There are several different estimates of how many people have mental illness, but most of the figures are more or less the same.

At least one percent of a population is likely to have a serious and persistent mental illness at any given time. This is equal to about 300,000 Canadians.

Approximately one out of every five people is likely to be diagnosed with a mental illness at some time during their entire life. In other words, close to six million Canadians will have a mental illness during some period in their lives.

The rates of mental illness vary from one illness to another. For example, it is estimated that:
* schizophrenia affects about 1% of the population,
* mood disorders affect about 10%, and
* anxiety disorders affect about 12%.

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An estimated 1 in 10 children and adolescents suffer from mental illness severe enough to cause some level of impairment. However, fewer than 1 in 5 of these children receives treatment.

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Schizophrenia is a brain disease that has a devastating effect on the people who suffer from it as well as their family and friends. The signs and symptoms cause marked social, educational and occupational dysfunction. As a result, many persons with individuals are marginalized in our society with a poor quality of life. An estimated 80% will abuse drugs and/or alcohol during their lifetime. Substance abuse is associated with poor functional recovery and suicidal behaviour.

Schizophrenia affects approximately one per cent of the population and typically appears in adolescence and the early twenties for men and the twenties and thirties for women.

Too many young people do not receive the prompt care that they require when they become ill. These delays can have devastating consequences, disrupting family life and alienating young people from their friends, school workplaces and communities. Men are especially disadvantaged by the fact that the onset of the disease often occurs before they have been able to complete their high school or university education or join the work force.

The disease is characterized by:
Positive symptoms are also know as psychotic symptoms because the patient has lost touch with reality. The most common symptoms include delusions and hallucinations. Other symptoms may include anti-social behaviour, hostility, grandiosity as well as paranoia and distrustful behaviour.
Negative symptoms refer to emotional withdrawal, apathy, poor hygiene, disordered thought and loss of interest in daily activities.
Cognitive deficits are experienced by 94% of patients with schizophrenia and are probably the most important factor for poor outcome in people with the illness. Compared to psychotic symptoms, neurocognitive deficits are not as noticeable or odd. But the deficits have an enormous impact on the patient's life. Cognition problems include the following: reduced attention span, difficulties with memory, reasoning, judgement, problem solving and decision-making. Research has shown that verbal memory, executive functioning and visual vigilance predict functional outcome in schizophrenia.

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Bipolar disorder is a severe, recurrent, chronic condition often associated with significant functional impairment. Bipolar disorder affects one per cent of the population and the average age of onset is between 15 and 25. Most individuals diagnosed with bipolar disorder require treatment the rest of their lives.

Formerly known as manic-depressive illness, bipolar disorder is an extremely complex biological disorder of the brain. Like schizophrenia, there are no physiological markers used to diagnose the disease. Instead, it is identified by behavioural symptoms including abnormal fluctuations of moods between marked highs (hypomania or mania) and disabling lows (depression). No single medication is likely to completely achieve all therapeutic objectives and patients with bipolar disorder are often prescribed a combination of mood stabilizers and antipsychotics.

Many individuals suffer for as much as a decade before being properly diagnosed. Prompt professional intervention and treatment are extremely important for individuals experiencing a manic episode since they are often susceptible to harming themselves intentionally or unintentionally. Bouts of disabling depression can be just as dangerous. Nearly half of all U.S. suicide deaths each year are in patients with bipolar disorder; the risk is 20 times that of the general population.

Many individuals with bipolar disorder also experience short or long-term impairment in social, educational or occupational functioning. Relationships with family, friends and employers are often at risk. Judgement may be impaired as far as financial decisions are concerned and eventually, there is impairment in social and occupational functioning. Reckless spending sprees during manic periods have had a devastating financial impact on many families and bankruptcies are not uncommon. More than 50% of people with bipolar disorder have a substance abuse problem and more than 40% have comorbid alcohol use. The lack of impulse control may result in destructive behaviours such as gambling and stealing.

Only a small percentage of people with bipolar disorder will experience severe mania. At first, they may be overly enthusiastic, energetic and outgoing. As they become more manic, they can be irritable, argumentative and hostile. In most instances, they are not aware that they may be a danger to themselves and others. Immediate treatment with the most effective antipsychotic medication is critical. The police may have to be contacted to assist with hospitalization.

Clinical or major depressive disorder is a recurrent illness with frequent episode relapses and recurrences for more than 50% of the patients experiencing symptoms. Often referred to as clinical depression, the disease is diagnosed when a person has been experiencing severe and persistent symptoms of depression day after day for at least two weeks. The prevalence of major depression varies from 5% to 9% of the population depending on the study.

People suffering from clinical depression have no control over the intensity of their symptoms and simply cannot “snap out of it." However, only about one-third of those with depression seek help because of reasons such as the stigma associated with emotional difficulties and mental illnesses. Other reasons that deter these individuals from seeking help lie in the symptoms themselves, such as: feelings of worthlessness and hopelessness; excessive guilt; and lack of motivation. Also, many of these individuals are unlikely to appreciate the benefits of treatment.

Most people with depression have significant anxiety disorders which may increase suicide risk.

Symptoms of clinical depression can include any of the following:

• changes in appetite and sleep patterns
  
• loss of interest and pleasure in all activities
• low energy levels, fatigue, difficulty getting out of bed
• inability to concentrate or make decisions
• increased feelings of anxiety
• prolonged sadness, frequent crying spells
• pessimism about the future
• decreased sexual drive
• feelings of hopelessness or uselessness
• thoughts about suicide or death
• abuse of alcohol and/or drugs
• delusions of guilt or ruin
• catatonia.

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According to a Stats Canada survey of more than 36,000 people in 2002, less than 20% of Canadians received drug treatment for mental health issues.
* Women (9.5%) were more likely to use psychotropic drugs than men (5%)
* 64% of persons diagnosed with schizophrenia were taking medications
* 33% of persons with mood disorders,such as depression, were prescribed medications, including 30% who took antidepressants and 11% who use a sedative hypnotic (benzodiazepines)
* 28% of people with bipolar disorder (manic depressive illness) were being treated with medications.

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There is no single cause and that there are several different factors which can contribute to mental illness, either alone or in combination.

Mental illnesses are:
* biological - linked with disturbances in the brain or other body-system chemistry
* psychological - linked with disturbances in thought or emotion
* social - linked with life events and stresses.

Mental health professionals look at all three areas of a person's life when they design a plan for treating the illness.

Biological factors that may affect whether someone becomes mentally ill include:
* pre-natal damage
* physical trauma
* disease and infection
* chemical imbalances in the brain.
Genetics may play a part too. Studies show that close relatives of someone with schizophrenia or an affective disorder are much more likely to have the same illness a non-relative. However, people don't inherit mental illnesses, they only inherit the tendency to develop them.

Psychological and social factors could include:
* lack of support from relationships
* child abuse
* family violence
* unemployment
* major changes in life.

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The stigma attached to mental illness and psychiatry is a major obstacle to early and successful treatment.

Providing the best quality mental health care is always the best policy. Denying access to critically needed medications to save, literally a few dollars a day, per patient is a reflection of society’s misconception that the treatment of mental illnesses has less value than the treatment of physical illnesses.

The stigma of mental illness continues to be pervasive in our society and it is one of the many barriers that discourage people from getting the help they need. Nearly two-thirds of all people with diagnosable mental disorders do not seek treatment. Even though there is clear, scientific evidence that these diseases have a biological basis, many people still feel that persons with mental illnesses are somehow responsible for their own symptoms. As a result, they are unfairly discriminated against as far as employment, education, relationships and even health care.

The homeless in our cities reinforce our images of the mentally ill that were locked up in “lunatic” asylums. The public is painfully aware of the disabling impacts of the illness at its worst. These include: alcohol and substance abuse; dysfunctional thinking and cognitive impairment; disturbing and threatening presence; unkempt appearance; and violence.

The fear of unpredictable and violent behaviour contributes to stigma more than any other single factor. In fact, the perception of people with psychosis as being dangerous is stronger than ever before. There is no question that the media has reinforced stereotypes linking mental illness with violence.

Individuals with severe psychiatric disorders are not more dangerous than the general population - IF they are being treated.
Stigma must and can be overcome.
The most effective means to eliminate stigma is to discover the cause of mental disorders and find more effective treatments.

Our government must commit more dollars into research. In the meantime, AAs are a significant advancement in the treatment of schizophrenia and bipolar disorder and should be available to those who need them. They have fewer adverse side effects than many of the conventional antipsychotics and they shorten the course of the illness, reduce disability, improve cognition and help prevent relapses.

The new generation of antidepressants is also a significant improvement because they are safer and have fewer side effects than the older treatments.

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Addiction has two components: Psychological dependence occurs when a person feels that he/she needs alcohol or drugs to function or feel comfortable in certain situations, such as needing a drink and/or a drug to feel comfortable at a party or enjoy sexual encounters. Some people feel that they need a drink or a drug just to cope with daily life. Physical dependence occurs when a person's body has adapted to the presence of alcohol and/or a drug. As he/she develops greater tolerance to alcohol and/or drugs, he/she needs more to get the same effect. Continued heavy alcohol and drug use can cause permanent changes in the body and brain. These changes may explain why people continue to crave substances long after they have stopped using them, and slip back into substance use long after they have stopped using them.

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People become addicted to alcohol and drugs because of a number of factors, including: * Genetic factors - Studies have shown that some people may inherit a vulnerability to the addictive properties of alcohol and drugs. * Environment - The home, neighbourhood or community where people live, go to school or work can influence whether or not they develop substance use problems. People may use alcohol and/or drugs to cope with difficult emotions when they feel angry or upset. They may also use alcohol and/or drugs to relieve stress, anxiety, boredom or sadness. * Mental health issues - research shows that more than half the people with substance abuse disorders also have mental health problems, especially anxiety or depression. * Spiritual or religious affiliation - People who lack a sense of spiritual connection may not feel connected to others and the world around them. They may mask feelings of emptiness or hopelessness with alcohol and/or drug use.

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Low Risk Drinking Guidelines recommend that healthy people who decide to drink: * Should not drink more than 2 standard drinks on any single day. * Should stay below a weekly maximum of 14 standard drinks for men, and 9 standard drinks for women The Low Risk Drinking Guidelines note that some people should limit their use to less than the maximum amounts, including: * people with serious health problems, such as liver disease or certain psychiatric illnesses (e.g. depression), * people taking medications, such as sedatives, sleeping pills and pain killers, and * people who have a personal or family history of serious drinking problems. Some people should not drink at all, including: * women who are pregnant, trying to become pregnant or breast-feeding,and * people who are taking medications such as sedatives, painkillers or sleeping pills.

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