Mental Health and MAID: Canadians who struggle to get help more likely to support expanding eligibility
Two-in-five who sought mental health care in past year encountered barriers
September 28, 2023 – As the debate over expanding eligibility to medical assistance in dying to include individuals whose sole condition is mental illness continues, there is much concern among Canadians over the state of mental health care in the country ahead of this weighty decision.
New data from the non-profit Angus Reid Institute, in partnership Cardus, finds a vast majority of Canadians concerned with the mental health care resources available in the country (80%) and the state of Canadians’ mental health overall (81%).
This concern is more elevated among those who sought care from the country’s mental health-care system in the past year. Overall, one-in-five (19%) Canadians say they’ve looked for treatment for a mental health issue from a professional in the last 12 months. In that group, two-in-five say they’ve faced barriers to receive the treatment they wanted. These obstacles appear to be more of an issue for women (45% of those who sought treatment say it was difficult to receive) and young Canadian adults aged 18-34 (51%).
With this in the background, the federal government is continuing deliberations on expanding eligibility for MAID to include those whose sole condition is mental illness. Majorities of Canadians support the previous rules governing MAID, first passed in 2016 (64%) and then updated in 2021 (60%), but there is more hesitation when it comes to this next step. Three-in-ten (28%) say they support allowing those whose sole condition is mental illness to seek MAID, while half are opposed (50%).
However, for those who have sought treatment for their mental health and found it difficult to access, there is elevated support. Two-in-five (41%) who have encountered barriers to mental health care believe those whose sole condition is mental illness should be able to receive MAID. Comparatively, 26 per cent of those who have not needed to use the mental health-care system in the past year say the same.
More Key Findings:
- Those who encountered barriers to receive mental health care are more likely to be in lower income households (36%) than those who found their access easy (24%).
- When asked to describe their recent mood, Canadians are most likely to select “fatigued” (47%), “normal” (41%) and “anxious” (38%). One-quarter (27%) say they have been “happy” over the last couple of weeks.
- Majorities of those who faced difficult access to mental health care (60%) and easy access (83%) say the treatment they received helped.
About ARI
The Angus Reid Institute (ARI) was founded in October 2014 by pollster and sociologist, Dr. Angus Reid. ARI is a national, not-for-profit, non-partisan public opinion research foundation established to advance education by commissioning, conducting and disseminating to the public accessible and impartial statistical data, research and policy analysis on economics, political science, philanthropy, public administration, domestic and international affairs and other socio-economic issues of importance to Canada and its world.
About Cardus
Founded in 1974, Cardus is a non-partisan think tank dedicated to clarifying and strengthening, through research and dialogue, the ways in which society’s institutions can work together for the common good.
INDEX
Part One: The state of mental health in Canada
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One-in-three have sought mental health support in past year
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Mental health care access: Many have encountered barriers to treatment
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Those with difficulties accessing system report feeling anxious, depressed at higher rates
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Majority among those with difficult access say treatment improved their condition
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High levels of concern with Canadians’ access to mental health care
Part Two: Mental health and MAID
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Mental health care access and MAID expansion
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Overall support for original law, trepidation over mental health elements
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Opponents to eligibility expansion worry over deprioritization of treatment
Part One: The state of mental health in Canada
One-in-three have sought mental health support in past year
The onset of COVID-19, and the restrictions the virus brought, challenged Canadians on many fronts. In March 2022, half of Canadians said their mental health worsened during two years of the pandemic.
With the public health emergency over, and restrictions removed, most Canadians have returned to pre-pandemic routines. There has been a concurrent boost in Canadians’ mood. Canadians are more likely to say they have felt great (23%) or good (51%) mentally in recent weeks than 18 months ago.
Still, half (47%) say they feel fatigued, while approaching two-in-five (38%) say they’ve been feeling anxious in recent weeks (see detailed tables).
In this environment, one-in-three (33%) Canadians say they have sought support for mental health in the past year. Another one-in-ten (9%) say they felt like they needed assistance but didn’t seek it. A further one-in-five (20%) have looked for help for their mental health in the past. A minority – one-third (34%) – say they have never sought support for their mental health.
Men, and older Canadians, are more likely to be in the latter category. More than half (58%) of 18- to 34-year-old women say they have either sought support (45%) or felt like they needed to (13%) in the past 12 months, the most of any demographic.
As well, two-in-five (40%) say they know a close friend or family member who was looking for help with their mental health in the past year, providing further evidence of the significant number of Canadians who feel they need mental health support (see detailed tables).
While professional support (64%) was the most common mental health care Canadians sought, many also turned to the internet for more information (39%) or tried out one of the suite of wellness or meditation apps available (19%).
For those who turn to the mental health-care system, counselling (62%), therapy (44%) and prescriptions (44%) are the most common requested services:
Mental health care access: Many have encountered barriers to treatment
To better understand the ease of access for Canadians to mental health care, the Angus Reid Institute developed the Mental Health Care Access Index. This index separates Canadians who encountered barriers to mental health care from those who say they found it easy to access to the services they sought (click here to see how the index was scored).
One-in-five (19%) Canadians sought support from mental health care professionals in the past year. Of that group, eight per cent – or more than three million adults – say they encountered difficulty to receive the care they needed. The remaining 11 per cent accessed the mental health care they needed with ease.
Four-in-five (81%) Canadians have not sought out mental health support from professionals in the public or private system in the past year:
When looking at just those who sought mental health care in the past year, two-in-five (41%) found barriers to the help they wanted. Canadians aged 18- to 34-years-old were more likely to encounter barriers than older ones, and women more likely to have difficulty accessing mental health care than men:
Those who report difficulties accessing mental health care are more likely to be lower income than those who found few barriers to the care they wanted.
Canadians are more likely to report difficulties accessing counselling and therapy than prescription drugs.
Few people say they or someone they knew encountered barriers to receive prescriptions for their mental health issue. That was not the case for counselling or therapy, where two-in-five say it was difficult for them, or someone they know, to access this treatment:
Those with difficulties accessing system report feeling anxious, depressed at higher rates
Canadians who report difficult access to mental health care are also more likely than others to describe their mood negatively. Seven-in-ten (70%) in the Difficult Access group say they’ve been anxious in recent weeks, while two-in-five (38%) say they’ve been depressed. Canadians who have had easy access to mental health care, and those who needed no access at all, are much less likely to use those terms to describe their recent feelings:
Majority among those with difficult access say treatment improved their condition
Regardless of whether their access was difficult or easy, majorities of Canadians who received treatment for their mental health in the past year say it made a difference. However, those who encountered few or no barriers are twice as likely to say it helped a lot (42%) than those who say it was difficult to get the mental health care they needed (21%):
High levels of concern with Canadians’ access to mental health care
Most Canadians – four-in-five – worry over the availability of resources and access to mental health care in the country and the state of Canadians’ mental health overall. That includes nearly all who have struggled to access mental health care in the past 12 months:
Part Two: Mental health and MAID
Health care has been under the microscope in recent years as provincial and federal governments have looked for solutions to fix a health-care system described as in crisis.
Related:
- Access to Health Care: Free, but for all? Nearly nine million Canadians report chronic difficulty getting help
- After a ‘decade of decline’ in health care, Canadians not convinced that money is enough to solve the crisis
Mental health care in the country has also received intense scrutiny. During the 2021 federal election, the Liberals promised to launch a mental health transfer that would provide provinces and territories with $4.5 billion over five years to “expand the delivery of high-quality, accessible and free mental health services.” However, advocates worry that the focus on mental health has been lost, as the Liberals appear to have rolled the promised boost into the general health care funding agreement it struck with the provinces and territories earlier this year.
Against this backdrop, there has been an intensifying conversation regarding making Canadians whose only medical condition is a mental illness eligible for medical assistance in dying (MAID). MAID was first legalized in Canada in 2016. The initial legislation allowed for MAID for those with a serious, incurable medical condition whose deaths were reasonably foreseeable. The latter requirement was removed in a 2021 update to the legislation.
In the pathway laid out in the 2021 legislation, eligibility was set to expand in 2023 to allow mental illness as the sole medical condition for the MAID application. This has been delayed to 2024 as the government looks to set out guidelines and best practices.
Mental health care access and MAID expansion
There is broad support for the 2016 law and the 2021 update among Canadians, but more opposition to the proposed expansion of eligibility to include mental illness as a sole condition. Note, the survey questionnaire asked Canadians about the eligibility for MAID as laid out in the 2016. Then it asked about the 2021 update as laid out in the legislation. Finally, it asked about the potential further expansion of eligibility to include mental illness as a sole condition. To read the questionnaire, click here.
Those who have needed professional assistance from the mental health-care system in the past year are much more likely than those who have not to support expanding eligibility to allow mental illness as a sole condition for a MAID application. Two-in-five (41%) who have encountered barriers to accessing mental health support they feel they needed say they support this proposed expansion of MAID eligibility:
This increased support for MAID among those who have encountered barriers to mental health care is also evident when respondents are presented with specific scenarios which may engender a request for MAID. While opposition outweighs support, Canadians who have had difficulties accessing the mental health-care system are more likely than others to support someone suffering from PTSD, depression or anxiety seeking MAID (see detailed tables for all scenarios presented).
Overall support for original law, trepidation over mental health elements
Across the country, there is broad support for MAID as it was laid out in 2016 and with the 2021 expansion to include those whose deaths are not reasonably foreseeable. Only in Alberta (45%) does support for either MAID framework fall below half:
There is much more opposition to the proposed expansion to include mental illness as an eligible sole condition for MAID. At most, one-third in B.C. (33%), Manitoba (35%) and Quebec (31%) say they support this change to MAID eligibility. But, in those three provinces and elsewhere, there are more opposed than in favour:
Majorities of men of all ages oppose expanding eligibility to include mental illness as an eligible sole condition for MAID. Women are more conflicted on the matter, but pluralities are in opposition:
Two-thirds (67%) of past Conservative voters oppose expanding MAID eligibility to individuals whose sole condition is mental illness. Conservative leader Pierre Poilievre said a government under his party would repeal MAID for those with a mental illness in the event a private member’s bill introduced earlier this year from Conservative MP Ed Fast fails to accomplish that goal. Past NDP voters are the most divided between support (37%) and opposition (40%) for this proposed MAID eligibility, while those who voted Liberal in 2021 are more opposed (42%) than in support (31%):
Four-in-five (82%) Canadians feel mental health care should be improved first before MAID eligibility is expanded to include those whose sole condition is a mental illness. That includes seven-in-ten (69%) of those who support this expansion of MAID eligibility:
Opponents to eligibility expansion worry over deprioritization of treatment
Half of Canadians (52%) worry that treating mental health will not be a priority MAID eligibility is expanded to include individuals whose sole condition is mental illness. This is a greater concern for those who oppose this proposed expansion of MAID eligibility:
Survey Methodology:
The Angus Reid Institute in partnership with Cardus conducted an online survey from Sept. 19-22, 2023 among a representative randomized sample of 1,872 Canadian adults who are members of Angus Reid Forum. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 2 percentage points, 19 times out of 20. Discrepancies in or between totals are due to rounding. The survey was commissioned and paid for jointly by ARI and Cardus.
For detailed results by age, gender, region, education, and other demographics, click here.
For detailed results by the Mental Health Access Index, click here.
To read the full report, including detailed tables and methodology, click here.
To read the questionnaire, click here.
Image – Nik Shuliahin/ Unsplash
MEDIA CONTACT:
Shachi Kurl, President, ARI: shachi.kurl@angusreid.org @shachikurl
Daniel Proussalidis, Director of Communications, Cardus: 613.899.5174 dproussalidis@cardus.ca
