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

A Phenomenological Account of Women Graduate Students: Lived Experience of Challenges in Global Public Health Practice

During the last two decades academic global public health grew dramatically, including higher student demand to participate in internationally-based fieldwork. As a foundational space for graduate level training, practice, and research activities, the university plays a primary and significant role in the formation and future practice of students. While academic research and practice opportunities within international settings may provide unique experiences for U.S. and Canadian graduate students, it remains an overlooked area of inquiry. At times, these experiences can be intensely challenging or distressing, with additional burdens experienced by women. This study aims to gain insight into the lived experience of Canadian and U.S. women graduate students participating in global public health practice, and how they experience this phenomenon. This study is situated within Max van Manen’s qualitative methodology, phenomenology of practice. This hermeneutic approach is aimed at meaning-making through emotional, embodied, existential, and pathic ways of knowing. Seven women participated in 18 in-depth phenomenological interviews, while 18 women completed a guided writing exercise. Data creation methods were designed to capture lived experience descriptions of global public health practice. Key themes discussed in this dissertation include sexual and gender-based violence and harassment, discomfort with privilege, mental health challenges (specifically depression), and not being heard. Further findings focused on the burden of hidden labor performed by women to keep themselves safe from sexual and gender-based violence, including discussion on travel safety and transportation, witnessing or experiencing violence, lack of preparedness or follow-up, financial burdens and stress, and support networks and peer relationships as protective. The experience of participating in global public health practice is of particular consequence to the training, education, and future practice of graduate students. This study holds the potential to positively affect an individual’s experience, and thus practice, through offering new meaning structures, language for an unfamiliar experience, or ways to describe, conceive of, and respond to global public health fieldwork. Furthermore, by dedicating space to this phenomenon and giving voice to women graduate students’ lived experience, public health institutions may be better able to recognize, validate, respond to, and support students participating in global public health practice.Ph.D

Food-related worry and food bank use during the COVID-19 pandemic in Canada: results from a nationally representative multi-round study

Abstract Background Early in the COVID-19 pandemic, nearly one in five adults in Canada worried about having enough food to meet their household’s needs. Relatedly, throughout the pandemic, public messaging repeatedly urged Canadians to support food charities, including food banks. Yet few studies have examined food bank usage during the pandemic or whether food charities were widely used by Canadians worried about food access. Methods This study draws on four rounds of nationally representative surveying conducted during the COVID-19 pandemic between May 2020 and December 2021 among adults 18 years and older living in Canada. Descriptive statistics were used to examine rates of food-related worry during all four survey rounds. Data from the fourth survey round, collected in December 2021, were used to explore use of food-based community programs since the onset of the pandemic, including food banks. Logistic regression analyses were used to examine differences in socio-demographic and health-related characteristics between adults who did and did not report accessing food banks before and after adjusting for household income. Results Across survey rounds (n = 12,091), more than one in seven participants reported stress or worry related to having enough food to meet their household’s basic needs in the previous two weeks. Yet, by December 2021, fewer than 4% of participants reported ever accessing a food bank during the pandemic. Younger age, living with a child, financial concerns due to the pandemic, two different measures of food worry, pre-existing mental health conditions, disability, LGBT2Q + identity, and racialized or Indigenous identity, were each statistically significantly associated with higher odds of using food banks even when controlling for household income. Conclusions Despite persistently high rates of food-related worry in 2020 and 2021 in Canada, relatively few adults reported accessing food banks or other charity-based community food programs. While respondents facing social, financial, and health-related inequities and reporting food worry were more likely to use food banks, most respondents did not report food bank use, regardless of financial or demographic circumstances or experiences of food worry. Findings align with previous research indicating that more adequate and comprehensive supports are needed to alleviate food-related-worry in Canada

Anchoring to life: A photovoice study of resiliencies among sexual and gender minority women post-suicide attempt

Lesbian, bisexual, trans, queer, and other sexual and gender minority (SGM) women are at high risk of suicide. Stigma, discrimination, and exclusion are known risk factors. Contrasting longstanding trends of risk-focused research, this study examines the experiences of SGM women who have attempted suicide focusing on their embodied strengths and resiliencies to continue living post-attempt. Qualitative data from Photovoice methods and in-depth interviews with 11 Canadian-based women who survived a suicide attempt were collected in 2017. Analysis involved an inductive, reflexive thematic approach informed by the minority strengths model. The analysis generated three interconnected themes: 1) reconciling identities and traumas, 2) anchoring to life, and 3) staying afloat: blending professional- and self-help. First, participants described the importance of reconciling past traumas and coming to terms with – and embracing – their SGM identities to live well post-attempt. Second, participants emphasized the potential for community supports to facilitate connectedness, belonging, and a sense of purpose following a suicide attempt. Importantly, this “anchoring” to community also provided a key outlet through which SGM women could process and mitigate experiences of mental health hardship, thereby directly buffering against suicidality. Third, participants underscored that staying afloat post-attempt was a journey requiring persistent and proactive efforts, including use of effective self-management strategies and professional mental-health services. Taken together, these findings offer important insights into the strengths and resiliencies of SGM women who have attempted suicide to guide the efforts of mental health practitioners and the design and evaluation of tailored suicide prevention programs

Reddit Users’ Experiences of Suicidal Thoughts During the COVID-19 Pandemic : A Qualitative Analysis of r/Covid19_support Posts

Background: The COVID-19 pandemic is having considerable impacts on population-level mental health, with research illustrating an increased prevalence in suicidal thoughts due to pandemic stressors. While the drivers of suicidal thoughts amid the pandemic are poorly understood, qualitative research holds great potential for expanding upon projections from pre-pandemic work and nuancing emerging epidemiological data. Despite calls for qualitative inquiry, there is a paucity of qualitative research examining experiences of suicidality related to COVID-19. The use of publicly available data from social media offers timely and pertinent information into ongoing pandemic-related mental health, including individual experiences of suicidal thoughts. Objective: To examine how Reddit users within the r/COVID19_support community describe their experiences of suicidal thoughts amid the COVID-19 pandemic. Methods: This study draws on online posts from within r/COVID19_support that describe users’ suicidal thoughts during and related to the COVID-19 pandemic. Data were collected from creation of this subreddit on February 12, 2020 until December 31, 2020. A qualitative thematic analysis was conducted to generate themes reflecting users’ experiences of suicidal thoughts. Results: A total of 83 posts from 57 users were included in the analysis. Posts described a range of users’ lived and living experiences of suicidal thoughts related to the pandemic, including deterioration in mental health and complex emotions associated with suicidal thinking. Reddit users situated their experiences of suicidal thoughts within various pandemic stressors: social isolation, employment and finances, virus exposure and COVID-19 illness, uncertain timeline of the pandemic, news and social media, pre-existing mental health conditions, and lack of access to mental health resources. Some users described individual coping strategies and supports used in attempt to manage suicidal thoughts, however these were recognized as insufficient for addressing the multilevel stressors of the pandemic. Conclusions: Multiple and intersecting stressors have contributed to individuals’ experiences of suicidal thoughts amid the COVID-19 pandemic, requiring thoughtful and complex public health responses. While ongoing challenges exist with self-disclosure of mental health challenges on social media, Reddit and other online platforms may offer a space for users to share suicidal thoughts and discuss potential coping strategies.Applied Science, Faculty ofOther UBCNursing, School ofReviewedFacultyResearcherPostdoctoralGraduat

Examining the impacts of the COVID-19 pandemic on family mental health in Canada : findings from a national cross-sectional study

Objectives In the first wave of the COVID-19 pandemic, social isolation, school/child care closures and employment instability have created unprecedented conditions for families raising children at home. This study describes the mental health impacts of the COVID-19 pandemic on families with children in Canada. Design, setting and participants This descriptive study used a nationally representative, cross-sectional survey of adults living in Canada (n=3000) to examine the mental health impacts of the COVID-19 pandemic. Outcomes among parents with children <18 years old living at home (n=618) were compared with the rest of the sample. Data were collected via an online survey between 14 May to 29 May 2020. Outcome measures Participants reported on changes to their mental health since the onset of the pandemic and sources of stress, emotional responses, substance use patterns and suicidality/self-harm. Additionally, parents identified changes in their interactions with their children, impacts on their children’s mental health and sources of support accessed. Results 44.3% of parents with children <18 years living at home reported worse mental health as a result of the COVID-19 pandemic compared with 35.6% of respondents without children <18 living at home, χ2 (1, n=3000)=16.2, p<0.001. More parents compared with the rest of the sample reported increased alcohol consumption (27.7% vs 16.1%, χ2 (1, n=3000)=43.8, p<0.001), suicidal thoughts/ feelings (8.3% vs 5.2%, χ2 (1, n=3000)=8.0, p=0.005) and stress about being safe from physical/emotional domestic violence (11.5% vs 7.9%, χ2 (1, n=3000)=8.1, p=0.005). 24.8% (95% CI 21.4 to 28.4) of parents reported their children’s mental health had worsened since the pandemic. Parents also reported more frequent negative as well as positive interactions with their children due to the pandemic (eg, more conflicts, 22.2% (95% CI 19.0 to 25.7); increased feelings of closeness, 49.7% (95% CI 45.7 to 53.7)). Conclusions This study identifies that families with children <18 at home have experienced deteriorated mental health due to the pandemic. Population-level responses are required to adequately respond to families’ diverse needs and mitigate the potential for widening health and social inequities for parents and children.Applied Science, Faculty ofMedicine, Faculty ofNursing, School ofPopulation and Public Health (SPPH), School ofReviewedFacultyResearcherPostdoctora

Impacts of the COVID-19 Pandemic on Family Mental Health in Canada: Findings from a Multi-Round Cross-Sectional Study

Pandemic-related disruptions, including school, child care, and workplace closures, financial stressors, and relationship challenges, present unique risks to families’ mental health. We examined the mental health impacts of the coronavirus disease 2019 (COVID-19) pandemic among parents with children &lt;18 years old living at home over three study rounds in May 2020 (n = 618), September 2020 (n = 804), and January 2021 (n = 602). Data were collected using a cross-sectional online survey of adults living in Canada, nationally representative by age, gender, household income, and region. Chi-square tests and logistic regression compared outcomes between parents and the rest of the sample, among parent subgroups, and over time. Parents reported worsened mental health compared with before the pandemic, as well as not coping well, increased alcohol use, increased suicidal thoughts/feelings, worsened mental health among their children, and increases in both negative and positive parent–child interactions. Mental health challenges were more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial/relationship stressors. Increased alcohol use was more frequently reported among younger parents and men. Sustained mental health challenges of parents throughout nearly a year of the pandemic suggest that intervention efforts to support family mental health may not be adequately meeting families’ needs. Addressing family stressors through financial benefit programs and virtual mental health supports should be further explored

Impacts of the COVID-19 Pandemic on Family Mental Health in Canada: Findings from a Multi-Round Cross-Sectional Study

Pandemic-related disruptions, including school, child care, and workplace closures, financial stressors, and relationship challenges, present unique risks to families’ mental health. We examined the mental health impacts of the coronavirus disease 2019 (COVID-19) pandemic among parents with children <18 years old living at home over three study rounds in May 2020 (n = 618), September 2020 (n = 804), and January 2021 (n = 602). Data were collected using a cross-sectional online survey of adults living in Canada, nationally representative by age, gender, household income, and region. Chi-square tests and logistic regression compared outcomes between parents and the rest of the sample, among parent subgroups, and over time. Parents reported worsened mental health compared with before the pandemic, as well as not coping well, increased alcohol use, increased suicidal thoughts/feelings, worsened mental health among their children, and increases in both negative and positive parent–child interactions. Mental health challenges were more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial/relationship stressors. Increased alcohol use was more frequently reported among younger parents and men. Sustained mental health challenges of parents throughout nearly a year of the pandemic suggest that intervention efforts to support family mental health may not be adequately meeting families’ needs. Addressing family stressors through financial benefit programs and virtual mental health supports should be further explored.Applied Science, Faculty ofMedicine, Faculty ofNursing, School ofPopulation and Public Health (SPPH), School ofReviewedFacultyResearche

A portrait of the early and differential mental health impacts of the COVID-19 pandemic in Canada: Findings from the first wave of a nationally representative cross-sectional survey.

Evidence on the population-level mental health impacts of COVID-19 are beginning to amass; however, to date, there are significant gaps in our understandings of whose mental health is most impacted, how the pandemic is contributing to widening mental health inequities, and the coping strategies being used to sustain mental health. The first wave of a repeated cross-sectional monitoring survey was conducted between May 14-29, 2020 to assess the mental health impacts of the pandemic and to identify the disproportionate impacts on populations or groups identified as experiencing increased risks due to structural vulnerability and pre-existing health and social inequities. Respondents included a nationally representative probability sample (n = 3000) of Canadian adults 18 years and older. Overall, Canadian populations are experiencing a deterioration in mental health and coping due to the pandemic. Those who experience health, social, and/or structural vulnerabilities due to pre-existing mental health conditions, disability, income, ethnicity, sexuality, and/or gender are more likely to endorse mental health deterioration, challenging emotions, and difficulties coping. This monitoring study highlights the differential mental health impacts of the pandemic for those who experience health, social, and structural inequities. These data are critical to informing responsive, equity-oriented public health, and policy responses in real-time to protect and promote the mental health of those most at risk during the pandemic and beyond