Over four million people live in Alberta, with 38% of those residing outside of the seven largest urban centres in the province (Edmonton, Calgary, Fort McMurray, Grande Prairie, Medicine Hat, Lethbridge, and Red Deer). Over half of the Indigenous peoples (220,695 people) in Alberta live outside of Calgary and Edmonton. The Government of Alberta’s Valuing Mental Health report (2015, p.15) highlighted the need for specialized attention to mental health in rural and remote areas due to barriers such as scarcity of resources, cost of services and effectiveness (e.g., no long-term follow up) of services.
All Albertans have mental health, and we all struggle with our mental health at times; this necessitates thoughtful, community-based approaches to identify community priorities, strengths, and opportunities on a local level. Promoting mentally healthy communities is a complex problem. Solutions to complex problems need to align with the types of issues, which requires appropriate framing, principles, and approach. Responses to complex problems also need to be emergent and adaptable, responding to the situation based on what we learn and by having more people and perspectives involved. There is no single solution or silver bullet that will address the complexity of mental health in rural communities across Alberta. Although mental health services are important and necessary, we need to explore other ways of creating community-wide support. For example, it is unlikely that there will ever be enough resources or experts to have a psychologist for every Albertan. We also know that visiting a psychologist is not always the appropriate solution for every challenge we face throughout our lives.
The complexity of nurturing mentally healthy communities requires us to think broadly about mental health and focus on the areas that we live, work and play. This includes access to treatment services but also goes further. There are multiple “upstream” factors that influence and impact community wellbeing. For example, history, access to resources, social cohesion and economic position of the community are all factors which can deeply impact a community’s wellbeing and capacity to promote mental health, and thus impact the wellbeing of community members. The Rural Mental Health Project uses the 8 Domain model, adapted from the social determinants of health, to describe and illustrate the different features of our communities that impact our mental health. Upstream approaches that target these domains in our communities can reduce the need and demand for services, tackling the complexity of community mental health in a holistic way.
The Rural Mental Health Project focuses on building the capacity of rural communities through education, promotion, and prevention activities related to mental health, mental disorders, addiction, and community mental wellness. Consistent with CMHA’s history, this type of grassroots work supports communities in identifying priorities and working to build local projects and capacity.
The Government of Alberta, Alberta Health Services, municipal governments, and non-governmental organizations are challenged to support communities due to the pace of growth in urban, rural, and remote communities. We all are challenged to think differently about how we each can play a role in working together to support improved mentally healthy communities. In this environment, CMHA Alberta Division continues to strive towards its vision of “mentally healthy people in a healthy society.”