Time to take action on mental health
Next week the federal minister of health will meet with her provincial counterparts in Toronto to negotiate a new health accord. There is a crisis that desperately requires the ministers’ attention: the gap between physical health care and mental health care in Canada.
We’ve come a long way. Honest conversations have galvanized attention across the country; people with lived experience of mental illness have bravely shared their stories; innovative brain research is reaching a tipping point; novel treatments and care models are emerging. People have come to recognize that there is no health without mental health. But, given the burden of mental illness in Canada, it’s hasn’t been enough.
Canadians with anxiety disorders, depression, suicide and substance use are not getting the help they need and the care they deserve. Wait lists are growing. People are in pain. Lives are being lost. It shouldn’t be this way.
Mental health care is under-resourced in Canada. Mental illness accounts for about 10 per cent of the burden of illness in Ontario but receives just 7 per cent of health-care dollars. That translates into a $1.5-billion gap.
Bridging that gap is not just the right thing to do. It’s also smart economics in a country that loses $50 billion a year in lost productivity from mental illness
There is also a wide gap between the quality of care that Canadians receive for physical ailments compared to mental illnesses.
Take, for example, cognitive behavioural therapy or CBT, a widely used evidence-based therapeutic intervention. It is a key tool for treating illnesses like anxiety and depression.
CBT and other structured psychotherapies are not publicly insured except in narrow circumstances. It is covered through third-party insurance providers, but even then, most third-party insurance policies cover the equivalent of 11⁄ treatment sessions per
2 year.
Can you imagine if that was our approach to palliative care or chemotherapy? We’d consider that unthinkable and completely unacceptable. Yet thousands of Canadians suffering from depression do not have access to a valuable intervention. It’s outrageous — and deeply unjust. To begin to bridge the gap, a new agreement must include a stand-alone outcome-oriented investment in mental health.
Under the 2004 accord, Canada’s first ministers signed a 10-year agreement that included $5.5 billion to reduce wait times for five clinical procedures. The initiative was driven by public outcry at the long wait times for these services. Mental health never appears on such lists.
Canadians need to know that Tuesday’s meeting is a once-in-a-lifetime opportunity to bring justice, and their Charter-protected right to health care to those who suffer from mental illness. There is no health without mental health.
Our health ministers should know that Canadians with mental illness and their families won’t stand for being left out of the health accord again.
We can’t stand by while another 4,000 Canadians die by suicide this year.
We won’t let inaction fail another generation of Canadians.
Anything less than a meaningful investment will perpetuate the prejudice and discrimination that is familiar to Canadians with mental illness.
Plenty of time has been spent on strategy. It’s now time for action. Catherine Zahn, MD, is president and CEO of the Centre for Addiction and Mental Health.
There is a wide gap between the quality of care Canadians receive for physical ailments compared to mental illnesses