Mental health care

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’ worries about economic stressors 

Notes 
* Canada’s 2023 result is significantly higher than the CMWF average. 
† Canada’s 2023 result is similar to the CMWF average.
Canada’s 2023 results are significantly different from 2020 results.
Lower percentages are more desirable.
Excludes respondents who answered “not applicable” to these questions.

Sources
International Health Policy Survey of the General Population, 2020 and 2023, The Commonwealth Fund.

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

Notes
* The coefficient of variation is between 16.6% and 33.3%; use with caution.
Canada’s result is significantly higher than the CMWF average. 
A lower percentage is more desirable.
Excludes respondents who answered “not applicable” to this question.

Source
International Health 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. 

Primary care providers and other health care professionals can support patients’ 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’s 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

Notes 
Canada’s 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 Health Policy Survey of the General Population, 2023, The Commonwealth Fund.

Discussions about lifestyle factors with health care professionals

Notes
* Canada’s result is similar to the CMWF average. 
† Canada’s 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 Health Policy Survey of the General Population, 2023, The Commonwealth Fund.

Use of virtual mental health care has grown considerably during the COVID-19 pandemic.Reference6  Virtual care — which includes talking to a professional by telephone, video or text message — is one tool that physicians use to support their patients’ 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. 
 

Back to Commonwealth Fund survey, 2023