Joseph Puyat

Healthcare workers (HCWs) have been shown to be impacted physically and mentally by the COVID-19 pandemic, attributed to stress and an increased workload. However, there is currently a gap in the literature regarding examination of mental disorders occurring in the workplace among HCWs. This study aims to address this gap by analyzing mental disorders claims that were accepted for workers’ compensation before and during the pandemic among HCWs and non-HCWs. Cases of mental disorder claims occurring among HCWs and non-HCWs were identified from accepted time-loss claims from the province of British Columbia’s workers’ compensation board (WorkSafeBC). Incidence rates were calculated using monthly estimates of the BC working population from Statistics Canada’s Labour Force Survey as the denominator. The periods assessed were January 2017 – December 2021. Changes in the incidence of mental disorder claims between healthcare workers and non-healthcare workers before and during the pandemic were estimated using controlled interrupted time series analysis. The results from the controlled interrupted time series analysis revealed no change in mental disorders claims among HCWs during the pandemic while a level change occurred for non-HCWs. This phenomenon cannot be attributed to a single factor. Potential explanations include the provincial healthcare system’s response to the pandemic, labour dynamics, as well as how WorkSafeBC addresses mental disorder needs among HCWs. Further research is needed to understand the long-term effects of mental disorders occurring in the HCWs population beyond the pandemic.

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College students experience high rates of mental health problems. While college contexts can provide an opportunity for early intervention, college students report low treatment rates. Further, a range of sociodemographic disparities in the rates of mental health treatment among students experiencing mental health problems have been identified. This thesis aimed to quantify the magnitude of these treatment disparities, identify the sub-groups of students experiencing the largest treatment disparities, and identify the stage(s) of the treatment-seeking pathway through which these disparities emerge.First, a systematic review and meta-analysis of the literature was conducted. Pooled prevalence ratios of receiving treatment, conditional on experiencing a mental health problem, were calculated for each sociodemographic disparity identified in the literature. Next, a regression analysis of survey data from four Canadian universities was conducted to quantify the disparities at two stages of the treatment-seeking pathway, among students experiencing a mental health problem. Odds ratios of 1) having a perceived need for treatment and 2) receiving treatment, conditional on having a perceived need were calculated for a range of sociodemographic characteristics.The first study identified a range of significant sociodemographic disparities in the treatment rates of students experiencing mental health problems, with the largest disparities based on race and ethnicity, international student status, sex, and gender. Results from the second study suggest that disparities based on gender, sexual orientation, race, ethnicity, age, and parental education emerge through differences at both stages of the treatment pathway, whereas disparities based on international student status and level of financial stress predominately emerge through differences at the second stage of the pathway. Together, these findings highlight the need for targeted efforts to promote equitable access to mental health treatment in student populations and inform the sub-groups and corresponding stages of the treatment-seeking pathway to target in said efforts.

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