The current state of mental health in Canada is “alarming,” with consequences for individuals and their employers alike. Meanwhile, no jurisdictions in Canada are currently spending sufficient amounts on mental health – even by their own, outdated standards – instead leaving it up to the individual (and their insurance providers) to fund their own treatments.

How did we get here? 

Today, the Canadian Mental Health Association (CMHA) says provinces and territories are only spending an average of 6.3 per cent of their overall health budgets on mental health.

“This doesn’t even meet the level of spending called for in Canada’s own, stale-dated mental health strategy,” they write in the report, The State of Mental Health in Canada 2024. (The country’s national mental health strategy, Changing Directions, Changing Lives: The Mental Health Strategy for Canada, was drafted in 2012.)

“The (State of Mental Health in Canada 2024) report tells us that people receive drastically different care depending on their home province or territory.” They add that the problem is worse in the north and among Indigenous and racialized populations. 

The CMHA is calling on the federal government to write mental health care into federal law, either by amending the Canada Health Act to explicitly include mental health and substance use health care or by creating parallel legislation and a funding transfer mechanism that includes accountability measures for provinces and territories.

Medicare today does not explicitly include mental health, addictions and substance use health care. “While the Canada Health Act includes mental health services delivered in hospitals or by physicians, it does not require provinces or territories to cover any other mental health, addictions or substance use health service,” they add. Not only is this problematic as mental health is usually addressed by professionals not on this short list, they say the public resources dedicated to mental health are often insufficient to meet the need.

The association is also calling for the government to increase spending, such that spending in mental health, addictions and substance use services makes up 12 per cent of all health care spending.

They also say Canada is failing to collect key information and is calling on the government to collect mental health data across an adequate set of indicators. “You can’t fix what you don’t measure,” they write.

The report also discusses introducing a universal basic income program to address poverty and the reorientation of the Canada Disability Benefit such that mental health disabilities can qualify for the benefit, as well.

“As it stands, accessing mental health care in Canada is often a privilege when it should be a fundamental right,” they write. “Research shows that no province or territory is spending what they should be on mental health, in part because they’re not obligated to.” 

The report is just one of three released recently on Canadian’s mental health and well-being. Together, they paint an interesting picture of what mental health, addictions and substance abuse sufferers are up against, those who are most affected, the consequences, particularly for employers, and the implications for all involved.

Benefits plans pick up the bulk of the costs 

The second report, this time from Dialogue Health Technologies Inc., finds that outside of work, Canadians face barriers that prevent or limit their access to health services in general, including the lack of a family doctor, long wait times and financial constraints. As a result, 47 per cent say they rely heavily on their employer sponsored benefits. 

“In the absence of universal mental health care, workplace benefits cover the majority (70 per cent) of mental health services,” the company’s researchers write in the report, Health and Well-Being Report: A Canadian benchmark. “At Dialogue, mental health is the top reason members consult.” 

Despite this, Canadians’ opinions about their benefits are low – according to Dialogue, one in two Canadians believe their overall benefits plan doesn’t meet their needs, while one in three continue to view their mental health benefits as insufficient.

Notably, this has consequences for employers: According to the latest TELUS Mental Health Index, workers who perceive poor employer support for their physical well-being lose 22 more days of productivity annually and score 22 points lower in mental health than those perceiving excellent support.

They say just 26 per cent of those surveyed for the monthly index report say their employer’s support for mental well-being is good or excellent. “The mental health score of this group is at least 21 points higher than workers rating employer support as poor and at least nine points higher than the national average. Productivity losses increase as the employer’s rating for support declines,” the TELUS report states.

“Workers rating employer support for mental well-being as excellent lose 27 working days per year in productivity compared to 54.9 working days per year in productivity loss among workers rating employer support as poor.” 

Employee Assistance Plans underutilized  

As rising food prices and housing costs affect Canadians nationwide, the Dialogue report says 49 per cent of Canadians are losing sleep over financial worries. Similarly, the TELUS research suggests that employees without emergency funds are twice as likely to report having an anxiety or depression diagnosis.

Despite the help they provide to those seeking counselling and financial planning assistance, EAPs remain generally underutilized. Dialogue states that “as workplace benefits continue to evolve, working Canadians are increasingly willing to use them, but often don’t know what’s available.” They add that 53 per cent of those surveyed in their research who have an EAP have never accessed it.

TELUS similarly says two in five workers in Canada lack knowledge of what an EAP entails. “The mental health score of workers who don’t know, or report that their employer doesn’t offer an EAP, is at least three points lower than workers with an EAP,” they write.

Prevalence and productivity  

For those interested in the prevalence of certain conditions, the papers all provide their own statistics, as well. According to CMHA, Canadians report having poor or fair mental health three times more often than before the pandemic (26 per cent in 2021, compared to just 8.9 per cent in 2019). They add that 2.5-million people with mental health needs reported that they weren’t getting adequate care. “That’s about equal to the population of Manitoba and Saskatchewan combined,” they write.

Dialogue’s report shows that Canadians in their twenties have the lowest mental health scores, averaging 46.4; the highest well-being scores (52.4 per cent) were reported by those between the ages of 50 and 69.

According to TELUS, meanwhile, 32 per cent of workers have a high mental health risk, 44 per cent have a moderate mental health risk and 24 per cent have a low risk of developing mental health problems.

  • 14 per cent of survey respondents reported having a depression diagnosis to TELUS.
  • Those diagnosed with depression lose 66.9 working days of productivity per year and have a mental health score more than 28 points lower than workers with no diagnosed health conditions. “This is more than 21 points below the national average,” they write.
  • 22 per cent reported an anxiety diagnosis to the same researchers who add that those diagnosed with anxiety lose 62.5 working days of productivity per year.
  • Workers under 40 are more than twice as likely as workers over 50 to report being diagnosed with anxiety and depression. 
  • Dialogue, meanwhile, says 54 per cent of those surveyed for that research reported having negative symptoms including anxiety and depression (38 per cent), disruptions in productivity (16 per cent) and strained personal relationships (16 per cent).
  • In the TELUS research, workers dissatisfied with their physical health score 22 points lower in mental health matters, as well, and lose 21 more days of productivity annually than their satisfied counterparts.

Also according to TELUS, more than one quarter (27 per cent) of workers surveyed have a mental health score of 50 or lower. “The productivity loss of this group is at least three times the number of lost workdays as the 24 per cent of workers with a mental health score of 80 or higher,” they write. “Mental health conditions are disproportionately reported among younger workers, women and those without savings.” 

Canada overall, has a score of 64.4, a 1.3 point improvement over August 2024 figures. TELUS says scores under 49 correspond with distress levels, scores between 50 and 79 correspond with strain levels and scores between 80 to 100 correspond with optimal levels of mental health. 

“Canada must improve the mental health of its people and enhance access to mental health, addictions and substance use care and social supports,” CMHA writes. “While COVID-19 brought a heightened awareness of mental health and its importance, the evidence here demonstrates that this awareness has not translated into the policies needed for systemic change.”