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On this page: Our journey | Members leading change | Members mobilizing change | Partnerships and engagements | RNAO policy | Capacity building | Mental health and substance use in the media
Our journey: Mental Health and Substance Use Best Practices Program
Mental health and wellbeing are essential to everyday health. Pre-pandemic data suggested that each year, one in five Canadians experienced a mental health concern, highlighting a crisis in Canada. Since the pandemic began, 50 per cent of Canadians have reported worsening mental health, with increases in stress levels, depression, anxiety and, higher rates of substance use and associated deaths related to opioid toxicity.
The need for increased mental health and substance use supports – in an already fragile health-care system in crisis – has never been clearer. Nurses are at the forefront of the system providing mental health supports to people in need of care and healing.
The Registered Nursesʼ Association of Ontarioʼs (RNAO) Mental Health and Substance Use Best Practices Program, established in 2006, drives change by providing leadership to enhance evidence-based care and services.
"As nurses, the single most important thing we can do to support mental health in the community is to nurture the seeds of resilience, connection and hope – both in our clients and in ourselves."
– Dr. Rosie Yoon, NP
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
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If you are in crisis, please call your local distress line (learn more). If you are facing a mental health emergency, please call 911.
RNAO knows that people across Ontario are experiencing tremendous levels of physical and emotional stress at this time. Nurses who are struggling or feeling overwhelmed can reach out to any of the resources listed below. Most are also open to other health-care providers or members of the public.
- ConnexOntario provides accurate and up-to-date mental health information 24/7 by telephone, chat and email.
- Wellness Together Canada is a free and confidential mental health and substance use support available 24/7 by text or phone.
- 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.
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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
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Interest group chair
Shauna Graf
RN, BScN, CPMHN (C)
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Interest group chair-elect
Kaitlin Marriner Brulotte
RN, RP, MA
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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
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Interest group president
Mathew McGuigan
RN, BHSc, BScN, MScN (Candidate)
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Interest group past-president
Susan Tam
RN, BScN, MScN, CCHN(C)
2021 resolutions
Integrated strategy to address substance use disorder (SUD)
Decriminalization of the possession of illegal drugs for personal use
Taking action to facilitate access to mental health supports for Ontario children and youth
Strategy on increasing knowledge and availability of safer opioid supply
Other resolutions
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.
Your Health Space
Your Health Space supports health care organizations across Ontario to improve mental health in the workplace through live workshops, self-directed modules, and microlearning Wellness Moments. It embraces the holistic view that promoting psychological health and safety in the workplace takes the collective effort of individuals across an entire health care organization.
The Ontario Coalition for Children and Youth Mental Health
The Ontario Coalition for Children and Youth Mental Health (CCYMA) unites education, mental health, community and health sectors to promote the priority of social and emotional wellbeing as a part of healthy child development in Ontario. CCYMA also catalyzes provincewide change for different and more effective approaches to improving supports and services for children and youth wherever they live in Ontario.
Youth Mental Health and Addiction Champion Initiative
YMHAC, a youth-led, peer-based model founded by RNAO in 2014, aims to promote mental health, reduce stigma, and improve knowledge and awareness concerning substance use and its prevention, supporting the creation of a resilient and supportive school environment.
The Nursesʼ Health Program
The Nursesʼ Health Program was developed by RNAO in partnership with the College of Nurses of Ontario (CNO), the Ontario Nursesʼ Association (ONA) and the Registered Practical Nurses Association of Ontario (WeRPN). The program provides an effective channel for nurses with substance use and/or mental health disorders to receive support to recover and practise nursing safely.
International Overdose Awareness Day
International Overdose Awareness Day (Aug. 31) is a time to remember the lives lost and individuals left behind due to drug overdose. RNAO continues to call on the provincial government to respond to the opioid crisis to decrease the toxic drug supply and prevent deaths. Opioid overdose knows no bounds and leads to tragic, preventable deaths.
Brad Chapman coronerʼs inquest recommendations
An inquest into the death of Brad Chapman, a 43-year-old father who experienced homelessness and struggled with substance use, was completed in December 2018. RNAO was a party to the inquest, which allowed representatives from the association to ask questions and make submissions. The inquest resulted in 55 recommendations to better safeguard vulnerable people who use substances.
Insite - Nurses support harm reduction model
RNAO has been a strong advocate of a harm reduction approach to drug use for over a decade. In 2011, RNAO along with the Canadian Nurses Association (CNA) and the Association of Registered Nurses of British Columbia (ARNBC) was granted intervener status before the high court to defend Insite, Canadaʼs first safe injection site located in Vancouver. Insite continues to reduce health risks from drug use, and connect clients to health and social services.
#DecriminalizeNow
The criminalization of simple drug possession in cities across Ontario is costing lives. Toronto is no exception. On May 15, 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.
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.
Capacity building
Best practice guidelines (BPG)
BPGs 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 about 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
Toolkits
Nurse Educator Mental Health and Addiction Resource Toolkit
This resource supports undergraduate educators in integrating mental health and substance use knowledge and skills into nursing curriculums.
Youth Mental Health and Addiction Champion (YMHAC) Toolkit
This toolkit supports the implementation of evidence-based, youth-led mental health promotion and substance use prevention initiatives in school settings. It provides users with a comprehensive step-by-step understanding of the YMHAC initiative and all of its components.
RNAO programs for nurses
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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.
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Nursesʼ health and wellbeing In Focus page
The global pandemic has clearly demonstrated the importance of healthy work environments for nurses. This RNAO In Focus page is a one-stop shop outlining our research, advocacy, partnerships, resources, tools and other work in this area.
RNJ
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
CBC News
Almost a year after Hamilton city councillors voted to decriminalize the possession of small amounts of illegal drugs, CBC Hamilton has learned city officials still haven't submitted that request for exemption to Health Canada. Researchers and advocates have mixed feelings about whether the delay is "inexcusable" or part of "good faith" efforts.
The Pointer
The opioid crisis—at its root—is an epidemic of an endless search for relief. More than eight people are dying per day in Ontario due to opioid overdoses. In Canada, there were nearly 20 deaths a day between the months of January and June 2022. As many as 98 percent of these overdoses are classified as accidental.
