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The pandemic has taken a toll on mental health in Canada. Will it also change mental health care?

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How has the pandemic hurt the psyche of Canadians?

It’s a question that nagged at Michael Cooper since Canada’s first COVID-19 cases were identified. Sitting on a call with his colleagues at Mental Health Research Canada on March 10, Cooper discussed how the pandemic had the potential to upend the mental health of many, as evidenced by large-scale disruptive events that came before it, like the financial crisis of 2008 or the Fort McMurray fires of 2016.

“People were feeling anxious,” Cooper reflected on the general psyche of the time. “They were feeling nervous.”

It was a conversation that many elsewhere were having as well. From the Canadian Mental Health Association, to the Centre for Addiction and Mental Health, to big human resources companies like Morneau Shepell, major organizations knew that COVID-19 and the public health measures to combat it were going to hurt Canadians psychologically, whether the pandemic lasted two months or two years.

The pandemic has signalled a shift in how society talks about mental health, and opened conversations about what the future of mental health care could look like. Companies have invested in an unprecedented quantity of mental health research, including in Canada, where major mental health organizations have actively monitored changes in people’s well-being over the course of the pandemic. They did this through surveys, strategically implemented during pivotal moments in the pandemic’s progression, to measure COVID-19’s impact in almost real-time.

The results, researchers say, prove more Canadians are struggling with their mental health than ever before as a result of COVID-19. This has re-energized calls for systemic change in mental health care, particularly demands to include psychologists and psychotherapists under Canada’s publicly funded health-care system.

At the dawn of 2021, hospitals in Canada are under great strain as the country broke record numbers of COVID cases at the turn of the year. Lockdowns are being enforced for the second time in many regions, including the Greater Toronto Area, where social isolation has been emphasized as the only effective remedy until mass vaccination efforts begin.

All of these challenges are coupled with an economic crash that has hurt businesses and resulted in mass job and revenue loss, leaving Canadians adjusting to “the new normal.”

Back in March, Cooper, the director of development at Mental Health Research Canada, couldn’t have predicted to what extent the pandemic would evolve. But his team did predict the mental health toll the virus and subsequent lockdowns would have regardless.

“It’s a recipe for mental health issues,” said Dr. David Dozois, a professor of psychology at Western University and a member of MHRC’s board of directors.

“We know that social isolation and loneliness are strong predictors of mortality — they predict life expectancy better than smoking, obesity and diabetes,” Dozois said. “So being lonelier and socially isolated has a huge impact on us physically.”

Knowing this, the MHRC moved quickly to measure this impact. It began surveying Canadians on their mental health in April, then did so again in August and October.

They weren’t the only ones: CAMH did a survey of its own in six waves, ending in November, with the help of Delvinia, a Toronto-based research company. At the click of a button, researchers were able to deploy surveys to participants in real time, measuring the pulse of Canadians’ mental health at critical moments, said Sam Wells, senior director for CAMH’s Institute for Mental Health Policy Research.

“What makes the Delvinia study unique is the ability to be nimble, sort of press the button and collect the data at strategic time points,” Wells said, like how Canadians reacted to back-to-school in September or the easing of social distancing restrictions earlier in July.

Even the Canadian Mental Health Association, which focuses more on program delivery than research, did two surveys of its own in conjunction with the University of British Columbia.

“We typically wouldn’t do this kind of public polling,” said national CEO Margaret Eaton. “It wouldn’t be something we’d be able to afford, honestly.”

But Eaton said the association felt doing rounds of polling on Canadians’ mental health was “worth the investment.” The CMHA pooled money to conduct two surveys, one in May and one in September, with two more on the way.

Previous research on large-scale disasters shows a post-traumatic stress response follows and lingers for several years. Eaton said she witnessed this with CMHA’s Wood Buffalo branch as it tried to respond to the mental health toll left by the fires that devastated Fort McMurray, Alta., in 2016.

In a report published by University of Alberta researchers more than three years later, 37 per cent of 3,000 Fort McMurray students surveyed matched the criteria for PTSD, and 17 per cent dealt with depression of moderate severity. Eaton hypothesized similar results in the aftermath of COVID-19.

“It can sometimes take a while for the impact to even really be understood,” Eaton said, and while much remains unknown, she said it’s important to be prepared by monitoring the issue in real time so mental health services can respond adequately when the pandemic’s toll becomes more clear.

Plenty of information, however, has been uncovered thus far through the ongoing polling on the mental health of Canadians.