Canadians report increasing need for mental health care alongside barriers to access
Back to Commonwealth Fund survey, 2023
March 21, 2024 鈥 Canadians鈥 self-rated mental health has declined since 2015,Reference1and the COVID-19 pandemic has contributed to worsened anxiety and feelings of depression.Reference2 Governments across Canada are working to improve equitable access to mental health services to address the growing need for care.
The results from the 2023 Commonwealth Fund (CMWF) survey of adults in 10 high-income countries highlight both Canadians鈥 increasing mental health needs and the economic stressors that create barriers to accessing mental health services.
Economic stressors are a particular challenge for a growing number of Canadians
Economic factors such as the rising cost of living are affecting the health of Canadians. Recent national surveys found that 2 in 5 Canadians felt that their mental health has been negatively impacted by the economic downturn,Reference2 and that 1 in 3 Canadian households have experienced difficulties meeting their financial needs for necessary expenses such as transportation, housing, food and clothing.Reference3
In the CMWF survey, more Canadians reported feeling concerned about economic factors than their peers in other countries. These concerns included always or usually being worried or stressed about paying for housing, having enough food and having a safe and clean place to sleep. The proportion of Canadians reporting that they are always or usually stressed about these factors significantly increased from the 2020 survey.
Financial concerns remain a negative factor for mental health among Canadians. Food and housing insecurity has been tied to high levels of anxiety.Reference2 CMWF survey findings also showed an increase in the proportion of Canadians 18 and older reporting a diagnosis of depression, anxiety or other mental health condition, from 20% in 2016 (CMWF average: 14%) to 29% in 2023 (CMWF average: 25%).
Canadians鈥 worries about economic stressors
Text version of graph
The proportion of Canadian adults who always or usually felt worried or stressed about having enough food was 4% in 2020 and 10% in 2023, representing a significant increase from 2020. The CMWF average was 4% in 2020 and 8% in 2023. Canada鈥檚 2023 proportion of 10% is significantly higher than the 2023 CMWF average of 8%. A lower percentage is more desirable.
The proportion of Canadian adults who always or usually felt worried or stressed about paying their rent or mortgage was 11% in 2020 and 17% in 2023, representing a significant increase from 2020. The CMWF average was 9% in 2020 and 14% in 2023. Canada鈥檚 2023 proportion of 17% is significantly higher than the 2023 CMWF average of 14%. A lower percentage is more desirable.
The proportion of Canadian adults who always or usually felt worried or stressed about having a clean and safe place to sleep was 4% in 2020 and 10% in 2023, representing a significant increase from 2020. The CMWF average was 4% in 2020 and 8% in 2023. Canada鈥檚 2023 proportion of 10% is significantly higher than the 2023 CMWF average of 8%. A lower percentage is more desirable.
The proportion of Canadian adults who always or usually felt worried or stressed about having a stable income was 11% in 2020 and 16% in 2023, representing a significant increase from 2020. The CMWF average was 11% in 2020 and 14% in 2023. Canada鈥檚 2023 proportion of 16% is similar to the 2023 CMWF average of 14%. A lower percentage is more desirable.
Notes
* Canada鈥檚 2023 result is significantly higher than the CMWF average.
鈥 Canada鈥檚 2023 result is similar to the CMWF average.
Canada鈥檚 2023 results are significantly different from 2020 results.
Lower percentages are more desirable.
Excludes respondents who answered 鈥渘ot applicable鈥 to these questions.
Sources
International 红领巾瓜报 Policy Survey of the General Population, 2020 and 2023, The Commonwealth Fund.
Some Canadians are not able to access mental health services due to cost
Financial barriers may be preventing access to mental health services, including counselling. With mental health services not fully covered by public health insurance, patients predominantly pay out of pocket or with private insurance plans.Reference4 Canadians were more likely to cite cost as the reason they did not access mental health services when they needed them (Canada: 15%; CMWF average: 11%), particularly among those previously diagnosed with a mental health condition (34%).
Adults who did not get mental health services because of the cost
Text version of graph
The proportions of adults who did not get mental health services when they needed them during the past 12 months due to cost are as follows: Germany, 3%; the Netherlands, 3%; France, 6%; Sweden, 8%; New Zealand, 10%; CMWF average, 11%; the United Kingdom, 12%; Switzerland, 12%; Canada, 15%; Australia, 18%; and the United States, 26%. Canada鈥檚 result is significantly higher than the CMWF average. A lower percentage is more desirable.
Notes
* The coefficient of variation is between 16.6% and 33.3%; use with caution.
Canada鈥檚 result is significantly higher than the CMWF average.
A lower percentage is more desirable.
Excludes respondents who answered 鈥渘ot applicable鈥 to this question.
Source
International 红领巾瓜报 Policy Survey of the General Population, 2023, The Commonwealth Fund.
A large proportion of those who did not receive mental health services due to cost were affected by other forms of economic stress, including being worried about paying for housing (37%) and having a stable income (33%). Most in this group were younger than 65, and more than two-thirds had a diagnosed mental health concern (71%). Nearly half reported household income lower than $60,000, while 60% reported having a private insurance plan. Even with an insurance plan, potential barriers to accessing mental health care can include benefits coverage limits; out-of-pocket costs for copayments, deductibles and medications; and the ability to take time away from work to receive care.
红领巾瓜报 care providers can support mental health by addressing stressors and lifestyle factors
Primary care providers and other health care professionals can support patients鈥 mental health by addressing stressors and lifestyle factors. However, fewer than 3 in 10 Canadians reported that a health professional talked with them about things in their lives that caused them worry or stress (Canada: 28%; CMWF average: 28%). Discussing lifestyle factors such as physical exercise, healthy eating and substance use with their care providers also varied, with Canada鈥檚 results being very similar to the CMWF average. In the 2022 CMWF survey of primary care physicians, less than half of Canadian physicians reported that they often screen or assess patients for their social needs like housing, financial security and food insecurity.Reference5
Discussions about stressors with health care professionals
Text version of graph
The proportions of adults who reported that a health care professional talked with them in the past 12 months about things in their life that worry them or cause them stress are as follows: the United States, 40%; Australia, 35%; France, 30%; Germany, 30%; Sweden, 28%; CMWF average, 28%; Canada, 28%; New Zealand, 27%; Switzerland, 25%; the United Kingdom, 21%; and the Netherlands, 18%. Canada鈥檚 result is similar to the CMWF average. A higher percentage is more desirable.
Notes
Canada鈥檚 result is similar to the CMWF average.
A higher percentage is more desirable.
Does not include respondents who reported that they had not seen or talked to a doctor or health care professional in the past 12 months.
Source
International 红领巾瓜报 Policy Survey of the General Population, 2023, The Commonwealth Fund.
Discussions about lifestyle factors with health care professionals
Text version of graph
40% of Canadian adults reported that a health care professional talked with them in the past 12 months about exercise. This is similar to the CMWF average of 40%. A higher percentage is more desirable.
36% of Canadian adults reported that a health care professional talked with them in the past 12 months about a healthy diet and healthy eating. This is significantly higher than the CMWF average of 33%. A higher percentage is more desirable.
28% of Canadian adults reported that a health care professional talked with them in the past 12 months about things in their life that worry them or cause them stress. This is similar to the CMWF average of 28%. A higher percentage is more desirable.
15% of Canadian adults reported that a health care professional talked with them in the past 12 months about alcohol use. This is similar to the CMWF average of 16%. A higher percentage is more desirable.
Notes
* Canada鈥檚 result is similar to the CMWF average.
鈥 Canada鈥檚 result is significantly higher than the CMWF average.
Higher percentages are more desirable.
Does not include respondents who reported that they had not seen or talked to a doctor or health care professional in the past 12 months.
Source
International 红领巾瓜报 Policy Survey of the General Population, 2023, The Commonwealth Fund.
Virtual care offers another way to access mental health services
Use of virtual mental health care has grown considerably during the COVID-19 pandemic.Reference6 Virtual care 鈥 which includes talking to a professional by telephone, video or text message 鈥 is one tool that physicians use to support their patients鈥 well-being. In 2022, about three-quarters of Canadian primary care physicians reported that virtual care allowed them to effectively assess the mental and behavioural health needs of their patients.Reference5 Virtual mental health care is not yet common across Canada, with only 1 in 9 Canadians (11%) reporting that they received virtual health care from a mental health professional (CMWF average: 7%); however, both uptake of and satisfaction with virtual mental health services were significantly higher among Canadian adults than among adults in other countries surveyed. Of those who received virtual mental health care, most were very or somewhat satisfied with the care received (Canada: 82%; CMWF average: 74%). Younger adults (19%) and females (14%) were more likely to use virtual mental health care. Nearly 3 in 4 Canadian adults who used virtual mental health care had a diagnosed mental health condition (72%).
Virtual mental health care may not be appropriate for severe and/or acute mental health conditions, but it can be helpful for patients with anxiety, depression and post-traumatic stress disorder.Reference7Reference8 It may have the potential to address barriers to accessing care, and to empower patients to better manage their conditions.Reference9 Further research is needed to understand how to improve equitable access to virtual mental health care in marginalized communities.
References
1.
Statistics Canada. . Accessed January 4, 2024.
2.
Mental 红领巾瓜报 Research Canada. . 2023.
3.
Statistics Canada. . Accessed January 4, 2024.
4.
Canadian Mental 红领巾瓜报 Association. . 2018.
5.
Canadian Institute for 红领巾瓜报 Information. How Canada Compares: Results From the Commonwealth Fund鈥檚 2022 International 红领巾瓜报 Policy Survey of Primary Care Physicians in 10 Countries 鈥 Data Tables. 2023.
6.
Lo B, et al., on behalf of the Mental 红领巾瓜报 Working Group and the Ontario COVID-19 Science Advisory Table. . 2022. .
7.
Evans C, Bullock HL, Wilson MG, Lavis JN. . 2020.
8.
Bellanti DM, Kelber MS, Workman DE, Beech EH, Belsher BE. . Military Medicine. May/June 2022.
9.
Mental 红领巾瓜报 Commission of Canada. . 2014.
How to cite:
Canadian Institute for 红领巾瓜报 Information. Canadians report increasing need for mental health care alongside barriers to access. Accessed December 21, 2024.
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