At-a-glance - An update on positive mental health among youth in Canada

Abstract

The Positive Mental Health Surveillance Indicator Framework (PMHSIF) provides estimates of positive mental health outcomes and associated risk and protective factors for youth aged 12 to 17 years in Canada. This study explored the relationship between sociodemographic factors and psychological and social well-being among youth in Canada using data from the Canadian Student Tobacco, Alcohol and Drugs Survey 2016–2017. Grade and province were significantly associated with psychological and social well-being.

Highlights

• The Quick Stats table presents recent estimates of positive mental health outcomes and determinants among youth in Canada.

• Over three-quarters of youth have high relatedness (81.8%), a high level of happiness (79.3%), high competence (78.4%) and high selfrated mental health (75.9%).

• The majority of youth reported high autonomy (73.0%) and life satisfaction (61.0%).

• Students in middle school (Grades 7–8) were more likely to have higher psychological and social well-being compared to students in high school (Grades 9–12).

Introduction

In 2017, the Public Health Agency of Canada (PHAC) released the Positive Mental Health Surveillance Indicator Framework (PMHSIF) for youth, which identified five positive mental health (PMH) outcomes: self-rated mental health, happiness, life satisfaction, and psychological and social well-being.¹ The PMHSIF-Youth aims to address a gap in PMH surveillance, provide a snapshot of the state of PMH and inform mental health policy and programming in Canada.² This At-a-glance article includes updated positive mental health estimates and associated individual, familial, community and societal determinants for youth aged 12 to 17 years in Canada. Well-being is a crucial component of positive mental health, and as such is an important concept to promote.³ To get a more complete picture of youth well-being in Canada, we also examined relationships between sociodemographic factors and three elements of psychological and social well-being: autonomy, competence and relatedness.

Methods

We explored the relationships between sex, grade and province and autonomy, competence and relatedness using the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) 2016–2017. Due to the complex survey design, estimates were weighted with the survey sampling weight and variance was estimated using the bootstrap method. We conducted three adjusted logistic regression models. All statistical analyses were executed using SAS Enterprise Guide version 7.1 (SAS Institute Inc., Cary, NC, USA).

Psychological well-being—CSTADS 2016–2017

Autonomy

Youth were asked to circle the response that best represented how they felt and how they thought others perceived them in the past week. The following six statements were included: 1) “I feel free to express myself at home”; 2) “I feel free to express myself with my friends”; 3) “I feel I have a choice about when and how to do my schoolwork”; 4) “I feel I have a choice about which activities to do with my friends”; 5) “I feel free to express myself at school”; and 6) “I feel like I have a choice about when and how to do my household chores.”

Competence

Youth were asked to circle the response that best represented how they felt and how they thought others perceived them in the past week. The following six statements were included: 1) “I feel I do things well at school”; 2) “I feel my teachers think I am good at things”; 3) “I feel I do things well at home”; 4) “I feel my parents think that I am good at things”; 5) “I feel I do things well when I am with my friends”; and 6) “I feel my friends think I am good at things.”

Social well-being—CSTADS 2016–2017

Relatedness

Youth were asked to circle the response that best represented how they felt and how they thought others perceived them in the past week. The following six statements were included: 1) “My teachers like me and care about me”; 2) “I like to spend time with my parents”; 3) “My parents like me and care about me”; 4) “I like to be with my teachers”; 5) “My friends like me and care about me”; and 6) “I like to spend time with my friends.”

Response options for autonomy, competence and relatedness questions were: “really false for me,” “sort of false for me,” “sort of true for me,” and “really true for me.” High autonomy, competence and relatedness were defined as having a mean score of 3 (response category “sort of true for me”) or 4 (response category “really true for me”) on a scale of 1 to 4.

Results

Main findings

Updated prevalence estimates can be found in Table 1. Of all youth in Canada, 75.9% reported high self-rated mental health and 61.0% reported high life satisfaction in 2017. In 2015, 79.3% of youth reported high happiness. In 2016/17, 73.0% of youths reported high autonomy, 78.4% reported high competence and 81.8% reported high relatedness. Due to significant changes that were made to the Canadian Community Health Survey (CCHS) methodology in 2015,⁴ estimates presented in the previous edition (2017) of the youth PMHSIF,¹ which includes data from CCHS 2014, should not be compared to the numbers in this edition (2019).

Table 1. POSITIVE MENTAL HEALTH SURVEILLANCE INDICATOR FRAMEWORK QUICK STATS, YOUTH (12 TO 17 YEARS OF AGE), CANADA, 2019 EDITION.

Sociodemographic determinants and PMH outcomes

The odds ratios (ORs) for autonomy, competence and relatedness adjusted for sex, grade and province are displayed in Table 2.

Table 2. Adjusted odds ratios of three positive mental health outcomes for youth, Canada, 2016–2017.

Autonomy

The odds of Grade 12 students having high autonomy were 12% (adjusted odds ratio [aOR] = 1.12, 95% confidence interval [CI]: 1.07–1.17) greater than Grade 10 students. Similarly, the odds of Grade 7 students having high autonomy were 7% (aOR = 1.07, 95% CI: 1.01–1.14) greater than the odds of Grade 10 students having high autonomy. Youth in Quebec were approximately two times (aOR = 1.98, 95% CI: 1.92–2.04) more likely to report high autonomy compared to youth in Newfoundland and Labrador. Additional odds ratios for other provinces can be seen in Table 2.

Competence

Students in Grades 7 to 9 were more likely to have high competence compared to students in Grade 10, whereas students in Grade 11 were less likely. There was no significant difference in likelihood of competence for students in Grade 12. In comparison to youth in Newfoundland and Labrador, youth in Prince Edward Island, Ontario, British Columbia, Alberta, Nova Scotia, Manitoba, Saskatchewan and Quebec were more likely to have high competence. For instance, the odds of high competence for youth in Prince Edward Island were 1.40 times higher (aOR = 1.40, 95% CI: 1.35–1.46) compared to youth in Newfoundland and Labrador. Additional odds ratios for other provinces are provided in Table 2.

Relatedness

Males were less likely to report high relatedness compared to females (aOR = 0.83, 95% CI: 0.81–0.85). Overall, youth in Grades 7 to 9 and Grade 12 were more likely to report high relatedness compared to the Grade 10 reference group. However, the odds of Grade 7 and 8 students having high relatedness were greater than the other grades (Table 2). There was no significant difference in likelihood of relatedness for students in Grade 11. Similar to provincial differences observed with high autonomy and competence, the odds of high relatedness were greater for Quebec, Ontario, Prince Edward Island, British Columbia, Alberta, Manitoba, Nova Scotia and Saskatchewan compared to Newfoundland and Labrador (Table 2).

Conclusion

The PMHSIF-Youth is an evidence-based resource that provides information on the state of PMH among youth in Canada. Overall, the majority of youth in Canada have high positive mental health. Our findings also show that students in Grades 7 and 8 had significantly higher odds of competence and relatedness compared to high school students. Interestingly, we observed provincial differences in the odds of psychological and social well-being outcomes. Compared to other provinces, the association for autonomy and relatedness was strongest among youth in Quebec. However, youth in Quebec had the weakest association for competence compared to other provinces. The findings reported in this At-a-glance have the potential to inform mental health promotion initiatives, particularly among specific grades and provinces.

Conflicts of interest

The authors have no conflicts of interest to disclose.

Authors’ contributions and statement

MV, EP, TL and MB drafted the At-aglance. MV analyzed the prevalence estimates for the positive mental health outcomes and indicators, and conducted the logistic regression model analyses. All co-authors interpreted the data and reviewed or revised the At-a-glance.

The content and views expressed herein are those of the authors and do not necessarily reflect those of the Government of Canada.