The increased prevalence of mental health problems and illnesses in Canada necessitates a consequent increase in the level of need for accessible care and services within the health care system. However, such services (not including hospitalization costs) are not guaranteed under the current system. Exploring the operation and potential areas of improvement of mental health care provides insight into the state of mental health in Canada and the health care system itself, thus allowing a fuller understanding. This page examines the scale of mental illness and the costs to the economy, the obstacles many face when accessing care, how mental health services are delivered, and how these could be improved to help both people and the economy.
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According to the Mental Health Commission of Canada (MHCC), it is likely that more than 7.5 million Canadians, about 1 in 5, faced one of the common mental illnesses in 2016. These common illnesses include anxiety, mood, and substance use disorders, dementia and cognitive impairments. This is twice the amount of people in all age groups suffering from heart disease or type 2 diabetes. Furthermore, among people under the age of 65, mental illness makes up approximately 38% of all illnesses in Canada.
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Graph: Estimated number of people aged nine years and over with a mental illness in Canada, 2016.
The significance of mental health concerns increases when considering the effects on both the individual and the economy. Such struggles are thought to have an impact 1.5 times that of most cancers and are linked with premature death and years of reduced functioning. In addition to the human and emotional impact, the growing presence of mental illnesses among young people suggests long-term effects on the economy. As such, the MHCC recommends that Canada invest in mental health care sooner rather than later, as expenditures, while still substantial, are much less than other OECD countries and leave many with unmet needs. Additional statistics about the prevalence and effects of mental illness in Canada are available from the Centre for Addiction and Mental Health.
Mental Illness and Addiction: Facts and Statistics
Age profile of estimated number of people in Canada with mental health problems and illnesses, 2011-2041
The MHCC estimated in 2016 that the total cost to Canada’s economy incurred by mental health problems and illnesses is well over $50 billion annually or nearly $1,400 per person. This figure includes both direct (private and public expenditures acquired in providing services and supports in the treatment, care, and recovery process) and indirect (those absorbed by the economy, representing lost output because of illness, work-related disability or early death) costs. To understand the costs to the health care system, the estimated non-dementia-related direct costs in 2015 were nearly $23.8 billion, or, excluding the 17.8% that can be attributed to the private sector, just over $19.5 billion.
The $15.8 billion in total healthcare-related costs for mental illnesses amount to roughly 7.2% of all health care spending in Canada. Despite this substantial figure, spending is below that of other OECD countries such as Great Britain, whose National Health Service dedicates 13% of health care spending to a similar set of services. Furthermore, the services provided do not adequately meet the needs and standards of care that the issue merits. In response, calls for change regarding a service-need gap, system-pressures such as a rise in hospitalizations and increasing wait-times have expanded.
While discussing the healthcare issues in Canada, especially in delivering mental health services to minority groups, it has been recognized that there are barriers to accessing Canada's mental health system. Some Canadian studies also indicate possible inequities created in the process of accessing care. Therefore, increasing funding to extend the universal health care system to include mental health requires a concerted effort so that all people have easy and equitable access to mental health services.
Some barriers affect the use of mental health treatment services, which causes many people with mental illness to gave unmet health care needs. According to the annual average data of 2008 - 2012 provided by the Substance Abuse and Mental Health Services Administration (2015), one of the main barriers for people from all races is the cost of insurance and mental healthcare services, as they are not covered under Medicare and vary across the provinces and territories. However, the association between race and the different barriers was seen in the histogram data of the other reasons for unmet need. For white people, one of the main reasons for their unmet need for mental health treatment, apart from the cost, is that they are unwilling to believe that mental healthcare services can work and thus may resist or fail to participate in the process of mental health treatment. Also, white people may face barriers in having lower levels of perceived need according to health care professionals. In comparison, the main reasons that causing black and Hispanic people to have unmet mental health needs are prejudice and discrimination and structural barriers. It is not hard to see, according to this data, that barriers to accessing mental health services for white people are more subjective than the external and objective factors for black and Hispanic people.
Moreover, while discussing the mental health needs among the minority groups in connection with North American history, Aboriginal children in Canada were forced to attend residential schools and were often treated unfairly in those schools, which meant that an entire generation of Aboriginal people has been faced with greater mental health issues. In addition, health and welfare systems for Aboriginal children have not been effective enough for a long time, resulting in a high proportion of the Aboriginal population suffering from mental issues. Thus, due to the high incidence of mental illness among Aboriginal people and the more general issues associated with care in Indigenous communities, mental health care services for Aboriginal people have traditionally been an area of concern and controversy in North America, particularly in Canada. This is in large part due to barriers of accessibility and prejudice, not unlike those discussed above.
Generally, the responses to mental health needs vary and are primarily dependent on what the individual is experiencing. A study from 2012 indicates that of the 17% of Canadians that reported needing mental health care in the span of 12 months, 12% needed counselling, 10% needed medication, 7% reported a need for information regarding mental health problems they were experiencing, and 1% reported another type of need. Interestingly, counselling was the need least likely to be met, especially among those with higher levels of distress.
Statistics Canada reported that in 2015, 14% of Canadians over the age of 12 had seen or talked to a health professional about their mental or emotional health in the span of 12 months. Among this percentage, 2/3 were female, and 1/3 were male. The figure below illustrates who Canadians looked to for help.