COVID-19 anxiety shows why Canada needs a 9-8-8 number for mental health emergencies

The Canadian government is falling short in addressing the mental health impact of the COVID-19 pandemic, and also turning its back on a new idea that could help people during times of mental health crisis.

Canada is turning its back on a new idea that could help people during times of mental health crisis

The U.S. is adopting a 9-8-8 mental health crisis phone number so people can get in touch with help quickly. Think of it as 9-1-1 for brain emergencies. (Hector Retamal/AFP via Getty Images)

This column is an opinion by Kathleen Finlay, a mental health advocate, CEO of The Center for Patient Protection, and founder of The 988 Campaign for Canada. For more information about CBC's Opinion section, please see the FAQ.

Just about everyone knows about the physical health risks connected with the COVID-19 pandemic, but what about its threat to mental health?

Unprecedented disruptions to daily living and uncertainty on a scale unknown before by most is causing anxiety to go, well, viral. Yet the mental health side of this public health emergency is not receiving nearly as much attention as it needs when it comes to Canada's national response.

So far, the resources put into it have been scant and lacking in strategic focus. That's disappointing, but not surprising. 

Mental health care has always been the poor cousin in the Canadian health care system. Help is just not always available where and when it needs to be, especially for the most vulnerable among us.

That's one of the reasons I founded the campaign for a new three-digit nationwide hotline using the number 9-8-8 to put people facing a mental health crisis quickly in touch with trained counsellors who can help during times of severe emotional distress. It's part of a bigger push to get the federal government to up its game when it comes to the mental health of Canadians.

A 9-8-8 system, like the one being developed in the U.S., is needed now more than ever. Since the COVID-19 outbreak hit Canada, I've heard from dozens of people who have felt overwhelmed by the enormity of this global threat. Some have experienced panic attacks that mimic the breathing problems associated with the virus. Many report feelings of depression. Others are petrified to leave their homes. Then there is the buying up of vast amounts of toilet paper.

U.K.-based psychotherapist Kathryn Kinmond told The Guardian that, "Coronavirus gives rise to lots of uncertainty, and this has particular resonance with people who suffer from anxiety." The B.C. crisis centre reports that their hotline has been overwhelmed by calls from people worried about COVID-19.

The truth is Canada's national effort falls alarmingly short of other countries in providing the resources people with mental health conditions need in moments of crisis like this. For example, The U.S. Centers for Disease Control and Prevention (CDC) has a helpful page on its website devoted to dealing with the anxiety and stress produced by COVID-19. It also provides a toll-free number for the government-operated, nationwide distress hotline for those experiencing a mental health crisis.

The CDC's Canadian equivalent, the Public Health Agency of Canada, has a lot of useful information about the physical symptoms of COVID-19, including fact sheets, videos and infographics about how Canadians can protect themselves from the physical threats of the virus. But there is zero information devoted to its mental health risks, and nothing about where to get distress-related help.

Besides being hard to remember, Canada's 11-digit national distress hotline number is difficult to find. (Andrew Berezovsky/Shutterstock)

In addition, Canada has no government-designated national distress hotline. Since 2017, there's been a nationwide 11-digit toll-free number – 1-833-456-4566 – to reach suicide prevention counsellors, and it's now doubling as a support line for those with anxiety related to COVID-19, but the service is run by a non-profit network. It's not integrated into the federal government's response to COVID-19, despite the mental health challenges posed by the pandemic.

Besides being hard to remember, the number isn't even easy to find. The federal government doesn't include it in any of its COVID-19 resources — on purpose. I was recently told by a senior official with the Public Health Agency of Canada that it has deliberately chosen not to promote the hotline, saying in an email that, "the marketing of (the toll-free number) has remained modest as the service continues to build its capacity."

That's shocking, especially now.

COVID-19 is a national crisis. Canada's response and the resources it makes available to fight it, including mental-health resources, need to be fully integrated, robust and aggressively publicized. "Modest" measures simply don't cut it.

Mental health professionals say a simple, easy to remember three-digit number like 9-8-8 will get help to people faster when seconds count. (sergey causelove/Shutterstock)

Meanwhile, there are dozens of other toll-free and local numbers that operate as mental health crisis and suicide prevention hotlines across the country. What number is the right number to call in an emergency? It's a perfect storm for delay and confusion. The last thing anyone experiencing acute anxiety, feelings of helplessness, or the exacerbation of an underlying mental health condition needs is to have to spend precious time plowing through web pages or telephone directories for the right number to call to access immediate crisis counselling.

That's why Canada needs to adopt the system that's being rolled out in the U.S. to replace its current 11-digit number. Soon anyone there will be able to dial 9-8-8 to reach the national suicide prevention and mental health crisis hotline.

Think of it as 9-1-1 for brain emergencies.

The move, approved by the Federal Communications Commission (FCC), has the full support of the mental health community and, surprisingly, the blessing of the U.S. Congress on a rare bi-partisan basis. Mental health professionals like the idea, because they say a simple, easy to remember, intuitive three-digit number like 9-8-8 will get help to people faster when seconds count.

In stark contrast to the strong support of U.S. politicians for 9-8-8, Canada's federal leaders have shown no interest in the idea.

I know this all too well, because over the past eight months, long before the current COVID-19 crisis, I've repeatedly reached out to the prime minister, the minister of health, and key cabinet ministers with responsibility for Indigenous communities and other populations at disproportionately high risk for suicide, to make them aware of this game-changing innovation. They can't seem to find the "reply" button.

A 9-8-8 number would put seeking help for mental health emergencies where it needs to be: on an equal footing with medical emergencies. (Shutterstock / Chanintorn.v)

It's not just fighting the COVID-19 threat where Canada falls short in mental health care. Every 24 hours, 11 Canadians take their own lives and there are 275 attempts. Every year, 4,000 die by suicide. It's the second-leading cause of death among young people. Mental health advocates like me are worried that the panic and anxiety created by the pandemic will cause a spike in suicide deaths. 

Oddly, Canada is the only G7 nation without a suicide prevention strategy, even though they've been shown to work. And our political leaders don't seem open to new ideas like 9-8-8, even when overwhelming evidence from the U.S. shows that it can make a huge difference in getting the right help to people when they need it most. As Ajit Pai, chairman of the FCC, said in a tweet in December, "988 … will save lives."

I believe in it so much that I've been paying for The 988 Campaign for Canada out of my own pocket. I'm convinced that it is something Canada desperately needs. It would deliver help faster. It would save lives. And it would put seeking help for mental health emergencies where it needs to be: on an equal footing with medical emergencies.

Canadians who encounter strains and blows to their mental health — and over a lifetime, that will be a lot of us — are not second-class citizens. Whether the issue is a global pandemic like COVID-19 or an everyday personal crisis, we should not accept second-class access to care and treatment — or political leadership that fails us when we are most in need.


Kathleen Finlay is a mental health advocate, CEO of The Center for Patient Protection, and founder of The 988 Campaign for Canada.