work,
but sometimes education is quite a bit behind,
(26:07):
but also how they can support people just through words,
just as a professional peer support,
you're not going to be able to do deep counseling,
but making that human connection and understanding that someone is suffering and giving them some guidance or direction towards really good tools.
That's what you're talking about.
I think when you talk about all health care providers being able to be part of this bigger solution.
(26:34):
Absolutely.
I mean,
last week I went to the pharmacy and got my booster and flu shots and it was pharmacist who gave it to me.
And we had a wonderful discussion and I could envision,
you know,
I felt good when I left there because it wasn't just somebody jabbing me.
It was somebody talking about,
(26:54):
you know,
how many people they had come in that they've given the boosters too and the impact that was having.
And,
you know,
I left feeling good about it.
And so it's,
it's so much more you said then that it was almost as if that was the tool to get somebody talking.
And I think that disciplines are not performing to the highest level that they can and that they're capable of.
(27:17):
I would agree with you completely.
And once again,
coming back to just being kind and compassionate,
how powerful that isn't an interaction.
Absolutely.
You know,
it's having that connection.
Kindness is,
you know,
I'm part of a homeless initiative here in ST John's and all of the ads I see them coming out,
(27:39):
we see it on the side of the busses,
it says kindness wanted.
And I thought,
wow,
it's more than just at the gathering place that kindness is wanted.
I think it could be a principle that could be applied just about anywhere.
And I think we underestimate the impact and the importance of that.
(27:59):
I agree,
taking care of others is one of the greatest gifts we can give and the rewards,
what you get back is just so much greater than any time or energy you put out.
But the other good thing is it keeps us young louise because your brain as you're learning new things is constantly modeling and remodeling that neural plasticity that protects us.
(28:22):
So we have to keep learning in order to be able to continue to stay young and continue to contribute.
I guess the last question I want to ask you about is if you had an ability to ask one critical question,
one big ask to healthcare leaders or government or industry to improve mental health care in Canada,
(28:44):
what would that ask be?
Um I'm going to just jump right in here and,
and I think you want the first thing that comes in my mind and that is to develop a national suicide prevention strategy And not only a strategy but one that will actually see plans to be rolled out,
(29:08):
these are senseless deaths and if there are 5000 people every year who die by suicide,
and those are the ones that are registered as dying by suicide.
And I know how it impacts the mental health of the families and the friends around that person who died.
And as I said,
(29:29):
it's my one regret in being with the commission that I didn't see a change in those numbers and they're stubbornly sticking there.
So that would be my big wish I would be very happy if we could see that being taken more seriously.
I agree with you.
So,
first of all,
I'm just so grateful for your time louise.
(29:51):
I'm thinking back to when I started,
I've been a psychiatrist close to 25 years now.
You've been in this,
this world for a long while trying to make a difference.
Mental health now and discussions about mental health,
mental illness are everywhere.
Did you imagine you get to this place where everyone's talking about it?
(30:12):
Yeah.
No,
no,
I did not.
Um You know,
it,
it was shrouded in secrecy for so long and it was something,
a source of shame because,
you know,
just pull up your socks for God's sakes and you'll be okay.
And so now to,
to get to this,
(30:32):
you know,
I,
and seeing it being discussed in places I never dreamt of.
But yeah,
so that's why when I hear people saying that things are dark and dismal and nothing has changed.
That's not true.
It really isn't true.
And so I really appreciate this discussion today because um you know,
(30:53):
you mull it around in your own mind but talking about it out loud like this somebody else.
It's like,
yes,
it really has improved and I know there's a long way to go,
but there has been a difference.
Thank God for that.
Thank God for that and thank God for you louise such a pleasure for you.
You're a wonderful interviewer.
(31:14):
Thank you.
Great.
Well,
it was enjoyable.
So thank you and I hope our paths will cross again soon.
Me to take good care.
Thank you.
Bye bye.
As I reflect on my conversation with Louise,
I'm just so thankful we have people like her in our world.
(31:34):
People who have a big vision for what needs to happen and are also willing to dedicate their life to translating vision into action,
Louise background and mental health care delivery.
Together with her personal and heartbreaking experience with suicide,
have informed her compassionate caring leadership through the efforts of people like Louise,
(31:57):
we have seen substantial moved in mental health policy,
attitudes and programs both in the community and in the workplace.
I left this conversation inspired to do more and I felt hopeful while our mental health care system is desperately far from perfect Louise is a living testament to what willpower and stick to itiveness can accomplish until next time.
(32:23):
Thanks for listening.
The Wicked Mind podcast is a series of unique conversations with individuals that share experiences and perspectives on mental health care.
Together.
We will uncover ideas that inspire action.
Please make sure you subscribe,
share and comment.
And if you have a topic or guest suggestion,
(32:45):
please reach out to me at Dr Diane McIntosh dot com.
I found out that no matter how often I told it,
it didn't get easier.
So I think it has,
I've had people tell me that it has inspired them that they have tried it out themselves.
And so if there's a super power to be had,
it's not so super but being vulnerable and showing that uh you are human,
(00:25):
but yet in a leadership position,
I think is one of the most powerful things that I have ever experienced in all my years in leadership positions.
Today,
I'm speaking with Louise Bradley and I just have so much respect for what Louise has accomplished.
She recently stepped down as president and CEO of the Mental Health Commission of Canada,
(00:49):
which was a post she held for 12 years under her leadership.
Louise advanced many important issues,
improved psychological safety in the workplace,
as well as addressing issues around homelessness and driving people centered care.
In 2019,
Louise was presented with the Order of Canada in recognition for the outstanding achievement and service to the nation in the field of mental health.
(01:15):
Personally,
Louise and I not only share our love of Atlantic Canada,
but also many of the same views and concerns on the state of Canadian mental health care and what needs to happen to create meaningful desperately needed change.
Today,
we talk about stigma,
the workplace,
being vulnerable and we also talk about kindness.
(01:36):
Now,
let's get to my conversation with Louise early in your leadership,
you developed the first mental health strategy for all Canadians called changing directions,
changing lives.
And this was published in 2012.
Thinking back,
What did Canada look like?
10 years ago before this strategy was developed?
(01:59):
And what do you think Canada looks like?
Now,
10 years later after the strategy was published?
Well,
I'm happy to say that it does look different.
So back in 2012,
we were just beginning to talk about stigma and you know,
talking about the workplace where we spend most of our waking hours,
(02:20):
talking about mental health and workplace simply was not happening.
And if you needed time off to go for help to a psychologist or any kind of mental health assistance,
you didn't say,
I mean,
you lied about it.
You said I have to go for,
(02:41):
you know,
something physical,
you could talk about having cancer,
but you couldn't talk about having a mental health problem and certainly not in the workplace.
It was a time when if you were off for surgery,
you got all kinds of cards and flowers and well wishes.
If you were off because of a mental health problem,
(03:03):
there was radio silence and you didn't want to talk about it and people quite frankly didn't know how to talk about it.
So,
in that regard,
I'm actually happy you asked that question because now that I think about it,
yes,
there is a big difference in that period of time.
And notwithstanding,
(03:23):
we have a ways to go.
As I said,
we have made some progress and the commission at that time started a 10 year anti stigma initiative.
And I don't think there's a day goes by now that you turn on the radio or listen to TV,
that you don't hear mental health talked about.
That's improvement.
(03:44):
I am personally a glass half full kind of girl.
I'm always looking for the win.
What's the solution?
But I do find myself feeling quite negative about where we are now.
But in that context,
a lot has changed,
particularly around talking about mental health,
mental illness and around stigma.
(04:05):
I guess your follow up to that was in 2013,
your MHCC team developed the standard for psychological health and safety,
which really has become known internationally as the standard and really a framework for employers to use towards creating a healthier,
more psychologically safe work space that's used in all sectors and all kinds of different business.
(04:31):
What was going on then?
That made you think employers,
that's where we need to go.
Why the focus on employers and what role do you feel that they have in improving the mental health and well being of their teammates.
I think they have a very big role and an important one.
But also to,
it's important for them to realize that it's a huge return on investment.
(04:53):
And there have been many workplaces that have shown that I have spent most of my career in mental health and but I did take a little time away for a couple of years where I worked in a very large tertiary care hospital.
And I began to see that hospitals as ironic as it may sound can be in our very toxic places to work in.
(05:21):
And,
you know,
I was feeling a little bit out of a whole lot out of my depth in a tertiary care setting where I had responsibility for everything except mental health.
And I soon discovered the real reason why I was asked to go there to work was not to tell people how to do surgery.
(05:42):
But the work environment,
the culture there really did need changing.
And I worked hard on that.
And I like to think there was some improvement,
but I think it lit in me of passion that you know,
(06:02):
this was happening in this one place.
It had to be happening everywhere else.
And you know,
like I said,
I was feeling a bit out of my depth.
But I think I was also looked upon as being not a real clinician because I worked in mental health.
And so when the opportunity came to do something new and innovative,
(06:28):
I thought,
wow,
this is where we have to go and just think about it,
the domino effect of having a psychological safety standard for the workplace probably makes it a little more likely that you will go home at the end of the day and talk about it around the dinner table to family,
(06:51):
to friends.
And I think that in places where we have looked at where the standard has been implemented,
it's a wonderful place to begin with because my belief is that the only way we're going to improve the health care system is to develop strong healthy prevention programs.
(07:11):
And what better place to do that than in the work environment who wants to have staff who are,
Are stressed out tired.
There's no way that you're getting the best out of a person.
So the employer suffers and the employee suffers.
So I am really happy to see mental health being talked about plans being developed and actually implemented in places that,
(07:43):
you know,
back in 2012 simply would not have occurred to them,
let alone happened.
I completely agree.
And as a leader of a team now I've learned so much particularly and I have my list.
So this is what I'm going to ask you.
I have this list in my brain.
Now what I consider to be leadership superpower.
So for me,
there are things like integrity compassion,
(08:06):
vulnerability,
courage,
grit,
and maybe one of the most important is your ability to listen.
We all have the attention span,
not of a goldfish,
but of a dead goldfish.
Now it appears and actually people listening silently with intention is to me,
a leadership superpower.
So what I'd like to ask you is what are your leadership superpowers?
(08:30):
And also how do we engage leaders in order to create this change?
Because the change in my mind has to come from the top.
If the CEO doesn't buy it,
it ain't happening.
So what are your powers?
What do you encourage in other people?
And how do you get the C E O s to buy in?
That's a very good question.
And if I had a complete,
(08:50):
you know,
failed proof answer,
I'd be very happy.
I don't,
but I encourage leaders to do something that I've done myself.
And so I can say to them,
I know this isn't easy,
but here has been my experience and what I'm talking about is being vulnerable.
(09:13):
And so I always encourage leaders to tell their story.
We all have a story.
Uh There's not one of us that hasn't been impacted by mental health,
whether it's yourself a family member,
a good friend.
But in talking about it,
it empowers other people.
And my experience has been like,
(09:37):
I've been,
I was blown away.
It was actually a young woman who worked at the commission used to help me with writing speeches,
articles.
And so when I would talk to her about the messaging that I wanted to get across,
I would share a story with her.
Well,
lo and behold,
I started seeing these stories verbatim showing up in what she was writing.
(10:02):
And I was like Suzanne,
I can't talk about this in public and she pushed me out of my comfort zone.
And I did,
I shared the story of growing up here in ST John's actually where I am today.
And growing up in a,
I don't think you could even call it a system,
(10:23):
but we'll call it the foster system And talking about the impact that that had on me,
talking about losing my best friend to suicide in her 30s.
And one of the first times I did that,
I remember somebody coming up to me,
which always happened afterwards.
(10:43):
And she said,
Well,
she said I was just looking at my phone and starting to read Twitter.
And suddenly she said,
I thought,
oh wow,
this is not just another CEO type.
This is actually a real person.
And so she said,
I put my phone away and listened to every word and she had tears in her eyes.
(11:04):
And I have had that experience similar to that so many times.
And so,
but it's not easy,
as I said,
it was very difficult to talk about something that's deeply personal.
And it's,
I found out that no matter how often I told it,
it didn't get easier.
(11:25):
So I think it has,
I've had people tell me that it has inspired them that they have tried it out themselves.
And so if there's a superpower to be had,
it's not so super but being vulnerable and showing that uh you are human,
(11:45):
but yet in a leadership position I think is one of the most powerful things that I have ever experienced in all my years in leadership positions.
We did mention it was a young woman who was pushing you.
And it's interesting when I'm meeting young people now,
whether it's looking forward to maybe employing them or,
(12:09):
you know,
they're working as contractors,
how open they are.
And even starting once they know,
um a psychiatrist starting a conversation,
talking about their own mental health journey,
about their own experience so openly.
So I think they're going to change the world from a stigma perspective.
We've got a long way to go.
(12:30):
I guess I'd like to understand why creating national standards for psychological health and safety for post secondary students was important to you.
Well,
you know,
having,
well,
I'll share another story uh in,
I've had the immense privilege of being in every corner of this country through my work with the commission.
(12:52):
And so there were post secondary institutions as well where I would get invited to speak or just to talk about.
Was there anything that they could do?
And this one particular time I was visiting a very well known university and one that has a hugely high reputation and they were talking about,
(13:15):
um,
the fact that they lost 3-4 students every year to suicide.
And,
and it was almost as if,
you know,
as long as we don't go over that number,
then we're okay.
And I'm like,
how could 3 to 4 young people dying each year be normalized?
(13:38):
I,
I,
I was absolutely shocked and it hit the core of my being,
it really did.
And I was in a meeting shortly after that with a group of academics at the university and it was actually a group of deans.
(13:59):
And when I was talking about,
you know,
would you be interested in participating in something like this?
They said,
oh no,
we don't have any problems here.
You know,
this university is just fine.
And I said,
what about your faculty and your staff?
No,
no,
just fine as I was leaving,
(14:20):
I had no less than four deans come to me and talked to me about how difficult it was to work there.
So I thought Holy Anna,
this is like second only to hospitals in terms of toxicity.
And so there I really and truly came to understand that this was something that desperately needed to be addressed.
(14:47):
It was the,
you know,
the incidents around suicide rates that really triggered it for me.
But there were all of these other conversations that I that I was having and,
you know,
I don't think universities would want me to say this or many of them,
but it's a workplace like anywhere else,
but it has the impact of influencing so many people and so many lives that I really felt strongly that and there are other places that I'm pretty sure the commission will go on to expand and offer specialties in other situations as well.
(15:26):
So,
which would be great.
Well,
you demonstrated some vulnerability louise by talking about growing up in the foster care system.
And I wonder how those experiences have shaped you professionally in your approach,
going to post secondary students or just in general,
how have they shaped you professionally?
That experience?
(15:47):
I'm sure it has.
I mean,
I there was never an aha moment for me,
it was more organic,
it kind of just happened.
But finding somebody after you come through a situation like that and feeling so alone and feeling so abandoned and being abandoned.
It showed me the importance of somebody believing in you.
(16:12):
It has a huge impact.
I think it is an important thing.
And I believe that with my whole heart,
I do too.
And I think the loss of kindness and compassion in our health care system and particularly when someone is really struggling and they're going into what is an overloaded health care system,
(16:34):
you know,
going to an emergency department.
The kindness and compassion are so often missing and I don't think we think enough about the downstream consequences of someone asking for help and being treated so horrendously,
it's so impactful.
So I wonder when we think about the system we have now and the great challenges that we're facing with our public system.
(17:00):
Do you see a role for a private sector in mental health care delivery in Canada?
Could that be an added benefit for our health care system?
Do you imagine?
I think it does.
I really do.
I have seen,
you know,
wonderful examples of because I do believe corporate Canada has a big role to play in providing mental health services,
(17:28):
be it in their own individual workplaces or giving back to the communities that are so generously funding them and giving them their business.
And so I do think,
and I also think that there's probably more of a chance of more innovative ways of doing it instead of those of us who grew up in the system where,
(17:54):
you know,
I was used to.
But I want to see somebody,
I had to go in an office and sit in a waiting room and physically walk in.
There's private companies that are developing new and different innovations and I really do believe that they are doing really good things.
And so I do feel there is a role and that's not to diminish in any way or public health care system because I'm quite proud of it.
(18:21):
But I do believe that just to stick to that is actually depriving people of something that they could have just started carrying on from that last point that you made,
you said earlier that you were spoken to or perceived perhaps as not being a real clinician because you worked in mental health.
(18:42):
And I will say that really did influence my choice of a specialty.
I went into pediatrics when my passion was in psychiatry.
Then I figured out I didn't really like parents all that much and had to give in and become a psychiatrist.
But it was,
you know,
the losers in the class go into psychiatry,
the people that,
that can't get into anything else.
(19:02):
This was the stigma and I think it has a massive impact on funding.
It has a massive impact on perpetuating the stigma that people living with mental illness face within the health care system.
Why do you think that that stigma continues to exist in mental health care?
I think,
(19:23):
you know,
this is not something that you change overnight,
it's improving,
but this is decades,
if not hundreds of years in the making,
you simply don't change it by saying it's wrong.
I mean,
look at how hard it was for you and I as individuals to come to grips with that.
(19:44):
So it's a very difficult thing to overcome,
very difficult.
And I think that that's why the 10 year anti stigma initiative that the commission did was so important and so powerful and it looked at the issue of self stigma because that's extremely important and it's really,
(20:05):
really complex and it's difficult to deal with.
I bet you if I stopped and was really honest with myself,
there's still a little tinge of that belief roaming around inside this head of mine.
And so I think we need to be kinder to ourselves and accept that we're human beings and This was created over time and we were doing the best that we can,
(20:34):
but it's really complex and really difficult to shake.
I would fully agree.
Louise in 2019,
you were invested as a member of the Order of Canada,
which of course is our country's highest civilian honor.
And that was for your contributions to advancing mental health.
I want to start by saying that as a Canadian,
(20:54):
I just feel so proud of winners of the Order of Canada because they represent our best and brightest with all of your accomplishments.
What are you proudest of?
I would have to say that its workplace,
the psychological safety standard.
I really am so proud of that.
I'm proud of the team who put in so many countless hours,
(21:18):
the Canadian Standards Association.
It was a collaborative effort unlike anything else.
But when I see the aviation sector wanting me to be on their board because I have a background in mental health,
then by God,
we've done something,
right?
And so I'm very proud of that.
(21:39):
Now,
you know,
as a true blue Newfoundland or the flip side of that,
my greatest disappointment was having left the commission with the suicide rates not being touched.
It breaks my heart.
And particularly when I believe that almost every one of them were,
are preventable every year.
(22:01):
So,
you know,
we're going in the right direction,
but I also wish we could speed it along.
But I think that doing things in the workplace is a place where we can prevent things because we've learned that,
you know,
if you can get seen,
when you need to be seen,
it's the timing and that maybe once or twice is enough.
(22:23):
Whereas there was a lovely young woman when we Released the report here in ST.
John's who said that before stepped care,
she would call and ask for help and they put her on a wait list of 18 months for a backhoe when she said that very day,
if someone had offered her a shovel,
she would have been perfectly fine.
(22:45):
And I thought that example was just great.
And so I think that in looking at the standard which has,
I think influenced things like virtual and e mental health that it has had a broader reach than we actually expect.
(23:06):
And so I'm very proud of that and so proud of the team that put so much effort into it.
Well,
rightfully so for my part,
as a psychiatrist,
my focus has always been on supporting primary care providers,
nurse practitioners,
family doctors who I believe really bear most of the weight of mental health care delivery in this country.
(23:32):
We're never going to have enough psychiatrists.
But if we keep going the way we're going,
we're actually going to bankrupt our country from a healthcare perspective.
How do we better support these clinicians?
What innovations have you seen or do you imagine might make a difference when supporting our primary care providers to improve access for people when they're struggling?
(23:54):
I would agree with you with regard to primary care positions.
But I think expanding that and utilizing other disciplines as you know,
my background is nursing.
And I said,
I'm a staunch believer in peer support.
I have seen the impact that it can have and it is so hugely helpful.
(24:17):
And when I say peer support,
I mean,
trained peer supporters so that you're just not putting a hat on and saying I can talk to you and that's all you need.
But not everybody needs a psychiatrist or a psychologist,
it could be someone else who has walked a mile in their shoes and nose has learned some ways of being able to talk and help.
(24:39):
And so I think that we're going to have to start thinking differently about who mental health practitioners are and think myself included that,
you know,
just because I became an RN doesn't mean that there aren't other kinds of nurses who can offer and provide care every bit as good,
(25:00):
if not better than me.
And that was,
you know,
it took me a while to accept that because I was hanging on to that image that,
that role that I thought was so important.
And so I think that when we,
we think like that it closes us,
closes our minds to looking at other ways of doing things.
(25:24):
And so I think we've really got to start thinking differently about where and who provides mental health care.
I would agree with you.
And before medical school,
I was a pharmacist and I know now pharmacists are amongst the most trusted health care professionals as far as the general public viewing them with,
(25:47):
with a huge amount of trust.
I think one of the critical piece is,
is making sure that the education is aligned with the opportunity to make sure that pharmacists understanding of mental health care,
not just from a pharmacy perspective,
knowing how the drugs work,
but sometimes education is quite a bit behind,
(26:07):
but also how they can support people just through words,
just as a professional peer support,
you're not going to be able to do deep counseling,
but making that human connection and understanding that someone is suffering and giving them some guidance or direction towards really good tools.
That's what you're talking about.
I think when you talk about all health care providers being able to be part of this bigger solution.
(26:34):
Absolutely.
I mean,
last week I went to the pharmacy and got my booster and flu shots and it was pharmacist who gave it to me.
And we had a wonderful discussion and I could envision,
you know,
I felt good when I left there because it wasn't just somebody jabbing me.
It was somebody talking about,
(26:54):
you know,
how many people they had come in that they've given the boosters too and the impact that was having.
And,
you know,
I left feeling good about it.
And so it's,
it's so much more you said then that it was almost as if that was the tool to get somebody talking.
And I think that disciplines are not performing to the highest level that they can and that they're capable of.
(27:17):
I would agree with you completely.
And once again,
coming back to just being kind and compassionate,
how powerful that isn't an interaction.
Absolutely.
You know,
it's having that connection.
Kindness is,
you know,
I'm part of a homeless initiative here in ST John's and all of the ads I see them coming out,
(27:39):
we see it on the side of the busses,
it says kindness wanted.
And I thought,
wow,
it's more than just at the gathering place that kindness is wanted.
I think it could be a principle that could be applied just about anywhere.
And I think we underestimate the impact and the importance of that.
(27:59):
I agree,
taking care of others is one of the greatest gifts we can give and the rewards,
what you get back is just so much greater than any time or energy you put out.
But the other good thing is it keeps us young louise because your brain as you're learning new things is constantly modeling and remodeling that neural plasticity that protects us.
(28:22):
So we have to keep learning in order to be able to continue to stay young and continue to contribute.
I guess the last question I want to ask you about is if you had an ability to ask one critical question,
one big ask to healthcare leaders or government or industry to improve mental health care in Canada,
(28:44):
what would that ask be?
Um I'm going to just jump right in here and,
and I think you want the first thing that comes in my mind and that is to develop a national suicide prevention strategy And not only a strategy but one that will actually see plans to be rolled out,
(29:08):
these are senseless deaths and if there are 5000 people every year who die by suicide,
and those are the ones that are registered as dying by suicide.
And I know how it impacts the mental health of the families and the friends around that person who died.
And as I said,
(29:29):
it's my one regret in being with the commission that I didn't see a change in those numbers and they're stubbornly sticking there.
So that would be my big wish I would be very happy if we could see that being taken more seriously.
I agree with you.
So,
first of all,
I'm just so grateful for your time louise.
(29:51):
I'm thinking back to when I started,
I've been a psychiatrist close to 25 years now.
You've been in this,
this world for a long while trying to make a difference.
Mental health now and discussions about mental health,
mental illness are everywhere.
Did you imagine you get to this place where everyone's talking about it?
(30:12):
Yeah.
No,
no,
I did not.
Um You know,
it,
it was shrouded in secrecy for so long and it was something,
a source of shame because,
you know,
just pull up your socks for God's sakes and you'll be okay.
And so now to,
to get to this,
(30:32):
you know,
I,
and seeing it being discussed in places I never dreamt of.
But yeah,
so that's why when I hear people saying that things are dark and dismal and nothing has changed.
That's not true.
It really isn't true.
And so I really appreciate this discussion today because um you know,
(30:53):
you mull it around in your own mind but talking about it out loud like this somebody else.
It's like,
yes,
it really has improved and I know there's a long way to go,
but there has been a difference.
Thank God for that.
Thank God for that and thank God for you louise such a pleasure for you.
You're a wonderful interviewer.
(31:14):
Thank you.
Great.
Well,
it was enjoyable.
So thank you and I hope our paths will cross again soon.
Me to take good care.
Thank you.
Bye bye.
As I reflect on my conversation with Louise,
I'm just so thankful we have people like her in our world.
(31:34):
People who have a big vision for what needs to happen and are also willing to dedicate their life to translating vision into action,
Louise background and mental health care delivery.
Together with her personal and heartbreaking experience with suicide,
have informed her compassionate caring leadership through the efforts of people like Louise,
(31:57):
we have seen substantial moved in mental health policy,
attitudes and programs both in the community and in the workplace.
I left this conversation inspired to do more and I felt hopeful while our mental health care system is desperately far from perfect Louise is a living testament to what willpower and stick to itiveness can accomplish until next time.
(32:23):
Thanks for listening.
The Wicked Mind podcast is a series of unique conversations with individuals that share experiences and perspectives on mental health care.
Together.
We will uncover ideas that inspire action.
Please make sure you subscribe,
share and comment.
And if you have a topic or guest suggestion,
(32:45):
please reach out to me at Dr Diane McIntosh dot com.
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