Strengthening the Case for Investing in Canada’s Mental Health System: Economic Considerations builds on Making the Case for Investing in Mental Health in Canada, a foundational report published by the Mental Health Commission of Canada in 2013, which made a compelling economic argument for investing in mental health.
Strengthening the Case goes one step further by examining where investments can have the greatest impact, demonstrating that wise mental health spending pays dividends. As policy makers, healthcare administrators and elected officials make difficult decisions about where to invest money in mental health programs and services, Strengthening the Case can help guide their choices.
While there is extensive international evidence about the cost-effectiveness of certain interventions in mental health, this report highlights nine important Canadian studies that underscore the cost offsets of investing in evidence-based approaches. The key findings from these studies include:
There is strong evidence that promotion, prevention and early intervention, especially among children and youth, can produce significant net cost benefits.
- Investing in the early years can save the system nearly 25 per cent in publicly funded services per person.
- Having a rapid response team in place for a young person presenting with suicidal thoughts in an emergency room can cut the health care costs for that person by half.
Most mental health problems and illnesses can be addressed with fairly inexpensive, relatively short-term interventions. Most people with a mental health problem or illness have a mild to moderate condition. They represent about 15 per cent of the population each year.
- Offering people on short-term disability timely collaborative care can result in an average of 16 fewer days on disability per person, and fewer people transitioning to long-term disability.
- Offering one session of counselling for high users of emergency rooms—the cost of which is offset from averted hospital visits and savings from an earlier return to work—saves at least $21 per client in the first month.
- Providing six psychotherapy sessions in primary care for aging adults, rather than only providing sedatives or no treatment, has as much as $13,000 in economic benefits.
There are more cost-effective means to meet the needs of people who have a serious mental illness or live with a persistent mental health problem or illness.
- Investing in intensive services, such as the Housing First approach, can end up costing only half as much as would otherwise be spent on offering the usual services. Only 1.5 per cent of the population need intensive services, and another 3.5 per cent need more specialized services.
These effective interventions mirror the recommendations put forward in the MHCC report Changing Directions, Changing Lives: The Mental Health Strategy for Canada, and the 13 provincial and territorial mental health and addictions strategies.
Mental health problems and illnesses impact many Canadians.
- In 2016, 7.5 million people in Canada were living with a mental health problem or illness - that’s one in five people in any given year.
- By comparison, this represents more than the population of our 13 capital cities combined, and nearly twice the number of people in all age groups living with heart disease or type 2 diabetes.
- About 1.6 million Canadians recently reported that their need for mental health care was only partially met or not met at all.
The economic costs of mental health problems and illnesses are significant.
- The total cost from mental health problems to the Canadian economy exceeds $50 billion annually, this isnearly $1,400 for every person living in Canada.
How much does Canada invest in mental health?
- The $15.8 billion spent by the public and private sectors in 2015 for mental health care represented about 7.2 per cent of Canada’s total health spending ($219.1 billion). This is well below Canada’s G8 peers. For example, England’s National Health Service spends 12 per cent.
Mental health problems and illnesses have a long-term economic impact because of their early onset.
- Symptoms for common mental health problems and illnesses can begin as early as 4 years of age.
- A reported 1.2 million children and youth under age 19 are living with a mental health problem or illness.
- About 50 per cent of all mental health problems and illnesses likely began by the teenage years.
- Hospitalizations of children and youth with mental health problems and illnesses increased 37 per cent from 2013 to 2014.
- The highest rate of mental health problems and illnesses is among young adults ages 20 to 29, a time when people are completing their education or starting careers.
Mental health in Canada’s aging population is an increasing issue.
- In 2016, 1.8 million people in Canada over the age of 60 were living with a mental health problem or illness.
- Up 25 per cent of emergency department visits are made by people aged 65 years or older with a mental health problem or illness.