Mental Health andCOVID-19: Impact on Community & Frontline Workers

By: JeavanaSritharan, BHSc, MHSc, PhD 

Throughout history,there have been major widespread influenza outbreaks that have had substantial impacts globally. It was previously predicted that another pandemic was likely, given increased air travel and globalization. Although this time, instead of influenza, it is a coronavirus –COVID-19. As the widespread pandemic of COVID-19 continues to impact Canadians, and those around the world, it is expected that the mental health impact will be tremendous. As physical distancing restrictions will remain for the foreseeable future and given that COVID-19 mayoccur in multiple waves, there will be an increase in mental health risks across communities. There are multiple factors affecting mental health that have developedthroughout this pandemic, which includesocial isolation, quarantine, physical distancing, caregiver stress, death/illness, and lack of employment.

Prior to the development of a vaccine, to reduce the spread of COVID-19, measures have been put in place which primarily involve social isolation, quarantine, and physical distancing. Social isolation and quarantine for a long period of time can lead to increased stress, anxiety, and confusion, while also having a significant emotional toll on individuals. With physical distancing continuing for months on end, there will be a lack of social interaction that is difficult for communities to comprehend.¹ A decline in shared social and milestone events – such as graduations and weddings, and other get togethers can also contribute to a mental health decline. Aside from social restrictions, there is concern with primary caregivers of young children, elderly, or the ill, who are likely to experience higher levels of stress, anxiety, and fear.¹The mental health impact will be even greater among individuals who are suspected to have or test positive for COVID-19. These individuals are likelyto experience social stigmatization in the community, while also being fearful that they may transmit the virus to loved ones. Also, individuals may be dealing with the death or illness of close family or friendswhich is especially difficult if they cannot be present to support one another.¹This is further amplifiedby the restrictions in hospital and health care settings where contact with loved ones is not permitted. Throughout these difficult situations, it is clear that there will be increased levels of fear, anxiety, worry, stress, grief and depression among individuals.¹ A recent poll by the Angus Reid Institute has shown that half of Canadians are reporting that their mental health has worsened over the time period of the pandemic.²

Lack of employment

The impact of unemployment is especially concerning for the most vulnerable workers in the community. Those employed in low paying or low skilled jobs, and non-essential work that has been shut downare likely to experience a mental health decline. Lack of employment can lead to increased financial strain, debt, and job-seeking challenges.¹ This can also decrease the overall mental health of familiesas the loss of employment not only affects the individual but their family or loved ones as well. Even as those still employed are primarily working from home, there is a lack of workplace or social interaction which can also lead to a mental health decline.

Frontline workers

At the core of the pandemic are the health care workers, specifically those who are directly involved with diagnosing, treating, and providing care for COVID-19 patients. Health care workers are expected to perform their duty at full capacity while meeting the demands of the current public health systems crisis. At the same time, they are shouldering fears of contracting the virus themselves while also putting their loved ones at risk. A recent poll in Canada found that almost half of healthcare workers involved in this crisis are reporting the need for mental health help.³It is important to remember that a mentally healthy and protected workforce is needed for managing COVID-19 affected individuals especially as the course of this pandemic is expected to be long-term. As the number of infected patients increases, there will be an increase in the number of exposed healthcare workers leading to increases in self-isolation and quarantine among these workers. As more workers are at risk of contracting COVID-19, this will in turn lead to a much larger burden on the health workforce, increasing the workload in those who are left working. With these overlapping stresses, healthcare workers are at a higher risk of a mental health decline which will be more pronounced as the pandemic slows down.

Other frontline workers are also at a higher risk of contracting COVID-19 due to their increased community interaction. Thisincludeshospital staff, home care staff, paramedics, police officers, firefighters, military, pharmacists, and grocery/retail staff. An important group of workers often overlooked are the home care workers (those employed in long term care homes, group homes, etc.). These workers have consistently felt the burden of the workload, lack of resources, and low pay for many years, which has now been exacerbated by the pandemic. Given the demands of meeting the needs of vulnerable patients and while keeping patients, themselves, and their own families safe, this in turn increases levels of stress and fear among these workers. This is associated to the heightened fear of working in an environment with potential exposure to contracting the virus, especially without appropriate protective equipment.Due to multiple outbreaks across Canada in long term care and group homes, this has led to severe staffing shortages – remember that these workers are taking care of the most vulnerable members of our community. The outbreaks in these facilities has proven to be overwhelming andan extremely tough situation for workers, patients, and their loved ones.

There are also other essential workers who cannot necessarily work from home, lack the appropriate protective equipment, or feel an overall lack of health and safety at work. It is crucial for employers to ensure that their staff is willing and able to work in safe environments, while adhering to the physical distancing recommendations. It is also imperative to understand the mental health impact to better prepare for the immense need in mental health resources across the workforce. Workers are struggling to maintain a balance between mental health and overall wellbeing as they are thrown into extremely stressful situations every day. This will not only impact workers and the services that they provide, but also their own families.

Although there are multiple mental health issues stemming from this crisis, there are also mitigating factors that can have a positive impact on mental health. Increased technology has proven to be vital during this pandemic, with increased social media interaction and video conversations. This allows individuals to remain intact with their support system and provides a sense of connectivity. There have also been increases in online mental health support groups and resources to help during this crisis. Continuous media and government messaging providein dividuals with access to up to date information and ultimately can provide a sense of unity. There is comfort in knowing that the global population is going through this pandemic together, and that no one is alone in this.

For mental health resources, please contact:

• Toronto Distress Centres: 416 408-4357 or 408-HELP
• Durham Crisis and Mental Health Line: 905 666-0483
• Oakville Distress Centre: 905 849-4541
• Kids Help Phone: 1 800 668-6868

1. Sritharan J & Sritharan A. (2020).
2. Angus Reid Institute (2020).
3. Potloc and the Canadian Public Health Association (2020).

JeavanaSritharan, PhD, has a background in occupational epidemiology, cancer biology, mental health, and community health.