Survey on COVID-19 and Mental Health, September to December 2020
Symptoms of mental health disorders during the COVID-19 pandemic
The COVID-19 pandemic has significantly altered the daily lives of most Canadians. There has been ongoing concern that the impacts of the pandemic, such as increases in social isolation, job and income loss, and difficulties meeting financial obligations, could be affecting mental health. Changes in behaviours, thoughts, and feelings can be a normal response to stressful situations and experiencing symptoms consistent with one or more mental health conditions does not always indicate a disorder. Nevertheless, such symptoms can undermine well-being and the quality of life, and may create a need for mental health supports. Assessing how the wide-ranging impacts of the COVID-19 pandemic have affected mental health in Canada helps inform the supports needed to care for Canadians.
One in five Canadians screened positive for symptoms of depression, anxiety or posttraumatic stress disorder
Findings released today from the Survey on COVID-19 and Mental Health indicate that about one in five (21%) Canadian adults aged 18 and older screened positive for at least one of three mental disorders that were assessed: major depressive disorder, generalized anxiety disorder and posttraumatic stress disorder (PTSD). This survey was developed by Statistics Canada in collaboration with the Public Health Agency of Canada to better understand the mental health of Canadian adults in the context of the pandemic. Data released today were collected from September to December 2020.
Examining each disorder separately, major depressive disorder was the most prevalent, with 15% of Canadians screening positive based on symptoms in the previous two weeks. Almost as many Canadian adults (13%) screened positive for generalized anxiety disorder in the previous two weeks, which is characterized by symptoms related to excessive, ongoing anxiety and worry that are difficult to control. PTSD is a disorder that may develop in some people after exposure to one or more potentially psychologically traumatic events. Based on symptoms experienced in the previous month, 6% of Canadians screened positive for probable PTSD. The event(s) that triggered the current symptoms could have occurred at any point in the person's life and may not be related to the pandemic.
Respondents were not asked to report their symptoms in specific relation to the COVID-19 pandemic; as such, any reported symptoms may have been present before the beginning of the pandemic. For some people who were experiencing mental health problems prior to the pandemic, pre-existing symptoms may have intensified during the pandemic. Of those who screened positive for a disorder, 68% reported that their mental health had worsened since the start of the pandemic.
Young adults aged 18 to 24 most likely to report symptoms of depression, anxiety, and posttraumatic stress disorder
The prevalence of positive screens for major depressive disorder, generalized anxiety disorder, and probable PTSD were over three times higher among young adults than among older adults. For example, 27% of young adults aged 18 to 24 screened positive for major depressive disorder compared with 7% of adults aged 65 and older. A similar pattern was observed for the proportions of positive screens for generalized anxiety disorder (21% versus 7%) and probable PTSD (11% versus 3%).
Overall, almost one in four women (24%) screened positive for at least one disorder, compared with 17% of men. The higher rates for women compared with men were consistent across all three disorders when these were considered individually as well.
Prevalence of mental disorders more than four times higher among those who experienced feelings of loneliness or isolation as an impact of the COVID-19 pandemic
To better understand the mental health of Canadians who have been negatively affected by the pandemic, the prevalence of positive screens for mental disorders were compared between those who experienced various impacts due to the COVID-19 pandemic with those who did not. Almost 38% of Canadians reported that, due to the COVID-19 pandemic, they experienced feelings of loneliness or isolation. Those reporting this impact had more than four times higher prevalence of major depressive disorder (29% versus 6%), generalized anxiety disorder (25% versus 6%), and probable PTSD (13% versus 2%), compared with those who did not report experiencing this impact.
More than 40% of Canadians who reported difficulty meeting financial obligations or essential needs due to the COVID-19 pandemic screened positive for one of the three mental disorders
The economic implications of the COVID-19 pandemic have resulted in financial difficulties for many Canadians. Overall, 15% of respondents reported difficulty meeting financial obligations or essential needs (e.g., rent or mortgage payments, utilities, and groceries) due to the COVID-19 pandemic. Almost one-third of Canadians who reported financial difficulties due to the pandemic also screened positive for major depressive disorder (32%) or generalized anxiety disorder (29%). By comparison, among those who did not experience financial difficulties due to the pandemic, 12% screened positive for depression and 10% screened positive for anxiety. As well, 17% of Canadians who reported experiencing financial difficulties screened positive for probable PTSD, compared with 5% of those who did not experience financial difficulties due to the pandemic. This pattern is consistent with pre-pandemic findings of an association between higher rates of mental disorders, and low income and financial strain. Those who reported job or income loss due to the COVID-19 pandemic also had much higher rates of screening positive for each of the mental disorders compared with those who did not experience that impact due to the pandemic.
Positive screens for major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder, by age group and by gender, proportion, Canada
Positive screens for major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder, by COVID-19 pandemic impact, proportion, Canada
Note to readers
The Survey on COVID-19 and Mental Health used screening tools to assess symptoms associated with major depressive disorder (PHQ-9), generalized anxiety disorder (GAD-7), and posttraumatic stress disorder (PTSD) (PCL-5). The self-report screening tools are useful to monitor the prevalence of mental disorder symptoms and probable diagnoses in the population. A positive screen is not a clinical diagnosis and does not always indicate that a disorder is present for an individual. Diagnosis generally requires clinical interviews and related evaluations conducted by licensed health professionals. The symptoms associated with a positive screen typically justify further assessment.
For the current survey, symptoms associated with major depressive disorder were measured using the 9-item Patient Health Questionnaire (PHQ-9), symptoms associated with generalized anxiety disorder were measured using the 7-item Generalized Anxiety Disorder (GAD-7) scale, and symptoms associated with PTSD were measured using the 20-item PTSD Checklist (PCL-5). The PHQ-9, GAD-7, and PCL-5 are screening tools that allowed respondents to self-report the frequency and severity of symptoms they experienced within a given time period (i.e., the previous two weeks for PHQ-9 and GAD-7, and the previous month for the PCL-5). Thresholds were then applied to determine positive screens for major depressive disorder with moderate or severe symptoms (score of 10 or more), generalized anxiety disorder with moderate or severe symptoms (score of 10 or more), and probable PTSD (score of 33 or more).
In contrast to instruments used for assessing mental disorder symptoms in previous surveys conducted by Statistics Canada, such as the 2012 Canadian Community Health Survey – Mental Health, some of the current screening tools are shorter and not comparable to those used previously. The PHQ-9 for depression has been used in the 2015 to 2019 Canadian Community Health Surveys.
The same survey will be repeated from February to May 2021 using a new sample of Canadian adults.
The Public Health Agency of Canada will be releasing additional results from this survey in the future.
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; STATCAN.infostats-infostats.STATCAN@canada.ca) or Media Relations (613-951-4636; STATCAN.mediahotline-ligneinfomedias.STATCAN@canada.ca).