By Sue Tiffin

Mental health support and crisis intervention workers are preparing for the second wave of COVID-19, and the potential government rollback to provisions that might accompany that surge of cases, as the seasons change and winter – which allows for less distanced gathering outside for vulnerable populations – approaches.

“We can say with a lot of certainty that since COVID hit that it’s impacted Ontarians’ mental health in a detrimental fashion for sure,” said Jack Veitch, manager of community engagement and education, Canadian Mental Health Association Haliburton, Kawartha, Pine Ridge.
Crisis call volume in the area has increased, and is 30 per cent higher than what crisis intervention and mental health support workers would typically see.

“We’ve seen, even locally … our crisis calls are up 30 per cent [from March to current date] which is pretty significant when we talk about the volume we’re receiving. Even if we look at some of the data we collected provincially, for Ontarians through polling back in May and September, we did some polling and found that – we know historically that about 2.5 per cent of Ontarians experience thoughts of suicide – at September of this year, that number was up to almost six per cent of Ontarians were experiencing thoughts of suicide,” said Veitch. “So we’re seeing some really, I hate to say not-surprising, but yet, sort of staggering numbers that this pandemic has really impacted the mental health of our communities.”

Those calls are from people expressing struggles with generalized anxiety as well as those challenged by isolation, or health anxiety – people worried about becoming ill, or their loved ones becoming ill. Feelings of isolation due to lockdown, which occurred earlier this spring when the pandemic was first declared, has negatively impacted the mental health of people throughout the province, especially those who live alone.

CMHA HKPR is, as an organization, is “absolutely doing everything we can,” said Veitch, to plan, prepare, and best service the community.
“I think we’re fortunate that we’re in a position as an organization where in March it was all brand new, so all of a sudden figuring out, well, what PPE do we need, how do we wear it, how do we distribute it, how do staff get it? We have a lot of processes in place that we’re hopeful that if things do unfortunately worsen with numbers increasing of those that are experiencing coronavirus, that we have the health and safety measures in place we need to respond and to serve our communities without disruption in service.”

Veitch said the team can still do face-to-face visits, community visits at this point, when necessary, and can also offer virtual visits through Zoom.
“Those are things back in March we had to scramble to put together, the processes are now already in place so we’re hopeful we can continue to rely on the measures we have in place to provide that care,” he said.
Typically, the holidays are a heightened time for people to struggle.
“We know the holidays can be, for some, a really joyous time where I get to gather with my family and friends and I can be well and I can think of all the things I’m fortunate enough to have and enjoy,” said Veitch. “For others it can be a really stressful or a time of reflection that they don’t have that as much, that they’re alone or isolating.”

Prior to those holidays starting, Veitch said it’s important that people put things into place while feeling fine, so that if life gets harder or they start to feel worse or not do as well, they have a plan to get well again, faster.
“Reminding people, well, if I wasn’t doing well, who would I call or what resource would I access or who would I reach out to for support, or what do I do to be well? Things we can start to think of before it gets to that point of unwell,” he said.
Prevention can be key, with preparation for support during crisis and changes in lifestyle to support mental health helping to avoid long-term or disruptive interventions.

“What I always remind people, the really simple lifestyle changes can have a huge impact on mental health,” said Veitch. “Making sure I’m getting adequate sleep. Making sure I’m eating relatively healthy, three times a day. Making sure I’m getting some exercise. It doesn’t have to be intensive weight training, but getting out and walking the dog. If you get your heart rate elevated three times a week for 30 minutes a session you’ll see clinical improvement. That little bit of lifestyle, things that I can start to do proactively, to help my brain stay well.”

Living during a pandemic can cause mild and moderate stress and anxiety for everybody, but Veitch said when there is disruption in function, it’s important to immediately reach out for care.
“Feeling sad right now, feeling anxious, or stressed, that’s OK,” he said. “It’s not bad to feel sad, it’s not bad to feel nervous or upset, those are important human processes. It’s important to feel sad from time to time. When sadness or stress or tension become more disruptive is when they disrupt or impair function. That difference between, you know what, I’m feeling really down and sad today so I’m going to do something to help myself feel better – go for a walk, call a family friend, reach out to a trusted support – versus, I’m feeling so sad today, I can’t get out of bed, I can’t eat, I can’t care for my family or do the things I normally need to do. That’s more sort of crossing that line between again that mental health problem, potentially more of a mental illness or mental health concern.”

In these times, when people might be working from home, homeschooling the kids, preparing dinner for the family, caring for elders, working to keep a business going and struggling with financial challenges more than before, Veitch said people need to set boundaries.
“It sounds strange, but one thing I can suggest is routine,” said Veitch. “People do well in routine. If you think about a typical workday, a typical workday for many is that I wake up at X time, I prepare for my day, I commute for X time, I work from hours A to Z, and then I commute back home. There’s structure to that day and it gives time for debriefing, and structure. I would encourage that same type of routine if I work from home. So even though I’m not commuting anywhere, I’m not driving anywhere, I’m still going to say, OK, I plan to wake up at 7 o’clock, I’m going to have my breakfast at 7:30, I’m going to get showered, dressed, and start work at 9, when I normally start things. It’s so easy for us to blur those lines, start work early, or roll out of bed and I’m already on my phone, already doing emails. Building that structure back into that day is one big thing that is going to help people with that routine.”

The pandemic, especially during lockdown, saw an increase in jokes about day drinking and homeschooling parents being driven to alcohol, but Veitch said alcohol is a depressant, and can be problematic if used outside of Canada’s guidelines for alcohol use.
“Being mindful,” said Veitch. “If I’m using alcohol as a means to help regulate an emotion. If I’m using alcohol to help calm myself down, that’s potentially problematic and I might want to explore that a bit further with a trusted professional.”

Those boundaries are especially important to put at place for those working at home.
“When working from home, all of a sudden, it’s not my couch anymore, that’s my office, and it’s not the kitchen table, that’s the board room,” said Veitch. “Well let’s start to really draw boundaries – maybe I don’t have a home office, but in my home, this chair at the kitchen table is my worksite. When I’m in this chair, I’m at work. When I leave that chair, I’m no longer at work, I’m on break or I’m at lunch, but when I remove myself I’m setting those types of boundaries for myself for limits to where I’m working. So I don’t just end up working 24 hours a day.”

Veitch also stressed the importance of rest.
“Routine and structure, setting healthy boundaries and just being realistic with yourself, and honest with yourself, that we need time to rest, recoup, and have realistic expectations for ourselves,” said Veitch. “Again, it’s easy to start thinking, I need to be doing all of this, because I’m working from home I should be doing even more. The reality is we’re living through unprecedented times, and we need to make sure we’re taking care of the mental health of ourselves and our loved ones, it’s just as important as taking care of our job.”
Bedtime routine can help tremendously as well, said Veitch, distancing screen time from sleep time – trying to distance screen time at least 60 minutes before sleep by reading a book, talking with a partner or family or friend in person or on the phone. This is a time, too, to check in on our most vulnerable.  

“It might be a reminder to some of us, maybe it’s the responsibility or maybe it’s an opportunity for the younger generation to give Mom or Dad a call, or give that elderly neighbour a call, just to check in,” said Veitch. “It can be a face-to-face visit, we can be mindful and respectful of social distancing measures, but even just checking in with that loved one, that person in your life you know who might be isolated, that check-in might make a world of difference to that person.”

And if all of this seems too much, that’s the opportunity people need to reach out for help, said Veitch.
“Whenever we talk about mental health and specifically mental illness, mental illness isn’t just a light switch, I go from nothing to full-borne, high level intensive depression necessarily, illness is sort of a spectrum based on levels of impairment,” he said. “And you can imagine for some that level of impairment right now is mild to moderate, for others it might be much more extreme where some of the things we’re suggesting, I’m at such a disruptive level of mood, I can’t even engage in those simple lifestyle things, I might require more intensive support system. In that case if I can’t do those things because I’m still high level disruptive, I’m strongly encouraging those of you to reach out for family support, their family doctor [and other trusted health professionals in the community].”

“There’s an old saying in social work, every door is the right door,” he said.
On the other end of the crisis line, health professionals can help direct the call, inform people of what is available in the community and find the right direction for each individual.
“Four Counties Crisis has a crisis line available to all residents of Haliburton County, 24 hours a day, seven days a week, 365 days a year for absolutely free,” said Veitch. “That line is there. And just knowing it’s there, if something does go wrong, I don’t have to worry about who I can call, I know I can call and talk to that trained mental health professional. Maybe it’s reaching out to the family doctor or trusted support at Haliburton Highlands Mental Health Services, knowing what resources are available and accessible is going to be a big advantage to rather, there’s a crisis happening and we have to search for somebody.”

Free, professional, confidential crisis support for anyone struggling with mental health, relationships, addiction or work life, 24 hours a day, seven days a week by calling Four County Crisis at 705-745-6484 or 1-866-995-9933. Visit https://cmhahkpr.ca/ for more information.