MENTAL ILLNESS

Research Highlights

• 20% of Canadians will personally experience a mental illness during their lifetime.
• According to the World Health Organization, five of the leading 10 causes of disability are related to mental disorders.
• Mental illnesses affect people of all ages, educational and income levels, and cultures.
• Mental illnesses are costly to the individual, the family, the health care system and the community.
• The two greatest social service issues affecting individuals with mental health problems in Guelph-Wellington are:
  • Community Awareness & Education - Mental illness still carries a stigma, having a detrimental effect on an individual’s ability to obtain services, their recovery, type of treatment and support, as well as acceptance in the community.
  • Homelessness - People with serious mental illness are disproportionately affected by homelessness.

Research Profile on Health & Independent Living

What is Mental Illness?
Mental illnesses are characterized by alterations in thinking, mood or behaviour (or some combination thereof) associated with significant distress and impaired functioning over an extended period of time.  A complex interplay of genetic, biological, personality and environmental factors cause mental illnesses.  Symptoms of a mental illness vary from mild to severe, depending on the type of mental illness, the individual, the family and the socio-economic environment.  Mental illnesses affect people in all occupations, educational and income levels, and cultures.¹
 
Types of Mental Illness
Eight categories exist under the Diagnostic & Statistical Manual of Mental Disorders (DSM IV) identifying and grouping common mental illnesses.  These include:

• Anxiety Disorder (e.g. panic disorder, post-traumatic stress disorder, etc.)
• Childhood Disorder (e.g. attention-deficit/hyperactivity disorder, etc.)
• Eating Disorder (e.g. anorexia nervosa, bulimia nervosa, etc.)
• Mood Disorder (e.g. bipolar disorder, major depressive disorder, etc.)
• Personality Disorder (e.g. antisocial disorder, narcissistic disorder, etc.) 
• Psychotic Disorder (e.g. delusional disorder, schizophrenia, etc.)
• Substance Related Disorder (e.g. alcohol dependence, amphetamine dependence, etc.)
• Other (e.g. autistic disorder, dementia, etc.)

Mental illnesses may occur together.  For example, an individual can experience both depression and an anxiety disorder.  In addition, attempts to manage symptoms through alcohol or drugs may contribute to substance abuse for some individuals.  In a U.S. study, 54% of those with a lifetime history of at least one mental illness also had at least one other mental illness or addiction to substances.²
 
Incidence and Prevalence
According to the World Health Organization (WHO), five of the 10 leading causes of disability are related to mental health disorders. The WHO predicts that in less than 20 years depression will be the second-leading cause of disability and mortality in the world.³
 
Health Canada indicates that⁴:

• 20% of Canadians will personally experience a mental illness during their lifetime
• 8% will experience a major depression
• 1% will be diagnosed with schizophrenia
• 12% will suffer mild to severe impairment as a result of an anxiety disorder
• Suicide accounts for 24% of all deaths among 15 to 24 year olds, and 16% among those from 25 to 44

According to the 2002 Canadian Community Health Survey (CCHS) - Mental Health and Well-being, one out of every 10 Canadians aged 15 and over (about 2.6 million people) reported symptoms consistent with major depression, mania disorder, panic disorder, social phobia, agoraphobia, and alcohol or illicit drug dependence.⁵
 
The overall prevalence rates for the surveyed mental health disorders and substance dependencies were about the same for women as for men.  Of the overall population surveyed, 11% of women (1.4 million) reported symptoms, compared to 10% of men (1.2 million).  While the overall rate between men and women was similar, there were differences by type of disorder.  The survey showed that mood disorders and anxiety disorders were more common for women; 6% respectively for women compared to 4% for men. 
 
Mental disorders are present through all the stages of life.  Results from the CCHS indicate that teenagers and young adults (aged 15 and 24) were most likely to report suffering from the disorders surveyed.  About 18% reported symptoms, compared to 12% of those aged 25 - 44, 8% of those aged 45 – 64, and less than 3% of those aged 65 and over.

What are the Personal Effects of Mental Illness?
The onset of a mental illness often occurs during adolescence and young adulthood, affecting educational attainment, occupational/career opportunities, and the formation and nature of personal relationships.  These effects often extend throughout an individual’s life. The greater the number of mental health episodes experienced by an individual, the greater the degree of lasting disability.
 
Suicide is a significant risk for individuals with some mental illnesses, such as major depression, bipolar disorder, schizophrenia and borderline personality disorder.⁶
 
Receiving and complying with effective treatment and having the security of strong social supports and adequate housing are essential elements in minimizing the impact of mental illness.
 
Mental illness not only has a significant impact on the individual but also on the family as well.  Decisions concerning treatment, hospitalization, and housing create tremendous amounts of anxiety and stress for families.  In addition, the heavy demands of care may result in caregiver burnout.
 
The Cost of Mental Health Care
Mental illnesses are costly to the individual, the family, the health care system and the community. 
 
A 1993 study by Health Canada estimated the economic cost of mental illnesses in Canada to be $7.3 billion.  A later study, using data from the 1996/97 National Population Health Survey, estimated the annual economic cost of mental health problems in Canada to be $14.4 billion.⁷
 
Mental illnesses are a major contributor to hospital costs.  In 1999, 3.8% of all admissions in general hospitals (1.5 million hospital stays) were due to anxiety disorders, bipolar disorders, schizophrenia, major depression, personality disorders, eating disorders and suicidal behaviour.  According to the Canadian Institute of Health Information (CIHI), in 1999/2000, the overall average length of hospital stays related to mental illness was 45 days – 160 days in psychiatric hospitals, compared to 27 days in general hospitals.⁸  

Community Supports & Services (non-institutional)
The Canadian Mental Health Association (CMHA) focuses on combating mental health problems and emotional disorders through research and information services.  In addition, CMHA acts as a social advocate to encourage public action and commitment to strengthening community mental health services as well as legislation and policies affecting services.

The Community Mental Health Clinic (CMHC) offers specialized mental health and psychiatric services for children, adolescents, adults and seniors experiencing mental health difficulties.

Dunara Wellington Dufferin Homes for Psychiatric Rehabilitation provides a psycho-social rehabilitation housing program which is designed to serve adults who are experiencing chronic psychiatric problems and have a demonstrated need for residential support.  Trinity House also provides safe affordable housing for up to 4 adults who are being supported by a community mental health worker.  In addition, they provide facilitated self-help and support groups employing open discussions, guest speakers, videos and mutual sharing. 

Homewood Health Centre is a privately owned and publicly funded mental health and addiction treatment centre, providing specialized psychiatric services.  In addition to an inpatient program, Homewood offers the following community services:  an alcohol and drug outpatient program, a community outreach and support program (both case coordination and transitional care), a crisis assessment and stabilization program, a program for older adults, an eating disorder program, an integrated mood and anxiety program, and a program for traumatic stress recovery.

The Mood Disorders Support Group of Guelph is a self-help and support group for people dealing with depression, bipolar, and anxiety disorders working towards reducing stigma both within the group as well as in the community.

The Schizophrenia Society of Ontario (SSO) is a family-based, non-profit organization.  The objectives of the organization are to provide family support and education, increase public awareness, advocate for improved services and raise money for research.

Spark of Brilliance is an art therapy program for individuals with a serious mental illness.  It is intended to empower persons dealing with serious mental health issues, as well as the family members who support them, in discovering an interest, a talent, or an untapped resource, and to foster creativity.

Assertive Community Treatment Team (ACTT) - the Ministry of Health and Long-Term Care recently announced new funding of $1.2 million for the Homewood Health Centre to provide new ACTT services in the Guelph region.  An ACTT is a group of multidisciplinary mental health providers, including a psychiatrist, a nurse, a social worker, an occupational therapist, a program coordinator and a program assistant, who deliver services to people in their homes.  The ACTT provides the majority of the treatment, rehabilitation and support that clients need to achieve their goals.  The Guelph team can serve up to 100 people.
 
Of the above mentioned organizations the United Way of Guelph & Wellington funds the Canadian Mental Health Association: Wellington-Dufferin Branch (Community Development and Education Services), The Mood Disorders Support Group of Guelph and Spark of Brilliance.

What are the Social Service Issues in Guelph and Wellington?

Community Awareness & Education
Unfortunately, mental illness still carries a stigma which has a detrimental effect on an individual’s ability to obtain services, their recovery, type of treatment and support, as well as acceptance in the community.  Likewise, discrimination and community misconceptions remain among the most significant barriers to people with a mental illness being able to actively participate in the community and gain access to the services they need.
 
There are many myths about mental illness.  Due to stigma, the typical reaction encountered by someone with a mental illness (and his or her family members) is fear and rejection.  Some have been denied adequate housing, loans, health insurance and jobs due to their history of mental illness.  As a result, many individuals afflicted with a mental illness experience a loss in self-esteem and have difficulty making friends.  The stigma attached to mental illness is so pervasive that people who suspect that they might be mentally ill are often unwilling to seek help for fear of what others may think. Spouses may be reluctant to acknowledge their partners as mentally ill, while parents may delay seeking help for their child because of their fears and shame.  Rejection of people with mental illness inevitably spills over to the caregiver and family members resulting in isolation.
 
There is little evidence to suggest that there has been widespread change/improvement in the prevailing attitude toward and acceptance of people who experience mental health problems.  The Canadian Alliance for Mental Illness and Mental Health has identified educating the public and the media about mental illness as a first step toward reducing the stigma and encouraging greater acceptance and understanding of mental health problems.⁹
 
Homelessness
People with serious mental illness are disproportionately affected by homelessness. The link between homelessness and mental illness is well documented.  30-35% of the homeless in general, and up to 75% of homeless women specifically, have a mental illness¹⁰.  In Ontario, 6,100 people sleep in shelters every night – out of these, 2,013 have a mental illness, and 1,220 have an additional concurrent disorder.¹¹  Individuals with mental illness remain homeless for longer periods of time and have less contact with family and friends.  They encounter more barriers to employment and tend to be in poorer health than other homeless people.
 
Research indicates that there is a link between rural and urban homelessness.  Over half of the people who end up homeless in big cities originally came from small towns or rural communities.
 
The most significant cause of homelessness is poverty.  Shelter allowance through Ontario Works or the Ontario Disability Support Plan is wholly inadequate to meet the actual housing needs of people.  This has been repeatedly documented in many communities across Ontario for the past decade.  This insufficiency means that income for food and clothing etc. must be used to meet housing needs, which then has a negative impact on all other financial aspects of life (e.g. healthy diet, social and fitness pursuits, etc.).
 
Community Support Services
Local service providers report a shortage of mental health professionals and support services in the Guelph-Wellington area.  Many organizations within the region serving psychiatric patients cope with this challenge by treating only those with the most complex mental health issues and/or those who are at risk to themselves or society.  This has reduced the number of clients receiving one-on-one treatment and increased reliance on group treatment. 
 
As a result of the Provincial-Federal Health Accord (2003), the Ontario government initiated a four-year $185 million plan in 2005 to enhance community-based mental health services.

For more information please contact:
United Way Social Planning Committee
85 Westmount Rd.
Guelph, ON
N1H 5J2
P: 519-821-0571
F: 519-821-7847
www.unitedwayguelph.com

1. Public Health Agency of Canada (2002).  A Report on Mental Illness in Canada.  Ottawa, Ontario: Public Health Agency of Canada.
2. Kessler, R. & Ahangang, Z. (1999).  The prevalence of mental illness.  In Horwitz, A. & Sheid, T. (Eds.)  A Handbook for the Study of Mental Health – Social Context, Theories and Systems.  Cambridge: Cambridge University Press. 
3. Stephes, T. & Joubert, N. (2001).  The economic burden of mental health problems in Canada.  Chronic Diseases in Canada, 22(1), pp. 18-23.
4. Public Health Agency of Canada (2002).  A Report on Mental Illness in Canada.  Ottawa, Ontario: Public Health Agency of Canada.
5. Symptoms occurred at some time during the 12 months prior to the interview.
6. Public Health Agency of Canada (2002).  A Report on Mental Illness in Canada.  Ottawa, Ontario: Public Health Agency of Canada.
7. Ibid
8. Ibid
9. Ibid
10. City of Toronto (1999). Taking Responsibility for Homelessness: An action plan for Toronto [Report of the Mayor’s Homelessness Action Task Force]. Toronto, Ontario: City of Toronto.
11. Statistics Canada. (2002). 2001 Census: Collective Dwellings. Ottawa, Ontario: Statistics Canada – Catalogue No. 96F0030XIE2001004.