Substance use, mental health and RNAO
I live the reality of accidental drug overdose awareness everyday having lost my 18-year-old son Austin to fentanyl in June 2020. He fell through the cracks of a broken system. Harm reduction involves upstream prevention through a variety of ways: housing and mental health support, education, safe supply for those not ready to stop using, consumption and treatment services, decriminalization for minor possession (to redirect resources to housing and mental health), and appropriate, accessible, evidence-informed treatment available for those ready to recover. We must do better.
Resources for support
If you are in crisis, please call your local distress line (learn more). If you are facing a mental health emergency, please call 911.
- ConnexOntario provides accurate and up-to-date mental health information 24/7 by telephone, chat and email.
- 9-8-8: Suicide Crisis Helpline is a national three-digit number for suicide prevention and emotional distress, available across Canada 24/7 by text or phone in English and French.
- The Government of Ontario's mental health support page provides links to mental health, wellness and substance use supports for the general public.
- FOR NURSES ONLY: Nurses' Health Program is a free, voluntary program for Ontario nurses designed to encourage them to seek treatment for substance use or mental health disorders.
Substance use policy and advocacy
RNAO continues to advocate for health policies that are grounded in determinants of health, supporting people who use drugs wherever they are at in their care trajectory. For example, people with mental health and substance use issues need adequate income supports and affordable housing.
While we wait for government action, we tirelessly assert the need for an integrated system of care – including harm reduction – to best support people with mental health or substance use issues. This requires continued funding of supervised consumption services (SCS) sites and other harm reduction services. RNAO demands funding of SCS sites in every community in need and decriminalizing simple drug possession across Ontario.
RNAO submission to the Controlled Substances Directorate of Health Canada (2020)
RNAO provided feedback in response to a federal government consultation on the intent to develop new regulations under the Controlled Drugs and Substances Act with respect to supervised consumption sites and services.
#DecriminalizeNow
The criminalization of simple drug possession in cities across Ontario is costing lives. Toronto is no exception. On May 15, 2023, RNAO wrote to candidates in Toronto’s 2023 by-election for mayor asking them to sign a pledge to support decriminalizing simple drug possession in Toronto. Find out which candidates signed the pledge.
Mental Health Nursing Interest Group (MHNIG)
MHNIG, an RNAO interest group, promotes:
- the health and wellbeing of people who are at risk of experiencing mental illness and/or emotional distress
- mental health services responsive to the needs and wishes of individuals with lived experience and the community
- the role of RNs and NPs in serving people with mental health concerns
Interest group chair
Andrew Marlowe
RN, BScN, MN, MBA
Interest group chair-elect
Kaitlin Marriner Brulotte
RN, RP, MA
Community Health Nurses' Initiatives Group (CHNIG)
CHNIG, an RNAO interest group, provides a voice for all community health nurses (CHN). The group works to:
- build capacity and leadership in CHNs
- strengthen the profile of CHNs and articulate the significance of their practice
- maximize nursing student involvement in community health nursing
- influence the health-care system, health and social policy affecting their work and the public they serve
Interest group president
Mathew McGuigan
RN, BHSc, BScN, MScN (Candidate)
Interest group past-president
Susan Tam
RN, BScN, MScN, CCHN(C)
Include vaping and nicotine in Ontario’s Smoke-Free strategy
Renew Ontario’s Smoke-Free Strategy to include vaping and nicotine.
Advocate for anti-bullying initiatives in nursing education
Advocate for establishing anti-bullying initiatives within nursing education programs across Ontario.
Improve nursing working conditions to prevent workplace injuries
Improve the working conditions of nurses and build necessary capacity to prevent workplace injuries and provide mental health support to the health-care workforce.
Advocate for a strategy to address the opioid crisis
Advocate for an integrated strategy to address the opioid crisis.
Expand NP scope of practice to include authority to complete forms under the Mental Health Act
Advocating for NP scope of practice expansion to include the ability to initiate and complete all forms under the Mental Health Act.
Timely Access to Perinatal Mental Health Services
Advocating municipal, provincial and federal governments for funding to increase timely access to perinatal mental health services.
Accessibility of Sharps Boxes in Patients Room
Promote education and information regarding appropriate organization policies and client centered assessment to ensure individuals who use substances have access to appropriate harm reduction tools.
Integrated Strategy to Address Substance Use Disorder
Advocate for the Ministry of Health and its allies to: 1. Accelerate and augment the Road to Wellness (2020) initiatives and by implementing a province-wide, integrated strategy for substance use disorder (SUD) that will address prevention; and 2. Create and fund roles for trauma-informed SUD coordinators to support and educate those working with this population and those they serve.
Decriminalization of drug possession for personal use
Advocate for municipal, provincial and federal governments to take all actions within their power to decriminalize the possession of drugs for personal use, in order to reduce the harms of the opioid crisis.
Access to mental health supports for Ontario children and youth
Lobby the government for designated funds to ensure equitable access to mental health services within 30 days of presenting mental health related concerns, so that children and youth, up to and including eighteen years of age, do not suffer long term consequences related to delayed assessments, diagnoses, and interventions.
Increasing knowledge of safer opioid supply
Advocate for the increased knowledge and accessibility of safer supply prescribing programs and practices among Ontario health-care and social service professionals.
Psychotherapy insurance
Cell
It has been seven years this month since my son Bradley John Chapman died after an overdose of toxic drugs. Memories of Brad are with me always and leave me broken on many days still.
He has left siblings, children, grandchildren and friends trying to understand this needless death. It was a needless death as are the many that occurred before and after, from lack of understanding, lack of services and neglect for people suffering from mental health and addictions.
There have been improvements and steps forward including RNAO's Best Practice Guidelines and implementation of Supervised Injection Sites in some jurisdictions. However, the lack of housing, and toxic drug supply continue to exacerbate the problem.
The grief never dies and my life and our family are forever changed by this loss.
Cell
Capacity building
RNAO’s Mental Health and Substance Use (MHSU) Program enhances evidence-based care and services related to mental health and substance use across all health-care settings. We also produce educational toolkits and education guides for practitioners.
Do you want to access webinars, events, e-learn modules, educational videos? Visit the program web page: Mental Health and Substance Use Program
Best practice guidelines
RNAO Best Practice Guidelines (BPG) are systematically developed, evidence-based documents that include recommendations for nurses and the interprofessional team, educators, leaders and policy-makers, persons and their chosen families on specific clinical and healthy work environment topics. RNAO has more than 50 BPGs covering four themes: foundational, clinical, system and healthy work environment, and population and public health.
What is stigma?
The video features an NP and a person with lived experience discussing stigma, how it impacts nurses and other health-care providers, and ways to reduce stigma.
E-Learning modules
These free e-Learning modules help broaden nursesʼ knowledge and skills to better support individuals experiencing mental health and/or substance use issues.
- Engaging Clients Who Use Substances
- Nursing Towards Equity: Applying the Social Determinants of Health in Practice
- Integrating Tobacco Interventions into Daily Practice
- Tobacco Use and Cessation with Youth and Young Adults
RNAO programs for nurses
Advanced Clinical Practice Fellowships
RNAO established the new ACPF Health and Wellness Stream in the Spring of 2022 in response to chronic shortages of nurses within the system and increases in nurse fatigue and burnout associated with the COVID-19 pandemic. If pursuing a fellowship in this stream, you can focus on promoting wellbeing and creating a healthy work environment, improving retention or recruitment of nurses, or providing mentorship or support for new staff.
Mental health and substance use in the media
RNJ
Speaking out is part of nursing
As the son of a teacher, Simon Donato-Woodger knew from a very young age the importance of being politically active. Seeing his mother participate in walk-outs, call for increased education funding and advocate for her students instilled in him a sense of pride and drive for change that defined his impressionable years as a young man. When his mother passed away when he was 12 years old, that passion for advocacy didn’t leave him.
Redefining mental health
Rosanra (Rosie) Yoon’s earliest childhood memories harken back to her days accompanying her mother on the streetcar for monthly visits to Toronto’s St. Michael’s Hospital. From the age of four to eight, she was scared and nervous on these outings, but as soon as she saw her mother’s nurse, she felt safe.
Media hits
Windsor Star
It is deeply troubling that Mayor Drew Dilkens and 12 other Ontario “Big City Mayors” have embraced Premier Doug Ford’s suggestion to invoke the notwithstanding clause to dismantle homeless encampments and impose involuntary treatment for individuals struggling with substance use disorder.
CBC Power & Politics
The Registered Nurses' Association of Ontario is calling the province’s move to ban supervised drug consumption sites near schools and child-care centres “a death sentence for people that use substances.” The new rules will force more than half of the supervised injection sites in Ontario to either transition into treatment centres or close down.
Brockville Recorder & Times
The crosses lining the ground may have caught some by surprise, but to Andrea Keller they were all too sadly familiar. The Kingston resident was among the members of the public attending a Community Forum at Armagh Sifton Price Park bringing together agencies dealing with mental illness and addictions.
CBC News
Ontario has banned supervised drug consumption sites within 200 metres of schools and child-care centres. Ten facilities across the province will be forced to stop providing safe consumption services by March 2025, and they will be given the option to transition into "treatment hubs."
The Hamilton Spectator
The operator of a supervised drug-consumption service facing closure in downtown Hamilton says it’s “well positioned” to take on a new hub model the province plans to roll out to tackle homelessness and addiction. Hamilton Urban Core Community Health Centre must close its consumption and treatment services (CTS) site at St. Paul’s Presbyterian Church by next March under new provincial restrictions.
QP Briefing
Health Minister Sylvia Jones on Tuesday announced new restrictions that will lead to the closure of 10 supervised consumption sites across Ontario. As first reported by the Toronto Sun, the province is planning on closing sites that are located within 200 metres of schools or childcare centres. The Ford government on Tuesday confirmed that the change will see sites in Ottawa, Guelph, Hamilton, Thunder Bay, Kitchener and Toronto close by March 31, 2025.
Media stories
RNAO has been mentioned in the following stories:
March 3
Dec. 6
- Waterloo Record: ‘Law and order’ tactics will not solve root cause of homelessness
Nov. 29
Sept. 4
Sept. 3
- Globe and Mail: Toxic rhetoric
Aug. 31
Aug. 28:
- Toronto Star: Political leaders who mock nurses don't have my vote
Aug. 26:
- Toronto Star: Pierre Poilievre’s overheated insults. Canadians of all stripes being nasty to each other online. it’s past time for all of us to heed Jack Layton
- CambridgeToday.ca: LETTER: Ontario's addiction response: the good, the bad, the ugly
- Toronto Star: Ford's new policy is the wrong policy
- Globe and Mail: By slamming experts, Pierre Poilievre and his staff are degrading political debate
Aug. 25
Aug. 24
- CBC News: Toronto shelters with internal drug consumption sites near schools, daycares impacted by Ontario ban: Province
- The Pointer: PC decision to abandon safe injection sites amid opioid crisis could have deadly implications; peel's plan up in the air
Aug. 23
- Hamilton Spectator: Closure of Hamilton supervised drug-use site 'raises many concerns': operator
- SooToday.com: Grieving mom warns of more deaths when supervised consumption sites close
Aug. 22
Aug. 21
- Sudbury.com: Nurses say consumption site announcement a 'death sentence'
- QP Observer: Why Ford's owning the political war on drugs
- CBC Radio London: New rules on Ontario's safe consumption sites sparks reaction
Aug. 20
- ICI Radio-Canada: Ontario bans drug consumption sites near schools, child-care centres
- The Trillium: Ford government to close 10 supervised consumption sites, ban new ones in favour of 'hub' model
- CP24: Ontario making changes to addiction & mental health supports
- CTV News: Kitchener, Guelph drug consumption sites to close due to Ontario ban
- CBC Radio: Registered Nurses' Association of Ontario reacts to provincial changes to safe consumption site rules
- Ottawa Citizen: Somerset West supervised consumption site to close after new provincial rules
- CBC News Power & Politics: Critics call Ontario's ban of supervised drug consumption sites near schools 'a death sentence'
- CBC News Power & Politics: Some Ontario nurses say new supervised injection site rules will do more harm than good
- CBC News: Ontario bans drug consumption sites near schools, child-care centres
- Windsor Star: 'People will die' — Province's controversial move to restrict supervised consumption sites means Windsor's SafePoint will not reopen
- QP Briefing: Ontario bans supervised consumption sites located near schools, childcare centres
Aug. 19
- Globe and Mail: Ontario to unveil new supervised consumption site plan, a year after shooting spurred pause on new locations
Aug. 15
June 6
June 1
May 28
- Humber News: Advocates rally at Queen's Park for safe consumption sites amid the drug crisis
- Radio-Canada: Des manifestants à Queen’s Park pour défendre les centres de consommation supervisée
May 27
May 20
May 13
- Windsor Star: 'So difficult to stop' — Mom who lost son to fentanyl joins calls to reopen Windsor SafePoint
May 10
- Radio-Canada: Des infirmiers plaident pour le financement des sites de consommation supervisée
- CTV News: Calls for SafePoint reopening
May 9
- Windsor Star: 'You cannot treat a dead person' — Ontario nurses demand reopening of Windsor's SafePoint
May 1
April 29
April 24
- Windsor Star: Windsor's SafePoint 'must be reopened
April 3
- Windsor News Today: RNAO joins fight for safe consumption sites
April 2
- The Trillium: 'These delays equal deaths': Sudbury consumption site closes as it awaits response on provincial funding
March 27
Feb. 29
Feb. 21
- Belleville Intelligencer: Province needs to act urgently to end opioid crisis
Jan. 29
Jan. 26
Jan. 25
- Sudbury.com: RNAO president heads to Sudbury to champion The Spot
Nov. 24
Nov. 10
- Brockville Recorder & Times: Health care hub in the works for city's most vulnerable
Aug. 30
Aug. 26
- Toronto Star: Province needs more supervised consumption sites
Aug. 4
- CBC News: Almost a year later, Hamilton hasn't requested to decriminalize illicit drugs for personal use
July 18
Feb. 10
Oct. 21
Oct. 18
Oct. 13
Oct. 12
Oct. 10
- Guelph Mercury: Ontario nurses association calls on Guelph mayoral candidates to support decriminalizing drug possession
Oct. 9
Oct. 6
Oct. 5
- The Chatham Daily News: RNAO calls on Ontario mayoral candidates to support decriminalizing simple drug possession
- Blackburn News: Registered Nurses of Ontario want decriminalization of simple drug possession
- Sudbury Star: RNAO calls for mayoral candidates in Sudbury to support decriminalization of simple drug possession
Oct. 4
- Canada Today: There’s a new push to decriminalize drugs for personal use in Toronto
- CP24: RNAO wants to decriminalize simple drug possession
- AM800 CKLW: Support for decriminalization of simple drug possession
- tbnewswatch.com: Nurses ask mayoral candidates to support decriminalizing drug possession
- InSauga: Ontario nurses advocate for drug decriminalization in Mississauga and Brampton as overdose deaths increase 133%
- CityNews Ottawa: RNAO urging mayoral candidates to seek to decriminalize simple drug possession for personal use
- BlogTO: There's a new push to get drugs decriminalized for personal use in Toronto
Aug. 10
Social media
Get involved. Use the following hashtags on X (formerly Twitter), Facebook and Instagram to participate in the ongoing dialogue:
#MentalHealth #MentalIllness #SubstanceUse #HarmReduction #OpioidOverdoseCrisis
