IIMHL I-CIRCLE in Toronto

I-CIRCLE

I-CIRCLE is an initiative, supported by the International Initiative for Mental Health Leadership (IIMHL), that involves cities and urban regions within eight countries working together to problem-solve and spread innovations. The purpose of this collaborative work is to support mental health and wellbeing within urban settings and enable citizens to thrive.  

I-CIRCLE has a report which describes concrete examples of how the I-CIRCLE principles have been implemented in I-CIRCLE member Cities and Urban Regions  across several countries:

History

The idea was conceived when Dr Arthur Evans, then Philadelphia’s Commissioner of Behavioral Health and disability Services, was presented at the IIMHL Leadership Exchange in Vancouver in September 2015. (Dr Evans is well-known to IIMHL New Zealand members). Dr Evans spoke about the City of Philadelphia’s ten years of work with its communities and city government, which had been prompted by the recognition that the major issues for our urban communities (e.g. homelessness, education, employment, criminal justice) are intertwined with behavioural health issues and that effectively addressing those behavioural health issues actually helps people in other areas of their lives.Click here for more information.

This 2019 match showcased some of the inaugural work of the THRIVE Toronto Table and its partners. Key actions described were:

• reducing stigma and discrimination and building mental health and well-being literacy
• addressing disparities in mental health outcomes by developing a plan to enhance supportive housing for Torontonians who have mental illness and/or addictions and are homeless
• creating neighbourhoods where residents can thrive using multi-sectoral collaboration to address serious addiction issues in the Downtown East (DTE) neighbourhood of Toronto.

Participants were from Toronto, Ottawa, Calgary, New York, Pittsburgh, Philadelphia, New Zealand, Amsterdam, Stockholm, and London (UK). Leaders represented a broad cross-section of municipal and regional governments, non-governmental organizations, hospitals (clinical settings), community-based organizations and people with lived mental health and addiction experience.

What is key to mobilizing others to foster mental health and well-being?

The match leaders noted that key issues were:

• a shared understanding about what we mean by mental health and well-being
• resources (human and financial)
• making the link to related areas and topics such as housing supply, affordability/cost of living, food security, justice, physical/general health/public health
• and getting the topic on the political agenda; and, organizations demonstrating that they care about employees and creating a sustainable, supportive workplace culture (consider YMCA Toronto’s example).

Moving in the same direction

In Toronto, to get everyone moving in the same direction and getting different sectors to work together, many actions were taken.

Examples are meaningful inclusion of people with lived experience of mental illness and addictions and sharing best practices, ie what is working well in various sectors and regions then considering how to adapt and replicate. Working with politicians was seen as important (as evidenced by the engagement and commitment of Mayor Bill de Blasio in New York City; Mayor John Tory in Toronto; and in Stockholm and New Zealand where well-being frameworks have been developed by the government).

Collaboration, partnership and sharing between cities and agencies is important; for example, between Thrive cities such as Canadian and Nordic cities, private organizations and government (City Mental Health Alliance and YMCA Greater Toronto examples).

Finally celebrating accomplishments is always valuable.

How to manage complexity

How do you get complex urban regions/cities working toward mental health and well-being? Bringing the conversation into the workplace is important. Examples are Bell Let's Talk - which is a national conversation about mental health being led by a private company, and Minds Matter – a Civic Action initiative. We need to change the way we are talking about mental health and well-being so that it’s less stigmatized, and engage people (including youth) who live in cities to share what conditions are needed for wellbeing, Creating a space/forum to hear people’s stories (both challenges and solutions)

Sometimes a crisis can be the catalyst for action and galvanize support (evidenced by the examples of work underway in New Zealand like the student army). Finally having a dedicated mental health and well-being budget is critical.

Sustaining the effort

What is essential to sustaining effective efforts to foster mental health and well-being in cities? How do you support multisectoral collectives to do this work?

• Identify resources (consider how expertise and influence can be shared across jurisdictions and sectors)
• Foster ongoing conversations, engagement and sharing (Thrive model offers a great forum to support multisectoral work and collaboration across participating cities and countries)
• Share stories (effectively and authentically); also share challenges and best practices
• Create the space for leaders [influencers] to tell their own personal stories; use social media where possible
• Purposeful alignment
• Clear governance models
• Common and consistent metrics and data
• Explore opportunities to adapt and replicate initiatives that have shown good results (example: friendship bench)
• Mechanisms to track and monitor progress on initiatives
• Change the existing knowledge and resource base, which currently is quite vertical and has limited reach.

Game changer?

What will be the game changer for mental health and well-being in cities? What makes the greatest impact to the mental health and well-being in cities?

1. If building healthy communities is important – then healthy communities require healthy workplaces (so this is an important place to start)
2. More and more people are talking about mental health and well-being. There is growing awareness globally, so opportunities to continue the conversation are necessary
3. Increasing and improving access to mental health resources is critical

Examples of work in other cities

• Christchurch “All Right?” campaign
• Thrive New York City
• City Mental Health Alliance, London. Also see https://thriveldn.co.uk/core-activities/
• Thriving Places, Easterhouse in Scotland