Mental Health & COVID-19
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If you are in a crisis, please contact the local crisis line at 519-973-4435, 911, or go to your local emergency department.
Taking Care of Yourself
If you find that you are experiencing stress and worry that is causing difficulties in your life, help is available. Visit Where to Access Help & Resources to learn more. Keep reading below to learn some strategies that you can use today to help cope with COVID-19 stressors, and other things that can cause stress in our lives.
There are many strategies that can be used to challenge stressful and anxious thoughts during the pandemic:
Engage in positive self-talk.
Positive self-talk strategies can help shift negative ways of thinking into more helpful mindsets. These strategies may include the following:
- Think of stressful experiences in the past and remind yourself about the skills used to cope with them. Remember that people are resilient and use coping skills every single day. Continue to remind yourself that you can handle stress and that family, friends, colleagues, or professionals are available for additional support if needed.
- Catch negative or anxious thoughts as they occur and stop to write them down. Challenge these thoughts by questioning their validity/accuracy and asking yourself whether they are grounded in beliefs or facts. Try to re-frame worries and anxious thoughts by focusing on self-talk strategies that facilitate problem-solving and conflict resolution. After engaging in these practices, try to replace catastrophic thinking with more balanced approaches. This may include statements such as, “This is a difficult time, but I will get through this with the support of family and friends”.
- Try to focus on things that you can control during the COVID-19 pandemic, such as maintaining proper hand hygiene and practicing physical distancing. For situations that are beyond an individual’s control, try to shift emotional responses to these situations by focusing your attention on other activities or tasks, such as playing a board game, reading a book, or practicing meditation.
Use reflective journaling.
Consider writing in a daily or weekly journal. Writing in a journal can be an emotional release for many people. In fact, journaling can help people process their feelings and emotions, get rid of negative thoughts, and explore positive self-talk strategies.
Engage in deep breathing techniques.
Deep breathing exercises can be calming to the nervous system, alleviate feelings of anxiety or worry, and help individuals think more clearly. Try box breathing. Find a quiet, comfortable place to sit or lie down and take a slow deep breath in while counting to four, hold for four seconds, breathe out for four seconds, and then hold for four seconds. Repeat these steps for three to five minutes to help re-center your breath. For more great tips, please see CAMH’s resources for challenging worries and anxious thoughts and dealing with problems in a structured way during the COVID-19 pandemic.
A video that explains the square breathing technique can also be found below
Taking the appropriate safety measures to protect and maintain physical health during the COVID-19 pandemic can help to alleviate the stress and fear that may be associated with this disease.
Engage in daily physical activity.
Find ways to stay active during the COVID-19 pandemic. Physical activity does not have to be complicated. It can be as simple as taking the dog for a walk, riding a bike, playing active video games, or having a dance party! If you are required to self-isolate, remember that you cannot leave your home.
Virtual workouts and fitness classes are also widely available online for all fitness levels. For more great tips on selecting an online fitness class or staying active during the COVID-19 pandemic, please refer to the Physical Activity section of this website.
Eat healthy and sufficient foods at regular intervals according to Canada’s Food Guide.
Eating healthy can help to increase feelings of both physical and mental well-being. Canada’s Food Guide has many healthy eating tips, cooking guides, and healthy recipes for individuals and families to follow. Give some of the recipes a try! Cooking healthy recipes at home can be a great opportunity to bring the family together and do a fun learning activity.
For more great tips on developing food skills, preparing meals, and maintaining a healthy diet during the COVID-19 pandemic, please refer to the Food & Nutrition section of this website.
Practice meditation, relaxation techniques, or yoga.
Free guided meditations, relaxation exercises, and yoga classes can be found on Youtube or through Apple/Android apps. These practices can help to reduce anxiety or stress, instil a sense of calmness in the mind, and help individuals think more clearly. A few examples are provided below:
- For Adults: 5-Minute Guided Meditation to Relax and Recharge & 5 Minute Breathing Space
- For Kids: Check out Cosmic Kids Yoga on Youtube. They have a variety of yoga and mindfulness videos that parents and children can do together!
Minimize or avoid the use of alcohol and other substances.
Try to avoid using alcohol as a coping strategy to combat stress during the COVID-19 pandemic.
Healthier methods to cope with COVID-19 stress exist and can include staying active and involved in enjoyable activities, connecting with friends and family for support, practicing self-care, or seeking help from a mental health professional when needed. If you choose to drink or use cannabis, follow Canada’s Low-Risk Alcohol Drinking Guidelines and Canada’s Lower-Risk Cannabis Use Guidelines to reduce risk. Make efforts to recognize and avoid possible triggers for alcohol or other substance use during the COVID-19 pandemic, such as emotional or psychological stress. Find answers to FAQs related to COVID-19 and substance use.
Maintain a regular schedule and daily routine.
Create a schedule each day to plan your daily tasks and activities. A consistent structure and routine can help individuals and their family members feel safe and re-establish a sense of normalcy within their everyday lives.
Stay connected to friends, family members, and other social networks through technology.
Keep in mind that physical distancing does not have to mean socially disconnecting. Receiving and maintaining support from social networks during the COVID-19 crisis can be very helpful for managing feelings of stress.
Participate in enjoyable activities.
Do things that make you feel good! Make these activities apart of your regular routine. This can include the following:
- Read a book
- Play a board game during family game night
- Watch a movie
- Try a new recipe
- Listen to music or a podcast
- Do a craft, paint, or colour
- Do a traditional puzzle or a mind stimulating puzzle (e.g., crossword, word search, Sudoku)
Keep your mind stimulated.
There are many online courses and resources available during this time to help keep your mind stimulated:
- Coursera: Offers a variety of free courses from recognized universities and companies.
- Duolingo: Learn a new language using Duolingo. It’s free and easy to use.
- Khan Academy: Offers free courses to children and adults covering math, science, and a variety of other topics.
- National Geographic for kids: Provides free educational videos, quizzes, and games to keep children entertained!
- PBS Kids: Free educational games and links to educational resources for parents and teachers.
- TVO Kids: Free educational videos, games, and other content for preschool and school-aged kids.
- Google Arts & Culture: Partnered with over 1,200 museums worldwide to offer online virtual tours! Plan a family virtual visit to a museum here.
- Windsor-Essex Public Libraries: Local libraries offer online resources for those with a library card. Visit Windsor Public Library or Essex County Library to access books, magazines, music, and more!
Stay up-to-date on accurate information from legitimate sources.
It is important to stay informed about COVID-19 in order to take action in reducing its spread; however, the mass of information circulating through social media and other media channels can be overwhelming. A lot of information is disseminated about COVID-19 every day, but not all of it is accurate. Seek information from credible and reliable sources that can be trusted, such as this website or those from other credible health authorities, such as Health Canada or Public Health Ontario.
Limit media consumption.
Limiting media consumption can help to avoid increased feelings of stress or anxiety. Try to check in with media sources only once or twice per day and avoid watching or listening to media that may cause stress, anxiety, or fear. Instead, schedule enough time for activities that do not involve screens or technology, such as crafts, gardening, or reading.
For information about preventing and reducing stigma and discrimination during the COVID-19 pandemic, please see the following resources:
Taking Care of Others
Recognize that some people may struggle at times more than others, and that people will have different needs and desires for support from friends and family. Find out more about how to support your loved ones and others around you through anxieties and difficult times below.
How to Support Someone Experiencing Anxiety about COVID-19, or another Mental Health Concern
If a loved one is in a crisis, please contact the local crisis line at 519-973-4435, 911, or go to your local emergency department.
Every person will respond differently to the COVID-19 pandemic and will have a different method of coping. Regardless of coping style, loved ones can offer support to family members and friends experiencing anxiety or stress during the COVID-19 pandemic by doing the following:
- Invite the person to talk. Listen to the person non-judgmentally and empathize with their situation. This includes allowing the person to speak freely by listening and asking questions without telling the person what to do. Try to understand where the person is coming from and always maintain open lines of communication.
- Take an interest in the person’s well-being by asking how they prefer to be supported. This may involve simply listening to the person, helping them to problem solve, taking them for a walk, or referring them to a mental health professional.
- Remind the person that it is normal to feel stressed or anxious during this time and that there are supports available that have helped others. This message helps to counter any shame associated with mental distress, reluctance to talk about it, or reluctance to reach out for help.
- With the person’s permission, share credible facts with them about COVID-19 from reliable sources, such as this website or other governmental or health authorities.
- If the person is open to it, share resources with them about coping with stress and anxiety during the COVID-19 crisis. Continue to check in with the person on a regular basis to offer support and assistance.
Be mindful of your abilities to help in certain situations and know when it is appropriate to refer to professional support. If the person is experiencing high levels of stress or their mental state is significantly hindering their ability to cope, encourage them to reach out for support from a mental health professional. Please see the “Where to Access Help & Resources” section of this website for more information about the community resources that are available during this time.
When possible, connect with people who may find this time especially stressful, such as:
- Older adults and those with chronic health conditions who are at increased risk of COVID-19.
- People who have a history of depression, anxiety or substance use disorders.
- People who may be heavily impacted by COVID-19 through job loss, health concerns, separation
from loved ones, or other issues.
- People who have mobility challenges or few social supports.
If you can, offer your support to these individuals by:
- Checking in on them regularly through phone, email, video chat, or other digital methods.
Offering to pick up additional grocery items or other necessities for them if you are heading to the store for food. Place their groceries at the doorstep or porch and contact them to let them know their groceries are outside. Be mindful of the supplies you keep at home, and ensure that you have a plan for how to get groceries and other supplies if you or someone else has to isolate for a period of time.
Children may also be experiencing anxiety or distress as a result of the shifts to and from in-class and virtual learning, and other changes to their routines and activities caused by the pandemic. Here are some strategies to help you support your child’s mental health.
Children’s Mental Health Ontario developed a resource to help parents talk to their children about COVID-19. Some of their tips include:
- Become informed about COVID-19 yourself and limit news exposure. Correct any misinformation about COVID-19.
- Focus on the details that are most relevant and things that you and your child can control.
- Limit routine changes where possible.
- Share information in as concrete a way as possible. Don’t complicate the situation – keep it simple and clear.
- Take time to validate their concerns with your words and attention.
- Review good hygiene practices and, if appropriate, make fun games out of these habits.
Some other resources include:
For more great tips, please see CAMH’s resource for Talking to Children about COVID-19 and Its Impact or the Ministry of Health and Long-Term Care’s resource for Talking to Children about the Pandemic.
A child might be struggling with their mental health if they have changes in behaviour or emotions (e.g., angry outbursts or depressed mood) that last most of the day or for a period of time (e.g., more than a week), or interfere with their thoughts, feelings, or daily functioning.
In addition, a child may be identified as struggling with their mental health if they tell their parents that they feel sad or anxious a lot or if they express thoughts of hurting themselves.
If your child is in a crisis situation, seek help from a mental health professional immediately. For mental health emergencies, or if your child is at an immediate risk to harm themselves or others, call 911 or go to a local emergency department. When visiting an emergency room, individuals will have to participate in an active screening for COVID-19.
If your child is struggling with their mental health, reach out for support from a mental health professional. For more information about the mental health programs, services, and resources available for children during this time, please visit the “Where to Access Help & Resources section of this website.
People Who Use Substances or Smoke FAQs
- The use of tobacco harms your respiratory system which is the main area of the body that COVID-19 attacks.
- It also weakens your immune system making it harder for your body to fight off the virus.
- Individuals who smoke may already have lung disease, reduced lung capacity, or cardiovascular disease which increases their risk of serious outcomes if they contract COVID-19.
- Conditions that increase oxygen needs or reduce the ability of the body to use it properly will put patients at higher risk of serious lung conditions like pneumonia.
- People who smoke or vape are likely to be at higher risk of getting COVID-19 as the act of smoking means bringing your hands to your face, increasing the likelihood of transmitting the virus.
- It is known that smoking increases the risk of both bacterial and viral infections.
- Smoking can be a social activity and sharing cigarettes or other smoking devices such as e-cigarettes and water pipes, often involve the sharing of mouth pieces and hoses, can present a risk for transmitting the virus between people.
- Currently this is not known. However, it is well know that quitting smoking improves lung health quickly
- Visit the Smokers’ Helpline webpage to learn more about the health benefits of quitting smoking.
If, in the course of your work, you encounter a client with a suspected case of COVID-19, it is recommended that you immediately report this to your Supervisor/Manager. The following are safety measures that you may consider implementing;
- Educate clients about safer drug use
- Provide clients with drug use education to prevent sharing of drug supplies and equipment.
- Focus education on the need for social distancing in order to by advising clients to reduce physical contact with other people who use drugs wherever possible
- Clients should be advised to prepare their drugs themselves
- Ensure health monitoring and surveillance activities for people who use drugs
- Identify and isolate individuals who show signs of a respiratory infection
- Closely monitor symptoms and immediately refer serious cases to the hospital
- Maintain hygiene
- Provide COVID-19 prevention supplies such as soap, alcohol-based sanitizers, trash baskets and face-masks for clients at the facility.
- Maintaining a clean space is critical in curbing the spread of COVID-19 your facility. Workers are advised to regularly disinfect and clean surfaces
- Educate clients about proper hand hygiene methods and encourage them to immediately report symptoms
- Stock up on supplies
- Stock up on essential supplies such as personal protective equipment, First Aid supplies, needles, syringes and naloxone.
- Recommend buddy up system for people who use drugs
- It is advisable for clients who are on quarantine to find buddies who can bring them food, harm reduction supplies, medicines and drugs that they require.
- Ensure clients maintain 2 metres from their buddy in order to minimize the risk of transmitting infected respiratory droplets from person to person.
Some professionals will provide tele-rehabilitation (using technology to access physiotherapy services at a distance when an in-person visit is not possible), but there are also some on-line and self-help resources available to patients to utilize to manage chronic pain without the use of opioids or other pharmacological therapies.
The high prevalence of chronic medical conditions among people who use drugs suggests that they may be at higher risk of getting infected with COVID-19. Recreational drug use is linked with reduced pulmonary function and immune suppression, both of which are risk factors for COVID-19. Because COVID-19 attacks the lungs, people who smoke or vape drugs are likely to experience severe respiratory symptoms if they become infected. With evidence showing that the odds of COVID-19 infection becoming severe is 14 times higher among people who had a history of smoking compared to those who don’t smoke, more attention should be focused on people within this population. Some examples of severe respiratory and immune system complications from drug use include:
- Tobacco and nicotine dependence from the use of cigarettes and vaping devices have been associated with negative health outcomes such as cancer, bronchitis and emphysema.
- Cannabis smoke has been shown to cause chronic bronchitis, a respiratory condition that could be worsened by COVID-19.
- Smoking crack cocaine has been associated with lung damage and severe respiratory problems. Thus, with the imminent reduced lungs function from COVID-19, people who use drugs would likely experience negative health outcomes.
- Methamphetamine has been shown to reduce lung function by constricting blood vessels. A COVID-19 diagnosis could further lead to poor prognosis.
- Opioid use can negatively impact the body’s immune system and may increase the risk of getting infected with COVID-19 virus.
- Alcohol use can negatively impact the immune system, as well as respiratory health, by weakening the lungs and upper respiratory system, causing a person to be more prone to respiratory diseases.
Other social and environmental reasons that may increase the risks of COVID-19 infection among people who use drugs include:
- High-risk activities, such as sharing drug equipment, may lead people who use substances to be less likely to follow instructions around physical distancing or other public health guidance.
- Stigma, social marginalization and economic challenges, including a lack of access to housing and health care can add to risk during this time.
Healthcare providers in RAAM clinics are encouraged to make modifications. Here are some recommendations from the network of RAAM clinic administrators and care providers across Ontario (META:PHI, 2020).
- See already-connected patients over OTN or telephone.
- Perform screening tests at the door, and see patients who screen positive through a protective barrier (e.g., a mask, a window, etc.).
- Provide masks to all patients who do not already have one.
- Increase the distance between seats in the waiting room.
- Ask patients with both cell phones and cars to wait in their cars rather than in the waiting room, and call or text them when it is their turn to be seen.
- Extend prescriptions for stable patients.
- Dedicate additional hours to booked appointments with walk-in patients who cannot be seen during regular walk-in hours due to limited space and capacity.
A patient who screens positive or is in self isolation should have someone from outside of their household to pick up their medications or the pharmacy should arrange for the delivery of medications.
Health Canada’s policy position Transportation of Controlled Substances in Canada permits pharmacists to transport controlled substances to patients with an appropriate prescription. During COVID-19, the Office of Controlled Substances has issued a short-term subsection 56(1) exemption from the Controlled Drugs and Substances Act (Health Canada, 2020). Subject to the laws and regulations of the province in which the pharmacist is entitled to practice, this exemption will authorize pharmacists to:
- Prescribe, sell, or provide controlled substances in limited circumstances;
- Transfer prescriptions for controlled substances.
In Ontario, a pharmacy owner or designated manager should determine the most appropriate process, considering the particulars of the medication with respect to security and storage and articulate this process to the pharmacy team. For further guidance please review Ontario Pharmacy Association’s Pharmacist’s Role in Managing Opioid Use Disorder’s during COVID-19
For professionals in the healthcare sector that work with people who use substances, there are unique considerations due to the COVID-19 pandemic. Some of these include:
- Potential medication shortages,
- Pharmacy disruption to dispensing
- Patient illness or quarantine
Access to prescription medications may be limited during this time; so, it is important to work with clients, especially those that are taking Opioid Agonist Therapies (OAT), such a methadone and buprenorphine. Recent guidance for management of OAT during the COVID-19 pandemic addresses office visits, remote visits, carry doses, frequency of urine drug testing, and the re-introduction of contingency management principles (if/when applicable) during the COVID-19 pandemic (METAPHI & CAMH, 2021). For additional guidance please visit: www.metaphi.ca
Some patients that use substances or have a substance use disorder may find self-isolation and stress due to the COVID-19 pandemic could worsen their problems. Additional information on supports for these patients can be accessed on Windsor Essex Community Opioid and Substance Strategy’s website - Get Help in Windsor-Essex during COVID-19.
- It is not currently known if former smokers have a higher risk of getting COVID-19 compared to people who have never smoked.
- People who smoke are at increased risk of lung infections in general, but the lungs do heal relatively quickly when people stop smoking. It is not yet known how long is long enough to reduce the risk to the same as someone who has never smoked.
- If you previously smoked and are now quit, it is likely you will have a lower risk of severe complications (if you were infected with the virus) than you would have if you were still smoking.
When administering naloxone to client, use a face shield with one-way valve masks as it provides adequate protection to the harm reduction worker and the client. It is important to note that the use of bag valve mask, high flow oxygen and non-rebreathers may increase the risk of transmission due to possible contact with respiratory droplets.
People who use substances and their loved ones may be especially impacted by this current public health emergency. A list of local services and supports, as well as any changes to those services can be found by visiting the Windsor Essex Community Opioid and Substance Strategy’s website -Get Help in Windsor-Essex during COVID-19.
- Adapting spaces within your facility in order to increase physical distancing between clients.
- Establishing measures to prevent overcrowding such as limiting the number of visitors at the facility and reducing the duration of stay.
- Ensuring that the environment is kept clean and frequently disinfected to protect the health of the workers and clients at the facility.
- Educating clients about respiratory etiquettes to prevent spread of COVID-19
- Creating spaces within the facility that can be used to accommodate clients who show symptoms of respiratory illness.
- Monitoring the Windsor-Essex County Health Unit website for current information related to COVID-19.