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Background: The increased need for mental health and substance use health (MHSUH) services during the COVID-19 pandemic underscores the need to better understand workforce capacity. This study aimed to examine the pandemic's impact on the capacity of MHSUH service providers and to understand reasons contributing to changes in availability or ability to provide services. Methods: We conducted a mixed method study including a pan-Canadian survey of 2177 providers of MHSUH services and semi-structured interviews with 13 key informants. Survey participants answered questions about how the pandemic had changed their capacity to provide services, reasons for changes in capacity, and how their practice had during the pandemic. Thematic analysis of key informant interviews was conducted to gain a deeper understanding of the impact of the pandemic on the MHSUH workforce. Results: Analyses of the survey data indicated that the pandemic has had diverse effects on the capacity of MHSUH workers to provide services: 43% indicated decreased, 24% indicated no change, and 33% indicated increased capacity. Logistic regression analyses showed that privately funded participants had 3.2 times greater odds of increased capacity (B = 1.17, p < 0.001), and participants receiving funding from a mix of public and private sources had 2.4 times greater odds of increased capacity (B = 0.88, p < 0.001) compared to publicly funded participants. Top reasons for decreases included lockdown measures and clients lacking access or comfort with virtual care. Top reasons for increases included using virtual care and more people having problems relevant to the participant's skills. Three themes were constructed from thematic analysis of key informant interviews: the differential impact of public health measures, long-term effects of pandemic work conditions, and critical gaps in MHSUH workforce data. Conclusions: The COVID-19 pandemic has had a substantial impact on the capacity of the MHSUH workforce to provide services. Findings indicate the importance of increasing and harmonizing funding for MHSUH services across the public and private sectors, developing standardized datasets describing the MHSUH workforce, and prioritizing equity across the spectrum of MHSUH services. [ABSTRACT FROM AUTHOR]

Background: Timely knowledge mobilization has become increasingly critical during the COVID-19 pandemic and complicated by the need to establish or maintain lines of communication between researchers and decision-makers virtually. Our recent pan-Canadian research study on the mental health and substance use health (MHSUH) workforce during the pandemic identified key policy barriers impacting this essential workforce. To bridge the evidence–policy gap in addressing these barriers, we held a facilitated virtual policy dialogue. This paper discusses the insights generated at this virtual policy dialogue and highlights how this integrated knowledge mobilization strategy can help drive evidence-based policy in an increasingly digital world. Methods: We held a 3-hour virtual policy dialogue with 46 stakeholders and policy decision-makers as the final phase in our year-long mixed-methods research study. The event was part of our integrated knowledge mobilization strategy and was designed to generate stakeholder-driven policy implications and priority actions based on our research findings. The data collected from the virtual policy dialogue included transcripts from the small-group breakout rooms and main sessions, reflective field notes and the final report from the external facilitator. Coded data were thematically analysed to inform our understanding of the prioritization of the policy implications and action items. Results: Facilitated virtual policy dialogues generate rich qualitative insights that guide community-informed knowledge mobilization strategies and promote evidence-informed policy. Our policy dialogue identified actionable policy recommendations with equity as a cross-cutting theme. Adapting policy dialogues to virtual formats and including technology-assisted facilitation can offer advantages for equitable stakeholder participation, allow for deeper analysis and help build consensus regarding evidence-based policy priorities. Conclusions: Our facilitated virtual policy dialogue was a key knowledge mobilization strategy for our research on the capacity of the Canadian MHSUH workforce to respond to the COVID-19 pandemic. Our policy dialogue allowed us to engage a diverse group of MHSUH workforce stakeholders in a meaningful action-oriented way, provided an avenue to get feedback on our research findings, and generated prioritized action items that incorporated the knowledge and experience of these MHSUH workforce stakeholders. [ABSTRACT FROM AUTHOR]

Recovery is a key concept driving system transformation in both the addiction and mental health sectors, with shared roots in advocacy and a shared focus on hope in the face of stigma, self-determination and meaningful lives. Nevertheless, while mental health recovery is possible even with on-going symptoms, addiction recovery generally starts with or leads to abstinence. This disconnection undermines coherence at the policy level and exacerbates fragmentation between services and supports in the mental health and addiction sectors in Canada and internationally. At the same time, harm reduction, which does not require abstinence, has been gaining ground in the Canadian addiction sector. This qualitative policy study explores the potential for harm reduction to bridge the gap between mental health recovery and addiction recovery in the Canadian context, drawing on diverse experiences from the mental health and addiction sectors. The findings could be adapted internationally to address similar policy challenges. [ABSTRACT FROM AUTHOR]

Both workplace mental health and gender equity issues are in the spotlight in Canada as they are internationally. Accordingly, it is timely for Employee Assistance Programs (EAPs) to systematically consider sex, gender, and intersecting identities. Four cross-cutting priorities emerged from a focused analysis of the literature: (1) targeted outreach to men and other priority populations, (2) enhanced gender and diversity training for EAP counselors, (3) digital EAP services to meet preferences beyond face-to-face counseling, and (4) performance and quality improvement of both the EAP process and outcomes. The implications of these are considered using a Canadian case example. [ABSTRACT FROM AUTHOR]

Objective: Provincial and territorial governments are considering how best to improve access to psychotherapy from the current patchwork of programmes. To achieve the best value for money, new funding needs to reach a wider population rather than simply replacing services funded through insurance benefits. We considered lessons for Canada from the relative uptake of private insurance and public funding for allied health psychotherapy in Australia.Method: We analysed published administrative claims data from 2003-2004 to 2014-2015 on Australian privately insured psychologist services, publicly insured psychotherapy under the 'Better Access' initiative, and public grant funding for psychotherapy through the 'Access to Allied Psychological Services' programme. Utilisation was compared to the prevalence of mental disorders and treatment rates in the 2007 National Survey of Mental Health and Wellbeing.Results: The introduction of public funding for psychotherapy led to a 52.1% reduction in private insurance claims. Costs per session were more than double under private insurance and likely contributed to individuals with private coverage choosing to instead access public programmes. However, despite substantial community unmet need, we estimate just 0.4% of the population made private insurance claims in the 2006-2007 period. By contrast, from its introduction, growth in the utilisation of Better Access quickly dwarfed other programmes and led to significantly increased community access to treatment.Conclusions: Although insurance in Canada is sponsored by employers, psychology claims also appear surprisingly low, and unmet need similarly high. Careful consideration will be needed in designing publicly funded psychotherapy programmes to prepare for the high demand while minimizing reductions in private insurance claims. [ABSTRACT FROM AUTHOR]

The article examines the reason for a need for targeted federal funding for mental health services in Canada. Topics discussed include amount that will be transferred to provincial and territorial governments over the next 10 years as part of the 2017/2018 Canadian federal budget, major investments made by Great Britain and Australia to improve access to mental health services, and actions needed to ensure a good return on the federal government's investment on mental health services.

Background: Mental health research in Canada is not only underfunded but there remains an inequitable distribution of funding to address unmet needs especially in clinical and applied research. In 2018, the legalization of cannabis for non-medical use in Canada sparked the need to examine the relationship between cannabis use and mental health. The federal government allocated $10 M over 5 years to the Mental Health Commission of Canada (MHCC), a pan-Canadian health organization funded at arm's length by the federal government. Methods: In 2020, the MHCC implemented an innovative community-based research (CBR) program to investigate this relationship among priority populations including people who use cannabis and live with mental illness, First Nations, Inuit and Métis, two-spirit, lesbian, gay, bisexual, trans and/or queer (2SLGBTQ+) individuals, and racialized populations. Extensive consultations, a scoping review and an environmental scan set the research agenda. Key program components included a review committee with representation from diverse priority populations, extensive proposal-writing support for applicants, and capacity bridging workshops for the 14 funded projects. Results: Of the 14 funded research projects, 6 focus on and are led by Indigenous communities, 5 focus on other equity-seeking populations, and 9 explore the perceived patterns, influence and effects of use including benefits and harms. Lessons learned include the importance of a health equity lens and diverse sources of knowledge setting the CBR research agenda. In addition to capacity bridging that promote equitable roles among knowledge co-producers as well as the critical role of organizational support in increasing research productivity, especially in the area of mental health and cannabis use where there is a need for more applied research. Conclusion: Centering equity and lived and living experience strengthened the rationale for investments and ensured user-led evidence generation and utilization – a key public health gain. Organizational support for proposal development and capacity bridging yields significant value that can be replicated in future CBR initiatives. [ABSTRACT FROM AUTHOR]

Background: The impact of the COVID-19 pandemic on young people with eating disorders (EDs) and their families was profound, with surging rates of hospitalizations and referrals reported internationally. This paper provides an account of the additional health and social costs of ED care for young people living in Canada incurred during the COVID-19 pandemic, drawing attention to the available data to inform these estimates while noting gaps in data capacities to account for a full view of the ED system of care. Methods: Three methodologies were used to capture costs: (1) provincial administrative data holdings available at the Canadian Institute of Health Information (CIHI) were used by Deloitte Access Economics to conduct analyses on costs related to hospitalizations, emergency room visits, outpatient visits with physicians and loss of well-being from being on a waitlist. These were examined across three fiscal years (April 1 to March 31, 2019–2022) to compare costs from one year before to two years after the onset of the pandemic, (2) data collected on support-based community ED organizations and, (3) costs identified by young people, caregivers and health care professionals. Results: Estimates of additional health care costs and social costs arising from ED care waitlists were estimated to have increased by 21% across the two years after the onset of the pandemic and is likely to represent an underestimate of costs. Costs related to some standard ED care services (e.g. day treatment programs) and support-based community ED organizations that saw a 118% increase in services during this time, are some examples of costs not captured in the current cost estimate. Conclusions: This paper provides a first account of the additional health and social ED care costs associated with the pandemic, which indicate at minimum, a 21% increase. The results invite discussion for more investments in ED services for young people in Canada, as it is unclear if needs are expected to remain elevated. We suggest a call for a national surveillance strategy to improve data holdings to aid in managing services and informing policy. A robust strategy could open the door for much-needed, data-informed, system transformation efforts that can improve ED care for youth, families and clinicians. [ABSTRACT FROM AUTHOR]

The field of psychedelics is in an important era, with a significant focus on the potential role of psychedelic compounds in the treatment of mental health and substance use disorders. In 2022, a scientific research conference was held in Toronto to bring together stakeholders from a variety of disciplines and to promote dialogue and collaboration. This Special Issue includes 8 papers based on presentations from the conference, which showcase the breadth of topics that were brought forward. Included are both quantitative and qualitative works, as well as two letters to the editors which further advance these important conversations. These articles not only present the current state of research into psychedelics, but also present viewpoints about their impacts on underrepresented communities, the need to recognize the history of these compounds that extends beyond this new Western "renaissance," and the complexities of integrating psychedelics into mainstream medicine. This Special Issue serves as both an exploration of a much-discussed topic and a reminder that collaboration can advance the field in order to harness its potential impact. [ABSTRACT FROM AUTHOR]

Background: Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. Aims: Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place. Methods: The sample included participants (n = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) who responded to the CanPath COVID-19 health surveys (May–December 2020 and January–June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety (n = 2,237). Results: In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care. Conclusions: Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care. [ABSTRACT FROM AUTHOR]

The majority of people who contract COVID-19 experience a short period of symptomatic infection. However, symptoms persist for months or years following initial exposure to the virus in some cases. This has been described as long COVID. Little is known about the lived experience of this condition, as it has only recently emerged. This study aimed to explore the experiences of mental health, quality of life, and coping among people living with long COVID. A sample of 47 adults with lived experience participated in web-based focus groups. Separate focus groups were held for 24 individuals with pre-existing mental health conditions and 23 individuals without pre-existing mental health conditions. Data were analyzed using a codebook thematic analysis approach. Five themes were identified as integral to the long COVID experience: The Emotional Landscape of Long COVID, New Limits to Daily Functioning, Grief and Loss of Former Identity, Long COVID-related Stigmatization, and Learning to Cope with Persisting Symptoms. These findings illustrate the immense impact of long COVID on mental health and quality of life. Minimal differences were found between those with and those without pre-existing mental health conditions, as both groups were substantially impacted by the condition. Attention to the perspectives of people with lived experience of long COVID is necessary to inform future directions for research and clinical practice. [ABSTRACT FROM AUTHOR]

Background: Generally, pandemics such as COVID-19 take an enormous toll on people's lives. As the pandemic now turns to an endemic state, growing attention has been paid to the multiple adverse mental health and behavioral issues, such as suicidal ideation and substance use. However, the interplay of suicidality and substance misuse during the pandemic has been limited. We aimed to investigate the prevalence of co-occurrence of suicide ideation, alcohol and cannabis misuse, and the factors that are associated with these co-occurrences in the province of Saskatchewan during the COVID-19 pandemic. Methods: We performed a multivariable trivariate probit regression on a sample of 666 Saskatchewan adolescents and adults (16 years or older), drawn from the cycle 10 data collection (March 2022) of the Mental Health Commission of Canada, and Canadian Centre on Substance Use and Addiction (MHCC-CCSA) dataset. Results: The prevalence of suicidal ideation was higher among respondents who reported both problematic cannabis and alcohol use (25.8%) than single users of alcohol (23.2%) and cannabis (18.7%). Younger respondents (16–34 years) and those who reported recent changes in other substance use were independent factors that were associated with the common experience of suicide ideation, problematic cannabis, and alcohol use. Having a diagnosis of mental health disorders either before or during the pandemic, and the perceived inability to bounce back after the pandemic (low resilience) are strong correlates of suicidal ideation. Those who lived alone, between 35 and 55 years of age were more likely to report problematic alcohol use. Those who reported changes in alternative activities, who reported pandemic stress, and declared a LGBTQIA2S + identity had higher probability of problematic cannabis use. Conclusions: As the pandemic persists, improving access to suicide and substance use interventions for the vulnerable groups identified in this study may be impactful. [ABSTRACT FROM AUTHOR]

Objectives: Using Andersen's model of health care seeking behavior, we examined the predisposing, enabling, and need factors associated with mental health service use (MHSU) during the first wave of the COVID-19 pandemic across Canada. Methods: The sample included n = 45,542 participants in the 5 established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) and who responded to the CanPath COVID-19 health survey (May-December 2020), with complete data on MHSU. Multivariable logistic regression analyses were carried out to study MHSU as a function of predisposing, enabling, and need factors. Analyses were stratified by regional cohort. Results: Among the need factors, individuals reporting moderate/severe symptoms of depression and anxiety and poorer self-rated mental health were more likely to report MHSU. Among the enabling factors, receipt of informational/financial/practical support was associated with increased MHSU. While income was not consistently associated with MHSU, reported decrease in income was marginally associated with reduced MHSU. Among the predisposing factors, identifying as female or other gender minority was associated with increased MHSU, as was the presence of past-year cannabis use. In contrast, older age and alcohol consumption were associated with reduced MHSU. Conclusion: Need factors were consistently associated with MHSU. Although income inequities in MHSU were not observed, changes such as reduced income during the pandemic may lead to barriers in accessing mental health services. Future research should focus on better identifying contextual enabling factors and policies that overcome financial barriers to MHSU. [ABSTRACT FROM AUTHOR]

Citizen engagement through deliberative dialogue is increasingly being used to address ‘wicked problems’ in policy-making, such as the development of national mental health policy. In 2012, the Mental Health Commission of Canada (MHCC), a national organization funded by and operating at arm's length from the federal government, released the first Mental Health Strategy for Canada: Changing Directions, Changing Lives (Mental Health Commission of Canada, 2012). Despite much-needed reform, Canada, unlike most other industrialized countries, had never previously developed a national Mental Health Strategy (the Strategy). This was due to a mix of policy factors, including a federalist system of government where primary responsibility for healthcare resides with provincial and territorial governments and a highly diverse set of stakeholder groups with diverging core ideas for mental health reform that were rooted in deeply held value differences. In this case study, we review the essential role that engagement of civil society played in the creation of the Strategy, beginning with the efforts to create a national body to shine the light on the need for mental health reform in Canada, followed by the development of a framework of specific goals based on core principles to guide the development of the Strategy, and ultimately, the creation of the Strategy itself. We discuss the various approaches to civil society engagement in each step of this process and focus in particular on how deliberative approaches helped build trust and common ground amongst stakeholders around complex, and often contentious, issues. The nature and outcomes of the deliberative processes including the key tensions between different stakeholder perspectives and values are described. We close by highlighting the lessons learned in a process that culminated with a Strategy that received strong endorsement from stakeholders across Canada. Mental Health Commission of Canada (2012). Changing Directions Changing Lives, The Mental Health Strategy for Canada. Calgary, AB: MHCC. [ABSTRACT FROM AUTHOR]

No abstract available for this article. [ABSTRACT FROM PUBLISHER]