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A-Way’s Route to Wellness

Network, Winter 2006

Health involves more than the absence of illness — it also means being able to take care of oneself in order to keep healthy or to live with ongoing health problems. To get and stay healthy often requires doctors and pills. But it can also require basic things like having a home and a job — things that we don’t often think of as related to health, but which are, in fact, essential.

When the Canadian Collaborative Mental Health Initiative (CCMHI) consulted with consumers, families and caregivers across the country to find out what people thought about collaborative care, they heard about the importance of traditional health care services, like doctors, therapists and medications. But they also heard about the “determinants of health,” basic needs such as housing and nutrition which are considered “critical influences on overall health and well-being.”

Putting “the needs of consumers at the core of collaborative mental health care” is a priority, according to CCMHI. This means that consumers must be “involved in all aspects of their care, from treatment choices to program evaluation.” Collaborative care initiatives must be designed “to address the needs of specific groups; in particular, those that are often underserved or have a great need for both primary and mental health care.”

CCMHI recognizes that peer support is one element of collaborative care. Peer support, peer advocacy, and consumer-run programs offer support from others who have similar experiences of living with and recovering from mental health problems. Around Ontario, there are many peer support and consumer-run programs that are ideally suited to respond to the growing recognition that collaboration is a key method of increasing access to health care services.

The Wellness Program at A-Way Express Courier Service in Toronto is an exciting example of this potential. The program was inspired by Mary Lucas, A-Way’s executive director, who noticed “extraordinarily high levels of multiple health problems such as arthritis, heart problems, obesity and diabetes” among her couriers.

A-Way’s employees are all people with direct personal experience of the mental health system. In business since 1987, A-Way was designed not only to provide excellent service to their 1200 customers, but also flexible and supportive part- and full-time employment to people who are too often shut out of the workforce. A-Way is one of a number of alternative businesses in the province which, altogether, currently employ about 800 consumer/survivors, according to the Ontario Coalition of Alternative Businesses. “Some of our folks hadn’t worked in 10 to 15 years before coming to A-Way,” says Lucas.

Working at A-Way not only gives people a job, but also an opportunity to participate in running the business and creating a community. “Every year at the annual general meeting we fly some idea,” says Lucas. Last October, she asked if people were interested in a wellness program addressing issues like losing weight, nutrition or quitting smoking. When the votes came in, people were clearly interested.

When Lucas asked people exactly what they wanted to learn, she quickly figured out they needed “two separate programs.” One group of people wanted to learn new and healthy recipes, such as hearty soups and low-fat and low-salt cooking. The other group said they didn’t know how to cook at all and needed “cooking for those who don’t know how to boil water,” or what A-Way calls the “Culinary Challenged.”

Lucas says one courier told her she was interested in a cooking class because, right now, she “eats mostly pastry.” For people who haven’t developed cooking skills and who are living on a low income, there is great temptation to rely upon junk and fast food, which is relatively cheap and easy to find. Even when you know that you’re not eating healthily, it’s hard to know how to begin to change your diet.

A-Way has already taken the first steps to respond to the needs of the couriers. They’ve partnered with a local restaurant, the Relish Bar and Grill, who provides healthy sandwiches at a reduced rate for their board, committee and staff meetings, instead of the usual fast-food pizza. They’re encouraging people to order from the Good Food Box, a non-profit buying club run by FoodShare that offers fresh, low-cost fruits and vegetables.

A-Way has bigger plans as well, and Lucas is now seeking funding to turn those ideas into a reality. There is a lot that the staff can do together to support each other, says Lucas, but for “some things you need professional advice.” Especially considering that some people have multiple health challenges. Not just diabetes, for example, but “diabetes, plus heart problems, plus arthritis, all in one package.”

One particular goal is to provide support and advice from a dietitian, who can help people develop individualized nutritional plans. Lucas has seen the “huge difference in people’s lives” that access to professional nutritional advice can make. Providing access through a consumer-run business helps to overcome the barriers both of cost and of transportation. “It’s easy to put off trucking across town to some office where you’ve never been, paying for travel with money you don’t have, and without the money to pay for the dietitian when you get there.”

Lucas stresses that the people working at A-Way have the same physical health issues that everyone faces. Just like everyone else, people with significant mental health problems must cope with the frustration of waiting lists for health services. At the same time, however, they also have to deal with their mental health. Their physical issues are “not unique problems, but made worse” by the extra challenge.

Lucas describes the life many couriers had before coming to work at A-Way as “sitting on the couch for umpteen years.” Unemployment among people with significant mental health problems is huge — some studies show the rate to be as high as 90 percent. People with mental illnesses are considered “unemployable” by many employers and, traditionally, even by mental health professionals. Alternative businesses, developed by consumer/survivors to provide supportive, flexible workplaces, have proven those other employers wrong.

Both physical and mental health depend on access to the basics of life that everyone is entitled to — a safe place to call home, work that provides an opportunity to give back to the community, and friends and family to share good times and bad.

Through their work at A-Way, the couriers and other employees are actively making social connections. “People do not flourish without social connections,” says Lucas. “Work gives people a reason to get out of bed in the morning.” And ultimately this benefits people’s physical, as well as mental, health. As Lucas says, “It’s all one piece.”

For more information about A-Way Express Courier Service, visit

Heather McKee is a community mental health analyst for CMHA, Ontario.

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