2 new COVID-19 deaths, rising mental health concerns among First Nations, pandemic team says

Nine First Nations people in Manitoba have died from COVID-19, officials working with the Assembly of Manitoba Chiefs said, as they announced two new deaths, 60 new cases and fielded questions about mental health on Friday.

There are now a total of 838 active cases of COVID-19 among First Nations people in Manitoba, including 442 on First Nations themselves, said Dr. Marcia Anderson, a doctor with the Manitoba First Nations COVID-19 Pandemic Response Coordination Team.

Roughly a quarter of the 243 new COVID-19 cases provincewide announced Friday were among First Nations people, Anderson said. First Nations people also make up 26 per cent of all COVID-19 hospitalizations — 42 out of 161 — and nearly half of all people in Manitoba ICUs: nine out of 20.

"What we are seeing consistently is an overrepresentation of First Nations people in case counts, in hospitalizations and in ICUs, which are all indicators both of higher rates of disease but also of increased severity of disease," Anderson said.

"I think it's really important that we are all aware and informed about why that is."

The overrepresentation is due to a combination of reduced social determinants of health and the resulting effects on chronic conditions, Anderson says.

"[Those include] higher rates of overcrowded and inadequate housing with ... poor ventilation, which is really important in respiratory illnesses, higher rates of income insecurity and being more likely to live in low-income situations, which impacts how we are able to buffer risk for ourselves, and then some of the underlying issues around health-care access, too," Anderson said.

Those factors and others have led to historically higher rates of chronic conditions such as Type 2 diabetes and hypertension, Anderson said.

"This gets complicated when, also, heath-care access is, you know, challenging at baseline and then gets worsened by some of the pandemic-related measures, which might make our underlying chronic diseases a bit more unstable as well."

Rising concerns about mental health, substance use — but resources growing

As pandemic numbers worsen, Anderson said the response team has heard increasing concerns about mental health issues, isolation and stress among First Nations youth, and a related rise in substance use.

"In both urban and rural, remote communities, [we are] hearing a lot of concerns about youth mental health. Isolation has been really challenging," Anderson said.

"We have a lot of youth who work in community-based outreach programs and things like that that aren't operating right now, [which is] putting people under a lot of income-related stress, which is resulting in housing and food security challenges as well."

As stress and mental health issues rise, Anderson said it's unsurprising that she's hearing of increasing substance abuse, including of opioids. That brings with it increased risk of overdose, she added, since more people are using drugs they're not familiar with.

In the face of rising concerns, organizations are finding ways to adapt and expand their services, said Justin Courchene, who works with Manitoba Keewatinowi Okimakanak's Mobile Crisis Response Team. That includes work underway now to deliver mental health supports virtually and over the phone.

"Because of the nature of COVID, we've gotten a lot of request for [supports services] from various communities," Courchene said. "It's sometimes hard to keep up with the demand but we do the best that we can."

In the past, the group did the majority of its work through home visits, said Greg Fontaine, also with the crisis response team. There are still cases where home visits are the only way to provide services, he said, such as when a client has mobility issues or lacks transportation, so workers have even done home visits through people's windows.

"It's not a very rigid thing where we're saying absolutely not — it's all case-by-case," he said.

"If we're standing outside somebody's window with a cup of coffee in the cold, we're not lost. We're where we need to be."

Canadian Mental Health Association working on partnerships

Programs with the Canadian Mental Health Association have also seen an uptick in demand during the pandemic, said Stan Kipling, who directs the association's Bounce Back and Futures Forward programs. 

Futures Forward offers support to people between 15-29 who are or have been involved in the child welfare system, and Bounce Back is a telephone coaching service. The CMHA has gone into fly-in and drive-in First Nations to share information, he said.

Marion Cooper, executive director for Canadian Mental Health Association's Manitoba and Winnipeg office, said the CMHA is working to build new partnerships with First Nations in Manitoba, Cooper said, and to make its programming more culturally relevant.

"A lot of cultural pieces have come in to CMHA and we're trying to expand on that to make more awareness for our staff and partners," Cooper said.