This study reveals a stratified mental health care system in Canada, where sociodemographic factors shape who accesses which providers, with family doctors consistently the most accessed and psychiatrists least accessed for mental health concerns.
Key Findings
Results
Family doctors were consistently the most accessed providers for mental health concerns in Canada across all survey cycles examined.
Study analyzed seven cycles (2007-2020) of the Canadian Community Health Survey, a nationally representative cross-sectional survey
Provider access ranking from most to least: family doctors, psychologists, social workers, and psychiatrists
Psychologist and social worker use increased between 2017 and 2019
Trends were examined using weighted proportions and counts of service users
Results
Women had higher odds of using family doctors and social workers for mental health concerns but lower odds of using psychiatrists compared to men.
Women had higher odds of family doctor use (AOR = 1.21, 95% CI: 1.05-1.39)
Women had higher odds of social worker use (AOR = 1.19, 95% CI: 1.02-1.40)
Women had lower odds of psychiatrist use (AOR = 0.66, 95% CI: 0.55-0.79)
These findings are from adjusted regression models using the 2019-2020 cycle
Results
Adults aged 65 and older had substantially greater odds of using family doctors but lower odds of using psychologists or social workers compared to adolescents aged 12-17.
Adults 65+ had greater odds of family doctor use (AOR = 4.82, 95% CI: 3.59-6.47) compared to ages 12-17
Adults 65+ had lower odds of psychologist use (AOR = 0.33, 95% CI: 0.24-0.45) compared to ages 12-17
Adults 65+ had lower odds of social worker use (AOR = 0.21, 95% CI: 0.16-0.29) compared to ages 12-17
These were among the largest effect sizes observed in the adjusted models
Results
Post-secondary education was associated with higher odds of psychologist use compared to less than secondary school education.
Post-secondary education vs. less than secondary school was associated with higher psychologist use (AOR = 1.83, 95% CI: 1.12-2.98)
This finding suggests an education-based gradient in access to psychologists specifically
Finding is from weighted multivariable logistic regression models applied to the 2019-2020 cycle
Results
Higher household income was associated with lower odds of psychiatrist use compared to the lowest income group.
Household income ≥$80,000 vs. <$20,000 was associated with lower psychiatrist use (AOR = 0.66, 95% CI: 0.50-0.86)
This inverse relationship suggests lower-income individuals may rely more on psychiatrists, possibly through publicly funded pathways
Income-based differences in provider access reflect structural patterns in the Canadian mental health care system
Results
Non-Indigenous respondents more often used psychologists and respondents who were not a visible minority more often used family doctors for mental health concerns.
Non-Indigenous respondents had higher odds of psychologist use compared to Indigenous respondents (AOR = 1.58, 95% CI: 1.13-2.23)
Respondents who were not a visible minority had higher odds of family doctor use (AOR = 1.37, 95% CI: 1.06-1.77)
These findings indicate racial and Indigenous identity as significant predictors of differential provider access
Results are from adjusted multivariable logistic regression models from the 2019-2020 CCHS cycle
What This Means
This research suggests that in Canada, who you see for mental health support is strongly shaped by your age, gender, income, education, and cultural background. Using data from over a decade of a large national health survey (2007-2020), the study found that family doctors are by far the most common source of mental health care, while psychiatrists are the least accessed. Between 2017 and 2019, more people began seeing psychologists and social workers, suggesting some shift in how Canadians engage with mental health services.
The study also found significant gaps in who accesses which type of provider. For example, women were more likely than men to see family doctors and social workers but less likely to see psychiatrists. Older adults (65+) were heavily reliant on family doctors and far less likely to see psychologists or social workers. People with higher levels of education were more likely to see psychologists, and those with lower household incomes were more likely to use psychiatrists—possibly because psychiatry is publicly funded in Canada while psychology often is not. Indigenous Canadians and visible minorities also faced notable disparities in accessing certain provider types.
This research suggests Canada's mental health system is stratified, meaning different groups of people navigate very different pathways to care depending on their social and economic circumstances. The findings point to a need for policy changes that reduce financial and structural barriers—such as expanding insurance coverage for psychologists and social workers—and that work to ensure more equitable access to mental health care for all Canadians regardless of background.
Pang N, Yeung J. (2026). Sociodemographic and mental health predictors of mental health service use across provider types.. PloS one. https://doi.org/10.1371/journal.pone.0326556