High toll of mental illness and addictions must be addressed
Mental illnesses and addictions take more of a toll on the health of Ontarians than cancer or infectious diseases, according to a new report by the Institute for Clinical Evaluative Sciences and Public Health Ontario – yet this burden could be reduced with treatment, say scientists from Canada's Centre for Addiction and Mental Health (CAMH).
"The majority of people with mental illness or addiction aren't receiving treatment, even though effective interventions are available," says report co-author Dr. Paul Kurdyak, Chief of General and Health Systems Psychiatry at CAMH, and Adjunct Scientist at ICES. "For instance, only a small fraction of people with depression or alcohol use disorders are accessing health services."
"If such a low percentage of people with diabetes were receiving treatment, there would be a public outcry."
Released today, the report Opening Eyes, Opening Minds, shows that the overall burden of mental illness and addictions in Ontario is 1.5 times higher than all cancers and seven times higher than all infectious diseases.
"The reasons for this burden are because mental illnesses and addictions emerge at a young age, they are highly disabling and prevalent in society, and they can last a lifetime," says Dr. Kurdyak.
In Ontario, Canada's most populous province, depression had the highest burden of all nine conditions measured in the report. Its burden was more than the combined impact of lung, colorectal, breast and prostate cancers. The problem is world-wide, with the World Health Organization drawing attention to untreated depression a "global crisis" as its theme for World Mental Illness Awareness Day today.
"Approximately 60 to 65 per cent of people with depression, and as many as 90 per cent of those with alcohol use disorder, remain untreated," says Dr. Kurdyak. "Yet there are effective therapies available for people suffering from these disorders."
Alcohol use disorders accounted for 88 per cent of all mental illness and addiction-attributable deaths in Ontario and 91 per cent of years lost due to early death.
"People don't seek care because of stigma around these disorders, particularly for problematic alcohol use," says Dr. Jürgen Rehm, co-author of the report and Director of CAMH's Social and Epidemiological Research Department. "This report reinforces the need for changes, such as strengthening the role of family physicians in treatment, exploring effective approaches from other jurisdictions, and reducing stigma so that people begin to ask for help."
Burden refers to the impact of an illness on reducing life expectancy and quality of life, based on factors such as pain, functioning and social relations, among others. Using the same methodology as earlier reports on the burden of cancer and infectious diseases, burden was calculated using a measure called a health-adjusted life year (HALY), which shows the amount of healthy life lost.
Overall, the nine conditions measured in the report contributed to the loss of more than 600,000 HALYs in Ontario. In addition to alcohol use disorders and depression, conditions examined were bipolar disorder, social phobia, schizophrenia, panic disorder, agoraphobia, cocaine addiction and prescription opioid misuse. Opening Eyes, Opening Minds: The Ontario Burden of Mental Illness and Addictions Report is the most thorough evaluation of the impact of mental illness and addictions on Ontarians to date.
"However, there is hope and it's important to remember that these conditions are treatable. If we increase the likelihood that people seek and get timely access to treatments, the burden for individuals and the entire population will be reduced," says Dr. Kurdyak.