Blog: How the pandemic affected the mental health of communities made vulnerable

With the COVID-19 response still focused on mitigating the spread of infection, treating severe cases, and ensuring the health care system does not collapse, people in Canada have coped very differently on how the virus could potentially impact their lives. Even with the existence of online support and help, these services may not necessarily directly address how the pandemic itself threatens the mental health of those with severe mental health illness, addictions, and those living in high-risk and vulnerable situations. A nationwide survey entitled, COVID-19 effects on the mental health of vulnerable populations, by the Canadian Mental Health Association has looked at how the pandemic has exacerbated mental health problems in different groups “including parents, those with existing mental illness or mental health issues, Indigenous people and those with a disability or who identify as LGBTQ+” (CMHA, 2020).

Overall, people in Canada feel very anxious and report that their mental health has declined due to the pandemic. Although most people have continuously connected with their family and friends virtually and maintained a healthy lifestyle, not everyone is affected equally. Compared to 6% of the general population, those with disability, living in low income, who are Indigenous, POC, and identify as LGBTQ+ have higher rates of suicidal thoughts since the pandemic started. The mental health of women in families are also more impacted than those of men. This pandemic has taken a toll on and widened the mental health inequities of people who are already made vulnerable due to social, economic, and systemic inequalities.

Furthermore, those with preexisting mental health illness and/or substance use disorders are even more vulnerable during the pandemic (Vigo, Patten, & Pajer, 2020). Since these individuals are generally at higher risk of other health problems and are more likely to engage in unhealthy coping behaviours, it’s plausible that they have underlying health issues that make them vulnerable to the virus. Because of the strict social distancing measures initially enacted by the government, isolation and lack of social interaction with families and friends worsen symptoms of anxiety and any subsequent coping responses or relapses. Additionally, disruptions in social services and mental health care or possibilities of unemployment can turn recreational use of substances into something problematic (CAMH, 2020). As well, those who are houseless or live in shelters or group homes are more vulnerable not just to contracting and spreading the virus, but also to the increasing mental health inequities intensified by the pandemic.

The existence of online support and other wellness information have been curated to meet the needs of the general population. These types of information services may not necessarily be appropriate for individuals in vulnerable situations who may be better helped with in-person services and may have barriers to accessing online services (MHCC, 2020). Other factors include confidentiality on who has access to emails and text messages, and who is potentially watching or reading over their shoulder while getting online help. Furthermore, those who live in violent living conditions such as domestic abuse and/or child abuse are placed in more precarious situations while isolated with their abuser and are less likely to access safe spaces and services, or may not feel comfortable seeking virtual help. With women and children’s mental health already negatively impacted by the pandemic, this problem is heightened in these high-risk living conditions.

The CMHA report highlights that families are finding ways to cope with and protect their mental health by exercising and connecting with family and friends. However, this privilege doesn’t necessarily apply to everyone who are in vulnerable positions. The impact of COVID-19 does not just put these individuals at increased risk of negative health, economic, and social outcomes, but it also highlights pre-existing inequities in access to health care, housing, income and social supports that currently exists. Significant policy and systemic changes must occur to not just to protect every person’s mental health, but to improve the social conditions of those made vulnerable by systemic inequities. Both the Mental Health Commission of Canada and the Centre for Addiction and Mental Health have provided their own recommendations on long-term policy and systemic changes which include: providing and expanding a range of mental health resources and supports (in-person and virtually); investing in social determinants of health such as income supports (i.e. basic income guarantee and affordable housing); and providing more support for health and mental health providers so that they can better serve the community.