Why do we continue to starve mental health?

Well over 30% of all disability claims and medical absences are due to mental illness – from stress and burnout, to depression and worse. That number is rising during the pandemic as lock-downs and social isolation follow in the wake of the physical illness that sparked it.

But mental illness not only isn’t funded to the same degree as physical illness, the level of its funding, support and treatment is shockingly less.  It’s no wonder that people suffering from mental illness can’t get timely help. They can’t access the mental health system, because that system is so small, scattered and chronically underfunded.

This was one of many insights from a report issued last week by the Royal Society of Canada on Easing the Disruption of COVID-19: Supporting the Mental Health of the People of Canada. 

Its 21 recommendations highlight the fundamental difference between our physical care system, which is largely publicly-funded, and our mental care system, which isn’t. Physicians and surgeons are paid by the provinces; psychologists and counsellors are paid by the patient. The only mental-health professionals who are doctors are psychiatrists, whose chronic shortage they themselves raise alarms about. 

This slotting of mental health into second-class status is everywhere in the system:

• Canada spends just 7.2% of its total health budget (public and private) on mental health. This is well below what most developed countries (UK 13%) spend on mental health.
• Waitlists for children with mental health issues in Ontario saw some children wait 2.5 years for help. This was before the pandemic.
• The Canadian Institutes of Health Research (CIHR) is the principal funder of health research in Canada. In 2018-19, CIHR funded grants and awards worth $1.089 billion. Of this, $28.1 million went to addictions research and $72.1 million to mental health research for a total of $100.3 million. This is just 9% of its overall funding.  

These three examples of how much Canada spends, how long its most vulnerable citizens have to wait for help, and how little its main funders allocate to find new forms of diagnosis, treatment and cure, all speak to what I would call systemic neglect.

Our mental health system has been so chronically underfunded that even the best-intentioned measures may only give it enough to keep it in a state of perpetual ill-health. 

Here are three of those measures: 

1. In the 2017 Federal budget, Ottawa pledged a modest beginning to overcome the disparity; that is $5 billion over 10 years to improve mental health care. This works out to $500 million a year, which is 0.2 percent of the $250 billion Canada spends on healthcare every year.
2. This August, recognizing the specific needs of Indigenous communities in the COVID-19 pandemic, Federal Indigenous Services Minister Marc Miller announced $82.5 million in new funding for Indigenous communities to address increased mental health needs as a result of the COVID-19 pandemic.
3. In April, Ottawa launched the Wellness Together Canada Portal. This may help Canadians with minor mental health needs. But I’d be interested to see how much it’s actually being used.

All to say, the Royal Society of Canada has done us a favour by publishing such a clear and dispassionate alarm of the rising mental health crisis in Canada and its all-too-chronic causes.