Rebecca Shields: A Cure for Mental Illness

Imagery for Episode 72 of Healthcare Change Makers including an image of our guest, Rebecca Shields

(Access show transcript) Rebecca Shields, CEO of the Canadian Mental Health Association (York and South Simcoe) has a fierce desire to serve her community through incorporating different voices and leveraging governance to do great things.

Summary

Rebecca Shields and her team at CMHA York and South Simcoe have strong throughlines in place for their 2025-2028 Strategic Plan. A key driver of this plan is the update of their mission and values, and their new vision which is all about a cure for mental illness. This disruptive and exciting thought stems from CHMA’s belief that true recovery is possible when institutions globally work together towards this goal.  

What does this vision mean for their organization? “It means that we begin more and more to look at how do we partner in research, how do we ensure that we’re adopting promising, evidence-based best practices, how are we adopting better data analytics and decision making,” explains Rebecca.

In this episode of Healthcare Change Makers, Rebecca also shares insight into York Region's first Mental Health Community Care Centre. She speaks passionately about how healthcare organizations can work together to move the needle around mental health and addiction issues, and the importance of equity, diversity, inclusion, accessibility and reconciliation strategies.

Mentioned in this Episode

Transcript 

Imagine you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers, and what makes them tick.

Welcome to Healthcare Change Makers, a podcast where we talk to leaders about the joys and challenges of driving change and working with partners to create the safest healthcare system.

Michelle Holden: Hey, listeners, it's Michelle here from HIROC. Welcome to another great episode of Healthcare Change Makers. Abi, my colleague, and I sit down today to chat with Rebecca Shields. She is the CEO of the Canadian Mental Health Association, York & South Simcoe. Rebecca is absolutely charming and engaging to speak with.

We were really excited to hear about their organization's strategic plan, the 2025 to 2028 fiscal year. We also talked a little bit about their first Mental Health Community Care Centre. Abi, do you want to give listeners a little bit more about what our conversation entails?

Abi Sivakumar: Yeah. So Rebecca was also honored with the IABC/Toronto 2024 Communicator of the Year Award. So she shares more a bit about that, and the organization's renewal of its equity and reconciliation strategy.

She also shares her love for spy TV shows, so we talk about a variety of topics, as you can tell.

Michelle Holden: I loved that part, yeah. As we know in Healthcare Change Makers, we love our TV, so have a listen. Let us know what you think and rate and review our show if you get a minute. Thank you.

Okay. Good morning, Rebecca. Thank you for joining us on Healthcare Change Makers today.

Rebecca Shields: Thank you so much. This is great.

Michelle Holden: Yeah. We're going to start with a really easy one, so tell us about your first job ever.

Rebecca Shields: So my first job ever actually goes back to my family, so my father imported and was a wholesaler of bicycles and bike parts. And I remember going to his warehouse when I was in child labor status, and making bicycle tire repair kits. And when I got a little bit older, I would go and I would fill out the orders for replacement parts.

This is back in the day when they would mail you their order, cut a check, and I'd have to fill it out, package it up and send it back. And I worked for doughnuts, so that was my first job. And then professionally, my first job where I wasn't hired by my family, I was one of the early employees of Canada's Wonderland, but that didn't last that long.

Michelle Holden: A summer maybe?

Rebecca Shields: Yeah.

Michelle Holden: I did not expect that right out of the gate, the bike parts repair kit story. That's amazing. I really love that. My grandfather used to collect used bicycles and sell them, and he would also make us test them out and try them.

So that was kind of funny, that one hits home. Before we dig more into the interview, what is one song that gets you pumped up if you hear it on the radio before a big day? Maybe you played it this morning.

Rebecca Shields: I'm going to tell you, anything ABBA. Girls, anything ABBA.
But I also will tell you, Solsbury Hill by Peter Gabriel. I'm dating myself, but put me back into the '70s and I'm a happy camper.

Michelle Holden: I love that. I'm anything ABBA too though. I love singing in the car. Okay, that's amazing. Those are really good.

So we know who you are, Rebecca, and we know where you work today. But just tell us the story a little bit of how your career started and maybe how you landed at CMHA York & South Simcoe?

Rebecca Shields: So I always like to say that I come by my profession honestly. I come from a family who was always very, very committed to community and volunteering. Back to my father again, he was a Lions, he was always volunteering for everything he could. I remember him handing out blankets in Toronto way, way back in the '70s and the '80s.

And my mother, she volunteered for the heart and stroke foundation, for MS, for Girl Guides, and I was always a volunteer. I was on every committee through high school, through university organizing and planning. And there I was doing a master's in science thinking, "Is this really what I want to do with my life? Is this a career in a laboratory?" And I thought, "No."

And my best friend at the time, a man named David, this is the early '90s, came and said, "I just got this job as a fundraiser," which I'd never heard of before. And I said, "You mean you could get paid to do what I do for fun?" I was like, "I want that job." So I pivoted and my very first job out of the gate, believe it or not, was a director of development and communication for the Greater Vancouver Food Bank Society.

And within a year, I both doubled the amount of food and monetary donations. I'd found what I was most passionate about, which was being able to support community. And I had been privileged to have a whole career in the social profit sector. And I worked in HIV and AIDS in Vancouver's Downtown Eastside at the time.

I worked in an organization that has now been merged with somebody else. But at the time it was called Besman Court Housing Society, which provided housing for Indigenous youth who are homeless and at risk of homelessness in the Downtown Eastside. I worked in deafblindness for both adults who were congenitally deafblind in a community living, as well as acquired.

And I took a small agency and made it a provincial services. And from there, I was recruited into the Canadian Mental Health Association, Vancouver/Burnaby branch, and I worked there for five years. And as I was growing my family, I saw the position at Canadian Mental Health Association, York Region & South Simcoe, which since you heard about my first job at Canada's Wonderland, you know I'm from this region.

I jumped at the chance to come back, raise my family and support care, and continuing care in this community. And that's how I ended up where I am.

Michelle Holden: That is a very interesting trajectory. I just love it. I think just hearing about that reminds me just that you can start out somewhere and end up somewhere totally different. I love that, and all of the organizations you've touched on.

So CMHA York & South Simcoe, like HIROC, is wrapping up its current strat plan this year. As you are planning for what's next, is there a through line or just one piece from the current plan that you know will continue to guide your work?

Rebecca Shields: Guide our work. Well, all healthcare organizations are committed to doing our best to improve the outcomes, and I think in mental healthcare, more so than ever. What I would say is we're actually becoming hyperfocused and we'll talk a lot about this. But the key driver, and I'm very excited about this because we just approved our new strategic plan for '25, '28, but we updated our mission, vision and values.

And I'm very excited that we came up with a new vision. And our vision is that we believe there is a cure for mental illness. And this is a disruptive, exciting thought to actually say, "No, we don't want this to be a condition that people have to manage for life. We want to be part of a vision and advocating for the idea that we could actually cure this." And everybody got really excited about the hope that that could bring.

And what does that mean for our organization? It means that we begin more and more to look at how do we partner in research? How do we ensure that we're adopting promising, evidence-based best practices? How are we adopting better data analytics and decision-making? How are we integrating and standardizing care?

It is all of those things that come into this idea that we want to do the best we can to actually cure, support people with true recovery from mental illness. And we believe that underpinning the idea that it doesn't go away is a stigma. And so the idea that this is a lifelong battle, we don't want to accept that anymore.

We want to challenge and disrupt the idea that if we all work together, and great institutions like CAMH and academic institutions all across this country and globally are working towards that. And we want to really push that, and be part of that and advocate for that.

Michelle Holden: I think that's a big through line and a big, important mission.
I noticed when you talk about the organization, the staff and the team that you're with, you use a lot of the term we and you talk about you as a group.

So I was just wondering how do you bring the staff along on that very big mission?

Rebecca Shields: Because this is a HIROC podcast and we think a lot about risk with HIROC and how we do things, not everybody loves the idea that there's a cure. Some people who have been in the space of mental health, feel that when they hear the word cure, it strikes them that there's something wrong with them. And there's been a lot of work done to normalize mental health and mental illness that this happens to everyone.

And so the way we are approaching this is to talk about the idea that healthcare and health practices change over time. And one of the... I use analogies. We look at 35 years ago. If you had pediatric cancer in your family, you had a child, the mortality rate was over 80%. Today with research, early intervention, incredible healthcare support, that's less than 5%.

In July 2024, the World Health Organization announced the second cure for HIV and AIDS, which is unbelievable. The most stigmatized disease in the world can now be cured. And when I think about whether it's happening around the fact that the US is withdrawing aid and treatment for HIV. The fact that there might be a cure there that could prevent the death of 10 million people a year is unbelievable.

We cannot just sit there and say, "This is good enough." And the field of mental illness, because the stigma has been left behind in research, investment and care. And so bringing people along is helping them believe, and turning that belief into action that things can actually improve. And that we don't have to subject people for a lifetime of management.

That people can fully recover and they do. And just like any other healthcare, we all have to eat well, exercise, sleep well, all of those things for all of our health. But mental illness can be treated, people can recover, and that, I think, we can all get behind.

Michelle Holden: I really like that comparison. Not a positive thing to think about some of the cures that we've had to go through, but just we don't often hear about how we can cure mental illness. So thank you for sharing that with us.

I wanted to just ask you about York Region's first Mental Health Community Care Centre. It's a project that's currently in development for your team, so what makes it the first of its kind for our province?

Rebecca Shields: So this is an exciting project, and I'm so glad you're asking me about it because it really ties into our belief in how we do what we can, and lead the team and our community into a process. So the York Region Mental Health Community Care Centre is a first of its kind. It will be built up in Newmarket. And at a high level, it is a 24/7 alternative to an emergency department for ages 12 and above.

So there is a whole child and youth there as well as adult. There will be 10 crisis stabilization beds and 10 addiction withdrawal support beds that are flexed for ages 16 and above. And it'll be staffed with an interdisciplinary team, all the way from physicians, nurse practitioners, social workers, peer support specialists, Indigenous care specialists, a whole range of support services.

And it is done in partnership with over 20 supportive healthcare agencies, and all of our social service partners from the region in housing and homelessness, all the way through to public health and other supports. But what makes it the first of its kind, most importantly, is that we have a collective vision.

And the collective vision is what do we need to do to ensure that somebody's first mental health crisis is their last? It is our goal to think through what needs to change, so that we stop this perpetual event where people are constantly in crisis, where they get stabilized and then they end up back where they were.

So what needs to change if you are a mom with a 15-year-old son, who now is not leaving his house and is falling behind in school? What does the school need to know? What do we need to know before you even come through our doors? And what does that care experience where instead of we're triaging, we're actually welcoming you into the space?

And having that care experience that both supports a deescalation of the crisis, and a plan to ensure that that crisis doesn't happen again. And how then do we work with all of our partners to connect you to the right level of care, so that we're not doing the same thing, giving everybody the same here, go on this wait list?

But we actually match you and connect you with our partners in the center, to ensure that you are connected and supported in the next step of your journey to make recovery right for you, and what happens after. So that is our vision and it's been 10 years. And I just want to say a huge gratitude to all of our partners and Ontario Health and the government for stepping up and supporting this work.

This is about system change. And although we're leading it, everybody is committed to a collective vision, and we can't do it without going back and believing in the possible.

Michelle Holden: That's a really big achievement, just seeing it come to life. And I was just thinking because you mentioned partnership and how important it is, and I can't do it alone without the partners. And it is the same for that mom that you mentioned, who might have a 15-year-old at home not leaving the house, they can't do it alone either.

So it all draws together, and yes, it is important to have the partnership. We at HIROC also very much believe in that, so thank you very much for sharing that. I'm going to pass it to my colleague, Abi. She just has a couple of questions for you as well, Rebecca.

Rebecca Shields: Sure.

Abi Sivakumar: Yeah. Hi, Rebecca, I'm excited to join in on the conversation. So we saw that in 2024, your organization renewed its equity and reconciliation strategy.

Why is this work especially important in our current landscape?

Rebecca Shields: Wow. All of us have to lean in right now, as we see an erosion of and people trying to dismantle the respect and dignity of each and every person and their own personal identities. And so I could start by saying we know that there is a tie between racism and oppression and mental health. It is a stressor, it is morally disruptive. Absolutely, that kind of trauma, that ongoing trauma of racism and discrimination and oppression actually impacts somebody's well-being.

So there's a reason to do that just in terms of mental healthcare. But overall, the gains that we have, create belonging in our society and belonging is part of wellness. And I've always thought back about Dr. Ian Dawe, who used to say, "All of us, as healthcare providers, we might be able to treat the symptoms and treat mental illness, but mental health is a home, a job, a friend."

And racism and lack of access to care prevent somebody from having a home, a job and a friend, and that belonging. And so for us, the equity and reconciliation strategy, it might be a strategy, but it's the way we live and do and believe in the work that we do. And just circling back to the center, that work, we have been so privileged to work with so many communities.

We are being supported by Health Commons Solutions Lab, a team out of Sinai, to ensure we're doing the deep work and understanding of how different ethnocultural groups. All the way from different cultures and different communities, to the 2SLGTBQ+ youth, understand mental health support so that everybody feel welcome in our center, and how that translates across our services.

And it comes right down to partnerships. Because the value of each person and the perspective in what they can bring, actually will be part of what makes communities resilient. And allows for the recovery and support of people for all of us, and our kids and our families, and our seniors.

Abi Sivakumar: Yeah. Thank you for being an advocate of this work and for this topic at large, it's so, so important. And I love how you tie everything back into partnerships in every answer. It's so important.

And you're a director of the CAMH board, as well as serving on committees at South Lake and numerous other Ontario mental health initiatives. So where does this desire to serve your community in the area of mental health stem from?

Rebecca Shields: I've always been on various boards of directors and volunteer, and I think I started off the conversation talking about that. I feel that governance is incredibly important, and good governance really supports an organization to achieve great things.

And poor governance, leadership matters and poor governance can really impact an organization's ability to achieve its goals. And we're in the social profit sector and we are trying to solve wicked problems together, and good governance and leadership are part of that.

So I've really enjoyed being part of the CAMH board and I believe in their mission. But that idea of how do we include voices and elevate the governance and the ability to work together is something that I'm particularly passionate about. And I think one of the things that I have honed my skills on over the years is how do I...

Whether I'm co-chair of the Ontario Health Central Region Mental Health and Addiction table, or I'm supporting the Human Services Planning Board of York region as their co-chair, all these things. Is how do I ensure that each of the voices at that table is able to contribute their ideas, their passion?

And not just at the table, but then turn that around and bring it back to community so that we can work on things together. And that is the only way that we're going to move forward. It's that old African proverb that says, "If you want to go fast, go alone, but if you want to go far, go together." And I think we have a long way to go and it's a lot more fun to do it with a group of people.

Abi Sivakumar: Yeah, that's amazing. And like I mentioned before, the first thing that comes to mind whenever you answer is advocate. And I can just tell from how you speak and the passion in your voice, that's who you are, an advocate.

And speaking of amazing, not too long ago you were honored with the IABC/Toronto 2024 Communicator of the Year Award. Wow, congratulations. What does the award mean to you?

Rebecca Shields: I was super, super touched to receive this award and I didn't realize I was being nominated. So it was even a lovely surprise to be recognized for what I'm doing, which is advocating for services, and being given a platform to share the message of opportunity, possibility.

And to really challenge everybody to come together and coalesce behind better services and support for people experiencing a mental illness or substance use issue. So it was great. I'm also going to say on the other hand, it was also a bit terrifying when I found out I had to give a speech to the communications community.

I thought, "Oh gosh, no pressure. This will be the TED Talk of my life." But I really enjoy public speaking and I really enjoy not just speaking, but actually meeting people after I have a chance to present. And have people come up to me and say, "That's really great. How do I get involved with this? What can I do?"

And that ability to connect is really what is one of my motivators and drivers personally. So it was an exciting award and I'm excited to be part of their event that's coming up in later April.

Abi Sivakumar: Well, it's 100% well deserved with all the work you're doing.
And what, in your opinion, can healthcare organizations across the province do right now to start moving the needle around mental health and addiction issues?

Rebecca Shields: I think we think a lot about this in two ways. One, I'm going to get on a little bit of a soapbox and say it is care integration. And it is about thinking about how we better link organizations, particularly community mental health services, into broader services. So I'll give an example of what I'm thinking about. I'm thinking a lot about the primary healthcare reform that is happening now here in Ontario.

And I'm really excited because the idea that people would have their primary care home and that that home would be linked to mental health services. But what I want to see is them hiring social workers or mental health professionals from CMHA to work inside that primary care home, rather than what we see now, which is a family health team, which has their own social worker.

Because when you can link us in, then that connection to all of the services that are provided through CMHA and beyond are immediately there rather than setting up a series of silos, and then everybody says navigation, navigation, navigation. We spend so much money navigating people rather than actually treating people.

So if we can link people better by actually linking organizations together, and allowing us all to bring our best selves, that would truly be what we need to do. Because it doesn't matter if you're dealing with a chronic health condition, you are likely to experience depression and anxiety. And if that depression and anxiety is left untreated, you're more likely to have a secondary or tertiary event.

So we want mental health services available as people are going through other kinds of healthcare. 

Conversely, people who experience severe mental illness often die from the same chronic health conditions that everybody else does, but on average 20 years or more earlier, because they don't get treated appropriately for some of those issues.

So if we're all in it together, I think the outcomes are going to be better across the board, and we can focus more on treatment and rather than trying to navigate people to the services that they need. And that's really where healthcare efficiency and better service, and better patient-client experience actually comes from.

Because I think a lot of people say it's just figuring out what I need to do is so difficult. So that's what I'm thinking a lot about and I'm talking a lot about right now. And if we're going to go into this idea of cure, then all that comes from early identification, education, access to care, ensuring people get the right treatment, treatment matching, precision medicine.

All of those things together that we need to work on in adopting those best practices, rather than continuing to have a siloed, broken system where we're not all working together. I'll just finalize by saying there has been a lot of movement in Ontario. The Centre of Excellence is doing a really good job laying the foundations. We're a proud partner.

I love to see what we've done as a network lead organization for Ontario Structured Psychotherapy, being part of the first evidence-based CBT program that's province wide, it's really exciting. So good things are happening, and it's really building on that momentum and ensuring that we continue to build in that direction.

Abi Sivakumar: Yeah. Thank you for sharing such great advice and such important points on early intervention. And again, that ties into that partnership point you're mentioning before of bringing organizations together and being in it together. So thank you for that.

Hey, it's Abi here. You know me from HIROC's Healthcare Change Makers podcast. I'm so excited to tell you all about a new show we're working on this year. I'll be co-hosting Share Scale Repeat alongside Trevor Hall.

You know him as HIROC's Vice President of Healthcare Safety and Risk Management. Trevor, maybe you can give our listeners a bit of a teaser.

Trevor Hall: Absolutely. Share Scale Repeat is a podcast about how even the smallest idea can spark big change. It's about discovery, understanding and exploring complex topics that we don't always talk about in healthcare.

It's about sharing and scaling knowledge and experiences, what may work, and importantly, lessons in trying.

Abi Sivakumar: Trevor and his team hear so many amazing ideas through HIROC's Safety Grants Program. So every episode, we'll be sitting down with an expert to understand a complex risk issue.
And most importantly, explore ways we are trying to reduce this risk.

Trevor Hall: That's right, Abi. What's so cool about some of these projects we've helped support and fund over the years, is that many of them can be scaled at organizations right across the country.
We just need to get the word out. Ultimately, it's about partnering to create the safest healthcare systems.

Abi Sivakumar: We'll be bringing the first episode to you wherever you get your podcasts this spring. So for now, follow Share Scale Repeat so you'll be ready when we drop new episodes. Thanks for listening.

Okay. So now it's time for our lightning round. Michelle and I will ask you a few quick and short questions and you can say the first thing that comes to mind. Sounds good?

Rebecca Shields: Yep.

Abi Sivakumar: Perfect. So here on Healthcare Change Makers, we love talking about TV. So what's one TV show you're excited about right now?

Rebecca Shields: Anything with a spy or an assassin.

Abi Sivakumar: Okay.

Rebecca Shields: That is my brain candy. So that's what I love.

Michelle Holden: The Night Agent, you know that one that's out right now?

Rebecca Shields: Night Agent, The Recruit, that's all CIA, but all that stuff. They seem to blow things up.
Jason Statham, The Beekeeper, who can take that entire building and walk out alive. All that stuff is where I turn my brain off.

Michelle Holden: I was going to say, you must need to turn your brain off sometimes after all of this heavy lifting that you're doing.

Moving on, any other podcasts, other than this one, that you stay up to date on?

Rebecca Shields: I'm a big fan of The Daily from The New York Times and I love Acquired. And Acquired, if people don't know about it, it's the history of companies like Rolex and Novo Nordisk.

And they just go into depth about how these companies and the strategy of their growth and changes. I just love that one.

Michelle Holden: No, I don't know that one.

Abi Sivakumar: What's one thing you miss about being a little kid?

Rebecca Shields: That's a great question. I remember as a kid, I used to love, and again, I'm dating myself, but I grew up in Vaughan in York region and, of course, there was growth. I used to love hunting for beer bottles and cans, and I used to hunt for them and then my dad or my mom would drive me to the beer store where I could change them in.

And I would get my 25 cents and go to the Becker store and be able to buy candy, and it was like the most exciting. My sister and I would go and we'd get our bag, and we'd have 15 cents and you could actually get a lot for 15 cents back then. So the hunt.

Abi Sivakumar: The hunt.

Rebecca Shields: The hunt, a little entrepreneur at a very young age, maybe it says a lot about me.

Michelle Holden: What would you say, Rebecca, that your guiding principle has been?

Rebecca Shields: So I want to give credit, I've had this as a guiding principle, but I really need to give credit to somebody who I admire so much, Dr. Catherine Zahn, who I got the pleasure to know when she was a CEO of CAMH and I was on the board. And I asked her once what her leadership philosophy was, and she said what I believed in such a succinct way.

And so I've adopted it, but it's been when I've lived my whole life. And she said, "Rebecca, what I tell people is I always keep my promises and I always try to do better. I keep my promises and I always try to do better." And I thought that's it. It's about integrity and honesty and keep an accountability.

And the Dr. Maya Angelou quote, "Do the best you can until you know better. And once you know better, do better." And those two things are how I approach everything I do and everybody else. So it's about giving people grace around learning, but also holding people accountable and holding myself accountable to my commitments.

Abi Sivakumar: Yeah, I love that. And finally ending off with food, pizza or pasta?

Rebecca Shields: Sushi, no. Definitely pizza.

Michelle Holden: I guess we should have given a non-carb option, but I love both of those things. Pizza's a good choice.

Rebecca Shields: Carbs are always more fun.

Michelle Holden: I know, they're so good. Thank you so much, Rebecca, for chatting with us on Healthcare Change Makers for sharing CAMH's story with our listeners, and just for giving us all those great words of wisdom.

Honestly, we'll be keeping an eye on all the projects that you're up to and all the work that you're doing, as well as that award in communications, IABC awards. So congratulations again. Thank you very much for chatting with us.

Thank you for listening. You can hear more episodes of Healthcare Change Makers on our website, HIROC.com, and on your favorite podcasting apps. If you like what you hear, please rate us or post a review.

Healthcare Change Makers is recorded by HIROC's Communications and Marketing Team and produced by Podfly Productions. Follow us on Twitter at @HIROCGROUP, or email us at [email protected]. We'd love to hear from you.