“Evidence-based” is a term Dr. Patricia Rockman hears often. As the co-founder of the not-for-profit Centre for Mindfulness Studies in Toronto, Rockman and her colleagues are committed to bringing the most effective mindfulness-based interventions to the most disadvantaged and marginalized in our society—the poor, homeless, unemployed, and disabled—as well as the “front-line workers” who interact most directly with them.
According to the center, mental-health problems, including depression and anxiety, disproportionately impact these groups, which also face the greatest economic and social barriers to getting proper treatment.
The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse. There’s also some early evidence that it can be advantageous for people struggling with addictions, and appears to be particularly promising for smoking cessation. And when suffering causes someone to “have a fixed and negative view of themselves … or their circumstances,” Rockman says, mindfulness can help give them access to a different perspective, helps them open to other possibilities, and enhances resilience and their capacity to tolerate distress.
But mindfulness isn’t a one-size-fits-all solution, she warns. “I think it’s really important to know mindfulness is not a panacea,” Rockman says. “We do need to step back and be discerning about what it’s good for—or at least not harmful—and where we need to be cautious.”
Who Should Use Mindfulness for Mental Health?
Clients in the center’s personal and community programs are screened before they start any of the mindfulness-based interventions. “If someone is too sick—too depressed, too dysregulated, has unprocessed trauma or is actively psychotic—and doesn’t have adequate supports, we let them know that this likely isn’t a good time for them to enter one of our programs. They really need to receive some other form of treatment first,” she says. “We need to know when to refer and when mindfulness is a suitable option for treatment or self-care.”
“Is mindfulness better than medication or other therapies? No, probably not”
Also key to the organization’s mission is to support the people who deal directly with those who have the greatest needs. The Community Program, which Rockman calls “the heart of the center,” teaches mindfulness to professionals, including social-service workers, guidance counselors, and people who work with the homeless.
“We tackle the needs of the caregivers using mindfulness for stress management and to prevent burnout, as well as the needs of clients they serve who may have serious and persistent mental illness,” Rockman explains.
Is Mindfulness More Effective than Medicine?
In all of their programs, Rockman notes, “evidence-based” is an important quantifier. For example, MBCT has been well researched and found to be as effective as antidepressants in preventing depressive relapse.
But even with this sanction, mindfulness programs may not be enough to meet the needs of certain clients, and for others its role may be best viewed as part of an overall treatment plan, as “one of the interventions that help,” Rockman says.
“Is mindfulness better than medication or other therapies? No, probably not,” she says. “But if you are someone who doesn’t believe in taking medication or seeing an individual therapist you might be more inclined to engage in the practice of mindfulness.
“So, it becomes, ‘OK, we have a modality that people like, it’s appealing and accessible to them, so they’re more motivated to use it.’ [In that case] mindfulness may work better for them.”
Ultimately, she adds, it may be that providing people with a number of options for treating mental-health conditions, managing chronic illness, or reducing stress is actually the best medicine. ▫
On Sunday Oct. 15 a four-hour event will raise money to support the Centre for Mindfulness Studies’ Community Program. The Mindfulness Challenge, featuring meditation instruction, yoga, and more, will be offered in three locations (Toronto, Oakville, and London) and also virtually. Participants are asked to raise donations for their enrollment. Learn more here.