Margaret Eaton, National CEO, CMHA, discusses the importance of the Canada Mental Health Transfer to the provinces and territories in Budget 2023
A lack of family doctors, psychiatrists, or funding for counselling and for community services. If you’re getting care for your mental health, there may very well be luck at play.
There is a growing movement of Canadians who will no longer accept a mental health system where you have to be lucky to get care. That’s why the Canadian Mental Health Association (CMHA) and 35 other organizations, including the Canadian Psychiatric Association, the Canadian Psychological Association, Kids Help Phone, CAMH, and the College of Family Physicians of Canada have come together to demand the inclusion of the promised Canada Mental Health Transfer to the provinces and territories in Budget 2023.
One in three affected by mental illness and substance use disorders
In Canada, mental illnesses and substance use disorders will affect one in three people in their lifetime, and research shows the pandemic made things worse. Of those Canadians, one in three can’t get the care they need. That rises to three in four children. It’s both astonishing and true. Many will wind up in the emergency department because their mental health has reached a crisis point, and there is nowhere else to turn. All because they couldn’t get the care upfront when they needed it. We’re also failing people once a crisis passes. Often, they’re discharged without follow-up supports because those supports either don’t exist, or they aren’t covered.
We know what to expect when we break our leg, detect a lump or have shortness of breath. We can expect that a doctor – whether in their office or a walk-in clinic or in the hospital – will know what to do or where to send us. And we can expect that care to be covered by public health insurance. But when it comes to mental health and substance use health, it’s a different and terrible story. The human reality in all of this is stark: people are suffering, and people are dying from their mental illnesses. These should never be terminal illnesses.
When the Canada Health Act made our system universal in 1984, it also determined that mental health and substance use health care would be covered only when provided by physicians and/or in hospitals. Today, millions of Canadians – 15% in fact – don’t have a family doctor. Without one, the search for mental health care is challenging. Even futile.
As for psychiatrists, even if you have a serious mental illness or substance use disorder, you might wait – and wait – as you cycle through hospitals, shelters, and the criminal justice system, without getting the care you need.
But having a family doctor and a psychiatrist isn’t a magic pill. Doctors face barriers to caring for their patients with mental health concerns and often don’t have referral pathways that are publicly funded. When it comes to “free” services, you might find community-based services delivered by not-for-profit agencies like CMHA. That’s if you’re lucky, because these agencies are underfunded, and their wait lists are long.
What about insurance benefits?
If you have insurance benefits from work, you might get some (limited) counselling or psychotherapy. Otherwise, you will pay from your own pocket. As a conservative estimate, Canadians pay over $1 billion every year on private psychological services alone. When you can’t afford to pay and you have no other access, you are out of luck.
The government has promised major investments in mental health, but we have yet to see real action. They say they’re waiting to build in standards. We say, we already know where the gaps are, and Canadians can’t afford to wait.
How can we demand a Canada Mental Health Transfer?
If you’re asking how we can demand a Canada Mental Health Transfer in the middle of a healthcare crisis, we say, how can we not? Mental health care is health care and there is a mental health crisis. Transferring money to the provinces and territories for mental health and substance use health care, especially community-based care, will take pressure off the rest of the healthcare system. Pressure off emergency departments. Pressure off the doctors. Pressure off social services. And pressure off the millions who are suffering, some of whom will die from their mental illness.
Yes, some of us get lucky and get care. But how can we let “luck” decide?