Last month, Unbelts met with the Alberta Women’s Health Foundation (AWHF) to chat about how we might work together to support women’s health initiatives during the Black Friday/Cyber Monday weekend.
When their team mentioned that there was an opportunity to chat with Dr. Kingston about the challenges women are facing accessing mental health care, and how to close some of those gaps, we jumped at the chance.
Dr. Kingston's research focuses on improving perinatal mental healthcare by developing and evaluating approaches for screening and treating women who struggle with depression and anxiety during pregnancy. She and her team are leading the field in using e-technology for screening and therapy in pregnant women so that women can get help whenever they need it, wherever they are.
Our Marketing Manager Devonne was eager to learn more about Dr. Kingston's research and her plans to expand this technology to even more women - not just those who are pre- or post-partum.
Devonne: I’ve been diving into some of the findings from your research and there are a few things that stand out to me as particularly interesting. Your team discovered that 70% of women don’t bring up their mental health concerns with their doctor. On the flip side, 97% of women say they're willing to talk about their mental health if asked. There seems to be such a disconnect there - women are willing to talk about it, but reluctant to bring it up themselves. What are some of the reasons that women are hesitant to initiate conversations about their mental health?
Dr. Kingston: There are many reasons that women do not want to bring up their mental health with their physicians themselves. The most common is that they do not want to be judged. As well, there are other reasons: they want to be ‘good’ patients and not take up a lot of the doctor’s time; they don’t want to be seen as a ‘bad mother’ among others. Our research shows that if a physician asks women about their mental health, that the women feel cared for and they will respond.
Devonne: Another thing that really struck me is that your research showed three out of four women want to self-manage their mental health. Why do you think that is? And what are some of the ways that women can self-manage mental health?
Dr. Kingston: We believe self-management taps into a women’s sense of control over her life and empowers her to make decisions that are in her best interest. Often women are so busy juggling the many aspects of their life that they don’t have time or the financial resources to follow up with traditional therapy or doctor’s appointments and they prefer being able to take steps on their own. Our digital HOPE platform allows women to access therapy and educational resources anytime, anywhere to improve their mental health.
Devonne: COVID-19 has had a huge impact on almost every aspect of our lives, and some of those mental health impacts have disproportionately affected women. Can you tell me a little bit about the connection between the pandemic and women’s mental health?
Dr. Kingston: Women often bear the disproportionate responsibility for caregiving, whether of children or of the elderly. As we have seen with the pandemic, women are more likely to stay home from their work in order to homeschool their children through the school closures or to take on more care of their elderly parents during lockdowns. Added onto already busy lives, the pandemic has increased women’s life stressors and increased the risk of anxiety and/or depression.
Devonne: Absolutely. Those additional caregiving responsibilities are something that's directly impacted our team Unbelts over the past couple years. Trying to juggle a full-time job and household responsibilities...it's a lot even in regular times.
A lot of things moved to virtual formats almost overnight because of COVID. But the app that your team has created was launched pre-pandemic, back in 2018, and in hindsight that seems really forward-thinking on your part. What are some of the unique advantages of web-based mental health resources?
Dr. Kingston: The bottom line is all about overcoming barriers to mental health care,” said Dr. Kingston, “No country anywhere in the world has been able to offer accessible, affordable mental healthcare for all, and it has always been an ambition of ours to do that.
Devonne: The more I’ve learned about this app, the more I’ve found myself wishing that something like this had been available to me at various times in my life. There are other mental health apps out there but a lot are focused primarily on online therapy. The HOPE app is incredibly comprehensive. Why are those other components (ongoing screening, referral, online therapies, coach, psycho-education, mood tracking) so important?
Dr. Kingston: Each one of the HOPE components adds to the comprehensive care that all women need to ensure quality mental healthcare. If we leave out one of these components, a gap in care occurs. For example, if we leave out screening then women don’t know the extent of their needs; they often do not know if what they are experiencing is ‘normal’ mental health. If we leave out online therapies, then women have reduced access to evidence-based therapies. The HOPE platform brings together a comprehensive format so that all pieces of the mental health puzzle are available and women can begin their journey to better mental health no matter what their starting point.
Devonne: The app has already supported 4,000 pregnant or postpartum people, and now you’re working with AWHF to expand the app to women at all stages of life. What are some of your goals as you embark on this new iteration of the HOPE app?
Dr. Kingston: That’s why we built [the HOPE platform]—to be accessible by anyone, any time, and to get the kind of help that they need. Knowing the perinatal period is an area of high risk, it helps give women the chance to start their families the way they want to. But as we’ve discovered through our journey, so many women come into pregnancy and leave the post-partum period still having mental health problems, so what we’ve wanted to do is extend the program so that it will be available across the full life course… Helping women helps the broader family.
You can learn more about Dr. Kingston's work in AWHF's report "Finding the Fractures: The Pandemic, Women's Health Disparities, and the Path to Equity."
And from November 26-30, Unbelts will donate $5 from each belt purchased towards expanding mental health research and resources across Canada in partnership with the Alberta Women’s Health Foundation. You can learn more about our campaign here.