National ME/FM Action Network responds to public service

classification of CFS as a mental illness


July 9, 2012

The Honourable Tony Clement


President of the Treasury Board of Canada

140 O'Connor Street

Ottawa, ON

K1A 0R5


Dear Sir:



Re: ME/CFS community's trust in the Public Service Disability Insurance Plan shaken


The National ME/FM Action Network is a registered charity that has been working to support Canadians with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and/or Fibromyalgia since 1993.


According to the 2010 Canadian Community Health Survey, over 400,000 Canadians had a diagnosis of CFS and most were of working age. The survey went on to show that people with CFS experienced a high degree of disability, disadvantage and unmet needs.


Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is not a mental illness. It is not included in the Diagnostic and Statistical Manual of the American Psychiatric Association. It is not classified as a mental or behavioural disorder in the World Health Organization's International Classification of Diseases. (ICD-10 classifies it as a disease of the nervous system.) Research has shown that the pathophysiological consequences of ME/CFS are multi-systemic and may include immune and neuroendocrine abnormalities, brain dysfunction and neurocognitive defects, cardiovascular and autonomic disturbances, abnormalities in energy production including mitochondrial dysfunction, and changes in the expression of certain genes. These are not characteristics of a mental illness.


We were therefore shocked to read an article in the Ottawa Citizen on June 29, 2012 which was later picked up by other outlets in the media chain. The article discussed the Public Service Disability Insurance Plan managed by Treasury Board. It noted that 48% of public service disability claims relate to mental illness. The article then provided a breakdown of the 48% by type of illness. Chronic fatigue syndrome was included on the list. We do not know the exact source of the data, but a breakdown like this must have come from within the Plan.


Including CFS on the list of mental illnesses covered by the government's disability insurance plan seriously undermines the ME/CFS community's confidence in the Plan itself. How can we have any trust that ME/CFS cases will be adjudicated and managed in an informed and fair manner when the Plan does not even classify the illness correctly?


The situation needs to be investigated. How was CFS misclassified? How widespread is the impression that ME/CFS is a mental illness? Are ME/CFS cases being adjudicated fairly? Are ME/CFS cases being managed appropriately?


Public trust in the Plan needs to be rebuilt. The Plan needs to demonstrate that it understands ME/CFS, an illness that is affecting so many Canadians. The Plan needs to demonstrate that it is adjudicating and managing cases based on fact, not fiction.


Yours truly,


Margaret Parlor


National ME/FM Action Network




Note:  The June 29 article is entitled "Mental illness accounts for almost half of all public service disability claims" and can be found at



The key section reads as follows:


But the most worrisome statistic is that mental health conditions, led by depression and anxiety, are now responsible for 48 per cent of all approved claims. That is the highest proportion since the plan was created 45 years ago.


Twenty years ago, mental health conditions accounted for 23.7 per cent of approved claims and have been rising ever since. They have represented more than 40 per cent of all claims cent since 1997.


The breakdown of health issues include:


23 per cent of all claims are for depression
6.4 per cent for recurrent depressive disorder
4.7 per cent adjustment disorder caused by grief or separation
4.1 per cent for anxiety
2.1 per cent for bipolar disorder
1.8 per cent post-traumatic stress disorder.
5.9 per cent include acute stress reaction, chronic fatigue syndrome, obsessive-compulsive disorder, panic disorder, schizophrenia, bulimia, anorexia, dementia phobias and illness related drug and alcohol use.