When is the Liberal government going to make mental health a priority? The 2022 federal budget outlined plans to engage the provinces and territories in the development of a Canada mental health transfer. It also repeats the 2021 federal budget plan to create national standards on mental health.
But, in reality what do these budget plans mean to the average Canadian seeking mental health services in the community today? Nothing.
The incidence of mental health problems is staggering. Prior to COVID, it was reported that one-in-five Canadians experience a mental illness or mental health problem at some point in their lives. These figures have become significantly worse since the onset of the pandemic. Rates of depression and anxiety have increased dramatically, and 61 per cent of those with pre-existing mental health concerns say they have experienced a deterioration in their mental health.
Tragically, the greatest decline in mental health is reported in children and young adults. Anxiety is reported by 45 per cent of those aged 16 to 24. Admissions to hospital for suicide attempts are higher for youth than any other group. Poor mental health is associated with an increased use of substances such as alcohol and cannabis. Substance use and opioid-related deaths have increased dramatically with the pandemic. With increasingly contaminated drugs on the streets, and the continued stigma of use, the statistics are not likely to improve.
We are all affected by mental health problems, whether it is ourselves, our family members, our friends, our classmates or our colleagues. Some of us are disproportionately impacted due to Indigenous heritage, race, income, gender/identity, or the intersection of having more than one of these factors. These groups are more vulnerable, lack stability, and will find it harder to recover.
Most community mental health services are not covered by the Canada Health Act. Many stakeholders have called for the creation of a Canada Mental Health Act with funding from a Canada mental health transfer.
This idea is not novel. The United States, the United Kingdom and Australia have legislation that recognizes mental health parity and provides services that improve access to psychiatrists, psychologists and general practitioners. These are the solutions the federal government should provide. Canadians need appropriate and fair legislation with funding to institute change at the level of the community, where the average Canadian has a chance of getting help.
The creation of the new position of minister of mental health and addictions in the fall of 2021 gave hope to many of those working in mental health that the federal government would address the gaps in mental health care in Canada. These include the lack of proper funding and the lack of access to mental health professionals in the community where services are desperately needed.
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The 2022 budget contains merely a Band-Aid approach to addressing mental health needs. It was an opportunity to introduce the promised Canada mental health transfer and bring about change in communities where mental health services are desperately needed. However, the 2022 budget was disappointing in that it didn’t go far enough.
Carolyn Bennett, the new minister of mental health and addictions, recently announced that the government will be working with the Standards Council of Canada to develop national standards on mental health and substance use services across key priority areas. These are youth services, primary care and complex mental health and substance use. How do the new standards reconcile with the work that has already been done?
The Mental Health Commission of Canada (MHCC) is already operating with government funding and has produced reports and recommendations that many would like to see implemented. In February 2022, the MHCC recommended a national psychotherapy program, in which fixed annual federal funding would be implemented for providers not currently covered under the Canada Health Act.
Margaret Eaton. the national chief executive officer of the Canadian Mental Health Association (CMHA) testified before the Commons standing committee on health in April: “this emergency mode [in the provision of mental health services] isn’t sustainable, either for our staff or for our clients.” She also said the mental health effects of COVID will persist for years to come.
At that meeting, the CMHA called on the government to establish long-term stable federal funding for key programs, services and supports delivered by community mental health providers; to invest in mental health promotion and mental illness prevention programs; publicly fund community-based counselling and psychotherapy; and invest in housing, income support and food security.
In a column written for the Ottawa Citizen, Joanne Bezzubetz, the Royal Ottawa Mental Health Centre’s chief executive officer, recommended the government reduce the “lip service” it gives to mental health. She called on the government to start by tackling the gross underfunding on programs available to clients.
Professionals have recommended time-limited pop-up clinics during periods of increased stress – for example, during the so-called freedom convoy in downtown Ottawa, which created anxiety for many living in that area. This could allow health-care providers to deal with the increased number of individuals who are suffering.
There is a financial cost to inaction. While mental health services have been estimated in the past to cost $50 billion annually, the estimate for 2021 is projected to be close to $80 billion. Calculations indicate that the implementation of public funding for psychologist services alone would result in savings – for each $1 spent, an estimated $2 is saved. Health indicators have been developed by the Canadian Institute for Health Information to ensure accountability of how health care dollars are spent.
The 2022 budget was a missed opportunity for the Liberal government to deliver on its election promise of a Canada mental health transfer. Canadians are looking to Bennett to implement tangible change and offer hope, especially in the aftermath of COVID.