The Impact of the University of Toronto on the Advancement of Mental Health
Address to the Annual General Meeting of the University of Toronto Alumni Association
June 1, 2013
The Hon. Michael Wilson, P.C., C.C., B.Com., LL.D.
Chancellor of the University of Toronto
Ladies and gentlemen, fellow alumni of the University of Toronto, I am honoured to speak to you today. I have been asked to speak on a topic close to my heart and of great importance to each of us, our families, our communities, and our society.
There is a lot to say about the impact of U of T on the advancement of mental health – and a lot to be proud of, as U of T alumni. But before sketching the big picture, I would like to start with a few very local, recent illustrations.
A remarkable event took place at Hart House during exams this spring. The Department of Psychiatry’s inaugural MindFest drew some 500 people, from ages 18 to 99 and including students, faculty, staff, alumni, and members of the wider community. Billed as a mental health fair and festival celebrating all minds, programming ranged from inspirational talks to documentary films, from exhibit booths to stand-up comedy. People with lived experience, experts, and advocates, came together to share and learn, and above all to celebrate mental health.
Around the same time, one of our students wrote on the Life @ U of T blog about a new student group, called Engineering Happiness. The group promotes mindfulness, compassion, and a sense of community on campus. One of its co-founders, Engineering student Suthamathy Sathananthan, was inspired after taking a course last fall in the cognitive and psychological foundations of effective leadership.
I’ve seen since then that U of T offers an amazing range of health and wellness programming for our students, across our three campuses. The University takes a holistic and integrated approach to health services, health promotion, and counselling and psychological services.
Health and Wellness collaborates with other departments in the University in observing Mental Health Awareness Month, in October. Faculty, staff, and residence dons are trained to identify students in distress and to know how to assist and when to refer them for special help. Several programs offer support for students in transition from high school to university, when early intervention in mental illness can do so much good. The Coping Skills Workshop Series offers all students in need, help in developing cognitive, behavioural, emotional, and self-care skills. And the Bounce Back program helps students on academic probation to strengthen their psychological resiliency while advancing toward academic success.
I could provide many more examples. But it is impressive and heartening to see the efforts constantly underway to respond to the evolving needs of our students. Even in preparing my remarks for today, I learned of a meta-analysis of stress and mental health in university students, led by Cheryl Regehr, Vice-Provost, Academic (who will become Vice-President and Provost, in September). In light of that paper the University is applying to the Movember Foundation for a new program to address more effectively, mental health needs among male students.
I mention these things as signs of progress and hope, of a growing culture of mental health awareness across the University of Toronto. Each of you will have a sense of how things have developed since you were a student here. Certainly it is very different from my student days in the 1950s, which were set in a wider social context in which mental illness was wholly stigmatized – not spoken of, a source of shame, a kind of moral failing.
We have taken great strides in overcoming that stigma, especially over the last two decades. I was first exposed to the suffering caused by mental illness when I was a Member of Parliament, and saw how some of my constituents were dealing with mental illness, some with tragic outcomes. To that point my not-for-profit work had focused on the Canadian Cancer Society, which of course is an eminently worthy and urgent cause. But from then on I felt moved to focus my volunteering on the promotion of mental health.
And then, as many of you may know, we lost a son to mental illness. During what should have been an exciting time of exploring all of life’s possibilities, Cameron lost all hope of those possibilities, and succumbed to his illness. So, I know firsthand what it is like to see all of the potential that your child holds, and have that taken away.
I spoke at Cameron’s funeral, in part to raise awareness among those who attended of the challenge of mental illness. Like others who began to speak up in those years, I found there was great interest. People began to ask me to make speeches; and after those speeches, people approached me with questions and to share their stories. Most often, they would begin by saying, “I’ve never talked about this, but…” while looking side to side.
Talking about it was new. But the more people talked about it, the more progress we made. Arnie Cader, one of our fellow alumni, suffered clinical depression in the 1980s. Arnie is a long-time volunteer and supporter of the Centre for Addiction and Mental Health, or CAMH. He co-founded and was first chairman of the Clark Institute of Psychiatry Foundation. (The Clarke Institute was established through U of T’s leadership and is now a key part of CAMH.) The Foundation was a big step forward – but at first, Arnie couldn’t get anyone to sit on the board. People he asked said, “If I do it, I’ll have to explain why. And I can’t talk about what happened to me and my family.”
Fortunately, business and community leaders did agree to sit on the board. Individuals and corporations began to make landmark donations. And CAMH now has a new, state-of-the-art campus (I’ll return to that in a few moments).
So the social context has changed significantly. But there is still so much to be done. One in five Canadians – that is, one in five of us – will experience a mental illness or addiction in our lifetime. Mental illness is the number-one cause of workplace disability in Canada. By 2020, depression will be the leading cause of disability on the planet.
What about our kids? The second-leading cause of death among young people in this country today is suicide. The rates among aboriginal youth are five to seven times higher than among non-aboriginal youth. At any one time in Canada, 800,000 children aged four to 17 experience mental disorders causing stress and impairment through to adulthood. And we know that 70 percent of adults who suffer from mental illness experienced the first signs before age 18.
All of this leads to the fact that every single one of us in this room has been or will be affected by a mental illness or addiction – either through an illness of our own or through a family member, colleague or friend. No one is untouched by these diseases – no one – including me. And stigma still remains a barrier to access.
I can attest to this. I remember Cameron pleading with us not to tell people that he had been hospitalized for a mental illness. Afraid of being judged by friends and family or fired by employers, Canadians are still afraid to talk about the most significant health care problem we face. Only a third of Canadians who actually need care ever receive it.
But again, we are making progress. And U of T has played a leading role in driving this cultural change – not just on campus but in the Toronto region, across Canada, and around the world.
U of T faculty member Dr. David Goldbloom is Chair of the Mental Health Commission of Canada, established by the federal government in 2007. Last year the Commission launched Canada’s first national mental health strategy – much of which is informed by U of T research. The first of its six strategic directions is to promote mental health across the lifespan, in homes, schools, and workplaces, and to prevent mental illness and suicide wherever possible. In other words, promotion and prevention efforts must be focused in everyday settings.
Here in Toronto, we see a dramatic example – where an entire neighbourhood has been transformed according to this crucial insight. And U of T faculty members have led this transformation, through CAMH, one of our nine partner research and teaching hospitals.
Some of you may think of CAMH as the former “999 Queen Street”. Its hub sits on the site of the historic Ontario Lunatic Asylum. Those who grew up in Toronto might remember being told as children that they would be sent to “999” if they didn’t behave. People were known to hold their breath when passing by on the streetcar, so as to not catch the “crazy disease”. A brick wall surrounded the site, keeping patients out of sight and out of mind.
Today, an ambitious redevelopment is well underway, providing a model for the world in patient care, education, and research, and community integration. Most of the wall has been torn down, and what used to be an asylum on barren land “outside” the city is now a modern mental health centre designed to be fully integrated in the neighbourhood – a neighbourhood which is increasingly one of the most vibrant in Toronto.
A few years ago, when the main building fronting Queen Street came down, one of the patients remarked, rather poignantly, “Now we can see out and they can see us”. The environment at the new campus is designed to be “normal”, comfortable, and caring; the rooms are bright and colourful, and there is welcoming open space outside; and programming and treatment varies according to the needs of individuals. But connecting to the community is key.
Reducing stigma has led in turn to increasing support. I will mention just a few recent landmarks. Five grants were announced this spring, through the new Canada Brain Research Fund and The W. Garfield Weston Foundation – and two of the five were awarded to research teams led by U of T faculty members at Sunnybrook and Sick Kids. The Tanenbaum Centre for Pharmacogenetics opened at CAMH last year. In 2011, the Campbell Family Mental Health Research Institute was established there, through the largest donation to mental health research in Canada’s history. And in 2009, the McCain Building was named – the first CAMH building named for a donor – signalling a wonderful shift, in which people are now enthusiastically associating themselves with the cause of mental health.
Ladies and gentlemen, so far I’ve spoken of the progress we’ve made in terms of the virtuous cycle set in motion by individuals willing and able to speak out. But another crucial factor is the convergence of talent and multidisciplinary strength here at U of T, which long predates the anti-stigma and philanthropic initiatives of recent decades. Quite simply, mental health is attracting support here because of the remarkable concentration of world-leading experts in the field at this University. They in turn are strengthened by the astonishing breadth and depth of excellence among their colleagues in other departments and faculties. And their collective efforts are enhanced immeasurably by the socio-economic and cultural diversity of the Toronto region.
The University of Toronto offers the largest training program in psychiatry in North America. Twenty-five percent of the English-speaking psychiatrists in Canada and 60 percent of psychiatrists in Ontario, were trained at U of T. The department’s clinician-researcher stream is preparing the next generation of Canadian academic leaders in the field. And the department is providing training opportunities in mental health for nurses, occupational therapists, and other health professionals.
U of T is the only university in Canada accredited in all three subspecialties of psychiatry – child and adolescent, geriatric, and forensic. The department ranks first in Canada in publications and citations. And, in 2011-2012, its faculty members won a very impressive $79-million in research funding – all of this contributing to U of T’s status as Canada’s leading research-intensive university.
The department has been a leader and innovator in the field since its founding just over a century ago. Its leaders have worked to strengthen education in psychiatry in medical schools; to integrate research, training, and clinical care; to do so through an inclusive, multidisciplinary approach; and to raise psychiatric research to the highest scientific standards. U of T psychiatry researchers have made breakthrough contributions, from the discovery of the brain dopamine deficiency, to pioneering work on eating disorders, sleep disorders, schizophrenia, and addictions, to the world’s first PET scanner dedicated to psychiatric research and treatment.
Today U of T psychiatry is a national and global leader in brain imaging, epigenetics, personalized medicine, social research, and evidence-based psychotherapies, including cognitive-behavioural therapy and mindfulness. And U of T faculty are reaching out – to the immediate community as I’ve described; to underserviced communities in Northern Ontario and Nunavut; and to people around the world who are interested in learning about mental health, or who are in need of mental health care.
On that note, ladies and gentlemen, I would like to close my remarks as I began, with some concrete, human examples of U of T’s progressive culture, and its leadership in the promotion of mental health. But while I began with a couple of very local illustrations, I will end with examples of our global impact.
Our alma mater’s contribution to mental health extends across disciplines, as I noted earlier. Charmaine Williams is Associate Dean, Academic in the Factor-Inwentash Faculty of Social Work. Last fall, Professor Williams launched a course she developed, The Social Context of Mental Health and Illness, as one of U of T’s first MOOCs. Now, a MOOC, for those of you who are not as plugged in as I am, is a “massive open online course” – part of the fast-changing world of online education. MOOCs are free, non-credit courses open to anyone with an internet connection; and U of T has recently joined online platforms to deliver these courses alongside North America’s leading universities.
In its first few months alone, Professor Williams’ course attracted 24,000 students from around the world. It has helped set a very high standard in this new way of teaching and expanding access to higher education.
Here’s another, final example of our global impact. The Toronto Addis Ababa Academic Collaboration is just one of U of T’s many international partnerships. As a part of that collaboration, the departments of psychiatry at U of T and Addis Ababa University have built the first psychiatry residency program in Ethiopia. Last fall, Maclean’s magazine reported on the challenge they’re facing, and the progress they’ve made. Because of a desperate shortage of health care workers in Ethiopia, many people with mental illnesses there are isolated and untreated. Maclean’s recounts some seriously ill people taking refuge in a monastery, where they were kept in chains – not out of cruelty, but as a desperate measure to protect them from harm, in the absence of any knowledge or means to treat them.
Two Ethiopian psychiatrists who trained through the Toronto Addis Ababa partnership now visit the monastery twice a month, providing psychotherapy and medication, while the priests continue providing shelter and spiritual care. The magazine quotes one of the doctors as saying, “Now no patient is chained.”
Ladies and gentlemen, the needs in our world – in this city, and oceans away – are still so great. And access to care – whether it’s limited by fear and stigma or a lack of doctors – is still an enormous challenge. But the University of Toronto is showing that progress is possible – that chains of isolation in illness can be turned to chains of collaboration for wellness. Our alma mater is not only a centre of convergent excellence, it is a beacon of hope in the promotion of mental health, here at home and around the globe.
Thank you for your kind attention.
Photo credits: Petia Karrin