Abstract

BackgroundThe COVID-19 pandemic has resulted in profound mental health impacts among the general population worldwide. As many in-person mental health support services have been suspended or transitioned online to facilitate physical distancing, there have been numerous calls for the rapid expansion of asynchronous virtual mental health (AVMH) resources. These AVMH resources have great potential to provide support for people coping with negative mental health impacts associated with the pandemic; however, literature examining use prior to COVID-19 illustrates that the uptake of these resources is consistently low.ObjectiveThe aim of this paper is to examine the use of AVMH resources in Canada during the COVID-19 pandemic among the general population and among a participant subgroup classified as experiencing an adverse mental health impact related to the pandemic.MethodsData from this study were drawn from the first wave of a large multiwave cross-sectional monitoring survey, distributed from May 14 to 29, 2020. Participants (N=3000) were adults living in Canada. Descriptive statistics were used to characterize the sample, and bivariate cross-tabulations were used to examine the relationships between the use of AVMH resources and self-reported indicators of mental health that included a range of emotional and coping-related responses to the pandemic. Univariate and fully adjusted multivariate logistic regression models were used to examine associations between sociodemographic and health-related characteristics and use of AVMH resources in the subgroup of participants who reported experiencing one or more adverse mental health impacts identified in the set of self-reported mental health indicators.ResultsAmong the total sample, 2.0% (n=59) of participants reported accessing AVMH resources in the prior 2 weeks to cope with stress related to the COVID-19 pandemic, with the highest rates of use among individuals who reported self-harm (n=5, 10.4%) and those who reported coping “not well” with COVID-19–related stress (n=22, 5.5%). Within the subgroup of 1954 participants (65.1% of the total sample) who reported an adverse mental health impact related to COVID-19, 54 (2.8%) reported use of AVMH resources. Individuals were more likely to have used AVMH resources if they had reported receiving in-person mental health supports, were connecting virtually with a mental health worker or counselor, or belonged to a visible minority group.ConclusionsDespite substantial government investment into AVMH resources, uptake is low among both the general population and individuals who may benefit from the use of these resources as a means of coping with the adverse mental health impacts of the COVID-19 pandemic. Further research is needed to improve our understanding of the barriers to use.

Highlights

  • With growing global access to the internet [1], the World Health Organization [2] has identified digital health as a key health promotion strategy that can “benefit people in a way that is ethical, safe, secure, reliable, equitable and sustainable." Broadly, digital mental health comprises health care activities that are not carried out in traditional face-to-face format and may include synchronous video visits with mental health care providers or asynchronous use of online self-management skill-building programs [3]

  • Among the total sample, 2.0% (n=59) of participants reported accessing asynchronous virtual mental health (AVMH) resources in the prior 2 weeks to cope with stress related to the COVID-19 pandemic, with the highest rates of use among individuals who reported self-harm (n=5, 10.4%) and those who reported coping “not well” with COVID-19–related stress (n=22, 5.5%)

  • Within the subgroup of 1954 participants (65.1% of the total sample) who reported an adverse mental health impact related to COVID-19, 54 (2.8%) reported use of AVMH resources

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Summary

Introduction

With growing global access to the internet [1], the World Health Organization [2] has identified digital health as a key health promotion strategy that can “benefit people in a way that is ethical, safe, secure, reliable, equitable and sustainable." Broadly, digital mental health comprises health care activities that are not carried out in traditional face-to-face format and may include synchronous (ie, in real time) video visits with mental health care providers or asynchronous (ie, not in real time) use of online self-management skill-building programs [3]. We use the term asynchronous virtual mental health (AVMH) resources to refer to any app, website, online tool, or other online support that does not involve synchronous direct contact with a mental health care provider Many of these publicly available mental health apps and online programs have been endorsed by users with generally high ratings and positive review comments [4], most are lacking direct scientific evidence of their effectiveness [5]. As many in-person mental health support services have been suspended or transitioned online to facilitate physical distancing, there have been numerous calls for the rapid expansion of asynchronous virtual mental health (AVMH) resources These AVMH resources have great potential to provide support for people coping with negative mental health impacts associated with the pandemic; literature examining use prior to COVID-19 illustrates that the uptake of these resources is consistently low

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