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It’s time to turn the corner on mental health for the frontline

Mental health · Jan 18, 2021

Canada’s one million frontline workers are both more in need of mental health support and less likely to seek it. How are we changing that?


Frontline workers rush in where most of us rush away. Their often dangerous work exposure to potentially traumatic events can take its toll on nurses, care workers, physicians, paramedics, public safety communications officials, firefighters, police, and corrections officers alike.

Expecting these professionals to be untouched by their daily experience of suffering and loss is, as Dr. Rachel Naomi Remen puts it, “as unrealistic as expecting to be able to walk through water without getting wet.”1

So while the need is so great, what’s standing in the way and how is TELUS Health playing a part?

More challenges, less help: The frontline mental health dilemma

In Canada: 44% of frontline workers experience mental health issues, 4X the norm:2

  • 1 in 3 nurses screen positive for major depressive disorder.3

  • A quarter of all physicians report high levels of burnout.4

  • Paramedics have a higher rate of PTSD than active duty soldiers.5

  • 34% of firefighters screened positive for mental health symptoms.6

Despite these high rates, frontline mental health issues often go untreated because of the demands of shift work and the stigma regarding mental health and asking for help.7 A recent study revealed that 93% of first responders feel mental health is as important as physical health, but 47% think seeking help would negatively impact their work and the perception of co-workers.8

Frontline mental health is at a double disadvantage to start with. When you include the stress, exhaustion, and lack of access to in-person services, brought on by the COVID-19 pandemic, you have a perfect storm for a mental health crisis among our most essential professionals.

Canada thanks our frontline workers

Canadians have expressed our appreciation with singing, horn honking and handmade signs, and we’ve also stepped up in other ways to help frontline workers stay healthy and strong.

  • In April 2020, one month after the pandemic sent many Canadians into lock-down, the Mental Health Commission of Canada offered free virtual crisis response training to help frontline workers care for themselves and those around them.

  • Through the Canadian Psychological Association, psychologists have been donating therapy to those who need it.

  • Virtual care has been a lifeline. The use of virtual care jumped from 20% to 60%9 in a matter of weeks when Canadians were forced to seek alternate channels to care in response to COVID-19. Virtual access has become the new normal, offering safely distanced services to people wherever they are. And 76% of Canadians are willing to keep using virtual care after the pandemic.10

  • Apps like Espri by TELUS Health have been introduced to help break down the barriers between frontline workers and mental health and wellness support. With learning tools, goal setting, support resources and group videoconferencing for training and support forums, Espri is designed to bring together mental health supports for our frontline into the palm of their hands.

Digital health shows promise - let’s turn the corner on mental health

When demands for support increase, as they did in April 2020 when BC paramedics reached out for support at almost twice the rate of April 201911 - digital health can play a promising role in improving access to support for a combination of reasons including convenience, cost savings, reduced stigma, and the comfort and safety of the home environment. Some members have even shared that teletherapy lets them build a relationship with their therapist as well as they did during in-person treatment. 12

We still have a ways to go in addressing both the gap in support services and barriers like stigma. But we’ve taken a positive step forward by making digital tools available to those who need them. As frontline workers show their willingness to reach out and try new things like virtual mental health, we may begin to turn the corner on mental health for the people who take care of us in our most difficult moments.


1 Remen, R. N. (1996). Kitchen table wisdom: Stories that heal. New York: Riverhead Books

2 Carleton, R. Nicholas, et al. “Mental Disorder Symptoms among Public Safety Personnel in Canada.” The Canadian Journal of Psychiatry, vol. 63, no. 1, Jan. 2018, pp. 54–64, doi:10.1177/0706743717723825.

3 Stelnecki, Andrea M, et. al. “Mental Disorder Symptoms among Nurses in Canada.” Canadian Federation of Nurses Unions, 2020, retrieved from https://nursesunions.ca/wp-content/uploads/2020/06/OSI-REPORT_final.pdf

4,5 Canadian Medical Association. National Physician Health Survey: A National Snapshot, October 2018; retrieved from http://www.cma.ca/sites/default/files/2018-11/nph-survey-e.pdf 6 Wiklanski, Dave, “Health and wellness: Signs of Trauma.” Firefighting in Canada, Feb. 2019, retrieved from https://www.firefightingincanada.com/signs-of-trauma-26755/

7 CAMH, PTSD in the First Responder, retrieved from https://www.camh.ca/en/camh-news-and-stories/ptsd-in-the-first-responder-world

8 Dutton, Sam, “Study reveals roadblocks to mental health counseling in first responders.” EMS1. Jan. 2019, retrieved from https://www.ems1.com/mental-health/articles/study-reveals-roadblocks-to-mental-health-counseling-in-first-responders-qrZWWNyka49PSBjN/

9 Green, Michael. “Virtual Care is the Future of Health Care Delivery in Canada. Dec. 2020, retrieved from https://www.hilltimes.com/2020/05/10/paid-content-virtual-care-is-the-future-of-health-care-delivery-incanada/ 247763#:~:text=In%202019%2C%20virtual%20care%20saved,is%20better%20for%20everyone's%20health.

10 Canada Health Infoway. “Consulting Canadians on the Future of their Health System: A Healthy Dialogue.” Nov. 2020, retrieved from https://www.infoway-inforoute.ca/en/component/edocman/3850-a-healthy-dialogue-executive-summary/viewdocument? Itemid=0

11 Bailey, Ian. “COVID-19 stress pushing more paramedics to seek mental-health support in B.C.” May 2020. The Globe and Mail, retrieved from https://www.theglobeandmail.com/canada/british-columbia/article-covid-19-stress-pushing-more-paramedics-to-seekmental- health-support/https://www.theglobeandmail.com/canada/british-columbia/article-covid-19-stress-pushing-more-paramedicsto- seek-mental-health-support/

12 Jones C, Miguel-Cruz A, Smith-MacDonald L, Cruikshank E, Baghoori D, Kaur Chohan A, Laidlaw A, White A, Cao B, Agyapong V, Burback L, Winkler O, Sevigny PR, Dennett L, Ferguson-Pell M, Greenshaw A, Brémault-Phillips S. “Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review.” JMIR Mhealth Uhealth 2020;8(9):e22079 URL: https://mhealth.jmir.org/2020/9/e22079 DOI: 10.2196/22079 PMID: 32955456 PMCID: 7536597