By Nate Hendley
Spring 2004, Vol 7 No 3
A first-of-its-kind survey released in September by Statistics Canada has found that one in 10 Canadians has experienced a psychiatric disorder within the past 12 months. Some disorders, such as depression, are as common as diabetes, heart disease and thyroid problems.
The Canadian Community Health Survey (CCHS) is based on data gathered in 2002 from 37,000 people across Canada. Survey participants were asked if they had experienced one of five mental health disorders: major depression, mania disorder, panic disorder, social phobia or agoraphobia. They were also questioned about alcohol use and illicit drug dependence. Major depression was reported by 4.5 per cent of respondents, 0.8 per cent reported experience with mania disorder, 1.6 per cent experienced panic disorder, 0.7 per cent reported agoraphobia and 3.0 per cent experienced social phobia. Alcohol dependence was cited by 2.6 per cent of respondents, while 0.7 per cent reported illicit drug dependence.
By comparison, 5 per cent of Canadians have diabetes, 5 per cent have heart disease and another 6 per cent have a thyroid condition. The high prevalence of mental illness comes at a stiff price. According to the World Health Organization, five of the 10 leading causes of disability in the world are related to psychiatric disorders. Health Canada, meanwhile, estimates that in 1998, psychiatric disorders were responsible for $4.7 billion in Canadian medical care costs. But for all the havoc psychiatric disorders cause, the CCHS found that only 32 per cent of people with mental problems sought professional help.
Dr. Alain Lesage, a Montreal psychiatrist and visiting scholar at the Harvard School of Public Health, offers several suggestions to remedy this situation. He urges the federal and provincial governments to treat mental illness as a public health issue and launch an awareness campaign similar to measures used to combat drinking and driving or smoking. Such a campaign, which could include public service announcements and advertisements, would be aimed at reducing the stigma of mental illness while raising awareness of specific disorders. Professional psychiatric organizations could work together to assist this campaign or initiate their own education efforts. Any awareness campaign should stress the affordability and bottom-line benefits of psychotherapy, adds Lesage. “Let’s say your course of treatment is 20 sessions with a psychologist at $70 per hour,” says Lesage. “That comes to $1,400 in total, for treating a lifelong problem ... even for an average-income person, who would have to pay by themselves, the total is not huge.” He points out that most people wouldn’t hesitate to spend a similar amount on a dentist.
The CCHS found that 26 per cent of people who do seek professional help typically approach their GP, while only 12 per cent approached psychiatrists and 8 per cent consulted psychologists. Lesage says mental health associations and government health agencies need to beef up psychiatric resources available to GPs. This could be as simple as supplying them with in-depth information about treatment services in their communities, so they are in a better position to make referrals.
According to the CCHS, young people are the most likely to experience psychiatric disorders or dependence problems. 18 per cent of respondents between age 15 and 24 said they had experienced a mental disorder, compared with 12 per cent of respondents between 25 and 44, 8 per cent of those between 45 and 64 and less than three per cent of seniors over 65. But young people were found to be the least likely to seek help. They often don’t know enough about mental disorders to seek treatment or think they can overcome their problems on their own. There is also the communication factor – knowing how to reach young people. Lesage suggests that the best approach may be through their parents: educate mothers and fathers on mental health issues, and hopefully, they’ll pass this information on to their kids or lead by example (i.e., recognize their own problems and seek treatment). At the least, educated parents would be in a good position to recognize signs of mental illness in their children.
While experts advise anyone with a psychiatric disorder to get help, they say it is not essential to see a specialist, such as a psychiatrist or psychologist. Community health workers, family physicians, nurses, self-help groups and counsellors are also capable of dealing with psychiatric disorders, particularly less severe ones. “I compare mental illness to diabetes,” says Lesage. “Do you want everyone to see a specialist every time they have a diabetes problem? If we say, Everybody must see a psychiatrist or clinical psychologist when they have agoraphobia, we would bankrupt the system,” he adds.
For more information, as well as other population-based health surveys, visit the Canadian Community Health Survey
Federal and provincial governments need to treat mental illness as a public health issue and launch awareness campaigns similar to measures used to combat drinking and driving or smoking.