This article originally appeared in the Fall 2021 issue of the Ontario Medical Review magazine.
Alcohol and drug use are up; our young people are dealing with rising levels of depression and anxiety and more women are experiencing increased domestic abuse.
And there’s more.
Our seniors are feeling alone, their caregivers worn out, and marginalized communities have been pushed further into isolation.
People are suffering as the worst public health crisis of our generation takes an alarming toll on our mental health and well-being. And Ontario’s doctors are working through strategies to help.
“Without mincing words, it’s concerning to learn about the increasing challenges Ontarians face,” Dr. Adam Kassam, president of the Ontario Medical Association said as he opened the association’s most recent virtual OMATalks event: COVID-19 Impact on Mental Health: What We Need to Do Now.
The statistics are staggering:
“These COVID times have just brought these issues to the fore so much more,” said Valerie Pringle, a broadcaster and Centre for Addiction and Mental Health Foundation board member who moderated the panel. “The cost in human suffering is enormous, and so we can learn a great deal from the doctors we’re about to hear from.”
The OMA brought together a panel of physicians who are leaders in their fields in a number of areas related to mental health. This OMATalks event provided an opportunity to shine a light on the devastating effects of the pandemic on our well-being and to share ideas about how to address this phenomenon.
Dr. Sharon Burey, a behavioural pediatrician and president of the Pediatricians Alliance of Ontario, said even before the pandemic she was concerned about a 60 per cent rise in hospitalizations of children and adolescents across Canada between 2008 and 2019 reported by the Canadian Institute for Health Information.
The OMA’s white paper, Recommendations to Strengthen the Role of Physicians in Mental Health and Addictions Care, makes 20 recommendations and calls to action to address gaps in care.
Some of them include:
“The data for Ontario is similar and, despite this, funding for children’s mental health continues to fall way behind funding for physical health,” said Dr. Burey, noting that only one in five young people in Ontario who need mental health services receive them. “If this were the case for cancer, heart disease, asthma, stroke, diabetes, etc., I don’t think that this is something our society would tolerate.”
Driving home the seriousness, Dr. Burey said suicide attempts among children are also up.
“Attempts, which is a horrible thing to hear about, actually have increased. I’ve seen a number in my own practice in the 10 to 14 age group,” she said.
“COVID-19 is indeed not just a viral pandemic, but a global psychological pandemic.”
Dr. Robbie Campbell, a psychiatrist who specializes in eating disorders, said the pandemic has also escalated eating disorders, relapses and hospitalizations. The National Eating Disorder Information Centre is receiving twice as many calls and inpatient units are more than 200 per cent overcapacity.
“Ten per cent will die from physical and mental anguish in the form of suicide,” Dr. Campbell said. “We must address these issues and recognize that eating disorders are a serious mental illness.”
“These COVID times have just brought these issues to the fore so much more. The cost in human suffering is enormous, and so we can learn a great deal from the doctors we’re about to hear from.” —Valerie Pringle, OMATalks moderator
To illustrate the thought patterns of those with anorexia, the eating disorder with the highest mortality rate, Dr. Campbell shared a poem written by a 16-year-old girl at the time of her diagnosis who agonized all day because she had eaten a bite of toast that morning.
“It really portrays the struggle that someone goes through on a daily basis,” Dr. Campbell said. “It’s been an eight-year journey since that time and she’s now moving into her wellness phase.”
Dr. Vicky Stergiopoulos, physician-in-chief at the Centre for Addiction and Mental Health, said almost half of Canadians reported worsening mental health during the pandemic, and that substance use is also on the rise.
Among drinkers, 15 per cent reported an increase in alcohol use; while nearly half of cannabis users surveyed said they used more during the pandemic, “to calm their fears,” Dr. Stergiopoulos said.
“When it comes to abuse-related deaths and overdose deaths, we see a marked increase in both,” she added.
Seniors have also been suffering during 18 months of lockdowns and restrictions on their movement and social interactions.
Dr. Hugh Boyd, a care of the elderly physician, said we must recognize that loneliness and isolation are risk factors for disease and disability. He urged Ontarians to check in with seniors living in our communities throughout the pandemic and beyond.
Similarly, Dr. Sarita Verma, president of the Northern Ontario School of Medicine in Thunder Bay, Ont., said social isolation of Indigenous communities in the North, and the inequities experienced by Indigenous Peoples have also been exacerbated by the pandemic.
“Our inequity bathtub in northern Ontario was nine-tenths full before COVID, and now it is overflowing,” said Dr. Verma, pointing to gender-based violence and economic vulnerabilities as examples of hardships women in the North face.
“You talk about washing your hands? Well, we have 40 communities, right now, that are on boil-water advisories. Talk about food security? A bottle of orange juice costs $25, and there is no fresh produce.”
Dr. Yusra Ahmad, a community and academic psychiatrist, said the pandemic has “lifted a veil on exclusion,” of marginalized groups, especially women.
She cited a Canadian Femicide Observatory for Justice and Accountability statistic that shows a woman is murdered in Canada every six days trying to leave her partner — a frequency that has escalated to 2.5 days over the course of the pandemic.
“This inequity, this absence of palpable attention paid to social issues like gender-based violence and racism, are so pervasive and far-reaching in scale and scope that we can no longer afford to turn a collective blind eye,” Dr. Ahmad said.
Although more than 6,000 women and children were sleeping in a shelter in Canada each night before the pandemic, many more have sought shelter over the last 18 months only to be turned away for lack of space.
“There’s the mental health toll,” Dr. Ahmad said. “Physical elements, the injuries, the ER visits, the impact on our children, the losses to our human resources and social capital, the unfulfilled potential, the shattered dreams, the invisible prisons, the walking dead and the actual dead.”