World Mental Health Day is dedicated to global mental health education, awareness and advocacy against social stigma. Today, Canadians and people all around the world reflect on the central role that mental health has in the lives of our loved ones, our workplaces, our communities and on our own well-being. As our Canadian Prime Minster noted in his statement today:
“Today is a chance to celebrate the people who are working to make mental health care a reality around the world- and a reminder that all of us have a role to play to fight stigma and create cultures where we can talk openly about mental health. We also recognize the importance of the lived experience of those directly affected by a mental health issue, and of their loved ones. Their stories and voices must be at the core of efforts to improve mental health care for all.”
So here’s a little story I’d like to share. A couple weeknights ago, I took a seat at a dinner party named advertised to diabetes educators across the province to “learn about new research exploring the impact of the OmniPod insulin pump on Quality of Life & Hear from Young and Type 1 Community Founder”. What seemingly sounds like just another education session (if you don’t know what OmniPod is – it is one of may innovative insulin administration devices used by people living with Type 1 diabetes available on the market today) quickly unravelled to become so much more.
The speaker, Ramya Chittaranjan-Hosak, is a passionate type 1 diabetes advocate and Young & Type 1 diabetes community co-founder. She stood before us and shared her story – from exhaustion to hospitalization, diagnosis to relief, and the constant frustrations and hurdles a young adult struggles through just plain adult-ing, layered with this new diagnosis of an autoimmune disease. Exams worth fifty to ninety percent of your grade for a course, endless papers, sleepless nights, and on top of that? Learning to live on your own – away from home and your usual support network – as we all know, is already enough of a challenge on its own. Laundry piles up in the corners if the dormitory, dishes playing Tetris in the sink, and still attempting to stay active, cook your own meals and just when you’ve gotten the hang of it and pulled through school, you find yourself back where you started, in a new and unfamiliar market: the workforce. Adult-ing is tough! Now imagine all of that, plus meeting (type one) diabetes – a chronic condition that has no cure whom which you just met and have suddenly become married to for the rest of your life. Despite the million times “why me’s”, there is no choice but to accept. After all, there’s not much room for denial for type one diabetes. You can appreciate the challenges and frustrations one faces in these types of situations. Beyond that, this all happened when Ramya was 19 years old. In other words, she had did not qualify to be a part of the Diabetes Unit at BC Children’s Hospital like her co-founder Ben had gone through, supported by a team of doctors, nurses and dietitians that had taught him carbohydrate counting, insulin troubleshooting, and over the years, had become his support network. Unlike Ben, Ramya was brought into the adult healthcare system.
Currently, I work a couple times a month in one of our community adult diabetes centres. I love it there, and I wish that my family was exposed to centres like this growing up. Perhaps then my grandfather’s diabetes would have been better managed and his quality of life could have been so much more than it was. However, there is no doubt that gaps in the system exist. Most specifically, in the area of mental health. Moved by Ramya’s story, I sat down next to her and her husband to learn more about their perspectives. Ramya shared her motivations for founding “Young and Type 1” stemming from a place of desperation, post-depression, seeking for a community that understood what she was going through: the challenges of transitioning into adulthood and managing a full time job called “type 1 diabetes” one the side. Because it wasn’t that she did not understand the pathophysiology, how insulin works, how to carb-count, or the technicalities of her pump…. it was the beat and battered mental wellbeing that prohibited her from building motivation to take control of her health again.
I learned that neither of them continue to visit dietitians at their diabetes health centres. She shared a little excerpt of her wishes to eat a lower-carbohydrate diet, and the lack of support she felt from her diabetes health team. This got me questioning, what can we do better to support our clients? As healthcare providers, we have the potential to do more than just relay information. We have to do better at being mindful of how we approach our clients, ensuring that we provide health advice based on a wholesome assessment of each client’s individual needs and goals. Withdraw our own agendas, because not everyone has the same belief system as us, and everyone is entitled to their own opinions and beliefs. Open each session with an open mind, refrain our own judgements, be cognoscente of the challenges others may be facing, ask open ended questions out out of curiosity and with the intent of getting to know our clients as individuals, not their disease states. Inquire genuinely about their motivations and feelings, and assist them in navigating their health goals in the way they wish to be supported. We may not be experts in mental health, but whether we are dietitians, physicians, nurses, a family member or a friend, we have the ability to impact the mental well-being of those around us; to be a positive support system, or to be a source of stress and anxiety. So, speak with empathy, act with compassion and respect each other for their decisions.
And to Ramya: I hope that one experience with a particular healthcare provider will not hold you back from continuing to follow up with others. I hope that you will continue to share your story with others, living with diabetes, or any other chronic disease, their family members and healthcare providers. To inspire us to continue doing the best we can. To give us feedback for what we can do to best support you and others like you, and to work together in bridging this gap in our healthcare system.