Illustration by Jeffrey Kam

I grew up surrounded by a family of storm enthusiasts on the east coast of Canada, where I developed a fluency in the threat of tropical storms, hurricanes, and winter storms. Each weather system evolved according to its own unique before, during, and after. For me, each event was a coupling of fascination and fear, and my interest in science and my experience living with anxiety and obsessive-compulsive disorder (OCD) stoked this preoccupation. At present, I live on Treaty 7 territory in the city of Calgary, which is located around the confluence of two rivers, the Bow River and the Elbow River. The Blackfoot name for this place is Moh’kins’tsis.

Both rivers experienced flooding in 2013. At the time, my husband and I were renting a small, character house that was just a stone’s throw away from the Bow. Only the street and a modest green space separated us from the river. This was supposed to be an exciting time. In just under a week we were set to become homeowners. We expected the move to be hectic, but we didn’t plan on dealing with a natural disaster during the transition. I cut my workday short on June 20, 2013. I was concerned about the unfolding situation and decided to take the opportunity to move some items from our basement to the main floor. I asked the property owner what to do to protect the house, but he didn’t seem worried and explained that the house had been fine during the 2005 flood, so he thought it would probably be okay this time too. In advance of an official evacuation notice, we decided to spend the night with friends across the city as a precaution. We packed our hatchback with cherished art, family heirlooms, and our cat and dog, and crossed our fingers.

According to the City of Calgary, the Bow River swelled to “eight times its regular flow rate” during the peak of the 2013 flood. This still fell “within the natural range for the Bow River,” but the last flood of comparable magnitude had occurred 81 years prior in 1932. Unfortunately, the rental house wasn’t spared. The main floor was okay, but the basement filled with several feet of water. The first sign of trouble during our initial re-entry was a cluster of floating plastic bins around the top of the staircase leading down to the lower level. After some clean-up assisted by family and neighbourhood volunteers, we left the old house behind and settled into the home we purchased, but a new obsession focused on the destructive power of water continues to follow me almost a decade later.

I have lived with anxiety and OCD for as long as I can remember. As a young child, I strived to keep things in pristine condition, I almost never lost things, and I regularly second-guessed my decisions. As an older child, I established routines to check that appliances perceived as fire hazards were turned off and to lock up the house on my way to school. I sometimes risked missing the school bus to rush back and check the front door and if I didn’t have time to go back and check, the worry would sit with me all day. These behaviours continued into my adulthood—and moving away from home, making large purchases such as vehicles, and independently completing important tasks such as taxes increased the stakes. I am a geologist and geographer, and before enrolling in my current graduate degree program researching the carbon cycle, I worked as a geologist in the oil and gas industry. My career trajectory has included work in field, laboratory, and office settings and my professional experience often involved decision-making that had real-world safety or monetary considerations. One of the manifestations of my OCD in the workplace is excessive worry that I have made errors in my work and that these errors will negatively affect my colleagues or compromise workplace safety or security. This list might seem like a lot, but it boils down to a common element—checking and double-checking that things are accurate, safe, and complete. This experience is not unusual. The Canadian Psychological Association’s “Psychology Works” fact sheet for obsessive-compulsive disorder estimates that about one percent of Canadians will experience OCD at some point in their lives and lists “checking” as a common type of compulsion. The checking compulsion is carried out in response to obsessive thoughts, which in my case include fears of harm to others or myself, and damage to my home, the homes of friends and family, or my workplace. Engaging in checking behaviours can be disruptive. I have been late for work, school, and social commitments because of checking. In extreme cases, I have skipped activities altogether because preparing to leave home was too stressful.

At different points in my life, I have received different types of treatment for anxiety, OCD, and associated depression. At present, I find myself living in relative peace with OCD. I maintain a slow schedule and prioritize tasks to complete with increased focus and intention to keep a low baseline stress level, so I have capacity to cope with stressors and challenges as they arise. (My life with OCD is always in flux, so this strategy may change in the future and is not intended as a how-to or as medical advice for others.)

My equilibrium is most easily upset by rapid change, uncertainty, and perception of harm. Extreme weather events can develop quickly, evolve in unpredictable ways, cause significant damage to property and the environment, and be hazardous to people and pets. A good storm checks off all of the criteria to trigger my personal brand of anxiety and OCD checking responses. Calgary has no shortage of extreme weather and natural hazards. Each season features its own cast of potential disasters: blizzards and extreme freezing temperatures in winter, heavy rainfall and flooding in spring, tinder-dry conditions and severe thunderstorms equipped with large hailstones in summer, and early snow and cold conditions in fall. As a province, Alberta is intimately familiar with the impacts these types of extreme events can have on the landscape and the people who live there. In August 2020, The Weather Network published an article called “Top five costliest Canadian natural disasters of the decade.” Unsurprisingly, Alberta’s fires, floods, and hailstorms occupied four of the five spots. A summary of the “Top Insured Damage Severe Weather Events in 2020” released by the Insurance Bureau of Canada shows a similar story, with Alberta flooding and storms taking three of six places on the list.

Extreme weather and natural hazards are part of living in Alberta and my obsessive thought patterns and compulsions reflect the perceived risks associated with my surroundings.

I don’t leave windows open when I leave the house in case of a sudden storm; I wake in the night to check the leaky patio door during the rainy season, and I check—and check again—pipes and walls for signs of freezing during periods of deep cold. These may seem like reasonable actions to prevent damage or catch issues early, but the problem lies in the disruptive nature of the checking behaviours and the amount of time they occupy, as well as the distress experienced if I don’t engage in the routines. These behaviours also cause tension in relationships and may be a source of conflict when family members don’t agree on what is justified as worrisome.

My OCD changed because of my experience during the 2013 flood and my obsessive thoughts now include worrying about water damage. I more frequently incorporate checking faucets and other water-related elements into my routines, and as extreme weather events become more frequent with climate change, I expect this personal trend to continue.

Greenhouse gas emissions, including carbon dioxide (CO2), and related increases in average global temperatures have caused increases in the frequency and intensity of extreme events such as heavy precipitation and associated flooding, droughts, and some storms, as well as changes to temperature extremes. The Intergovernmental Panel on Climate Change (IPCC) recognizes these connections and its latest report, Climate Change 2021: The Physical Science Basis, explains that these effects will continue with additional warming. This report is approved and available from the IPCC, but is subject to final revisions, as detailed on their website. In its Summary for Policymakers, the IPCC reports that “global surface temperature will continue to increase until at least mid-century under all emissions scenarios considered.” This includes a scenario where all greenhouse gas emissions are low and CO2 emissions are lowered to net zero (reduced to zero or offset by removal) around 2050 and dip into the negative after that, which means CO2 removal from the atmosphere would exceed emissions. Right here at home, the Government of Alberta says that climate change may increase the “frequency and/or intensity” of forest fires, droughts, heavy precipitation, and associated flooding, and severe storms on an individual basis. This outlook is sombre from my OCD perspective. None of the trajectories considered by the IPCC can provide immediate relief and the changes in my home region are expected to include more frequent OCD-triggering events. Thus my extreme weather and climate change-focused OCD is likely to persist.

There is clear evidence linking climate change to mental health concerns and work such as researcher Susan Clayton’s 2020 article, “Climate anxiety: Psychological responses to climate change,” demonstrates this while highlighting that the effects on mental health may be both direct and indirect. More specifically, I am not alone in recognizing connections between OCD, weather, and climate. In their 2012 article, “The impact of climate change on obsessive compulsive checking concerns,” Mairwen K. Jones, Bethany M. Wootton, Lisa D. Vaccaro, and Ross G. Menzies discuss the experiences of 50 people with checking OCD and report that 28 percent of participants had “OCD concerns directly related to climate change.” Most of the participants engaged in checking behaviours motivated by worries of wasting water, gas, or electricity that would further contribute to the climate emergency, while others were concerned about potential harms caused by climate change and engaged in checking related to perceived negative consequences. My experience is most closely aligned with that of the participants worried about the impacts of climate change, with an emphasis on the increasing frequency and intensity of extreme weather events and natural hazards. The researchers acknowledged that OCD can be affected by external factors, which is consistent with my experience. Jones and colleagues explain that, to the best of their knowledge, their research on climate change and OCD checking is the first study of its type. This highlights the novelty of this type of narrative in discussions about living with OCD and suggests that more work is needed to understand this facet of the OCD experience and what the future might bring for people living with OCD.

These days, I feel like I’m on the cusp of a new era of my OCD and anticipate a future reckoning. I plan to draw on the strengths of my OCD to help me navigate what’s to come, even though I don’t know what that will look like. It’s important to recognize that my OCD is not all about anxiety and disruption; it also comes with a thoughtful mind, deep honesty, and a sense of responsibility to my community. I am skilled in anticipating challenges in all areas of my life and taking preventative action to minimize negative consequences for myself and those around me. My competence in risk assessment and attention to detail gives me an advantage when it comes to emergency preparedness, though, looking forward, I’m not sure what exactly I’ll need to weather the next storm.

Art by Valerie Thai

Ashwin Mehra’s mother had COVID-19 in Mumbai. In Toronto, he wasn’t sleeping well.

Before the diagnosis, even the thought of Mehra’s parents falling sick in India with him stranded in Toronto would keep him up at night. If they died, he knew he wouldn’t be able to attend their funerals.

And so, when his sister called one September weekend and said that their mother had tested positive, his worries found something to cling to. He ran through all the possibilities of what could happen in his head, barely sleeping for two nights. He reached out to a friend who was a travel agent to see if he could fly into Mumbai or Delhi, but eventually decided against it: India’s COVID-19 cases were rising and there was no guarantee he wouldn’t catch the virus. Continents away, he realized there was no way that he could help.

In his counselling sessions that week, Mehra, a clinical psychologist who works for a private practice in Toronto, listened to his clients’ worries around COVID-19—such as their own aging parents falling sick—unknown to them that Mehra could relate to those worries so intimately. One minute he  was fine, and the next, he would be reminded of his mother—it was, for him, a week from hell.

To be a therapist, says Mehra, is to sit with people’s pain, to watch and listen while thoughts and emotions run their course. But in a global pandemic, while his own anxieties run rampant, that’s become harder to do.

On a May 2020 episode of The Social Work Podcast called “Shared Trauma in the COVID-19 Pandemic,” Carol Tosone, a therapist, says that on the morning of Sept. 11, 2001, she was in a session with a client named David. He was comparing a recent date to his overbearing mother when, at 8:46 a.m., a plane flew overhead their office in New York City, rattling the windows. It wasn’t until Tosone stepped outside that she realized the enormity of what had happened: her office was a mile away from the Twin Towers and she could see everything burning, a trail of grey ominous smoke billowing from the North Tower.

In the weeks that followed, Tosone found herself dreading her sessions with David, worrying that 9/11 might come up. Reflecting on her own experiences, she writes in a 2011 article in the journal Traumatology, “Was it his traumatic reaction
or mine that I was sensing?”

As a professor of social work at New York University, Tosone is one of few academics whose research has shaped understandings of shared trauma or shared traumatic reality. During times of war, natural disaster, or upheaval, therapists often live through the same traumas as their clients but put their own needs aside to help others. COVID-19 is no different, says Tosone, calling it “shared trauma on steroids.”

One of Mehra’s clients that week happened to mention India’s rising COVID-19 cases, which, at the time were peaking at 95,000 a day. His thoughts took him to his own mother, isolated in the COVID-19 ward of a Mumbai hospital. He didn’t say anything, and they carried on with the session—clients shouldn’t have to comfort their therapists.

Therapy has that visible but invisible nature to it, says Hillary McBride, an author and clinical counsellor based in Vancouver, B.C. Therapists are often discouraged from speaking about their personal experiences or worries, so they stay hidden from clients. And unlike medical care, the work that therapists do is largely hidden away from the public eye.

But, if there was ever a time when therapy was more needed, we’re living through it: a poll by the Angus Reid Institute found that 50 percent of Canadians reported a decrease in their mental health since the onset of the pandemic. Substance use is on the rise. People are lonely. Quarantining has been linked to anxiety and post-traumatic stress. Researchers have predicted that up to 2,114 suicides will have taken place in 2020 and 2021 across Canada, fueled by the pandemic’s mass layoffs.

As Suzanne Dennison, a psychotherapist, puts it, “the walking well are falling apart.”

Therapists contend with clients’ pain and trauma every day and, unsurprisingly, it can lead to burnout. Up to 67 percent of psychotherapists will experience severe burnout sometime in their career. But in a global pandemic, that stress is exacerbated, as therapists face their own worries and witness the toll that the virus has on everyday people. Lindsay Ross, a social worker with her own private practice in Toronto, has charted the pandemic’s progression through the eyes of her clients: when infection rates soared in the first wave, so did anxiety. As a mom of two, she’s felt that herself. She took a week off in May 2020 and then another in July to cope with the added stress and burnout, but says no therapist right now is completely free of it.

Once September hit and school started, it felt like she was throwing her kids into the dragon’s den.

Good therapy requires therapists to feel the grief, loneliness, and anxiety their clients carry, but still keep themselves separate from that pain. Connecting too deeply with clients, research has found, can lead to emotional exhaustion and added stress. Ross, too, struggles with this balancing act: her struggle is amplified by being a mother and a therapist, and balancing those roles. Ross emphasizes the importance of checking in with herself when it comes to absorbing her clients’ emotions.

“If you’re too empathetic, you’re sharing in an exorbitant amount of pain that these people you’re interacting with are going through,” says Steve Joordens, a psychology professor at the University of Toronto who has been studying anxiety during the COVID-19 pandemic and designed and teaches a course on how to manage anxiety during COVID-19. “And how to share it but not carry it is a difficult thing and not something most of us are wired to do.”

Before he became a therapist, Mehra was a management consultant in India in the early 2000s. While the job paid well and he was good at what he did, he couldn’t imagine doing it for the rest of his life. And so, he turned to Google for answers. The 50 vocational, aptitude, and personality tests he took pointed to more or less the same profession: counsellor, therapist, or psychotherapist.

“I was like, what the hell is this?” he says, laughing.

A friend suggested he try counselling, so Mehra signed up to be a suicide helpline volunteer at a Mumbai-based helpline called the Samaritans. For seven months, between June and December 2006, Mehra spent his weekends in a sparse apartment turned makeshift office, sipping tea and eating Parle-G biscuits, listening to callers who struggled with depression, suicidal thoughts, and anxiety. Helping those in distress was the most emotionally and spiritually rewarding experience of his life, he says, challenging him in ways that consulting never did. He eventually quit his job to attend New York University for a PhD in psychology.

More than a decade later, Mehra still finds his work deeply spiritual. As a therapist, he witnesses the fragility of human life and the addictions, depressions, and anxieties that ravage people in waking nightmares. But he also sees the beauty of life in the strength and resilience that people show in overcoming their traumas. When someone chooses to get help, they become a better friend, spouse, and child, and those effects are felt for generations to come. There have been countless times, says Mehra, when clients thanked him for saving their life. “The way I look at it, we’re all in this together,” he says. “I’m doing my part so there is less tragedy and unhappiness in the world.”

In her research, Tosone found that what buoyed therapists counselling during times of shared trauma was their sense of purpose. No one goes into therapy for money or prestige, says Kathy Offet-Gartner, a registered psychologist based in Calgary, Alberta, and the incoming president of the Canadian Counselling and Psychotherapy Association. “We do it because it’s a calling,” she says. “We do it because we genuinely care.” She’s been seeing clients for the past 38 years and says she’ll provide therapy until she doesn’t “have a brain cell left.”

“I will go to my grave with millions of secrets—not hundreds, not thousands, but millions,” she says. “And I hold each one of them as a treasure and as a gift. So, to stay well and to stay healthy is my responsibility.” She knows her work is
still needed.

At a memorial ground in Washington, D.C., there are over 200,000 small white flags planted in never-ending rows, printed with names of those who have died from COVID-19. Long after the pandemic stops taking lives, therapists will remain on the frontlines. The mental health effects of the pandemic are a tsunami we’ve barely seen the tip of, says
Offet-Gartner, and it touches everyone in some way. “I don’t have enough hours in the day to see people,” she said.
But as public health officials preach to mask, sanitize, and distance, it can be easy to assume that COVID-19 only affects our physical bodies. “This false dichotomy of separating mental health from physical health is an insane perspective,” says Offet-Gartner. “It’s the same damn coin. Why are we only flipping it always to be on one side, not the other?”

Beyond anecdotal evidence, there is virtually no research on the burnout or mental health effects faced by therapists counselling during COVID-19 or during the SARS epidemic in the early 2000s. What does exist, is ample research looking at the burnout faced by medical frontline responders. During SARS, nurses and physicians in Toronto, which had the largest outbreak outside of Asia, reported increased levels of burnout, psychological distress and post-traumatic stress disorder. Anna Banerji, an infectious disease specialist who worked during the tail end of SARS in Toronto in July 2003, said that most medical professionals were working 15-hour days and were traumatized: “Every time they had a kid with a fever, they assumed it was SARS.” While literature on COVID-19 is new, studies on burnout that have been done largely focus on physicians and nurses. One study looking at 1,257 medical healthcare workers across hospitals in China, for example, found that they were more likely to report anxiety, insomnia, and depression.

The lack of research on therapists’ mental health is symptomatic of a wider problem, says Abi Sriharan, an assistant professor at the University of Toronto’s Institute of Health Policy, Management and Evaluation. When we medicalize epidemics, we only see doctors and nurses as frontline responders, when, in reality, “healthcare is a team sport,” she says. Sriharan is researching the burnout and stress faced by healthcare providers—therapists included—during the pandemic.

In a culture that praises the everyday heroes on the frontlines, one is either a healthcare provider or someone needing help. Therapists are often seen by clients as being psychologically perfect, somehow immune to the stresses and anxieties that plague their clients, which can make it harder to seek help. It’s an ideal that clients like to uphold themselves: if therapists don’t have it all figured out, what hope do the rest of us have?

“For those who have ever looked at their therapists and wondered how they were so high functioning, I’ll let you in on a secret: we are not,” writes Brittany Wade, a psychotherapist based in New England, in a psychiatry journal. “So here I sit, at my little ramshackle home desk, in complete discomfort, reflecting on the irony that the very illness, anxiety, isolation, and loss that erode the mental health of my patients are now the main characters on my emotional stage.” In other words, it is impossible to exist without emotion or worry or stress, especially in a global pandemic.

Within a week, Mehra’s mother had turned around for the better. It was painful knowing that he couldn’t see her. He had to resign himself to updates on the WhatsApp family group chat and conversations with his mother, who offered frequent updates on the food served in the hospital ward that day. Though he felt the added strain in each of his sessions that week, providing therapy also helped him cope—he couldn’t help his mother, but he could help the person in front of him.

It’s frontline responders like therapists that play the invaluable role of healing the broken and will continue to long after we’re all vaccinated. But they are only human, and these days, that means burnout can come with the job.

Created in support of Ryerson University’s Office of Sexual Violence Support and Education, We Believe You is a colouring book for survivors of sexual violence. Toronto speaker and educator Farrah Khan and artist Karen Campos Castillo are behind the project, offering affirmations for those affected by sexual and gender violence.

When Krista Dale was 11 years old, she awoke from a sleepwalking episode to find her stepfather on the couch next to her.

“He was trying to have sex with me,” she remembers, 18 years after the incident. “I freaked out.” She ran to the bathroom, locked herself in, and began yelling for her mother, who was sleeping next door.

Dale, whose name has been changed to protect her identity, told her mother what happened, but her stepfather suggested Dale dreamed it all. Dale insisted that wasn’t what happened, but her stepfather was adamant. Eventually, Dale caved under the pressure and, against her gut instincts, agreed she had probably imagined the whole thing.

“In the morning, I was so embarrassed. I thought I had been sleepwalking and accused this man, who was like a father to me,” she says. “I apologized to him.”

In the weeks and months that followed, however, Dale’s stepfather continued his visits, this time in her bedroom. Sometimes he would touch her, sometimes not—sometimes, she says, she would wake and he would be in her room, watching her. “You’re a kid. You don’t even understand what’s happening. I just assumed this was something girls had to deal with,” she says.

In her early teens, Dale became increasingly depressed, even suicidal. At 15, she began drinking heavily, staying out all night to avoid sleeping in her own bed. “It’s pretty fucked that, at 13, I was thinking about killing myself,” she says. As time passed, the abuse continued.

Some of these encounters took on a “hazy, surreal” quality. She caught him, once, trying to put something in her drink. She began to suspect he was drugging her. That same night, Dale decided to try to catch her stepfather in the act. She waited, pretending to sleep. He opened the door to her bedroom. She sat up, and her stepfather, stunned, stopped in his tracks. He turned away and left, shutting the door behind him. Dale confronted him the next day but he denied his actions. Her mother and five other siblings continued to stay silent. A week later, he emptied the bank account her mother and he shared, and disappeared.

Dale never reported the abuse, nor did her mother, including the missing money. “I think we were all just happy he was gone.”

***

Now 29, Dale is a fast-talking, kind-eyed, funny young woman who loves music. Although her stepfather is gone from her life, Dale says the impact his actions had on her mental health was deep and long-lasting. She attributes her mental health issues, including depression and severe anxiety, to the trauma of the abuse. “It just broke me down, I guess. Sex with men was really terrible for a long time,” she says. “I felt like a pretty useless human being. I felt like a piece of meat.”

Stories like Dale’s are unfortunately common among women. A 2015 study from the journal Psychology Medicine found that, compared to 12 percent of men and seven percent of women in a control group from the general population, a staggering 40 percent of surveyed women with severe mental illness reported being sexually assaulted. Meanwhile, a 2006 paper by the National Resource Centre on Domestic Violence noted that victims of childhood sexual assault were five times more likely to be diagnosed with Post-Traumatic Stress Disorder (PTSD) than non-victims, and up to 65 percent of women who experienced sexual trauma as adults reported symptoms of PTSD.

It happened to me, too. I was sexually assaulted in the fall of 2016 by a man I trusted, someone I thought was my friend.

The assault itself was the culmination of several months of verbal, emotional and, at times, physical abuse by a man who was emotionally and mentally unstable. Following that act of violence, I suffered a clinical nervous breakdown.

The breakdown manifested itself in a depression so thick it had a physical weight that made each step and each breath a gruelling act of will. Anxiety and chronic insomnia dominated my nights. I suffered panic attacks, dreams that the man who harmed me was in my house, hunting me down. I drank constantly, spiralling into outright alcoholism. The thought of suicide dogged me, a ghoul that whispered unceasingly in my ear.

The #MeToo movement has done a lot to bring attention to sexual assault, but not enough has been said about the long-term effects of that violence. The movement has largely focused on male entitlement and toxic masculinity, which manifests itself in acts of sexual assault and harassment. Failing to discuss, support, and connect the patriarchy-endorsed violence against women with its long-term mental health effects is a sign of how deeply entrenched male dominance is: We focus on the immediate male-centric acts of violence and harassment, and downplay the emotional, female-centric suffering it creates.

Dale and I are excellent examples of this: We both lived in Whitehorse, a small town of about 21,000 people, and knew each other well enough to give the other a nod at the grocery store. She was a bartender at one of my favourite watering holes, but it wasn’t until we chatted for this story that I had any idea what she had experienced. Likewise, Dale couldn’t have known, as she poured me pints of IPA, that I had recently been sexually assaulted myself.

I’m not exactly sure what that means about human beings in general, except to say that perhaps we should be gentler with each other.

***

How the medical system deals in the aftermath of sexual assault with the resulting mental health effects is “quite complex,” says Bailey Reid, the sexual assault services coordinator for Carleton University in Ottawa. “We medicalize trauma response to the violence, which results in mental health issues that are a normal response to this kind of violence,” says Reid. “Physiologically, this is how our bodies respond to this kind of trauma.”

When a woman seeks treatment for a mental health issue following a sexual assault, the focus is identifying and categorizing symptoms caused by the trauma—depression, anxiety, dissociation—so they can be treated like any other mental illness. While this is practical from a health care perspective, it puts effect before cause and assumes that all mental health issues, regardless of their root, should be treated in the same way. It’s akin to treating a patient with brain cancer the same way as someone who has a concussion; the symptoms of headaches, memory loss, and behaviour change may be similar, but the treatment required to make a patient well again is very different.

As Diane Pétrin, a women’s advocate with the Victoria Faulkner Women’s Centre in Whitehorse, notes, an assault— and, if reported, the legal battle that may follow—are sources of extreme emotional stress: A woman who “was fine, who had a life” prior to an assault might develop depression afterward. If a woman was already experiencing mental health issues prior to the assault, she “might find them intensified.”

“There are assessments, phone calls, appointments, court appearances, they’re dealing with trauma… there’s no one to keep [women who report] going and [the police] aren’t really good at explaining what is going to happen [after an assault is reported],” Pétrin says.

Even more troublingly, if a woman is diagnosed with a mental health issue and decides to press charges against her assailant, the defence for the accused may use it to make her look unstable, says Pétrin. The use of drugs or alcohol prior to an assault can also be used to discredit their reliability.

When it comes to reporting sexual assaults, Reid says, the legal system can be problematic for survivors. “It’s heavy on this burden of proof [on the victim], which is really impossible,” she says. “If you’re outside this perfect legal paradigm of what a victim looks like… the legal system has a way of warping around you [that] is not really respectful.” As Pétrin says, “People think [accessing the legal system] is about whether or not a woman has suffered. It’s not; it’s about the legal system’s version of the law, and whether that law has been broken. It has nothing to do with the suffering of the individual.”

This burden deters some women, like me, Dale, and Shonagh McCrindle, from pursuing charges. McCrindle says she was sexually assaulted by a man she knew casually during the 2016 Dawson City Music Festival, an annual Yukon event known for its heavy drinking and drug use. She says she can’t remember much from the time of the assault, possibly due to trauma. Although she had a rape kit done, she decided not to pursue charges; she didn’t feel strong enough to undergo such public scrutiny. “I wasn’t stable enough [to go to court],” she says. “It definitely changed my mental state. I definitely suffered very hard for over a year.”

***

If I had to do it over again, I wouldn’t have reported my assault, either.

My experience with the justice system was a major factor in my nervous breakdown. Interactions with the police were pointless and disempowering at best; at worst they were combative, intrusive, and accusatory.

In early 2017, I attempted to get a peace bond against my assailant. Although the assault happened in B.C., procedure dictates that you must first file with police in the jurisdiction where you are presently living; for me, that was Montreal. When I called and said I had been sexually assaulted, I was informed that, whether I wanted to or not, an investigation had to take place. Shortly thereafter, two male police officers showed up at my Plateau-area apartment, fully armed. Neither officer spoke passable English, which meant I had to repeat traumatic and highly personal details multiple times. During questioning, the elder of the two officers asked me—over and over, as if hoping to catch me in a lie—why, if things were as bad as I claimed they were, it had taken me several months to file a report. He asked this so many times his partner finally had to tell him to stop.

Once I had reported to the Montreal police, I found I also had to give a statement to RCMP in Whistler, this time on a recorded phone call. It meant telling another strange man the intimate, sexually explicit details of my assault. To add insult to injury, there was a delay of nearly a month between the time I filed with the Montreal police and the time the RCMP contacted me. The Montreal police had recorded my phone number incorrectly.

In addition to these highly personal statements, I also provided the name of someone I had called in a panic after the assault, text messages between me and my assailant, and pages from my private journal to help create my case. I did all that was asked of me. I waited.

And nothing happened.

Months passed. I was told my attacker could not be found in the small coastal B.C. community where he lived, which meant the peace bond could not be served.

Six months later, I received a phone call informing me the Crown had decided not to pursue charges. The Crown did not feel they could go forward with the case, due to an “inconsistency” in my testimony. This “inconsistency” amounted to the fact that, in my statement, I stated the accused had initiated anal sex against my will, but in a submitted text message between me and the accused, I said he had “tried” to “stick his dick in my ass” against my will.

If you really must know, he got about one-third of the way in—unlubricated, without a condom—before my yelling, pushing, and striking made him stop. This is apparently not the legal standard of “fucked in the ass” as the Crown defines it.

***

Shortly after my case was dropped, my attacker showed up unexpectedly in Whitehorse, where I was then living. I was having a beer with a colleague after work, and bam—there he was. This man, an emotionally volatile person with a history of criminal involvement, was standing at the bar holding a pitcher. Smiling.

I panicked.

I immediately went to the RCMP in Whitehorse. I pressed again for a peace bond, and considered appealing to a specialist regarding my case. The RCMP were sympathetic but told me it was outside of their jurisdiction; anything I claimed against him was being handled in B.C. They sent a pair of officers down to the bar, but when they arrived he was gone.

I saw my attacker twice more after that; I don’t think he saw me. I was afraid he would see my name in the newspaper I wrote for, wait for me outside the office and attack me. I was afraid he would do something to my dog, or sabotage my vehicle. I was afraid he would find out where I lived, come to my home at night, and murder me. He lurked, physically and mentally, beyond the edge of every shadow.

There was nothing I could do. At the advice of my doctor I took medical leave from work and went to stay outside of the territory with friends on a farm in the Okanagan. I was a nervous wreck, but the fresh air and trees helped. I lost wages and travel expenses, but I got a little better.

That was until I had to come back and resume my life, still not knowing where he was or when I might run into him. Then I got worse all over again. If a photograph of a “complete mental breakdown” might be taken, it could have been a candid shot of me, sitting in the messy backseat of my car on a Tuesday, frantically pounding cheap red wine from a used coffee cup in a Canadian Tire parking lot just to get through the day.

***

Following my breakdown, I found therapy a useful release valve. I received eight sessions of cognitive behavioural therapy as part of a victim services program in Whitehorse. When I had used up all those sessions, my work insurance did not cover additional therapy costs. I could either pay for treatment myself, cease treatment, or start over with a new therapist. Considering the high costs, I chose to discontinue treatment, although I feel I would have benefitted from more.

According to my doctor, my therapist, and several documents, what I was experiencing leading up to my breakdown was PTSD, brought on by abuse and the trauma of the sexual assault. It was comforting at first to have some kind of a label, to be able to box the bruises and the gaslighting, the shouting and the constant fear. Now that I’m doing better, though, I understand it my experience differently: some messed-up shit happened to me, and the people who were supposed to support and protect me—the police, legal system, and government, represented by the Crown—failed to help me in any meaningful way.

My assailant has never been charged, and neither Dale nor McCrindle pressed charges against their assailants. Dale, who is a server and bartender, paid for her therapy herself. She says her therapist never mentioned programs that might be available to help her pay for treatment. She has never completed treatment. McCrindle, meanwhile, had “extensive health benefits” through her job and received therapy. She also had a good support system of friends who helped her recover, she says.

The reality of many sex crimes is that, when charges are dropped or aren’t laid, survivors must find ways outside the system to protect themselves, often by restricting their own choices and movements, even as their attackers move freely. We live in a state of constant fear and hypervigilance; even if the threat is more perceived than actual, this is emotionally and physically draining.

I can’t publicly name my attacker without fear of libel or slander. Many assailants are protected by the legal bodies and social mores that have failed us.

At its core, being raped is less about the physical act and more about what it symbolizes. To be raped is to have agency over your own body taken away from you, a complex psychic attack completed through base physical violence. Someone else uses your body—sometimes goes inside your body— without your consent, demeaning the very will within you that otherwise defines you as a human being. Rape is a despicable act of violence, but the scar it leaves is in a quieter, deeper place in the country of the self than the mere crude physicality of the act would imply. It is the dirty bomb of the gender war; long after the blast is over, the dispersed pathogens remain.

And let me assure you, from the front lines, this is a war.

For the first time in the history of Canadian mental health, in 2017, the federal government announced an investment of $5 billion to improve access to nationwide services. The lump sum, which is part of the government’s Health Accord with the provinces and territories, is slated to roll out over the next 10 years. Mental health advocates, care workers, and organizations acknowledge that the investment is a welcome first step in tackling Canada’s growing mental health spending.

But the funding is a “mere drop in the bucket to address all the lack of resources and capacity,” says Chris Summerville, co-chair of the Canadian Alliance on Mental Illness and Mental Health. In 2015, Canada’s mental health spending was 7.2 percent of the total health spending budget. To raise mental health spending to the nine percent minimum recommended by the Mental Health Commission of Canada in 2012, “the federal government would have to release nearly $778 million annually, to reach all of the provinces and territories,” says Summerville—well above the pledged $5 billion.

Just over a year after the investment was announced, we break down how much each province is receiving over 10 years.

BRITISH COLUMBIA
Population (2017): 4.81 million
Mental health funding: $655 million

While B.C.’s budget has significant spending allotments for affordable housing and supports of Indigenous people, according to the Canadian Mental Health Association (CMHA), it does not show direct allocations for mental illness. CMHA national director of research and public policy Fardous Hosseiny says Canada’s mental health systems focus “more on crisis care.” CMHA recommends that governments adopt a bottom-up approach to funding mental health, by focusing on early intervention, screening and assessment by community and peer support groups, mental health and addictions counsellors, recovery coaches, psychiatric nurses, elders in Indigenous communities, and so on.

ALBERTA
Population (2017): 4.29 million
Mental health funding: $586 million

Facing an opioid crisis that claimed 343 lives in 2016 alone, Alberta’s Minister of Health Sarah Hoffman received a 3.5 percent funding boost from the federal government, in response to her 5.2 percent ask. In 2018, the province’s budget allocated its own $7 million to improve mental health services. Recently, the province also promised a $5 million grant to hire staff and build school-based programs, extending mental health support to 100,000 students across the province.

SASKATCHEWAN
Population (2017): 1.16 million
Mental health funding: $158.5 million

Mental health makes up five percent of Saskatchewan’s total health budget. The province aims to increase that allocation to seven percent. Meanwhile, suicide deaths among First Nations people in Saskatchewan is 4.3 times higher than non-First Nations Saskatchewanians, according to a 2017 Saskatchewan First Nations Suicide Prevention Strategy report presented by the Federation of Sovereign Indigenous Nations’ Mental Health Technical Working Group. The province’s 2018-19 budget estimates mental health expenses of $367 million. New targeted investments in mental health include $4.6 million for improved children and youth mental health, $5.2 million for better access to community mental health supports, and $1.5 million for greater mental health delivery.

MANITOBA
Population (2017): 1.34 million
Mental health funding: $181.6 million

At first, Manitoba Premier Brian Pallister held out on signing the federal Health Accord, demanding more money for Indigenous health care and rising rates of kidney disease and diabetes. In August 2017, the province signed the health pact and received an additional $5 million for 2017-18 in health care funding to fight kidney failures. Currently, “mental health spending in Manitoba is approximately 4 percent of its health spending budget. Even though the funding announcements have been made, those funds will not bring mental health into parity with physical health,” says Summerville.

ONTARIO
Population (2017): 14.19 million
Mental health funding: $1.9 billion

One in three Ontarians will suffer a mental health or addictions crisis in their lifetime. The province estimates an expenditure of $29 billion on mental health in the next five years. The recent 10-year allocation from the health accord is “simply not sustainable,” said former health minister Eric Hoskins. To match the federal allotment, Ontario is funnelling a supplementary $2.1 billion to mental health and addictions care for the next four years. The province has also increased the annual funding for mental health and addictions operations to $3.8 billion.

QUEBEC
Population (2017): 8.39 million
Home care and mental health funding: $2.5 billion

Every year, over 500,000 Québécois aged 12-24 and 430,000 aged 25-64 are diagnosed with depression and anxiety. Up to 50 percent of long-term absenteeism in the province is attributed to mental disorders. The Québec Health and Welfare Commissioner estimates the yearly cost of psychotherapy in the province to $400 million. In 2017, Quebec announced an investment of $35 million in mental health which will support their first public psychotherapy program.

NEW BRUNSWICK
Population (2017): 759,700
Mental health funding: $104.3 million

In 2015, Moncton reported 22 suicides. In 2016, that number grew to 40. Suicide rates in northern New Brunswick are even higher, and youth hospitalization in the province is almost twice the national average. Wait times for those in crisis range from six months to a year at mental health facilities in Moncton. Most mental health professionals operate private practices not are not covered under the province’s health plan. But recently, the Medavie Health Foundation donated $360,000 to support mental health research and evaluation.

NEWFOUNDLAND AND LABRADOR
Population (2017): 528,800
Mental health funding: $73 million

In 2014-15 Newfoundland and Labrador reported an average of 13.5 percent of citizens who experienced repeat hospital stays due to mental illness, in comparison to a national average of 11.5 percent, according to the Canadian Institute for Health Information. Fatal police shootings in the province are rare, but two out of three that have occurred since 2000 involved people living with mental illness. The province is hoping to tackle this $1.7 million allocated in its 2018 budget toward mobile intervention units. And $6.1 million has been reserved to replace Waterford Hospital, the province’s century-old mental health facility.

NOVA SCOTIA
Population (2017): 953,900
Mental health funding: $130.8 million

In 2017 health services audit, Nova Scotia reported an expenditure of $225 million on mental health services per year. The report by Nova Scotia’s Auditor General, Michael Pickup, found that the government lacks a specific plan on how it intends to deliver mental health services to those who need it the most, delivery is inconsistent based on location, wait times and assessment methods vary, and there are ongoing concerns around patient and staff safety. The province’s 2018-2019 budget has allocated $3.9 million for mental health and youth supports.

P.E.I.
Population (2017): 152,000
Mental health funding: $20.5 million

In 2015, Prince Edward Island reported a suicide rate of about eight people for every 100,000. The province’s 2018 budget allocated funding for student wellbeing teams, a 24/7 mental health response team, a $175,000 grant to CMHA for island-wide support groups, and more.

YUKON
Population (2017): 38,500
Mental health funding: $5.2 million

Both Ontario and Yukon have almost the same amount of funding allotted per capita. But the territory has a suicide rate of 20 percent, while Ontario’s suicide rate is 9.7 percent, making it clear that the amount of funding allotted to Yukon is disproportionate to what it needs.

NORTHWEST TERRITORIES
Population (2017): 44,500
Mental health funding: $6.1 million

In 2015, the Northwest Territories reported a high suicide rate of 24.7 per 100,000. The 2018-19 budget allocated targeted mental health funding of $1.5 million for education and training of child and youth mental health counsellors, and $500,000 for on-going funding for the youth-in-crisis mental health programs and existing community care for Indigenous peoples.

NUNAVUT
Population (2017): 38,000
Mental health funding: $5.1 million

In 2016, Nunavut’s suicide rate of about 86 people for every 100,000 was the highest recorded in the country. The provincial government, Nunavut Tunngavik, the Embrace Life Council, and the RCMP have embarked upon a five-year action plan, Inuusivut Anninaqtuq, by investing $16 million to bring wellness programs within reach of all Nunavut communities.

NATIONAL
On Indigenous mental health

In its 2018 budget, the federal government committed a separate $200 million over five years for the delivery of culturally appropriate addictions treatment and preventions services in First Nations communities, and $248.6 million over three years for mental health and emotional supports for residential school survivors and their families. But according to Yipeng Ge, Vice President of Government Affairs at the Canadian Federation of Medical Students (CFMS), there’s still a need for more accountability and transparency in tracking the distribution of the funding to the communities that need it the most. Budget reports don’t get conveyed to those working on the ground, Ge said. CFMS has called on the government to adopt the frameworks and strategies recommended by Indigenous peoples to address First Nations and Inuit suicide, comprehensively review current distribution of funding through the National Aboriginal Youth Suicide Prevention Strategy, and more.

Lena Dunham as Hannah in HBO’s Girls

I am quite open about the fact that I have Obsessive Compulsive Disorder, or OCD. Talking about it comes easy to me. More difficult to handle are the reactions I get from others. “So are you like that nerd on The Big Bang Theory?” someone in a work meeting recently joked after I mentioned my OCD.

That nerd is Sheldon Cooper, a character on the popular CBS sitcom whose habits include not wanting his roommates to sit in his spot on the couch and knocking three times. Sheldon is often what people think OCD looks like.

I don’t watch the show, but I have yet to hear of an episode where it takes Sheldon more than an hour to leave the house because he needs to repeatedly check all the taps in his apartment to make sure there is not even the tiniest drip that could lead to a massive flood, destroying all his Nirvana memorabilia, killing his cat, and leaving him homeless. I doubt this would make for Emmy-winning television.

The Big Bang Theory is certainly not the only show to play OCD for laughs. Glee, Friends, and Monk have also reduced it to a punchline. Movies from As Good as It Gets to The Aviator depict OCD as a quirk, eccentricity, or Type-A personality indicator. Marketing campaigns joke about Obsessive Christmas Disorder, online quizzes ask “How OCD are you?” and Khloe Kardashian calls OCD, which she doesn’t have, a “blessing” because it enables her to create perfectly symmetrical stacks of Oreos.

Of those with clinical OCD, more than 90 percent have both obsessions and compulsions, but pop culture portrayals focus only on the latter. Portrayals are also often exaggerated, with OCD depicted as being performed in a specific way (often counting) or as a character’s defining personality trait. These negative portrayals not only diminish the severity of the problem, but also hurt those, like me, who don’t consider embarrassing blisters on their hands from repeated doorknob checking a blessing.

These portrayals also lead to silence and suffering for those who fear they will be dismissed or mocked for their OCD. (I was seriously once asked if I bottled my urine like Howard Hughes after someone watched The Aviator.)

Not all people with OCD are clean freaks, counters, or constant hand washers, but that is what pop culture has reduced us to. A few months ago, a friend visited my apartment and was disappointed it wasn’t cleaner. They assumed my OCD made me exactly like Friends’ Monica Geller. The apartment wasn’t clean, but my stove certainly was—I hadn’t used it in months because checking to make sure it was off became too exhausting and it was easier not to use it. Unlike me, Monica never survived on microwaveable Lean Cuisine entreés and Cheerios for several months to avoid the stove.

It took until 2013 for me to see a portrayal of OCD I could finally relate to. Many things about Lena Dunham’s HBO series Girls frustrated me, but the show’s depiction of OCD perfectly captured my crippling feeling of frustration, darkness, and isolation. Talking to her therapist, Dunham’s character described how her compulsions and rituals would keep her up until the wee hours, leaving her exhausted and zombie-like in the morning, when she would wake up and do it all again. When my OCD is at its worst I often put off going to bed, staying up until 2 or 3 a.m. to watch something I am not even all that interested in (Top Chef: Colorado, anyone?) just so I can avoid my pre-bedtime lock and window checking.

In the morning, I stay in bed long after my alarm has gone off because the thought of getting up and doing my hours-long pre-leaving-the-house checking, followed hours later by my pre-leaving-the-office checking, has me feeling exhausted before I even have my feet in slippers.

In between all my checking, I remain hopeful there will be more positive pop culture depictions of OCD and mental illness. John Green’s recent novel Turtles All the Way Down, which is an account of Green’s own struggles with OCD, gives me hope, as do the better and broader representations of mental health issues in characters like Gretchen Cutler in You’re the Worst and Ian Gallagher on Shameless.

Take that, Khloe Kardashian.

Illustration by Erin McCluskey

On a rainy Thursday in April, I arrive at a yellow brick, split-level house in London, Ont. People are doing word searches at a large dining table. Some help themselves to a container of freshly baked peanut butter cookies, and CBC News is playing on a television in the living room. This house, tucked away in a quiet, tree-lined neighbourhood a few kilometres from London’s gritty city centre, feels almost like a family home. “You’ve come right in time for morning break,” says Sarah Dutsch, the homeowner, as I take off my shoes. This is one of Ontario’s Homes for Special Care: a controversial custodial housing program for people living with severe psychiatric challenges. Sarah and dozens of other Homes for Special Care operators are now in talks with the Ministry of Health and Long-Term Care about the future of mental health housing in Ontario.

At first I am surprised by the peaceful, if static energy at Sarah’s place this morning. In the weeks leading up to the visit, mental health experts expressed to me major concerns about Homes for Special Care. They are government-funded, for-profit operations, born in the 1960s as a place to live for those discharged from psychiatric hospitals. Today, they are criticized for offering outdated and misguided support to vulnerable people. Sarah and her staff spend 24 hours a day, seven days a week caring for eight tenants living with mental illnesses, including schizophrenia, obsessive-compulsive disorder, and bipolar disorder.

She bought the Home for Special Care and renamed it the Dutsch Residence six and a half years ago, leaving behind a travel and tourism career in British Columbia because she wanted to do something “more meaningful” with her life.

In her kitchen she points to a row of colour-coded cups, one for each tenant, on a windowsill. There is also a code of ethics on the fridge, sign-up sheets for activities, and a list of tenants’ initials on the wall so Sarah can keep track of who is around for mealtimes. Residents can take out money from their monthly allowance from the Ministry of Health and LongTerm Care three days a week; Sarah goes to the bank to do the withdrawals. With the help of staff members, she cooks three meals a day (plus snacks), cleans, does laundry, shops, and supplies personal items like soap, shampoo, and diapers.

Outsiders may criticize the Homes for Special Care program, but it doesn’t change Sarah’s perspective on them. “We can’t lose the reason why these homes exist in the first place: to provide a safe, directed program, based on the needs of the tenant,” she says. “Sometimes the supports need to be pretty active, and that’s okay.”

Research, however, shows that the unconditional and mandatory support in place in Homes for Special Care operations could be hindering some residents from building the skills they need to reintegrate into the world around them. The program “meets almost no best practice criteria, and this has been known for 35 years, at least,” says John Trainor, former director of the Community Support and Research Unit at the Centre for Addiction and Mental Health (CAMH). At one time Trainor was in charge of inspecting some Homes for Special Care operations in Toronto, and for decades he tried to close the program down. “It’s a scandal, really,” he says. “It shouldn’t be there. It’s worse than many models in countries with fewer resources.” In the 1990s, Trainor says he was pulled into a meeting with senior Ministry of Health and Long-Term Care officials who told him that the program was, in fact, slated for closure. But those plans never went through. “We never got called back to another meeting,” he says.

Founded at the start of de-institutionalization, in 1964, and despite the Ministry’s apparent efforts to shut the program down, Homes for Special Care endures. Now, the program that houses some of the province’s most mentally ill citizens is slated for modernization, to be completed by 2020. Homes for Special Care operators and the Ministry of Health and Long-Term Care agree that the program needs to change, but the two sides are at odds about what, exactly, to improve. Talks are stop-and-go. Outside experts, including Trainor, question if the 50-year-old custodial housing program should exist at all.

***

In Sarah’s dining room she begins to introduce me to some of her tenants—eight people who are part of a group of hundreds in Ontario whose lives and homes are at the centre of this debate. A woman named Carol (whose name has been changed to protect her identity) with grey hair and a stable, intense gaze appears from the kitchen. As I turn around to greet her, she immediately asks to speak with me in private. Sarah grows tense as Carol leads me into the living room.

We sit side-by-side on a couch. Carol wears a pink, flowery shirt and though she has asked to talk in private, she speaks loudly enough that Sarah can hear her from the adjoining dining room. “I don’t like the atmosphere here, it has a very negative impact on me,” says Carol. Years ago, Carol lived in a supportive housing apartment for individuals with disabilities with her boyfriend, James. After more than one fire started in the apartment and bed bugs were found, Carol and James were evicted, and Carol found herself living in Sarah’s residence. Her niece now picks her up and drives her for weekly visits to see James who, following the eviction, was placed in a tightly controlled long-term care home. “It was hard for me to adjust, because of not having the nurturing relationship [with him],” says Carol. She says she wants to live independently again, to be with James; she feels restless and isolated. I ask what she likes to do for fun. “I go to the variety store quite a lot,” she says. Sometimes, she stays in her bedroom. “I have my TV in there and I like the solitude.”

As Carol and I talk I can feel Sarah’s presence in the next room. She sighs audibly and then appears in the doorway: “Should we set a time limit on this?” This was not how she expected the visit to start, she admits. Later, she tells me Carol has “stuff on the go” almost every day—community programs three days a week and visits with her niece and James on Tuesdays. Still, Carol maintains that she wants more. “I call Carol my Eeyore, lovingly, because everything is always dark even though she has the most supports,” says Sarah.

In a series of meetings conducted by the Ministry of Health and Long-Term Care for the modernization of the Homes for Special Care program, many residents echo Carol’s sentiment: They want more independence. The Ministry did not agree to multiple requests for interviews, and they would not provide me with the raw data from the survey they conducted, or the interview notes.

But other research shows similar findings. In a 2017 meta analysis of housing choice for people with mental disorders, published in the journal Administration and Policy in Mental Health and Mental Health Services Research, researchers’ pooled analysis showed that 84 percent of study subjects preferred to live in their own apartment, with family, or with people with whom they’ve had a choice in selecting.

However, Homes for Special Care operators argue that some tenants would struggle to live without the constant and custodial support that they provide. “I invite [critics] to come for a weekend. Because this type of program, as much as they disagree with it, it works,” says Lisa Zavitz, an energetic, self-effacing woman who runs another eight-bedroom home down the street from Sarah. For some, she says, “if someone is not there cooking them a meal, they don’t eat. If I don’t remind them to put on deodorant and change their underwear, some of them won’t. This is the reason we’re here.” Jim Akey, who owns one home in St. Marys, Ont., and another in St. Thomas, Ont., had similar concerns about independent living: “Some people might function fine with it, but I think they would be the exception, rather than the rule.”

When I posed this idea to Geoffrey Nelson, a psychology professor at Wilfrid Laurier University whose research focuses on community mental health programs, including Homes for Special Care, he disagreed. “That’s the kind of mindset that makes people stay where they’re at,” he says. “Some operators don’t believe that people have the potential for recovery, but we know from research that a substantial number of people with mental illness do get better.” Nelson conducted a study of mental health housing in London, Ont., in 2003 for the Canadian Journal of Community Mental Health. The study found that while 79.3 percent of subjects said they preferred independent living, 76 percent were not living in independent housing. Also, with the exception of only two people in the study, subjects who said they preferred to live in Homes for Special Care were already living in one. “When you start saying people can’t survive outside these walls, you might get a self-fulfilling prophecy,” Nelson says.

John Sylvestre, vice-dean of research at the University of Ottawa’s Faculty of Social Sciences, is the co-editor of a textbook on mental health housing. When I called him at his office on campus, he agreed. “If people want to try, let them try. Who am I to say that a fellow citizen has gone far enough?”

At the Dutsch Residence, Sarah and Carol lead me to the basement to see Carol’s bedroom. Full of books, photographs, and art, Carol’s room is small and lived in, and she appears proud of it. She is one tenant in the house with her own bedroom. In two other bedrooms, Sarah has created privacy barriers using various objects. For one tenant, a sizeable sheet of plywood from Home Depot and a dark wood dresser that’s taller than his bed separates him from his two roommates. “In a perfect world would he benefit from a single room? Probably,” Sarah says. In another room, she’s separated two beds using a room divider from Jysk, an affordable furniture store.

“We still see that people are sharing rooms with unrelated adults,” says Sylvestre. “They don’t get to choose who [their roommates] are. That’s not accepted in any other part of the specialized housing system. We’re in 2018 and to still see a form of housing that isn’t in its basic form or shape changed since the [1970s], I find it disappointing.” Some homeowners, including Sarah, say some tenants like sharing rooms. Plus, at the current level of funding, she says the only way she can operate this business is by housing eight tenants in a four-bedroom house. Long-term care homes in Ontario, and prisons and hospitals across Canada all get more per diem funding than Homes for Special Care. To keep a resident in hospital costs the province between $700 to $1,400 per day, according to the 2018-19 Ontario hospitals’ interprovincial per diem rates for inpatient services. In Homes for Special Care, a resident costs the province $51 per day.

In Sarah’s kitchen, jazz plays on the radio as Sarah puts together chicken salad sandwiches with the help of one of her tenants. “At first I was worried about you talking to Carol,” she confesses. “But really, she’s the perfect one for you to talk to. She indicates what the struggle is. Somewhere in her mind, she wants more independence, but in the day-to-day realities of how her life trajectory has gone…”

She trails off, but doesn’t need to finish. The mental illnesses that tenants in Homes for Special Care deal with are not minor by any measure. Operators regularly struggle with where to draw the line when it comes to providing support for their tenants—when to let them live their own lives and make their own choices, and when to intervene because those choices are against the best interests and sometimes safety of the tenant.

Every month, tenants get about $140 from the Ministry of Health and Long-Term Care for personal spending. According to homeowners, many spend the allowance immediately. “It’s gone within 24 hours,” says Lisa Zavitz. Often, she says, she finds tenants lying on the sidewalk near their home, having defecated in the street after trips to Valu-mart on payday. “They eat so much their bodies can’t break it down.” Increased appetite is a common side effect of medication for schizophrenia, and “the medication pushes their addiction button.” She says one of her tenants drinks oil. “Within human rights, I can’t physically stop them from that, so I clean up the messes, I make sure they get bathed, I make sure the whole place has been bleached, and then I sit down and have the same conversation with them: ‘I’m here if you need help budgeting money. You can’t do this, this is bad for your system.’”

The Ministry of Health and Long-Term Care plans to increase tenants’ spending allowance to $500 per month, a move that every operator I spoke with opposes. Sarah put her stance on it simply: “Sometimes, them not having money can be one of their only controls.”

***

The homeowners and operators I spoke with are open, even enthusiastic, about giving more individualized care and independence to tenants, but they say they need more funding to do so safely and effectively. Many of the homes are now closing down—smaller ones have become too expensive to run, owners say.

“We’re not like small businesses, we can’t just increase our costs,” says Connie Evans, an owner and president of the Ontario Homes for Special Needs Association. “Empower the homeowner” is a maxim used by several Homes for Special Care operators who say they need more money from the province to survive. “The small homeowners have been struggling, they are not making any money,” says Rahim Charania, another operator.

Policy experts argue that the for-profit model of Homes for Special Care is one of its most fundamental flaws. “It provides an incentive for people making money to keep a stable pool in their house and to have attitudes to say that they can’t do any better,” says Nelson.

Sarah’s Home for Special Care is perhaps one of the best in the business, and not all homes are run like hers. “The one-on-one care, the home-like setting, making sure that they matter and are part of the family. We’re a family, and we’ll argue and bicker and everyone is entitled to that,” says Lisa, who guesses that 50 percent of homes could use significant improvements.

***

On a warm day in May I pull up to a building tucked away on a side street in downtown Toronto. This residence, which opened in 1994, is inconspicuously large with high ceilings and 20 private bedrooms each equipped with an ensuite four-piece bathroom. “This is the Cadillac of mental health housing,” says Janet Huang, the executive director of the non-profit housing program Pilot Place Society, who welcomes me at the door.

With just slightly more staffing than Homes for Special Care, this non-profit is known as one of the best ways to house people with mental illness. “Homes for Special Care went out of fashion, although they were the answer to a lot of things,” Janet says.

The program should not be abolished entirely, Janet says. “There are people who could do well there,” though, she says, it certainly shouldn’t be the only option.

At Pilot Place Society’s three Ontario residences, the philosophy is recovery. “We are re-training people for community living,” Janet explains. They’re taught the basics, like how to bathe and pick out an outfit. Some tenants are employed by alternative businesses as mail couriers and others as helpers in a cafe in the city. There is a Tenant Council run and led by the residents.

Even in this type of housing, where increased independence is an explicit, mandated goal, getting people to recover is difficult. Janet and her staff took at least a year to successfully train residents to go to the corner store next door unsupervised. One Pilot Place Society resident named Ivan showed up in 2009 from CAMH’s inpatient unit, where he says employees told him he could not cross the street because he’d previously been hit by a car. At Pilot Place Society, Janet pairs Ivan up with other residents to go on walks around the neighbourhood. “Here, we’re part of a society,” Ivan says, adding that he’s much happier than his days in the hospital. “I have freedom here.”

Perhaps Carol, the woman in Sarah’s house with the stable, intense gaze, would fare better living somewhere like Pilot Place Society. Or perhaps Sarah and the Homes for Special Care program are offering Carol just what she needs for her specific challenges and abilities.

Carol’s niece, one of her only surviving family members, is happy with the care her aunt gets at the Dutsch Residence. “Sarah has a routine, a grasp on these guys. Carol doesn’t seem happy there, but it’s a wonderful place,” she says. Is the embattled custodial housing program fundamentally and philosophically flawed, or is it in need of a serious fix? Sarah doesn’t know what, exactly, the Ministry’s modernization and the plans to change the program will ultimately mean for tenants.

“We’re all kind of scratching our heads going, are they losing something, or are they gaining something? I’m just anxious about caring for these people.”

Johnson chose to fight back. In September 2011, he showed up at Cedar Centre and begged them to take him in. Over its 31-year history, the Newmarket, Ont.-based non-profit has helped save many lives like Johnson’s. The centre provides intense, personalized trauma therapy to those who have suffered childhood sexual abuse or other forms of interpersonal violence. It’s run by a staff of therapists, counsellors, volunteers, and Alison Peck, the centre’s executive director, who work to ensure victims of trauma get the help they need.

When the centre was nearing its 30th anniversary in 2016, it underwent a rebrand. Called the York Region Abuse Program at the time, the centre had long been considered the region’s best kept secret. Successful as it was, Peck wanted more people to know about it, and she wanted its name to reflect their doors-open philosophy.

“Abuse is a big word,” says Peck. Switching to “Cedar Centre” has not only de-limited the organization’s reach and work in trauma, but also conveyed that, like the cedar tree, the centre is that place where the fragile can gather for shelter during difficult times of the year. “This is where they can find safety and security, and learn to seed, nest, and fly back into nature,” she says.

Cedar Centre’s trauma therapists are a mix of psychotherapists and social workers practicing psychotherapy. While she is not a trained psychologist herself, Peck provides support to those dealing with secondary trauma or compassion fatigue through her own private practice.

Operating Cedar Centre is at once the most difficult and rewarding work of Peck’s career. Certainly, it’s invaluable. The most recent Statistics Canada numbers show that 33 percent of Canadian adults experienced childhood trauma. Of them, 67 percent never told friends or family about it and 93 percent didn’t report the incidents to authorities. The impacts on a person’s life are severe and long-lasting. Adults who experienced physical or sexual abuse are more than twice as likely to have psychological limitations and to experience violence as adults, and nearly twice as likely to use illegal substances than those who had not experienced childhood trauma, even with similar education, employment, and income levels.

Meanwhile, a 2012 study measured the economic impact of not treating childhood trauma at about $270,000 over the course of a victim’s life, to say nothing of the immeasurable social and emotional impacts.

After three years of therapy and group sessions at the centre, Johnson, the paramedic from York Region, felt empowered to take his abuser to court, with his Cedar Centre therapist at his side for some appearances. “Their therapists are very supportive and nonjudgmental,” says Johnson. “They allow you to have your voice and they validate what’s being said.” Today, Johnson is an advocate for Cedar Centre’s work, and a member of its Speakers Bureau, which allows former adult patients of the centre to share their lived experiences of trauma and stories of recovery.

Delivering these services isn’t easy for many reasons. But Peck says the biggest challenge is funding. Despite raising about $100,000 per year through their annual fundraising activities, plus support from the United Way, the centre’s resources are tapped. For clients 18 years and older, there’s a year-and-a-half to two-year wait-list, which is expected to grow by half a year every quarter. The wait-list is merely to receive the basic services patients need before they’re moved onto more intensive therapy.

This is significant for someone who has, after much consideration, committed to a trauma program. “Trauma work is tough work, and to ask people to wait for that long is difficult,” she says.

According to Peck, those who come through Cedar Centre’s doors to use its services “are probably the most resilient people I know because they have survived terrible things that have happened to them. They’ve been able to draw on their inner resources to make it to our door. If they can show up, I can show up too.”

For more than half my life, someone has been trying to kill me.

That someone is me.

The first time I considered ending my life, I was eight or nine years old, living in a rented house with my father and brother in Owen Sound, Ont. My mother had moved out years earlier, after my father tried to stab her; he had started directing his misogyny at me instead. We had just watched The Towering Inferno, an early-1970s drama about a fire in a skyscraper. My brother described how he would climb balconies and elevator shafts to safety, and I thought: I’d just jump.

I knew I shouldn’t say it out loud, that the thought was somehow shameful, but it seemed clear to me that there are better and worse ways to die. I couldn’t see a good answer to the question, “Why not?”

Karen Letofsky, board president at the Canadian Association for Suicide Prevention (CASP), was not surprised to hear this. “There is a lot of social ambiguity around suicide,” she says. Much of what we think we know about suicide is based on social mythology, which creates barriers to the honest conversations Letofsky says people who attempt suicide need to have.

Yvonne Bergmans also emphasizes the importance of talking about suicidal thoughts. Bergmans is a CASP board member and suicide intervention consultant at the University of Toronto’s Arthur Sommer Rotenberg Chair in Suicide and Depression Studies Program at St. Michael’s Hospital in Toronto. She says suicide attempts and suicidal ideations speak to a “great, deep pain: that hurt where there’s a story being written about ‘I can’t survive this’ or ‘I need to end this.’”

In our discussions about suicide, both women say our country’s mental health system is under-resourced and prioritizes crisis over long-term support. Its uneven structure leaves it poorly equipped to help survivors do what we most need to: articulate and understand the stories behind our suicide attempts. And those stories matter—hearing them helps demythologize suicide, so we can understand and address it as a social problem.

I grew up in poverty, in an abusive home. I learned early in life that my physical safety and bodily autonomy were not guaranteed, that I had little control over what happened to me, and that being killed was a real possibility. My earliest suicidal thoughts aren’t about giving up. They’re about regaining control: If I can’t choose not to die, I’ll settle for choosing how to die.

***

Suicidal ideation was a secret I kept throughout my childhood. Even if there had been someone for me to share my feelings with, I didn’t have language to do so. Bergmans says this is a common problem. About 80 percent of her clients experience alexithymia, or an inability to identify and describe their emotions.

“A lot of folks can only talk about how they need ‘it’ to go away, without any language to understand what ‘it’ might be,” she explains: “The emotional literacy to be able to say, ‘I’m so angry,’ or ‘I’m so frustrated,’ or ‘I’m so lonely,’ or ‘I’m so hurt’ just doesn’t exist.”

Unable to communicate our feelings with words, people who attempt suicide learn to communicate with behaviour instead. I was 16 the first time I acted on suicidal thoughts. While I didn’t attempt suicide that day, I made a detailed plan: I was going to slit my wrists and then hang myself from the railing above the stairs in my foster home. My hanging body would block my foster parents’ path to the garage—they would have no choice but to acknowledge my pain. The idea scared me; that it seemed inevitable scared me more.

I confessed my plan in an online chatroom for people with depression, and someone called the cops. That was the first of many arrests under Ontario’s Mental Health Act—often referred to as “being formed” because there is a form the arresting officer or doctor fills out to require you to submit to psychiatric assessment.

The hospital discharged me back to my foster home the following morning.

The next year, I began struggling to determine what was real. My mind battered me with thoughts about scooping out my eyes, splitting open my abdomen and removing my uterus, cutting off my hands because they were being operated by someone else. I now have a word for what was happening to me—dissociation—but I didn’t then. I overdosed and wound up in the hospital again. Once again, I was discharged with limited follow-up. In these and other suicide attempts throughout my teens and 20s, I was telling a story, whether anyone wanted to hear it or not: I’ve got good reasons to feel this angry, and I demand to be heard.

Bergmans says it’s common to feel isolated after a suicide attempt: “Even when people are in crisis, their experience with the mental health system is often, ‘let’s find a diagnosis, try to medicate, and send them on their way.’ And what gets missed is the trauma of the experience that somebody has in attempting suicide.” The problem is both interpersonal and systemic. In a crisis, a person with suicidal thoughts can present themselves at the emergency room or call a suicide hotline and get immediate care. But, argues Letofsky, “once the crisis has passed, there really aren’t many resources. That compounds the problem.”

One area where we see the mental health system’s “crisis-driven service orientation” is in the programming that attempts to respond to youth suicides and attempts, such as the suicide crisis in Canada’s Northern Indigenous communities. “Most of the resources are front-ended and applied at the time of crisis,” Letofsky says, “and then you never hear again about that story or its longer-term impact.”

Indigenous people in Canada live with the trauma of ongoing genocide, a history that includes over-representation in the foster care system, in prisons, in poverty, and among suicide deaths. While Indigenous people are over-burdened with trauma that demands to be heard, the mental health system serving them is even more under-resourced than in the rest of Canada.

Makwa is an Indigenous social worker and mother of two from Sault Ste. Marie, Ont. Intergenerational trauma has shaped the experience of suicide for her and her daughter, Nimkii. (Both names and their location have been changed to protect their identities.)

Makwa’s mother, an Indian day school survivor, struggled throughout her life with self-harm, suicide attempts, and a substance use disorder, and Makwa and her siblings were apprehended by Children’s Aid when she was a baby. The first time Makwa attempted suicide, she was nine years old. She overdosed on acetaminophen in her foster home, thinking that if she died, she could leave the home.

By the time she was 11, Makwa was regularly self-harming. Each episode led to another crisis call: police, paramedics, hospitals, new foster homes, group homes when the foster homes would no longer take her. Sometimes, the hospital or jail Makwa was held in couldn’t discharge her because she had nowhere to go. Her sense that the system was tired of dealing with her crises left her “feeling even more worthless.” Eventually, a guard from one of Makwa’s detention facilities agreed to foster her.

Makwa developed a substance use disorder in her late teens, and when she aged out of foster care at 17, she was pregnant with Nimkii. Nimkii’s father, also a child welfare system survivor, used substances and abused Makwa. They lost custody of Nimkii and their infant son after Makwa, reeling from an episode of domestic violence, slit her wrists.

To be able to parent Nimkii and her brother, Makwa needed to change. She left her abusive partner, overcame her substance use disorder, went back to school, sought mental health treatment, and regained custody of her children. But as Nimkii entered her teenage years, Makwa saw familiar behaviour in her daughter: Nimkii began to self-harm, attempted suicide, and assaulted others.

For years, Nimkii’s only consistent support was Makwa. Makwa believed Nimkii needed residential treatment, and she knew being a child in the foster care system would open doors to treatment that she couldn’t afford. Makwa reluctantly agreed to a temporary care order with Children’s Aid, in hopes of getting Nimkii into the Roberts/Smart Youth Mental Health Centre in Ottawa. Nimkii eventually got into treatment, but at an enormous cost. She was placed into foster care. Like Makwa, she bounced between group homes, hospitals, and jails. She began using substances. Her behaviours worsened, and her criminal charges began to pile up. She ran away and was sexually assaulted. In the end, it took a year and a half to get Nimkii into treatment, and Makwa had to sign her parental rights away to do it.

Jane, a Barrie, Ont., high school teacher whose name and location have been changed to protect her job, also feels stuck in a repetitive cycle of crisis care. “When I was in crisis,” she explains, “I was able to talk one-on-one with a nurse, and they gave me phone numbers and set up initial appointments, but after that, I was on my own,” she says. Jane feels that, once the crisis is over, nobody cares whether she seeks treatment.

Both Makwa and Jane have had their parenting abilities questioned because of their mental illnesses. When Nimkii was released from residential treatment and returned to Makwa’s home, Children’s Aid remained involved. Their file was finally closed in November 2017, but it was reopened in January when Nimkii had an episode that required Makwa to call police. Most recently, Children’s Aid cited Nimkii’s mental illness as a reason to deny Makwa kinship care of another family member.

For Jane, the call from Children’s Aid came after her husband discussed suicide with a psychiatrist. In Barrie, the mental health system is so under-resourced that most patients can receive only a one-time assessment from a psychiatrist. Unfamiliar with Jane’s family, the psychiatrist concluded that two parents with the potential to self-harm constituted a risk to their children and reported them to Children’s Aid. She never considered that Jane and her family could find a way to cope with the risk of suicide.

Bergmans’s research found that even when follow-up support is offered to survivors, the conversation focuses on changing behaviour, not understanding emotions. One of Bergmans’s clients described behavioural therapies as “putting a doily on top of a pile of shit; there’s a pretty doily there now, but it still stinks.” Jane agrees: “As long as you’re making a valiant effort to fix your behaviour, people are more comfortable with that than with ‘this is who I am, this is how I am, this is how I think.’”

***

Sarah at an Athabasca University award ceremony in Toronto in 2013. Photo courtesy of photographer Janyce Mann.

Today, there are efforts to change that mode of thinking. Bergmans started trying to change the system in 1999, when her first therapy group for suicide attempt survivors in Toronto began, using an established intervention model that remains popular for treating suicidal individuals. But Bergmans’s eight group participants weren’t finding the therapy useful. So Bergmans adapted the group, working with survivors to build on academic research and on Bergmans’s experience working with children and youth. Together, they developed a program that “targeted the key areas for suicidality—safety, emotions, problem-solving, and interpersonal relationships.”

Bergmans’s intervention model lays out the core concepts participants use to understand the stories behind their attempts. The program includes 20 weeks of group therapy, during which participants also receive one-on-one support to process their learning and emotions. The challenge for participants is not to simply change their behaviour, as suggested in typical therapy models, but to understand it. Bergmans’s technique is in use at hospitals and community mental health centres in southern Ontario, including St. Michael’s Hospital, where 433 people have participated in the therapy. In fact, 121 of them have returned to complete it a second time.

Despite the success of Bergmans’s model, the Canadian mental health system is ill-prepared for widespread adoption of such resource-heavy methods. At St. Mike’s, Bergmans’s group participants all have one-on-one support. Other groups employ paid part-time staff, or they add the group to the workload of existing staff. It’s also a program in which service providers must become comfortable with risk—participants must feel safe discussing their suicidal thoughts and mental health challenges. In the risk-averse bureaucracy of the system, that’s not something health care workers are trained to do.

***

By 2013, I had scraped my way through a three-year Bachelor of Arts program at Toronto’s York University and made it into a graduate program in St. Catharines, Ont., but I had stopped coping. I still lived in poverty. I was raped two years prior, exacerbating my depression, anxiety, and gory, vivid nightmares—symptoms that would eventually be diagnosed as Post-Traumatic Stress Disorder. I was using opioids to cope with constant anger, sadness, and existential terror. There was nowhere, nothing that felt safe. A doctor at the walk-in clinic gave me a couple months’ supply of Cymbalta and sent me home. I took them all and texted goodbye to a friend.

This time, the hospital kept me. I spent 10 days in the Niagara Health system’s new mental health unit. They offered me group therapy, but the idea of explaining why I was so fucked up to strangers, doctors, and social workers sounded like torture. I played Uno with my friend when he came to visit, staring blankly across the room, dazed by the drugs I had poisoned myself with, while he dealt and nudged me to take my turns. I was discharged abruptly when a male patient grabbed me and tried to kiss me. Sometimes the story is just this: This story sucks.

But when I was discharged, I had a plan for follow-up. I would see a case manager at the Niagara branch of the Canadian Mental Health Association (CMHA), and I had an intake appointment at Quest, a community health centre in St. Catharines that specializes in providing health care to poor people, people with mental illnesses, and drug users.

My substance use disorder, which had been developing over years of increased use of OxyContin, heroin, and cocaine, worsened and eventually imploded. I often found the mental health system hostile, invasive, or outright harmful. Over the next three years, I was hospitalized nine more times, sometimes because I voluntarily presented at the ER in crisis, and others because I was apprehended under the Mental Health Act. But there were safe havens: a short-term crisis shelter at the CMHA, daily visits to a pharmacy for addiction medication, weekly visits from my case manager, monthly visits to the doctor. When I had suicidal thoughts, I brought them to people I trusted, who were knowledgeable about my mental illnesses, honest about what they thought would help, and consistent in these behaviours. I was learning to write another story: Slamming my head against this wall is exhausting. You slam it for me for a while.

None of my health care providers was consulted about that metaphor. And it’s hard, I imagine, for anyone who has never considered suicide to conceptualize such violence as therapeutic. It is absurd to crawl through a maze of bureaucracy and stigma, looking for someone to help me bash my drug-addled, self-destructive brains out. Why not just stop slamming my head into the wall? Finally, I was learning how to answer, “Why not?”

***

One way or another stories demand to be told to completion. At worst, these stories end in death. The key to reducing the number of suicide deaths is listening to the stories with alternate endings.

Although I still think about suicide most days, my last suicide attempt was in 2014. It took three years to find a combination of medications and therapy to keep me sane. By the fall of 2016, my mental health was stable enough that I was able to stop using drugs. Last year, when I returned to writing, art, activism, and community organizing, I realized I felt more like myself. Next year, I’m considering returning to graduate school.

Working with the Mental Health Commission of Canada, CASP has developed toolkits to support suicide attempt survivors. What’s important, Letofsky says, is being honest about the situation. Often, family and friends of suicide attempt survivors are afraid of saying the wrong thing. Letofsky advises support persons to begin by asking the survivor to tell their story: “What do I need to know? What do you need from me to help you stay safe?”

Jane’s Children’s Aid worker agreed that she and her husband pose no harm to their children and closed their file. The experience was stressful for Jane and for her eight-year-old daughter, who was recently diagnosed with an anxiety disorder. The ordeal had a chilling effect on Jane’s willingness to seek treatment. “All this experience has done for me,” she says, “is create and solidify more distrust in the system.”

Makwa works to help other Indigenous people navigate the mental health system and practises her Anishinaabe culture at home. Nimkii is stable and has returned to her mother’s home. She receives treatment at a community health centre for Indigenous women and sees a psychiatrist. They spend hours making jewelry together. While Makwa is afraid of what will happen when her daughter has to face the hospitals, community, and police on her own, she is also aware, from her own recovery, that her culture and traditions provide comfort and guidance. Decolonization is a healing practice.

In Bergmans’s therapy groups, suicide attempt survivors do the hard work of understanding their own stories. They make safety plans not for “what if” their suicidal ideations return, but “even if” they do. How will they manage their turmoil as safely as possible? How will they cope with suicidal thoughts that might never go away?

Suicide is scary, and a magic formula for answering those questions would be very reassuring. But there isn’t one. The best I can offer is this: This story has barely begun.

IF YOU NEED HELP, HERE ARE SOME RESOURCES ACROSS THE COUNTRY TO CONSIDER:

CANADA SUICIDE PREVENTION SERVICE:
By phone: 1.833.456.4566
By text: 45645
Online: crisisservicescanada.ca

KIDS HELP PHONE: 1.800.668.6868

FOR RESOURCES IN YOUR PROVINCE OR TERRITORY: yourlifecounts.org
READ MORE ABOUT SUICIDE PREVENTION: suicideprevention.ca

The new issue of People magazine has both celebrity chef Anthony Bourdain and fashion designer Kate Spade on its cover. Sadly, the magazine is the only weekly tabloid to give both stars the cover treatment, with other magazines featuring only Bourdain.

When Spade and Bourdain died by suicide, just days apart, tributes and tweets celebrated the lives of both, but there was a distinct gender bias in the media coverage of the two deaths. While articles on Bourdain celebrated his life and accomplishments, writers speculated that Spade’s professional success and the pressure associated with it had, perhaps, finally taken its toll on her. Bourdain was heroic; Spade was tragic. If you don’t think gender has anything to do with it, please consider these two headlines:

From Rolling Stone: “Anthony Bourdain’s Meal With Obama Was a Proud American Moment” 

From Business Insider: “Kate Spade reportedly addressed a suicide note to her daughter”

The media largely focused on Spade’s career as a successful designer, on the business she built, and on the effect the things she created, most notably handbags, had on those who purchased them (often with some serious classist overtones). At times it was as if Spade was invisible, existing only in relation to how she made others feel, how owning a Kate Spade purse had made a writer feel like they had finally crossed over the threshold to adulthood. Spade was not a woman, but a symbol of first careers, of first moves to big cities like New York, of first steps towards the Carrie Bradshawing of one’s life. 

Bourdain’s tributes were much more emotional, much rawer, and more focused on keeping Bourdain front and centre. He was repeatedly described as a great listener, a great conversationalist, a great checker of white privilege. It was not just about his resumé, what he produced, or how we consumed it, as it had been with Spade. People talked about the effect Bourdain had on their lives, but never in a way that rendered him absent from the narrative.

Significantly more column inches were devoted to the sensationalist, tabloid-like aspects of Spade’s death. How did she do it? Was there a note? If so, what did the note say? Who was it addressed to? There was US Weekly-style speculation that perhaps Spade’s separation from her husband and business partner Andy Spade had led to her death.

In the hours after Spade’s death, the media was like TMZ on steroids. Spade was not a human, but a headline. A CNN online story notes the cause of Spade’s death in the first paragraph. It takes CNN eight paragraphs to get to the cause of death in their reporting on Bourdain.

Coverage of Bourdain avoided the celebrity gossip angle and was less concerned with details of motive or method. No one speculated about the state of his relationship with actress and director Asia Argento and no one questioned how or if it could have been a factor in his death.

Writers were respectful of Bourdain, repeatedly acknowledging that they may not have known what the TV host was going through. The same can definitely be said of Spade, but that didn’t stop the media from speculating widely about it. As a woman, they felt it was okay to project, to speculate, to speak for Spade—even in death.

Bourdain’s coverage largely questioned why he would take his own life when he had everything. His was a glass half full. Spade’s coverage referenced what she had lost, her business troubles, her marriage troubles, and how it might have all been too much. The underlying narrative was that women are weak, that this world is too much for them. That they cannot survive. She was a glass half empty.

Coverage of Spade’s death mentioned that she may have been drinking too much, may have been self-medicating with alcohol and pills to deal with business challenges and her crumbling relationship. Writers discussed how Spade may have been afraid her depression and drinking would jeopardize her brand so she kept it hidden. Remember, Spade was a brand. Bourdain was a human. It makes me incredibly sad that in her professional and personal life, Spade could have felt like she had to hide addiction, darkness, and depression to preserve an empire built on positivity and polka dots. This says so much more about the pressures that society places on women, and especially successful women, then it does about Spade.

Articles hinted at Spade’s drinking, but largely treated it like a shameful secret she kept. If only Spade had been a man, then her drinking would have been good for business. Bourdain’s coverage described him as a “drug-loving chef,” and while his battles with heroin have been well documented, most notably in his 2000 book Kitchen Confidential, tributes largely treated his addiction as a thing of the past.

While coverage didn’t speculate on whether Bourdain was using drugs again, it certainly would have if he was a woman. It celebrated his bad boy image, his status as a “renegade chef,” and talked of his second act which, of course, doesn’t include his past drug use. Celebrating, rewarding, and excusing the bad boy is something media and pop culture do again and again (see also: Charlie Sheen, Sean Penn, Johnny Depp and so many more). Both in life and in death, male celebrities always get a redemption story.

Both might have been drinking too much, but only one merits mention. In death Bourdain was a saint, and Spade a sinner. If you want to see this tired narrative in action some more, just compare the tabloid-like documentaries of the lives of Whitney Houston or Amy Winehouse, which chronicle every drug use detail and bad relationship decision, with the 2017 documentary devoted to George Michael’s life and career, with doesn’t mention drugs, public restrooms or undercover cops at all. Of course, Michael’s film was authorized by the artist; with Houston and Winehouse’s docs, male filmmakers thought it was okay to just take a woman’s story, pick it apart, and package it for moviegoers.

It’s not surprising that Spade’s role as a wife and mother was front and centre in all the tributes. Spade’s coverage often referenced her 13-year-old daughter and painted Spade as a selfish mother who had abandoned her child. Bourdain’s daughter was not mentioned as often, if at all, nor was he accused of abandonment or neglect. I actually had no clue he had a daughter until one article mentioned it days after his death.

Eventually, coverage of Spade’s death was replaced by Bourdain’s as he took centre stage. The tributes to Bourdain continue, while Spade’s death has largely faded from the media spotlight. Female celebrities are always upstaged by their male counterparts—and even in death, it is no different.

Photo by Neno Grae.

Poetry isn’t a vocation associated with typical career paths, but even so, Toronto-based poet Sabrina Benaim’s journey has been unusually meteoric. In 2014, she performed a poem called Explaining My Depression to My Mother at the National Poetry Slam in Oakland, California.

“Mom, my depression is a shapeshifter,” she begins in the video that has now been viewed more than 6.7 million times, making her one of the most-viewed performance poets in the world. “One day it’s as small as a firefly in the palm of a bear / The next it’s the bear / On those days I play dead until the bear leaves me alone.”

Overnight, she became a viral sensation. Benaim has since published a collection, Depression and Other Magic Tricks, acquired a devoted social media following, and toured internationally. She also became, in her own words, “a bit of a poster child” for depression and anxiety and began receiving a lot of messages from other people eager to share their own struggles.

“Some of them just knock you sideways—the things that people go through and are willing to tell you,” she says. “I mean,” she adds, laughing, “Who would listen to that poem and think: oh, she has all the answers to my problems?”

The poem offers no answers, only a heartrending depiction of the agony and isolation of depression. Benaim’s reading is desperate and powerful; she is like a wild animal caught in a net. Her pain is palpable. “I like to think of a poem as a room,” she says. “You create an atmosphere, so that when someone walks into the room—even if they don’t live there, or even like it there very much—they can feel how you feel. A lot of the time, just sharing an experience is enough. You don’t have to understand it.”

She says it is okay that people don’t understand mental illness as long as they listen. “I tell my mom all the time, ‘I could never make you understand how I feel, I just need you to understand that how I feel is real.’”

In the video of that performance, Benaim looks terrified—because she was. She had been performing poetry on stage for less than a year at that point and was new to speaking openly about mental illness. “I looked at slamming as Coyote Uglying myself. In the movie, she’s very afraid [to sing] but knows she has to, and that’s how performing made me feel: I didn’t necessarily want to but somewhere inside of me, I knew I had to overcome this, and it would be worth it.”

And it was.

Writing on the internet was her outlet as a teenager and has remained a welcoming home for Benaim and her work. Explaining My Depression to My Mother is a poem about loneliness, but she feels far less alone than she used to. “A lot of people, after they read [my book], say, ‘I feel like you’re my friend, I feel like I know you.’ I’m like, of course you know me! You just read 70 pages of my innermost thoughts. We are friends!”

Fortunately for Benaim and her more than 27,000 Instagram followers, she likes interacting with people on social media. Her perspective on online interactions is remarkably unjaded and open-hearted. “To have a video like I have, and not have a thousand trolling comments on it is, I think, a testament to there being good people out there.”

Mental health is a dominant theme of her work, but it’s far from the only topic she explores. She is an avid consumer of folklore and myths; the story she loves best is Beauty and the Beast. “I really relate to both of them,” she says, “because for me mental illness has felt like the beast that hides in the castle and doesn’t want anyone to see it. But the other part of me is Belle, who wants to see the world, and read everything there is to read, and sing songs about it.”

She plans to turn this interest into a children’s book of fairy tale poetry, one of many future projects she’s dreaming of. She says she holds onto a lot of stories: “When I see the future, it’s like, wow, the possibilities feel endless for what I’m doing right now.”

“It’s nice to think the best thing that could happen to me I can’t even fathom. Because that’s what it’s been like so far. This whole experience, I couldn’t have dreamed it.”