Research Projects

Sommaire à la direction

Au Canada, la détresse psychologique et les problèmes de santé mentale ont tendance à augmenter; ils sont inégalement répartis et fort coûteux. Les insuffisances et les lacunes des recherches dans ce domaine limitent notre capacité de comprendre en quoi et comment les conditions de travail et les facteurs socio-économiques influent sur notre santé mentale et notre bien-être psychologique.

Cet examen des recherches universitaires et populaires confirme ce que nous savions déjà d’instinct : notre situation personnelle a un impact décisif sur notre santé mentale, en particulier nos conditions de travail et notre situation socio-économique. De nombreuses études et recherches de grande qualité - revues par les pairs - établissent un lien entre travail, situation socio-économique et santé mentale.

La détresse psychologique est un phénomène répandu, 54 p. 100 des Canadien.ne.s ayant admis que leur santé mentale s’était détériorée pendant la pandémie. Les résultats des recherches indiquent en outre que cette détresse est inégalement répartie :

les travailleurs ayant assumé un rôle central lors de la pandémie ont connu des degrés élevés d’anxiété
les collectivités où les revenus sont plus faibles et où le travail est plus instable comptent un plus grand nombre de personnes en situation de détresse l’intimidation et le harcèlement, comme le harcèlement de nature sexuelle et raciste, sont des facteurs déclencheurs de détresse le chômage et la précarité de l’emploi sont des facteurs associés à la dépression et à l’anxiété les emplois où les exigences sont élevées et le degré de latitude faible sont plus susceptibles de donner lieu à de l’épuisement professionnel

Les coûts économiques sont élevés, estimés à quelque 60 milliards de dollars par année. Les personnes éprouvant de la détresse psychologique se présentent dans les urgences des hôpitaux pour obtenir de l’aide. Elles ont besoin du soutien des travailleurs des services d’urgence et des services sociaux. Elles ont besoin de traitements. Elles sont susceptibles de s’absenter du travail ou de demander des prestations d’invalidité de longue durée.

Lire le rapport complet ici.

Executive Summary

Mental health distress in Canada is growing, unevenly spread and costly. And research gaps limit our ability to understand exactly how work and socioeconomic factors affect our mental well-being.

This review of academic and popular research confirms what we instinctively know: our personal situations play a big role in our mental health, especially our work and socioeconomic situations. Numerous high-quality, peer-reviewed research studies draw the link between people’s work or economic situations and their mental health.

The distress is widespread with 54 per cent of Canadians say their mental health has worsened during the pandemic. And the research shows this mental health distress is unevenly spread:

• workers at the centre of the pandemic experienced high levels of anxiety
• communities with lower incomes and more job instability have more people in distress
• bullying and harassment, such as sexual and racist harassment, are a significant cause of distress
• unemployment and job insecurity are associated with depression and anxiety 
• jobs with high demands and low control are associated with burnout

The economic costs are high, estimated at about $60 billion a year. People in mental health distress seek help in our hospital emergency rooms. They require help from our emergency and social services workers. They need treatment support. They may miss work or require long-term disability support. 

But there is some good news. Since there are socioeconomic determinants driving a lot of Canadians’ mental health distress, socioeconomic policy reforms hold the hope of improving our mental health. The research shows factors like job insecurity, economic insecurity, harassment and working through the pandemic are playing a key role in undermining mental wellbeing. However, the specific factors harming mental well-being are not well-researched. More work needs to be done and the Douglas Coldwell Layton Foundation intends to continue this research.

The mission of the Douglas Coldwell Layton Foundation is to contribute to public policy dialogue and provoke discussions on important Canadian conversations through research and education. Tommy Douglas, as premier of Saskatchewan, pioneered Canadian medicare and worked with the federal government to turn it into a national, universal program. Perhaps not surprisingly, his efforts to build socioeconomic security and social cohesion may be key to preventing mental health distress and improving Canadians’ well-being as we try to recover from a pandemic.

We hope this research can provoke a discussion on the work and economic factors driving mental health distress. In our next research phase, due in summer 2022, we plan to look closely at the specific conditions driving mental health distress to more clearly identify who is being hurt and the factors that must be addressed. We hope this work can inform the work of policy reformers interested in creating and implementing policies to improve Canadians’ well-being.

Executive Summary

Most Canadian provincial governments lack multi-year capital plans to build long term care and no province with a plan is sufficient to meet the expected demands for long term care caused by an aging population, according to our analysis of provincial documents.

Many provincial ministries of health or long term care have developed strategic plans that acknowledge the coming bulge in Canada’s senior population. Many are orienting themselves to a goal of “age in place.” However, no provincial strategy document shows how much such a re-orientation can reduce the demand for long term care beds. “Age in place” appears as more of a hope than a plan. 

With care needs already unmet, seniors’ population to rise dramatically

According to data from the Canadian Institute for Health Information and the Canadian Medical Association, provinces are already far behind the demand for long term care residences. In March 2021, CIHI reported there are spaces for 198,220 long-term care residents in Canada. The CMA, also in 2021, reported an unmet need of 77,000 care residences. To meet demand in 2021, an additional 275,200 long term care beds were required.

Without significant expansion of long term care facilities or other actions to reduce expected demand on them, the current shortage can be expected to grow as Canada’s population increases. 

Statistics Canada measured the population of people aged 75 years or older at 2,994,300 in 2021. Based on their medium growth assumption, Statistics Canada projects the population of those 75 years old and more to increase by 25 per cent by 2026, rising to 3,740,700. It will increase by 53 per cent by 2031, when the population is projected to reach 4,592,900. 

An analysis of Census data by Environics found the percentage of people living in a health-related facility to be 2.4 per cent of people aged 70 to 79, 10.3 per cent among those aged 80 and 84, and 26.9 per cent among those aged 85 or more. If the same percent of Canadians in these age ranges require a long term care bed, the demand for long-term care residence will rise to 344,025 by 2026 and 421,087 by 2031.

Distributing these findings of current unmet demands and anticipated future demands across provincial jurisdictions, we can readily see an aggressive investment plan is required to accommodate Canada’s quickly growing population of seniors.

To complete this report, health or long term care ministries’ websites, annual reports and provincial budget documents were reviewed. Where no comprehensive view of investment plans was found, provincial ministry and government communications or public engagement departments were contacted with requests for further information. Some departments responded. Most did not.

For a few provinces there is evidence of a multi-year report for long term care expansion. However, in most, there is no evidence of comprehensive plans. In some of these there is fragmentary information in government news releases, annual reports, and budget documents. 

This report analyses the known data from provincial ministries and compares them to our estimates of need by 2026 and 2031.

No clear plan despite a clear problem getting closer 

No Canadian province is constructing enough new long term care capacity to match the projected demand caused by the increase in Canada’s senior population. Few provinces appear to even have multi-year plans for construction and some show no plans for expansion and little or no recent increase to the number of beds in their jurisdiction. 

Many provinces acknowledge the coming surge in senior population and are proposing alternate strategies to allow residents to “age in place.” While many ministry strategic plans discuss this orientation, none provide a view on how effective their strategies will be in reducing demand for long term care facilities. “Age in place” appears to be more of a hope than a plan.

Next Steps

Taken together, the research compiled in this report paints a grim picture for the future of seniors care and economic security.  A future where governments fall well short of meeting the growing demand for long-term and home care, and rely more and more on privatization.  A future where seniors needing care are abandoned to a highly financialized system that puts profit over their well-being and the well-being of care workers, and where access to care rests on ability to pay. A future where too many seniors must rely on their own private wealth to finance a dignified retirement, and one where poorer seniors face an uncertain future of poverty and an inability to pay for basic care. 

As a next step in our research and convening, the DCLF is interested to bring together workers, unions, academics, civil society and a broad range of health and social policy experts to consider the following issues:

• Policy options to bring home, community and long-term care under the Canada Health Act and balance Federal and provincial responsibilities
• Regulating the financialization of seniors care and housing
• Models for transitioning to public and not-for profit models of ownership and service delivery in home, community and long-term care
• Regulatory approaches to enforce national standards of care like evidence-based staffing levels and other measures to improve workplace conditions and patient care outcomes 
• Options to expand access to defined benefit pension plans, both in unionized and non-unionized workplaces
• Reform options to expand the CPP/QPP
• Policy options to improve income security programs for low and middle income seniors

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