Mental Illness and Addictions

The terms ‘mental illness’ and ‘addiction’ refer to a wide range of disorders that affect mood, thinking and behaviour.

Examples include depression, anxiety disorders, schizophrenia, as well as substance use disorders and problem gambling. Mental illness and addictions can be associated with distress and/or impairment of functioning. Symptoms vary from mild to severe.

With appropriate treatment and support, most people with mental illness will recover.

Prevalence

• In any given year, 1 in 5 Canadians experiences a mental health or addiction problem.¹
• By the time Canadians reach 40 years of age, 1 in 2 have – or have had – a mental illness.¹

 Who is affected?

• 70% of mental health problems have their onset during childhood or adolescence.²
• Young people aged 15 to 24 are more likely to experience mental illness and/or substance use disorders than any other age group.³
• 34% of Ontario high-school students indicate a moderate-to-serious level of psychological distress (symptoms of anxiety and depression). 14% indicate a serious level of psychological distress.³³
• Men have higher rates of addiction than women, while women have higher rates of mood and anxiety disorders.³
• Mental and physical health are linked. People with a long-term medical condition such as chronic pain are much more likely to also experience mood disorders. Conversely, people with a mood disorder are at much higher risk of developing a long-term medical condition.³⁴
• People with a mental illness are twice as likely to have a substance use problem compared to the general population. At least 20% of people with a mental illness have a co-occurring substance use problem.⁴ For people with schizophrenia, the number may be as high as 50%.⁵
• Similarly, people with substance use problems are up to 3 times more likely to have a mental illness. More than 15% of people with a substance use problem have a co-occurring mental illness.⁴
• Canadians in the lowest income group are 3 to 4 times more likely than those in the highest income group to report poor to fair mental health.⁶
• Studies in various Canadian cities indicate that between 23% and 67% of homeless people report having a mental illness.⁷

 Morbidity and mortality

• Mental illness is a leading cause of disability in Canada.^{8, 9, 10}
• People with mental illness and addictions are more likely to die prematurely than the general population. Mental illness can cut 10 to 20 years from a person’s life expectancy.¹¹
• The disease burden of mental illness and addiction in Ontario is 1.5 times higher than all cancers put together and more than 7 times that of all infectious diseases. This includes years lived with less than full function and years lost to early death.¹²
• Tobacco, the most widely used addictive substance, is the leading cause of premature mortality in Canada. Smoking is responsible for nearly 17% of all deaths.¹³
• Among Ontarians aged 25 to 34, 1 of every 8 deaths is related to opioid use.¹⁴

Suicide

• Nearly 4,000 Canadians die by suicide each year – an average of almost 11 suicides a day.¹⁵ It affects people of all ages and backgrounds.
  • In Ontario about 2% of adults and 12% of high-school students report having seriously contemplated suicide in the past year. 3% of high-school students report having attempted suicide.^{16, 33}
    
  • More than 75% of suicides involve men, but women attempt suicide 3 to 4 times more often.^{15, 17}
  • In 2012, suicide accounted for 17% of deaths among youth aged 10 to 14, 28% among youth aged 15 to 19, and 25% among young adults aged 20-24.¹⁵
  • After accidents, it is the second leading cause of death for people aged 15 to 34.¹⁵
  • First Nations youth die by suicide about 5 to 6 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.¹⁸
  • More than half of suicides involve people aged 45 or older.¹⁵
    

 Stigma

• According to a 2008 survey:¹⁹
  • Just 50% of Canadians would tell friends or co-workers that they have a family member with a mental illness, compared to 72% who would discuss a diagnosis of cancer and 68% who would talk about a family member having diabetes.
  • 42% of Canadians were unsure whether they would socialize with a friend who has a mental illness.
  • 55% of Canadians said they would be unlikely to enter a spousal relationship with someone who has a mental illness.
  • 46% of Canadians thought people use the term mental illness as an excuse for bad behaviour, and 27% said they would be fearful of being around someone who suffers from serious mental illness.
• In 2015: ²⁰
  • 57% believe that the stigma associated with mental illness has been reduced compared to 5 years ago.
  • 81% are more aware of mental health issues compared to 5 years ago.
  • 70% believe attitudes about mental health issues have changed for the better compared to 5 years ago.
• But stigma remains a barrier: ²¹
  • 64% of Ontario workers would be concerned about how work would be affected if a colleague had a mental illness.
  • 39% of Ontario workers indicate that they would not tell their managers if they were experiencing a mental health problem.
  • 40% of respondents to a 2016 survey agreed they have experienced feelings of anxiety or depression but never sought medical help for it.³⁵

 Access to services

• 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.³
• Only about half of Canadians experiencing a major depressive episode receive ‘‘potentially adequate care.’’³⁶
• An estimated 75% of children with mental disorders do not access specialized treatment services.²²
• Wait times for counselling and therapy can be long, especially for children and youth. In Ontario, wait times of six months to one year are common.^{37, 38}

• In 2013-2014, 5% of ED visits and 18% of inpatient hospitalizations for children and youth age 5 to 24 in Canada were for a mental disorder.²³
• While mental illness accounts for about 10% of the burden of disease in Ontario, it receives just 7% of health care dollars. Relative to this burden, mental health care in Ontario is underfunded by about $1.5 billion.^{8, 24}
• The Mental Health Strategy for Canada recommends raising the proportion of health spending that is devoted to mental health to 9% by 2022.²⁵

 Costs to society

• The economic burden of mental illness in Canada is estimated at $51 billion per year. This includes health care costs, lost productivity, and reductions in health-related quality of life.^{1, 10}
• Individuals with a mental illness are much less likely to be employed.²⁶ Unemployment rates are as high as 70% to 90% for people with the most severe mental illnesses.²⁷
• In any given week, at least 500,000 employed Canadians are unable to work due to mental health problems. This includes:
  • approximately 355,000 disability cases due to mental and/or behavioural disorders²⁸plus
  • approximately 175,000 full-time workers absent from work due to mental illness.²⁹
• The cost of a disability leave for a mental illness is about double the cost of a leave due to a physical illness.²⁸

• A small proportion of all health care patients account for a disproportionately large share of health care costs. Patients with high mental health costs incur over 30% more costs than other high-cost patients.³⁰
• In Ontario the annual cost of alcohol-related health care, law enforcement, corrections, lost productivity, and other problems is estimated to be at least $5 billion.³¹
• A growing body of international evidence demonstrates that promotion, prevention, and early intervention initiatives show positive returns on investment.^{9, 32}

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