Mental health crisis needs to be a priority in Canada

Canada is grappling with overlapping crises in mental health and overdoses that are outpacing the capacity of the mental health and substance use health (MHSUH) system.

While governments across the country are taking steps to increase access to these services — including $500 million recently from Ottawa to support community-based youth mental health organizations — these measures often overlook the MHSUH workforce itself: the psychologists and social workers, counselling therapists and addiction counsellors, peer support and harm reduction workers, nurses and physicians, occupational therapists and other practitioners.

Canada cannot close the gap in access to MHSUH services unless it develops a MHSUH workforce action plan to co-ordinate planning across jurisdictions, provider types, and the public and private sectors.

Although the mental health and overdose crises predate COVID-19, the pandemic exacerbated them. Fears of infection, financial stress, shutdowns, isolation and interruptions in work, education, family, social and health care routines in the early stages of the pandemic led to an alarming increase in mental health and substance use concerns.

Staffing shortages, restrictions on in-person visits and the need to move to virtual care challenged the capacity of the MHSUH system to respond to growing population needs. The pandemic also further burdened MHSUH providers, many of whom were already dealing with difficult working conditions, low pay, stigma, stress and burnout.

There have been some recent improvements reported in mental health; however, the number of people reporting symptoms of depression, anxiety and post-traumatic stress disorder has not declined.

Canada must develop an MHSUH workforce action plan. Other countries have adopted plans to tackle issues such as workforce planning, recruitment and training.

The plan must also prioritize better data collection. Significant data gaps exist — especially for unregulated providers that hinder workforce planning. Without robust data on all occupations providing MHSUH services across the country, decision makers do not have a clear picture of gaps in service delivery.

The action plan must also include regulatory changes that develop and expand roles, scopes of practice and the skill mix of MHSUH workers — including a flexible approach to quality assurance for some currently unregulated provider groups.

It must also address inequities in access and the need for more public funding of MHSUH services.

Education, training and ongoing development must also be important components of the plan, as must integrated team-based care so that mental health, substance use, primary care and other health sectors work together collaboratively.

Finally, given the shift to virtual care it is also essential that the plan include funding to ensure that MHSUH workers have the digital infrastructure and training to provide virtual care in an equitable way.