Mental health ‘shadow pandemic’ may be an issue for years

By Tony Poland, LegalMatters Staff • A rise in mental health issues during the COVID-19 crisis has resulted in a “shadow pandemic” and many people are not getting the help they need and deserve, says Toronto and Markham-area disability lawyer Rupa Karyampudi.

According to the World Health Organization, the coronavirus pandemic has “led to a worldwide increase in mental health problems, including widespread depression and anxiety. People living with pre-existing mental disorders are also at greater risk of severe illness and death from COVID-19 and should be considered a risk group upon diagnosis of infection.” 

“There has been a great deal of uncertainty leading to chronic stress in the past two years. People really don’t know what is going to happen next and many are at their breaking point,” says Karyampudi, a partner at MK Disability Lawyers. “There are reports about how Canada’s mental health care system is at a crisis point. It is a significant problem.

“Many of our clients are unable to work and don’t have coverage for therapists or medication and there is a long wait list for government-funded programs,” she tells LegalMattersCanada.ca. “The world may be slowly getting kind back to normal but it doesn’t mean we can expect clear sailing in the immediate future. People are stressed because of the pandemic. They are worrying about new variants. Then there are world events, such as the war in Ukraine, coupled with rising prices and inflation that lead to financial stress.”

Canadians report their mental health has worsened

An Angus Reid Institute survey, conducted in partnership with CBC, found 54 per cent of Canadians said their mental health had worsened during the past two years. 

According to the CBC, researchers found some Canadians could face long-term mental health implications due to pandemic-related stress.

“There is an epidemic of chronic stress that’s been going on for so long, and people are feeling so much uncertainty, that we’re concerned now that it will take much time for them to get over this experience of the pandemic,” Margaret Eaton, national CEO of the Canadian Mental Health Association told CBC. “We live in this patchwork quilt system of mental health where some people, if you have a good employer with a benefits plan, then you might get some psychotherapy. But a lot of people have suffered through the pandemic and haven’t found any support.”

Karyampudi says even if you have an employer with a benefits plan, it does not guarantee you will get help.

‘It is always a challenge with so-called invisible conditions’

“It is always a challenge with so-called invisible conditions, such as mental health issues, because there is no diagnostic such as an x-ray or CAT scan ,” she says. “We are dealing with subjective, self-reported symptoms so insurance providers are often going to challenge the diagnosis and the severity of the condition when someone makes a claim.

“The mental health crisis is not going to suddenly disappear. In fact, I actually believe it will get worse because treatment costs a significant amount of money and insurers are going to be even more stringent when adjudicating these claims,” adds Karyampudi. “They are going to make the same arguments they often do and deserving people will be denied benefits.”

Working from home tends to blur the lines when it comes to mental health, she says, adding people have less of a work-life balance and lack a readily accessible support system because they are isolated. 

MD recommendation doesn’t guarantee benefits will be approved

Even when a doctor is supportive and a person is getting treatment and taking their medications, insurance companies may still deny a claim, says Karyampudi.

“They might recognize that someone is suffering from depression or anxiety, but the insurer often refuses to pay the benefits, claiming the condition is not at a level where the person is unable to perform their job duties,” she explains. “The test for disability benefits is somewhat subjective.”

• The challenge of representing clients who have PTSD
• Better understanding is needed of LGTBQ mental health issues
• Path to mental health care can be difficult for immigrants, racialized

Karyampudi says people may be entitled to benefits for a mental health issue but don’t always pursue a claim or seek the treatment they need.

“There can be multiple reasons. They may not realize mental illness is a disability and can be the basis of an insurance application. There really are misunderstandings and misconceptions about mental illness,” she says. “Some people are hesitant to take a leave, preferring to work through an issue. People may feel judged, like they are weak. They are very hesitant and even if they do admit they need treatment, they have a difficult time accessing resources that are appropriate for them. 

“Some people also don’t realize that if the claim is denied, they can talk to a lawyer who can help them to appeal that decision, ” Karyampudi adds. “We see all these issues in our practice.”

Some have difficulty acknowledging a problem

She says people sometimes find it difficult to admit to themselves that they are dealing with a mental health issue.

“In those instances, it can really do more harm if you try to push on. Especially if you are in a job where people depend on you,” Karyampudi says. “If you are not performing at the level you should, there can be a danger to others.

“Just as important, you can aggravate your condition and prolong your recovery in the long run,” she adds. “You can jeopardize or strain your relationship with your employer. It can also interfere with your ability to communicate with other people. There are many risks tied up in ignoring a problem.”

Karyampudi says claimants should be precise when making an application for benefits.

‘Be careful when it comes to short-term and LTD claims’

“You have to be careful when it comes to short-term and long-term disability (LTD) claims based on burnout or workplace stress because many policies have language that preclude making claims for that. You really have to be cautious with the wording,” she says. “The test under short-term and LTD policies is whether you can perform the duties of your job. You need to focus on that. Your issue needs to be at a severity that prevents you from doing your job.” 

You should include all the symptoms of your condition, says Karyampudi. 

“Try to be as comprehensive as you can on your application,” she says. You can talk to a disability lawyer who will be able to guide you through your insurance policy and help you understand the requirements.

“We practise trauma-informed lawyering. We are very aware of how difficult dealing with a mental health issue is,” Karyampudi adds. “We try to make it as easy as possible for those seeking help. There are so many challenges when you are suffering and it can be overwhelming.”

More from MK Disability Lawyers:

Important to understand how AI fits in the legal profession

---