Mental health care must be more equitable

Shorter days and colder weather are known to heavily impact the mental health of Canadians every year, but this winter is especially difficult.

COVID-19 has brought us stricter government-imposed lockdowns, social isolation and an unprecedented economic crisis. There’s no doubt that these factors have exacerbated mental health concerns for many of us. The pandemic has affected Canadians unequally, with members of marginalized communities bearing the worst brunt. Beyond the negative physical effects of the virus there are increased cases in vulnerable populations, and a new poll suggests that recent immigrants and racialized people are reporting a higher decline in their mental health.

Now, more than ever, all people in

Canada need equitable health care, and marginalized communities especially need services that are accessible, affordable and culturally competent.

Pre-COVID, 80 per cent of Canadians were relying on their family doctors to support their mental health needs. But access to care requires private funding for outpatient services, which nearly a third of Canadians cannot afford. Yet mental-health supports continue to be vastly underfunded here.

In 2018, the Canadian Mental Health Association (CMHA) reported that just 7.2 per cent of Canada’s health budget is dedicated to mental health care. The system was already overburdened; now we are in a crisis. It is clear that mental health needs to be a “universal health care” priority.

I recently conducted a study in collaboration with the CMHA on Muslim women’s mental health. Our findings, which predate the pandemic, indicated that mental health supports were inaccessible and unaffordable for this population. The lack of insurance coverage created a high price for mental health care. Those who were lucky enough to access private insurance through employment found coverage to be short-term.

But for those without coverage, the out-of-pocket costs made much-needed services inaccessible. This is concerning, as consequences to inequitable treatment of mental illness include a decrease in life expectancy of 10 to 25 years; increased rates of other chronic medical conditions such as diabetes, cardiovascular illnesses, respiratory and infectious diseases; and higher rates of suicide.

What all of this shows is that our one-size-fits-all approach needs work. Mental-health-care supports need to be part of the solution, and we must ensure that our marginalized communities are not left behind.

I applaud the federal government’s investment of $240.5 million to help provinces and territories develop and expand virtual care tools, including mental health supports. The Wellness Together Canada portal that came from this funding provides Canadians with access to free, credible information and supports to help reinforce mental wellness.

As I look through the portal and the consortium of service providers, I wonder how an equity and inclusion lens is being applied to an initiative like this. A more inclusive approach may involve brining in community service providers like TAIBU Community Health Centre (which works towards a “model of Black health and well-being”), Naseeha, which serves clients who are predominantly Muslim, and SOCH, an initiative focused on the well-being of the South Asian community. These grassroots organizations function on tight budgets and have an understanding of the needs of the diverse clients they support.

Even before the pandemic, there was a shortage of mental health resources for minority communities, but organizations like these are picking up the slack. This is where the government can add needed resources and tap into their experiences of supporting racialized communities. As we move forward, policy change must be swift, and ensure that interventions are culturally relevant and reflective of the needs of the populations they are meant to effect.

Mental health needs to be included in universal health care funding. We also need to support local initiatives. We urgently need to commit to permanently funding these policies.

Thursday is Bell Let’s Talk Day, and now, more than ever, every action counts. I hope some of our conversation will focus on inequities in mental health services, as these can no longer be ignored.