Canada does not fund mental health care and we are all paying for it

One in five Canadians will experience a mental health problem in any given year, and by the time a Canadian reaches 40, half will have experienced a diagnosable mental illness. In 2018, Statistics Canada found that 5.3 million Canadians needed mental health services. Although two-fifths of these (three million) had their needs fully met, another fifth (1.2 million) had their needs only partially met, and a staggering 1.7 million people were left with their needs entirely unmet. This situation has only worsened since the COVID-19 pandemic. In partnership with the Angus Reid Institute, my University of Ottawa research group conducted its own nationwide survey earlier this year and found the needs to be even more dire than we had imagined. Over half of the 1,500 respondents had sought out mental health care but experienced barriers to access. The most common difficulties were largely structural: long waitlists (62 per cent), financial barriers (58 per cent), lack of resources/professionals in the area (47 per cent), difficulty finding specialists (41 per cent), and difficulty accessing in-person care during the pandemic (34 per cent). Many did not realize how long wait-times were until they needed care for themselves or their loved ones. Delaying care for weeks or months when someone is in crisis is inhumane and medically unsound. Monnica Williams is the Canada Research Chair in Mental Health Disparities at the University of Ottawa. Photograph courtesy of Monnica Williams We further examined the experiences of more vulnerable groups. People of colour (visible minorities and Indigenous people) had more difficulty accessing care, as did younger adults and those with lower income. Race and ethnicity were related to difficulties as many could not find a clinician of the same ethnic group (25 per cent of Black respondents), someone who spoke their preferred language (22 per cent of South Asian respondents), or they had had prior negative experiences (50 per cent of Indigenous respondents). So, although Canadians from all sectors face difficulty finding care, for the most marginalized, difficulties are compounded. Provincial health plans do not cover mental health care until a patient's problems become so severe that intensive or inpatient care is needed. However, early outpatient therapy can prevent many of the crises that bring patients to emergency rooms, where last-resort care is the most expensive. There has been resistance to the idea of spending more taxpayer dollars on health care, given the perceived tax burden already borne by so many Canadians, even if theoretically it will save money in the long run. There are viable models for providing mental health care without increasing costs, but there has not been enough push for implementation. Given the amount of taxes that Canadians already pay, it is hard to understand why so many barriers occur at every level: from finding a family doctor, to having a broken arm set, to getting an MRI. Not to mention that unmet medical needs are stressful and can exacerbate mental health concerns. Canadians generally believe the United States, our closest neighbour, has a problematic health-care system that leaves the most critically ill unserved. This misperception has created widespread complacency in Canadian consumers, physicians, and policy-makers. In fact, there are some things the U.S. is doing well. Our southern neighbour actually has an excellent health provisory care system, with relatively short wait times and ample specialists. Over one-third of Americans are covered by a public insurance plan, with lower income Americans having health coverage through Medicaid (fully 25 per cent of the population), eight per cent of Americans remain uninsured for various reasons including personal choice. Further, in 1996 the U.S. passed the Mental Health Parity Act, which was expanded in 2008 and 2010, requiring private and public plans to cover mental health care at the same level as physical health. Insurance costs rose by just a tiny amount as a result of this addition. As a compassionate and progressive nation, Canada should do the same. Let’s compare one U.S. state to one Canadian province—Ontario and Illinois—which have relatively similar populations (15-million in Ontario compared to 12.7-million in Illinois) and GDP ($746-billion for Ontario compared to $775-billion in 2021). In Ontario, provincial health care spending was $5,042 per person, plus the federal health transfer of $1,128, for a total of $6,170 in 2021. Critics have noted that health-care spending in Ontario is below other provinces and continues to drop. Meanwhile, in Illinois, the government spends $14,000 per person (federal and state contribution) on Medicaid—over double what is spent on Ontarians. Stop and think about this a moment… the poorest people in Illinois receive better funded health care than every Canadian living in Ontario. In Illinois they get outpatient mental health care and prescription drug coverage, too. In fact, on average, low income Americans receive government-funded health care that is quicker, higher quality, and more comprehensive than what Canadians receive in general. But it is not good enough to boost spending if there are no mental health providers to treat people. We also need to increase the capacity of practitioner training programs and reduce barriers to licensure for foreign-trained clinicians. Further, as a nation Canada owes a generational moral debt to the Indigenous peoples whose mental health suffers at a higher rate than white Canadians due to historical trauma and ongoing discrimination. In many areas where Indigenous Canadians live there is no clean drinking water, much less any modern mental health care infrastructure or wide-spread training of Indigenous providers. One must wonder why people who live in one of the world’s wealthiest nations tolerate this state of affairs—where nearly everyone suffers from a lack of proper access, with marginalized groups suffering the most. Monnica Williams is the Canada Research Chair in Mental Health Disparities at the University of Ottawa. The Hill Times

Canada does not fund mental health care and we are all paying for it

In 2022, Angus Reid Institute and University of Ottawa nationwide survey found the mental health needs of Canadians to be even more dire than we had imagined.

Trudeau calls Ford’s health-care changes an ‘innovation,’ but some Ontario Liberal MPs call it ‘American’-style health care ‘fundamentally’ opposed to Canadian values

This Veterans’ Week, let’s demand better service and accountability

We need to uphold the Canada Health Act

Trudeau calls Ford’s health-care changes an ‘innovation,’ but some Ontario Liberal MPs call it ‘American’-style health care ‘fundamentally’ opposed to Canadian values

Canada needs a modern, national health data architecture

To address online harms, Canada must commit to digital media literacy

A cure for multiple sclerosis could be just around the corner

Renewable energy is the way to go, says letter writer

Supporting local broadcasters is critical for our democracy

Bennett’s new portfolio is our chance to start getting military mental health right, says doc

We need all hands on deck to address Canada’s mental health challenges

Community-centred, Indigenous approach needed for mental health in the North, say territory denizens

In 2021, motherhood is breaking us

Mental health key to economic recovery, but we’re running out of time

News

Get free news updates

Opinion

Submit a guest opinion article

resources

Advertise

subscribe

get help

Canada does not fund mental health care and we are all paying for it

In 2022, Angus Reid Institute and University of Ottawa nationwide survey found the mental health needs of Canadians to be even more dire than we had imagined.

Get The Policy Briefings Newsletter