More Ontarians are reporting mental anguish and almost a quarter million have considered killing themselves in the past 12 months, according to a report from the Centre for Addiction and Mental Health.

The CAMH Monitor, published Thursday, is part of a 37-year study of Ontario adults’ mental health and substance use. For the first time, this year’s cycle – which surveyed 3,021 adults across the province – also asked about suicidal ideation and suicide attempts.

It found about 2.2 per cent – an estimated 231,500 of the total population – say they’ve thought seriously about killing themselves in the past year. People aged 18 to 34 were almost three times more likely to say they’d considered suicide than those 55 and older.

(That’s the inverse of Canada’s statistics on completed suicides, which indicate older people – older men, especially – are most at risk of killing themselves. So suicidal thoughts, in this report’s case, may be tied more closely to significant psychiatric distress than a likelihood of killing oneself.)

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If you are, or someone you know is, in crisis and needs help, visit suicideprevention.ca for a list of resources. In case of an emergency, please call 911.

Between 2003 and 2013, the report found, there have been significant increases in the percentage of respondents citing poor mental health – from 4.7 to 7.1 per cent – and “frequent mental distress days” – from 5.4 to 7.3 per cent.

“The rate of distress and [thoughts about] suicide is very high, especially in the younger age category,” said CAMH psychiatrist and clinician Paul Kurdyak

“We’ve also observed increases in the rates of young people visiting emergency departments for depression and anxiety,” he said.

That increase began in 2008, and while he said it’s possible it’s tied to a financial slowdown that’s hit youth particularly hard, it’s far too soon to make any causal inferences.

But, “I do think there’s sort of an overlaying of these determinants that are adding stress at a pre-existing vulnerable period” of transition in young people’s lives, he said.

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“If you have employment insecurity, you have financial insecurity. And you have no way of having financial stability to get housing – it’s just a cascade. That can’t do anything to help with someone’s distress anxiety and thoughts of hopelessness that lead to suicidal thoughts.” Tweet This

The report also found more encouraging trends when it comes to substance use and abuse:

Weekly binge drinking decreased from 12.3 per cent in 2006 to 6.8 per cent in 2013

decreased from to Current cigarette smoking declined from 26.8 per cent in 1996 to 16.8 per cent in 2013

declined from to Past year cannabis use increased from 8.7 per cent in 1996 to 14.1 per cent in 2013

increased from to Drinking and driving dropped from 13.1 per cent in 1996 to 5.1 per cent in 2013

from to Past year non-medical use of prescription opioids decreased from 7.7 per cent in 2010 to 2.8 per cent in 2013

The drop in people saying they’ve used prescription painkillers for non-medical purposes suggests messaging around the toll opioids take is having an effect, said Robert Mann, the study’s co-author and a senior scientist at CAMH.

“That’s been recognized as an important issue. These are very powerful, addictive drugs … and that corresponds with the recognition and, I think, efforts on the part of the government and other groups.”

READ MORE: Canada’s pill problem

So if more people are admitting to experiencing mental illness, is that because it’s become more common, or because people are less hesitant to talk about it?

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“We are in the midst of an unbelievable society-wide destigmatization of mental illness,” Kurdyak said. Tweet This

“If people are more comfortable disclosing their mental health issues, and more likely to seek help because of that. … That would be a bit of a silver lining.”

It also underscores the importance of talking openly and thoughtfully about mental illness and suicide, which for decades was considered a taboo topic.

“It’s really important to have a social discussion about mental health in general,” he said. “To not talk about it is not the right way to proceed.” Tweet This

“The suicidal ideation is a cause for concern … because it’s a marker of distress,” he said – and a sign we need to do more to ensure people experiencing that psychiatric distress are accessing the care they need.

Both Mann and Kurdyak pointed to the Ontario government’s mental health strategy as a good sign the province takes the issue seriously. But there continue to be worrisome gaps in a fractured mental-health system, Kurdyak said.

“We need to continue to work on the accessibility issue in the mental health system,” he said. “People need to know where they need to go, when they need to. And I think that’s notentirely the case currently. … What we do have is a pretty fragmented system.”

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If you are, or someone you know is, in crisis and needs help, visit suicideprevention.ca for a list of resources. In case of an emergency, please call 911.