COVID-19 Series: New Study Looks at Mental Health Needs of High-Risk Groups

In the coming weeks, we will be profiling COVID-19 work and expertise from Djavad Mowafaghian Centre for Brain Health members. In this story we profile DMCBH researchers Drs. Raymond Lam, Jill Murphy and Erin Michalak, who received a CIHR grant to assess the mental health needs of high-risk groups in the context of COVID-19, and determine how to provide digital mental health care to these groups. Photo: APEC Digital Mental Health Members at a Roundtable in Singapore last year.

A team of DMCBH researchers has launched a project to assess the mental health needs of high-risk groups in the context of COVID-19, as a way to identify how best to provide digital mental health care to these groups.

The study is supported by a CIHR grant and is being led by Drs. Raymond Lam, Jill Murphy and Erin Michalak. The trio are members of the Executive of the Asia-Pacific Economic Corporation (APEC) Hub for Digital Mental Health, which is made up of 21 countries around the world. During a conference call in the early days of the pandemic, several APEC members pointed out that despite existing mental health initiatives in many countries, there were still a lot of gaps when it came to providing care to certain at-risk groups.

“There has been a shift, not only in Canada but across the world, to using digital technology to provide all sorts of health care and especially mental health care since the COVID-19 pandemic,” says Dr. Jill Murphy, Research Associate in the Mood Disorders Centre and Strategic Initiatives Director for the APEC Digital Hub for Mental Health. “But we worry that certain at-risk groups will be excluded from this. When the call for the CIHR grant came out, it seemed like the perfect opportunity to look at these issues.”

The first step of the project will be determining the mental health needs of these groups across the APEC region. Nine countries are represented in the project—Canada, Chile, China, Australia, Malaysia, South Korea, Japan, the USA and Vietnam—but data collected will be sent to team members across all 21 countries for review and input, in order to get an accurate and complete picture.

To identify needs, the team will be conducting a rapid literature review and consulting with as many groups as possible. They plan to target policy makers, heath care providers and people with lived experience, the latter of which will likely be identified through community organizations and patient groups. Dr. Murphy says the team has an idea of some groups who are at risk—including seniors, youth, people experiencing homelessness and those experiencing domestic violence—but that others will likely emerge as the study progresses.

“There will be different priorities based on which country we’re looking at, and while the challenges these groups face will probably be similar, the solutions will likely be different depending on the country,” says Dr. Murphy.

The second part of the project will be developing recommendations on how to deliver mental health services via digital technology based on the needs of the identified at-risk groups. The team is hopeful that in the future, these recommendations will be implemented in communities around the world.

Over the past several months many countries have adapted to digital health services, as the pandemic made it nearly impossible to schedule face-to-face appointments. There has also been a rise in the need for mental health services—in one survey, 50 per cent of Canadians reported a worsening in their mental health since COVID-19 struck and forced people into self-isolation.

Dr. Murphy expects the pandemic to result in long-term mental health impacts and believes that permanently shifting towards digital services could help alleviate some of the burden on the system.

“We know that digital health offers a lot of benefits in terms of improving access, for example for people living in rural or remote areas,” she says. “But at the same time, it can exclude people who are at higher risk, such as seniors who may not have as much digital literacy or people who don’t have access to smartphones. While we’re seeing these services expand which we think is a good thing, we want to make sure that we don’t exclude people who are most at risk.”