The Economic Burden of Anxiety Disorders in Canada.

Abstract

Abstract Concern over the costs of medical conditions has traditionally overshadowed interest in assessing the costs of mental health problems. Recent research, however, indicates that mental disorders impose considerable costs on society and on the sufferer. Most of this research comes from the United States, while little is known about health-care use patterns, impairment, and costs associated with psychological problems in Given that cost containment has become a priority, it is crucial to examine mental disorders that may exert pressure on Canada's health-care system. Among mental health problems, anxiety disorders have received considerable attention, as they have been shown to be costly. Among the anxiety disorders, generalized anxiety disorder deserves closer examination as it is highly prevalent in the community and in the general medical sector, and has been shown to be disabling, which suggests that this disorder is a potential cost driver. The restructuring of the Canadian health-care system has clearly been a major topic of concern for health planners, policymakers, administrators, providers, and the public alike, particularly in the last few years. Costs have been the key matter at hand and specific issues that have prompted the re-evaluation of the organization of our health-care system have included access to health-care providers, rising drug costs, wait-lists for tests and treatments, and privatization. Similar to countries worldwide, Canada has been striving for cost containment, as approximately onethird of all provincial budgets are spent solely on the provision of health care (Hunsley, 2003). In an effort to address these concerns, between April 2001 and November 2002, the Commission on the Future of Health Care in Canada (CFHCC) implemented a nationwide examination of the Canadian health-care system, and as part of its inquiry, the Commission vigorously solicited input and proposals for areas of improvement from Canadian citizens and individuals working in all fields of health, including mental health. Although the Canadian Psychological Association's (CPA) work in the CFHCC inquiry is considered by far to be the most significant advocacy effort Canadian psychology has engaged in, the extent of this effort is not entirely evident upon examination of the recommendations put forth in the final report. It seems that increasing access to mental health services is not among the top priorities of health-care planners, providers, and consumers at this time, as it was barely mentioned (except within the context of the provision of home-care services). In its analysis of the Commission's final report, the CPA alluded to the fact that the recommendations are a reflection of the model on which our health-care system is based - one that defines health as physical, despite the fact that health (as per the World Health Organization definition), is a state of complete physical, mental, and social well-being. Essentially, the report did not put human behaviour at the heart of health care in Canada. The argument has commonly been made that mental health does not yet figure equally into this fragmented health-care system, despite the plethora of scientific evidence showing that physical and mental health are intimately and inextricably intertwined (Allon & Service, 1999). Having said this, Canadian psychologists are now in a position, perhaps more than ever, to substantiate this long-standing assertion. Although the CPA and provincial psychological regulatory bodies did present extensive data to the Commission demonstrating the relationship between mental and physical health, as well as the costs associated with psychological disorders, this evidence was derived for the most part from research conducted in the United States and was then used to draw inferences about the Canadian health-care system. Although it has been the case that there have been few Canadian data to rely on, it clearly has become inadequate to rely on U. …