Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada.
Int J Environ Res Public Health. 2022 Oct 24;19(21):13808. doi: 10.3390/ijerph192113808.
This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021). We examined temporal changes in the prevalence of anxiety, depression, and service utilization. Using the responses from 577 respondents in cycle 5 dataset (as it coincides with the peak of 2nd wave), we performed multinomial logistic regression. The policy implications of the findings were explored empirically through a World Café approach with 30 service providers, service users and policy makers in the province. The prevalence of anxiety and depression remained steady but high. Mental health services were not accessed by many who need it. Participants reporting moderate or severe anxiety were more likely to be 30-49 years old, women, and immigrants who earned less than $20,000 annually. Immigrants with either college or technical education presented with a lesser risk of severe anxiety. Factors associated with moderate or severe depression were younger age (<50 years), low household income, as well as immigrants with lower levels of education. Racialized groups had a lower risk of severe depression if they were under 30 years. Students and retirees also had a lower risk of severe depression. Canadian-born residents were more likely to require mental health supports but were not accessing them, compared to immigrants. Our analysis suggests mental health outcomes and service utilization remain a problem in Saskatchewan, especially among equity-seeking groups. This study should help drive mental health service redesign towards a client-centred, integrated, and equity-driven system in Saskatchewan.
本文旨在探讨 COVID-19 对三种心理健康结果（焦虑、抑郁和心理健康服务利用）的影响。具体而言，就是要确定在萨斯喀彻温省（Saskatchewan）的权益寻求群体中，社会经济变量与这些结果之间的关联是否因疫情而加剧或缓冲。我们分析了加拿大心理健康研究所（Mental Health Research Canada，MHRC）在三个时间点进行的基于人群的全国性调查的萨斯喀彻温省成年人的二级数据集：第 2 轮（2020 年 8 月）、第 5 轮（2021 年 2 月）和第 7 轮（2021 年 6 月）。我们考察了焦虑、抑郁和服务利用的流行率随时间的变化。利用第 5 轮数据集中 577 名受访者（恰逢第二波高峰）的回复，我们进行了多项逻辑回归。通过在该省与 30 名服务提供者、服务使用者和政策制定者进行的世界咖啡（World Café）方法，从实证角度探讨了研究结果的政策意义。焦虑和抑郁的流行率保持稳定但仍然很高。许多需要心理健康服务的人并未获得服务。报告有中度或重度焦虑的人更可能是 30-49 岁、女性和年收入低于 20,000 加元的移民。年收入低于 20,000 加元且具有大专或技术教育背景的移民患严重焦虑症的风险较低。与中度或重度抑郁症相关的因素是年龄较轻（<50 岁）、家庭收入较低以及教育程度较低的移民。如果是 30 岁以下的少数族裔，患重度抑郁症的风险较低。学生和退休人员也有较低的重度抑郁症风险。与移民相比，加拿大出生的居民更有可能需要心理健康支持，但他们没有得到这些支持。我们的分析表明，心理健康结果和服务利用在萨斯喀彻温省仍然是一个问题，特别是在权益寻求群体中。这项研究应该有助于推动萨斯喀彻温省的心理健康服务重新设计，以建立以客户为中心、综合和公平驱动的系统。
