Trends in objectively measured and perceived mental health and use of mental health services: a population-based study in Ontario, 2002–2014
Open accessAbstract
BACKGROUND: Mental illness is widely perceived to be more of a public health concern now than in the past; however, it is unclear whether this perception is due to an increase in the prevalence of mental illness, an increase in help-seeking behaviours or both. We examined temporal trends in use of mental health services as well as objectively measured and perceived mental health. METHODS: We conducted a repeat cross-sectional study of Ontario residents who participated in Statistics Canada’s Canadian Community Health Survey (2002–2014). We assessed temporal trends in objectively measured past-year major depressive episode (based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, and International Classification of Diseases, 10th Revision) and past-month psychological distress (Kessler Psychological Distress Scale–6 score ≥ 8) and perceived, self-rated mental health. We also examined use of mental health services, including service use among those with a need for mental health care. RESULTS: A total of 260 090 survey participants were included. The age- and sex-standardized prevalence of a major depressive episode (4.8%, 95% confidence interval [CI] 4.2%–5.3% in 2002 v. 4.9%, 95% CI 4.2%–5.7% in 2012; p = 0.9) and psychological distress (7.0%, 95% CI 6.3%–7.6% in 2002 v. 6.5%, 95% CI 5.7%–7.5% in 2012; p = 0.4) did not change significantly over time. However, self-rated fair or poor mental health status increased from 4.9% in 2003–2005 to 6.5% in 2011–2014 (ptrend < 0.001), as did the use of mental health services (7.2% to 12.8%, ptrend < 0.001). The percentage of individuals who had subjective or objectively measured mental health problems and did not access mental health services decreased significantly over time. INTERPRETATION: Given the stable prevalence of objectively measured psychiatric symptoms, the increase in use of mental health services appears to be, at least partly, explained by an increase in perceived poor mental health and help-seeking behaviours.
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This issue is increasingly observed in youth seeking psychiatric care.
“This issue is increasingly observed in youth seeking psychiatric care [29, 45, 46].”
From Scrolling through adolescence: a systematic review of the impact of TikTok on adolescent mental health (2025) · cites this paper as [45]
The Results section, “Use of mental health services among those in need” (page unavailable), reports increasing service use among Ontario residents with mental health issues. The paper includes younger participants, but the cited passages do not establish that the unspecified issue is increasingly observed specifically in youth seeking psychiatric care. (LLM, conf=0.78)
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References 48 · Cited by 53
Research works printed but not linked: 3
- O'Connor EA, Whitlock EP, Gaynes B, et al. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews. In: Screening for depression in adults and older adults in primary care: an updated systematic review. Rockville (MD): Agency for Healthcare Research and Quality; 2009.
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- Béland Y, Bailie L, Catlin G, et al. CCHS and NPHS -an improved health survey pro- gram at Statistics Canada. In: Proceedings of the American Statistical Association Meeting, Survey Research Methods. 2000 Aug. 16;682-687.
- Authors
- Chiu, M., Amartey, A., Wang, X., Vigod, S., & Kurdyak, P.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Joule Inc.
- Published
- 2020-03-29
- Volume
- 192
- Issue
- 13
- Pages
- E329-E337
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC7124159
- OpenAlex
- W3013179097
- Cited by
- 53
- References
- 48
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 3 · 2023: 7 · 2022: 22 · 2021: 9 · 2020: 5
- FWCI
- 11.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Ministry of Health and Long-Term Care
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- mental health service utilization, help-seeking, self-rated mental health, major depressive episode, psychological distress, prevalence of mental disorders, temporal trends, unmet mental health needs, Ontario residents, Canadian Community Health Survey, mental health policy evaluation, mental health promotion and prevention, mental health professionals
- MeSH terms
- Facilities and Services Utilization, Adult, Mental Disorders, Cross-Sectional Studies, Female, Health Services Needs and Demand, Humans, Male, Mental Health Services, Middle Aged, Ontario, Patient Acceptance of Health Care, Prevalence, Self Report
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