Waterloo expert highlights expanding coverage, tech integration and proactive prevention strategies as key evidence-based solutions
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The mental health crisis in Canada remains a pressing issue marked by the lack of universal coverage of mental health services and the emergence of new social determinants affecting our mental health.
Dr. Peter Hall is a professor in the Faculty of Health with a cross appointment with the Department of Psychology
Dr. Peter Hall (PhD ’02), a professor at the University of Waterloo’s School of Public Health Sciences and a clinical psychologist, advocates for a comprehensive approach to addressing mental health challenges. He believes that expanding universal coverage, integrating relevant technology, addressing generational attitudes and developing proactive prevention strategies, can help break down the stigma around mental illness and improve access to mental health services.
Hall also highlights the importance of evidence-based materials, like the Lancet Psychiatry Commissions on Youth Mental Health, which provide insights into the declining mental health among young people and can guide informed government decisions and increased investments in mental health services.
“There is a lot of attention to younger adults, and they indeed seem to be reporting the most mental health problems in many countries,” Hall says. “But this is likely a combination of actual increased prevalence and willingness to disclose among young people.”
Hall argues that the stigma around mental illness has decreased because younger generations, Generation Z and millennials, are more open to discussing mental health issues — creating a generational difference in their willingness to seek help compared to older generations.
“There is comparable data that older adults have shown significant increases in poor mental health in recent years. This may not be as dramatic as for youth and is blunted by continued reluctance among the older generations to disclose problems freely,” Hall adds.
From large-scale existential issues like climate change to societal changes, the younger generation appears to be more distressed and experience more psychiatric challenges. Simultaneously, young people are becoming more open to discussing mental health issues and acknowledging them to the point where the rest of society is more receptive to these discussions as well.
“The most important takeaway is that, regardless of any of the above, the amount that we spend on mental health treatment and prevention is far too low in relation to the need,” Hall says. “This may be especially the case for youth, but all age groups can benefit from increased access and reduced stigma about help-seeking.”
Hall recognizes that climate change and social media contribute to heightened anxiety and distress among youth. Climate change will continue to cause young people to feel anxious and hopeless about their futures if we don’t address climate change on a planetary level.
“Prevention of mental health challenges is important throughout the lifespan, but perhaps more so with younger generations,” Hall says. “They are facing issues that represent existential challenges for the planet, and the degree of saliency of these in everyday life is very high via social media. At the same time, social bonds are getting more diffuse, leading to disconnection from each other while they face these threats."
Limiting social media use and addressing environmental concerns are crucial steps toward improving the mental health of younger generations. Social media has a large impact on how the current generation thinks, feels and acts daily, and reducing social media usage can be a proactive step and measure to facilitate positive mental health outcomes.
Hall stresses that the biggest concern that many people have is the lack of coverage for some types of mental health services, specifically, psychotherapy. For those without workplace insurance, the cost of psychotherapy services varies by province, making it difficult for many people to afford mental health treatment out of pocket.
“Timely universal access to mental health treatment and support is critical, but just not the reality today in Canada. No country has got this quite right, so we are not alone here,” Hall says. “But there is an opportunity to lead.”
Expanding coverage to include advanced treatments like transcranial magnetic stimulation (TMS), would improve accessibility and outcomes for individuals who do not respond to antidepressant medication or talk therapies.
“There is a lot of momentum in the right direction in terms of reducing stigma, and availability of help in flexible formats,” Hall says. “But the size of the problem is even larger, and we need to continue efforts to make help more available and be curious about and willing to try new types of interventions across all age ranges.”
Universal coverage of mental health services would be the ideal solution, where community providers who are licensed mental health professionals, can bill for services through the Ontario Health Insurance Plan (OHIP) — like standard medical appointments. This could broaden the accessibility and desire for Canadians to seek mental health support.
“This may also free up valuable time for primary care providers who want to be focussed on assessing and treating other things,” Hall says.
Technology plays a vital role in mental health services, with increasing demand for online therapy sessions. Hall stresses the importance of funding research into effective treatments for younger populations and involving patients in the development of mental health treatments to enhance care and effectiveness.
“Today Canada has far more people seeking help than professionals able to provide it,” Hall says. “There are treatment technologies that can be made more widely available. We also need more funding for research about what kinds of treatments work best among younger people, particularly adolescents."
The ongoing evolution in mental health awareness and service delivery is promising with the support of technology, but maintaining momentum and addressing these challenges proactively is essential for continued progress.
The mental health crisis demands a comprehensive approach that includes expanding coverage, integrating technology, addressing generational attitudes, and implementing proactive prevention strategies. Hall’s insights provide a roadmap for improving the mental health care system and making it more accessible and effective for all Canadians.
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