Christina Morino has been an advocate for mental health services throughout her career, but it was a “big swing” to one day become a client of those services. A perfect storm of life stressors had finally caught up with her, and “the carpet was pulled out from under me.”

Like many women, she wondered if her situation was really that bad. “Stigma and pride stop people from getting help,” says Christina. While she didn’t hesitate to tell people she’d had open heart surgery, she didn’t want to talk about her mental wellbeing. “It took a lot for me to realize I was using unhealthy coping strategies, so the first hard part is coming forward. The second hard part is doing the work.”

It was during this time, in late 2018, that Markham Stouffville Hospital (MSH) launched its Women’s Wellness Services, supported by funds from the SHOPPERS LOVE. YOU. Run for Women Unionville, which has contributed over $500,000 for women’s mental health care at MSH over the past four years.

These services include a variety of group therapy programs, open to patients across all departments including childbirth, cancer care, surgery and mental health—as well as to family and community members. Offered quarterly, they provide adjunct therapies to improve women’s quality of life, such as helping to manage difficult emotions.

“A woman doesn’t need a diagnosis of general anxiety disorder to feel anxiety about how a mastectomy will affect the way she looks or how a major surgery will affect her career trajectory,” says Teresa Wong, clinical manager of outpatient mental health services at MSH. “Or she might not know how to cope with chronic pain, grief or loss.”

That’s why a physician referral or intake consultation is not necessary; women can self-refer. And, this November, MSH relocated these women’s programs to its brand-new MSH Wellness Clinic, located offsite from the hospital’s main campus to offer protection against stigma while reducing wait times. The needs of the community are being met thanks to the support of generous donors—Shoppers Drug Mart and TD Bank Group.

Christina joined the Mindfulness- Based Stress Reduction Group, consisting of eight weekly sessions plus an all-day silent retreat, which provides training in guided meditation and gentle stretching to address unconscious thoughts, feelings and behaviours believed to increase stress and undermine health.

“The group setting kept me responsible and accountable, it kept me onboard with the work, it helped me connect with others and their struggles— and their successes,” says Christina. “Connection is important for people especially if they’re feeling isolated with their mental health struggles.”

Also available is an Art Therapy Group, a ten-week program that uses the creative therapeutic process to support the expression of thoughts and feelings otherwise difficult to articulate.

No one has to be an artist “to greatly benefit from art therapy,” says Wong. “Maybe they’re not much of a talker, but they get it worked out through art.” While the women work on their own projects with a certified art therapist, they create a joint canvas during the last week of the program, with a theme such as hope or gratitude.

Since launching a year ago, there have been over 1,200 visits to these group therapy sessions at MSH. “We believe to best serve our community we must provide evidence-based group therapies,” says Wong. “What we see from the research is that a sense of community and being on a journey with other people is as important as the actual skills being taught.”

Women also have access to the Interpersonal Psychotherapy Group, a 20-week program that focuses on relationship challenges, grief and loss, as well as the Postpartum Depression Cognitive Behaviour Therapy Group and Antenatal Depression Cognitive Behaviour Therapy Group—both weekly sessions for women with or at risk of depression either prior to or following the birth of their child.

With group therapy, women take comfort in the fact that they’re not alone, that other women face similar struggles. “When these women start showing up early for group to chit chat, you know it’s taken on a life of its own,” says Wong. “Women have found something else woven into these groups— a sense of community.”

Due to a combination of socio-economic factors, residents in York Region—one of Canada’s most diverse regions—are at increased risk for anxiety, depression, addictions and suicide. And women, in particular, are 1.5 times more likely than men to struggle with mood and anxiety disorders.

The prevalence of psychiatric disorders is thought to be approaching half our population, according to Dr. Rustom Sethna, chief of psychiatry at MSH. Despite this prevalence, many people are still undiagnosed or misdiagnosed. Less than half of those who meet the criteria for mental illness are actually identified, and only two out of five seek assistance within a year of the onset of their symptoms.

“Women are more commonly affected by depression and anxiety, with about one in three in our community affected by these disorders,” says Dr. Sethna. “It’s a significant public health concern in our community. Depression is twice as common and more persistent in women [than men] and is predicted to be the second-leading cause of disability in 2020.”

While MSH’s group therapy programs are structured, the individual and her own personal challenges are taken into account. “It’s not a cookie-cutter program, and it has an active care component so our patients continue to be supported beyond the session’s completion,” says Dr. Sethna. “They can get ‘tune-ups’, there are drop-in Saturdays, to help keep the threads of connectivity there.”

Last year MSH had 32,000 visits to its outpatient mental health department; this year it’s trending toward 38,000. “We see the need for services is there. We know that it actually makes a difference in people’s lives,” says Wong. “Women are very empowered by our group sessions.”

As for Christina, she’s in a much better place these days. “It’s an amazing resource for patients. As tough as it is, reaching out for help is definitely a strength,” she says. “I’m grateful because this is a lifestyle change—not a project. And I look forward to more learning and a healthier me.”

This article originally appeared in the November 30 issue of The Toronto Star.