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- OPEN ACCESSBackground: Abortion has been available without criminal restriction in Canada since 1988, and approximately 33 000 terminations take place in Ontario each year. Objectives: This study aimed to explore women’s expressed desire for post-abortion support services, document the priorities expressed by women in seeking post-abortion support, and identify actionable strategies to improve post-abortion support services in Ontario. Methods: Between 2012 and 2014 we conducted in-depth, open-ended interviews with 60 Anglophone women from across Ontario who had recently had an abortion. We aimed to rigorously explore the compounding issues of age and geography on women’s abortion experiences. We analyzed our data for content and themes and reported on the findings related to post-abortion support. Results: One third of our participants expressed a desire for post-abortion support, yet few were able to access a timely, affordable, non-directive service. Women were uncertain about how to find services; most contacted a provider recommended by the clinic or searched online. Women were enthusiastic about a talkline format citing anonymity and convenience as the main advantages. Conclusion: Our results suggest that exploring ways to expand post-abortion support services in Ontario is warranted. A talkline format could provide an anonymous, convenient, non-judgmental, and non-directive way to address this unmet need.
- OPEN ACCESSYoung mothers constitute a vulnerable population in Canada. Teens with children are at significant risk of subsequent pregnancy, a dynamic that can exacerbate health, emotional, and socio-economic challenges. We aimed to understand better the dynamics shaping “rapid repeat pregnancy” among young mothers in Ottawa, explore young mothers’ subsequent pregnancy experiences, and identify how services could be improved in Canada’s capital. In 2016, we conducted in-depth interviews with 10 young mothers and semi-structured interviews with 10 key informants working with pregnant and parenting youth. We analyzed interviews for content and themes using a multi-phased, iterative process. Four major themes emerged: (1) young mothers often plan their pregnancies actively or passively; (2) violence before, during, and after pregnancy is common; (3) mental health and substance abuse issues shape pregnancy risk; and (4) becoming pregnant often serves as a source of motivation for young mothers. Our results further indicate that young mothers have difficulty finding youth-friendly, non-judgmental support services and that integrated, multidisciplinary services offering individually tailored support and building on women’s strengths will likely be more successful in helping young mothers prevent subsequent pregnancies. Increasing awareness about existing services and supporting efforts that approach teen pregnancy comprehensively and holistically appear warranted.
- OPEN ACCESSThe origins of this report, and of the Mental Health and Policing Working Group, can be traced to the unique situation Canadians have faced as a result of the COVID-19 pandemic. The unique circumstances of this global outbreak, which have for many Canadians resulted in serious illness and death, intensified economic uncertainties, altered family and lifestyle dynamics, and generated or exacerbated feelings of loneliness and social dislocation, rightly led the Royal Society of Canada’s COVID-19 Taskforce to consider the strains and other negative impacts on individual, group, and community mental health. With the central role that police too often play in the lives of individuals in mental and (or) emotional crisis, we were tasked with exploring what can be reasonably said about the state of our current knowledge of police responses to persons with mental illness.
- OPEN ACCESS
- Linda Rabeneck,
- Chris McCabe,
- Mark Dobrow,
- Arlinda Ruco,
- Melissa Andrew,
- Sabrina Wong,
- Sharon Straus,
- Lawrence Paszat,
- Lisa Richardson,
- Chris Simpson, and
- Andrew Boozary
The purpose of this policy briefing is to examine our health care systems through the lens of the COVID-19 pandemic and identify how we can strengthen health care in Canada post-pandemic. The COVID-19 pandemic has provided compelling evidence that substantive changes to our health care systems are needed. Specifically, the pandemic has emphasized structural inequities on a broad scale within Canadian society. These include systemic racial and socioeconomic inequities that must be addressed broadly, including in the delivery of health care. We make recommendations about what we can do to emerge stronger from the pandemic. While these recommendations are not novel, how they are framed and contextualized differs because of the problems in our health care system that have been highlighted and exacerbated by the pandemic.The evidence is clear that socioeconomic circumstances, intergenerational trauma, adverse early life experiences, and educational opportunities are critical factors when it comes to health over the life course. Given the problems in the delivery of health care that the pandemic has revealed, we need a different approach. How health care was organized prior to the COVID-19 pandemic did not produce what people wanted and needed in terms of health care and outcomes. How do we emerge from COVID-19 with an effective, equitable, and resilient health care system for all Canadians?To address health inequities and emerge from the pandemic with strengthened health care in Canada, we must consider how Amartya Sen's capabilities framework on social well-being can be operationalized to achieve better health care and health outcomes. Specifically, we address the need to: strengthen primary care and improve access to primary care;utilize a community-embedded approach to care; andimplement better integration across the care continuum, including integration between primary care and public health.Coherent governance and leadership that are charged with realizing benefits through collaboration will maximize outcomes and promote sustainability. Only when we provide access to high-quality culturally competent care that is centered around the individual and their needs will we be able to make true headway in addressing these long-standing health inequities.