We need mental health justice now

Oct 23, 2024

Notes from a Senate roundtable on mental health parity

from Margaret Eaton, National CEO

September was National Recovery Month and I wanted to share some of what was discussed at a Senate roundtable I attended with colleagues from our CMHA Ottawa branch on September 20. Based on an inquiry into the parity (or rather, disparity) between mental health and physical health, Senator Sharon Burey organized and hosted the roundtable to explore the problems and talk about possible solutions.

First, you might ask what I mean by parity. Parity means providing equal access to mental health, addiction, and substance use services on par with physical health services. But more importantly, parity means valuing mental health and physical health equally. The value we place on mental health compared to physical health determines the investment we make in the services provided for each, and right now we don’t value these equally—but we must.

The powerful voice of Lynne Vail, our CMHA Ottawa board vice-chair, leveraged her lived experience to candidly explain the gaps in service she experienced when navigating our healthcare system for chronic mental health concerns. She also spoke to the critical role of community-based care in her recovery and the life-saving services she received at CMHA Ottawa. In sharing her story, Lynne helped crystallize the urgent need for parity between physical and mental health care.

Equal access to physical and mental health care services cannot exist without equal value. Too often in Canada, effective mental and substance use health care is only available to those who can afford to pay for it, and that’s a very small portion of our population. In fact, Dr. Alexander Caudarella, the CEO of the Canadian Centre on Substance Use and Addiction, shared that treatment rates in Canada are half of those in Europe. Other data show that nearly eight percent of Canada’s population say they have unmet mental health care needs.

Lack of access to vital services is a big part of the problem we face in Canada. But so too is the lack of continuity between these services, where they do exist, and that they typically don’t consider the social determinants of health or treat the whole person. This is something we strive to deliver at our community-based CMHA branches; we call this wrap-around care and it extends beyond direct mental health and addictions programming and services to things that support people along their recovery journey. Wrap-around care includes everything from mental health literacy and programming, including suicide prevention efforts, to helping people navigate services and systems, find housing, and get the disability benefits they’re entitled to. Wrap-around services are a fundamental aspect of achieving mental health care parity because even with the best treatment, if someone doesn’t have a place to call home, we’re neglecting a foundational requirement for successful and lasting recovery.

Community-based mental health and substance use health organizations sit outside the primary care system and we’re not only underfunded and dependent on the goodwill of people who have the capacity to give, but we’re also often left out of crucial health care conversations with decision-makers and overlooked in the data collection that informs the needs of our health care system. So this conversation was an important one. And our thoughts were echoed by many in the room. People like Dr. Theresa Tam, Canada’s Chief Public Health Officer, who spoke to parity in mental health care and substance use health care, including more upstream interventions and requiring the application of an equity lens for mental health and substance use health service planning and delivery. Senator Stan Kutcher proclaimed that we can’t keep doing things the way they’ve always been done. We completely agree. We need mental health justice, and we need it now. Thankfully, CMHA continues to be a valued stakeholder in the eyes of decision-makers across all levels of government in Canada. We’re grateful to be at the table for important conversations like this one where we, with the support of dozens of organizations from across Canada, can advocate for people who don’t have the same opportunities to be heard. And so, we call on our government to amend the Canada Health Act to bring mental health care and addictions health care out of the shadows, and on par with physical healthcare. We can’t wait any longer.