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Overpromised, Underdelivered
Oct 17, 2024
Analysis of Mental Health Care Investments in the 2023 Working Together Health Bilateral Agreements
Instead of permanently funding a Canada Mental Health Transfer as committed in the Liberal Party of Canada’s 2021 election campaign platform, the federal government, under Prime Minister Justin Trudeau’s leadership, negotiated ten-year bilateral healthcare deals with each province and territory. In Overpromised, Underdelivered: Analysis of Federal Mental Health Care Investments in the 2023 Working Together Health Bilateral Agreements, new Canadian Mental Health Association (CMHA) research reveals how many of those bilateral dollars are going toward mental health services.
What’s a bilateral agreement?
A bilateral funding agreement is a deal between the federal government and a province or territory. It outlines how the federal government provides financial support, and how the province or territory will use those funds. Each agreement is tailored to meet regional needs.
Main findings from the research
The federal government says that, on average, 30 percent of the bilateral healthcare deals negotiated last year are going to mental health, addictions, and substance use health care. Our research, meanwhile, finds most provinces and territories are spending far less.
Some key findings from the research:
- On average, only 15% of the 2023 Working Together investment is going to mental health care. In fact, the median of new federal money is just 5.7%—Manitoba, PEI, and BC are not using any new bilateral dollars for mental health services.
- Addiction health services and health human resourcing were the main areas of investment identified by provinces and territories in their bilateral action plans.
- The bilateral agreements lack detail on whether funding is going to community-delivered mental health services—a distinct and vital component of mental health service delivery in Canada. Because of this, governments may not be fully addressing challenges to the healthcare system, such as health human resourcing and unmet need.
The report examines the effectiveness of bilateral agreements as a tool to meet the critical challenges in mental health, addictions, and substance use healthcare service delivery. We conclude that further federal action beyond such agreements is needed to meet the mental healthcare needs of Canadians.
In Overpromised, Underdelivered, we urge the federal government to permanently and responsibly fund mental health, addiction, and substance use health services, and to amend the Canada Health Act to address the structural exclusion of mental health services in current federal health legislation.