Access to mental health services is an issue that significantly impacts all Canadians, whether living with a mental illness or not. When the First Ministers convened this past February to discuss the long-term future of health care in Canada, improving access and quality of community mental health services was identified as one of eight priority areas. We believe the federal government has a critical role to play in facilitating federal/provincial/ territorial partnerships to begin to address many of the access barriers facing Canadians today.
Defining Mental Health Services
We define mental health services within the framework of the determinants of health. While medical services are necessary, they are by no means sufficient to deal with the crippling social and economic factors that often accompany serious mental illness. People also need psychosocial services to assist with activities such as securing housing, income supports, education, and employment, and resources outside the formal service system such as peer and family support or generic community organizations.
Barriers to Service Access
Timely access to needed mental health services is a critical issue facing consumers nationwide. Numerous barriers to service access include: stigma; poverty; lack of integration between mental health and health services; shortage of mental health professionals; regional disparities and cross cultural diversity. As a result, demand for services often exceeds supply. Some community-based services considered essential for recovery (e.g. prescription drugs, psychological services) are not publicly funded, and some populations (children/youth, seniors and people with severe and persistent mental illness) are in particular need.
Prevalence and Costs
20% of the population will experience a mental illness at some time in their life and a recent Health Canada report has estimated that mental disorders (including stress and distress) resulted in a total cost of $14.4 billion in 1998, placing mental illness and mental health problems amongst the most costly of all conditions in Canada.
A Call for Collaborative Federal Leadership and Action
In 2000, the Canadian Alliance on Mental Illness and Mental Health (CAMIMH), of which CMHA is a founding member, put forward A Call for Action calling for federal government leadership in developing a National Action Plan on Mental Illness and Mental Health. CMHA endorses this document as well as a recent CAMIMH consensus statement (October 2002). Our recommendations for federal leadership and strategic action build on CAMIMH’s work, while placing particular emphasis on the determinants of health and the responses required by a variety of federal departments around issues such as income security, housing, immigration and justice. As part of a National Action Plan, CMHA urges the Committee to recommend to the federal government that it take leadership in the following three areas:
- Interdepartmental, intergovernmental and intersectoral.
2. Development and Implementation of a Mental Health Human Resource Plan
- To address the shortage of trained mental health professionals, the lack of integration between mental health professionals and the health care system and the needs of vulnerable populations.
3. Development and Implementation of National Programs
- A National Public Education and Awareness Strategy;
- Measures to ensure universal access to medically necessary medications; and
- National standards on home care to meet the needs of consumers and their caregivers.