Since the start of the pandemic, Canadians and residents of Quebec have been facing unparalleled challenges, whether it be the anxieties of living in isolation for extended periods, grief over a lost loved one, or uncertainties surrounding the future. While COVID-19 has been affecting Canadians’ mental health since March, a recent poll conducted by marketing research firm Leger suggests that about a quarter of Canadians feel their mental health in October has been worse than during the first waves in March and April. To weather the weary effects of this long pandemic, federal and provincial fiscal policies that include sound financial commitments supporting mental health are a priority.

Research conducted on previous recessions suggests adverse mental health outcomes may be long-lasting. Individuals impacted by the 2008-2009 financial crisis had higher odds of mental health issues, even three years after the recession. The economic impact due to mental health alone is anticipated to be costly; recently, economist and former President of Harvard University Lawrence Summers estimated a $1.6 trillion cost from 80 million individuals with COVID-related mental health conditions in the US. Given that the economic contraction due to COVID-19 is expected to be at least twice that of the financial crisis, government investment in mental health support during this recession will be imperative for faster economic recovery. 

In Canada, this has all been doubly difficult since our mental healthcare systems were strained prior to the onset of pandemic. In 2018, the Mental Health Commission of Canada found that every week, 500,000 employees are unable to work due to mental health-related problems. An analysis by the Globe and Mail in January 2019 found that half of Canadians live in regions that have either too few or no local psychiatrists. In light of the greater unmet need for mental health services since the pandemic began, interest groups such as the Centre for Addiction and Mental Health (CAMH) have been lobbying for increased funding towards expanding virtual mental health services. The federal government has made several financial commitments towards supporting mental health services to date. In May, Prime Minister Trudeau announced a $240 million commitment towards expanding virtual health care as well as online mental health services. Other investments by the federal government include $7.5 million in April to Kids Help Phone, a 24/7 national mental health support service, $11.5 million in September targeting suicide prevention in marginalized communitites, and $10.2 million in October towards mental health and substance-use research. 

Many provinces have also made financial commitments early on in the pandemic. Ontario announced $12 million in emergency funds to expand virtual mental health support in April. Alberta has spent $53 million since April to expand telephone and online support and to direct resources towards communities disproportionately affected by the pandemic. B.C. allocated $5 million to expand existing services and to launch new virtual mental health services in April. Quebec, which has seen the most COVID-19 cases since the beginning of the pandemic, only recently took action. On October 28th, the Quebec government provisioned $25 million for mental health services directed towards youth. Prior to the announcement, Legault publicly acknowledged the surge in mental health problems and urged anyone struggling to call 811, Quebec’s existing psychological services help hotline.

In a July 2020 policy paper, CAMH outlined the importance of following a stepped-care model of provision of resources; this model emphasizes a continuum of resources, where individuals receive the least intensive resources that are effective for them. Under these guidelines, lower intensity interventions such as non-directive support and intervention by self-directed groups would be considered prior to seeking psychotherapy or medical help. A stepped-care model has the potential of minimizing the costs of care per person while reaching more people via a broader variety of resources. Increasing support to crisis lines alone is simply not enough to engender a concerted response to the demand for mental health care. Improving access to a variety of resources such as internet-based cognitive behavioral therapy (iCBT) programs, which Ontario has recently made available for free, will help optimize resource allocation within the healthcare system. In 2019, the Quebec government introduced a new initiative, the Quebec Program for Mental Disorders: from Self-Care to Psychotherapy (PQPTM), a free service for Quebec residents covered by RAMQ that takes a stepped-care approach to improving mental health. Expanding and expediting the deployment of PQPTM represents one way the government can respond to the greater anticipated need for mental health care within the province. 

It would be remiss to think that financial commitments towards expanded mental health resources alone are sufficient to remedy this impending mental health crisis. Funding towards social support plays a vital role in mental wellbeing. This is evidenced by the climb in distress calls to mental health centres in August due to anxieties over termination of the Canada Emergency Response Benefit (CERB)—a $2000 taxable benefit to workers jobless, sick or forced to stay home due to the virus. Distress calls levelled off after the Canadian government announced the extension of CERB. To allay the long-term mental health effects of the virus, adequate social support in the form of recovery benefits are an essential component of the national and provincial mental health response. 

 COVID-19 has exacerbated a mental health epidemic that had long been growing. Reimagining the future, one with a lower burden of mental health, will require policies that touch all aspects of our lives, in addition to an investment in mental health support tailored to meet the needs of our most vulnerable groups.