The Impact of COVID-19 on Rural and Remote Mental Health and Substance Use

Nelly D. Oelke, PhD, RN, Associate Professor, University of British Columbia school of nursing, Okanagan Lauren Airth, MSN, RN, University of British Columbia school of nursing, Okanagan

Our new policy brief examines the pandemic’s distinct impact on mental health and substance use in rural and remote communities, which is brought to life through a case study from the community of Princeton, British Columbia.

Case Study: Princeton Community Health Table

Description of the community

Princeton is a beautiful town, situated in the Similkameen Valley and surrounded by mountains, as seen in the pictures below.52 Among the 4,780 people who live there, the majority are 50 and older. Over 10 per cent of the population identifies as Indigenous. While the mean income is $57,000, eight in 10 residents fall below the poverty line. Mental health and substance use have both been identified as significant concerns. The rates of anxiety, mood disorders, and depression are eight times as high as those in the rest of the province, and like many rural communities in B.C., the community suffers disproportionately from the toxic drug crisis and consistently has one of the highest drug-related death rates per capita.53 Over the past year, these high rates of mental health and substance use have been further exacerbated by the COVID-19 pandemic.

Like other rural communities, Princeton has more limited resources for addressing mental health and substance use concerns than urban settings.54 Currently, it has one mental health and substance use counsellor, one mental health adult psychiatric nurse, one youth mental health worker, and one outreach worker (shared with another town about 45 minutes away). These limits make it difficult for the community to provide services and supports that are adequate for the population’s needs. Another concern is the ability to retain staff, which is common in rural settings.

Despite these challenges Princeton has many strengths, which include the high level of resilience common to rural communities and the many people and organizations who work together to address the needs of community members. One such initiative is the Princeton Community Health Table (PCHT).

Development of the PCHT

The PCHT was formed in June 2020 as part of the BC Rural and First Nations Health and Wellness Summit, sponsored by the Rural Coordination Centre of BC and the First Nations Health Authority. At the summit, partners came together to discuss and plan for health services delivery in Princeton and surrounding areas. The PCHT identified mental health and substance use as priorities for the health and wellness of the community. The group began with eight members representing various partner groups, including community members, providers, policy makers, and academic partners. It decided to continue to meet after the summit to plan, develop, and implement various community- based activities to promote mental health and well-being. The final makeup of the group provided a strong representation of community members who could lead this grassroots initiative to improve services and supports for the community at large.

Goals of the PCHT

  1. Develop a community-driven package of mental health/substance use improvements.
  2. Study the implementation of specific enhancements to mental health/substance use service accessibility.
  3. Evaluate the outcomes attributed to the implementation of mental health/substance use service advancements.
  4. Sustain progress via new partnerships and existing community partnerships.
  5. Develop a transferable and adaptable model for implementing improved mental health/substance use services in rural and remote B.C. communities.

Current PCHT activities

1. Increasing awareness of mental health and substance use and the available services and supports:

  • two brochures (adults and youth) that include information about local and provincial resources
  • education sessions for students in the Princeton Secondary Highs Schoo
  • Princeton Secondary School forum with speaker
  • virtual public forum on Breaking the Stigma

2. Providing services and supports:

  • Working in partnership with the South Okanagan Women in Need Society, a Penticton- based agency that comes to Princeton one day each week to provide drug-testing resources and harm reduction information. Also offered is a pop-up table for health information (inclulding COVID) and basic wound care, along with other harm reduction materials.

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