“We know this next pandemic is upon us. We’re living it now.”
Behind the health implications of COVID-19 is a second pandemic: mental health and substance use challenges that have been increasingly straining our communities over the past eight months.
According to Ottawa Public Health, in October 2020, 40 per cent of residents in Ottawa reported their overall mental health and emotional wellbeing was ‘poor’ or ‘fair.’ During this same time in 2017, this number was only nine per cent. Additionally, crisis hotline calls are up 114 per cent in November 2020 over the same time last year, according to 211.
Ottawa Public Health, the Distress Centre of Ottawa and Region and 211 are all hearing that feelings of isolation and loneliness have unsurprisingly grown since the start of the pandemic, and our communities’ mental health is declining. With that, comes increased pressure on available mental health services.
By Michael Allen
President and CEO,
United Way East Ontario
“Our system was pretty taxed in mental health and addictions prior to the pandemic, and we already had a capacity issue and some wait times in our programs. We saw a 26 per cent increase in wait times during the pandemic.”
With crisis, comes the opportunity to rise to the occasion.
Mental health service agencies have been innovating, adapting and collaborating to make sure there is a strong foundation of service available to people experiencing mental health and substance use challenges. The pandemic spurred frontline agencies into action to bring services online, to better target outreach to marginalized communities, and to support frontline workers at risk of burnout.
A community-wide effort
When COVID-19 first entered our communities in early March, Ottawa Public Health asked United Way East Ontario to work with local social services to address the social needs in our communities.
Since then, United Way has led the COVID-19 Community Response Table: a group of public health authorities, municipalities, frontline agencies, corporate partners, elected officials from all levels of government, and many others committed to supporting people through the effects of COVID-19.
This week, United Way’s COVID-19 Community Response Table focused on sustaining innovation in mental health through the pandemic and beyond.
Regional collaboration allows for nimble innovation and best practices
In the early days of the pandemic, community-based mental health services mobilized quickly and launched Counselling Connect, with support from the Ottawa Community Foundation and United Way East Ontario.
Counselling Connect is an online tool to help people access existing mental health and addictions supports in a simple way. The website enables people to book themselves into a same-day or next-day counselling session. Behind the scenes, the system has seamless connections between 15 local mental health agencies so a client can connect quickly with the service that is most relevant to them.
Since May, Counselling Connect has had more than 3,300 bookings, serving clients between the ages of two and 95, with targeted support for children and youth, adults and older adults, and Indigenous peoples. Counselling Connect is also scaling up to better connect African, Caribbean and Black communities and the LGBTQ+ community with specialized care.
Greg Lubimiv of the Phoenix Centre for Children and Families in Renfrew County has been working with the Champlain Mental Health Network to ensure top-quality mental health service delivery during COVID-19 and beyond. As mental health services made the jump to online care, there were many considerations in order to be successful, and challenges to overcome.
With support from United Way and the Emergency Community Support Fund, Greg and his team led the collaboration to solve problems around:
- Platforms: Helping service providers choose a virtual platform that works, meets privacy and confidentiality requirements, and is cost-effective
- Technology: Getting equipment into the hands of organizations that weren’t set up to work remotely. The group is also making sure clients have access to the proper tools so they can attend their appointments remotely.
- Best practices: Meeting ethical standards of care, confidentiality standards, consistent documentation, dealing with challenging cases, delivering service in a way that is effective for clients who require nonverbal engagement, etc.
- Training: Teaching service providers and clients how to use platforms, how to successfully undertake virtual care for higher-needs clients, etc. This has resulted in a website for recorded training sessions to address common challenges.
“Virtual care is not just a secondary option that we need to choose, it needs to be part of the suite of services that we offer on an ongoing basis. Virtual care will not disappear after COVID.”
Local networks are coordinating and simplifying services in support of kids and families
“We are seeing an increase in complexity in the mental health and addictions needs among children and youth in our region.” — Joanne Lowe
Kids Come First (KCF) is an Innovative Ontario Health Team selected by the Ontario Ministry of Health, and the largest mobilization of child and youth health providers in Eastern Ontario.
While KCF existed prior to the pandemic, having the network in place allowed for quick responses to evolving issues that came as a result of COVID-19. Joanne Lowe, Vice President of Mental Health and Addictions at CHEO and Executive Director of Youth Services Bureau shared some of the challenges they’ve addressed:
- opening an isolation centre for homeless youth,
- creating an in-home respite program for kids with autism spectrum disorder, and most notably,
- starting the One Call/One Click program.
Kids with complex mental issues are often failed by the system.
One Call/One Click was established to be a single point of entry to Eastern Ontario’s system of care for youth mental health and addictions. One Call/One Click is just as it sounds: one number to call, one link to click in order to access virtual services. It includes a “service matching” feature with the option to access a care coordinator when needed, and peer and family support services. This service will launch in the spring.
"Kids and teens in our region are waiting too long for mental health and addiction services, and some of that is because it is difficult to know how to access the service right for them.”
Equitable, accessible and inclusive mental health is essential for the Black community
African, Caribbean and Black (ACB) communities experience disproportionate physical, social, mental and emotional harms as a result of anti-Black racism in health and mental health systems. The consequences of this historic oppression means Black people face significantly higher levels of poverty, social exclusion, barriers to educational achievement, and a lack of access to culturally-appropriate services.
“An additional burden in our community this summer was the highly-politicized display of violence against black bodies. The local and international Black Lives Matter movement has shone a light on the sustained violence, trauma and grief Black people experience.”
It is critical to understand the sources of mental stressors facing Black residents, and how their needs may not be adequately met by many of the systems currently in place:
- When looking at interactions with mental health care providers, 56 per cent of respondents rated service as fair, poor or very poor due to dismissive and disrespectful attitude, lack of cultural competency and racism and discrimination.
- Black Canadians were 60 per cent less likely than white Canadians to seek treatment for a major depressive episode.
- 60 per cent of Black people surveyed would be more willing to use mental health services if the mental health professional was Black.
Marie Remy, who founded Fabiola’s Addiction and Mental Health Awareness and Support (FAMHAS) foundation in memory of her sister, shared how the Black community started reaching out during the pandemic to access mental health services.
In mid-September, FAMHAS launched a mental health initiative focused on the needs of ACB communities. FAMHAS received 445 applications for free mental health counselling, which they delivered through 17 Black mental health providers in Ottawa.
“It shows that we want the help, we need the help, we’re willing to get the help, but we also need the right professionals for us because we have specific needs that must be met.”
Suzanne Obiorah, Director of Primary Care and Regional Programs at the Somerset West Community Health Centre (SWCHC) spoke about how the Ottawa Black Mental Health Coalition has identified strategies to normalize the conversation around mental health, and respond to the identified needs. Things like prioritizing space for community healing, collecting race-based data, implementing anti-racism and anti-oppression training for mental health professionals, and hiring more Black mental health professionals will help the Black community benefit from mental health services.
The Coalition has also achieved significant milestones to reduce the mental health burden on Black people during COVID-19, including:
- Free counseling sessions by ACB psychotherapists for the ACB community
- Neighbourhood engagement, wellness checks, food distribution, self-isolation kits and a multilingual crisis line
- With funding from United Way, SWCHC hired ACB COVID-19 crisis workers who offer phone support, case management, virtual health and wellbeing sessions, short-term counselling sessions
- Faith leader engagement to address mental health crises within their congregations
- Launch of anti-racism training for mental health professionals
- Hiring more Black mental health professionals
- Co-leading an anti-racism strategy with Addictions Mental Health Ontario
“We’ve learned through collaborative efforts, funding and investments, and quick response programs, we can minimize mental distress, we can foster hope, and we can support recovery.”
Frontline workers are facing burnout and mental health struggles
Burnout among frontline workers has emerged as a significant concern as the pandemic wears on. Crisis situations typically result in increased distress, trauma-related stress, depression and anxiety among healthcare workers, and this is no different during COVID-19.
“We’ve heard from frontline workers that the tendency is to put your head down and just work, and not think about how you’re feeling, and not reach out for help.” — Dr. Melanie Willows
Dr. Melanie Willows of the Royal Ottawa Mental Health Centre and Genevieve Arturi of the Hawkesbury General Hospital discussed the province-wide collaboration that resulted in the Ontario Frontline Wellness Service, that launched in May of 2020 and is led locally by the Royal Ottawa.
This service provides a digital, single point of access for health care workers to quickly connect with a clinician, who assesses their needs and connects them with appropriate mental health care. As a result, frontline workers stay healthy while taking care of the rest of us.
Recommendations for a way forward
The purpose of the COVID-19 Community Response Table is to address the inequitable impact of COVID-19 on our community, and to build collaborative solutions. Cameron Ketchum, Director of Community Initiatives for United Way East Ontario, summarized the investment, advocacy and coordination efforts needed to ensure community care is strengthened over the long-term:
- Coordinate a sustainable funding model that addresses growing mental health needs and strengthens existing collaboration between service providers and funders.
- Advocate for stronger technology resources for mental health service providers so virtual care can be a permanent offering.
- Strengthen the existing coordination between services so mental health systems are accessible and consistent for clients, beyond the pandemic.
- Recognize the need for flexibility on emergency funding that expires on March 31, 2021, so frontline agencies can plan for mental health challenges that will last much longer.
- Ensure culturally appropriate mental health services for communities disproportionately impacted by COVID-19. This includes African, Caribbean and Black communities and Indigenous populations.
- These services must remain a priority for the mental health sector over the long-term, and these groups must have the opportunity to actively inform adaptations to services to better serve their needs.
- These services must remain a priority for the mental health sector over the long-term, and these groups must have the opportunity to actively inform adaptations to services to better serve their needs.
- Acknowledge and address the risk of staff and volunteer burnout on the frontlines, which has the potential to impact service across all communities.
The road ahead
United Way East Ontario and our partners at the COVID-19 Community Response Table are committed to addressing the critical mental health challenges facing our region. We are stronger when services are integrated, when organizations work together, and when that collaboration shows positive results for people in need.
The mental health and addictions sector has shown speed, innovation, and razor-sharp client focus over the past eight months in building a system that is stronger than it has ever been.
We are now at a critical moment where we must ensure these successful services are in place over the long term, for the betterment of our diverse communities.
In early March, in partnership with Ottawa Public Health and dozens of organizations across the community sector, United Way launched an initiative to help support the most vulnerable in response to COVID-19 in our region. This collaboration has enabled local problem solving, prioritization of needs, and collaboration. To learn more about supporting the initiative, or if you require community service assistance, please visit unitedwayeo.ca/covid-19.
