Before we answer, “Are we there yet?” let’s confirm where we’re trying to go. We’ve been trying to create a community where people suffering from mental illness can access mental health programs and services without barriers. This can be through public health care, employer-provided benefits and workplace and community-based health promotion services. We’re trying to create psychologically safe and healthy workplaces and communities. We’re committed to supporting mental health conversations and actively removing stigma.
Today, it seems the conversations are happening; Canadians are more willing to discuss and put mental health on the agenda. Since COVID-19, virtual resources have been heavily promoted and are more easily accessible than ever. But, we also know more Canadians are suffering from mental health concerns; substance use, divorce and suicide numbers are all on the rise. Eighty-four per cent of Canadians reported their mental health has worsened during COVID-19[1].
If the stigma around getting help for mental illness is decreasing but our mental health is also decreasing, a full assessment of where we are becomes timely and important.
Unfortunately, there are still so many challenges; it seems we’re not there yet. Today most mental health community programs, even within hospitals, live with funding uncertainty. Many do not have funding commitments until the moment before funding runs out. This prevents hiring and planning and is all too common.
Waitlists and therapy costs continue to be an issue. The umbrella category of “mental health adult intensive services” refers to a handful of community support programs for people with significant mental health issues. A recent CBC report found that, in the Waterloo area of Ontario, these services had nearly 300 people waiting for an average wait time of 559 days. The same report found that mental health wards are bursting at the seams. Most people cannot afford private mental health care.
Access to psychiatry is still difficult for most Canadians. Global News recently reported that people in Quebec can wait more than a year for outpatient psychiatric care. Even today, most emergency departments struggle with mental illness crisis situations. Our criminal justice system disproportionately impacts people suffering from mental illnesses. Schools, universities and our correctional system are buckling under the strain of ever-increasing mental health challenges. Children’s Mental Health Ontario released a new report stating 28,000 children and youth are currently on waitlists for treatment across the province.
While employers have expanded their coverage for mental health and increased the professionals covered by insurance, mental health professionals still cannot directly invoice the carriers. Mental health services covered by employer benefit plans require participants to pay for services and be reimbursed. Invoicing the carrier directly is a common practice for physical treatments like chiropractic, massage therapy or physiotherapy which removes the burden of being out of pocket for the treatment. The practice of directly invoicing carriers would make mental health treatment more accessible to more people, removing the out-of-pocket burden.
Perhaps now that we’ve opened the conversation and used the Bell Let’s Talk mandate to go successfully after stigma, we need to look at the next level of reform. It’s time to push for systemic changes to the Canadian mental health care system, both publicly and privately funded. To have true parity between physical and mental health treatments, we still have a long way to go. Let’s take our efforts to the next level.