Self-Reported Mental Health

Key Messages

Putting self-reported mental health in context

Both physical health and mental health determine a person’s overall health and affect quality of life. Good mental health is now regarded as not only the absence of mental illness such as mental disorders, emotional problems, or distress but also the presence of factors such as the ability to enjoy life.¹

Depression, one of the leading causes of disability, affects about 121 million people worldwide.² Mood disorders, which include depression and bipolar affective disorder, are among the most common mental illnesses affecting Canadians. One in seven adults has had a mood disorder at some point in their lifetime, as identified by reported symptoms, according to Statistics Canada’s community health survey on mental health and well-being.³ An estimated 20 per cent of Canadians will experience mental illness at some point in their lives, and almost “one half (49 per cent) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem.”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 still the second leading cause of hospital admission among Canadians between 15 and 34 years of age, and the third leading cause of hospital admission for those aged 35 to 44.⁵ The prevalence of mood disorders in Canada continues to increase: 7.5 per cent of Canadians 12 years and older were diagnosed as having a mood disorder in 2013, up from 5.1 per cent in 2003.⁶

Self-reported mental health is a subjective measure of overall mental health status and gives an indication of the share of the population suffering from a “mental disorder, mental or emotional problems or distress, not necessarily reflected in self-perceived health.”⁷

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.⁸

According to Health Canada, “mental illnesses are characterized by alterations in thinking, mood, or behaviour associated with significant distress and impaired functioning.” Examples of specific mental illnesses include major depression and bipolar disorder, schizophrenia, anxiety disorders, personality disorders, eating disorders, substance dependency, and post-traumatic stress disorder, among others. “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.”⁹

How do the provinces and territories rate their mental health?

Newfoundland and Labrador has the highest rate of perceived mental health among the provinces and territories—74.5 per cent of the population aged 12 and over reported their own mental health status as being “excellent” or “very good” in 2013. Quebec is not far behind, with 73.9 per cent of the population reporting “excellent” or “very good” mental health. Nunavut ranks last and is an outlier—only 55 per cent of the population aged 12 and over reported their own mental health status as being “excellent” or “very good,” significantly below the Canadian average of 71.6 per cent.

The three territories rank at the bottom of the pack on self-reported mental health. Since Nunavut is an outlier, Yukon and N.W.T. score “B” grades, even though they rank quite low relative to the provinces. If we exclude Nunavut from the report card calculation, the other two territories score “D”s and three provinces stand out as “A” grade performers: Newfoundland and Labrador, Quebec, and Alberta.

How do the rankings compare with self-reported health status?

For the most part, the self-reported mental health rankings mirror the self-reported health status rankings. Quebec, Alberta, and Manitoba do well on both indicators, while Nunavut ranks last. However, there are some differences. N.W.T. ranks second-to-last on self-reported mental health, while it earns an “A+” grade on overall self-reported health, placing first among all the provinces, territories, and peer countries. Yukon also ranks high on self-reported health but low on self-reported mental health.

Conversely, Newfoundland and Labrador and Saskatchewan rank lower relative to the other provinces and territories on self-reported health, but do much better on self-reported mental health. In fact, Newfoundland and Labrador leads the country on self-reported mental health, but is below the national average on self-reported health.

Should Canadians worry about mental illness?

Yes, the rising rate of 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.

Mental illness is also a serious concern among the Aboriginal population—particularly for 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.¹⁰

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 is difficult to measure the precise impact, because many people with a mental illness still show up for work. However, it has been estimated that the economic burden of mental illness costs the Canadian economy about $51 billion per year.¹¹ This includes costs related to health care, lost productivity, and reductions in health-related quality of life.

The Conference Board of Canada released a study, Building Mentally Healthy Workplaces, based on a survey of more than 1,000 employees nationwide in 2011. 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.¹² In a separate report released in 2012, the Conference Board estimated that mental illness costs Canada $20.7 billion annually as a result of lost labour force participation.¹³

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 in the Conference Board survey stated their company promoted a mentally healthy work environment, but only 30 per cent of employees believed this to be the case.¹⁴

What is Canada doing to address mental illness?

In May 2006, the Senate Standing Committee on Social Affairs, Science, and Technology released its landmark mental health report, 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 partners across Canada to address stigma among health care providers, youth, the workforce, and media.¹⁵

In 2012, the Commission released a mental health strategy that aims to help improve the mental health and well-being of all people living in Canada, and to create a mental health system that can truly meet the needs of people living with mental health problems and illnesses and their families. It calls on Canadians to become more engaged in mental health issues and create a broad social movement for improved mental health. Raising the profile of mental health issues will help to reduce stigma and help to ensure that people with mental health problems and illnesses are treated with respect and dignity and get the help they need.¹⁶

Footnotes

1    Employment and Social Development Canada, Indicators of Well-Being in Canada.

2    World Health Organization, Mental Health: Depression (accessed January 13, 2012).

3    Public Health Agency of Canada, What Is Depression? (accessed January 13, 2012).

4    Canadian Mental Health Association, Fast Facts About Mental Illness (accessed November 25, 2014).

5    Parachute Canada, Leading Causes of Hospitalizations, Canada, 2009–10 (accessed November 25, 2014).

6    Statistics Canada, Mood Disorders (accessed October 3, 2014).

7    Statistics Canada, Perceived Mental Health (accessed October 3, 2014).

8    Public Health Agency of Canada, Mental Illness (accessed January 13, 2012).

9    Public Health Agency of Canada, The Human Face of Mental Health and Mental Illness in Canada 2006.

10    Health Canada, Acting on What We Know: Preventing Youth Suicide in First Nations (accessed February 27, 2012).

11    K. L. Lim, P. Jacobs, A. Ohinmaa, D. Schopflocher, C. S. Dewa, “A New Population-Based Measure of the Burden of Mental Illness in Canada,” Chronic Disease Canada 28, no. 3 (2008), 92–8.

12    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.

13    The Conference Board of Canada, Mental Health Issues in the Labour Force: Reducing the Economic Impact on Canada (Ottawa: The Conference Board of Canada, July 2012).

14    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), ii.

15    Mental Health Commission of Canada, Opening Minds (accessed November 25, 2014).

16    Mental Health Commission of Canada, Changing Directions, Changing Lives: The Mental Health Strategy for Canada (Calgary: Mental Health Commission of Canada, 2012).