COVID-19 and Mental Health (CMH) Initiative: Research

Interventions to Mitigate COVID-19 Related Mental Health Risks for Those with Pre-existing Chronic Health Conditions and Facing Social and Economic Barriers: A Scoping and Rapid Realist Review

Key Messages

COVID-19’s impact has and continues to have devastating impacts, particularly among those who are at-risk and/or have challenges in functioning in a society that changed suddenly and dramatically. For many this has led to mental health effects such as depression, anxiety, uncharacteristic behavioural changes, and use of substances to help mask the pandemic’s consequences. However, there is opportunity to support population health during these difficult times by offering appropriate interventions that have the flexibility to be tailored to subpopulations with unique needs. The knowledge synthesis, currently in progress, aims to help identify such interventions that will foster individual resilience and mental well-being.

Lay Summary

Based on a preliminary high-level review of the literature there are many biological, social, behaviour, and environment factors that are shared between physical health conditions that present risk of COVID-19 and mental health responses. Biological contributors include one’s genetics as well as immune system and hormone imbalances. Social and behavioural factors include the stresses physical distancing, being vulnerable to lowered access to food, recreation, and public transport, disturbed sleep, overloaded hospital services that lead to premature discharges, and widespread panic to the uncertainties of a new illness may lead to mental health effects such as psychiatric condition diagnosis. At wider levels, issues such as reduced health services, absence of adequate testing, poor coordination among health and social services, and lack of accepted ways to manage COVID-19 may also weigh heavily on one’s consciousness. Mental health responses that have been reported include anxiety, depression, harmful use of substances, defensive and rebellious behaviour, in-home conflicts, repetitions of unresolved childhood issues, and emotional depletion. For families where a member has experienced COVID-19 infection or related death, delayed mourning and post-trauma experiences have also been documented.

Based on the COVID-19 events to date, more targeted and integrated interventions to lessen mental health impacts are needed. First, there is a need for widespread awareness-raising through common media channels that fully engages people and fosters understanding about COVID-19 and mental health. Second, for those experiencing poor mental health, diverse and flexible approaches such as shared health care planning, online counseling, and genuine social interaction and integration may be effective. Finally, rehabilitation guidelines for COVID-19 co-developed by different practitioners may also reduce the mental health burden of recovery. In conclusion, while the current COVID-19 situation appears to be somewhat controlled, the threat of future outbreaks points to the urgent need to identify and evaluate strategies that can promote mental well-being.


  • COVID-19
  • Mental health
  • Substance use
  • Chronic diseases
  • Autoimmune conditions
  • Inflammatory bowel disorders
  • Kidney diseases
  • Liver diseases
  • HIV or AIDS
  • Neurocognitive conditions


  • Nominated Principal Applicant: Karen Davison, Kwantlen Polytechnic University
  • Simon Carroll, Kwantlen Polytechnic University
  • Benjamin Collins, Kwantlen Polytechnic University
  • Marcie Dolce, Patient Advisor
  • Esme Fuller-Thomson, University of Toronto
  • Brandon Hey, Mental Health Commission of Canada
  • Krystal Kelly, Mental Health Commission of Canada
  • Marya Jaleel, Mental Health Commission of Canada
  • Shen (Lamson) Lin, University of Toronto
  • Maura MacPhee, University of British Columbia
  • JoAnne Marvin, Patient Advisor
  • Arun Ravindran, The Centre for Addiction and Mental Health
  • Ron Remick, Lookout Housing and Health Society and Mood Disorder Association of British Columbia
  • Lynda Robson, Patient Advisor
  • Janice Sorensen, Kwantlen Polytechnic University
  • Vicki Smye, Western University
  • Lori Stuart, Patient Advisor
  • Vidhi Thakkar, Kwantlen Polytechnic University

For more information, please contact: Karen Davison,

Related Syntheses


Full PDF


Chronic Disease and/or Mental Illness


To ensure the rapid dissemination of this critical information, information is published in the language in which it was submitted. Please contact us for French or English translations.

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