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A new Royal Society of Canada report urges governments to prioritize keeping schools open and be prepared with more mental-health support for Canadians if a spike in COVID-19 cases leads to another lockdown.

The wide-ranging report also calls for a larger chunk of health dollars to go toward mental-health care, as well as increased public funding for psychotherapy, with a particular focus on virtual care to improve access in more remote parts of the country.

To prepare for the next pandemic or national emergency, the report recommends that Ottawa create a national task force to study how to prevent mental illness and boost resilience.

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“COVID-19 brings with it a triple threat,” write the authors, a national task force of health care and academic experts. The social and economic consequences of the pandemic have meant that just as the population’s need for help with mental illness and substance abuse has grown, laid-off workers have lost the employee benefits that help cover those treatments. Access to public care was also reduced when hospitals were forced to shut down services.

The negative consequences of the pandemic have fallen heaviest on poor and marginalized Canadians, the authors point out. They make the case for better data collection to track how the system is doing, especially in delivering care to those groups, and for more mental health care programs designed and led by Indigenous Canadians.

“COVID-19 is not just an illness,” the reports states. “It also intensifies social ills that have long created health inequities.”

The report echoes recommendations that mental-health experts made even before the pandemic led to a spike in self-reported anxiety and depression among Canadians.

“We hope it adds to the chorus,” said the task-force chair, psychologist Patrick McGrath, a researcher at Dalhousie University. “Mental health plays an essential role in our response to the pandemic now and going forward.”

Mental-health advocates have long pushed for more coverage for talk therapy, so that Canadians without insurance through their employer do not have to pay out of pocket for an evidence-based treatment that other countries, such as Britain, have made standard first-step care for the most common mental illnesses – depression and anxiety.

Before COVID-19 shut down much of the country, waits-list to see a psychiatrist or to receive specialized treatment in the public system, especially for children and youth, could extend well beyond a year. Families struggled to get assistance in a confusing, fragmented system. Psychiatrists and family doctors often spoke about the difficulty of finding help for their patients, and a lack of standards in areas such as the treatment for youth who visit emergency departments after a suicide attempt or incident of self harm. As opposed to a stepped care model that delivers the right level of help based on need, the current system and its inefficiencies have meant that some people receive too much care, while those most in need often received too little, critics said.

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The Royal Society report highlights these trouble spots, and calls for governments to bring mental-health funding more in line with the investment put into physical illnesses, and to reduce the “unmet need” in mental-health care only made worse by the pandemic.

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