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A Report on Mental
Illnesses in Canada
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Mental illnesses are characterized by alterations in thinking,
mood or behaviour (or some combination thereof) associated with
significant distress and impaired functioning. 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
A health problem of the scope and importance of mental illness
requires a comprehensive surveillance system to monitor progress in
achieving policy and program goals. A workshop held in September,
1999, co-sponsored by Health Canada and the Canadian Alliance on
Mental Illness and Mental Health (CAMIMH), developed a
comprehensive indicator framework for a Mental Illnesses and Mental
Health Surveillance System. This report responds to the
recommendations from the workshop to collate existing data in order
to begin the process of creating a picture of mental illnesses in
Highlights Chapter 1 - Overview
- Mental illnesses indirectly affect all Canadians through
illness in a family member, friend or colleague.
- Twenty percent of Canadians will personally experience a mental
illness during their lifetime.
- Mental illnesses affect people of all ages, educational and
income levels, and cultures.
- The onset of most mental illnesses occurs during adolescence
and young adulthood.
- A complex interplay of genetic, biological, personality and
environmental factors causes mental illnesses.
- Mental illnesses can be treated effectively.
- Mental illnesses are costly to the individual, the family, the
health care system and the community.
- The economic cost of mental illnesses in Canada was estimated
to be at least $7.331 billion in 1993.
- Eight-six percent of hospitalizations for mental illness in
Canada occur in general hospitals.
- In 1999, 3.8% of all admissions in general hospitals (1.5
million hospital days) were due to anxiety disorders, bipolar
disorders, schizophrenia, major depression, personality disorders,
eating disorders and suicidal behaviour.
- The stigma attached to mental illnesses presents a serious
barrier not only to diagnosis and treatment but also to acceptance
in the community.
Highlights Chapter 2 - Mood Disorders
- Mood disorders include major depression, bipolar disorder
(combining episodes of both mania and depression) and
- Approximately 8% of adults will experience major depression at
some time in their lives. Approximately 1% will experience bipolar
- The onset of mood disorders usually occurs during
- Worldwide, major depression is the leading cause of years lived
with disability, and the fourth cause of disability-adjusted life
- Mood disorders have a major economic impact through associated
health care costs as well as lost work productivity.
- Most individuals with a mood disorder can be treated
effectively in the community. Unfortunately, many individuals delay
- Hospitalizations for mood disorders in general hospitals are
approximately one and a half times higher among women than
- The wide disparity among age groups in hospitalization rates
for depression in general hospitals has narrowed in recent years,
because of a greater decrease in hospitalization rates in older age
- Hospitalization rates for bipolar disorder in general hospitals
are increasing among women and men between 15 and 24 years of
- Individuals with mood disorders are at high risk of
Highlights Chapter 3 - Schizophrenia
- Schizophrenia affects 1% of the Canadian population.
- Onset is usually in early adulthood.
- Schizophrenia can be treated effectively with a combination of
medication, education, primary care services, hospital-based
services and community support, such as housing and
- Fifty-two percent of hospitalizations for schizophrenia in
general hospitals are among adults 25-44 years of age.
- Hospitalization rates for schizophrenia in general hospitals
are increasing among young and middle-aged men.
Highlights Chapter 4 - Anxiety Disorders
- Anxiety disorders affect 12% of the population, causing mild to
- For a variety of reasons, many individuals may not seek
treatment for their anxiety; they may consider the symptoms mild or
normal, or the symptoms themselves may interfere with
- Anxiety disorders can be effectively treated in the community
- Hospitalization rates for anxiety disorders in general
hospitals are twice as high among women as men.
- The highest rates of hospitalization for anxiety disorders in
general hospitals are among those aged 65 years and over.
- Since 1987, hospitalization rates for anxiety disorders in
general hospitals have decreased by 49%.
Highlights Chapter 5 - Personality Disorders
- Based on US data, about 6% to 9% of the population has a
- Personality disorders exist in several forms. Their influence
on interpersonal functioning varies from mild to serious.
- Onset usually occurs during adolescence or in early
- Anti-social personality disorder is frequently found among
prisoners (up to 50%).
- Of hospitalizations for personality disorders in general
hospitals, 78% are among young adults between 15 and 44 years of
Highlights Chapter 6 - Eating Disorders
- Approximately 3% of women will be affected by an eating
disorder during their lifetime.
- Eating disorders affect girls and women more than boys and
- Factors believed to contribute to eating disorders include
biological and personal factors as well as society's promotion
of the thin body image.
- Eating disorders carry with them a high risk of other mental
and physical illnesses that can lead to death.
- Since 1987, hospitalizations for eating disorders in general
hospitals have increased by 34% among young women under the age of
15 and by 29% among 15-24 year olds.
Highlights Chapter 7 - Suicidal Behaviour
- In 1998, 3,699 Canadians died as a result of suicide.
- Suicide accounts for 24% of all deaths among 15-24 year olds
and 16% among 25-44 year olds.
- The mortality rate due to suicide among men is 4 times the rate
- Individuals between 15-44 years of age account for 73% of
hospital admissions for attempted suicide.
- Women are hospitalized in general hospitals for attempted
suicide at 1.5 times the rate of men.
Future Surveillance Needs
Existing data provide a very limited profile of mental illnesses
in Canada. The available hospitalization data need to be
complemented with additional data to fully monitor these illnesses.
Priority data needs include:
- Incidence and prevalence of each of the mental illnesses by
age, sex and other key variables (for example, socio-economic
status, education, and ethnicity)
- Co-morbidity of mental illnesses with other mental illnesses
and/or with physical disorders
- Exposure to known or suspected risk and protective factors
- Impact of mental illnesses on the quality of life of the
individual and family
- Access to and use of primary and specialist health care
- Impact of mental illnesses on the workplace and the
- Stigma associated with mental illnesses
- Impact of mental illnesses on the legal and penal systems
- Access to and use of public and private mental health
- Access to and use of mental health services in other systems,
such as schools, criminal justice programs and facilities, and
employee assistance programs
- Treatment outcomes
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