Impact of social determinants of mental health on child and parent risk, resilience and support access in the COVID-19 era: A nested mixed-methods study of short and long-term outcomes

This award is co-funded by Health Research BC, through CIHR’s Operating Grant: Understanding and mitigating the impacts of the COVID-19 pandemic on children, youth and families in Canada. 


Project co-leads include Evelyn Stewart MD and Hasina Samji PhD, who brought together their extensive collaborative networks. Dr. Stewart is a UBC professor, child and adolescent psychiatrist and Director of Research for Child and Adolescent Psychiatry, BCCH. Dr. Samji is an epidemiologist, SFU assistant professor and senior scientist at BCCDC.


Between November 2020 and July 2021, the group collected baseline data for the Personal Impacts of COVID-19 Survey (PICS), a Canadian study identifying vulnerability factors to poor mental health related to preexisting medical and living conditions, sex/gender minorities and poverty. Based on our PICS baseline findings, which includes 3,351 Canadians, rates of several COVID-era mental illnesses were several-fold higher than expected; and one quarter of parents reported needing but not receiving mental health support.


Our mixed-methods study will build upon PICS findings by re-contacting participants to better understand their pandemic-era mental health service access, future preferences and the role of social risk and resilience factors. It will also identify those with persisting, resolving and newly emerging mental illness during the COVID-19 recovery phase. In this way, our study will provide a current, comprehensive perspective on families’ experience of the COVID-19 pandemic and how services providers, community organizations and policymakers can best serve child and parent populations at highest risk for ongoing mental health impacts.

End of Award Update – July 2024



Only 35% of participants reported accessing mental health supports for their youth throughout the pandemic. 20% reported needing but not receiving support. Most participants attributed their mental health needs to pandemic-related reasons. Those with unmet needs reported mostly needing a publicly funded psychiatrist/psychologist, or a private counsellor/psychologist. Participants also reported needing more mental health support from schools and community mental health teams. For many youths, informal coping strategies were very important, such as relying on friends for emotional support or engaging in hobbies and extracurriculars. These coping strategies were the most impacted by the pandemic and left many youths without both formal supports and informal coping strategies. Overall, these results highlight the amount of Canadian youths who needed but did not receive mental health services.



Participants will hopefully receive indirect benefits from this project in the form of improved provincial support services and policies regarding youth mental health and well-being during the COVID-19 pandemic recovery. Results from this project have informed the creation of a provincial report that is aimed at providing recommendations and action items for provincial service providers and policymakers who are in positions to make informed decisions and act on the outcomes reported in this project.

Additionally, we have been able to provide families and youths an opportunity to share their experiences and feel heard during a time that was very challenging and isolating. Several of our participants expressed positive therapeutic effects of participating in qualitative research and feeling connected and able to contribute to better outcomes in the future.


Potential Influence

The results and recommendations from this study have been shared widely with provincial healthcare providers, health institutions, patients, provincial decision-makers, and community organizations through posters, presentations, social media, infographics, and a provincial report. We hope that through wide dissemination to these different groups, the results of this project can contribute to the greater discussions on how to support BC resident’s mental health during the pandemic recovery phase. Our recommendations have already been incorporated into the ‘Improving Youth Mental Health and Well-Being During the COVID-19 Recovery Phase in BC Report’ that was organized and compiled through the combined efforts of the BC Children’s Hospital, The University of British Columbia, and Simon Fraser University. The purpose of this report was to identify strategies to support youth mental health and well-being during the pandemic recovery period. Findings from this project were presented at deliberative dialogue events to attendees that included partners from the education, health, community, and nonprofit sectors, alongside youth and families. These findings contributed to the report’s objective by examining the mental health impacts of the COVID-19 pandemic on youth, identifying which groups of youth have been disproportionately impacted, and what modifiable factors and coping strategies have helped to buffer the effects of the pandemic. This report presented recommendations and key action steps to hopefully guide youth mental health partners in the province to focus on recovering from the societal and mental health impacts of the pandemic.


Next Steps

We currently have two manuscripts in submission that we will continue to pursue for publication. This project has already provided opportunities for research trainees and will continue to provide opportunities for future trainees to conduct projects, particularly those examining how best to mitigate risk factors and support vulnerable identities that were most impacted during the pandemic.

Notably, we continue to collect longitudinal data through periodic survey follow-ups, which allows us to continue to track the long-term outcomes of COVID-19 on Canadian wellbeing and mental health and will support future analyses and manuscripts.

Open MRI for assessing joint biomechanics – applications for osteoarthritis

Hip osteoarthritis is prevalent, disabling and costly to individuals and the healthcare system. Symptomatic hip osteoarthritis affects 4.2 percent of people over 50, and radiographic degenerative changes are seen in almost 20 percent of the same population. In many patients, total hip arthroplasty is used to relieve pain and improve function. Though effective in improving a patient’s quality of life, joint replacements will eventually fail and require revision surgeries that have a higher complication rate and less predictable results. Better strategies to delay or stop the progression of osteoarthritis are needed, which can only be created with a clearer understanding of the disease’s etiology.

While there is strong evidence that structural changes around the hip are major etiological factors in the development of osteoarthritis, it is not clear how to protect hips from the disease. Anatomical abnormalities such as cam-type femoroacetabular impingement (a deformity of the hip bones) may account for 90 percent of hip osteoarthritis cases. However, it is not clear why only some people with these deformities get hip osteoarthritis. It is widely assumed that the relationships between activity and deformity size and their effect on joint mechanics are critical. Investigating these relationships has not been possible to date because there have been few well-validated methods for assessing impingement directly in vivo. This project will answer two research questions:

  1. Which activities lead to direct cam impingement at the hip in patients with FAI deformities?
  2. How is this impingement influenced by deformity size?

To answer these questions, we will use gait analysis to measure hip movements and mechanics in symptomatic and healthy subjects for a range of activities associated with hip pain. These measurements will be used to develop subject-specific numerical models predicting direct impingement for each participant. Model predictions of direct impingement will be validated by scanning participants using an established protocol in UBC’s upright open MRI scanner.

We have developed a knowledge translation strategy for this project with the Arthritis Patient Advisory Board; they will post the project summary on their website as well as profile the research findings on social media. Results will be published in both clinically- and research-oriented journals and at conferences for both clinicians and scientists.