People living in Ontario’s poorest neighbourhoods are about twice as likely to be hospitalized for cutting, burning and other forms of intentional self-harm than their wealthiest counterparts, according to an analysis of data released by the Canadian Institute for Health Information.
The analysis found that as neighbourhoods get poorer they also experience higher rates of people being hospitalized for self-injury. While 97 per 100,000 people were hospitalized for harming themselves in Ontario’s poorest neighbourhoods in 2015-2016, that rate fell to 50 per 100,000 people in the province’s wealthiest neighbourhoods.
These findings don’t surprise Dennis Raphael, the director of York University’s program in health policy and equity. “Depression, hopelessness and self-blame” are reasons people living in poverty may self-harm, he said in an email.
Living in poverty can have “health-threatening effects,” including on mental health, according to a report published by Raphael. He explained that people experiencing homelessness have a “much higher rate” of mental health concerns than the general population.
One of the reasons people living in poverty may have poor mental health is the stress that comes with being unemployed, according to Raphael. “Lack of employment is associated with physical and mental health problems that include depression, anxiety and increased suicide rates,” he said.
The Canadian Institute for Health Information’s data separates neighbourhoods in Ontario into five categories, from lowest to highest income. Although there was a large difference in the rate of self-injury hospitalizations between the poorest and wealthiest neighbourhoods, there was not as big of a difference between middle- and higher-income areas.
Although the wealthiest neighbourhoods had a rate of 50 per 100,000 people being hospitalized for intentionally harming themselves, that rate only increased to 57 per 100,000 people for middle-income neighbourhoods. However, when considering the second-poorest areas the rate increases significantly to 72 per 100,000 people.
The high rates of mental illness among lower income communities doesn’t go unnoticed by counselling services in Ontario. According to Family Services Ottawa, an agency that provides accessible counselling services to people in distress, 70 per cent of its clients live below the poverty line.
“There is a lot higher volume of folks who are looking for services that have lower fees,” said Tasha Levenick, the intake worker for Family Services Ottawa. She said she receives about 60 to 80 calls per day from people who are looking to access counselling services.
However, Levenick also said there are not enough subsidized counselling services to accommodate the demand. “As a result of the high volume and the limited staff, supply and demand says there ends up being an inflated wait list for the services,” she said.
While people wait to access counselling, Family Services Ottawa provides some free, drop-in services that people in distress can access immediately. From there, Levenick said she directs people to community resource centres that offer low-fee therapy sessions. “There are some limitations,” she admits.
“There is a lot higher volume of folks who are looking for services that have lower fees.”
— Tasha Levenick, Family Services Ottawa
Despite the services made available by organizations such as Family Services Ottawa, Raphael said not enough is being done to address the mental health concerns faced by lower-income communities. “Things are getting worse,” he said in an email, pointing to growing income inequalities and increasing numbers of people in precarious work.
To address this issue, Raphael said more focus should be placed on improving people’s living and working conditions. “Citizens experience better physical and mental health when they have a secure basis for living a productive life,” he said.
Until that happens, Raphael said lower-income communities in our province will continue to be faced with higher rates of hospitalizations attributed to mental illness.