From a primary prevention perspective, what is the most proactive thing we can do to prevent mental health issues?

Open conversations about mental health challenges in individuals’ personal lives and the workforce are essential for prevention of mental illness and substance-use disorders and, as noted earlier, to eliminate stigma so that everyone is comfortable seeking help when the need is recognised. Self-help and self-care can help prevent both the onset and progression of mental health and substance use disorders. Even small, daily acts of self-care can have a big impact by helping to manage stress, decrease risk of mental and physical illnesses, increase energy, improve mood and curb cravings for alcohol and other drugs. Strategies include exercising on a regular basis; eating a balanced diet and drinking plenty of water; following a schedule for sleep and not having phones or other devices nearby during sleep; doing breathing and other relaxation activities; setting goals and priorities; and focusing on positivity and what we value in our lives. These techniques can help prevent the urge to dilute emotions with alcohol and other drugs.

How best to address mental illness with adults who refuse treatment?

For the general public, there are guidelines for encouraging others to seek mental health care. The first piece of advice is to not say “you need help” or “you need therapy.” Many people may take offense at this particular wording, as it may be interpreted as a statement about their inability to fix their problems. Also, the presence of stigma may prevent individuals from being receptive. However, there are tactics that can be effective. For example, keep trying, asking questions, listening, and reflecting. Help them feel heard and ask again. Continue to say things like, ‘I’m really worried about you. I’m thinking we should just go get checked out by a doctor to see what’s going on.’ Reassure them that you’ll stay with them and help them through the process. While we are all aware of individuals’ right to refuse treatment and are respectful of civil liberties, we also understand that the law allows for behavioural healthcare providers and the justice system to intervene when individuals who refuse treatment are a danger to themselves, others and property. We strongly believe that involuntary treatment should always be in the least restrictive environment possible.