Mane Kara-Yakoubian
Mane Kara-Yakoubian is a graduate student in clinical psychology at Ryerson University in Toronto. Her research focuses on judgement and decisionmaking. Mane has been published in Areo Magazine and in academic journals such as Judgement & Decision Making
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Thought: Putting Mental Health On The Back Burner

Where's Mental Health Policy When It Matters?

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Mental health matters – at least that’s what we’re told. But Canada’s pandemic response has left me doubtful that mental health matters much at all. We have a mental health crisis unfolding and it is met with platitudes like, “we just have to hang in there”, “we’re all in this together” and most popularly – “follow the science.

But science does not revolve around COVID-19. As I have written beforescience is pointing to a mental health crisis, and we don’t seem to care.

It started with a two-week lockdown to flatten the curve which seamlessly morphed into 14-months of international embarrassment for Canada. For 14 months we were reminded to “stay home, save lives” and tragically, many died doing just that. Ontario’s science table outlines reasons why this might be the case, including delayed healthcare (e.g., cancer or cardiac events going untreated), violence arising from economic and social disruption, as well as suicide, overdosing and mental health troubles triggered from social isolation. For months, we saw the data coming in, and it was warning us of something dire. 

Addiction & Overdoses

In the first six months of Ontario’s pandemic, there were 6 people dying of an overdose each day. The province witnessed a 75% increase in opioid overdoses this past year: 888 more deaths than the previous year. The majority of the victims, 1109 of 2050 people, were between the ages 25-44. By contrast, in a broader age group ranging ages 0 to 59, approximately 589 people have died of COVID-19. Ironically, despite its alarming trend, even fewer people care about Canada’s deepening opioid crisis. As of 2019, 42% of Canadians were staying informed surrounding issues pertaining to illicit drug overdoses. But as of February of 2021, only 16% of Canadians were concerned.

Thought: Putting Mental Health On The Back Burner, Mane Kara-Yakoubian
Aerial view of crowd connected by lines

Unfortunately, this trend is not unique to Canada and extends well beyond its borders. By May 2020, there was a 38% increase in synthetic opioid overdose deaths in the United States, with some states seeing numbers surge by 98%. One research team examined the effect of the shelter-in-place order in San Francisco, finding that drug overdose deaths increased by 50% within the 8.5 months before and after the mandate. These tragedies are “excess” too, but unlike the lives lost to COVID-19, not many know or talk of them.

Going Beyond Words

This is odd, given “mental health is health” is a familiar maxim to many Canadians. This message has been broadcasted for years, particularly around the time of the annual Bell Let’s Talk campaign. On this day, social media feeds across the country become populated with sentiments such as “it’s okay to not be okay” and “end the stigma” due to Bell’s commitment to donate 5 cents to mental health programs every time the #BellLetsTalk hashtag is used.

This year was no exception – but it felt cynical, sarcastic even. 

Mental health is health” falls flat when for the past year, we have largely neglected the toll of the pandemic and associated measures on psychological well-being. Wash your hands, keep your distance, wear a mask, stay home and save livesThen what? Mental health is deteriorating. Trapped at home, separated from loved ones, facing financial hardship, many are stuck reliving the same nightmare on repeat.

Since the start of the pandemic, rates of anxiety, depression, post-traumatic stress disorder, distress, and stress have increased across the globe. This trend is exacerbated among women, students, younger adults, the unemployed, and those with chronic or psychiatric illnesses. Cases of domestic violence and child maltreatment are also rising. The number of infants presenting with fractures and trauma from physical abuse has doubled in the past year. In February, Dr. Daphne Korczak, a psychiatrist for the Toronto’s Hospital for Sick Children, reported that approximately “70 percent of children experienced deterioration of their mental health” in the domains of depression, anxiety, irritability, attention span, hyperactivity, and obsessions/compulsions. The effect was worse for children with pre-existing psychiatric conditions.

While buzzwords like “resilience” were thrown around, we learned that Ontario’s children had not recovered from the first lockdown: they entered the second less resilient than before. 59% of Ontario’s parents have noted behavioural changes in their children, ranging from negative developments in mood and sleep to outbursts and extreme irritability. SickKids hospital has reported a 60% increase in eating disorders. Kids Help Phone, a 24/7 support for children, was contacted over 4 million times in 2020, over a 100% increase from the previous year. According to McMaster Children’s Hospital, admissions have doubled for suicide attempts and tripled for substance use disorders (including opioid use).

The Canadian Pediatric Society has spoken of the importance of keeping schools open on numerous occasions, and has pleaded for the reopening of schools since their closure.

But their science is not the science we seem to be following.

The Tradeoffs

All this being said, I’m no expert in viral epidemiology. Frankly, I’m not an expert in mental health, either. I’m just a first-year graduate student of clinical psychology growing increasingly troubled by the unravelling mental health crisis. Fourteen months later, Ontario has finally started making meaningful progress in its vaccination campaign with an eye toward gradually easing restrictions.

But at what cost? Citizens are depressed, anxious, angry, psychologically and physically worse off than before.

The gravity of COVID-19 does not escape me. But the emerging mental health crisis is serious too. “Mental health is health” isn’t simply a slogan: it’s a reality. In 1954, the very first Director-General of the World Health Organization (WHO) said that “without mental health there can be no true physical health.” Decades later, numerous scientific studies are supporting this very idea. Consider that depression is a predictor of coronary heart disease in previously healthy people, with depressed people being more than twice as likely to suffer a heart attack compared to the general population. Evidently, poor mental health can have severe outcomes, including a shortened life expectancy. Depression, for example, is associated with a 1.8 times greater risk of untimely death. 

Thought: Putting Mental Health On The Back Burner, Mane Kara-Yakoubian

Despite the wealth of disturbing information, we continue demonizing people for criticizing the measures – we label them selfish and careless, unworthy of healthcare should they succumb to COVID-19. We denounce them for seeking refuge in fundamentally human things. Rarely do we bother to ask what they have been sacrificing throughout the past 14 months of this ongoing nightmare.

The Canadian public is frequently reassured that our pandemic response reflects the advice of experts. But whatever science or expertise is referenced, it largely ignores human psychology, reducing mental health to something secondary and inconsequential. We have taken drastic actions to minimize the possibility of contracting the COVID-19 virus – shutting down schools, small businesses, restaurants, public transportation, even banning contact with persons outside of one’s home. But avoiding the virus is not the be-all and end-all of health.

In combatting the pandemic, we have made a complete mockery of mental health. 

Mane Kara-Yakoubian
Mane Kara-Yakoubian is a graduate student in clinical psychology at Ryerson University in Toronto. Her research focuses on judgement and decisionmaking. Mane has been published in Areo Magazine and in academic journals such as Judgement & Decision Making

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  1. It’s great to hear someone speaking up about the devastating effects of the lockdowns. It’s time to learn to live with the virus as we did with so many others.

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