Navigating Inequities in Youth Addiction and Mental Health Services During the Pandemic

Overview: This study examined the experiences of youth with addiction and mental health concerns during the pandemic from the perspectives of youth, caregivers, and service providers. Findings showed that while mental health needs were higher, the addiction and mental health care system offered less support to youth and families.Proposal text:

Background: There have been concerns about the adverse effects of the pandemic on youth (aged 16-24) as this age group has the highest rates of mental health concerns (20%), the highest rate of substance use disorders (11.9%), and the most unmet mental health care needs even pre-pandemic (Sukhera et al., 2017). The pandemic has had emergency measures such as lockdowns, social distancing, and school/employment disruptions that have amplified addiction and mental health concerns in youth (Jones et al., 2021). Since the outbreak of the pandemic, youth have experienced a decline in mental health (Cost et al., 2021), and an increase in substance use (Bartel et al., 2021). There has also been reduced access to services (Fegert et al., 2020; Hawke et al., 2020) and widened inequities in the delivery of care during the pandemic attributed in part to social determinants of health (Jenkins et al., 2020). Although caregivers play an important role supporting youth in recovery, the lack of services and inadequate involvement of families creates an enormous burden on families (Miller et al., 2017). Service providers have also reported ‘feeling lost’ in how to treat youth in the fragmented system (Miller et al., 2020). This study was a university-community partnership where we explored the experiences of youth with addiction and mental health concerns, and their families during the pandemic from the perspectives of youth, caregivers, and service providers.

Method: Using a descriptive qualitative design and purposeful sampling, we recruited 15 service users (n=11 parents, n=4 youth) and 10 service providers. We conducted semi-structured virtual interviews and analyzed data using thematic analysis (Braun & Clarke, 2006).

Results: Three themes were identified: 1) youth addiction and mental health concerns have increased, while supports have decreased; 2) caregivers end up being the treatment team with increased burden and little support; and 3) addiction and mental health services for youth and caregivers are inadequate and inequitable and this was amplified during the pandemic.

Conclusions: This study highlighted how pandemic measures have impacted youth and their families and the disproportionate impacts related to social determinants. We have seen inequities and disparities widen for specific populations and these need to be addressed at the policy and service planning levels. The findings highlight the need for a syndemic and health equity approach (Jenkins et al., 2020) that shows a commitment to reducing disparities in mental health by focusing on social determinants and increasing access to quality addiction and mental health care. In this presentation, we will discuss implications for social workers who play an important role in the field of addictions and mental health, as well as implications for social work educators to prepare students for practice in addictions with youth and their families.