The burden of mental illness in Ontario
“Opening Eyes, Opening Minds: The Ontario Burden of Mental Illness and Addictions” report is the final issue in a three-part series, produced in partnership between the Institute for Clinical Evaluative Sciences (ICES) and Public Health Ontario (PHO). The report finds that the burden of mental illness is one and a half times that of all cancers, and seven times that of infectious diseases.
The report compares the impact of mental illnesses on a population making comparisons with other diseases using morbidity and mortality calculations. Prevalence data was taken from the Canadian Community Health Survey. Year-equivalents of reduced functioning (number of years living in a reduced capacity because of the disease) and health-adjusted life years (represented by the health state, incidence and duration of each disease) was provided for nine mental health conditions and three substance use conditions.
Some of the findings are as follows:
- Years lost to mental illness was highest for major depression,
- Schizophrenia was highest in males (while all other burden of illnesses was higher for females),
- Agoraphobia, social phobia and panic disorders did not account for any premature deaths,
- Some deaths were attributable to other reported mental illnesses. For instance, there were on average, 41 deaths per year attributed to schizophrenia.
- Authors cautioned that these numbers were underestimates because death due to mental illness is causal rather than direct. For example, persons with depression are more likely to die from cardiovascular disease as opposed to depression itself; whereas the cause of death in substance users can be directly attributed to the substance.
- Substance use is another category in which burden of disease is greater for men than women. Deaths related to alcohol disorders accounted for 25 per cent of the burden of illness, much greater than all other conditions reported.
- The authors note that even though people do not die directly from mental illnesses, they may live in poor health for a long time.
In addition to the duration and incidence of illness, the findings indicate that the burden of mental illness usually peaks in early adulthood and then decreases over the life cycle, with the exception of schizophrenia, which is lifelong. The study was not able to incorporate suicides or co-occurring conditions.
The report also discusses the role of public health in reducing stigma and promotion of positive mental health. The report underscores the need for early intervention and research of effective treatment strategies. The report can also be used to set public agendas by prioritizing mental illness and addictions.