A recently issued report has provided a rare opportunity for health care providers and policy drafters to directly compare mental illness and treatment statistics across various parts of the country. The report revealed striking differences in access to mental health services across Canada.

Collecting Data on Mental Health and Addictions

Data collection on mental health and addiction in Canada is inconsistent and not as common as it is in other areas of health care such as cancer care. Both the collection of statistics and the definition of information varies across jurisdictions, making direct comparisons challenging.

Information and data on youth mental health care is particularly challenging to collect since, in most provinces, it is split between various ministries including health, child services and education. Care provided by private psychologists and other health care professionals not covered by public insurance is also hard to track.

Towards Mental Health Services in Canada

The report was published by the Centre for Applied Research in Mental Health & Addiction at Simon Fraser University, with contributions from researchers across the country. It compiled standardized information on addiction and mental health care and access in Quebec, Ontario, Manitoba, Alberta, and British Columbia.

The report collected and compared provincial data on:

  • Access to family doctors;
  • ER visits as an initial point of contact for mental health services;
  • Physician follow-ups after hospital discharges;
  • Mortality rates; and
  • Suicide rates, including suicide attempts.

Dr. James Bolton, co-author of the report and associate professor of psychiatry at the University of Manitoba told the Toronto Star that:

(The data) really helps to inform, not only at a national level but on a provincial level, strategies and approaches for meeting a healthcare need. It’s key information for decision makers in the health sector and in government.

The Report’s Findings

The report found that no one province stood out as a leader in delivering mental health care. Moreover, there were significant differences across the provinces in terms of both access and outcomes of care, including:

  • In Quebec, first-contact in emergency rooms for those with mental health illnesses or addictions was particularly high, especially among those aged 30 and over;
  • Ontario had the lowest rate of suicide attempts among all age groups;
  • Manitoba has a markedly higher rate of suicide attempts among people with mental health or addiction issues, despite demonstrating a high rate of physician access relative to the other provinces and the lowest percentage of first-contact in emergency rooms for those with mental health illness or addictions;
  • Alberta had the lowest rate of patients between 20 and 29 with mental health illnesses or addictions who visit the same doctor two or more times, possibly reflecting limited access to physicians;
  • British Columbia was best in physician follow-up after hospitalization.

Across all provinces, youth between 10 and 19 years old with mental health illnesses and addictions had the highest rate of first-contact in emergency rooms, which researchers say shows there is room to improve early detection of possible mental health illnesses and addictions for young people.

Other findings included information that suicide among young girls and teenagers is far more likely than in older women across all provinces, and males have higher suicide rates than females.

Going Forward

Dr. Paul Kurdyak, co-author of the report, scientist at the Institute for Clinical Evaluative Sciences, and associate professor of psychiatry at the University of Toronto, views the report as a step towards addressing gaps in understanding and a chance to create standardized definitions across Canada, and a “mechanism for oversight” that can function as a means of regular, comprehensive measurement of the mental health and addictions care system.

Dr. Kurdyak, who also works in the emergency department at the Centre for Addiction and Mental Health (CAMH) told CTV News that on during every shift he hears stories from young people who do not know who or where to turn to for mental health and addiction treatment. In his mind, it is critical to address mental health accessibility for youth since some of the most common mental illnesses, including anxiety and depression, tend to have their initial onset between the ages of 16 and 30.

Dr. Kurdyak said:

I think the reason this report is so important is because we’ve been hearing more and more anecdotes about how difficult it is to get the right kind of care when and where you need it. And this kind of big picture is the kind of information that policy makers and we in the health service sector need to be able to course correct.

The Report itself concluded:

We have demonstrated that collaborative, cross-province processes for the generation of performance measures for mental health services is possible…There is enormous potential now to sustain and expand these successes for the ultimate benefit and quality of life for Canadians with mental health and addictions issues and their families.

We will continue to follow developments in mental health services across Canada and will blog about relevant information as it becomes available.

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