Survey on Mental Health and Stressful Events, 2023
Released: 2024-05-27
Stress is a common experience for many people. Stressful events can range from minor day-to-day challenges to more severe and potentially traumatic events. Findings released today from the Survey on Mental Health and Stressful Events (SMHSE) provide new insight into the most common potentially traumatic events that adults living in Canada have experienced and the connection these experiences have to symptoms of posttraumatic stress disorder (PTSD).
An event where there is exposure to actual or threatened death, serious injury, or sexual violence is sometimes referred to as a "potentially traumatic event" or a "potentially psychologically traumatic event." These types of events include war and combat, major accidents, natural- or human-caused disasters, and interpersonal violence.
Some people will develop symptoms of a mental health condition known as PTSD after being exposed to these kinds of events. Symptoms of PTSD include recurring and distressing memories, avoiding reminders of the event, and disturbed sleep. According to new results released today, about 8% of adults in Canada reported moderate to severe symptoms of PTSD in the month prior to completing the survey.
The goals of the SMHSE are to better understand the prevalence of PTSD, the types of traumatic events that can lead to such a mental health condition, and the impacts on daily life.
Almost two-thirds of adults are exposed to at least one potentially traumatic event at some point in their lives
Almost two-thirds (63%) of adults living in Canada reported that they had been exposed to a potentially traumatic event at some point in their lives. Events might have happened to them directly or indirectly. Survey respondents were instructed to include all four of the following: events that happened directly to them, events that they witnessed, events that they learned about that happened to a close family member or a close friend, and events that they were repeatedly exposed to details about as part of their job.
Exposure to a transportation accident (31%) was the most common type of potentially traumatic event, followed by physical assault (18%), life-threatening illness or injury (17%), natural disasters (15%), and unwanted sexual experiences other than sexual assaults (15%). Other types of events were quite rare, such as being held in captivity (1%) or having caused serious injury, harm, or death to someone else (2%).
Infographic 1
Lifetime prevalence of exposure to different types of traumatic events among adults aged 18 years and older, 2023
Women and men report being exposed to different types of traumatic events
Although the majority of both men (60%) and women (67%) reported exposure to a potentially traumatic event at some point in their lives, the types of events they reported were different.
Around one in six women (16%) reported having been exposed to sexual assault. For men, the figure was 4%. Exposure to other unwanted sexual experiences was also more common for women (23%) than men (6%), as was exposure to life-threatening illness or injury (19% of women compared with 15% of men).
Exposure to serious accidents was more common in men (15%) than women (11%). Similarly, men were more likely than women to report exposure to fire or explosions (11% versus 9%), and exposure to a toxic substance (7% versus 3%).
Infographic 2
Largest gender differences in exposure to different types of traumatic events among adults aged 18 years and older, 2023
About 8% of adults in Canada report moderate to severe symptoms of posttraumatic stress disorder in the month prior to completing the survey
Not everyone who experiences a traumatic event will develop PTSD. About 8% of adults reported moderate to severe symptoms of PTSD in the month prior to completing the survey. This percentage was similar to that from the first cycle of the SMHSE conducted in 2021.
People with moderate to severe symptoms of PTSD do not necessarily meet the criteria for a formal diagnosis of PTSD. It is indicative of a possible PTSD diagnosis, an impact on functioning and the need for mental health supports. Symptoms of PTSD can emerge weeks, months, or even years after a traumatic event.
Broken down by gender, 7% of men reported moderate to severe symptoms of PTSD compared with 10% of women. This gender difference in the prevalence of PTSD symptoms could be related to differences in exposure to potentially traumatic events that men and women have experienced, as well as differences in their reactions to these types of events.
Comparing age groups, 13% of young adults aged 18 to 24 years reported moderate to severe symptoms of PTSD, compared with 3% of seniors aged 65 years and older.
Similar patterns by age and gender were seen in the results from the first cycle of the SMHSE and the Survey on COVID-19 and Mental Health.
Sexual assault and being held in captivity are some of the events most strongly associated with probable posttraumatic stress disorder
The type, frequency and severity of traumatic events that a person has experienced can affect their likelihood of developing PTSD. Even events that did not trigger the onset of the PTSD symptoms can contribute to a higher likelihood of having PTSD.
Although very few people ever experienced being held in captivity, more than one-third (35%) of those who were exposed to this type of event reported moderate to severe symptoms that are consistent with probable PTSD.
Exposure to sexual assault is a more common experience that is also strongly associated with probable PTSD. More than one in four people (29%) who were exposed to sexual assault reported moderate to severe symptoms of PTSD in the month before completing the survey. Moderate to severe symptoms of PTSD were also reported by many people who had experienced other forms of assault or harassment, including assault with a weapon (24%), physical assault (23%) and other unwanted sexual contact (23%).
The survey did not ask respondents to report how many times they have experienced each type of potentially traumatic event in their lifetime. Instead, it captured the number of different types of potentially traumatic events they have experienced.
Those who reported having been exposed to more than one type of traumatic event were more likely to report moderate to severe symptoms of PTSD. Among those who were exposed to one type of traumatic event, about 7% reported moderate to severe symptoms of PTSD. That figure was nearly four times higher (26%) among those who had been exposed to five or more types of events.
Infographic 3
Percentage of adults aged 18 years and older who reported moderate to severe symptoms of posttraumatic stress disorder in the past month, by type of traumatic event exposure, 2023
People experiencing moderate to severe symptoms of posttraumatic stress disorder are affected at work
PTSD symptoms may affect various aspects of daily life, making it hard for people to function in their day-to-day activities, such as work. Most adults aged 25 to 54 years are part of the labour force. This age group has a higher employment and labour force participation rate, compared with younger and older age groups.
One-quarter (25%) of the people aged 25 to 54 years who reported moderate to severe symptoms of PTSD had not worked in the three months prior to completing the survey. In contrast, among those who did not report moderate to severe symptoms of PTSD, 12% had not worked in the three months prior to completing the survey.
Even among those who reported working for pay in the three months prior to completing the survey, PTSD can impact the amount of work done or the types of activities done at work. Just under two in five (38%) of those with moderate to severe symptoms of PTSD who had been working in the three months prior to completing the survey reported that their own physical, mental or emotional health reduced the amount or the kind of activity they could do at work "quite a bit" or "extremely". This proportion was 1 in 20 (5%) among people who did not report moderate to severe symptoms of PTSD.
Infographic 4
Percentage of working adults aged 24 to 54 years who have reduced the amount or kind of activity performed at work due to physical, mental or emotional health, based on whether or not they experience moderate to severe posttraumatic stress disorder (PTSD) symptoms
Heavy drinking and cannabis use are more common among people experiencing moderate to severe symptoms of posttraumatic stress disorder
When comparing people with and without moderate to severe symptoms of PTSD, heavy drinking and cannabis use in the 30 days prior to completing the survey were more common in those who reported moderate to severe symptoms of PTSD. During that period, 38% of those experiencing moderate to severe symptoms of PTSD reported drinking heavily on at least one occasion and 15% reported using cannabis daily. These percentages were lower among people who were not experiencing moderate to severe symptoms of PTSD over the same period (29% reported drinking heavily on at least one occasion and 4% reported using cannabis daily).
Cannabis can be used for medical and non-medical purposes. Among those with moderate to severe symptoms of PTSD who used cannabis in the month prior to completing the survey, close to two-thirds (64%) reported using cannabis for medical reasons.
Infographic 5
Cannabis use among people with and without moderate to severe symptoms of posttraumatic stress disorder (PTSD), 2023
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Note to readers
The Survey on Mental Health and Stressful Events (SMHSE) was conducted by Statistics Canada in collaboration with the Public Health Agency of Canada. Data for this survey were collected from September to December 2023.
The target population for the survey was people aged 18 years and older living in the 10 provinces and excluded people 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.
The 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 that 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 the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5), along with a modified version of the Life Events Checklist (LEC-5). The PCL-5 is a screening tool that allowed respondents to self-report the severity of symptoms they had in the month prior to completing the survey relating to the worst event they have ever experienced. Thresholds were then applied to determine whether the individual met the criteria for probable PTSD (a score of 33 or higher) or "screened positive for PTSD". To complete the PCL-5, respondents must have been exposed to at least one very stressful or traumatic event. The LEC-5 is a list of 17 different types of events that may lead to PTSD. It was used to measure exposure to potentially traumatic life events among all respondents.
On this survey, respondents were asked about their alcohol consumption in the 30 days prior to completing the survey. In this context, "heavy drinking" is defined as having five or more drinks for males and four or more drinks for their female counterparts, on one occasion, at least once in the 30 days prior to completing the survey.
Contact information
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; infostats@statcan.gc.ca) or Media Relations (statcan.mediahotline-ligneinfomedias.statcan@statcan.gc.ca).
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