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Warning: This article may be triggering for some readers. Please read at your own discretion.
The death of Dr. Karine Dion, an emergency physician from Granby, Que., devastated Canadians across the country.
Dion died by suicide earlier this month and according to her family, it was the stress of the COVID-19 pandemic that led to her death.
David Daigle, Dion’s husband, said his wife was his confidante.
“She was my love. We had a very strong link,” he said in a recent interview with Global News.
As the pandemic continues, numerous health-care and front-line workers have been working long, consecutive hours around the clock to take care of those in need. And while they’ve been celebrated as heroes, experts say they are also just as vulnerable to the same mental health hardships as any other person.
In order to better support their mental health and well-being, advocates and workers have been calling for increased awareness, support and resources to aid them under stressors and challenges stemming from COVID-19.
Dr. Naheed Dosani, a palliative care physician and health justice activist based in Toronto, says Dion’s death is an absolute tragedy.
“We’ve gone from banging pots in the first wave to celebrate our health[-care] workers to losing one of our own by suicide due to distress in this pandemic.”
Last June, the Canadian Federation of Nurses Union (CFNU), along with the University of Regina, compiled a study on the pre-pandemic mental illness among nurses. The study revealed one in three nurses reported having suicidal ideation, while 17 per cent reported planning suicide and eight per cent reported attempting suicide during their lifetime.
Additionally, according to a 2020 policy brief by the Mental Health Commission of Canada (MHCC), elevated suicide rates that existed among medical professionals prior to COVID-19 “are now being amplified by concerns about infection, exposure of family members, sick colleagues, shortages of necessary personal protective equipment (PPE), and overwhelmed facilities.”
“When you’re able to have a glimpse of what’s happening in our long-term care facilities, what’s happening in our hospitals — it is not hero work,” said Linda Stiles, president of the CFNU, adding she instead describes the workers as health-care warriors.
Dr. Matthew Chow, president of Doctors of BC, adds the notion of health-care workers being heroes may make them seem invincible.
“We are not superhuman. We get tired and we get sick and we get overwhelmed sometimes,” he said.
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“I’m not convinced that we can make people work at [over 120] per cent capacity, forever… Maybe for a short time we can tap into those internal reserves of resiliency and heroism,” said Chow.
“But that’s not a long-term way to run a health-care system, not if we care about the people working in it, and not if we want it to be sustainable.”
Ongoing challenges for health providers
Before COVID-19, health-care workers were already at a higher risk for mental illness, says Ed Mantler, vice president, programs and priorities at MHCC.
According to Mantler, before the pandemic, about 65 to 70 per cent of Canadians rated their mental health as very strong or excellent but since fall and periods of lockdown across provinces, that number has dropped to about 40 per cent.
“We can only speculate that the impact has been even more so for health-care workers,” he said, adding that on top of the nature of their work, they too also facing the stressors of the lockdown like coping with childcare and disrupted holidays.
“When we look at the health-care workforce, many are women, people of colour, are in relatively low-income types of jobs and some have to stack up several jobs in order to make ends meet,” said Mantler.
“So those individuals are at higher risk for mental health problems.”
Additionally, Karen Cohen, CEO of the Canadian Psychological Association, says some of the hardships health-care workers have continued to encounter throughout the pandemic include facing an abundance of COVID-19 information at once, limited breaks at workplaces and the burden of watching patients suffer, isolated from family.
“We have to remember that health providers are going to have the same set of strengths and weaknesses that any human being has when it comes to coping with stress.”
Cohen says that for a long time, there has been a lingering stigma about people talking about their mental health but the pandemic has shown us the importance of paying attention to one’s physical and mental capacity.
Health-care workers are experiencing grief, loss and suffering, Dosani says.
“People are so busy working double shifts, overtime, taking on new leadership roles … They’re not actually having time to process what they’re experiencing,” he said.
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Although government leaders and health officials across the country have advised sick people to stay home, experts say many workers simply cannot afford to, or are not eligible for paid sick days.
When it comes to doctors who are considered independent contractors and paid via fee-for-service, rather than by salary, Chow says they don’t have benefits like paid sick days, health and dental coverage or insurance.
“We have to find our own sick time, sick leave, quarantine time, costs for medications … In some provinces, there’s a little bit of support for some of those things but it’s not 100 per cent,” he said.
For nurses, Stiles highlights that although the majority of nurses would have some kind of paid sick days, it is the casual and part-time workforce that often don’t.
“Let’s be real. If you cannot bring food [or] guarantee food on your table, pay your rent, you will go into work sick,” said Stiles.
“We have to have some kind of a system of securing paid sick time, especially in a pandemic time, it is just unsafe for communities to expect essential workers to stay home when they’re sick or injured during a pandemic.”
Stiles also added that there has to be increased flexibility in work schedules for workers to be able to go to medical or mental health appointments.
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“The pressure that is put on the health-care workforce makes them feel guilty to take time off during their work hours for these appointments, which only worsens the situation,” she said.
Providing community spaces and support in the workforce
When it comes to increasing support, Chow says that building supportive environments for health-care workers to express themselves without feeling censored is needed.
It contributes to ensuring workplaces are safe from a physical standpoint, like having personal protective equipment but also psychologically safe, he said.
Mantler says that creating a work culture where it is OK for a worker to admit they’re struggling and in need of help is the most important.
“Health-care workers, even more so, feel the need to be stoic … and they don’t really express how the work is impacting their mental health,” he said.
Similarly, providing community spaces to share the best practices on dealing with grief as well as resources for people in different health-care professions is important, says Dosani. For the past six years, he and his colleagues have been holding grief circles to hold a moment of silence when one of their clients pass away.
“We reflect on what it was like to care for them and we talk about how we can renew and reinvest in each other.”
Additionally, to increase support among health-care fields, Chow says some solutions can include having things like physician health programs, online counseling that’s readily available and making sure they are not limited to accessing services due to finances.
“I think society and health care needs to realize that while we’re trying to fight a global pandemic, we need to give each other a bit of a break here, and realize that we’re not going to be able to get to everything that we normally do,” said Chow.
Dosani says if you know someone who is working on the front-lines, reach out to them and check-in.
“These kinds of warm thoughts are needed now on the front-lines for health-care workers more than ever.”
Where to find help
If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 9-1-1 for immediate help.
Crisis Services Canada’s toll-free helpline provides 24-7 support at 1-833-456-4566.
The toll-free Hope for Wellness helpline provides 24-7 support for Indigenous Peoples at 1-855-242-3310. Online chat services are also available.
Trans Lifeline operates a toll-free peer support hotline for trans and questioning people at 1-877-330-6366.
For a directory of support services in your area, visit the Canadian Association for Suicide Prevention.
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