The mental health of survivors of violence against women who accessed supportive services during the COVID-19 pandemic: A narrative thematic analysis.

Background: Violence against women (VAW) is a pervasive public health problem in Canada with detrimental impacts on the mental health of survivors. The COVID-19 pandemic led to an increase in the incidence and severity of VAW, deterioration in population level mental health and well-being, and exacerbated barriers to accessing health and social services. People who were already vulnerable to mental illness or people experiencing marginalization across social factors experienced even greater challenges with their mental health.

Objectives: We aimed to understand the mental health of VAW survivors accessing services during the pandemic and how experiences differed across diverse life histories and sociodemographic factors.

Design: We conducted interviews from April to September 2021, with 10 adult women who had accessed at least one VAW service in the Greater Toronto Area since March 11, 2020. These data were collected as part of a community-based study on the processes, experiences, and outcomes of adapting VAW programming during the COVID-19 pandemic. Participants were sampled through staff contacts at VAW organizations to represent a diverse cross-section of sociodemographic factors and types of services accessed.

Methods: We used narrative thematic analysis to analyze our interview data and identified how life histories and sociodemographic factors intersected with themes about their mental health.

Results: The research team identified four narrative themes pertaining to survivor mental health: (1) new and exacerbated anxiety, depression, and substance use, (2) feelings of hopelessness and mental exhaustion, (3) shame and low self-esteem, and (4) resiliency. Survivor's experiences across these themes differed based on personal factors and life histories (e.g. being a newcomer, being a mother, experiences of childhood trauma and abuse, living with a disability, and socioeconomic status).

Conclusion: During the pandemic, survivors experienced greater mental health needs and at the same time encountered greater challenges in accessing support, which had significant consequences for their mental well-being. Services that support VAW survivors (as essential services) require increased funding and resources to offer effective, accessible, and timely support that improves the lives of survivors. This support must consider survivors' unique needs based on personal factors and life histories during and beyond public health emergencies.