The Impact of COVID-19 on the Mental Health and Substance Use Health (MHSUH) Workforce in Canada: A Mixed Methods Study

Abstract

Abstract Background The increased need for mental health and substance use health (MHSUH) services during the COVID-19 pandemic underscores the need to better understand workforce capacity. This study aimed to examine the pandemic's impact on the capacity of MHSUH service providers and to understand reasons contributing to changes in availability or ability to provide services. Methods We conducted a mixed method study including a pan-Canadian survey of 2,177 providers of MHSUH services and semi-structured interviews with 13 key informants. Survey participants answered questions about how the pandemic had changed their capacity to provide services, reasons for changes in capacity, and how their practice had during the pandemic. Thematic analysis of key informant interviews was conducted to gain a deeper understanding of the impact of the pandemic on the MHSUH workforce. Results Analyses of the survey data indicated that the pandemic has had diverse effects on the capacity of MHSUH workers to provide services: 43% indicated decreased, 24% indicated no change, and 33% indicated increased capacity. Logistic regression analyses showed that privately-funded participants had 3.2 times greater odds of increased capacity (B = 1.20, p < .001), and participants receiving funding from a mix of public and private sources had 2.4 times greater odds of increased capacity (B = 0.88, p < .001) compared to publicly-funded participants. Top reasons for decreases included lockdown measures and clients lacking access or comfort with virtual care. Top reasons for increases included using virtual care and more people having problems relevant to the participant's skills. Five themes were constructed from thematic analysis of key informant interviews: the differential impact of public health measures, increased inequity accessing MHSUH services, improving recognition driven by need for services, the accumulating impact of stressful working conditions, and critical gaps in MHSUH workforce data. Conclusions The COVID-19 pandemic has had a substantial impact on the capacity of the MHSUH workforce to provide services. Findings indicate the importance of increasing and harmonizing funding for MHSUH services across the public and private sectors, developing standardized datasets describing the MHSUH workforce, and prioritizing equity across the spectrum of MHSUH services.