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We have identified the following recommendations to improve mental health equity. These recommendations were developed based on emerging findings related to mental health outcomes and inequities and gaps in mental health service provision and access in British Columbia.

Invest in mental health care accessibility, specifically reducing barriers for equity-deserving groups

"It is essential that governments, health systems, care providers and other key stakeholders recognize and act upon the opportunity to invest in accessible and equitable mental health care delivery" - Dr. Jill Murphy

For many, accessing mental health care is very challenging. As such, reducing these access barriers and improving access to tailored services, specifically for equity-deserving populations is crucial.

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Population/Community Approach to Mental Health Promotion and Empowerment

"Not unlike the physical health consequences, growth in the prevalence of mental health challenges amid the pandemic illustrates how profoundly population-level mental health is shaped by the social determinants of health." (Jenkins et al., 2021)

We recommend that British Columbia invest in a population approach to mental health, inclusive of promotion, prevention and treatment.

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Better mental health screening and referral pathways

"During COVID-19 quarantine, follow-up phone calls or visits from public health professionals should include appropriate mental health checks." (Daly et al., 2021)

We recommend improved screening for mental health challenges into primary care practice as well as pathways for people who screen positive to gain rapid access to initial follow-up consultation.

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Develop evidence-based policy and practice guidelines for digital mental healthcare and make digital programs and services more accessible and equitable.

"Though digital mental health may improve access, there are also risks that it might exacerbate inequities in access to care among high-risk populations who may face poorer digital resources or other barriers. Equity-oriented research is needed to identify needs and gaps to equitable digital health care delivery." (TEAM-CAP)

There is a need to develop and disseminate guidelines to support the implementation of digital mental health care and psychosocial support that takes into account the context of delivery. Tailored guidelines are needed to ensure implementation and delivery across settings.

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Integrated responses to mental health and substance use disorders

"As a means of coping with deteriorations in mental health and stressors of the pandemic, many parents identified an increase in alcohol use." (Gadermann et al., 2021)

High levels of concurrent mental health and substance use disorders may be exacerbated by COVID-19 pandemic. Integrated responses that address concurrent challenges are needed.

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Invest in training and infrastructure support for mental health providers

"Training and capacity building for providers will also be needed to ensure effective implementation of evidence-based e-mental health care..." (Murphy et al., 2021)

Investment in capacity building and infrastructure support for providers is needed during and beyond the pandemic to support a successful shift to digital or hybrid care models in the longer term.

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Invest in structural support for healthcare workers

"Specific strategies must be developed to provide support to those providing unpaid care work and emotional labour alongside medical expertise. These might include improved access to childcare and mental health resources, among other strategies. Without such structural changes, there is a real risk of disproportionate levels of COVID-19-related burnout among women physicians." (Smith et al., 2021)

COVID-19 related burnout among healthcare workers is in part caused by structural factors such as unpaid sick leave, inadequate staffing, and lack of access to childcare. Increased investment in structural support for healthcare workers is needed.

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BC Alliance for Monitoring Mental Health Equity respectfully acknowledges that the land on which we work is the unceded territory of the Coast Salish peoples, including the xʷməθkwəy̓əm (Musqueam), Skwxwú7mesh (Squamish) and Səl̓ílwətaʔ (Tsleil-Waututh) First Nations.

BC Alliance for Monitoring Mental Health Equity

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