Zul Merali is president and CEO of The Royal Institute of Mental Health Research in Ottawa and founding scientific director of the Canadian Depression Research & Intervention Network. Keith Gibbs is a research analyst at The Royal and Keith Busby is a scientist at The Royal.
The Centre for Addiction and Mental Health announced recently it received a record $100-million donation from an anonymous donor – money that will be dedicated to research.
This is welcome news, as our recent analysis confirms that, relative to other health conditions, Canada spends little on mental-health research. Using a proxy measure, we analyzed the dollar amount allocated for mental-health research by the Canadian Institute of Health Research (CIHR) – the main federal source of biomedical and health research in Canada – and compared it with the figure allocated to cancer research. We chose to compare mental illness and cancer because both of these illnesses have been highly stigmatized and both result in a high toll (burden of illness) personally and economically.
During an eight-year period (2008-15) CIHR invested about $44.7-million a year in mental-health-related research, compared with $133.8-million a year for cancer-related research; thus, mental health received only about one-third as much as cancer, even though mental illness carries the largest burden of illness (surpassing that of cancer) both nationally and globally. In addition to the federal research investment through CIHR, there are more than 40 organizations that fuel cancer research, including several provincial agencies (e.g. Cancer Care Ontario) and voluntary organizations (e.g. Canadian Cancer Society and Canadian Breast Cancer Foundation), that contribute more than $230-million a year to cancer.
In contrast, mental health lacks such large national, provincial and voluntary organizations dedicated to funding mental-health research. Furthermore, there are no provincial or federal organizations attempting to coalesce or align the few bodies that fund mental-health research.
It was encouraging, therefore, to see such a large donation by a philanthropist. As The Globe and Mail's André Picard wrote, "… it is doubly noteworthy because it dramatically underscores a significant cultural shift, where it is as legitimate – and socially acceptable – for a philanthropist to embrace mental health as a cause as it is cancer or heart disease."
This cultural shift is also perceptible elsewhere in Canada; for instance, the Royal's Institute of Mental Health Research in Ottawa recently received its largest-ever philanthropic gift – $6-million – that will be directed toward the establishment of a mental-health research incubator, Emerging Research Innovators in Mental Health (e-RIMh). This endeavour will help six young scientists launch their careers in mental-health research.
Mental illness affects at least one in five Canadians and its effects are felt strongly and widely. Statistics indicate mortality and morbidity rates related to mental illness have not changed for decades; people suffering with mental illness live 10-17 years less than those who are not afflicted and 500,000 Canadians miss work every week because of mental illness. The effect on Canada's economy is estimated at more than $50-billion annually.
Progress has been slow – the diagnosis of mental illness still remains symptom-based (that would be akin to diagnosing heart disease based on chest pain); we do not yet have blood tests or brain scans to identify specific mental illnesses. Like other diseases (AIDS, cancer or heart disease), breakthroughs and improved outcomes have, in large part, come through research and innovation.
Our collective hope is that investment in mental-health research will bring much-needed respite to the personal and economic woes of mental illness. Our analysis revealed that the largest contributor to mental-health research is the CIHR. However, CIHR spends only about 4.3 per cent of its total annual research budget on mental-health research.
Hope is in the air, because much progress is being made to move mental illness out of the shadows. The groundbreaking 2006 Kirby Report led to the establishment of the Mental Health Commission of Canada; campaigns such as Bell Let's Talk and The Royal's You Know Who I Am are also helping to reduce the stigma of mental illness. Destigmatization will hopefully lead to less discrimination toward those suffering in silence, much like advances in cancer research and care did, and provoke more public attention and investment in mental-health research and care.
There have been calls (such as the Naylor report) to increase the national research budget. As our governments contemplate future policies and budgets, it is hoped that research allocations for mental health will increase. But equally important, it is hoped that large private-sector gifts are just the beginning of more support from private organizations and philanthropists to bolster the funding of mental-health research.