Use of medication and psychological counselling among Canadians with mood and/or anxiety disorders

Mental Health and Addiction Services Exclusive to LGBTQ2S+ during COVID-19: An Environmental Scan

BACKGROUND

Youth who are lesbian, gay, bisexual, trans, queer, 2-spirit, and of other identities (LGBTQ2S+) experience mental health disparities and higher rates of substance use when compared to their cisgender and heterosexual peers and yet also experience more barriers to access to services. The purpose of this paper is to determine the types of mental health and substance use programs and services exclusive to LGBTQ2S+ youth in Ontario during the pandemic.

METHODS

An environmental scan was conducted to identify existing programs and services in Ontario, Canada that offered exclusive mental health and addiction services to LGBTQ2S+ individuals aged 16-29, either by offering services to all or subgroups within the population. Organizations, services and programs were classified by the geographical distribution of services, populations served, types of programming or services, methods of service delivery, and program criteria.

RESULTS

In total, 113 organizations and 240 programs and services were identified as providing mental health and substance use services exclusively to LGBTQ2S+ youth. Identified adaptations for the COVID-19 pandemic included cancelling in-person services, increasing online and telephone services, and expansion to province wide from local availability.

CONCLUSIONS

The findings highlight the importance of offering services that provide culturally inclusive care for LGBTQ2S+ youth, and these results can also be used by policy makers to inform policies. In particular, there was a lack of culturally relevant clinical services for youth requiring a greater intensity of treatment.

Impact of anxiety and depression disorders on sustained return to work after work-related musculoskeletal strain or sprain: a gender stratified cohort study

Objective:

The aim of this study was to examine the impact of anxiety and depression disorders on sustained return to work (RTW) for men and women with musculoskeletal strain or sprain.

Methods:

Accepted lost-time claims for spine and upper-extremity strain or sprain were extracted for workers in the Canadian province of British Columbia from 2009 to 2013 (N=84 925). Pre-existing and new onset anxiety and depression disorders were identified using longitudinal health claims data. Probability of sustained RTW was analyzed using Cox proportional hazards models, stratified by gender and adjusted for potential confounders.

Results:

For pre-existing disorders, compared to men with no anxiety and no depression, men with anxiety only [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.84–0.93], depression only (HR 0.94, 95% CI 0.89–1.00), and anxiety and depression (HR 0.93, 95% CI 0.90–0.97) had lower probabilities of sustained RTW in adjusted models. The same direction of effect was found for women, but anxiety only had a smaller effect size among women compared to men (HR anxiety only 0.95, 95% CI 0.92–0.99; HR depression only 0.98, 95% CI 0.93–1.03, HR anxiety and depression 0.94, 95% CI 0.91–0.97). Among men and women, new onset disorders were associated with lower probability of sustained RTW and the effect estimates were larger than for pre-existing disorders.

Conclusions:

Findings suggest that workers’ compensation benefits and programs intended to improve RTW after musculoskeletal injury should take pre-existing and new onset anxiety and depression disorders into consideration and that gender-sensitive work disability strategies may be warranted.

CBT and medication in depression (Review)

Depression is a serious problem, primarily for the patient, but in-extenso, for society. The World Health Organization has long signaled an increase in the number of cases of mental health problems globally and, in particular, an increase in the number of people suffering from depression. In the context in which the most effective solutions are sought for the reduction and even remission of depressive symptoms. In the present review literature is analyzed on two current treatment modalities for depression: Cognitive behavioral therapy (CBT) and antidepressive medication (ADM). Both modalities act by the same internal mechanisms, in the same order, but studies found also differences between the ADM and CBT effects depending on early traumatic experiences of the patients, cognitive and genetic variables, other epigenetic factors and patient's history. A literature review is presented, which systematically collects actual data and synthesizes previous research findings in the field of depression treatment using ADM and CBT.

Mental health services in Canada: Barriers and cost-effective solutions to increase access

In this article, an overview of the barriers to accessing mental health services in Canada is provided and the recent federal funding commitments toward increasing the availability of evidence-based and cost-effective solutions to improve access to mental health services are highlighted. Barriers pertain mainly to costs, not knowing where to get help, excessive wait times, and insufficient funding. Through the Common Statement of Principles on Shared Health Priorities agreement, action is being taken by all jurisdictions in Canada to increase community-based mental health promotion programs and early interventions, especially those targeting children and youth. A growing body of evidence is demonstrating how specific community and primary care-based interventions are both effective and cost-effective. These integrated community solutions, shown to be effective for increasing access to appropriate services for patients while saving costs to the healthcare system, would benefit from the recent funding investments put in place by the federal government.

Introduction

We are pleased to bring you the second of two special issues on mood and anxiety disorders focussing on data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorder Component (SLCDC-MA). In December of 2016, we published the first issue, which included three articles describing various aspects of Canadian adults with a self-reported diagnosed mood and/or anxiety disorder including their sociodemographic characteristics, health status, activity limitations and level of disability and factors associated with well-being. The three articles in this (second) issue investigate topics related to the management of these disorders. Collectively, the articles explore key sociodemographic factors known to influence health-related outcomes and discuss strategies aimed at promoting the recovery and well-being of Canadian adults with a self-reported mood and/or anxiety disorder diagnosis.