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Mental health in Canada has gained significant attention and recognition in recent years, yet challenges persist in ensuring widespread access to adequate care and support. 

Despite efforts to reduce stigma, many individuals still face barriers to seeking help due to societal misconceptions or limited resources, particularly in remote or underserved regions. 

Continued advocacy, improved accessibility to mental health professionals, and increased community support remain crucial for fostering a society where mental health is prioritized and accessible to all.

Mental health challenges are particularly prevalent among young people aged 15 to 24. Nearly 40% of Ontario high school students report moderate to severe psychological distress, with 17% indicating severe distress [1].

Men are more likely than women to struggle with substance use disorders, while women are more likely to experience mood and anxiety disorders.

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Mental health challenges are also prevalent among homeless individuals. Studies in various Canadian cities have shown that between 23% and 67% of homeless people may have a mental illness [3].

Socioeconomic status also plays a role in mental health outcomes. Canadians in the lowest income group are three to four times more likely to report poor to fair mental health compared to those in the highest income group.

Substance use disorders and mental illnesses often coexist. People with mental illnesses are twice as likely to have a substance use disorder compared to the general population. At least 20% of individuals with mental illnesses have a co-occurring substance use disorder [4]. This number may be as high as 50% for those with schizophrenia [5].

Similarly, people with substance use disorders are up to three times more likely to have a mental illness. More than 15% of individuals with substance use disorders have a co-occurring mental illness.

Mental health and physical health are interconnected. Individuals with chronic physical conditions, such as chronic pain, are more likely to develop mood disorders. Conversely, those with mood disorders are at a higher risk of developing long-term medical conditions.

Mental health problems are a common issue in Canada. These conditions can range from mild to severe and can significantly impact a person’s daily life, relationships, and overall well-being.

According to Mental Illness Statistics Canada, the most common mental health problems are:

Mood disorders: These include major depressive disorder, bipolar disorder, and dysthymia. These conditions can cause persistent sadness, changes in sleep and appetite, and difficulty concentrating or making decisions.

Anxiety disorders: These include generalized anxiety disorder, social anxiety disorder, and phobias. These conditions involve excessive worry, fear, or anxiety that can interfere with daily life.

Substance use disorders: These include alcohol and drug use disorders, which can lead to dependence, addiction, and serious health problems.

Post-traumatic stress disorder (PTSD): This condition is caused by experiencing a traumatic event, such as war, violence, or natural disaster. Symptoms of PTSD include flashbacks, nightmares, and avoidance of reminders of the traumatic event.

Attention deficit hyperactivity disorder (ADHD): This condition is characterized by difficulty focusing, controlling impulses, and sitting still. ADHD can affect children, adolescents, and adults.

Eating disorders: These include anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders are serious mental health conditions that can lead to physical health problems, social isolation, and even death.

Personality disorders: These are long-lasting patterns of thinking and behaving that deviate from cultural norms and cause distress or impairment. Examples of personality disorders include borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder.

In Canada, mental illness and substance use disorders stand as primary causes of disability. Individuals grappling with these conditions face a significantly elevated risk of premature death compared to the general population, potentially reducing life expectancy by 10 to 20 years [6]. 

The collective burden of mental illness and substance use in Ontario surpasses that of all cancers combined by 1.5 times and is over 7 times greater than that of all infectious diseases [7]. This burden encompasses both years lived with limited functionality and years lost due to premature mortality.

Risk Of Suicide Associated With Mental Health

In Ontario, approximately 4% of adults and 14% of high-school students report seriously contemplating suicide within the past year. Notably, 4% of high school students report having attempted suicide. Surprisingly, while more than 75% of suicides involve men, women tend to attempt suicide three to four times more frequently. A majority of suicides, over 50%, involve individuals aged 45 or older.

Youth Mental Health Statistics Canada from the year 2018 reveals that suicide accounted for a significant portion of deaths among specific age groups: 21% for children aged 10 to 14, 29% for youth aged 15 to 19, and 24% for young adults aged 20-24 [8]. 

Shockingly, after accidents, suicide stands as the second leading cause of death for individuals aged 15 to 24. Alarmingly, suicide was identified as the primary cause of death for children aged 10 to 14 in 2018.

Moreover, the distressing impact of suicide extends disproportionately to Indigenous communities. Indigenous individuals, particularly youth, experience significantly higher suicide rates compared to non-Indigenous populations. 

First Nations youth aged 15 to 24 face suicide rates approximately six times higher than their non-Indigenous counterparts, while suicide rates among Inuit youth soar to about 24 times the national average.

Disability And Death Associated With Mental Health

Mental Health Canada statistical approximations indicate that approximately 67,000 deaths annually in Canada can be attributed to substance use, notably with over 47,000 related to tobacco and nearly 15,000 linked to alcohol consumption. 

Between January 2016 and September 2019, an estimated 14,700 deaths in Canada were tied to opioid usage.

Around 4,000 Canadians succumb to suicide each year, marking an average of nearly 11 suicides daily. This deeply impactful issue affects individuals across diverse age groups and backgrounds. 

Despite this distressing reality, Canada has observed a decline in suicide rates per capita, which peaked in 1983 at 15.1 deaths per 100,000 people, contrasting with the 2018 figure of 10.3 per 100,000 individuals, the most recent available data [9].

At the intersection of societal perceptions, service availability, and financial implications lies a pressing need for holistic solutions to address mental health and substance use issues. Let’s have a look at the challenges faced by individuals and authorities to eradicate substance use and mental health issues.

Access To Services

Wait times for mental health services in Ontario, particularly for children and youth, pose significant challenges:

  • In January 2020, around 28,000 children and youth were on waiting lists for mental health treatment, more than doubling since 2017.
  • The average wait time for counseling and therapy is approximately 67 days, while intensive treatment averages 92 days.
  • Geographical disparities are evident, with some areas offering immediate access while others experience wait times of up to 2.5 years [10].
  • Despite mental illness and substance use disorders accounting for 11% to 15% of Ontario’s disease burden, only about 7% of healthcare funds are allocated to these issues.

Stigma

According to a 2019 survey of employed Canadians [11]:

  • Seventy-five percent of respondents expressed hesitance or outright refusal to disclose a mental illness to an employer or colleague.
  • They were almost three times more reluctant to disclose a mental illness like depression compared to a physical ailment such as cancer.
  • Primary reasons for this reluctance included perceived stigma around mental health, fear of being treated differently or judged, and concerns about negative repercussions like job loss.
  • Interestingly, 76% of respondents claimed they would be fully comfortable supporting a colleague dealing with mental health issues.

Costs To Society

The economic toll of mental illness and substance use in Canada is staggering:

  • Mental illness costs over $50 billion annually, encompassing healthcare expenses, reduced productivity, and declines in health-related quality of life [12].
  • Substance use incurs an estimated annual cost of nearly $40 billion, spanning healthcare, criminal justice, and lost productivity.
  • Alcohol and tobacco contribute significantly, accounting for more than two-thirds of these costs, with opioids and cannabis following suit.
  • Employment rates for individuals with severe mental illnesses stand as low as 70% to 90%, significantly impacting their ability to work.

As the mental health crisis in Canada continues to grapple with the growing burden of mental illness, it is imperative to foster a collaborative environment where policy, education, and long-term vision converge to create a more inclusive, accessible, and supportive mental health landscape.

Policy Recommendations: The Foundations of Mental Health

Investment in Early Intervention and Prevention: Prioritize early intervention and prevention programs that address the root causes of mental illness, such as trauma, social determinants of health, and substance abuse. This includes expanding access to mental health services in schools, community centers, and primary care settings.

Enhancing Culturally Responsive Care: Recognize and address the unique mental health needs of diverse populations, including Indigenous communities, racialized groups, and individuals with disabilities. This necessitates culturally competent training for mental health professionals and culturally sensitive service delivery.

Promoting Digital Mental Health Solutions: Leverage technology to expand access to mental health services, particularly in underserved areas. This includes developing online platforms, mobile apps, and telemedicine services to bridge geographic and socioeconomic barriers.

Strengthening the Mental Health Workforce: Address the shortage of mental health professionals by increasing funding for training programs, offering competitive salaries, and promoting retention strategies. This ensures a robust workforce capable of meeting the growing demand for mental health services.

Promoting Awareness: Fostering Mental Health Literacy

Public Awareness Campaigns: Implement national and provincial awareness campaigns to combat stigma and promote mental health literacy. This includes utilizing various media channels, such as television, radio, and social media, to educate the public about mental illness, its signs and symptoms, and available treatment options.

Mental Health Education in Schools: Integrate mental health education into the school curriculum from an early age. This includes teaching students about mental health awareness, coping skills, and resilience-building strategies.

Mental Health Training for Professionals: Provide mandatory mental health training for educators, healthcare providers, law enforcement, and other frontline workers. This empowers them to recognize signs of mental distress, provide appropriate support, and connect individuals with mental health services.

Community Outreach and Engagement: Foster partnerships between mental health organizations, community groups, and cultural institutions to engage with diverse populations and reduce stigma at the grassroots level. This includes organizing community events, workshops, and support groups tailored to specific cultural contexts.

Long-term Vision: A Mental Health-Inclusive Canada

A System of Care: Break down silos and promote seamless integration between mental health services, primary care, social services, and other relevant sectors. This ensures a comprehensive system of care that addresses all aspects of an individual’s well-being.

Data-Driven Decision Making: Leverage data collection and analysis to inform evidence-based policy decisions and resource allocation. This includes tracking mental health outcomes, identifying disparities, and evaluating the effectiveness of interventions.

Prioritizing Research and Innovation: Invest in the Canadian mental health care system and encourage research to develop innovative treatment approaches, prevention strategies, and early intervention programs. This includes supporting basic and applied research, as well as research focused on specific mental health conditions and populations.

Mental Health Promotion in the Workplace: Implement workplace mental health strategies that promote employee well-being, reduce stigma, and provide access to mental health support. This includes creating inclusive work environments, offering flexible work arrangements, and training managers to recognize and support employees experiencing mental distress.

1. Pearson, Janz & Ali. Health at a glance: Mental and substance use disorders in Canada. Statistics Canada Catalogue no. 82-624-X.

2. Boak et al. The mental health and well-being of Ontario students. Detailed OSDUHS findings. CAMH Research Document Series no. 47. Toronto: Centre for Addiction and Mental Health.

3. Canadian Institute for Health Information. Improving the health of Canadians: Mental health and homelessness. Ottawa: CIHI.

4. Rush et al. Prevalence of co-occurring substance use and other mental disorders in the Canadian population. Canadian Journal of Psychiatry, 53: 800-809.

5. Buckley et al. Psychiatric comorbidities and schizophrenia. Schizophrenia Bulletin, 35: 383-402.

6. Chesney, Goodwin & Fazel. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry, 13: 153-160.

7. Ratnasingham et al. Opening eyes, opening minds: The Ontario burden of mental illness and addictions. An Institute for Clinical Evaluative Sciences / Public Health Ontario report. Toronto: ICES.

8. Statistics Canada, 2020. https://www.statcan.gc.ca/en/start

9. Public Health Agency of Canada. Opioid-related harms in Canada. Retrieved from https://health-infobase.canada.ca/substance-related-harms/opioids/

10. Children’s Mental Health Ontario. 28,000 Ontario children and youth are waiting for community mental health services. https://cmho.org/28000-ontario-children-and-youth-are-waiting-for-community-mental-health-services/

11. Ipsos. Mental illnesses increasingly recognized as disability, but stigma persists. https://www.ipsos.com/en-ca/news-polls/mental-illness-increasingly-recognized-as-disability

12. Smetanin et al., 2011. https://www.mentalhealthcommission.ca/wp-content/uploads/drupal/MHCC_Report_Base_Case_FINAL_ENG_0_0.pdf

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Mental health in Canada has gained significant attention and recognition in recent years, yet challenges persist in ensuring widespread access to adequate care and support

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