It’s not that this is not true, but rather, the drastic need for mental health services was prevalent long before the presence of COVID-19.
With that said, what we can attribute to COVID-19 has been its ability to highlight the cracks and erosions in the current mental health care system in Canada. One of the biggest challenges in the current system is the ability to access mental health services. This has resulted in therapy waiting lists where patients wait for extended periods due to a lack of public funding and a shortage of mental health clinicians.
Distinguishing Between Mental Health and Mental Illness
First, it is important to differentiate between mental health and mental illness. While mental health refers to a person’s feelings, internal thoughts and emotions, examples of mental illness include (but are not limited to), mood disorders, anxiety disorders, schizophrenia, and personality disorders.
In highlighting this distinction, we must also acknowledge that a person’s mental illness status does not determine their mental health.
The Centre for Addiction and Mental Health (CAMH) has noted that the most prominent group to experience a mental illness are young people between the ages of 15 to 24. Specifically, for youth, there was a 61 percent rise in visits to the emergency department and an increase of 60 percent in mental disorder hospitalizations between 2008-09 and 2018-19.
Although mental illnesses can affect all Canadians – with 20 percent of people likely to experience this problem in any given year – there are some environmental factors that have the ability to exacerbate negative symptoms of mental illness and deteriorate mental health. These include “systemic inequalities such as racism, poverty, homelessness, discrimination, and colonial and gender-based violence”.
For example, this year on World Mental Health Day, Prime Minister Justin Trudeau spoke about addressing the root causes of mental health through “creating safe and supportive communities by investing in charities and community organizations, [supporting] seniors at home, fighting homelessness, and addressing systemic racism.”
Without a doubt, these issues need to be combated, but this has to go hand-in-hand with providing better access to mental health services for these marginalized groups in the community.
The Availability of Mental Health Services
Statistics Canada has found that regardless of the mental disorder a person had, “the most commonly reported need was for counselling.” When looking at the mental health system in Canada, these services are either inaccessible or too expensive, with Canadians spending an annual approximation of $950 million on private psychologists. If racism, poverty, and homelessness are contributing factors that cause declines in mental health, then these groups are less likely to afford private psychologists or therapists, and thus are not the ones receiving help.
In Ontario, mental illness accounts for one tenth of the burden of disease, however it is allocated only 7 percent of Ontario’s health care budget, with some estimating that it is underfunded by $1.5 billion. Such a large estimation leads to two key questions: firstly, why is mental healthcare underfunded and secondly, which areas within the mental healthcare system are underfunded? It is through the latter question where researchers and policy analysts will discover the demographic details of mental healthcare by looking at which services are not provided, which areas of Canada have better mental health services and which groups within Canada are struggling to receive mental health care.
These questions are important because around 50 percent of all Canadians live in areas where there are not enough psychiatrists, a number quantifiable when compared to the ratio recommended by the Canadian Psychiatric Association. Even worse, the number of Canadians who live in areas where there are no permanent psychiatrists is 2.3 million.
As a result, Prime Minister Trudeau has put forward the initiative of Wellness Together Canada which is a portal that offers access to mental health services online. This is part of the Government of Canada’s aim “to ensure that mental health is treated as a full and equal part of Canada’s universal public health care system.”
Critical here is the fact that this offers mental health services, such as “Grief and Loss Coaching,” “Understanding Anxiety,” and “Abdominal Breathing”. These services therefore are not much help for people experiencing a mental illness. Oftentimes, in-person interactions can be extremely beneficial in overcoming obstacles that are associated with mental health. Although this initiative offers helpful online resources, it lacks the face-to-face aspect that can be a key factor in overcoming a mental illness.
One bright light: Assertive Community Treatment Teams
Assertive Community Treatment (ACT) Teams provide care to individuals in the community with serious mental illnesses, such as schizophrenia, bipolar disorder, or major depression, occupying the gap that often emerges from a difficulty “to engage in other mental health services.”
What makes these teams unique is their multidisciplinary nature as they consist of a “social worker, nurses, vocational specialist, occupational therapist, psychiatrist, peer support worker, and an addictions specialist.” Together, these healthcare practitioners provide psychiatric treatment and medications to their patients, while allowing these individuals to remain in their community and continue their daily life with minor disruptions.
The success of ACT Teams can be found in their ability to cater to individuals’ needs, provide mobile and community services, or care in their homes – the latter a service that is often overlooked in Canada’s healthcare system.
There are a lot of different policy options and approaches that can be undertaken to address this mental health crisis. However, these approaches must work collaboratively across disciplines from start to finish. Oftentimes when people are able to access publicly funded mental health services, the few outpatient clinics available sometimes cause patients to deteriorate as their support system shrinks once they re-enter the community.
People need better access to publicly funded mental health services and a stronger focus on continuation of care within the community, especially for patients that were hospitalized. In focusing more on continuation of care this can ensure both the wellness of Canadians and reduce rehospitalizations.
“Mental health is health” and it is time we treat it as such, because pushing mental health aside is a disservice to all Canadians.