There were probably more than a few people who were surprised when they cracked open the Conservative Party’s election platform and saw that “securing mental health” was one of its five pillars, right up there with such traditional Tory grist as government accountability, job creation and deficit reduction.
The New Democratic Party has also made improving Canada’s inadequate mental-health care services a theme in this election. The pending Liberal platform will no doubt include nods. It’s a development that is both encouraging and disheartening.
Encouraging, because it’s high time Canada tackled this issue. Mental-health care is one of those medical necessities that, like prescription drugs, is partly inside medicare, but largely outside it. A rare referral to a psychiatrist is publicly insured; other forms of treatment and counselling are a very different story. Some treatments are offered as part of publicly funded social services, while people whose jobs offer employee benefits may find at least some of their costs covered.
But millions of Canadians suffering from mild to moderate mental illness are paying out of pocket for medically necessary treatments, or forgoing them altogether.
So it’s disheartening that the parties raising the subject seem more intent on profiting electorally from an issue that has been magnified by the COVID-19 pandemic than they are on addressing it.
There’s no question the pandemic has been hard on the mental health of Canadians – from children who’ve lost social contact with schoolmates, to adults who’ve struggled financially while managing their home life, to senior citizens isolated for long periods.
Anyone whose addictions, anxieties or depression overwhelmed them, and who sought counselling, would have quickly learned how hard it is to get help.
In 2018, 5.3 million Canadians sought mental-health care, according to Statistics Canada. Of those, 21 per cent reported that their needs went entirely unmet, and 22 per cent said their needs were only partly met.
People who have employee benefits that include psychotherapy can get help from private, non-physician providers, but that coverage typically maxes out quickly and doesn’t go far when one session can cost as much as $200. And an estimated 12 million Canadians do not have such employment-based benefits.
The last-resort option is hospital emergency rooms. Mental-health-related visits to Canada’s ERs increased 75 per cent from 2007 to 2018 for children and youth aged 5 to 24, according to the Canadian Institute for Health Information.
The Conservatives say they would boost funding to the provinces for mental-health care. But health care is a provincial jurisdiction; Ottawa has limited ability to direct its transfers, and the Conservatives have made a point of saying that, when it comes to health care overall, they want to offer the provinces more money – not more direction.
The Conservatives also promise tax breaks for companies that increase their employee benefits for psychotherapy, but that does little to address the underlying issue.
The NDP platform hints at the real issue, without providing details. It promises “a historic expansion of the services covered under our national health care system,” including mental-health services for “uninsured Canadians.”
That misses the point that even insured Canadians seeking care aren’t well served. But it at least raises the question Canada has to ask: Should we bring some non-MDs – psychologists, social workers and others – under the medicare umbrella, thereby publicly insuring more types of mental-health treatments?
Other countries with public-health care systems, notably Britain and Australia, have done so, while also increasing access to mental-health services, according to a study by the Mental Health Commission of Canada.
And in Nova Scotia, the Progressive Conservatives this month won a majority with a platform focused on health care. It included an unprecedented promise to “become the first province in Canada to provide all of its citizens with universal access to mental-health and addiction services.”
Is Canada as a whole ready to follow suit? It would take federal cash and a commitment to help the provinces expand publicly insured counselling services. Anything else is just electioneering.
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