As Canada continues to grapple with a mental health issue exacerbated by the COVID-19 pandemic, a new poll shows that a vast majority of Canadians want the government to provide universal access to systems such as therapy, medication and support groups.
The survey released Monday by the Canadian Mental Health Association (CMHA) based on an online survey of 1,626 adult Canadians conducted between April 6 and April 10, found that 87 per cent of Canadians want universal mental health care and 69 per cent believe the country is in a mental health crisis.
“If you break your leg, you know that you can go anywhere in the country and you’re going to get the same level of treatment and care. But we can’t say that about mental health,” Margaret Eaton, national CEO for the CMHA told Global News.
The idea of universal mental health care is that services are funded through public health insurance and are free to all Canadians, Eaton said.
“We think it’s wonderful that Canadians also want universal mental health care because it’s been something we’ve been talking to the federal government and to provinces about for some time now,” she said.
“A great percentage of Canadians, especially vulnerable Canadians, children and youth, the LGBTQ community, and racialized people were really affected by the pandemic and their mental health continues to suffer.”
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For example, a study published in Jama Pediatrics on Monday found an increase in depression and anxiety symptoms among youth, especially girls after the pandemic.
And a Calgary-based study published in the Lancet in March, said the pandemic increased mental distress for kids, leading to a sharp increase in emergency department visits for attempted suicide and suicide ideation among children and adolescents under the age of 19 years old.
“Universal access to mental health care is so important,” Sheri Madigan, a professor of clinical psychology based in Calgary, said, noting the influx of mental health issues that arose among youth during the pandemic.
“So we need greater access to mental health care, and that can happen by making it universally accessible,” she said.
How would universal mental health care work?
The CMHA survey found that of the 35 per cent of Canadians who have had a mental health concern in the past year, one-third have not reached out for help, primarily because it is too expensive or because they don’t know where to find it.
A majority of Canadians who receive counselling for mild-to-moderate illnesses pay out of pocket or through private insurance plans through their employer, a 2018 CMHA report found. Even if counselling is covered under insurance, the CMHA reported that it is limited, with coverage ranging from $400 to $1,500 anually.
And then there are individuals with more complex mental illnesses, which can face even greater barriers. These can range from long wait times and a lack of access to a primary physician or psychiatrist making many rely on emergency departments as their source of care, the CMHA said.
“If you don’t have an employer plan that offers you some free psychotherapy, or if you live outside of a major urban centre, you’re going to really struggle to find care for your mental health,” Eaton said.
“So Canada really doesn’t do a good job of making sure that whether you live in Nunavut or St. John’s, Newfoundland or even downtown Toronto, that you’ve got the same level of care and access to the same quality of mental health care.”
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But universal health care access could change this.
Whether it’s talk therapy, education in mindfulness or training for mental health first aid, Jean Clinton, a clinical professor in the Department of Psychology, Psychiatry and Behavioural Neurosciences at McMaster University, said the key is that anyone can access it.
She believes that Canada is in a mental health crisis that was exacerbated by the pandemic, and many people are burnt out.
“I think universal mental health care is a very, very good step in the right direction, but it needs to be comprehensive,” she said, adding that offering free talk therapy may not be enough.
Talk therapy, although beneficial, can cause huge amounts of wait time, she stressed.
For example, a 2020 report by Children’s Mental Health Ontario found the longest wait for community mental health child and youth services can reach 2.5 years in the province.
“With the numbers we’re talking about taking, we will never have enough clinicians to treat ourselves out of this problem,” she stressed.
She believes if a universal mental health system was implemented in Canada, it should also involve a public health campaign and more mental health training in schools.
Training teachers, coaches and even peers in mental health first aid could help reach many young Canadians who need immediate support, Clinton stressed.
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Barriers to universal mental health care
Funding is one of the biggest barriers to implementing a universal mental health care strategy, Eaton said.
“We really believe that that notion of universal mental health care must become something that all levels of government commit themselves to,” she said.
“We were very excited to see the creation of a possible mental health transfer from the federal government, which would be funded just like the Canada Health transfer, but they would be set aside just for mental health.”
In 2021, the Trudeau government made an election promise to create a new $4.5 billion Canada Mental Health Transfer that would be sent to provinces and territories over five years. However, there is still no information on when the transfer is happening.
“Making mental health care a full and equal part of our universal health care system is a key priority of ours, and we will continue to do whatever it takes to ensure that Canadians are able to access appropriate and timely care, by the most appropriate provider at the most appropriate place, including virtually, wherever they live,” a spokesperson for Carolyn Bennett, Canada’s minister of mental health and addictions, told Global News in an email Monday.
Another barrier is mental health stigma, Clinton said.
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“I think a huge barrier is a mentality that mental health problems are brought upon by your own deficit thinking,” she said.
“But it’s an illness, it’s not a character defect,” she added, arguing that education on destigmatizing mental health issues is key.
Some provinces, like Nova Scotia, have efforted to give their residents better access to mental health resources in the absence of a universal plan.
In 2022, the province announced it was funding an online mental health coaching program aimed at supporting people experiencing mild or moderate depression and anxiety.
The online program offers weekly one-on-one virtual coaching alongside cognitive behavioural therapy resources, which is free for all residents over the age of 16 without a referral.
The province estimated it will cost between $340,000 and $510,000 annually for the service.
Other countries have also implemented similar strategies.
The United Kingdom’s National Health Service (NHS) provides free mental health care services to all residents, including counselling, psychotherapy, and medication management.
The strategy, which was implemented in 2008, proved successful. According to the NHS, after more than a decade of this free service, about 50 per cent of patients with depression or anxiety were reported to recover and an average of seven sessions with a therapist.
Eaton says the influx of mental issues coupled with the high cost of living in Canada makes the need for better access to mental health care more important than ever.
“I feel like Canadians need to have relief from their psychological suffering,” she said. “And one way to do that is really by offering universal mental health care, free care for everyone who needs it, where they need it, and when they need it.”