COVID-19 and Mental Health Services

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Ever since the outbreak of the pandemic, researchers and medical practitioners have reported a rise in mental health issues, especially clinical anxiety, depression, and substance abuse. In a recent poll, 7 out of 10 Ontarians believed there would be a serious mental health crisis as a result of the pandemic. Canada was already in the midst of a mental health crisis before the pandemic outbreak, and the crisis has only been amplified. There is a need for stronger policy and more intensive care within the healthcare system to address this. 

Much of the mental health issues brought on by the pandemic have stemmed from uncertainty rising from changes in the nature of work, unemployment, fear of death and loss of loved ones. Ever since the pandemic began, people have started fearing for the health and wellbeing of themselves and their loved ones. Moreover, many have experienced unemployment and heightened financial insecurity. In January 2021, Canada’s economy lost an estimated 213,000 jobs, approximately five times higher than what economists predicted. The uncertainty caused by financial insecurity is one of the many factors that have added to people’s anxiety. 

Self-isolation, social distancing, and barriers to support systems have contributed to the increased rates of drug and alcohol abuse, which can aggravate mental and physical health issues. According to a poll by the Canadian Centre for Substance Abuse and Addiction, after the outbreak of the pandemic, approximately  25% of individuals aged between 35-54 and 21% of those aged 18-34 increased their alcohol consumption. The increase in substance abuse is concerning as it increases the risk of addiction and even death. This is another example of the consequences mental health issues can have. 

Amongst other mental health issues, rates of depression, in particular, have risen since the outbreak of the pandemic. The rise in depression is very strongly associated with isolation, unemployment, and a change in working environment and patterns. The percentage of people diagnosed with clinical depression in Canada has risen from 2% before the pandemic to 14% by February 2021, according to Canadian Community Health Survey. Moreover, mental health conditions may worsen for those that had depression and other mental health issues before the pandemic. Given these increases,, t policies and regulations must be improved in order  to help people adapt to changing work atmospheres during and post-pandemic. 

Policy Recommendations 

The Canadian government has recognized and has been responding to the mental health crisis by investing in virtual mental health platforms such as counselling apps. Examples of government-backed virtual counselling apps include Here2Talk and MySSP. However, certain segments of the population like the survivors of COVID-19, frontline workers, those who have lost their loved ones, and those going through financial insecurity should be the primary target of such policies. While the app offers counselling to the general public, there are no specialized services for these groups, and hence the services are not as comprehensive. The framework used to implement a COVID-19 response mental health program should use a stepped-care model, which argues that the most intensive care services should be reserved for those who do not respond to lower intensity services. For instance, there should be high-intensity rehabilitation programs for those with high levels of trauma due to loss of loved ones and employment, especially those with substance abuse issues. Existing publicly funded rehabilitation centres would benefit highly from providing specialized services for those who have survived COVID-19 or lost loved ones. One study shows that 64% of COVID-19 survivors would continue to show signs of depression, PTSD, and anxiety for at least one year. 

Many publicly provided mental health resources and services have been shifted to virtual platforms to align with the needs of social distancing and lockdowns. However, these resources, including apps and publicly-funded virtual counselling services, should be shifted to more intensive services, focusing on support with processing loss.. In particular, virtual resource outreach should be expanded to those in rural areas where the outreach often remains limited, and more comprehensive services should be curated for those at risk; for example, well-curated safety plans and action when there is a risk of suicide. This might be difficult to achieve due to the resources and manpower required, so it might be helpful to view it as a long term plan.

Based on research released by Harvard Business Review, it would be a good idea for the Canadian government to formulate a team of mental health consultants to train people in leadership positions of workplaces and institutions across Canada in mental health issues. It is particularly important to involve workplaces in the solution because a key trigger for depression has been the change in the work environment. In the process of training, it should be ensured that the vocabulary and language around mental health is sufficiently accessible to foster genuine relationships between employees and trainers. Having a mental health advocate or consultant in a company can be particularly helpful because they can provide information about very subtle signs of mental health conditions, which are otherwise difficult to recognize. One part of the policy could be incorporating all information given by mental health consultants into presentations for all employees of organizations and institutions in Canada to identify and address any signs of concern. 

Moreover, regarding substance abuse, the government should commit to a long-term policy to create awareness, through education programs in collaboration with civil society actors, on alcohol abuse.  In particular, individuals above the age of 18 have significantly increased alcohol consumption since the beginning of the pandemic. Alcohol abuse is a risk factor for nearly 15,000 deaths in Canada every year, and hence adds to the strain the health system is enduring during the pandemic. According to the National Alcohol Strategy outlined by the Commonwealth, alcohol abuse is likely to go down with higher pricing. Moreover, imposing higher taxes on alcohol to use the tax for funding programs aimed at raising awareness towards substance abuse would also be helpful. 

Above all, the federal government needs to collaborate with the public and private sectors to involve workplaces to work on mental health issues exacerbated by COVID-19. Loneliness and depression remain particularly elevated. The government has responded in multiple ways, including a Wellness Together Canada program, a partnership between the federal government and public and private sectors. However, moving forward, there should be a greater focus on services tailored for groups differentially impacted by COVID-19 and accessibility for people in all areas. For instance, the services should incorporate culturally relevant material for different ethnic groups all across Canada. Under the pandemic, existing mental health issues all across Canada have been exacerbated. While the government has responded through introducing virtual services like access to therapy and collaborations with public and private sectors, there still needs to be ongoing work around embedding COVID-19 related content, culturally relevant material, and intensive services for survivors of COVID-19 and those who have lost loved ones.