Almost all of the focus group participants agreed that there is a link between mental and physical illness. Many perceive the relationship as bilateral: that mental health could affect physical health and vice versa. Most said that mental health problems could lead to poor physical health through wear and tear on the body from stress or poor health habits. Many also thought that people with chronic, debilitating health problems, such as cancer, HIVAIDS, or chronic pain, could have an increased vulnerability to mental health problems. No one connected physical health problems to disorders such as schizophrenia. No one in any group made a specific linkage between heart disease and stress or depression.

Implications for Enhancing Mental Health Literacy

Canadians show a good intuitive understanding of the mind/body connection. A body of research investigating how this relationship works has emerged in recent years, and people could benefit from this information to protect their mental and physical health. ^{Footnote 133} Raising public awareness about the connections between stress, depression and chronic disease represents a good opportunity for intersectoral collaboration, which is itself integral to effective health promotion.^{Footnote 134}

SPECIFIC ISSUES

First Nation, Métis and Inuit People

FNMI survey respondents and focus group participants differed in some respects from the broader Canadian population. They placed less emphasis on biomedical causes of mental disorders and more emphasis on traumatic events and substance abuse. They were less inclined to recommend medical treatment and more in favour of seeking help from counselors, social workers or friends and family. They placed a high priority on access to culturally appropriate interventions, including a holistic approach, traditional medicine and Elders.

The experiences of colonization, oppression and abuse, and loss of cultural continuity have left a legacy of historical trauma for Indigenous people in Canada, and this continues to influence mental health. ^{Footnote 135} Suicide rates are much higher in many Aboriginal communities compared to suicide rates of the general population. ^{Footnote 136} Many Indigenous cultures around the world have been subjected to similar processes, the effects of which are akin to the disruptions and collective trauma experienced by victims of war and natural disasters.^{Footnote 137}

Strategies to enhance mental health literacy of Aboriginal people must involve community development and community empowerment, and must focus on the social determinants of mental health. Cultural renewal and enhancement are critical strategies for mental health promotion in Aboriginal communities ^{Footnote 138} and these must be led by Aboriginal people and be consistent with the Aboriginal worldview.^{Footnote 139} This involves conceptions of whole person and whole community health. ^{Footnote 140} Strategies to enhance mental health literacy must also attend to socioeconomic factors and basic needs such as food security, housing, and employment.^{Footnote 141}

Children and Youth

A number of the Canadian focus group participants spoke about the effects of early experience and parenting on mental health and emphasized the need for parent education. There is strong evidence of the effect of early experience, particularly traumatic experience, on mental health throughout life ^{Footnote 142} and improving the mental health literacy of parents with regard to the importance of good early nurturing, would appear to be a priority. Effective parenting interventions show good long-term results in terms of child mental health and well being. ^{Footnote 143}

Contrary to what previous research has shown, a recent Canadian study indicates that youth mental health is poor compared to persons in other age groups, and that mental health generally improves across the lifespan. ^{Footnote 144} This could be attributed to the improvement in socioeconomic conditions for seniors relative to those of youth over the past few decades. Responses of youth participants suggest that they experience significant social pressure to fit in with peers and to succeed in a competitive environment. Focus group participants stressed the need for education about and support for mental health problems in school, starting early, and school-based interventions for mental health promotion have shown positive results. Engaging youth in sharing information about mental disorders represents a promising approach to reducing stigma and building empowerment. ^{Footnote 145}

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