Region raises alarm bells over opioid use, declining mental health

York Region Public Health is raising alarm bells after recent studies have identified worrying trends when it comes to mental health, opioid use among youth, and food insecurity throughout York's nine municipalities.

The stats came through a Population Health Assessment presented to Regional Council on March 5 by Dr. Fareen Karachiwalla, York Region's Medical Officer of Health.

York Region has “quite a lot to be proud of” when it comes to Council's support for health, wellbeing and community resilience, she said, but some of the statistics presented last week raised concerns among elected officials.

“In York Region, cardiovascular disease is responsible for the majority of hospitalizations [and] that mirrors the rest of the country, really,” said Dr. Karachiwalla. “Mental health concerns are really on the rise. We used to have around 95 per cent of people reporting good mental health in the Region, and that's dropped since 2015 to 87 per cent in 2023 – quite a decline. When we survey secondary students, we do see that there [are] pretty high rates of serious psychological distress. Those reporting that have actually increased from 42.9 per cent in 2017 to over 55 per cent in 2023, again consistent with Provincial trends.

“A somewhat alarming trend, I would say, although we are seeing a decline in this now, is the non-medical use of prescription opioid pain relievers by high school students in York Region has pretty much doubled, from 8.6 per cent in 2021 to 16.5 per cent in 2025.”

Other areas of concern identified through the study, she said, include a near-doubling of those reporting food insecurity issues between 2019 and 2024, and the rise of vaccine-preventable diseases, such as measles.

“We do have rising rates of philosophical vaccine exemptions in our population,” said Dr. Karachiwalla. “It has almost doubled since pre-pandemic. It's still quite low compared to the rest of Ontario, which is good news, but we're seeing an increase from 1 per cent to 2 per cent. Climate change is worsening, so we are seeing higher rates of emergency department (ED) visits due to things like heat-related illness, particularly in seniors as a result of extreme weather.

“We are working on climate change, looking at that resiliency piece to health-related events. We are also working on the issue of opioids and substance use. We have a large community initiative with different community partners, people with lived experience at the table, that are informing us on how we can work with the school boards, for example, to not only address stigma, but really work on the prevention aspect and stopping people from using before they start.”

While this work is being done at the Region, elected representatives suggested more hands need to be on deck to address some of these concerns. Asked by Regional Councillor Michael Chan on how these stats fit into an overall picture of whether York Region is in a better or worse position now than in five years ago, Dr. Karachiwalla said while there has been a “gradual decline” in mental health Region-wide, some of the trends related to youth substance use are going in the right direction.

“If you look at youth and the trends of substance use over time, we are seeing a bit of a decline, which is very promising,” she said, noting declining rates in cigarette smoking and vaping. “Even cannabis use is starting to come down, alcohol as well. We are seeing a bit of a change for the better in those areas.

“Otherwise, if you look sort of big picture when you compare us to the rest of Ontario, our rates of many of our illnesses tend to be a little bit lower in York Region, which is very promising, so we're either close to the Ontario trend or superseding that, which is good in many of our indicators, but it is a bit of a complex picture. We're doing decently in the area of the substance use and a few of the chronic disease rates tracking to Ontario, but mental health for sure, like it is elsewhere, is on the decline.”

Although substance use is on the decline, the rates related to youth remained a primary focus for Regional Council, with Chan pressing for reasons on why both the rates for opiate use and food insecurity have doubled over the study period.

“I think it's a complex mix of factors,” said Dr. Karachiwalla. “If you look at opioid use in youth, and we're talking about use of prescription opioids for recreational reasons, we are seeing a little bit of a decline since I reported it to you, but it has been a jump if you compare it to, say, 2019. I think there are a number of different factors. I do think it correlates pretty closely with mental health, social isolation, loneliness, screen time. We are seeing all those things as an issue among our elementary and high school populations. I think that is definitely one of the factors is just declining mental health, looking for sort of ways to cope.

“Food insecurity, that we have seen a doubling over five years related to a number of different things like cost of living, cost of food prices are through the roof, and we don't just mean not having enough food when we talk about food security – it's also access to quality, nutritious food. We have seen fast food outlets really increase as well in density. That tends to be a cheaper way of obtaining food and feeling full with ongoing income insecurity and disparities. That probably explains a lot of the reasons we're seeing food insecurity as a big issue.”

Newmarket Mayor John Taylor said of the statistics of one in every two students “having a serious psychological distress in high school and opioid use increasing to 20 per cent for non-medical reasons,” if people “aren't shocked and concerned to extreme levels then apathy is running wild.”

“I think the public health sector has been worried about this and raising alarm bells for a very long time because these are shocking statistics,” replied Dr. Karachiwalla. “Opioid use alone, we see the harms associated with that – very poor mental health, particularly accelerating through the pandemic. We have a very close relationship with our school board partners [and] for years we've had a school standard where we work with them to think about prevention, bring mental health to light, normalize talking about mental health, reducing the stigma. We are working very closely with our school board partners on supporting their peer-based or student-led initiatives to talk about mental health and decrease that stigma. In York Region, because of the diversity we have, we also have a really strong sense of community and cultural norms, that stigma might be different in different populations as well. We have tried to take a more culturally-sensitive approach when dealing with that.

“Here in York Region, we have the Community Opioid Drug Response Collaborative, which is a set of community partners, people with lived experiences. We're talking about doing some surveillance, early warning when we see a spike in cases and really looking at that prevention aspect. I think one of the most important initiatives we do is, as much as we can, start earlier in life. We know that when we work on reducing adverse childhood experiences…that really changes somebody's trajectory in how resilient they are, how much they might suffer from mental health or additions. We're trying to work across sectors to begin at the early years and look at how we can reduce child abuse, neglect, poverty, all those things that affect you in your early years.”

Social isolation, she added, was a big factor when it comes to poor mental health and the Region is looking at a number of ways to combat that from reducing barriers to exercise, including the promotion of complete and age-friendly communities.

By Brock Weir
Editor
Local Journalism Initiative Reporter