Survey on Mental Health and Stressful Events, August to December 2021
Post-traumatic stress disorder (PTSD) is a mental health condition triggered by exposure to a traumatic event. This disorder can cause severe mental, emotional and behavioral symptoms, such as unwanted thoughts or dreams of the traumatic experience, strong physical reactions (like trouble breathing) when reminded of the event, strong negative emotions (like fear, horror, anger, guilt, or shame) and a loss of interest in doing things once enjoyed. According to new results available today, about 8% of adults in Canada experienced symptoms in the month preceding the survey that met the criteria for probable PTSD.
The traumatic events that lead to PTSD may happen at any time during a person's life. However, the COVID-19 pandemic has had an impact on the mental health of many Canadians. In spring 2021, one in three Canadians said that their mental health had gotten worse since the pandemic started. Given that many people are facing added stresses and delays in accessing care resulting from the pandemic, a new look at PTSD in Canada is important to understanding the well-being of the population.
Today, Statistics Canada is releasing findings from the Survey on Mental Health and Stressful Events (SMHSE) collected from August to December 2021 among adults living in the 10 provinces of Canada. The SMHSE was conducted by Statistics Canada in collaboration with the Public Health Agency of Canada. The survey asked respondents if they ever experienced one or more traumatic event during their life and to identify which event was the worst they ever experienced. Respondents were also asked to complete a screening tool to assess whether they met the criteria for probable PTSD (based on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition). The goals of the SMHSE are to better understand the prevalence of PTSD (or how common it is), the types of traumatic events that can lead to PTSD, and the impacts of PTSD on daily life.
About 8% of adults in Canada meet the criteria for probable post-traumatic stress disorder
While 5% of Canadians reported having PTSD that was diagnosed by a health professional, 8% met the criteria for probable PTSD based on symptoms they experienced in the past month. Meeting the criteria for probable PTSD is not a medical diagnosis, but it does indicate the presence of symptoms of PTSD, which can undermine an individual's well-being and quality of life and may create the need for mental health supports. The use of a screening tool to assess the prevalence of probable PTSD in the population can also help identify the proportion of Canadians who may have undiagnosed PTSD.
Broken down by gender, 10% of women met the criteria for probable PTSD, which is almost twice as high as men (6%). The percentage of younger adults (18 to 24 years old) that met the criteria for probable PTSD was over four times higher than seniors (65 years and older). Specifically, 13% of younger adults met the criteria compared with 3% of seniors.
Overall, 7% of the group that identified as visible minorities met the criteria for probable PTSD, which is similar to the 8% that met the criteria in the non-visible minority group. However, the percentages within specific visible minority population groups ranged from 5% for Chinese and Latin Canadians to 10% for Black Canadians and 11% for Arab Canadians. Some of the differences across these groups may be related to the types and severity of traumatic events that certain groups may be more likely to encounter. Also, the risk of developing PTSD may be lessened by factors such as higher education and income than average. These factors can be protective in nature as they may better equip the individual to access the supports they need to cope with trauma.
Sexual assault is the most commonly reported worst event among those who meet the criteria for probable posttraumatic stress disorder
Although almost two-thirds (64%) of Canadians reported being exposed to at least one potentially traumatic event during their life, not everyone develops PTSD. Among Canadians who met the criteria for probable PTSD, sexual assault (14%) was the most commonly reported worst event they experienced. This was followed by life-threatening illness or injury (10%), situation involving sudden accidental death (6%) and physical assault (6%).
Though the data were collected in fall 2021, the worst event that triggered the current symptoms could have occurred at any point during the person's life. At the same time, the pandemic has had considerable impacts on peoples' lives. It may have exacerbated existing symptoms for some individuals or resulted in PTSD for others.
About one in five (21%) Canadians who met the criteria for probable PTSD indicated that the worst event they ever experienced happened in the past two years, and about 1 in 10 (9%) stated that their worst event was related to the pandemic. While symptoms of PTSD can develop immediately after the event, they can also develop weeks, months or even years later. This means that the full extent of PTSD related to the pandemic may not yet be realized.
Canadians who meet the criteria for probable posttraumatic stress disorder report a range of negative impacts on their lives
PTSD symptoms may affect various aspects of daily life, making it hard for people to function in their day-to-day activities. Canadians who met the criteria for probable PTSD reported that the worst event they had ever experienced has negatively impacted their social life (72%), family life (68%), ability to form or maintain close relationships (65%), home responsibilities (58%), and ability to work or attend school (52%) in the past year. Less than 1 in 10 (9%) said they did not experience any of these negative impacts.
About four in five Canadians who met the criteria for probable posttraumatic stress disorder face challenges accessing care
Over half (55%) of Canadians who met the criteria for probable PTSD sought professional help in the year prior to the survey for problems related to the worst event they ever experienced. Among those who sought professional help, four in five (82%) had trouble accessing the health care services they needed.
More specifically, about two in five (39%) reported waiting too long between booking an appointment and attending their visit, 38% reported having one or more of their appointments cancelled, rescheduled or delayed due to the pandemic, and 37% mentioned cost of care as a barrier to accessing needed services.
As Canada continues to plan the "return to a new normal," it is important to note the impact of the pandemic on the mental health of Canadians. Health care systems across the country have adapted in many ways in response to the pandemic. They will need to continue to evolve to accommodate the missed, delayed and changing health care needs of Canadians in both the short term and the long term.
Percentage of Canadian adults in the 10 provinces who met the criteria for probable post-traumatic stress disorder (PTSD)
Percentage of Canadian adults in the 10 provinces who met the criteria for probable post-traumatic stress disorder and experienced difficulty accessing health care services in the 12 months preceding the survey
Note to readers
Estimates identified by an E in the tables should be interpreted with caution. High sampling variability is associated with these estimates, as the coefficients of variation are > 15.0%.
The target population for the survey was persons 18 years of age or older living in the ten provinces and excluded persons living on reserves, other Indigenous settlements in the provinces and the institutionalized population. The survey was administered by electronic questionnaire and computer-assisted telephone interview so those with valid telephone numbers or with internet access were included.
Professional help for problems related to worst event included talking to a health care professional like a psychiatrist, family doctor, general practitioner, psychologist, nurse, social worker, counsellor, psychotherapist, or other health care professionals.
Respondents could choose more than one category for ethnic groups, professional help received, impacts on their lives from the worst event and types of difficulties in accessing health care services.
The Survey on Mental Health and Stressful Events (SMHSE) used a screening tool to assess the symptoms associated with posttraumatic stress disorder (PTSD). The self-reporting screening tool is useful to monitor the prevalence of PTSD symptoms and probable diagnoses in the population. Meeting the criteria for probable PTSD is not a clinical diagnosis and does not always indicate a disorder is present for an individual. A PTSD diagnosis 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 PTSD were measured using the 20-item PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5). The PCL-5 is a screening tool that allowed respondents to self-report the severity of symptoms they had in the past month relating to the worst event they have ever experienced. Thresholds were then applied to determine whether the individual "met the criteria for probable PTSD" (score 33+).
Estimates on Canadians who met the criteria for probable PTSD are also available in other Statistics Canada surveys, such as the Survey on COVID-19 and Mental Health. However, the SMHSE questions may not be directly comparable to previous Statistics Canada surveys. As such, the estimates in this release might not be directly comparable to other information due to differences in how the estimates are obtained.
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