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Optimistic about new directions in mental health

Florence Budden is a long-time advocate for patients and their families.

When Florence Budden opened a copy of Changing Directions, Changing Lives, the report containing Canada’s new mental health strategy, she was elated to see that the voices of people affected by mental illness were finally being heard and respected.

“That was probably the proudest moment of my career,” says Budden, 47, a clinical nursing instructor at the Centre for Nursing Studies in St. John’s and president of the Schizophrenia Society of Canada (SSC). “I had contributed to a historic document [she is quoted and a photo of her even appears on the cover], and it’s one that’s going to be around for a long time. I hope other nurses will see that the smallest thing you start out doing and getting involved in can make a difference. You can actually be part of the change if you keep working toward it.”

Budden is a born advocate — and someone who “loves to talk,” she says with a laugh. She devotes much of her free time to theSSC, as part of her quest to improve the way Canada’s health-care system treats those living with mental health problems. “I’m a firm believer that advocacy is not just a word in nursing. It’s something we actually have to do,” says Budden from her home in Mount Pearl, just southwest of St. John’s. “We all have a responsibility to make the community we live in better.”

That sense of responsibility, nurtured in her childhood, defines her. “That’s just the way I grew up. My parents helped people,”Budden says. “And if I can do something to help you, I will.” From the age of 12, she was a family caregiver, helping her mother, who had a cardiac condition. She shared a genuine interest in people with her mother, and learned about resiliency and the importance of a positive attitude from her. Those early experiences drew Budden to nursing. As a student at Memorial University, where she graduated with her BN in 1988, she discovered she enjoyed working on mental health wards. “I was always very interested in listening to people’s stories.”

A nursing instructor and a friend working as a psychiatric nurse encouraged Budden to enter the mental health field. She spent the next 12 years in psychiatric/mental health nursing in the Waterford Hospital’s mental health program in St. John’s.

She left once, taking a leave to become a nurse manager in quality improvement at Temiskaming Hospital in New Liskeard, Ont. The hospital’s administrator had heard Budden speak on the topic at an international conference and asked her to interview for theTemiskaming job. Budget cuts eliminated the position a year later, and Budden moved back home.

Throughout her career, she has focused on the person living with the illness, not the illness itself. One particular client she remembers was a woman in her early 30s. Budden, who was just starting out, spent hours with her, trying to calm her. Twenty years later, Budden met the woman again. “She still remembered the amount of time I spent talking to her,” she says. “I had just listened, mostly. But I think the simple act of listening can be more than enough to give people the sense that they have someone who is supporting them.”

Budden’s husband, Brian, who is a nurse practitioner, and the rest of her extended family have always supported her work in mental health, she says. That encouragement was a catalyst for her efforts to fight the stigma around mental illness.

“When I first started working in psychiatry, some nurses believed that all I did was give out pills and play cards,” says Budden. Many of her peers did not understand the complex assessment and communication skills her job requires.
Reducing stigma is one of the reasons Budden took up teaching at the Centre for Nursing Studies, operated by Eastern Health, in 1998. “I had such a passion for mental health and psychiatry that I really felt it needed to be passed on to the next generation of nurses,” she says.

Throughout her career, which has spanned nearly 25 years, Budden has fought for the well-being and dignity of others. She has struggled to find housing for people discharged from hospital with no place to go, comforted clients and family members after diagnoses, and embraced opportunities to educate the public.

In 1999, Philomena Kavanagh, whose daughter was diagnosed with childhood schizophrenia, heard Budden speak about schizophrenia at an education event for families. She invited her to join her on the board of the Schizophrenia Society of Newfoundland and Labrador. At the time, Kavanagh was pushing the province to cover atypical antipsychotic medications through its health-care plan. Budden felt that people with schizophrenia were misunderstood and lacked support, and she was looking for a way to get more involved in her community. The fit seemed right, and they went on to win their fight to get the medications covered.

By 2002, Budden was serving on the board of the SSC, andshe found herself speaking on the national stage. She began by testifying before the Senate committee examining mental health. After the Mental Health Commission of Canada was formed, Budden was one of the stakeholders its staff regularly consulted as the mental health strategy was being developed.

Today, Budden’s advocacy work takes her across the country. She relishes the opportunity to travel (and it occasionally allows her to indulge her passion for shoe shopping), but the role of SSC president is demanding and can conflict with her desire to spend Sunday nights with Brian and their bowling league, walk her dog, Brandy (a Jack Russell mix), and hang out with family and friends.

Still, the couple always manages to find time to unwind and to discuss the issues of the day. Budden loves to read — she’s a mystery buff — but admits she hasn’t gotten the knack of relaxing and taking care of herself. “Sometimes I get worn out, but there is so much to do,” she says. “And I don’t consider what I do with the SSC to be work. I’ve gotten back more from them than I could ever give.”

Among the benefits are the lifelong friendships she has developed. Those relationships have helped her through some hard times, including the death of Ian Pollett, a close friend and provincial advocate for schizophrenia. Pollett took his life two years ago, andBudden found herself questioning whether she had done enough to support him. “That was a challenge for me, at the time,” she says. Ultimately, Budden was able to be at peace after realizing that the way Pollett chose to end his journey did not detract from who he was or diminish the importance of his message.

Experience, she says, has made her a better person, teacher and nurse. The new mental health strategy and an increasingly opendialogue about mental health that emphasizes recovery have infused Budden with hope. “Finally, I think our society and our leaders are beginning to see mental illness and mental health problems as a social justice issue as well as a health issue,” she says. That, she believes, is exactly the right direction for continuing progress. Being front and centre, leading change, is where she wants to be.

10 questions with Florence Budden

If you could change one thing about yourself, what would it be?
I like who I am, but I would like to be healthier.

What is one thing about you that people would be surprised to learn?
I love the Murder, She Wrote books and TV shows.

“If I had more free time, I would....”

Where did you go on your last vacation?

What is the one place in the world you’d most like to visit?

What was the last good book you read?
The Apprentice, by Tess Gerritsen

If there was a single person who inspired you to become a nurse, who was it?
Two people, really — my parents

What was the best piece of career advice you’ve received?
Be part of change in a positive way and bring your ideas forward.

What is the best thing about your current job?
Being part of the learning experience for nursing students

If you had the power to make one change to the health-care system, what would it be?
I’d eliminate the inequalities that exist for people living with mental illness.