The Trudeau government is facing mounting pressure to act more urgently on its election promise to create a new $4.5-billion mental health transfer — a pledge that has stalled despite critical gaps in care that are contributing to Canada’s ER crisis.
In an open letter to federal Mental Health and Addictions Minister Carolyn Bennett, 65 national health associations that represent and advocate for patients, physicians, nurses and mental health specialists are calling on Ottawa to immediately move forward with this platform pledge.
“Canada is at a critical juncture in a mounting health-care crisis, and we have grave concerns that delaying the Canada Mental Health Transfer will only exacerbate long-standing issues,” the letter to Bennett says.
As of March 2022, fewer than one in three Canadians with mental health issues were able to access care, according to results of a 12-month Leger survey commissioned by the Canadian Centre on Substance Use and Addiction and the Mental Health Commission of Canada.
The survey also found almost a third of Canadians reported moderate to severe mental health concerns since the pandemic began in 2020.
In addition, about 25 per cent of Canadians who use alcohol or cannabis reported problematic use, but only one in four could access addictions services, according to the survey.
Canada’s mental health and addictions treatment system was “broken” even before COVID-19, and the anxieties of the pandemic and nationwide gaps in care have only made things worse, says Sarah Kennell, national director of public policy with the Canadian Mental Health Association.
“We’re dealing with heightened levels of very serious mental illness and really ultimately preventable mental health issues that – should we invest in care before a crisis – can be resolved,” Kennell said.
Meanwhile, patients who need immediate mental health or addictions treatment are left with no option but to go to an emergency department.
But for months, ERs have been crumbling under the strain of nationwide staffing shortages, the ongoing COVID-19 pandemic as well as a surge in patients who don’t have access to primary care and, as a result, are presenting with more advanced illnesses.
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This has led to a cascade of temporary ER closures and ambulance diversions across the country and calls from burned-out doctors, nurses and paramedics for urgent action to stabilize the health system.
Despite this, no money for the promised new Canada mental health transfer was allocated in this year’s budget, including an initial $875 million that was supposed to have been spent or budgeted by now, according to the Liberal party’s costed 2021 election platform.
In a statement to Global News, Bennett’s office says the government remains committed to establishing a permanent Canada mental health transfer, but early engagement with partners and community-based organizations showed this new funding “must build in transparency and accountability.”
“The minister will continue to work with provinces and territories to inform the design of the new Canada mental health transfer, as well as a comprehensive, evidence-based plan with shared data on indicators and outcomes,” the statement said.
As part of this work, Ottawa is aiming to establish national standards for mental health and addiction services across the country – work that is not slated to finish until March 2023.
Kennell says developing national standards does not have to stall progress toward moving forward with the mental health transfer. The two efforts can be mounted simultaneously, she said – a sentiment also shared by the 65 national health organizations pushing for more immediate action on this promised transfer.
“It is unacceptable that we delayed the initiation of that promise any further on account of the standard development process,” Kennell said.
“Canadians are in need of mental health care and substance use health care support now, not a year from now. And we need to see that investment flow sooner rather than later.”
Debate over the stalled action on this transfer also sparked some emotional discussion in the House of Commons Thursday night.
Conservative mental health critic Todd Doherty shared a story from his own childhood detailing physical abuse that he and his brothers endured, including one incident in which his brother’s hand was forcefully placed on a stovetop burner as a form of punishment.
“I could hear the sound of his flesh burning. Oddly, I do not remember him crying or screaming, maybe because our screams drowned out his,” Doherty told the House of Commons, tears streaming down his face.
His brother has since struggled with substance abuse, Doherty said. He shared this story for the first time publicly because he says he wanted to break the stigma of talking about the real-life impacts of mental health and addictions to families across Canada, including his own.
“I know that far too many Canadians are falling through the cracks,” Doherty said.
“What we are doing just is not enough. Applying a band-aid does not help.”
NDP mental health and harm reduction critic, Gord Johns, whose call for an emergency debate on mental health led to Thursday’s four-hour discussion of the issue in the Commons, says MPs were united in their messaging that more must be done.
That means the political will is there, the government simply must take action with a greater sense of urgency, Johns said.
“Here we are, 14 months after an election, and they’re just starting to have those conversations with provinces (about the transfer),” he said.
“It’s not a priority. I mean, the stigma is really clear when it comes to mental health and substance use that this isn’t a priority of this government.”
Now, with Finance Minister Chrystia Freeland warning of “difficult days ahead” amid fears of a possible recession, Johns says he’s even more concerned about fiscal belt-tightening that could further delay progress on the promised mental health and addictions spending.
The gathering storm of financial uncertainty will only lead to more Canadians who need mental health care, he said.
If more urgent action is not taken, Canada’s already overburdened ERs will bear the brunt of the fallout, he added.
“People have nowhere to turn right now except crowded emergency rooms and we need to make sure that we’re doing the right thing and that the government follows through with their promise.”
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