Toronto isn't doing so well
Earlier this year, Thrive Toronto published Toronto’s first Mental Health Report Card, looking at how people across the city are actually doing. There is a lot in it, and not all of it makes particularly comfortable reading.
One of the figures that immediately stood out to us was the drop in the number of Torontonians reporting good mental health. In 2015 it was 73 per cent. By 2022, it had fallen to 52 per cent. That is a pretty significant change in a relatively short period of time, but what makes the report particularly interesting is that it doesn't just look at mental health in isolation. It looks at what might be happening around it too.
Work, money, loneliness, social support, community, discrimination and access to services all come into it. When you start looking at those things together, you get a much more human picture of what declining mental health in a city actually means.
Young people are having a particularly difficult time
The findings around children and young people are probably some of the hardest to read. In 2023, only around a third of Toronto's children and youth reported high perceived mental health, while more than half reported moderate to severe psychological distress.
Loneliness is a big part of the picture too. According to the report, 63 per cent of young people surveyed said they felt lonely at least occasionally, with some feeling it often or all of the time. Young people experiencing higher levels of loneliness were also far less likely to report good mental health.
Of course, none of this will feel particularly surprising to anyone working with young people. We hear about anxiety, friendships, school pressure, relationships, uncertainty about the future and feeling as though everybody else is somehow coping better than they are. There isn't always one obvious thing that has gone wrong. Sometimes life has simply become increasingly difficult to manage.
The report also found that some young people who felt they needed professional support didn't seek it. For some, the problem was remarkably basic: they didn't know where to go.
We think about this a lot at PITC, particularly as we have been doing more work around student support. Having services available is one thing. Making them easy to find, understand and actually use is another.
Toronto doesn't necessarily have a lack of help. It has a problem accessing it.
There is actually some good news in the report. People who do manage to access mental health services generally report that those services meet their needs. The difficulty is getting there in the first place.
Demand has increased and waiting lists have grown. The report found that the number of people waiting for some mental health and support services almost doubled between 2020/21 and 2022/23, while median waiting times increased from 147 days to 214 days.
That is a long time to wait when you're already struggling.
Cost is another very real part of the conversation. Therapy is expensive for many people. Insurance may cover a handful of appointments but not much beyond that. Students may have benefits and not know what they cover or how to use them. Other people simply don't know where to begin looking for somebody who can help.
This is one of the reasons we developed Affordable Therapy at PITC. We can't solve Toronto's access problem, but we can look at the bit of it that is within our control and ask what we can do differently. How do we make therapy available at a lower cost? How do we make that first appointment feel less complicated? How do we work with universities and other organisations so people know where they can go before they desperately need somewhere to go?
One of the biggest themes isn't actually therapy
Something else kept coming up as we read the report: people need other people.
The findings show a relationship between mental health and social support, loneliness and a sense of belonging to the community. Among young people, feeling connected to school and having supportive relationships mattered too.
It sounds obvious when you say it like that, but it made us think about how we approach mental health support. We quite rightly talk about access to therapists and mental health services, but a therapy appointment is usually an hour out of somebody's week. What about the rest of it?
This is really where the idea behind our Wellness Weekends came from. We wanted to try things that sit around therapy rather than trying to turn everything into therapy. We've had sessions around movement, nutrition, midlife, stress and other areas of wellbeing, some in person and some online. We are still figuring out what people want, what works and what is actually useful.
We also wanted cost not to be the thing that stopped somebody joining in, so we have been working with practitioners who are willing to offer sessions for free or at very low cost while we build the programme.
It is still evolving and we certainly don't have it all worked out. But reading the Thrive report made us feel that we are asking the right sort of question. If loneliness, social support and belonging have a relationship with mental health, perhaps mental health providers need to think about what they can offer outside the therapy room as well as inside it.
And then there's work
The report found that 28 per cent of people surveyed experienced high levels of work stress. Financial pressures, lack of time, work and concerns about family health were also among the common sources of stress. Again, probably not a revelation.
What is useful is seeing these things included in a report about mental wellness because it reminds us that people's mental health doesn't exist separately from the lives they are trying to live.
Therapy can help someone understand their stress, respond differently to it and develop better ways of coping. It can't make their rent cheaper or magically remove an unreasonable workload. A workplace wellness initiative isn't particularly useful if everybody attending it is exhausted because the underlying working culture hasn't changed.
There is a balance here that can sometimes get lost. We absolutely want people to have access to individual mental health support when they need it, but we also have to keep looking at what is making so many people stressed, isolated and overwhelmed in the first place.
So where does Toronto go from here?
Perhaps the thing we liked most about Thrive Toronto's report is that its recommendations aren't simply to put more people into therapy. It talks about strengthening community and social connections, creating healthier working environments, improving support for the groups being affected most and increasing access to services across the mental health continuum. In other words, helping people before things reach crisis point as well as being there when they do.
At PITC we are therapists, so obviously we believe enormously in what good therapy can do. But we don't think the answer to declining mental health can sit entirely inside therapy rooms. Affordable access matters. Earlier support matters. Schools and universities matter. Employers matter. Community matters. Sometimes simply knowing where to turn matters.
We are trying some things ourselves. Affordable Therapy is one. Building stronger links with students and universities is another. Wellness Weekends is probably the biggest experiment for us because it asks what a psychotherapy practice can offer its community beyond psychotherapy.
Some of it will work. Some of it might not. We will learn as we go.
This is Toronto's first Mental Health Report Card and Thrive Toronto intends to repeat the work, so it will be interesting to see what those numbers look like in the years ahead. For now, though, they give us a useful starting point and a fairly clear indication that carrying on exactly as we are probably isn't enough.
Read the full report
This article draws on findings from Mental Health in Decline: Toronto's First Report Card on Mental Wellness in the City, published by Thrive Toronto in January 2026.
We've only touched on a small part of it here. The full report looks in much more detail at the mental health of adults, children and young people across Toronto, as well as the social and economic factors associated with mental wellness and access to services.
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