Call for Abstracts

Hope in an Age of Uncertainty

As a concept, as a theory, and as a practice, hope has considerable value in mental health. Hope is anchored by one’s determination to set goals, as well as by having a sense of agency and a pathway to achieve them.[1] Hope is one of the four outcomes for mental wellness in the Indigenous Mental Wellness Framework alongside purpose, meaning and belonging.[2] In both Indigenous and non-Indigenous worldviews, hope makes it possible to imagine a positive future for oneself and one’s community and empowers people to build towards that future. The cultivation and promotion of hope is a key component in mental health care. For people living with mental health problems and mental illnesses, hope can generate therapeutic change and positive individual outcomes. In recovery-oriented practice, hope is a key principle in the process of recovery because the “expectation for positive development” empowers people with the motivation and strength to respond to the challenges that mental health problems and mental illnesses pose.[3] Hope-based therapies are effective in improving the symptoms of people living with depression.[4] It is also relevant in suicide prevention: when individuals develop their capacity for hopefulness, they are more likely to make and work towards  life-affirming commitments.[5] Hope can counter despair and “may be the key to coping in the face of multiple forms of direct, indirect (structural), and cultural violence. Hope can be spiritual, emotional, mental, and physical, and hope is multidimensional in that it can be directed toward individual or group desires, from small to big possible futures.”[6]

At present, several overlapping trends are leaving many people feeling that they live in an “age of uncertainty,” with reduced clarity and hope about what the future holds for our health, our livelihoods, and our social relationships. Climate change, fast-paced emergence of digital technologies, increasing political divisiveness, and persistent economic precariousness, are contributing to this profound feeling of uncertainty. These trends are having a noticeable impact on mental health in Canada and across the globe.[7] In the US, more than half the population experiences the current political climate as a significant source of stress, with a third reporting feeling overwhelmed, anxious or depressed.[8]

Climate trauma—the symptoms that emerge when people “live in fear of imminent disaster” and when “fear of future threat dominates consciousness”[9]—threatens to challenge mental health care systems in Canada and globally. The extreme weather events associated with the changing climate can trigger PTSD, survivor guilt, vicarious trauma, recovery fatigue, and problematic substance use.[10] The Lancet Countdown Report recently reported increasing symptoms of anxiety and ecological grief among Canadians[11]. Experts estimate that the “psychological impacts from any form of disaster exceed physical injury by 40-1.”[12] Climate scientists are reporting their own symptoms of depression caused by ecological grief, which they attribute to continuous exposure to environmental decline.[13]

As technological advancements proliferate, so do questions about their impact on mental health, social engagement, livelihoods, and labour. Social media connects us across distance and time and has been shown to enhance connectedness among people with mental illnesses, who use a range of platforms to share stories and coping strategies.[14] Still, there is also cause for critical reflection, as research demonstrates that loneliness is becoming more prevalent despite this digital connectedness. Humans benefit from meaningful and plentiful face-to-face connection and, in its absence, are at risk of mental and physical health issues.[15]

The presence of political turbulence and economic uncertainty compounds social division. Across the globe, political views appear to be more and more polarized, with many countries erupting into political turmoil leading to civil conflict and displacement.[16] Internationally, large numbers of displaced people are also reporting adverse mental health impacts.[17] New economic structures and precarious employment are leaving more workers financially unstable, competing intensely for insufficiently-paid work, and going without the health and other employment benefits that come with more stable forms of employment. Recent studies conclude that workers experiencing unstable and/or uncertain employment report poorer mental health outcomes than their counterparts in permanent employment.[18]

The confluence of these realities can galvanize fear, but they can also underscore the importance of hope. Within this atmosphere of rapid change and its impact on mental health, there is an immense opportunity—and need—to foster resilience and hope. Hope has been a key construct in mental health care because it supports an individual’s ability to cope with uncertainty, build resilience, and maintain a grounded and realistic orientation towards the future.

In thinking about the promise of hope and the cultivation of a mentally healthy society, however, we must also approach hope critically. If we don’t ground hope in real action, hope can turn our attention away from the reality of current suffering and diminish a sense of urgency.[19] In response to this concern, practitioners, researchers and educators are calling for “critical hope,” an “action-oriented response to contemporary despair” that maintains that different ways forward can only be created by challenging inequality, privilege, colonization, and injustice.[20] Given the disproportional burden of global inequity, stigmatization, and exploitation on some populations, it is necessary to reflect on who is most vulnerable to the effects of inequalities and how hope can be accessible and meaningful for all. Here lies the opportunity to work together to actively create healthy and just societies.

In learning how to hope and to apply hope-based approaches to mental health, community leaders, people with lived experience, practitioners, educators, and researchers must examine how and for whom “hope” is possible. We must consider what it means to be hopeful in the face of oppression, colonization, health inequity, adversity and uncertainty. We must identify what “hopeful” responses to mental health problems look like, mobilizing hope for positive and just outcomes.  

As scientist and environmental activist David Suzuki has said, “the environmental crisis is a human crisis” as humans are simultaneously its drivers and its victims. Similarly, it is likely that we will also be the drivers and/or the victims of increased mental health issues and insufficient access to support if we do not prioritize “mental health as a human right.”[21] It is time we embrace this potential for a critical hope, in order to make sustainable, systemic change in how we define and address mental health and mental illness. At Mental Health for All (MH4A) 2020, let’s come together to articulate how uncertainty and insecurity impact mental health and access to mental health care, and let’s share strategies and tools to promote hope that will spark transformative action for people and communities in Canada and across the globe.

References
  1. Snyder, C. R. The psychology of hope: You can get there from here. New York: Free Press, 1994; Snyder, C. R. H.S. Friedman (Ed.) Encyclopedia of Mental Health, 2nd ed., s.v. “Hope” (pp. 421–431). San Diego, CA: Academic, 1998.
  2. Indigenous Services Canada, Assembly of First Nations, and Thunderbird Partnership Foundation. 2015. “First Nations Mental Wellness Continuum Framework: Summary Report.” 140358
  3. Mental Health Commission of Canada. 2015. “Recovery Guidelines.” Ottawa, ON: Mental Health Commission of Canada. https://www.mentalhealthcommission.ca/sites/default/files/MHCC_RecoveryGuidelines_ENG_0.pdf
  4. Klausner, E. J., Clarkin, J. F., Spielman, L., Pupo, C., Abrams, R., & Alexopoulos, G. S. 1998. “Late‐life depression and functional disability: the role of goal‐focused group psychotherapy”. International journal of geriatric psychiatry, 13(10), 707-716; Klausner, E. J., Snyder, C. R., & Cheavens, J. “Physical illness and depression in older adults”. In A hope-based group treatment for depressed older adult outpatients, 295-310. Boston, MA: Springer, 2002.
  5. Vincent, P. J., Boddana, P., & MacLeod, A. K. 2004. “Positive life goals and plans in parasuicide.” Clinical Psychology & Psychotherapy, no. 11, 90–99.
  6. Standish, K. 2019. “Learning How to Hope: A Hope Curriculum”. Humanity & Society, 43(4), 484-504.
  7. Fairburn, C. G, and Vikram P. 2017. “The impact of digital technology on psychological treatments and their dissemination.” Behaviour research and therapy. Vol 88: 19-25. doi:10.1016/j.brat.2016.08.012; Gerhard, A., and Titov, N. 2014. “Advantages and limitations of Internet-based interventions for common mental disorders.” World psychiatry, official journal of the World Psychiatric Association (WPA) vol. 13,1: 4-11. 2014.  doi:10.1002/wps.20083; Tol, W.A., Kohrt, B.A., Jordans, M.J.D., Thapa, S.B., Pettigrew, J., Upadhaya, N., De Jong, J.T.V.M. 2010. “Political violence and mental health: A multi-disciplinary review of the literature on Nepal”. Soc Sci Med.; American Psychological Association. 2017. “Stress in America: The State of Our Nation. Stress in America Survey.”doi: https://www.apa.org/news/press/releases/stress/2017/state-nation.pdf; Fritze, J.C., Blashki, G.A., Burke, S., Wiseman, J. 2008. “Hope, despair and transformation: Climate change and the promotion of mental health and wellbeing.” Int J Ment Health Syst 2, 13. doi:10.1186/1752-4458-2-13; Berry, H.L., Bowen, K., Kjellstrom, T. 2010. “Climate change and mental health: A causal pathways framework.” Int J Public Health.
  8. American Psychological Association. 2017. “Stress in America: The State of Our Nation. Stress in America Survey.”doi: https://www.apa.org/news/press/releases/stress/2017/state-nation.pdf
  9. Kaplan, E.A. Climate trauma: Foreseeing the future in dystopian film and fiction. Climate Trauma: Foreseeing the Future in Dystopian Film and Fiction. Rutgers University Press, 2016.
  10. Clayton, S., Manning, C., Krygsman, K., and Speiser, M. 2017. “Mental health and our changing climate: Impacts, implications, guidance.” American Psychological Association and EcoAmerica. Washington, DC.
  11. Watts, Nick, Markus Amann, Nigel Arnell, Sonja Ayeb-Karlsson, Kristine Belesova, Helen Berry, Timothy Bouley, et al. 2018. “The 2018 Report of the Lancet Countdown on Health and Climate Change: Shaping the Health of Nations for Centuries to Come.” The Lancet. https://doi.org/10.1016/S0140-6736(18)32594-7.
  12. Links, J. “Predicting community resilience and recovery after a disaster.” Public Health Matters (blog), CDC, 2017. https://blogs.cdc.gov/publichealthmatters/2017/08/predicting -community-resilience-and-recovery-after-adisaster/.
  13. Corn, D.  “It’s the end of the world as they know it: The distinct burden of being a climate scientist.” Mother Jones, 2019. https://www.motherjones.com/environment/2019/07/weight-of-the-world-climate-change-scientist-grief/
  14. Burrow, A.L., Rainone, N. 2017. “How many likes did I get?: Purpose moderates links between positive social media feedback and self-esteem,” Journal of Experimental Social Psychology vol. 69: 232-236; Rui, J.R., Stefanone, M.A. 2013. “Strategic image management online: Self-presentation, self-esteem and social network perspectives,” Information, Communication & Society vol. 16, no. 8: 1286-1305.
  15. Yanguas, J., Sacramento, P.H., Francisco, J.T.S. 2018. “The complexity of loneliness.” Acta bio-medica. vol. 89,2 302-314. doi:10.23750/abm.v89i2.7404
  16. Walker, T. 2019. “2019 was a year of global unrest, spurred by anger at rising inequality – and 2020 is likely to be worst.” The Conversation. http://theconversation.com/2019-was-a-year-of-global-unrest-spurred-by-anger-at-rising-inequality-and-2020-is-likely-to-be-worse-128384
  17. Porter, M., Haslam, N. 2005. “Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis.” Journal of the American Medical Association.; Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R.A., Van Ommeren, M. 2009. “Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: A systematic review and meta-analysis.” JAMA - Journal of the American Medical Association.
  18. Gross, S.A., George, M., Jancuite, L. Well-Being and Mental Health in The Gig Economy: Policy Perspectives on Precarity, CAMRI Policy Briefs 4. London: University of Westminster, 2018.
  19. Duncan-Andrade, J.M.R. 2009. “Note to Educators: Hope Required When Growing Roses in Concrete.” Harv Educ Rev.
  20. Friere, P. Pedagogy of hope. New York: Continuum, 2007; Bozalek, V., Carolissen, R., Leibowitz, B., Boler, M (Eds.). Discerning critical hope in educational practices. New York: Routledge,2014; Grain, K.M., Lund, D.E. 2016. “The social justice turn: Cultivating “critical hope” in an age of despair”. Michigan J Community Serv Learn, 23 (1).
  21. United Nations Human Rights Office of the High Commissioner. 2018. “Mental Health is a human right.” https://www.ohchr.org/EN/NewsEvents/Pages/MentalHealthIsAhumanright.aspx
Conference Streams

Prevention, mental health promotion and wellness

This stream invites submissions that examine the connections between physical, socio-economic and cultural environments and mental health by drawing on lived experience, research and evaluation findings, and interventions to build hope and resilience. This stream is particularly interested in programs, practices, and policies that promote mental health, in Indigenous mental wellness/resilience practices, and in approaches that foster collaboration between governments, social services (education, housing, etc.) communities, advocates, citizens and health/mental health sectors. Mental health promotion needs approaches that actively address the biomedical, social, economic and environmental determinants of mental health issues. In a rapidly changing world, where uncertainty can aggravate risks to mental health, it is paramount to showcase research, innovation, systems reform and actions that prioritize wellness and work to improve access to resources that promote mental health.

Inclusion, diversity and equity

This stream invites submissions that address the barriers that marginalized groups—including racialized communities, LGBTQ2S+ individuals, First Nations, Inuit and Métis peoples, women, people experiencing poverty, justice-involved persons, people with disabilities, and refugees, immigrants and newcomers—face in cultivating good mental health and in accessing mental health care.

For certain communities, uncertainty is a reality that is linked to experiences of marginalization, interpersonal and systemic discrimination, and lack of access to resources. As climate change, political turmoil, economic instability and digital transformation characterize the present and threaten futures, marginalized communities are disproportionately burdened. These communities, including Indigenous communities, have faced and continue to experience colonialism and systemic racism, resulting in significant mental health disparities. Moreover, understandings of and care for mental health has been predominantly based on Western worldviews and has precluded Indigenous peoples’ worldviews, non-Western approaches, and lived experience. This stream emphasizes the creation and development of culturally honouring, gender responsive, and inclusive services.

Navigation, care pathways and supports

This stream seeks submissions that examine existing and envisioned mental health care systems, care pathways and supports for those with mental health issues and mental illnesses. Mental health care systems are increasingly digital, leveraging apps, online forums and online support groups, which creates opportunities for more accessible services. At the same time, we need to strengthen mental health literacy and knowledge of how to navigate systems, as well as to evaluate digital mental health care platforms critically. Emerging mental health issues, such as climate trauma, eco-anxiety and ecological grief, need greater research to anticipate their impact on the mental health care system, and to build these into care pathways and supports. It is imperative to discuss how to secure and bolster mental health care systems in the face of changes in the health care sector.

Substance use and recovery

This stream will explore how we can prevent and manage substance use issues, promote hope as an ingredient of recovery and harm reduction, and support mental wellness through research, education, programs, sharing of lived experience, policy change and advocacy.

A lack of meaningful relationships in one’s life; traumatic events; violent and tumultuous environments and experiences of racism, colonialism, discrimination and poverty have all been recognized as important contributors to substance use issues. Substance use issues are often understood as a strategy for coping with challenging circumstances, and an uncertain future. In North America, opioid-related overdoses have increased significantly in the past decades and have reached crisis proportions. Studies show that unemployment and underemployment, particularly in manufacturing, are linked to increases in substance use. First Nations, Inuit and Métis peoples have higher rates of substance use as a result of intergenerational trauma and colonization. Given the severe physical and mental health consequences that can both drive and result from substance use issues, addressing it is critical for public health and mental health promotion.

Mental health, hope and recovery-oriented practices

This stream invites submissions that address the role of hope in recovery-oriented practice. It is especially interested in submissions that explore how social context and identity inform recovery journeys. It welcomes contributions that explore approaches and practices for cultivating hope in ways that honour diverse cultures and respect diverse needs.

Many mental health and addictions services and supports now promote recovery-oriented philosophies in their practices. Recovery-oriented practice empowers people to choose among a range of supports, services, and treatment options. Hope is one of the three key principles in the Mental Health Commission of Canada’s (MHCC) Guidelines for Recovery-Oriented Practice, alongside dignity and inclusion. According to the MHCC, “acquiring the capabilities to nurture hope is the starting point for building a mental health system geared to fostering recovery.” However, the capacity for hope and potential for recovery can be limited by stigma, inaccurate and hurtful messages about mental illness, and inequitable access to supports and services. Cultivating hope is integral to recovery journeys as well as to fully integrating a recovery model into our mental health system.

Livelihoods and mental health

This stream is interested in the link between mental health and employment, education, caregiving, volunteering and other meaning-making pursuits.

According to the First Nations Mental Wellness Continuum Framework, purpose is a necessary component in balancing mental, physical, spiritual and emotional health and ultimately pursuing mental wellness. People can find purpose through education, employment, caregiving, creating, and/or volunteering, but uncertainty and disruption can impact people’s lives and livelihoods. Inuit hunters in Canada have reported mental health problems, as ice conditions change and threaten the hunt for food, cultural identity and livelihood practices. Economic uncertainty can compromise people’s livelihoods and their sense of purpose. Work and workplaces can be sources of purpose, but they can also be a source of psychological distress.