On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore new evidence suggesting that rates of psychotic disorders are increasing in younger generations in Canada. Drawing on population-level data and broader psychiatric research, the episode examines how generational trends in psychosis intersect with substance use, social change, and the ongoing youth mental health crisis.

Dr. Daniel Myran, a family physician and public health researcher at North York General Hospital, discusses findings from his CMAJ study, Incidence of psychotic disorders by birth cohort: a population-based cohort study in Ontario, Canada. He explains how overall rates of psychosis appear stable when populations are viewed as a whole, but mask a substantial rise among people born in the 1980s, 1990s, and early 2000s. Dr. Myran outlines possible contributors, including substance exposure, changes in diagnostic practices, and social determinants, and emphasizes the implications for early intervention psychosis programs and frontline care.

The conversation then widens with Dr. Dafna Kahana, an associate professor of psychiatry at the University of Toronto and staff psychiatrist at CAMH, who draws on her article in the Journal of Psychiatry and Neuroscience, Are the kids alright? Making sense of the current youth mental health crisis in Canada through heuristic and data. She unpacks how social media use, sleep disruption, physical inactivity, pandemic-related isolation, and exposure to global crises may interact to affect youth mental health, while cautioning against oversimplified explanations or single-factor solutions.

For clinicians, the takeaway is twofold: emerging generational shifts in psychosis warrant attention in both primary care and mental health planning, and addressing youth mental health requires a coordinated, multi-pronged approach that spans early identification, family support, and system-level investment rather than reliance on any single intervention.

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