Mental Health and COVID-19: Breakaway Addiction Services

In our third research brief, we discuss Toronto's growing mental health crisis amid COVID-19. The pandemic's impact is being referred to as a "tsunami" hitting the mental health and addictions sector. Breakaway Addiction Services provides seamless, comprehensive and effective harm reduction services and a full range of addictions treatment services through community-based facilities with a focus on street and community outreach. On May 6, we spoke with Breakaway's executive director Nicola Bangham on the critical need for mental health and addictions support right now.


1. How has Breakaway Addiction Services had to adapt its programming and the way it's delivered during the restrictions for COVID-19?

We are now delivering 60% of our services remotely. We are providing counselling, case management, consults with our addiction medicine doctor, and advocacy over video and telephone. In lieu of our community meals and drop-ins we are creating and distributing 85 to 100 food hampers a week with recipes, frozen prepared meals and, notes of encouragement and support. These are distributed to our most needy clients either living on the street, or in supportive and community housing. The staff are working tirelessly to stay connected in a world where we are suddenly disconnected.


2. Are there certain groups who are underserved and/or who you worry about?

We are worried about everybody that Breakaway serves. Crisis and trauma affects people in different ways. Many folks were already socially isolated and living through a public health crisis (the overdose crisis.)


3. Generally speaking we know that mental health and addiction are interconnected. Can you tell us a bit about how COVID-19 is impacting your clients?

The overdose crisis is only getting worse. Folks that use drugs are not getting access to regular supply and therefore the risk for overdose is higher. Consumption Treatment Services have been cut back and people are having to use alone, which is when they are more likely to overdose.  Isolation can lead to anxiety and depression, which can lead to using drugs and substances.


4. What do you want people to understand about mental health, addiction, equality and COVID-19?

The pandemic is exposing what we already knew: that there is a deep canyon that divides “those who have” and “those who have not.” To be able to isolate at home is a privilege. Many of our clients who struggle with mental health and substance use are under-housed, homeless, living in shelters and living rough. Access to health care, healthy food, clean water, washroom facilities are all things we take for granted, but many people do not have these basics.


5. As governments start talking about easing restrictions, what supports will you be aiming to provide your clients?

The sooner we can be face-to-face with our clients the better we can support them. Phone calls and video connection can only do so much. Staff are ready to get back in the “room” with our folks to share a meal and start to unpack what this has all meant for people.  We will continue to provide food and supplies, knowing that the economic impact on our clients will not suddenly ease.


6. Knowing that the effects of COVID-19 will be felt for some time, what help do you need to best support your clients now and in the coming year?

The impact of COVID-19 is being referred to as a “tsunami” hitting the mental health and addictions sector. In the Ipsos Public Affairs Annual Mental Health Index survey published on May 6, 2020: “74% of Ontarians who responded to the study, are experiencing an increase in addiction and mental health challenges.” The mental health and addictions sector was already underfunded and overloaded with long wait times for individuals in crisis. We need to prepare for this tsunami by flowing more funding to agencies that are already doing this work. We need more staff and more resources. Staff working in these agencies are also going to be impacted by vicarious trauma, PTSD and burnout. We need to strategize now to care for our caregivers.


7. Are there any silver linings for long-term and systemic change that you can see? What do we need to do to ensure the opportunity for change doesn't escape us?

It seems that it had to take a pandemic for those in power to address the enormous inequalities in this city and province. It is our hope that universal basic income, rights to housing and access to primary health care will be issues that more people will get behind and see as human rights, not as privileges.