Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada.

Objective: This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress. Methods: Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use. Results: Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons. Conclusions: This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.

Emotional response patterns, mental health, and structural vulnerability during the COVID-19 pandemic in Canada: a latent class analysis.

BACKGROUND: The COVID-19 pandemic has contributed to increases in negative emotions such as fear, worry, and loneliness, as well as changes in positive emotions, including calmness and hopefulness. Alongside these complex emotional changes has been an inequitable worsening of population mental health, with many people experiencing suicidal ideation and using substances to cope. This study examines how patterns of co-occurring positive and negative emotions relate to structural vulnerability and mental health amid the pandemic. METHODS: Data are drawn from a cross-sectional monitoring survey (January 22-28, 2021) on the mental health of adults in Canada during the pandemic. Latent class analysis was used to group participants (N = 3009) by emotional response pattern types. Descriptive statistics, bivariate cross-tabulations, and multivariable logistic regression were used to characterize each class while quantifying associations with suicidal ideation and increased use of substances to cope. RESULTS: A four-class model was identified as the best fit in this latent class analysis. This included the most at-risk Class 1 (15.6%; high negative emotions, low positive emotions), the mixed-risk Class 2 (7.1%; high negative emotions, high positive emotions), the norm/reference Class 3 (50.5%; moderate negative emotions, low positive emotions), and the most protected Class 4 (26.8% low negative emotions, high positive emotions). The most at-risk class disproportionately included people who were younger, with lower incomes, and with pre-existing mental health conditions. They were most likely to report not coping well (48.5%), deteriorated mental health (84.2%), suicidal ideation (21.5%), and increased use of substances to cope (27.2%). Compared to the norm/reference class, being in the most at-risk class was associated with suicidal ideation (OR = 2.84; 95% CI = 2.12, 3.80) and increased use of substances to cope (OR = 4.64; 95% CI = 3.19, 6.75). CONCLUSIONS: This study identified that adults experiencing structural vulnerabilities were disproportionately represented in a latent class characterized by high negative emotions and low positive emotions amid the COVID-19 pandemic in Canada. Membership in this class was associated with higher risk for adverse mental health outcomes, including suicidal ideation and increased use of substances to cope. Tailored population-level responses are needed to promote positive coping and redress mental health inequities throughout the pandemic and beyond.

Mental Health Inequities Amid the COVID-19 Pandemic: Findings From Three Rounds of a Cross-Sectional Monitoring Survey of Canadian Adults.

Objectives: Adverse mental health impacts of the COVID-19 pandemic are well documented; however, there remains limited data detailing trends in mental health at different points in time and across population sub-groups most impacted. This paper draws on data from three rounds of a nationally representative cross-sectional monitoring survey to characterize the mental health impacts of COVID-19 on adults living in Canada (N = 9,061). Methods: Descriptive statistics were used to examine the mental health impacts of the pandemic using a range of self-reported measures. Multivariate logistic regression models were then used to quantify the independent risks of experiencing adverse mental health outcomes for priority population sub-groups, adjusting for age, gender, and survey round. Results: Data illustrate significant disparities in the mental health consequences of the pandemic, with inequitable impacts for sub-groups who experience structural vulnerability related to pre-existing mental health conditions, disability, LGBTQ2+ identity, and Indigenous identity. Conclusion: There is immediate need for population-based approaches to support mental health in Canada and globally. Approaches should attend to the root causes of mental health inequities through promotion and prevention, in addition to treatment.

Use of Asynchronous Virtual Mental Health Resources for COVID-19 Pandemic-Related Stress Among the General Population in Canada: Cross-Sectional Survey Study.

BACKGROUND: The COVID-19 pandemic has resulted in profound mental health impacts among the general population worldwide. As many in-person mental health support services have been suspended or transitioned online to facilitate physical distancing, there have been numerous calls for the rapid expansion of asynchronous virtual mental health (AVMH) resources. These AVMH resources have great potential to provide support for people coping with negative mental health impacts associated with the pandemic; however, literature examining use prior to COVID-19 illustrates that the uptake of these resources is consistently low. OBJECTIVE: The aim of this paper is to examine the use of AVMH resources in Canada during the COVID-19 pandemic among the general population and among a participant subgroup classified as experiencing an adverse mental health impact related to the pandemic. METHODS: Data from this study were drawn from the first wave of a large multiwave cross-sectional monitoring survey, distributed from May 14 to 29, 2020. Participants (N=3000) were adults living in Canada. Descriptive statistics were used to characterize the sample, and bivariate cross-tabulations were used to examine the relationships between the use of AVMH resources and self-reported indicators of mental health that included a range of emotional and coping-related responses to the pandemic. Univariate and fully adjusted multivariate logistic regression models were used to examine associations between sociodemographic and health-related characteristics and use of AVMH resources in the subgroup of participants who reported experiencing one or more adverse mental health impacts identified in the set of self-reported mental health indicators. RESULTS: Among the total sample, 2.0% (n=59) of participants reported accessing AVMH resources in the prior 2 weeks to cope with stress related to the COVID-19 pandemic, with the highest rates of use among individuals who reported self-harm (n=5, 10.4%) and those who reported coping "not well" with COVID-19-related stress (n=22, 5.5%). Within the subgroup of 1954 participants (65.1% of the total sample) who reported an adverse mental health impact related to COVID-19, 54 (2.8%) reported use of AVMH resources. Individuals were more likely to have used AVMH resources if they had reported receiving in-person mental health supports, were connecting virtually with a mental health worker or counselor, or belonged to a visible minority group. CONCLUSIONS: Despite substantial government investment into AVMH resources, uptake is low among both the general population and individuals who may benefit from the use of these resources as a means of coping with the adverse mental health impacts of the COVID-19 pandemic. Further research is needed to improve our understanding of the barriers to use.

Associations between periods of COVID-19 quarantine and mental health in Canada.

Since the onset of the COVID-19 pandemic, many jurisdictions, including Canada, have made use of public health measures such as COVID-19 quarantine to reduce the transmission of the virus. To examine associations between these periods of quarantine and mental health, including suicidal ideation and deliberate self-harm, we examined data from a national survey of 3000 Canadian adults distributed between May 14-29, 2020. Notably, participants provided the reason(s) for quarantine. When pooling all reasons for quarantine together, this experience was associated with higher odds of suicidal ideation and deliberate self-harm in the two weeks preceding the survey. These associations remained even after controlling for age, household income, having a pre-existing mental health condition, being unemployed due to the pandemic, and living alone. However, the associations with mental health differed across reasons for quarantine; those who were self-isolating specifically due to recent travel were not found to have higher odds of suicidal ideation or deliberate self-harm. Our research suggests the importance of accounting for the reason(s) for quarantine in the implementation of this critical public health measure to reduce the mental health impacts of this experience.