Released in April 2018, this is the first of three Difference Makers Discussion Papers CAMH and our presenting partner, Morneau Shepell, are releasing to continue to engage Canadians in a national conversation on mental health leading up to the May 23, 2018 Difference Makers Symposium.
Stigma remains a powerful barrier to seeking help. Too many Canadians wait until a point of crisis to start
talking about the mental health and addiction challenges they face and some never seek or find help before
we lose them.
In the fall of 2017, we celebrated 150 CAMH Difference Makers helping to lead new dialogues around mental health and addiction, inspiring Canadians to recognize that we are all affected by mental illness. Their stories brought attention to a number of important realities:
They introduced us to a wide variety of identity groups (from sporting communities, to racialized groups such as those who identify as Black Canadians or Chinese Canadians) where there is a lack of experience in or openness to talking about mental illness.
They made clear that many mental health advocates have tragedy as their starting point, finding their voices after almost losing themselves or actually losing a loved one to death by suicide.
They let us know that inspiring people to talk is only step one. We must also ensure timely, quality care is available to Canadians when they reach out for help. That care must be person-centred and recognize each individual’s diverse needs and identities.
These stories make clear that the need is large and growing. As more and more communities are learning, it really is all of us who are affected by mental illness, whether that impact is felt through our own lived experiences, or through the experiences of those around us.
In 2016, more than 7.5 million people or one in five Canadians were likely facing a mental illness. This size of this group is greater than the population of our 13 capital cities combined. This is also nearly twice the number of people in all age groups with heart disease or Type 2 diabetes 1.
Of the 7.5 million people who were estimated to be living with a mental illness in 2016, over half were experiencing an anxiety and/or mood disorder, and a quarter were experiencing substance use disorders 2.
Seventy per cent of mental health problems have their onset during childhood or adolescence 3. Young people aged 15 to 24 are more likely to experience mental illness and/or substance use disorders than any other age group. 4
Researchers estimate that the impact of mental illnesses is more than one-and-a-half times that of all cancers, when taking into account years of life lost due to premature death and years of reduced functioning. 5
The impact of mental illnesses extends to family members. In 2012, about 38 per cent of people in Canada had a family member experiencing a mental health problem or illness, while 22 per cent had two or more family members experiencing a mental health problem or illness. 6
Although still a minority, the number of Canadians who say they have talked with someone about their mental health continues to increase from 31 per cent two years ago and 35 per cent in 2016 to 42 percent in 2017. 7
“Many immigrants from Mainland China are struggling with mental illness, but they have little knowledge of mental illness and are afraid to seek help due to stigma. Because of my work, many people have increased their knowledge . . . and have gained skills around early identification. I’d like to see . . . more and more people not afraid of seeking help when they get mentally sick.”
Liping Peng, CAMH Difference Maker and Mental Health Worker at Hong Fook Mental Health Association
The large number of Difference Maker nominations from survivors of suicide loss or individuals who have themselves struggled with suicidal thoughts reflected the devastating impact death by suicide has on the lives of many Canadians. While many of the 150 CAMH Difference Makers are helping to create change around how we talk about and prevent suicide, the need for broader, coordinated change remains urgent.
Nearly 4,000 Canadians die by suicide each year an average of almost 11 suicides a day. 8
More than 75 per cent of those who die by suicide are men, but women attempt suicide three to four times more often. 9
More than half of suicides involve people aged 45 or older. 10
After accidents, suicide is the second leading cause of death for people aged 15 to 34. 11
In 2012, suicide accounted for 17 per cent of deaths among youth aged 10 to 14, 28 per cent among youth aged 15 to 19, and 25 per cent among young adults aged 20 to 24. 12
First Nations youth die by suicide about five to seven times more often than non-Aboriginal youth. Suicide rates for Inuit youth are among the highest in the world, at 11 times the national average. 13
People at higher risk for suicide include those who live with serious mental illness or addiction, have a family history of suicide and who have previously attempted death by suicide. 14
“For myself, I felt firsthand the power of one person's courage to share their journey through mental illness, which in turn gave me the strength to continue on with mine . . . I would like to see more youth representation in the mental health community . . . [they] have the firsthand knowledge, and some amazing ideas . . . they are ready to make waves, they just need a few supportive adults to give them the opportunity to have their voices heard.”
Mackenzie Murphy, Difference Maker and Youth Mental Health Advocate
Stories of Difference Makers getting access to, or helping others access, the care they need provide pockets of hope: timely and appropriate care is available, and makes a difference. Unfortunately, that is not yet everyone’s experience.
The number of Canadians reaching out for care is on the rise. In 2017, the number of people who report talking to a counsellor, psychologist or psychiatrist about their mental health rose to 16 per cent (from 11 per cent in 2015) and those who report talking with their primary healthcare provider rose to 23 per cent (from 16 per cent in 2015. 15
When supports are available, people access them. In 2017, almost half (45.7 per cent) of clients with access to Morneau Shepell’s Employee and Family Assistance Programs listed the primary reason for seeking support as mental health, addiction or stress. 16
More individuals seeking care is a positive outcome of efforts to reduce stigma. However, unless resources are allocated to meet the growing demand for services, there is a risk that wait times will increase. In Ontario, for example, the 2016 Auditor General Report revealed that in speciality psychiatric hospitals, patients now wait longer for inpatient beds and outpatient programs than they did five years ago. 17
Of Canadians aged 15 or older who report having a mental health care need in the past year, one third state that their needs were not fully met. 18
Only about half of Canadians experiencing a major depressive episode receive "potentially adequate care." 19
There are a number of groups from marginalized communities, such as LGBTQ+ youth, 20 to members of certain professions, such as public safety personnel 21 who are at higher risk for mental illness and addiction, and whose needs are unique from those of mainstream populations. When services are made available that meet their needs, lives can be changed.
“Over the years, I worked in many different fields of social work and counselling within government, non-profit, hospitals and academia, and often came across the same issues the need to collaborate and overcome silos yet saw that these barriers remained despite the universal recognition of their harm.?I decided to do something about it by creating a counselling service available to anyone who needed it, and working with like-minded individuals and groups to provide the best support to our mutual clients. We provide counselling and support to nearly 2000 clients per week, and receive 30-40 new referrals (including self-referrals) per week. These clients would have otherwise never received services, or would have had to wait months or even years for such services. That is needless suffering.”
Gary Thandi, Difference Maker and Founder of Moving Forward Family Services
A growing number of proponents in a position to effect change are recognizing the need to increase access to high quality mental health services and supports. From recent announcements of investments in greater access to publically-funded psychotherapy in Quebec and Ontario, to employers investing resources in building mentally healthier workplaces, to the many Difference Makers leading the way for change, progress is being made. How do we build on this hope to keep the mental health movement moving forward? That critical question is explored in the soon to be released second Difference Makers Discussion Paper, exploring the theme of Connection through a look at mentally healthy spaces, as well as the third Discussion Paper, focusing on Innovation.
1Smetanin et al. (2011).?The life and economic impact of major mental illnesses in?Canada: 2011-2041. Prepared for the Mental Health Commission of Canada. Toronto: RiskAnalytica.
3Government of?Canada (2006).?The human face of mental health and mental illness in Canada. Ottawa: Minister of Public Works and Government Services Canada.
4Pearson, Janz and Ali (2013). Health at a glance: Mental and substance use disorders in Canada. Statistics Canada Catalogue no. 82-624-X.?
5Ratnasingham, S., Cariney, J., Rehm, J., Manson, H., Kurdyak, P. (2012). Opening eyes, opening minds: The Ontario burden of mental illness and addictions report. Institute for Clinical Evaluative Studies (ICES).
6Pearson, C. (2015). The impact of mental health problems on family members. Health at a Glance. Statistics Canada. Catalogue no 82-624-X.
7Ispos (2017). 3rd annual Canadian mental health check-up. Public Perspectives. Retrieved from https://www.ipsos.com/sites/default/files/2017-08/IpsosPA_PublicPerspectives_CA_Aprilper cent202017per cent20Mentalper cent20Health.pdf
8Statistics Canada (2015). Leading causes of death, total population, by age group and sex, Canada. CANSIM 102-0561.
13Health Canada (2018). First Nations & Inuit health suicide prevention. Retrieved from https://www.canada.ca/en/health-canada/services/first-nations-inuit-health/health-promotion/suicide-prevention.html
14retrieved from http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/suicide/Pages/default.aspx
15Ispos (2017). 3rd annual Canadian mental health check-up. Public Perspectives. Retrieved from https://www.ipsos.com/sites/default/files/2017-08/IpsosPA_PublicPerspectives_CA_Aprilper cent202017per cent20Mentalper cent20Health.pdf
16Morneau Shepell (2017). Annual utilization trends.
17Office of the Auditor General of Ontario (2016). Annual Report 2016. Queen’s Printer for Ontario. Retrieved from http://www.auditor.on.ca/en/content/annualreports/arreports/en16/v1_312en16.pdf
18Pearson, Janz and Ali (2013). Health at a glance: Mental and substance use disorders in Canada. Statistics Canada Catalogue no. 82-624-X.?
19Patten et al. (2016). Major depression in Canada: what has changed over the past 10 years? Canadian Journal of Psychiatry, 61: 80-85.?(“Potentially adequate treatment” defined as “taking an antidepressant or 6 or more visits to a health professional for mental health reasons.”)?
20Taylor, C., Peter, T., McMinn, T. L., Elliott, T., Beldom, S., Ferry, A., Gross, Z., et al. (2011).?Every class in every school: The first national climate survey on homophobia, biphobia, and transphobia in Canadian schools. Final Report.?Toronto, ON: Egale Canada Human Rights Trust.
21Carleton et al. (2017). Mental Disorder Symptoms among Public Safety Personnel in Canada. Canadian Journal of Psychiatry. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/0706743717723825