Feeling anxious or depressed? Good luck getting care

The pandemic has meant that many people had to choose between mental health care and paying rent, says Canadian Mental Health Association director.

Vanessa Hrvatin 5 minute read October 22, 2021

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Courtney Crosby is used to advocating for her family when it comes to mental health, but it wasn’t until the pandemic that she experienced a mental health crisis of her own. A couple months into lockdown Crosby says prior trauma resurfaced which eventually led her to an emergency room. She describes the experience as terrible, and says she was turned away and told to come back the next day because of a staff shortage.

Crosby was left feeling hurt and confused. Her friend drove her to another hospital where she was able to receive care, but she knew others must be facing similar roadblocks to accessing support. A lifelong resident of P.E.I., she started a Facebook group as a safe place for people to share their experiences with mental health, which quickly grew to over 2,000 members. Crosby says it’s high time for governments to step up and prioritize mental health, the same way they’ve prioritized the COVID-19 pandemic.

In many ways, the pandemic has simply exacerbated what many like Crosby have long known to be true: mental health services in Canada are grossly underfunded and under resourced. Research suggests there has been a steady decline in mental health across the country over the last 20 months. A recent survey conducted by the Centre for Addiction and Mental Health (CAMH) found nearly 20 per cent of participants reported moderate to severe anxiety, and close to 20 per cent also reported feeling depressed. But many of these people aren’t getting help.

“Despite large numbers of people and growing numbers of people identifying moderate to severe symptoms of anxiety or depression, still a relatively small number are reporting that they’re able to access services,” says Ed Mantler, vice president of programs and priorities at the Mental Health Commission of Canada. “Only around 20 per cent of people with some pretty serious mental health symptoms have been able to take advantage of services that are available.”

Mantler says along with elevated rates of depression and anxiety, another area of concern is the number of Canadians who have contemplated suicide, which he says has gone up “substantially,” especially among those diagnosed with a mental health disorder and people struggling with substance use.

Evidence also suggests marginalized groups and those who have struggled throughout the pandemic continue to face some of the biggest challenges. A report by Statistics Canada shows visible minorities, people who lost employment and those who experienced poor mental health prior to the pandemic are some of the groups whose mental health continues to be the most affected.

This is certainly the case for Elya White. Now 38 years old, White was diagnosed with depression and anxiety at the age of 15 and says several events throughout the pandemic worsened her mental health. White identifies as Indigenous, and says she experienced racism firsthand when she was admitted to hospital last year which later led to a post-traumatic stress disorder diagnosis. On top of this, White’s aunt died in February and due to COVID restrictions her family was unable to be by her side or have a traditional ceremony following her death.

“I understand that we’re trying to get through this pandemic but there’s also a humanity level that I think we’ve lost along the way,” says White. “For me, family is so important to my mental health, and we haven’t been able to really be a family this entire time.”

Along with population differences, the impacts of COVID-19 on mental health also varies geographically. According to Dr. Aristotle Voineskos, differences between provinces are tricky to unpack because of the many factors at play such as varying lockdown measures. But there is something to be said about the urban and rural divide.

“In rural communities the distance to a healthcare centre can be far, but the other big issue that’s come up during the pandemic is around access to WiFi, which in some cases means people aren’t able to access virtual care in a rural setting,” says Voineskos, vice president of research at CAMH and professor of psychiatry at the University of Toronto.

He also says much of the mental health research done to date has been survey-based which provides a snapshot in time, but more comprehensive research is needed to provide a fuller picture of the pandemic’s impacts, including how it’s affected different regions of the country.

With the mental health impacts of the pandemic expected to be felt for at least another three years, experts and advocates say there is a lot that must be considered moving forward. Sarah Kennell, national director of public policy at the Canadian Mental Health Association, says making sure Canadians can access mental health services should be high on the priority list.

“We have a two tier mental health care system in Canada where, unless you have private insurance and your employer is able to offset the cost, or you’re in need of acute or emergency related care which you get in a hospital setting, you’re paying out of pocket for services which means you’re incurring hundreds or thousands of dollars in a year for the mental health care that you need,” says Kennell. “During the pandemic, when there were job losses and unemployment, people were unable to afford care for many reasons like having to pay rent or having to put food on the table instead.”

Kennell adds that while the shift towards virtual care certainly has its perks, this method of delivery doesn’t work for everyone, and best practices will need to be established moving forward.

“Returning to the status quo pre 2020 isn’t good enough,” she says. “If the pandemic has taught us anything it’s that mental health needs to be considered on par with physical health and the way our systems have been created doesn’t allow us to live well and be well in all the ways we need.”