Bell Let’s Talk about how Canada still doesn’t have universal mental health support.
It's been over 10+ years of Bell Let's Talk, a day that clearly reflects the serious issues with mental health that Canadians across the country are experiencing. Yet, we've seen minimal progress from our governments in providing the care Canadians so desperately need - despite our so-called "universal" health care system.
Broke your arm and need a cast? That can be arranged. Can't get out of bed for several weeks? Sorry, you're either going to need to wait for months to see a psychiatrist or pay hundreds of dollars out of pocket for a therapist to maintain your mental wellbeing and participate in society.
Did You Know?
1/3 people in Canada will experience a mental illness or substance use disorder during their lifetime
In 2020, almost 1 in every 4 hospitalizations for people aged 5-24 were for mental health conditions
Mental illness is a leading cause of disability in Canada
Proactive vs Reactive
What's "covered": According to the Canada Health Act, mental health services are only covered if provided by a doctor and/or in a hospital. So if you are in an emergency crisis, you can get responsive mental health services to address your immediate needs.
What this means: When a person gets to the point of a crisis requiring emergency mental health support, they are likely at a point where they are hurting themselves and others, where they may have lost jobs, have had financial issues, developed substance abuse issues, etc. They've gotten so deep into the hole of mental illness that it is a lot harder to get back to a place where they are healthy and a lot harder to commit to getting help.
As a country, we aren't investing in preventative care that helps a person avoid hitting rock bottom. We know wealthy people will always be able to access therapy and additional services, but what about everyone else?
There are so many people who are left self-coping and managing the best they can. They are still at work, they are still parents, and they are still going to school, but they're heavily burdened by an illness that isn't their fault.
Preventative, Well Funded, and Comprehensive Mental Health Services for all
Instead of giving them the support they need to improve their quality of life (for them and anyone they provide care for), we leave them to their own devices.
Because our system will only support them for free when the illness gets so bad that they need emergency hospital support.
If we proactively invested in universal preventative care, we could ensure these individuals move towards a version of themselves that is coping in healthy ways, have the techniques to support themselves and increase their quality of life - which in the long run, benefits our overall systems.
Barriers to Care in our 'universal' healthcare system
Millions of Canadians don't have a primary care doctor (if we can't see a doctor, the emergency room becomes the only way to access free mental health services under the Canada Health Act)
Wait times across Canada can range from several months to a year (this varies between provinces)
Community mental health support programs are often funded by and dependent on short-term grants or donations(so they may not be reliably accessible)
If a service or treatment isn't covered, many people cannot afford to pay for it.
Necessary services are often unavailable or difficult to access in rural or remote communities.
Lack of pharamacare coverage in Canada means that once you get a prescription, you may have to pay out of pocket for it.
Communities that face additional barriers to care.
People experiencing poverty and houselessness
Financial instability and/or houselessness is a significant stressors that can contribute to mental health problems. It can also affect whether a person can reach out for help, attend and pay for treatments.
Intersectional identities.
Certain folks (e.g., BIPOC, 2SLGBTQIA+, immigrants, and refugees) may struggle to get help due to factors related to social inequity and stigma within their communities.
In addition, the present day mental health services which do exist in Canada are severely lacking in cultural competency, meaning that professionals re often unequipped to address many of the most critical issues experienced by marginalized populations. Without culturally competent care being accessible, these communities may develop a systemic lack of trust in these services and create more barriers to accessing help.
Why Aren't We Doing Anything About It?
As much as public education campaigns like Bell Let's Talk can help raise awareness about Canada's mental health crisis, we desperately need is government action and policy change.
This means updating the Canada Health Act to include services such as community support, crisis lines, psychotherapy, counselling and harm reduction programs, all of which are not currently covered.
It also means investing more in mental health, which can lower healthcare costs and boost the economy in the long run! For example, research shows that every dollar invested into mental health returns $4 to $10 to the economy (not a bad deal if you ask us!).
Check-in: The Libs still haven't followed through on their promise to invest $4.5 billion into mental health. The CMHA is concerned the Lib gov is taking a "piecemeal, band-aid approach" that "will not help address the systemic challenges our mental health system faces." This is especially troubling in light of a push for greater privatization of health care.
Poor policy shouldn’t prevent care
The spirit behind the Canada Health Act was to ensure that all Canadians had access to optimal health. We see this is not the case in Canada, so shouldn't we amend these documents to ensure we support all Canadians?
One of the biggest reasons why these services aren't covered today is because we're adhering to policies and jurisdictions that were created before we fully understood (1) the interconnected nature of health and (2) that doctors aren't the only health experts.
(1) We now understand medicine to be more than just biomedical and a highly interconnected issue with numerous social determinants of health.
(2) Way back when Canada divided responsibilities between provinces and the federal government, we believed one doctor could be the expert on the entirety of a person's health. Fast forward to today, where we have doctors and specialists for each body part and system - not to mention so many paramedical health providers like psychologists, osteopaths, RMTs, etc.,
Also, we’re living in a hellscape.
We've also got to start thinking about the stuff large parts of our population have experienced, which may impact their mental health but seem "normal" because it's always been there.
What impact does white supremacy, colonialism, ablism, heteropatriarchy, capitalism, etc., have on marginalized communities? For example, what is the sustained cost of being hypervigilant as a woman alone at night? Or the cost of codeswitching? What is the cost of internalized racism, sexism, etc.?
And do we understand the impact on our minds that watching back-to-back footage of 9/11 as children did to the mind of millennials? Or what has the pandemic done to Gen Z and Gen Alpha? Not to mention the imminent climate disaster Millennials and onwards were all warned about in school that our leaders have done the bare minimum to address.
Mental health issues aren't going away; compounding social forces only increases them. We need to be investing in a system that can support Canadians.
