- Canada receives a “B” and ranks 6th out of 17 peer countries.
- Ninety per cent of suicides are related to depression or another mental health disorder.
- Depression has been linked to absenteeism and reduced productivity.
Putting the mortality rate due to mental illness in context
Depression, one of the leading causes of disability, affects about 121 million people worldwide.1 Mood disorders, which include depression and bipolar affective disorder, are among the most common mental illnesses affecting Canadians. According to the Canadian Community Health Survey on mental health and well-being, one in seven adults has had a mood disorder at some point in their lifetime, as identified by reported symptoms.2 An estimated 20 per cent of Canadians will experience mental illness at some point in their lives, and two-thirds of these people will never receive treatment.3
The economic burden attributed to mental disorders in Canada is significant. In 2005, Canadian Senator Michael J. Kirby estimated that costs associated with mental illness in Canada were about $20 billion.4
Mortality rates are typically not used to monitor the impact of mental health disorders because not everyone dies from a mental illness; indeed, most are not even hospitalized. Yet mental illness is the leading cause of hospital admission among Canadians between 15 and 34 years of age, and the second leading cause of hospital admission for those aged 35 to 44.5 The prevalence of mood disorders in Canada continues to increase, and death due to mental illness continues to be a problem Canada and its peer countries.6 In 2004, in Canada, for example, about 3,600 people ended their lives through suicide.7 Ninety per cent of suicides are related to depression or another mental disorder.8
What is mental illness?
Health Canada defines mental health as “the capacity of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity.”9
"Mental illnesses are characterized by alterations in thinking, mood, or behaviour (or some combination there of) associated with significant distress and impaired functioning," according to Health Canada. "The symptoms of mental illness vary from mild to severe, depending on the type of mental illness, the individual, the family, and the socio-economic environment."10
Mental disorders include mood disorders (such as depression and bipolar affective disorder), schizophrenia and other delusional disorders, anxiety disorders, personality disorders, and eating disorders. According to the International Classification of Diseases used by the World Health Organization, the wide-ranging category of mental disorders also includes sleep disorders, substance abuse, mental retardation, dementia, paranoia, and mania. 11
What are the risk factors for mental disorders?
Mental disorders are the result of a complex interaction of factors, ranging from genetics to biological, personality, and environmental influences. Risk factors for mental disorders include family history of mental illness; family, workplace, and life event stresses; chronic diseases; substance abuse; age; and sex—depending on the mental disorder.12
For example, women are at a greater risk than men for certain mental disorders (such as eating disorders like anorexia nervosa and bulimia nervosa). Also, some mental disorders affect more younger people; others are primarily seen in older people (e.g., Alzheimer’s disease).
How does Canada compare to its peers on mortality due to mental disorders?
OECD numbers show that Canada’s mortality rate due to mental disorders in the 2000s averaged about 14 per 100,000 people, with higher incidence among white males and First Nations.13 With an aging population and the rise of chronic diseases in Canada, mental illness will also likely increase. Medical conditions such as stroke and cancer come with a particularly high risk for depression. Elderly people are also at a higher risk for depression than the younger members of the population.
Canada ranks well behind the leaders on this indicator: Japan and Italy each have at least half the mortality rate of Canada. In fact, Japan’s mortality rate is almost five times lower than that of Canada.
Two of Canada’s peers earn a “D” on this indicator: Denmark and the Netherlands. Denmark’s rate of mortality due to mental disorders is more than double that of Canada, with 29 deaths per 100,000 people.
How has Canada’s relative performance changed over time?
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Canada dropped from an “A” grade on this indicator in the 1960s to a “B” grade in the 1970s, where it has since remained.
Denmark’s performance on this indicator has fallen significantly over the past five decades. In the 1960s and 1970s, Denmark was an “A” grade performer. In the following two decades, the country dropped to “B” grades. Its ranking has continued to fall—Denmark is now a “D” grade performer.
Austria and Italy are the only countries that have maintained steady “A”s.
Are more Canadians dying of mental disorders than in the past?
Deaths related to mental illness have increased in Canada—from 3 deaths per 100,000 in the 1960s to nearly 14 deaths per 100,000 in the current decade.
In Denmark, the numbers are more shocking. In 1960, Denmark’s mortality rate was only 2 deaths per 100,000 population; this surged to 29 deaths in 2006.
Use the pull-down menu to compare the change in Canada’s mortality rate due to mental disorders with that of its peers.
How does mental illness affect Canadians in the workplace?
Mental illness not only affects personal relationships, physical health, and social functioning—it can also have a huge impact on workplace performance. It has been argued that the impact of depression on job performance is greater than that of other chronic conditions, including arthritis, hypertension, back problems, and diabetes.14
According to Canadian Community Health Survey results, most workers who had experienced depression in the year prior to the survey being conducted reported that depression had affected their work to some degree. Those who had experienced a major depressive episode in the previous 12 months were more likely to report reduced work activities due to a long-term physical or mental condition or health problems, at least one mental health disability day in the previous two weeks, and absence from work one or more days the previous week.15
Depression has been linked to absenteeism and reduced productivity in the workplace. The cost of Canadian productivity losses associated with depression-related short-term disability was estimated at $2.6 billion in 199816—this figure is likely greater now, given that depression is becoming increasingly prevalent. Depression is one of many mental disorders. The total productivity costs associated with all mental disorders, including depression, are likely much higher.
Last year, The Conference Board of Canada released a study, Building Mentally Healthy Workplaces, based on a survey of more than 1,000 employees nationwide. Of the survey respondents, 12 per cent said they were currently experiencing a mental health issue, while 32 per cent reported that they had experienced one in the past. So, almost half the employees surveyed reported experiencing a mental health issue at some point in their life.17
Given that mental health issues affect a large portion of employees in the workplace, companies need to learn how to manage mental health and wellness. Executives and employees don’t appear to be on the same page when it comes to the perception that workplaces promote a mentally healthy environment: 82 per cent of executives surveyed stated their company promoted a mentally healthy work environment, but only 30 per cent of employees believed this to be the case.18
Should Canadians worry about mental illness?
Yes, the rising level of mortality due to mental illness is a concern for several reasons. Canada’s health services—particularly for mental illness—need serious reform. Critics have argued there is a stigma attached to mental illness, including prejudice among health-care professionals. Lack of early intervention is also problematic, and has a huge economic impact. An estimated 70 per cent of adults with mental illness have suffered from their illnesses since childhood. The cost savings and improvements in lives from early intervention could be enormous. “It is high time we stop using the streets and prisons as the asylums of the 21st century,” Senator Kirby said at a 2005 symposium in Calgary.19
Mental health is also the most fragmented part of the health care system. Senator Kirby summed up the frustrations of advocates for mental health: “It’s unfair to say Canada has a mental health system because the word ‘system’ implies there is a degree of organization.” Kirby argued that the Canada Health Act approach does not work for mental health, because it does not cover specialized mental health institutions, nor does it cover the community services upon which mental health patients rely. Kirby called on the government to introduce a Canada mental health and addictions act.
Mental illness is a serious concern among the Aboriginal population—particularly among First Nations youth. The Aboriginal suicide rate is two to three times higher than the non-Aboriginal rate for Canada. Even more shocking, the youth suicide rate for the Aboriginal population is five to six times higher than that of non-Aboriginal youth.20
What is Canada doing to address mental illness?
In May 2006, the Standing Senate Committee on Social Affairs, Science, and Technology released its landmark mental health report entitled Out of the Shadows at Last. The report contains over 100 recommendations that sweep across the health system and could have a significant impact on this fragmented part of the health system. As a result, the federal government established the Mental Health Commission in August 2007. This commission is now the cornerstone of Canada’s strategy to address mental health issues
In 2009, the Commission launched Opening Minds, an initiative to reduce the stigma of mental illness in Canada. Opening Minds is working with 65 partners across Canada, and more than 50 anti-stigma programs have been identified through this initiative.21 The Commission also released a framework for a mental health strategy in 2009. The framework sets out a vision that contains a number of goals for transforming mental health systems in Canada:
- People of all ages living with mental health problems and illnesses are actively engaged and supported in their journey of recovery and well-being.
- Mental health is promoted, and mental health problems and illnesses are prevented wherever possible.
- The mental health system responds to the diverse needs of all people living in Canada.
- The role of families in promoting well-being and providing care is recognized, and their needs are supported.
- People have equitable and timely access to appropriate and effective programs, treatments, services, and supports that are seamlessly integrated around their needs.
- Actions are informed by the best evidence based on multiple sources of knowledge, outcomes are measured, and research is advanced.
- People living with mental health problems and illnesses are fully included as valued members of society.22
The Commission’s first-ever mental health strategy is in the process of being finalized.
1 World Health Organization, “Mental Health: Depression” (accessed January 13, 2012).
2 Public Health Agency of Canada, “What Is Depression?” (accessed January 13, 2012).
3 The Conference Board of Canada, Unleashing Innovation in Health Systems: Alberta’s Symposium on Health (Ottawa: CBoC, August 2005), 11.
5 Public Health Agency of Canada, “Table 2: Leading Causes of Hospitalizations, Canada, 2005–06, Males and Females Combined” (accessed January 13, 2012).
6 Statistics Canada, “Mood Disorders 2008” (accessed January 13, 2012).
7 OECD Health Data 2011, (accessed January 11, 2012]).
8 Medecinenet.com, “Suicide” (accessed January 13, 2012).
9 Health Canada, Exploring the Links Between Substance Use and Mental Health (Ottawa: Health Canada, 1996).
10 Health Canada, A Report on Mental Illnesses in Canada (Ottawa: Health Canada, October 2002), 7 (accessed September 23, 2009).
11 World Health Organization, International Classification of Diseases (accessed January 13, 2012).
12 Public Health Agency of Canada, “Mental Illness” (accessed January 13, 2012).
13 Helen-Maria Vasiliadis, et al., “Do Canada and the United States Differ in the Prevalence of Depression and Utlization of Services?” Psychiatric Services 58 (January 2007), 63–71.
14 Ronald C. Kessler, Paul E. Greenberg, Kristin D.Mickelson et al., “The effects of chronic medical conditions on work loss and work cutback,” Journal of Occupational and Environmental Medicine, 43, 3 (2001), 218–225.
15 Statistics Canada, Perspectives on Labour and Income, “Depression at Work,” 8, 11 (November 2007), 23 (accessed January 13, 2012).
16 Ibid., 19.
17 Karla Thorpe and Louise Chénier, Building Mentally Healthy Workplaces: Perspectives of Canadian Workers and Front-Line Managers (Ottawa: The Conference Board of Canada, June 2011), i.
18 Ibid., ii.
19 The information and quotes from Michael Kirby come from The Conference Board of Canada, Unleashing Innovation in Health Systems: Alberta’s Symposium on Health (Ottawa: CBoC, 2005), 12.
20 Health Canada, “Acting on What We Know: Preventing Youth Suicide in First Nations” (accessed February 27, 2012).
21 Mental Health Commission of Canada, “Opening Minds” (accessed January 23, 2012).
22 Mental Health Commission of Canada, “Mental Health Strategy for Canada” (accessed January 23, 2012).