Content warning: this piece will contain details about mental health issues surrounding COVID-19, including anxiety and depression, and impacts of colonialism and structural racism on mental health during the COVID-19 pandemic.
Illustrations by Alex McPhail, BA
Hello! My name is Emily and I am the author of this post! I am a white settler, cisgender woman living on the traditional, ancestral and unceded territory of the Coast Salish, Musqueam, Tsleil-Waututh, Squamish, Stó:lō, Stz’uminus peoples in what is now known as Vancouver, BC. I acknowledge my experience as a white, cisgender woman shapes how I interpret research regarding mental health disparities and as such, I do not claim to fully understand the complexities that individuals may experience with their mental health. Historically, racialized, LGBTQ2S+ and disabled groups have been excluded or “controlled for” in mental health research, and the subsequent resources often do not adequately support these groups or those with intersecting identities. I aim to utilize my privilege, education and this platform to bring awareness to social determinants of mental health that impacts folks, especially during the pandemic. I hope to continuously learn in the case of error or misrepresentation and educate myself on responsible allyship. Thanks for reading!
Needless to say, the COVID-19 pandemic has had a monumental impact on our day-to-day lives. This impact extends beyond our daily routines and physical health, but also has serious implications for mental health. Canadians continue to face collective trauma as we worry for at-risk loved ones, adapt to shifts and abolishment of routines, and feel the weight of economic stresses. On top of all of this, Canadians are isolated from supportive friends and family members. However, the pandemic has not hit Canadians equally, and it is not the “great equalizer” as many inaccurately predicted 10 months ago. Women, people who are racialized, Indigenous folks, LGBTQIA+ individuals and other groups are facing overexposure to COVID-19 and the corresponding mental health burden.
In this post, we will examine the:
Implications of COVID-19 on Women’s Mental Health
The October Mental Health Index Report from Morneau Shepell indicates that Canadians’ mental health continues to be strained as we progress through the COVID-19 pandemic, especially for women. Since March, women have shown consistently lower mental health scores and higher levels of stress versus men (1*). Historically, women tend to have an increased risk for depression and anxiety than men in both everyday life and pandemic life (2*-3*). Research has pointed to women’s roles as caregivers in the home and society as a major factor in mental health and burnout risk. With COVID-19, parents have been thrown into a new reality of parenting and caregiving with significantly less help/resources, such as school and daycare, while also potentially dealing with changes in their jobs and work responsibilities (4). Balancing the stress that comes from coping with a global pandemic with new or different caretaking and work responsibilities puts women at risk for burnout, depression and stress, or the exacerbation of existing mental illnesses (4-5).
Negative mental health is further amplified for those in societal caregiving roles, of which many are women, such as teachers, essential service workers and healthcare workers. Pre-pandemic, women physicians already faced a higher risk of burnout and mental health issues, such as depression, in comparison to physicians who identify as men. The COVID-19 pandemic has exacerbated psychological trauma in healthcare workers, especially women, leading to increased incidences of anxiety, depression, burnout and suicidal ideation (6*-7*). As described in the “Statement from Black Health Leaders on COVID-19’s impact on Black Communities in Ontario,” Black women are over-represented in essential healthcare roles, such as RPNs and PSWs. This suggests a significant burden placed on Black women during the pandemic, which has negatively impacted their mental health (8*).
While our healthcare system struggles to keep up with the ongoing COVID-19 pandemic, women are taking the brunt of the psychological trauma and mental health challenges, both personally and professionally.
What Does This Mean for Racialized Groups?
The COVID-19 pandemic has had inequitable impacts on Canadians’ mental health, amplifying disparities already present due to systemic racism and colonialism. White Canadians have consistently shown better mental health scores than racialized groups throughout the pandemic (9-10). Throughout the pandemic, Indigenous women reported worsened mental health, increased depression and anxiety, and heightened stress compared to Indigenous men and non-Indigenous Canadians (11*). Pre-pandemic, people who are racialized also had higher incidences of poverty, which has been magnified during COVID-19 lockdowns and lay-offs. Racialized groups, recent immigrants and Indigenous Peoples are reported to have greater financial insecurity than White Canadians, which is a major risk factor for poor mental health and stress (9, 12-13).
In addition to the economic impact of COVID-19 on racialized groups and their mental health, there has been increased incidences of racism in Canada (14). Since the beginning of the pandemic, there has been a rise in anti-Asian racism, specifically against Chinese, Korean, and Southeast Asian individuals and East Asian women (15-16). Coun. Krysten Wong-Tam, who represents Ward 13, Toronto Centre, points to world leaders like Donald Trump, who exacerbate “an environment of hate and anti-Asian racism that enables racist bullying of Asian children in schools and anti-immigrant violence in other civic spaces” by calling COVID-19 the “China virus”. Researchers have connected the rise in anti-Asian discriminatory events to worsened mental health in these groups (15).
The murder of the Black American, George Floyd, by Minneapolis police has had significant impact on the mental health of Black Canadians, amplifying the impact of anti-Black racism (17-19). Notably, across Canada, Black people and Indigenous Peoples experience higher rates of fatality due to police brutality, especially during wellness checks and mental health crises (20-21). The impact of police violence on Black people and its extensive media coverage is reflected in The Mental Health Index Reports, in which Black Canadians show the poorest mental health scores in July, September and November (10).
In her New Yorker article, Elizabeth Alexander describes the impact of police violence and structural racism on the mental health of young Black people,
“[...] I worry about this generation of young black people and depression. [...]. It isn’t just [about] the spectre of race-based violence and death that hangs over these young people. It’s that compounded with the constant display of inequity that has most recently been laid bare in the Covid-19 pandemic, with racial health disparities that are shocking even to those of us inured to our disproportionate suffering.” (22).
The COVID-19 pandemic is a multi-faceted eruption of pandemics: COVID-19, systemic sexism and systemic racism. The pandemic and the subsequent policy response has deepened the inequities faced by racialized groups, putting their mental health at even greater risk. COVID-19, systemic racism and day-to-day struggles are burdening the mental health of many Canadians.
Transgender, Non-Binary and Gender-Diverse Mental Health
Transgender populations experience higher incidences of mental illness and suicide, which has been further exacerbated by the pandemic due to increased stress, social isolation, unstable housing and/or dangerous living situations (23). Due to the overload on the healthcare system, elective surgeries, including gender-affirming surgeries, have been postponed and cancelled (24). Previous research has illustrated the connection between gender-affirming surgery and its positive effect on mental health and wellness. Postponing and cancelling these surgeries may have a negative impact on the mental health of those who require these health services (25). Additionally, transgender, non-binary and gender diverse folks also face higher rates of discrimination, violence and financial insecurity and poverty, which all have been amplified during the pandemic and could negatively impact mental health (26-27).
Conclusion
We acknowledge the aforementioned groups are addressed separately throughout this article, however, there are many individuals with intersecting identities that may experience COVID-19 and mental health in their own unique way. Ultimately, the COVID-19 pandemic has amplified existing inequities in our society, which has dire mental health consequences. As vaccines are rolling out, we must remember that receiving vaccines does not eradicate the mental health struggles that the COVID-19 pandemic has facilitated and exacerbated.
Calls to Action
As described by the Centre for Addiction and Mental Health, the impact of the COVID-19 pandemic on mental health will be
“serious and long-lasting, with certain people at greater risk of developing more severe mental health difficulties. This will put additional strain on a mental health system where demand for care has outweighed supply for years.” (28)
In order to adequately address mental health during COVID-19, we must take into consideration those who carry the burden of mental strain throughout the pandemic, namely women, gender diverse folks, and people who are racialized. Mental health care must appreciate and adapt to the unique needs of individuals who may have multiple intersecting identities. This can include one’s sexuality, gender identity, disability and neurodiversity, migrant status or class.
Past documented barriers to mental health treatment include: cost, not knowing where to get help, excessive wait times, lack of/transient funding for programs, as well as previous traumatic experience with racially insensitive or racist healthcare (29, 19). In this time of massive change, various social systems, such as education and research, have had to adapt in the face of crisis. Mental health services should also treat this moment in history as an opportunity to revamp and become more accessible and effective for individuals who need these services.
We suggest the following calls to action to address the inequitable negative impacts on mental health during the COVID-19 pandemic:
Increase awareness for existing/new mental health programs, especially those for marginalized groups and individuals with intersecting identities
Address financial barriers through sliding scale or free services
Solidify sustainable government funding for existing/new programs
Utilize community-centered, culturally-sensitive and anti-racist frameworks in mental health programs (19)
Find out how women and gender diverse leaders have gained leadership during COVID-19 and why what we can learn from them.
Some of the data available and used to inform this post compares women and men. The term “women” is used when referring to cisgender women or where research did not specifically mention the gender identity of women included.
*These sources do not specify the gender identity of the women included. Historical representation leads us to believe only cisgender women were included.
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References
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