Oh, Canada: Who stands on guard for them?

Bordered by the Arctic and the 49th Parallel and spanning two oceans, Canada is steeped in the stoic British ‘stiff upper lip’ and rugged individualism from our cousins to the South. We are also a conservative-minded country, with a not-so-minor secret belief in social Darwinism and coupled with a mechanistic view of human health issues, including mental health.  We need only look at how we react to the homeless, the unemployed, or the mentally disabled segments of our population:  “Why don’t they just get a job?  It’s their genetics. They are faking.  We should not encourage them.  They need to toughen up.”  While we espouse claims of being a compassionate nation, these other things, usually said privately in the interests of political correctness, occur on a daily basis. In truth, we stand divided on these issues as a country.  

The recent flurry of public interest into the mental health of military and other first responders has occurred primarily because of headline-catching reports of suicides.  Make no mistake, it is a terrible thing that these men and women decide that this is the only viable option to reduce mental anguish. But, realistically what are the alternatives?  What are first responders to do about competing messages from the larger society and within some work settings?  Training and operational duties demand toughness and independence while remaining task-focussed in the face of human suffering of all kinds.  At the same time, frontline managers, operational imperatives, and the organization of work settings offer no leniency for those who cannot pull their own weight while insurers are always looking to liability and their financial bottom lines.  In the midst of these realities, first responders are asked to step up to ask for help.  While receiving care and guidance from another person can be a wonderful human experience, first responders often risk incredible embarrassment for being a drain on their buddies and they can face harsh financial and career realities when they come forward to ask for help.  It is almost cliché to say that this takes courage; even so, I believe that it takes guts to face oneself and to admit to issues that cannot be overcome by following one’s training – sucking it up and trying harder.  Stepping forward means wrestling with Canadian values based on our British legacy, the belief in individual strength and prowess, and the social value placed on survival of the fittest – heroes are invincible. 

While specific programs can and probably will be put in place to address this present situation, I fear that they will carried out as quick fixes. If we are to face our shared stigma around mental health issues honestly, these social undercurrents will also need to be addressed directly.  To exclude from discussions the social determinants of mental health leaves us ‘guilty of economics’ – only the financial bottom line matters. The solution might require a reconsideration of how first responders are trained and how they are expected do their work on our behalf. Maybe, the expectation of Canadian society that requires silent heroes to keep the harshness of life away from them is simply too high.  Engaging these issues directly would be a true test of our commitment in addressing the mental health needs of first responders.      

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