Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca

 
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Halton Region
Mental Health Report
2018

A profile of mental health and wellbeing in Halton Region
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Reference:
Halton Region Health Department. (2018). Halton Region Mental Health Report. Oakville, Ontario.

Author:
Megan Brunner, Epidemiologist, Halton Region Health Department

Contributors:
Lorraine Gold, Public Health Nurse – Health Equity Advisor, Halton Region Health Department
Michelle Schwarz, Public Health Nurse – Health Equity Advisor, Halton Region Health Department

Acknowledgements:
Lisa Collimore, Chief Officer and MISA Leader, Halton Catholic District School Board
Jean Gresham, Manager, Halton Region Health Department
Kendra Habing, Epidemiologist, Halton Region Health Department
Lynne Hanna, Manager, Halton Region Health Department
Bonnie Hewitt, Manager, Halton Region Health Department
Dr. Daniela Kempkens, Associate Medical Officer of Health, Halton Region Health Department
Frank Nezavdal, Instructional Program Leader (K-12), Halton District School Board
Erika Norris, Public Health Nurse – Health Equity Advisor, Halton Region Health Department
Alison Rothwell, Epidemiologist, Halton Region Health Department
Emma Tucker, Manager and Senior Epidemiologist, Halton Region Health Department
Elisabeth Wells, Researcher and Knowledge Broker, Our Kids Network
Kristen Wheeler, Epidemiologist, Halton Region Health Department

                                                                                                  Halton Region Mental Health Report 2018 2
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Contents
Contents                                    3
Highlights                                  4
Data notes                                  6
Introduction                                8
Social determinants of mental health        9
Overview of mental health in Halton         10
Child and youth mental health               15
Mental health in pregnancy and parenthood   22
Adult mental health                         27
Older adult mental health                   33
Conclusion                                  39
References                                  40
Appendix A: Data sources and limitations    42
Appendix B: Definitions                     46
Appendix C: ICD-10-CA codes                 49

                                                 Halton Region Mental Health Report 2018 3
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Highlights
The Halton Region Mental Health Report           dementia and Alzheimer’s disease, mental         students. Elementary and secondary
provides a snapshot of the mental health of      and behavioural disorders due to substance       students who were born in Canada were
Halton residents across the lifespan.            use, mood disorders, and various other           most likely to have positive relationships
                                                 disorders of psychological development.          with their peers, while newcomers (less
Data from the Canadian Community Health                                                           than five years in Canada) were least likely.
Survey show that 4 out of 5 Halton               From 2006 to 2015, there was an increase         Newcomer secondary students were less
residents (ages 12+) reported having very        in ED visits and hospitalizations for mental     likely than both Canadian-born students
good or excellent mental health, which was       illness among Halton residents, although         and those who immigrated five or more
higher than Ontario. Having a higher             rates were consistently lower in Halton than     years ago to have a positive sense of
income, a strong sense of community              Ontario. Rates of ED visits for mental           belonging. Living in a two-parent household
belonging, and being a post-secondary            illness were highest among those aged 15         was also associated with positive mental
graduate were associated with better self-       to 24. Rates of hospitalizations were            health and social connectedness.
reported mental health.                          highest among 15 to 24 year olds, as well
                                                 as adults aged 85 and over. Rates of ED          The rate of ED visits for mental illness has
Some Halton residents face mental health         visits and hospitalizations for mental illness   increased for 10-17 year olds in Halton and
challenges: 23% reported that most days          were lower in high income neighbourhoods         Ontario over the past 10 years (particularly
were quite a bit or extremely stressful, and     compared to low income neighbourhoods.           among females), with the greatest increase
9% reported ever having been diagnosed                                                            occurring between 2010 and 2013. The rate
with a mood and/or anxiety disorder.             Children and youth                               of ED visits for mental illness was about 2.5
                                                 Data from the Tell Them From                     times higher among Halton females
This report also examined trends in              Me/OurSCHOOL Survey show that                    compared to males aged 10-17 from 2013
emergency department (ED) visits and             differences in mental health exist within        to 2015. Hospitalizations also increased in
hospitalizations over time for mental illness.   Halton’s student population. Grade 9             this age group during approximately the
For the purposes of this report, mental          students had lower depression, and higher        same time period.
illness includes a wide range of mental          self esteem, sense of belonging and
illnesses including organic disorders like       positive relationships compared to grade 12

                                                                                                  Halton Region Mental Health Report 2018 4
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Pregnancy and parenthood                        Like other age groups, there has been a rise
From 2013 to 2015, an average of 778            in ED visits and hospitalizations for mental
women per year in Halton (13.9% of women        illness among Halton adults (18-64), but the
who gave birth) reported experiencing one       rates have remained well below the
or more mental health concerns during           provincial average.
pregnancy. Pregnant women in Halton were
less likely to have experienced one or more     Older adults
mental health concerns during pregnancy         In Halton, life satisfaction decreased as age
compared to Ontario.                            increased. However, older adults (65+)
                                                reported being less stressed and having a
Halton parents who felt close to other          stronger sense of community belonging than
parents, were able to take time for their own   adults aged 18-64.
wellbeing, and felt supported in parenting
                                                There was no significant trend in ED visits
were less likely to report feeling stressed.
                                                for mental illness among adults aged 65+
Adults                                          from 2006 to 2015, however rates of
Good physical health, having a job, and         hospitalizations for mental illness in this age
higher household income was associated          group increased during this time period.
with better self-reported mental health
among Halton adults. However, one in three
Halton adults reported being stressed most
days at work.

                                                                                                  Halton Region Mental Health Report 2018 5
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Data notes
Data sources
Five data sources are presented in this report. The table below provides a brief summary of each data source. For more information on data
sources including limitations, see Appendix A.

DATA SOURCE             SECTION          YEARS          DESCRIPTION
Tell Them From          Youth            2015-16        The Tell Them From Me/OurSCHOOL is a voluntary, online survey asked of elementary
Me/OurSCHOOL                             school year    and high school students in the Halton District School Board and Halton Catholic District
Survey                                                  School Board. The survey explores topics such as student engagement, bullying,
                                                        emotional and physical wellbeing. For the 2015-16 school year, approximately 18,000
                                                        Grade 4-6 students and 17,500 grade 9-12 students completed the survey. Results
                                                        should not be compared between elementary and secondary school students, as they
                                                        completed different versions of the survey.

Better Outcomes         Parents and      2013-15        BORN includes data on pregnancy and birth (including home births) in Ontario from
Registry and            pregnancy                       hospitals, labs, midwifery practice groups, and clinical programs.
Network (BORN)

Halton                  Parents and      2015           The KPS is a voluntary online survey by the Our Kids Network, which is distributed to
Kindergarten            pregnancy                       parents of kindergarten children in the Halton District School Board and Halton Catholic
Parent Survey                                           District School Board. The KPS explores topics related to the health and wellbeing of
(KPS)                                                   kindergarten children and their parents. In 2015, 2,257 parents completed the KPS.

Canadian                Adults, Older    2009-14        The CCHS is a voluntary survey conducted in-person or by phone by Statistics Canada.
Community Health        adults                          CCHS collects data related to health status, healthcare, and health determinants across
Survey (CCHS)                                           Canada. About 600 Halton residents complete the CCHS each year.

National                Youth, Adults,   2006-15        NACRS contains data for all hospital-based and community-based ambulatory care in
Ambulatory Care         Older adults                    Ontario hospitals. This report includes NACRS data on emergency department visits and
Reporting System                                        hospital admissions where the patient’s main problem or diagnosis as determined by the
(NACRS)                                                 emergency department was a mental illness (ICD-10-CA: F00-F99, G30, O993).

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Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Years of data presented                          with an asterisk (*) and should be               was the Most Responsible Diagnosis – the
The years of data presented throughout           interpreted with caution due to high             one diagnosis or condition most
this report vary, as the years of data           variability.                                     responsible for a patient’s stay in a facility.
available differ depending on the data                                                            Note that ED visits and hospital admissions
source. Where counts were small, multiple        Definitions                                      for self-harm are not included in this report,
years of data were combined to account for       A complete list of definitions of indicators     but can be found in the Halton Self-Harm
unstable rates in the population which can       and key terms presented in this report can       and Suicide Report. See Appendix C for a
occur when examining a single year of data.      be found in Appendix B.                          complete list of ICD-10-CA codes and
                                                                                                  groupings included in this report.
Statistical significance                         Survey data
Differences between groups were tested           The indicators “anxiety” and “depression”        It is important to keep in mind throughout
for statistical significance by calculating      from the Tell Them from Me/OurSCHOOL             this report that the ED and hospital
95% confidence intervals for rates. If the       survey are based on a series of self-            admission data are not intended to reflect
confidence intervals between groups did          reported survey questions and should not         the true burden of mental illness in the
not overlap, differences were considered         be interpreted as rates of clinically            population, but rather to identify trends in
statistically significant. Trends over time      diagnosed anxiety and depression.                mental health service use for mental illness
were tested for significance using linear                                                         in the population. This report does not
regression and adjusting for auto-               ED and hospital admission data                   capture those who sought help for mental
correlation. If a trend is referred to as        For this report the term “mental illness”        illness from other sources such as family
“increasing” or “decreasing” throughout the      refers to codes F00-F99, G30, O993 from          doctors, walk-in clinics, counselors, or
report, the trend described is statistically     the Canadian version of the International        psychologists.
significant. Differences between groups          Statistical Classification of Diseases (ICD-
described in the report are also statistically   10-CA).1 This includes a wide range of           Data tables
significant, unless otherwise stated.            mental illnesses including organic               Please note that data tables to accompany
                                                 disorders like dementia and Alzheimer’s          the graphs, figures and key findings
Coefficient of variation                         disease, mental and behavioural disorders        presented in this report are available upon
The coefficient of variation refers to the       due to substance use, mood disorders, and        request.
precision of an estimate. With survey data,      various other disorders of psychological
where the coefficient of variation was           development. The report presents ED visits
between 16.6-33.3, estimates are marked          and hospitalizations where a mental illness

                                                                                                Halton Region Mental Health Report 2018 7
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Introduction
The Halton Region Mental Health Report            diagnosed mental illness to experience poor    community service providers, educators,
provides a snapshot of the mental health of       mental health.6                                and health care providers in the community.
children and youth, parents, adults, and
older adults living in Halton Region. The         Mental health is important at every stage of   The purpose of the Halton Region Mental
United Nations defines mental health as:          life, from birth and early childhood to        Health Report is to provide data on trends,
                                                  adolescence and throughout adulthood.          emerging issues, and the current status of
“a state of wellbeing in which every              Mental health is also dynamic. It changes      mental health in Halton to inform mental
individual realizes his or her own potential,     over time depending on various factors         health programs, services and policies in
can cope with the normal stresses of life,        such as life experiences, levels of stress,    our community. The report also seeks to
can work productively and fruitfully, and is      health and lifestyle behaviours, and           identify populations within Halton’s
able to make a contribution to her or his         genetics.3                                     community who may be disproportionately
community.”2                                                                                     affected by poor mental health.
                                                  Evidence shows that creating supportive
While the terms “mental health” and “mental       environments, increasing resiliency,           This report is divided into four major
illness” are often used interchangeably, the      improving mental health literacy, and          sections focusing on mental health during
two terms have different meanings.3               reducing stigma around mental illness can      various ages and stages in life, including
Everyone has mental health, just like             help improve mental health at all ages and     mental health among children and youth,
everyone has physical health.3,4 Mental           stages of life.7                               parents and pregnancy, adults, and older
health is the ability to feel, think and act in                                                  adults. While it is recognized that the
ways that help people to enjoy life and deal      Promoting positive mental health in the        foundation for good mental health begins
with any challenges they may face.4 Mental        community is an important goal of Halton       early in life,9 the early years are not
illness, on the other hand, refers to mental      Region’s 2015-2018 Strategic Action Plan.8     included as an area of focus in this report
health problems that are diagnosed and            The Halton Region Health Department            due to data limitations.
treated by mental health professionals.5 A        works towards this goal by providing
                                                                                                 This report also includes stories that
person can have a mental illness and still        information, programs and resources on a
                                                                                                 illustrate the impact of mental health on the
experience mental wellbeing.6 It is also          variety of mental health topics to teens,
                                                                                                 lives of Halton residents.
possible for a person who does not have a         parents, adults, older adults, caregivers,

                                                                                                 Halton Region Mental Health Report 2018 8
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Social determinants of mental health
Like physical health, mental health is                                    positive mental health.11 Belonging to a                                   Interwoven throughout this
influenced by the social and economic                                     strong social support network can act as a
factors in the environments where people                                  buffer against stress, promote positive
                                                                                                                                                     report are stories of individuals
live, learn, work and play. These factors,                                health, and help people to feel cared for and                              in our community and their
such as income, education, social support                                 valued.12 Social connectedness leads to                                    experiences with the social
networks and housing are often referred to                                stronger and more resilient communities.12                                 determinants of mental health.*
as the social determinants of health.10
Sometimes these factors limit access to the                               Discrimination and violence can lead to
opportunities and resources needed to be                                  poor mental health. Discrimination refers to
                                                                                                                                                     Some of the differences in mental health
healthy, and this can lead to avoidable                                   actions taken to exclude or treat others
                                                                                                                                                     between groups described in this report are
differences in health.                                                    differently due to factors such as their race,
                                                                                                                                                     related to individual factors such as biology.
                                                                          ethnicity, gender, sexual orientation and/or
                                                                          disability.11 Communities that value                                       However, some differences are related to
Three important social determinants of
                                                                          diversity, promote physical security, and                                  the social determinants of mental health. By
mental health include:
• social inclusion,                                                       empower individuals with the opportunity to                                taking action to address the social
• freedom from discrimination and                                         take control over their lives provide greater                              determinants of mental health, the
   violence, and                                                          opportunities for positive mental health.11                                conditions of everyday life can be improved
• access to economic resources.11                                                                                                                    and avoidable barriers to good health can
                                                                          Access to economic resources, such as                                      be reduced or eliminated.13 This means that
Social inclusion refers to the degree to                                  work, education, money and adequate                                        everyone has a fair and just opportunity to
which individuals feel connected to their                                 housing, is another important social                                       be as healthy as possible both physically
communities, and includes concepts such                                   determinant of mental health. Participation                                and mentally.
as supportive relationships, participation in                             in the economy not only provides access to
community and group activities, and civic                                 adequate income, but it also can improve
engagement.11 Social connectedness and                                    social connectedness and increase
inclusion is an important protective factor for                           opportunities for control over one’s life.11

*note that the stories presented in this report are works of fiction to help illustrate the important connection between mental health and the social determinants of health.

                                                                                                                                                   Halton Region Mental Health Report 2018 9
Mental Health Report Halton Region - A profile of mental health and wellbeing in Halton Region - Halton.ca
Overview of mental
health in Halton
This section of the report provides a high level overview of indicators of the
mental health of Halton residents aged 12 and over using data from the
Canadian Community Health Survey. Also included is an overview of trends
in emergency department visits and hospitalizations for mental illness for all
ages.

                                Halton Region Mental Health Report 2018 10
Background                                                                                     Mental health
Mental illness is one of the most common       In order to promote positive mental health      promotion in Halton
causes of disability in Canada.14 It is        and work towards improving the lives of         Mental health promotion refers to initiatives
estimated that in a given year, one in five    those living with mental illness in Halton,     that aim to create living conditions and
Canadians will experience a mental             it is important to gain a better                environments that support mental health and
illness or addiction.15 In Ontario, the        understanding of the picture of mental          allow people to adopt and maintain healthy
burden of mental illness is one and a half     health in Halton across the lifespan.           lifestyles.18 By working to enhance factors that
times higher than all cancers put              Indicators of mental health (such as self-      promote mental wellness (such as sense of
together, and more than seven times that       reported mental health and life                 belonging and good physical health) and
of all infectious diseases.16                  satisfaction), mental illness (such as self-    reduce risk factors for poor mental health
                                               reported diagnosis with a mood or anxiety       (such as discrimination, isolation, and stress) it
Mental illness places a substantial burden     disorder), and health service utilization       is possible to increase the proportion of the
on the healthcare system, on employers,        (such as emergency department visits            population experiencing good mental health.19
and individuals affected by mental             and hospitalizations) can be used to help
illness.14 It is estimated that the economic   identify issues, set priorities, and monitor    A recent review of the literature conducted by
                                                                                               the Halton Region Health Department found
burden of mental illness in Canada is $51      progress in improving the mental health
                                                                                               four areas of opportunity to improve the mental
billion dollars per year, which includes       of the population.17
                                                                                               health of Halton residents:
costs associated with healthcare, lost
productivity, and reduced health-related                                                       •   promoting opportunities to foster social
quality of life.14                                                                                 connectedness;
                                                                                               •   creating supportive, healthy, safe and
                                                                                                   inclusive environments where Halton
                                                                                                   residents live, learn, work and play;
                                                                                               •   increasing resiliency of Halton residents
                                                                                                   (i.e. ability to bounce back after major
                                                                                                   challenges) by promoting individual
                                                                                                   protective factors for mental wellness; and
                                                                                               •   Improving awareness and understanding of
                                                                                                   mental illness and reducing stigma.7

                                                                                              Halton Region Mental Health Report 2018 11
The social determinants of mental
 General mental health and wellbeing                                                                                          health impact people differently,
                                                                                                                              and this can lead to differences in
 Positive mental health is about both feeling good and functioning well. In Halton from                                       mental health in the population.
 2009-2014:
                                                                                                                In Halton from 2009-2014,

                                                                                7 out of 10 Halton residents    • Life satisfaction decreased with age, while the
                                                          94%                  reported a very or somewhat        middle age group (18-64) reported higher stress
                                                                                strong sense of community         and a lower sense of community belonging than
     4 out of 5 Halton                       of Halton residents
                                                                                          belonging
 residents reported that                     reported that they                                                   youth (12-17) and older adults (65+)
 their mental health was                     were satisfied with                                                • Females were more likely than males to report
  very good or excellent                             life
                                                                                                                  consulting a mental health professional, and
                                                                                                                  having been diagnosed with a mood and/or
                                                                                                                  anxiety disorder
             81% of Halton residents                                            Compared to Ontario, Halton     • As income increased, life satisfaction and self-
             reported that they were                                            residents were more likely to     reported mental health increased, while reported
             happy every day or                                                 rate their mental health as       diagnosis with a mood and/or anxiety disorder
             almost every day this                                              very good or excellent, and       decreased
             past month (2011-12 only)                                          to indicate that they were
                                                                                satisfied with life.            • Self-reported mental health was higher among
                                                                                                                  post-secondary graduates compared to non-
                                                                                                                  post-secondary graduates
Some Halton residents also experience mental health challenges. From 2009-2014,                                 • Halton residents with a strong sense of
                                                                                                                  community belonging also had higher self-
                                                                                                                  reported mental health and life satisfaction, and
              23%                                                9%                           12%                 lower reported life stress and diagnosis with a
                                                                                                                  mood or anxiety disorder
                                                                                                                • There were no significant differences by
    of Halton residents                            of Halton residents   of Halton residents reported             immigrant status.
reported that most days                        reported ever having been      consulting a health
of their life were quite a                       diagnosed with a mood      professional about their
bit or extremely stressful                       and/or anxiety disorder mental health in the last year
Data source: CCHS [2009-2014], Statistics Canada, Share File, Ontario MOHLTC

                                                                                                                   Halton Region Mental Health Report 2018 12
Emergency department visits for                                           Trends over time
mental illness                                                            Over the past ten years, there has been a significant increase in the rate of ED
                                                                          visits for mental illness in Halton and Ontario. Rates of ED visits were consistently
                                                                          lower in Halton compared to Ontario.
Most common mental illness ED visits
From 2013-15, there were an average of 2,800 ED                                                                                                                            Figure 2: Age-
                                                                                                                                                                           standardized rate of ED
visits per year among males and 2,929 ED visits per                                                                                                                        visits for mental illness,
year among females in Halton for mental illness. The                                                                                                                       Halton Region and
most common mental illnesses were:                                                                                                                                         Ontario, 2006-2015.

      1. Substance disorders (915 ED visits per year)
      2. Anxiety (515 ED visits per year)
      3. Depression (426 ED visits per year)

      1. Anxiety (730 ED visits per year)
      2. Depression (621 ED visits per year)
      3. Substance disorders (575 ED visits per year)
                                                                          Differences by age and sex
                                                                          From 2013-15, the rate of ED visits for mental illness was highest among 15-19
                                                                          year-olds for females. Rates generally decreased with age after this peak until
Differences by neighbourhood income
                                                                          older adulthood, when the rates then began to increase with age. Among Halton
In Halton from 2013-15, the rate of ED visits for
                                                                          males, rates were highest in the 20-24 year old age group, and then followed the
mental illness decreased as neighbourhood income
                                                                          same general pattern with age as females.
group increased. See Appendix B for income group
definition.
                                                                                                                                                                           Figure 3: Age-specific
                                                                                                                                                                           rate of ED visits for
                                                                                                                                                                           mental illness, by sex,
                                                                                                                                                                           Halton Region, 2013-
                                                                                                                                                                           2015 combined.

Figure 1: Age-standardized rate of ED visits for mental illness, Halton
Region, by neighbourhood income group, 2013-2015 combined.
                                                                          Data source: National Ambulatory Care Reporting System [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted June 2017
                                                                                       Population Estimates [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted August 2016

                                                                                                                                Halton Region Mental Health Report 2018 13
Hospitalizations for mental illness                                            Trends over time
                                                                               Over the past ten years, there has been a significant increase in the rate of
                                                                               hospitalizations for mental illness in Halton and Ontario. Rates of hospitalizations
Most common mental illness hospitalizations                                    were consistently lower in Halton compared to Ontario.
From 2013-15 there were an average of 785
hospitalizations among males and 816                                                                                                                                            Figure 5: Age-
hospitalizations among females for mental illness in                                                                                                                            standardized rate of
Halton per year. The most common mental health                                                                                                                                  hospitalizations for
                                                                                                                                                                                mental illness, Halton
illnesses resulting in hospitalization were:
                                                                                                                                                                                Region and Ontario,
                                                                                                                                                                                2006-2015.
       1. Schizophrenic and psychotic disorders
            (212 hospitalizations per year)
       2. Depression (172 hospitalizations per year)
       3. Substance-related disorders (212 hospitalizations
            per year)

       1. Depression (265 hospitalizations per year)
       2. Schizophrenic and psychotic disorders
            (140 hospitalizations per year)
       3. Organic disorders† (91 hospitalizations per year)                    Differences by age and sex
†See
                                                                               From 2013-15, for Halton females the rate of hospitalizations for mental illness
     Appendix C for definition of organic disorders and other mental illness
categories                                                                     was highest among the 15-19 year-old age group. Rates then decreased with age
                                                                               until older adulthood, when rates began to increase. Among males, rates
                                                                               increased with age until ages 20-24, and then generally decreased with age until
Differences by neighbourhood income
                                                                               older adulthood, where rates peaked in the 85 and older age group.
In Halton from 2013-15, the rate of hospitalizations
for mental illness decreased as neighbourhood
income group increased.                                                                                                                                                         Figure 6: Age-
                                                                                                                                                                                standardized rate of
                                                                                                                                                                                hospitalizations for
                                                                                                                                                                                mental illness, by sex,
                                                                                                                                                                                Halton Region and
                                                                                                                                                                                Ontario, 2006-2015.

Figure 4: Age-standardized rate of hospitalizations for mental illness,
Halton Region, by neighbourhood income group, 2013-2015 combined.              Data source: National Ambulatory Care Reporting System [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted June 2017
                                                                                            Population Estimates [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted August 2016

                                                                                                                                     Halton Region Mental Health Report 2018 14
Child and youth mental
health
This section of the report provides an overview of indicators of the mental
health and wellbeing of Halton students in grades 4-6 and 9-12 based on
data from the Tell Them From Me/OurSCHOOL survey. Also included is an
overview of trends in emergency department visits and hospitalizations for
mental illness among Halton youth aged 10-17.

This section starts with Zara’s story. Her story illustrates how social and
economic factors can negatively impact mental health, and how access to
community resources and other social supports can improve mental health.

                              Halton Region Mental Health Report 2018 15
Zara is a grade 12 student who attends         committee of students, staff, and parents
                                                                                                The facts
high school in Oakville. She came to           to explore strategies to help all students     ► Most Halton high school students report
Canada a year ago with her mother and          feel a sense of belonging and connection.        having a positive sense of belonging (68%)
younger brother, and together they live in     In order to ensure all students had the          and having positive relationships with their
a small apartment a few kilometers from        opportunity to participate the committee         peers (77%).
school. Zara recently began a part-time        organized meetings over the lunch hour,        ► However, high school students who were
job working three nights per week to help      which gave Zara a chance to join.                newcomers were less likely to report having
her mother with expenses.                                                                       a positive sense of belonging compared to
                                                                                                students born in Canada and students who
                                               At the meetings, Zara was able to make
                                                                                                immigrated five or more years ago.
Although Zara feels comfortable in her         new friends, and shared some of her
new school, she hasn’t made many friends       experiences trying to adjust to her new life   ► Students from single-parent households or
                                                                                                other family arrangements were less likely
and often spends time alone at lunch and       in Canada. The school also invited a local
                                                                                                to report having a positive sense of
between classes. She has been unable to        settlement worker to join the committee,         belonging and having positive relationships
join any clubs or teams because of the         which was a great connection for Zara and        compared to students from two-parent
hours of her job, and the fact that she        her family as well as other newcomer             households.
cares for her little brother after school.     families in the school.
Child care is too expensive for her family
to afford. Although Zara feels grateful for    The school social worker was also able to
her new life in Canada, she often feels that   share some important community
she doesn’t really belong in her               resources with Zara’s mother, including
neighbourhood or at her school.                childcare and housing subsidy supports.
                                               These resources have helped relieve
                                                                                                   Zara’s
At Zara’s school, staff understand that        some of the financial stress Zara and her            story
feeling connected to school is an important    family have experienced, and given them
factor in school success and positive          more opportunities to get involved in
mental health. Together with a Public          school and community life, and for the first
Health Nurse from the Halton Region            time since they came to Canada, Zara
Health Department, the school created a        feels a sense of belonging and connection.

                                                                                               Halton Region Mental Health Report 2018 16
Background
Adolescence is an important time of change.    mental illness among Canadian children and          Schools and mental health
Youth face many challenges during the          youth, a reduction in stigma resulting in           Schools are important avenues for
transition to adulthood, including pressures   more youth seeking help, and/or greater             promoting positive mental health among
to succeed at home, at school and in social    reliance on hospital care in the face of            children and youth. Schools are an optimal
groups.20 The onset of many mental             limited access to community services.22             setting to:
illnesses also occur during this period.21                                                         • identify students in need;
                                               In addition to increased rates of ED visits and     • build pathways to care;
In recent years, there has been an increase    hospitalizations for mental illness, there has      • develop student social-emotional skills
in rates of emergency department visits        been a parallel increase in the rate of                and resilience;
(ED) and inpatient hospitalizations among      hospitalizations for intentional self-harm          • prevent mental health problems in high
children and youth across Canada for           among Canadian youth, particularly among               risk groups;
mental illness.22 Between 2006-07 and          females.23 From 2009-10 to 2013-14, the             • promote positive mental health and
2013-14, the rate of ED visits for mental      rate of hospitalizations for self-harm                 wellbeing for all students; and
illness among Canadian children and youth      increased by 110% for Canadian females              • reduce stigma.24
increased by 45%, while the rate of            aged 10-17.23 As with mental illness, the
hospitalizations increased by 37%.22 The       reasons behind the increase in                      The Halton Region Health Department
greatest increase in rates during this time    hospitalizations for self-harm are complex          works together with the local school boards
period occurred among youth aged 10 to         and not well understood. For more                   and community partners to help build
17.22 Several possible explanations for this   information on self-harm, see the Halton            healthy school communities and promote
trend include increases in the prevalence of   Sefl-Harm and Suicide Report.                       positive mental health among Halton’s
                                                                                                   children and youth.

                                                                                                 Halton Region Mental Health Report 2018 17
General mental health and wellbeing in children and youth

The Tell Them From Me/OurSCHOOL survey asks elementary and secondary students a series of questions related to friendships, sense of
belonging, and experiences with self-esteem, anxiety and depression. See Appendix B for a description of each measure.

                 Elementary school students                                                                      Secondary school students

     Overall findings for students in grades 4-6                                            Overall findings for students in grades 9-12

              had a positive                               had positive                           had a positive                 had positive                 had positive self-
                sense of                                relationships with                          sense of               relationships with their               esteem
                belonging                             their peers at school                         belonging                  peers at school

             reported being                              had moderate to                         reported being               had moderate to                 had moderate to
           bullied at all in the                         high levels of                         bullied at least             high levels of                  high levels of
            past four weeks                                  anxiety†                           once per week in                  anxiety†                      depression†
                                                                                              the past four weeks

   Notes
   The bullying measure includes students who report being the victim of any one or more of the following types of bullying: physical, social, verbal, or cyber bullying.

   † Foranxiety and depression, the criteria used are NOT equivalent to those used in clinical diagnoses. The Tell Them From Me/OurSCHOOL survey assigns students to the
   categories of moderate and severe anxiety or depression based on their self-reported responses to a series of questions related to sadness and worry. High rates of anxiety
   and depression as rated by these items should not be confused with high rates of clinical anxiety and depression in the students.

Data source: Tell Them From Me/OurSCHOOL Survey [2015-16], The Learning Bar

                                                                                                                               Halton Region Mental Health Report 2018 18
Differences in mental health and wellness among Halton students
 Analysis of the Tell Them From Me/Our School data also showed that differences in indicators of mental health and wellness exist in Halton’s
 student population.

                                               Among students in grades 4-6,
                                               • Bullying decreased as grade increased.
 Secondary school
     students                                  • Males had a higher sense of belonging and less anxiety than females, while females reported higher positive
                                                 relationships and less bullying than males.
                                               • Having positive relationships was highest among Canadian-born students followed by students who immigrated
                                                 five or more years ago. Newcomers who immigrated less than five years ago were the least likely to report
                                                 having positive relationships.
                                               • Students from two-parent households had less anxiety and bullying, and a greater sense of belonging and
    Elementary school                            positive relationships compared to those from single parent or other arrangement households.
        students

                                                Among students in grades 9-12,
                                               • Grade 9 students had higher self-esteem, sense of belonging and positive relationships, and lower depression
                                                 compared to grade 12 students.
                                               • Males had lower anxiety and depression compared to females, and higher self-esteem and sense of belonging.
                                                 Females, however, reported higher positive relationships.
                                               • Having positive relationships was highest among Canadian-born students followed by students who immigrated
                                                 five or more years ago. Newcomers who immigrated less than five years ago were the least likely to report
                                                 having positive relationships. Sense of belonging was similar between students born in Canada and those who
                                                 immigrated five or more years ago, but lower among newcomers.
                                               • Anxiety, depression and bullying were lower among students from two-parent households, while sense of
     Secondary school                            belonging, self-esteem and positive relationships were higher.
         students

Data source: Tell Them From Me/OurSCHOOL Survey [2015-16], The Learning Bar

                                                                                                                  Halton Region Mental Health Report 2018 19
Emergency department visits for mental                   Trends over time
illness in children and youth                            The rate of ED visits for mental health illness among Halton females aged 10-17
                                                         increased significantly over the last 10 years, from 1,083 per 100,000 females
                                                         aged 10-17 in 2006 to 1,801 per 100,000 in 2015, with the greatest increase
Differences by sex                                       occurring between 2010 and 2013. Ontario females experienced a similar increase
From 2013-15, females aged 10-17 in Halton had           during this time period. The rate of ED visits for mental illness has generally been
nearly double the rate of ED visits for mental illness   lower among Halton females aged 10-17 compared to Ontario.
compared to males.
                                                         Males aged 10-17 in Halton and Ontario also experienced a significant increase in
                                                         the rate of ED visits for mental illness over the past 10 years, although this
                                                         increase was not as large as it was for females. The rate of ED visits for mental
  1,037                                 1,916            illness in Halton and Ontario for males aged 10-17 were fairly similar in past years,
  ED visits per                         ED visits per
                                                         but in more recent years (2013-15) Halton’s rate has been significantly lower than
 100,000 males                        100,000 females
  aged 10-17                            aged 10-17       Ontario for males.

Most common mental health illness ED visits
From 2013-15 there were an average of 303 ED visits
per year among males and 537 ED visits per year
among females aged 10-17 in Halton for mental illness.
The most common mental illnesses resulting in ED
visits were:

       1. Depression (66 ED visits per year)
       2. Substance disorders (60 ED visits per year)
       3. Anxiety (56 ED visits per year)

       1. Depression (265 ED visits per year)
       2. Anxiety (112 ED visits per year)               Figure 7: Age-specific rate of ED visits for mental illness, ages 10-17, by sex, Halton Region and
                                                         Ontario, 2006-2015.
       3. Substance disorders (69 ED visits per year)

                                                         Data source: National Ambulatory Care Reporting System [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted June 2017
                                                                      Population Estimates [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted August 2016

                                                                                                              Halton Region Mental Health Report 2018 20
Hospitalizations for mental illness in                       Trends over time
children and youth                                           The rate of hospitalizations for mental health illness among Halton females aged
                                                             10-17 nearly tripled over the last 10 years, from 188 per 100,000 females aged 10-
                                                             17 in 2006 to 529 per 100,000 in 2015, with the greatest increase occurring
Differences by sex                                           between 2011 and 2014. Ontario females experienced a similar increase during
From 2013-15, females aged 10-17 in Halton had 2.5           this time period. In general, the rate of hospitalizations for mental illness has been
times the rate of hospitalizations for mental illness        higher among Halton females compared to Ontario females, however these
compared to males.                                           differences were not statistically significant.

                                                             Males in Ontario aged 10-17 also experienced an increase in the rate of
                                                             hospitalizations for mental illness from 2006 to 2015. There were no significant
    224                                      550             trends among Halton males aged 10-17 during this time period. In 2008, 2009 and
 hospitalizations                        Hospitalizations
                                       per 100,000 females
                                                             2012, Halton males aged 10-17 had a significantly higher rate of hospitalizations
per 100,000 males
    aged 10-17                              aged 10-17       compared to Ontario males.

Most common mental illness hospitalizations
Each year in Halton from 2013-15 there were an
average of 66 hospitalizations for mental illness among
males and 154 hospitalizations for mental illness
among females aged 10-17. The most common mental
illnesses resulting in hospitalization were:

       1. Depression (22 hospitalizations per year)
       2. Schizophrenic and psychotic disorders
            (9 hospitalizations per year)
       3.   Acute stress (8 hospitalizations per year)

       1. Depression (73 hospitalizations per year)
       2. Anxiety (55 hospitalizations per year)              Figure 8: Age-specific rate of hospitalizations for mental illness, ages 10-17, by sex, Halton Region
       3. Eating disorders (14 hospitalizations per year)     and Ontario, 2006-2015.

                                                             Data source: National Ambulatory Care Reporting System [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted June 2017
                                                                          Population Estimates [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted August 2016

                                                                                                                   Halton Region Mental Health Report 2018 21
Mental health in pregnancy
and parenthood
This section of the report summarizes the incidence of mental health concerns
during pregnancy using data from the Better Outcomes Registry and Network
(BORN) Information System. Also presented in this section of the report are
several indicators of the mental wellbeing of Halton parents using data from
Halton’s Kindergarten Parent Survey (KPS).

This section starts with Candace’s story. Her story illustrates the impact of
social isolation on mental health, and how building a strong social support
network can reduce stress and improve mental health.

                                 Halton Region Mental Health Report 2018 22
Candace is a new parent of a three month            community resources available to support
                                                                                                        The facts
old girl. Candace and her partner live in a         new parents. Candace reached out and               ► 13.9% of women who give birth in
small bungalow in Halton Hills around the           joined a parenting group and was able to             Halton experience one or more mental
corner from her parents. Although                   meet other new parents. She found that               health concerns during pregnancy
Candace’s family has always lived in Halton         spending time with other parents helped her        ► Among women who give birth in Halton
Hills, her parents recently retired and now         to feel less isolated, and helped to reduce          each year,
spend six months per year in Florida. Her           her stress. A health care professional at the          ► 8.6% have anxiety during
parents were around for the birth of their          group also helped to answer her parenting                pregnancy
granddaughter, but left for Florida two             questions, and this support helped Candace             ► 6.6% have depression during
months ago once the winter weather arrived.         to relax and enjoy her time with her baby                pregnancy
                                                    much more. She found that her baby was
                                                                                                           ► 3.0% have a history of post-
Candace noticed that since her parents left         less fussy and that the interactions between             partum depression (among those
town, she has felt more stressed being at           them were more positive. Candace made                    who have previously given birth)
home with the baby. Candace’s partner               arrangements with some of the other
commutes to Toronto for work and spends             mothers in the group to get together once
long hours away from home on weekdays.              per week for coffee, and they plan to start
The winter weather has made it difficult to         walking together once the weather improves.
walk in the neighbourhood like she was able
to do in the first couple months of her             Maternal mental health has a direct impact
maternity leave. Candace realized that since        on the social-emotional development of
                                                                                                      Candace’s
her parents left, she spends a great deal of        children. Having a strong social support            story
time alone with the baby, and doesn’t feel          network is essential to reducing parenting
like she has any one to talk to. She was the        stress. By reaching out and connecting with
first of her friends to start a family, and feels   other parents, Candace was able to start
that she has lost some connection with them         building a network of other parents and
since the baby was born.                            professionals to support her with her
                                                    parenting journey.
Candace subscribed to the HaltonParents
emails and found information about

                                                                                                    Halton Region Mental Health Report 2018 23
Background
Pregnancy and parenthood can be an              Fathers can also experience stress and
exciting time in one’s life. However, the       other mental health concerns. Research
transition to parenthood and coping with        suggests that as many as 5-10% of
the demands of raising a family can be          fathers experience depression in the year
stressful at times. While parenting can be      after their baby is born.27
both rewarding and challenging for
anyone, it can pose particular challenges       Promoting positive mental health is
for those with a mental health condition.       important for both parents and their
                                                children. When parents look after
Maternal mental health concerns are             themselves and feel supported, they are
common, with as many as one in five             better able to accept and manage
women developing a mental health issue          difficulties, be responsive to their
while pregnant or during the first year after   children’s needs, and make good
childbirth.25 Maternal mental health is an      decisions for their children.28
important public health issue, as it can
impact the health of both a mother and her      Through HaltonParents, Halton Region
baby, including an increased risk for           offers a variety of free parenting programs
pregnancy complications and difficulty          and resources that promote positive
caring for herself and her baby.25,26 For       mental health, help people manage the
more information on mental health during        transition to parenthood, build confidence
pregnancy, see The Reproductive Health          to parent their child in a positive way, and
in Halton Report.                               support the healthy growth and
                                                development of their children.

                                                                                               Halton Region Mental Health Report 2018 24
Mental health concerns during
pregnancy

From 2013-15, an average of 778 women
per year (13.9% of women who gave birth)
in Halton reported experiencing one or
more mental health concerns during
pregnancy.

For 2013-15 (combined), Halton women
were slightly less likely than Ontario
women to report experiencing one or more
mental health concerns during pregnancy,
experiencing depression during
pregnancy, or having a history of post-
partum depression. However, Halton
women were slightly more likely than
Ontario women to have experienced          Figure 9: Percentage of females who gave birth who experienced any mental health concern, depression, anxiety
anxiety during pregnancy (Figure 9).       during pregnancy, or who had a history of post-partum depression, Halton and Ontario, 2013-15 (combined).

                                           Data source: BORN Information System [2013-2015], extracted January 2017 (history of post-partum depression data) and October 2016 (all other
                                           maternal mental health data)

                                                                                                                Halton Region Mental Health Report 2018 25
Mental health and parenting
                                                                                                                               Figure 10: Reported level
Halton’s Kindergarten Parent Survey asked                                                                                      of stress within the last
                                                                                                                               two weeks, parents of
parents of kindergarten children a series of                                                                                   kindergarten students,
questions related to parenting stress, as well                                                                                 Halton Region, 2015
as factors associated with positive mental
health like social connectedness.

In 2015, 15% of parents of kindergarten
students in Halton reported feeling very or
extremely stressed out in the last two weeks
(Figure 10). Mothers were more likely to
report feeling stressed compared to fathers,
and parents who were born in Canada were
more likely to report feeling stressed
compared to parents who were immigrants.
There were no significant differences in
reported stress by education or household
income.

The majority of Halton parents of
kindergarten parents reported feeling close to
other parents (82%), taking time for their own
wellbeing (73%), and feeling supported in
parenting by the people in their life (93%) .

                                                 of parents agreed or strongly       of parents agreed or                  of parents agreed or
Halton parents who felt close to other           agreed that they felt close to   strongly agreed that they             strongly agreed that they
parents, took time for their own                  other parents with children     take time to care for their          feel supported in parenting
wellbeing, and felt supported in                        the same age              own health and wellbeing              by the people in their life
parenting were less likely to report
feeling very or extremely stressed.
                                                                                                  Data source: Kindergarten Parent Survey, Our Kids Network, 2015.

                                                                                           Halton Region Mental Health Report 2018 26
Adult mental health
This section of the report provides a high level overview of several
indicators of the mental health of Halton residents aged 18-64 using data
from the Canadian Community Health Survey. Also included is an
overview of trends in emergency department visits and hospitalizations
for mental illness for adults aged 18-64.

This section starts with Dimitri’s story. His story illustrates how social and
economic factors influence the ability to manage mental illness and how
access to quality and timely health care, social supports, and good
working conditions can improve mental health.

                               Halton Region Mental Health Report 2018 27
Dimitri is a 23 year old man who lives in         Within a few weeks of being discharged
                                                                                                     The facts
Milton. Dimitri was diagnosed with anxiety        from the hospital, Dimitri was successful in      ► 9% of Halton adults (18-64) report
and depression a few years ago, but               getting a new job. His new employer                 having been diagnosed with a mood
usually manages his symptoms well with            offered a benefits program which helped             and/or anxiety disorder
the support of his doctor, family, and other      Dimitri to afford his new medication. His         ► 13% of Halton adults (18-64) reported
community resources. After losing his job         new employer also understood the benefits           consulting with a professional about
recently, Dimitri experienced significant         of promoting positive mental health for all         their mental health in the past year
stress and anxiety about his living               employees in the workplace, and offered a         ► Having a higher income and being
expenses. His family doctor prescribed a          variety of health and wellness activities.          employed is associated with more
new medication to help with his symptoms,         This positive workplace environment helped          positive self-reported mental health
but Dimitri was unable to fill the prescription   Dimitri to feel comfortable, connected, and       ► Each year an average of 4,178 Halton
as it was too expensive. Too embarrassed          well supported.                                     adults (18-64) visit the emergency
to go back to his doctor, Dimitri tried to                                                            department for a mental illness, and an
manage without the medication.                    Although access to timely, quality mental           average of 1,101 are hospitalized
                                                  health care had a significant positive impact
After several days of not seeing Dimitri          on Dimitri’s mental health, many of the
leave his apartment, a concerned                  factors that influence mental wellbeing fall
neighbour checked in, realized he needed          outside of the health care system. Living
some help, and called an ambulance.               with limited income can be a significant risk
Dimitri was transported to the local hospital     factor for poor physical and mental health.
emergency department. He was briefly              In order to influence health and mental
hospitalized in order to stabilize his mental     health in a meaningful way at an individual        Dimitri’s
health condition. While in the hospital, a        and community level, investments need to
discharge planner met with Dimitri to talk        strengthen social supports like                     story
about plans for going home. She referred          employment, affordable housing and
Dimitri to an employment program in the           education. Additionally, mental wellbeing is
community, designed to support residents          influenced by environments that offer
experiencing barriers to finding and keeping      opportunities for social connectedness.
a job.

                                                                                                  Halton Region Mental Health Report 2018 28
Background                                                                                           Workplace
Promoting positive mental health throughout    The Halton Region Health Department is                mental health
the lifespan is important as throughout our    involved in many initiatives that seek to
lives we encounter challenges, stress and      improve the conditions of every day life and          Workplaces can play an important role
periods of transition which can have an        support the mental health of Halton adults            in promoting positive mental health, as
impact on mental health. The loss of a loved   and residents of all ages, including:                 they can provide opportunities for
                                                                                                     individuals to feel productive and
one, unemployment, illness, struggles with
                                               •   Halton’s Community Safety and Well-               engaged. However, workplaces can
finances, unstable housing conditions,                                                               also be stressful environments, which
isolation from the community and                   Being Plan – an initiative led by Halton
                                                                                                     at times can negatively impact both
experiencing bullying or discrimination are        Region and the Halton Regional Police             physical and mental health.31
just a few examples of challenging life            Services that aims to identify and
circumstances that can negatively impact           address emerging issues and trends that           The Halton Region Health Department
mental health.29                                   impact safety and wellbeing together with         offers a variety of resources to both
                                                   a wide range of community partners.               employers and employees on reducing
                                                                                                     stress and promoting positive mental
In contrast, factors such as healthy family                                                          health in the workplace at
                                               •   Supporting workplaces to promote the
relationships, good working conditions,                                                              halton.ca.
                                                   physical and mental health of employees
positive educational experience,
                                                   and their families
involvement in the community, healthy and                                                            Mental health promotion in the
active lifestyles, safe and well-maintained                                                          workplace benefits both employees
                                               •   Reducing social isolation of individuals
housing, and access to supportive services                                                           and employers. Psychologically safe,
                                                   and families by connecting them with
                                                                                                     supportive and healthy environments
like counselling can help improve mental           community groups (e.g. Early Years                help to promote productivity,
health.29                                          Program Neighbourhood Groups)                     performance, job satisfaction, and
                                                                                                     reduce employee turnover.32 It can
Actions to improve the conditions of every     •   Conducting health equity impact                   also help to support employees with a
day life and foster resiliency when dealing        assessments to identify and address               mental illness on their journey towards
with life’s challenges can help increase the       potential unintended impacts of Health            recovery.32
proportion of the population experiencing          Department programs, initiatives, and
positive mental health.29,30                       activities on different population groups
                                                   (e.g. newcomers, low income families).

                                                                                               Halton Region Mental Health Report 2018 29
General mental health and wellbeing in adults                                                  Being employed and having a higher household income is
                                                                                               associated with better self-rated mental health in Halton.
Among Halton adults aged 18-64 for 2009-2014 combined,

           reported their mental                     reported that most                                        For 2009-14,                For 2009-14, self-reported
  81%      health as very good             26%       days are quite a bit or                                   Halton adults               mental health increased as
           or excellent                              extremely stressful                                       aged 18-64                      household income
                                                                                                               who had a job                increased among Halton
                                                                                                                                               adults aged 18-64.
           reported a somewhat/                      reported having been                      in the last week had higher
  65%      very strong sense of             9%       diagnosed with a mood                     self-reported mental health
           community belonging                       and/or anxiety disorder                   than those who did not have
                                                                                               a job or were permanently
           reported being                            reported consulting a                     unable to work.
  95% satisfied or very                    13% professional about mental
           satisfied with life                       health in the past year

                                                                                               Some Halton adults find work to be stressful
Mental health and physical health are often linked
For 2009-14 combined, Halton adults (18-64) who rated their physical                           For 2009-14 combined,
health as very good/excellent were more likely to experience favourable
mental health than those who rated their physical health as good/fair/poor.                                                                       There were no
                                                                                               1 in 3       Halton adults aged                    statistically significant
                                                                                                            18-64 reported that                   differences by sex or
                                                                                                            most days at work                     education in workplace
                                                                                                            were quite a bit or                   stress among Halton
                                                                                                            extremely stressful.                  adults aged 18-64.

                                                                                                                         Halton adults (18-64) in the middle
                                                                                                                         and high income groups were more
                                                                                                                         likely than those in the low income
                                                                                                                         group to report that most days at work
                                                                                                                         were quite a bit or extremely stressful.
Figure 11: Indicators of mental health, adults aged 18-64, Halton Region, 2009-14 (combined)
                                                                                                           Data source: CCHS [2009-2014], Statistics Canada, Share File, Ontario MOHLTC

                                                                                                                Halton Region Mental Health Report 2018 30
Emergency department visits for                             Trends over time
mental illness in adults                                    The rate of ED visits for mental illness among Halton males aged 18-64 increased
                                                            over the past 10 years, from 987 per 100,000 males aged 18-64 in 2006 to 1,328
                                                            per 100,000 in 2015. The rate of ED visits for mental illness increased for Ontario
Differences by sex                                          males from 2007 to 2015. Over the past 10 years, Halton males aged 18-64 have
From 2013-15, Halton males aged 18-64 had a                 consistently had a lower rate of ED visits for mental illness compared to Ontario
slightly higher rate of ED visits for mental illness than   males.
females.
                                                            The rate of ED visits for mental illness among Halton females increased slightly
                                                            over the last several years, from 1,034 per 100,000 females aged 18-64 in 2010 to
                                                            1,120 per 100,000 in 2015. Among Ontario females, the rate has been increasing
  1,289                                 1,122               since 2009. Halton females aged 18-64 have consistently had a lower rate of ED
  ED visits per                         ED visits per
                                                            visits for mental illness compared to Ontario.
 100,000 males                        100,000 females
  aged 18-64                            aged 18-64

Most common mental illness ED visits
From 2013-15 there were an average of 2,203 ED visits
per year among males and 1,975 ED visits per year
among females aged 18-64 in Halton for mental illness.
The most common mental illnesses resulting in ED
visits were:

       1. Substance disorders (788 ED visits per year)
       2. Anxiety (422 ED visits per year)
       3. Depression (332 ED visits per year)

       1. Anxiety(494 ED visits per year)
       2. Substance disorders (472 ED visits per year)      Figure 12: Age-specific rate of ED visits for mental illness, ages 18-64, by sex, Halton Region and
                                                            Ontario, 2006-2015.
       3. Depression (404 ED visits per year)

                                                            Data source: National Ambulatory Care Reporting System [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted June 2017
                                                                         Population Estimates [2006-2015], Ontario MOHLTC: IntelliHEALTH Ontario, extracted August 2016

                                                                                                                 Halton Region Mental Health Report 2018 31
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