Health at a Glance

Catalogue no.82-624-X ISSN 1925-6493

by Caryn Pearson

The impact of mental health problems on family members

Release date: October 7, 2015

Standard table symbolsThe following symbols are used in Statistics Canada publications:

. not available for any reference period

.. not available for a specific reference period

... not applicable 0 true zero or a value rounded to zero 0s value rounded to 0 (zero) where there is a meaningful distinction between true zero and the value that was rounded p preliminary r revised x suppressed to meet the confidentiality requirements of the Statistics Act E use with caution F too unreliable to be published * significantly different from reference category (p < 0.05)

How to obtain more informationFor information about this product or the wide range of services and data available from Statistics Canada, visit our website, www.statcan.gc.ca. You can also contact us by email at infostats@statcan.gc.ca telephone, from Monday to Friday, 8:30 a.m. to 4:30 p.m., at the following toll-free numbers:

• Statistical Information Service 1-800-263-1136 • National telecommunications device for the hearing impaired 1-800-363-7629 • Fax line 1-877-287-4369

Depository Services Program

• Inquiries line 1-800-635-7943 • Fax line 1-800-565-7757

Published by authority of the Minister responsible for Statistics Canada

© Minister of Industry, 2015

All rights reserved. Use of this publication is governed by the Statistics Canada Open Licence Agreement.

An HTML version is also available.

Cette publication est aussi disponible en français.

Note of appreciationCanada owes the success of its statistical system to a long-standing partnership between Statistics Canada, the citizens of Canada, its businesses, governments and other institutions. Accurate and timely statistical information could not be produced without their continued co-operation and goodwill.

Standards of service to the publicStatistics Canada is committed to serving its clients in a prompt, reliable and courteous manner. To this end, Statistics Canada has developed standards of service that its employees observe. To obtain a copy of these service standards, please contact Statistics Canada toll-free at 1-800-263-1136. The service standards are also published on www.statcan.gc.ca under “Contact us” > “Standards of service to the public.”

Highlights

• In2012,approximately11million(38%)Canadiansaged15andolderhadatleastoneimmediateorextendedfamilymemberwhohadamentalhealthproblem,definedasproblemswiththeiremotions,mentalhealth,oruseofalcoholordrugs.

• About1in5(22%)Canadianshadmorethanoneimmediateorextendedfamilymemberwithamentalhealthproblem.

• AmongCanadianswhohadatleastonefamilymemberwithamentalhealthproblem,overone-third(35%)thoughtthattheirliveshadbeenaffectedbytheirfamilymember’smentalhealth.

• Approximately71%ofCanadianswhoperceivedthattheirliveswereaffectedbyafamilymember’smentalhealthproblemreportedtheyhadprovidedcaretotheirfamilymember.

Statistics Canada, Catalogue no. 82-624-X • Health at a Glance, October 2015

The impact of mental health problems on family members

Healthat a Glance

The impact of mental health problems on family members byCarynPearson

Problemswithmentalhealthcanhaveaseriousimpactonanindividual’seducation,work,sociallifeandinteractionswiththeirfamily.1In2012,aboutoneintenCanadiansreportedtheyhad experienced symptomsof amentalor substanceuse disorder at some point in the previous 12months.2,3As such, the Mental Health Commission of CanadaestimatesthatalmosteveryfamilyinCanadawillbeaffected,tosomedegree,byproblemswithmentalhealth.4Families can play an important role in thewell-being ofmemberswhohavementalhealthproblems.5Forinstance,care, such as emotional and practical support, is oftenprovided by family members.6 While family care can bebeneficial, it can sometimesbecomea sourceof stress forfamilies.Peoplewhocareforfamilymemberswithmental

health issues often report that their time, energy,mentalhealth, physical health, and finances are affected when afamilymemberhasamentalhealthproblem.7Canadians who had an immediate or extended familymemberwhohadaproblemwith their emotions,mentalhealth, or use of alcohol or drugs were the focus of thisarticle. Using data from the 2012CanadianCommunityHealthSurvey–MentalHealth (CCHS–MH), this articlehighlights the number of Canadians who had a familymemberwithamentalhealthproblem,focusingonselectedcharacteristicsofCanadianswhoseliveshavebeenaffectedbytheirfamilymember’sproblem,aswellasthecaregivingrolestheyprovidedtotheirfamilymember(seeData source, method and definitions text box).

Statistics Canada, Catalogue no. 82-624-X • Health at a Glance, October 2015

The impact of mental health problems on family members 4

Approximately 38% of Canadians had a family member with a mental health problemIn2012,approximately11millionCanadians (38%)aged15 and older reported having at least one immediate orextended family member with a mental health problem,definedasproblemswiththeiremotions,mentalhealth,oruseofalcoholordrugs.8TheCCHS–MHbroaddefinitionof “family” includedboth immediateandextended familymembers, such as a spouse or partner, children, parents,parents-in-law,grandparents,brothersandsisters,cousins,aunts,uncles,niecesornephews.Aboutone-fifth(22%)ofCanadianshadtwoormorefamilymemberswithamentalhealthproblem.Approximately9%hadtwofamilymembers,and12%hadthreeormorefamilymemberswithamentalhealthproblem.A larger percentage ofCanadians who had two ormorefamily members with a mental health problem reportedhigh levelsofdaily stresscomparedwithpeoplewhohadoneornofamilymemberswithamentalhealthproblem.High daily stress was reported by 17% of people whohad no family members with mental health problems.Thiscompareswith29%reportinghighdaily stresswhenthere were two or more family members with a mentalhealthproblem(Chart1).

In2012,about10%ofpeoplewhohadonefamilymemberwithamentalhealthproblemreportedhavingexperiencedsymptoms themselves of a selected mental or substancedisorder in theprevious12months.This ratewas almosttwiceashighwhenthereweretwoormorefamilymemberswithamentalhealthproblem(18%).Therewasnodifferenceinthepercentageofpeoplereportinghigh life satisfaction,excellent/verygoodself-ratedhealthorfinancialdifficultybetweenthethreegroups(Chart1).

Canadians were affected by their family member’s mental health problems Amongpeoplewhohadatleastonefamilymemberwithamentalhealthproblem,justoverone-third(35%)perceivedthattheirtime,energy,emotions,financesordailyactivitieshad been affected because of their family member(s)problem.AmongthoseCanadianswhoperceivedthattheirliveshadbeenaffectedbyafamilymember’smentalhealthproblem,closetoone-fifth(19%)reportedthattheyhadexperiencedsymptomsofamentalorsubstanceusedisorderthemselvesintheprevious12months(Chart2).Furthermore,almosttwo thirds (62%) reported that their family member’s

Selected characteristics

percent

Chart 1Selected characteristics of Canadians aged 15 or older, by number of family members with a mental health problem, 2012

† reference group* significantly different from reference group (p < 0.05)Note: See Data source, method and definitions box for definitions of the variables in this chart.Source: Statistics Canada, 2012, Canadian Community Health Survey – Mental Health.

0

10

20

30

40

50

60

70

80

90

100

Life satisfaction(high)

Communitybelonging (strong)

Stress (high) Financial difficulty

No family members† One family member Two or more family members

Self-rated health (excellent/very good)

Selected mental or substance disorder

(12-month)

* *

**

*

*

Statistics Canada, Catalogue no. 82-624-X • Health at a Glance, October 2015

The impact of mental health problems on family members 5

problemshadcausedthemtobecomeworried,anxiousordepressed(datanotshown).The results of this study are similar to those of a studyconductedintheUnitedKingdom.Comparedwithpeoplewhodidnotperceiveanimpact,peoplewhoperceivedthattheir liveshadbeenaffectedbyafamilymember’smentalhealthweremorelikelytoreportthattheyhadexperiencedproblemswiththeirownmentalhealthwithintheprevious12months.6In 2012, people who perceived that their lives had beenaffectedreported lowerratesof life satisfaction,andratedtheirgeneralhealthmorenegatively thanpeoplewhodidnotperceivethattheirliveshadbeenaffected(Chart2).Canadianswhoperceivedthattheirliveshadbeenaffectedbya familymember’smentalhealthproblemwere justaslikelyasthosewhodidnotperceiveanaffecttofeelastrongsenseofbelonging to their local communities.Over two-thirds (68%)ofpeoplewhoperceived that their liveshadbeenaffectedbyafamilymember’smentalhealthreportedthattheywerenotembarrassedbythisproblem(datanotshown).

Most people who perceived their lives had been affected provided care to their family member About 71% of Canadians whose lives were affected by afamilymember’smentalhealthproblemsreportedprovidingcare(caregivers)totheirfamilymember(datanotshown).Emotionalsupport(27%),suchaskeepingafamilymembercompany,wasprovidedmoreoftenthanpracticalsupport(8%),suchashelpwithpaperworkorgettingaround.About 28% of caregivers provided both emotional andpractical support, and 7% reported spending time doingother things to care for their familymember. Emotionalsupport is generally needed more than practical supportbecause people with mental health problems are oftencapableofdoingpracticaltasksforthemselves.5Morewomen(30%) thanmen(22%)providedemotionalcaretotheirfamilymemberswithmentalhealthproblems,while more men (12%) than women (7%) providedpractical care (Chart 3). However, proportionally moremen(32%)providedbothemotionalandpracticalsupport

Selected characteristics

percent

Chart 2Percentage of people1 with selected characteristics, by whether or not their lives were affected by a family member’s mental health problem,2 2012

* significantly different from "life not affected" group (p < 0.05)1. Canadians who reported they had at least one family member who had a mental health problem. 2. Life affected by a family member’s mental health problems: respondents who reported that their family member's problems with mental health had affected their time, energy, emotions, finances and daily activities, “a lot” or “some of the time.” Note: See Data source, method and definitions box for definitions of the variables in this chart.Source: Statistics Canada, 2012, Canadian Community Health Survey – Mental Health.

0

10

20

30

40

50

60

70

80

90

100

Life satisfaction(high)

Communitybelonging (strong)

Stress (high) Financial difficulty

Life affected "a lot" or "some" of the time Life not affected

Self-rated health (excellent/very good)

Selected mental or substance disorder

(12-month)

*

*

*

**

Statistics Canada, Catalogue no. 82-624-X • Health at a Glance, October 2015

The impact of mental health problems on family members 6

toafamilymemberthanwomen(26%).Previousresearchhasconsistentlyfoundthatwomenweremorelikelytobecaregivers,4,5andprovideemotionalsupport,9thanmen.Onaverage, thoseprovidingcarespent twohoursaweekprovidingemotionalorpracticalcaretotheirfamilymemberwithamentalhealthproblem.However,30%ofcaregiversspentmorethanfivehoursaweekprovidingcare.Maleandfemale caregivers generally spent about the same amountof timeprovidingcare toa familymemberwithamentalhealthproblem.Providing care to a familymemberwith amental healthproblem can take a physical and emotional toll on thecaregiver.4,9In2012,abouttwo-thirds(66%)ofcaregiversreportedthattheirfamilymember’smentalhealthhadcausedthem to becomeworried, anxious or depressed (data notshown).Furthermore,aboutone-fifth (19%)ofcaregiversreported having experienced symptoms themselves of amentalorsubstanceusedisorderintheprevious12months(datanotshown).

Conclusion In2012,about38%ofCanadianshadat leastonefamilymemberwithamentalhealthproblem;ofthose,about35%reportedthattheseproblemshadaffectedtheirtime,energy,emotions, finances or daily activities. People who wereaffected by a familymember’smental health experiencedstressandsymptomsofmentalhealthproblemsthemselves;andabout62%reportedthattheirfamilymember’sproblemhadcausedthemtobecomeworried,anxiousordepressed.Sincementalhealthproblemsaresodiverse,futureresearchwouldbenefitfromanexaminationoftheimpactofspecifictypesofmentalhealthconditionsonfamilymembersandtheircaregivers.

Caryn Pearson is an analyst with the Health StatisticsDivision.

Type of care

percent

Chart 3Type of care1 provided by people affected by their family member’s mental health problem, by sex, 2012

* significantly different from males (p < 0.05)E use with caution (these data have a coefficient of variation from 16.6% to 33.3%)1. Questions on caregiving were only asked of respondents who reported that their family member’s mental health problems had affected their time, energy, emotions, finances and daily activities, “a lot” or “some of the time.” Source: Statistics Canada, 2012, Canadian Community Health Survey – Mental Health.

Females Males

*E

E*

*

*

0

10

20

30

40

Emotional and practical support Emotional support only Practical support only Other type of care

Statistics Canada, Catalogue no. 82-624-X • Health at a Glance, October 2015

The impact of mental health problems on family members 7

Data source, method and definitions

Data sourceEstimatesforthisstudywerebasedonthe2012Canadian Community Health Survey–Mental Health (CCHS–MH).TheCCHS–MH is a cross-sectional survey usedto collect information aboutmentalhealth status, accessto, and perceived need for formal and informal mentalhealth services and supports, functioning and disability,andfactorsdetermininghealthstatus.Thesurveyincludedthepopulation15yearsofageandoverwholivedinthetenprovinces.Excludedfromthesurvey’scoveragewere:personslivingonreservesandotherAboriginalsettlements;full-timemembersoftheCanadianArmedForcesandtheinstitutionalizedpopulation.Altogether, these exclusionsrepresentedabout3%ofthetargetpopulation.

MethodWeightedfrequenciesandcross-tabulationswereusedtoestimatethepercentageofpeoplewho:hadoneormorefamily members with a mental health problem, wereaffectedbytheirfamilymember’smentalhealthproblem,and were providing care to at least one family memberwithamentalhealthproblem.Thesewereexaminedbyavariety of selected characteristics. Significant differencesweredeterminedusingap-valueof0.05.P-valuesprovidean indication of whether the differences between theestimatesarereal.

DefinitionsFinancial difficulty:respondentswhoreportedthat,giventheir currenthousehold income, theyhaddifficultywithbasicexpensessuchasfood,shelterandclothing.

Life affected by a family member’s mental health problems: respondents who reported that a familymember’smentalhealthproblemshadaffectedtheirtime,energy, emotions,finances anddaily activities, “a lot” or“someofthetime”(versus“alittle”or“none”).Thismeasurewasusedforconsistencywithpreviousresearch.5,6

Life satisfaction (high)wasbasedonascalethatmeasuredtherespondent’sresponsestothequestion“Howdoyoufeelaboutyourlifeasawholerightnow?”Thosewhowerecategorizedas“verysatisfied”or“satisfied”(versus“neutral,”“dissatisfied”or“verydissatisfied”)wereconsideredtohave“high”lifesatisfaction.

Providing care:includedrespondentswhoperceivedthattheirliveshadbeenaffectedbyafamilymember’smentalhealth,andreportedtheyprovidedafamilymemberwithhelpwithemotional,practical,orother things,over andabovewhattheywouldnormallydobecauseoftheirfamilymember’smental health problems.Questionsmeasuringcaregivingwere only asked to peoplewho reported thattheir familymember’s problemswithmental health hadaffected their time, energy, emotions, finances and dailyactivities, “a lot” or “some of the time.” This may haveexcluded some respondents who were providing care.About71%ofpeoplewhoperceived that their liveshadbeenaffectedprovidedcaretoafamilymember.

Selected mental or substance use disorder (12-month):respondentswho reportedhavingexperienced symptomsthemselvesconsistentwithatleastoneofthesixdisorders(major depressive episode, bipolar disorder, generalizedanxietydisorder,andabuseofordependenceonalcohol,cannabis or other drugs)measured in the survey, in theprevious 12 months. The survey measured the disordersin accordance with the World Health Organization-Composite International Diagnostic Interview (WHO-CIDI) 3.0, which classifies respondents, according toselectedmentalorsubstanceusedisordersonthebasisoftheirreportedsymptoms.

Stress (high): Respondents who reported that most oftheirdayswere“quiteabit”or“extremely”stressful(versus“abit,”“notvery,”or“notatall”stressful).

Limitations In this study, using the 2012 CCHS–MH, it was notpossible to determine the family relationship betweenrespondentsandtheir familymemberwhohadamentalhealth problem, that is, whether a respondent’s familymemberwaspartoftheirimmediatefamily(i.e.,parentorchild),ormemberoftherespondent’sextendedfamily(i.e.,auntorcousin).

Caregiving questions were only asked to respondentswhoreportedthattheirliveswereaffectedbytheirfamilymember’smentalhealthproblems.Thismayhaveexcludedsomerespondentswhowereprovidingcare.

Statistics Canada, Catalogue no. 82-624-X • Health at a Glance, October 2015

The impact of mental health problems on family members 8

Referencesandnotes1. MentalHealthCommissionofCanada.2012.Changing

Directions,ChangingLives:TheMentalHealthStrategyforCanada.Calgary:Alberta.http://strategy.mentalhealthcommission.ca/download/

2. PearsonC,T.Janz,andAliJ.2013.“MentalandsubstanceusedisordersinCanada.”Health at a Glance.September.StatisticsCanadaCatalogueno.82-624-X.http://www.statcan.gc.ca/pub/82-624-x/2013001/article/11855-eng.htm

3. Symptomsconsistentwithatleastoneofthefollowingdisorders:majordepressiveepisode,generalizedanxiety,bipolardisorder,alcohol,cannabisorotherdrugabuseordependence.

4. MentalHealthCommissionofCanada.2009.TowardRecovery&Well-being:AFrameworkforaMentalHealthStrategyforCanada.Calgary:Alberta.http://www.mentalhealthcommission.ca/English/document/241/toward-recovery-and-well-being

5. Pirkis,J.,P.Burgess,J.Hardy,M.Harris,T.SladeandA.Johnston.2010.“Whocares?Aprofileofpeoplewhocareforrelativeswithamentaldisorder.”Australian and New Zealand Journal of Psychiatry.Vol.44,p.929-937.

6. Ennis,E.andB.P.Bunting.2013,“Familyburden,familyhealthandpersonalmentalhealth.”BMC Public Health.Vol.13.

7. MØller,T.,C.B.Gudde,G.E.FoldenandO.MLinaker.2009.“Theexperienceofcaringinrelativestopatientswithseriousmentalillness:genderdifferences,healthandfunctioning.”Scand J Caring Sci.Vol.23,p.153-160.

8. Afamilymember’sproblemsrelatedto:autism,Alzheimer’sorotherneurologicaldisordersanddevelopmentaldisabilities,werenotmeasuredinthesurvey.

9. Sinha,M.2013.“Portraitofcaregivers,2012:SpotlightonCanadians:ResultsfromtheGeneralSocialSurvey.”StatisticsCanadaCatalogueno.89-652-X.http://www.statcan.gc.ca/pub/89-652-x/89-652-x2013001-eng.htm