Mental illness, no one is untouched

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There are over 400 mental disorders —from depression to Alzheimer’s to attention deficit disorders— yet there are no biological tests to confirm a diagnosis, only subjective behavioral-based tests and, in a few cases, post-mortem confirmation through brain tissue analyses.

Imagine if we could diagnose those at risk of developing a mental illness before symptoms started, if we could prevent it!

What is a mental disorder?

Neither mental health, in terms of normal brain development, or mental illness are well understood. Consequently, as opposed to being defined in physiological characteristics, mental illnesses are still defined behaviorally: psychological syndromes that significantly interfere with an individual’s thought-processing abilities, social abilities, emotions and behaviour. Collectively referred to as ‘mental disorders’, the Ludmer Centre takes this definition at its broadest, inclusive of:

  • Childhood & adolescence disorders: mood disorders (bipolar), anxiety disorders, conduct disorder, attention deficit/hyperactivity disorder (ADD/ADHD), oppositional defiant disorder, Autism Spectrum Disorder…
  • Anxiety disorders: generalized anxiety disorder, panic disorder, phobias…
  • Psychotic disorders: schizophrenia …
  • Cognitive impairment: dementia, Alzheimer’s, organic psychotic conditions…
  • Substance use disorders: dependence on or harmful use of addictive substances; often a co-occurring disorder with mental illness.1

The International Classification of Diseases, 10th revision, identifies over four hundred mental disorders2 and the Diagnostic & Statistical Manual of Mental Disorders V lists over three hundred.

No one is untouched

Mental illness impacts us all — as individuals, family members, caregivers, friends, colleagues or employers.

20% of us, 1 in 5, including children and youth, will experience a mental illness in our lifetime; most will have no interfamilial or genetic history of mental illness.3,4,5

Mental illness is a global challenge.6,7,8 Depression alone ranks third in the World Health Organisation’s global burden of disease report and is projected to rank first in 2030.9

Thanks to anti-stigma campaigns such as ‘Bell Let’s Talk’ and the efforts of mental health organisations globally, the barriers to dialogue are coming down and the body of impact research has grown significantly. Beyond the devastating emotional, social and economic impact on individuals and their families, research clearly demonstrates the myriad and broader financial impacts on society.

  • Some 44% of employees claim to experience a mental health issue,10 accounting for $6 billion in lost productivity from absenteeism, presenteeism and turnover.11
  • Mental health issues accounts for some 30% of short- and long-term disability claims, one of the top three drivers of such claims by more than 80% of Canadian employers.12
  • In Canada, the economic cost is at least $50 billion annually in healthcare, social services and income-support costs: 2.8% of Canada’s 2011 gross domestic product and a total 30-year projected cost of 2.5 trillion.13,14

In the nature-nurture research debate and the search for causation, both dysfunctional parenting and genetics have taken a lead role. Today, mental health and mental illness are understood to be the complex interplay of genetic, biological, personality and environmental (physical, social & emotional) factors.15 Although the developmental processes through which these factors operate is ill-understood, most mental illnesses, 70 percent, are believed to have their onset in early childhood or their genesis in these crucial development years; even Alzheimer.16

Progress in mental health has been hampered by symptom-based approaches to diagnosis and the lack of research technologies capable of mapping the living brain.

Progress hampered by symptom-based approach to diagnosis & research 

  1. Marie Bussing-Birks, Mental Illness and Substance Abuse, National Bureau of Economic Research Accessed May 03, 2015: http://www.nber.org/digest/apr02/w8699.html
  2. World Health Organization: ICD-10 Version – Chapter V, Mental and Behavioural Disorders (F00-F99) [Internet]. World Health Organization and German Institute of Medical Documentation and Information; 1994/2006 [cited 2015 March 9]. Available at: http://apps.who.int/classifications/apps/icd/icd10online2007/index.htm?gf10.htm
  3. Smetanin, P; Stiff, D; Briante, C; Adair, C.E.; Ahmad, S.; and Khan, M. The Life and Economic Impact of Major Mental Illnesses in Canada: 2011 to 2041. (2011) Risk Analytica, for Mental Health Commission of Canada.
  4. WHO (2011) Mental Health Atlas 2011. http://whqlibdoc.who.int/publications/2011/9799241564359_eng.pdf
  5. Fast Facts about Mental Illness, Canadian Mental Health association, Accessed 01/07/2016: http://www.cmha.ca/media/fast-facts-about-mental-illness/#.Vo7RbVK-Svk
  6. Institute for Health Metrics and Evaluation. The Global Burden of Disease: Generating Evidence, Guiding Policy. Seattle, WA: IHME, 2013. http://www.healthdata.org/sites/default/files/files/policy_report/2013/GBD_GeneratingEvidence/IHME_GBD_GeneratingEvidence_FullReport.pdf
  7. Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T (2015) The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010. PLoS ONE 10(2): e0116820. doi:10.1371/journal.pone.0116820
  8. A. J. Baxter, T. Vos, K. M. Scott, A. J. Ferrari and H. A. Whiteford. The global burden of anxiety disorders in 2010. Psychological Medicine (2014), 44, 2363–2374. © Cambridge University Press 2014 doi:10.1017/S0033291713003243
  9. Policy Analysis document, World Health Organization in collaboration with the United Nations Department of Economic and Social Affairs: Mental Health and Development: Integrating Mental Health into All Development Efforts including MDGs, Sept 2010: http://www.un.org/disabilities/default.asp?id=1545
  10. Conference Board of Canada, 2011 report, Building Mentally Healthy Workplaces: Perspectives of Canadian Workers and Front-Line Managers: http://www.conferenceboard.ca/temp/7cf2a80b-7580-4849-8107-efc2f107418a/12-001_buildingmentallyhealthywk_rpt.pdf
  11. Smetanin, P; Stiff, D; Briante, C; Adair, C.E.; Ahmad, S.; and Khan, M. The Life and Economic Impact of Major Mental Illnesses in Canada: 2011 to 2041. (2011) Risk Analytica, for Mental Health Commission of Canada.
  12. Smetanin, P; Stiff, D; Briante, C; Adair, C.E.; Ahmad, S.; and Khan, M. The Life and Economic Impact of Major Mental Illnesses in Canada: 2011 to 2041. (2011) Risk Analytica, for Mental Health Commission of Canada.
  13. Smetanin, P; Stiff, D; Briante, C; Adair, C.E.; Ahmad, S.; and Khan, M. The Life and Economic Impact of Major Mental Illnesses in Canada: 2011 to 2041. (2011) Risk Analytica, for Mental Health Commission of Canada.
  14. Boivin, Michel, & Hertzman, Clyde. (Eds.). (2012). Early Childhood Development: adverse experiences and developmental health. Royal Society of Canada – Canadian Academy of Health Sciences Expert Panel (with Ronald Barr, Thomas Boyce, Alison Fleming, Harriet MacMillan, Candice Odgers, Marla Sokolowski, & Nico Trocmé). Ottawa, ON: Royal Society of Canada Available from: https://rsc-src.ca/sites/default/files/pdf/ECD%20Report_0.pdf
  15. Government of Canada (2006). The human face of mental health and mental illness in Canada.