‘Multiple wheels are falling off the train’: Canadians are struggling with mental-health costs of COVID-19

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For Margaret Eaton, warning bells have been ringing since May. That’s when the Canadian Mental Health Association (CMHA) conducted a poll of Ontarians, which revealed 70 per cent of those surveyed felt that a serious mental-health crisis was looming.

More recently, the CMHA learned that the pandemic is continuing to cause pronounced mental-health concerns, including suicidal thoughts and feelings, in many segments of the population. But can people afford the help they desperately need?

“People are showing more distress and seeking mental-health supports that they’re having to pay for,” says Ms. Eaton, the national chief executive of the CMHA in Toronto. Canadians spend almost $1-billion on counselling services each year – 30 per cent of it out of pocket, with the rest covered by private and public plans, according to the CMHA.

She says that even prior to the pandemic, Canadians were already struggling to pay. “We estimate that 1.6 million Canadians report unmet mental health needs per year,” she says.

And she worries about the cold months ahead. “This winter will be particularly challenging,” Ms. Eaton says.

While the pandemic has led to feelings of sadness and isolation among Canadians, those with mental-health issues prior to the pandemic are in a darker place. Many are wrestling with the high costs of treating mental illness, made worse by layoffs and economic instability. They’re experiencing conditions such as anxiety and depression, paying thousands of dollars for therapy for themselves or family members.

Rona Birenbaum, a financial planner and founder of Caring for Clients in Toronto, says she’s seeing many clients who have lost their jobs. Not only are their retirement savings in jeopardy – their mental health is on the line. “What we’re seeing is that multiple wheels are falling off the train."

Parents of teens or young adults struggling with mental-health issues, in particular, are depleting their emergency funds to pay for psychotherapy sessions that cost thousands of dollars annually. “Some are dipping into these savings,” she says. “But if anything qualifies as an emergency, it’s a mental-health issue."

Ms. Birenbaum says therapy is a long-term game and people should prepare by adjusting their spending in other areas. She advises if they do take on debt, they need to have a repayment plan in place.

And no one is immune to these types of mental health-driven financial setbacks. Among those at highest risk are people with pre-existing mental conditions before COVID-19, says Ms. Eaton, as are parents with kids under 18. Of the latter group, 45 per cent said their mental health declined, according to its spring poll.

If an outbreak of severe acute respiratory syndrome earlier this century is any indication, more mental-health issues will surface over time. One 2007 study found 64 per cent of SARS survivors had symptoms of depression, anxiety and post-traumatic stress one year later. With COVID-19, “[People] are going to need grief counselling, counselling, cognitive behavioural therapy – all these things are not funded under provincial plans,” Ms. Eaton says.

As Canada only covers psychiatry – not counselling with a psychologist or psychotherapist – many Canadians pay for therapy with employer coverage, which ranges from several hundred dollars annually to several thousand. Many find their benefits plans only cover three to four sessions before they run out.

For those without employer-sponsored benefits, therapy fees in Canada range from $50 to $240 a session, plus HST, according to Informed Choices about Depression. And waiting times for psychiatrists can be anywhere from a few months to a year, which is too long for many, Ms. Eaton says. They can’t afford to let a mental-health issue keep them from holding down a job or managing a household.

For people on disability, it’s even more challenging to fund treatment. The Centre for Addiction and Mental Health recently called out the governments of Ontario, Alberta and Manitoba for treating the Canada Emergency Response Benefit as earned income for people with serious mental illnesses and other disabilities who receive benefits through the Ontario Disability Support Program. “That means the government is clawing back $900 of each $2,000 monthly benefit,” it said in a recent policy paper.

To cope, many people struggling with mental health are heading to doctors' offices, says Chuck Bruce, board chair of the Mental Health Commission of Canada in St. John’s. There, general practitioners, well aware of the long waiting lists and costs of counselling, prescribe antidepressants or anti-anxiety aids in the interim.

A Deloitte report from August projects a 20-per-cent increase in antidepressant prescriptions and a twofold increase in visits to mental-health professionals, based on its analysis of the impact of the wildfires in Fort McMurray, Alta. It predicts that 5.9 million to 9.7 million Canadians may need to visit a mental-health professional during the pandemic.

It’s why Mr. Bruce says there is a need for more awareness around free mental-health services that are offered by employers via Employee Assistance Programs (EAPs) – or through federal programs.

“What is a little troubling is that the use of EAPs is only showing 4-per-cent utilization,” says Mr. Bruce, according to a joint survey in June from the Conference Board of Canada and the Mental Health Commission of Canada.

Yet some argue that free counselling isn’t for everyone. “There’s some great free stuff, but it’s not always appropriate for them – it might be too frighteningly clinical,” says Kate Scowen, founder of Hard Feelings, a not-for-profit mental-health centre in downtown Toronto.

Ms. Scowen’s centre offers psychological counselling at prices that are one-third or one-half of market rates. “The market rate option is not affordable for so many people,” she says.

Experts say demand will grow as the pandemic wears on. And the costs of paying for mental health will weigh heavily on many Canadians.

“I think a lot of Canadians are going to need these services,” Mr. Bruce says. “The burden of the pandemic will live well beyond a medical resolution.”

Free mental health counselling services

• Wellness Together Canada, a federal program that was launched in April, provides free digital mental health and substance use support, by organizations such as Stepped Care Solutions, Kids Help Phone, and Homewood Health supported by Greenspace Mental Health.
• MindBeacon, a digital therapy service that aims to support Canadians through heightened anxiety and stress related to the coronavirus pandemic. The service is free to residents of Ontario.
• Huddol: An app backed by the Canadian Caregiver Association, Huddol offers six free one-hour virtual sessions with a therapist.
• Crisis Text Line powered by Kids Help Phone. A 24-hour service, each young person who texts is connected with a Crisis Responder, a person trained in problem-solving.
• Crisis Services Canada: Suicide prevention and support.