Are Mental Health Policies Rational?

Science marches on.

I may sometimes use that phrase as a cynical joke, but there is an underlying truth to it. Take cancer outcomes. According to Statistics Canada, between 1992-4 and 2014-6, five-year net survival expectations increased from 14 to 23 percent for lung and bronchus cancer, from five to ten percent for pancreatic cancer, from 25 to 51 percent for myeloma, and from 62 to 85 percent for chronic lymphocytic leukemia.

That’s astonishing progress and it goes a long way to justify the billions we spend on cancer research.

There have been other public health victories over that time. Statistics Canada data also shows us that total cross-Canada deaths in transport accidents dropped from 3,129 in 2000 to just 1,990 in 2024. And that’s despite the population increasing by 34 percent over that time.

So then why is it that, despite spending around $300 million of public funds annually on mental health research, and another $20 billion annually on mental health treatment - around 7.5 percent of all public health spending - there’s been no noticeable improvement in related outcomes?

When it comes to mental health, getting data that represents outcomes can be tricky. In some cases, useful data seems to exist but, for unknown reasons, is withheld from the public.

Ontario’s ICES mental health dashboard does provide some metrics. Between October 2016 and January 2026, for example, 30-day mental health and addictions-related hospital readmissions increased from around 14 per 100 hospital discharges to around 15. In the context of therapeutic outcomes, any readmission would have to be taken as bad news.

Similarly, the median length of stay for mental health and addictions-related hospitalizations has remained unchanged at six days. Breaking those numbers down into individual diagnoses shows little variation across the board.

But what we’d really like to see is evidence that, say, people suffering from mood disorders are more quickly transitioning to symptom-free lives than in the past. Or perhaps that new medications are making a predictable and measurable difference at the population level.

Unfortunately, I’m simply unable to find any data about the only things that really matter: durable recovery, sustained remission, and restoration of normal functioning for mental illnesses.

And medication-related outcomes seem to have been disappointing. For example, analysis of data from the National Population Health Survey and the Canadian Community Health Survey a couple of decades ago showed “episodes occurring in antidepressant users lasted longer than those in non-users” along with higher incidence of major depressive episodes.

Some have suggested that results like those are caused by the treatment-prevalence paradox (where those in poorest health were more likely to participate in such trials, skewing the results). But as far as I can tell, that’s never been proven.

And “never been proven” seems to be the story behind a lot of what goes on in the mental health industry. No one is suggesting that we just pull the plug on current research and care programs. But it would be useful to give Canadians a glimpse into the absolute, objective value of current “best-practices”.

In the meantime, the public health policy officials controlling billions of dollars of annual spending are completely blind to the actual outcomes their choices will have.

Canadians suffering poor mental health are not being well served.

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