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Mental Health Calls

Police, physicians report surge in mental-health matters amid COVID-19 pandemic

As the second wave of the pandemic persists in Canada, the psychological toll of the lockdown has become increasingly clear. Newly released data from police agencies, the Ontario Medical Association, mental health organizations and researchers across the country show a surge in mental health needs that experts say will linger for years.

A recent RCMP report found, out of the 2 million total occurrences between Jan. 1 and Aug. 31, more than 88,460 mental health calls were logged in the force’s tracking systems. Newly released figures also show a major drop in police recorded crime during the first eight months of the pandemic, but show an increase in calls for service.

Statistics Canada conducted a special monthly data collection from 19 police services across the country. Between March and October 2020, crime declined by 18 per cent when compared with the same period a year earlier. In contrast, the number of calls for service, including wellness checks, mental health calls and calls for domestic disturbances rose eight per cent. When compared to the same period from the previous year, police fielded 13 per cent more calls for general well-being checks and 12 per cent more requests to respond to people in emotional crisis or apprehensions under the Mental Health Act. The Toronto Police Service also reported a recorded 12 per cent increase in mental health calls throughout the pandemic.

“The mental impact of COVID-19 will claim more lives than the virus but that won’t be seen until the pandemic subsides. We need to start dealing with this now because if we wait until the pandemic ends, it’ll be too late.” – Robert Perkins

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The Numbers

Prior to 2020, there were about 4,000 recorded completed suicides in Canada each year. After the initial lockdown, many experts began voicing concern about the pandemic’s potential effects on suicide rates—particularly those who already considered suicide an ongoing national crisis. Among them were Margaret Eaton, CEO of the Canadian Mental Health Association (CMHA), and Dr. Roger McIntyre, who leads the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto. Both cited economic distress as a major determinant in declining mental health and voiced concerns about a potential increase in suicides.

“Lots of data correlates mental health with finances,” Eaton said. “Experiencing poverty or loss of work results in higher levels of mental health challenges and mental illness, which is why a lot of mental health professionals were happy when the government announced the CERB program. We think that likely saved a lot of lives.”

88,460 mental health calls were recorded by police between Jan. 1 and Aug. 31, 2020.

In March, CMHA, in tandem with the University of British Columbia, began surveying Canadians to analyze the mental health impacts of COVID-19, with a particular focus on vulnerable communities. The most recent results were released on Dec. 3.

“At the beginning of the pandemic, many thought [the virus] was ‘the great equalizer’ in regards to the physical effects, but we quickly learned that wasn’t true,” said Eaton. “Our team thought the same was likely true for mental health issues, particularly affecting vulnerable communities more intensely. So far, the research suggests we were right.”

The report found that mental health has continually declined as the pandemic persists. When the country shifted into the second wave of COVID, they found anxiety and depression among Canadians surged. Of the 3,000 people surveyed, 40 per cent said their mental health had deteriorated since March. Almost half of women (45 per cent) and a third of men (34 per cent) said their mental health has worsened. This decline was also more pronounced in those who are unemployed (61 per cent), those with a pre-existing mental health issue (61 per cent), people age 18-24 (60 per cent), Indigenous peoples (54 per cent), those identify as LGBTQ2+ (54 per cent) and those with a disability (50 per cent).

Prior to the pandemic, CMHA reported 2.5 per cent of Canadians experienced thoughts of suicide. This number has now increased to 10 per cent. Despite the discovery of a vaccine, Eaton said this is likely attributed to widespread uncertainty as to when the pandemic will end, combined with loss of connection resulting from extended stay-at-home orders.

McIntyre’s preliminary research tells a similar story. He explained that whenever there is a shock to society—particularly an event that results in mass unemployment and financial insecurity—suicide rates tend to rise drastically.

“During the 2008 Great Recession, an increase in suicide was observed in Europe, North America and Asia in correlation with mass unemployment,” he said. “So, when the World Health Organization declared COVID a pandemic, it was very concerning because never in the history of humanity has something like this happened on a global scale. We were suddenly confronted and tasked with combating a triple threat: COVID, an economic crisis and coping with the ongoing mental health crisis we already faced in this country.”

Armed with this knowledge, when life in Canada was disrupted last March and thousands lost their jobs, McIntyre and his team of researchers began studying projected suicide rates. They predicted that, for every one per cent increase in unemployment, there would be a one per cent increase in the suicide rate across the population.

17 per cent of Canadians have increased substance use as a way to cope with stressors, Statistics Canada reports.

10 per cent of Canadians have experienced suicidal thoughts since the onset of COVID-19, CMHA reports.

“It would be unexpected not to see a massive increase in suicide as result of the massive increase in depression,” McIntyre told Blue Line in December. “It’s possible that these projections won’t come to fruition, and I hope they don’t, but we need to start combatting this now.”

He was not alone in the prediction of a surge in successful suicides. Numerous politicians, public figures and researchers warned of the risks associated with increased rates of depression (the leading predictor of suicide attempts).

Some provinces have since released annual reports, which paint a more hopeful picture. Newly released data from Alberta, British Columbia and Saskatchewan suggest suicide rates actually declined in 2020. In Alberta, preliminary data compiled and released by the province in January suggests 468 deaths by suicide in 2020 but reported 600 deaths by suicide in 2016, 2017, 2018 and 2019. Saskatchewan provincial data shows a recorded 134 deaths by suicide in 2020, but have reported an average of more than 200 over the previous four years. While British Columbia had not released their full data set at the time this story went to print, the province said the number of suicide deaths between January and August appeared to decrease by about seven per cent when compared to the same time period in 2019. The chief medical examiner in Newfoundland and Labrador as well as the coroner in Quebec have also publicly said there was not an increase in the suicide rates in their provinces last year. Other data from provinces, including Ontario, was not yet released at the time of publication.

Despite reports of decreased completed suicides, various distress centres have reported increased call volumes throughout the pandemic. For example, Toronto’s Gerstein Crisis Centre—a 24-hour intervention service that has a crisis hotline, care beds and mobile health teams—saw a 70 per cent increase over the previous year (most people reporting isolation and increased distress). Similarly, Hamilton’s Crisis Outreach and Support Team crisis line said their call volume increased by an estimated 10 to 15 per cent over the past year.

Statistics Canada also found 17 percent of Canadians have increased substance use as a way to cope—20 percent have increased alcohol, nine per cent increased cannabis and seven per cent increased prescription medication. Opioid deaths have also skyrocketed throughout the pandemic by an alarming rate, though overdoses are rarely ruled as suicides.

88,460 mental health calls were recorded by police between Jan. 1 and Aug. 31, 2020

“It does not confirm this but the stats do give [medical professionals] an eerie suspicion that we are beginning to see an increase in suicide by evidence of opioid overdoses across the country,” said McIntyre. “Under the age of 50, opioids are more likely to kill people in this country than COVID.”

Policing through a Mental Health Crisis

Law enforcement are not immune to the mental health impacts of the crisis either. In fact, some experts suggest officers may be even more likely to suffer by virtue of their work. Police are generally accustomed to exposure to threats, trauma and stress, but the heightened social unrest and potential exposure to a deadly virus has created more challenges. It did, however, generate a renewed call for better mental health resources for first responders.

Some organizations partnered with CMHA or other mental health organizations to provide a safe space for police to discuss their concerns, while others have worked to provide support through peer-to-peer models. One example of the latter is CopLine, a U.S.-based service that expanded to Canada in 2018. It is a confidential 24-hour hotline answered by retired law enforcement officers, who have gone through a rigorous 45-hour training course.

“The best aspect is that our listeners have lived experience and can actually understand what the caller is feeling,” said Stephanie Samuels, founder of CopLine. “They have a wealth of knowledge about resiliency that they can impart onto others and that’s invaluable. That’s not something you can train into someone.”

Adam Kinakin is the managing director of the International Law Enforcement Training (ILET) Network, an organization that raised USD$16,000 for CopLine during the 2020 ILET Summit in July. He is advocating for a more collaborative approach to officer wellbeing.

“The law enforcement community has a history of isolating mental health programs,” he said. “We are recently seeing police agencies begin to adopt preemptive measures to train their officers in critical incident stress and cognitive load, which is accrued throughout their careers. This is an important first step but we need to start calling on all trainers, organizations and agencies to openly share best practices with one another.”

While helplines and other resources are vital, Robert L. Perkins, a former police sergeant and psychophysiologist who works with the Ontario Critical Incident Stress Foundation, highlights the need for proactive measures to mental healthcare—particularly after people begin to transition back to regular life. He claims the psychological effects of COVID will be far more detrimental than the virus.

“We were suddenly confronted and tasked with combating a triple threat: COVID, an economic crisis and coping with the ongoing mental health crisis we already faced in this country.” – Dr. Roger McIntyre

In April, he published an academic article about the likelihood of a new mental health condition he dubbed Post-COVID Traumatic Stress Syndrome (PCTSS). Within the article, he divided the population in four subgroups based on the likely trauma they would accrue as a result of the pandemic. Emergency Services Personnel is one such group.

“The lack of distress signals can give the individual a false sense of security that the body and mind are performing optimally, creating a very dangerous pattern of behaviour that may accumulate in a much more serious trauma related injury in the future,” he writes in the report. “The increase of costs, resources and time for individuals to be treated and recover will be significantly greater if interventions are not put in place at the earliest possible point in time.”

Perkins suggests police are at an increased risk of PCTSS (which would present similarly to PTSD) because of their increased exposure to stressful events, their ability to delay emotional responses when on the job and the current lack of decompression and debriefing after stressful calls.

“Everybody has a limited capacity for how much stress that they can take and, eventually, the body will start to manifest symptoms. Most police officers don’t understand that so reinforcing the normality of an emotional reaction to an abnormal set of circumstances is important,” said Perkins. “The mental impact of COVID-19 will claim more lives than the virus but that won’t be seen until the pandemic subsides. We need to start dealing with this now because if we wait until the pandemic ends, it’ll be too late.”

This sentiment is echoed by mental health organizations across the country, who insist early intervention policy measures must be introduced.

Persisting Past the Pandemic: A Call for Policy Intervention

The Ontario Medical Association (OMA) reported that mental health visits to physicians did not rise during the first four months of the pandemic, but from August to December, critical mental-health visits jumped by eight per cent and all other mental health visits increased by 12 per cent—a trend medical experts suggest will continue to persist for years. This was reinforced in a press release from OMA (which represents Ontario’s 43,000 health professionals) that said mental-health issues linked to the 1918 influenza pandemic continued for at least six years after that virus had largely subsided.

“We need to start working to prevent an increase in depression and suicide by pushing the government and various organizations to get measures in place now,” said McIntyre.

Before COVID-19, 1.6 million Canadians went untreated for mental health issues each year and, while some provinces have allocated increased funding to mental health organizations, many are calling for a policy-driven, systemic change in mental health care with a particular interest to include community-based psychologists and psychotherapists in Canada’s publicly-funded health care system.

“From a policy perspective, once the vaccines are distributed, we’re concerned the government may decide they’re done but unfortunately, we don’t have a universal mental healthcare system the way we do for physical health, so much of the population is not well served to find support for suicidal feelings, depression or anxiety,” said Eaton. “We’re really behind in terms of being able to deal with the mental health issues that existed prior to the pandemic and our concern is there hasn’t been an investment in universal mental health care to ensure people are taken care of, not just over the next six months or the next few years, but forever.”

Editor’s Note: To reach CopLine, call 1-800-267-5463.