Over half of Canadians (53%) consider anxiety and depression to be ‘epidemic’ in Canada, with that perception spiking amongst younger people, according to a new survey commissioned by the Canadian Mental Health Association (CMHA). Fifty-nine per cent of 18 to 34-year-olds consider anxiety and depression to be ‘epidemic’ in Canada, followed closely by addiction (56%) and ahead of physical illnesses such as cancer (50%), heart disease and stroke (34%), diabetes (31%) and HIV/AIDS (13%). The survey accompanies a national CMHA policy paper, Mental Health in the Balance: Ending the Health Care Disparity in Canada, released today, which calls for new legislation to address unmet mental health needs and bring mental health care into balance with physical health care.

“Our universal health-care system is a point of pride for Canadians,” says Dr. Patrick Smith, national CEO, CMHA. “But the reality is, we don’t have a universal health-care system, but a universal medical system that doesn’t guarantee access to some of the most basic mental health services and supports.”

Eighty-five per cent of Canadians say mental health services are among the most underfunded services in our health-care system—and the majority agree (86%) that the Government of Canada should fund mental health at the same level as physical health.

Despite recent unprecedented mental health funding commitments made by the federal government, over 1.6 million Canadians report unmet mental health care needs each year. Worldwide, mental illness accounts for about 23 per cent of the total disease burden, yet Canada dedicates only 7.2 per cent of its health-care budget to mental health. And, the need for mental health services and supports is growing. By 2020, depression will be the leading cause of disease in Canada.

Changing the mental health landscape

“What we outline in our policy paper is that righting this balance is about more than just the balance sheet,” explains Dr. Smith. “The Mental Health Parity Act we are advocating for is not just about increasing funding for mental health services, but also improving coordination, treatment, research and access and making better choices about how best to spend health-care dollars effectively.”

Lengthy wait times are a problem, in part, because there has been a chronic underfunding of community-based mental health services and a reliance on intensive, high-cost services like psychiatrists and hospitals.

Up to 80 per cent of Canadians rely on their family physicians to meet their mental health care needs, but those services are limited. Evidence-based health care provided by addiction counselors, psychologists, social workers and specialized peer support workers is the foundation of the mental health response in other G7 countries, but these services are not guaranteed through our public system. Consequently, Canadians spend almost a billion dollars ($950 million) on counselling services each year—30 per cent of it out of pocket.

Many people with complex or chronic mental health problems do not receive the full scope of care they need and end up cycling through the acute care system.

A more integrated continuum of care provided through community mental health services can meet the needs of as many people with mental health problems as possible by including early intervention and prevention, enhanced treatment for those who need it, and longer-term follow-up and supervision for those with severe and persistent illness.

“Canadians are suffering from health conditions that are preventable or manageable with the right supports,” says Dr. Smith. “By adopting and promoting a ‘stepped-care approach’ to mental health service delivery that matches people to the right services and supports to meet their needs, Canadians will have better access to the right care at the right time.”

In addition to improving quality of life and health outcomes, mental health promotion, mental illness prevention and early intervention can reduce the burden on our health-care system. A recent study on the treatment of depression estimated that every dollar spent on publicly funded psychological services would save two dollars for the health system.

To make sure that those who need services and supports get them, new legislation must also address stigma and discrimination—in the health-care system, amongst practitioners and at the individual level—and improve access for those who are marginalized. Investments in social spending would address mental illness root causes of poverty, trauma and marginalization, boosting our most vulnerable citizens’ ability to contribute to their communities and lessening the burden of illness nationally.

The imbalance in research funding of mental health vis-à-vis physical health, should also be addressed. The Canadian Institutes of Health Research (CIHR), for instance, spends only 4.3 per cent of its annual research budget on mental health. Canada needs sustained research investment in mental health to spur innovation, better translate scientific knowledge into practice and develop therapies that are appropriate, effective and that promote treatment acceptance for people with mental illnesses. 

“The system is ailing, but we have a treatment plan to nurture it back to health,” says Dr. Smith. “When we improve service and supports for the one in five Canadians who will experience mental illness in any given year, we will see benefits in health outcomes, quality of life and wellbeing for all Canadians—the five in five—who have mental health.”

To download the Summary Report of Mental Health in the Balance, Ending the Health Care Disparity in Canada, or the 24-page Full Report, please visit www.cmha.ca.

About the survey
CMHA partnered with Maru/Matchbox to conduct an online survey from September 5-6, 2018 among a total of 1,510 randomly-selected Canadian adults aged 18+ who are members of Maru Voice Canada (formerly known as the Angus Reid Forum)—the premier Canadian online panel with many features that differentiate it from traditional online access panels. The margin of error, which measures sampling variability, is +/- 2.5%, 19 times out of 20. The results have been statistically weighted according to education, age, gender and region (and in Quebec, language) Census data to ensure a sample representative of the entire adult population of Canada. Discrepancies in or between totals are due to rounding.