Bill C-323

An Act to amend the Excise Tax Act (mental health services)

This enactment amends the Excise Tax Act in order to exempt psychotherapy and mental health counselling services from the goods and services tax.

Excise Tax Act

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Mr. Speaker, I am honoured to rise in the House today on behalf of the residents of Kelowna—Lake Country. I would like to thank my Conservative colleague, the member for Cumberland—Colchester, for introducing private member's bill, Bill C-323. It is my privilege to second this bill and speak to it today.

Canadians are facing a mental health crisis. The statistics are alarming. Nearly 200 people attempt suicide daily. One in four Canadians is experiencing anxiety, and 56% of the people who are struggling are not receiving the care they need and deserve. According to the Canadian Mental Health Association, the CMHA, in any given year, one in five people in Canada will personally experience a mental health problem or illness. By age 40, about 50% of the population will have or have had a mental illness. This continues to be a significant issue in my community and home province of British Columbia.

Back in 2010, the Government of B.C. estimated that mental health problems cost our economy an estimated $6.6 billion annually. When looking at increasing statistics of people struggling, we can only assume this would be much higher now. The CMHA reports that about 17% of British Columbians, somewhere around 800,000 people, are experiencing a mental illness or substance use issue today. The limitation of accessing mental health services already poses a barrier to many in accessing health care and tackling our nationwide health crisis.

In addition to the ongoing addiction health crisis, Canada is faced with a crisis in mental health. An estimated 84,000 children and youth in B.C. have a diagnosed mental disorder, yet fewer than one-third of those children seeking help are receiving mental health services. That means as many as 58,000 children in B.C. are not receiving the treatment they need.

I know that I have just given a lot of statistics about unmet mental health needs. However, behind each of these statistics is a person, a family affected and a community affected. Recently, a mom from Kelowna—Lake Country reached out to let me know about a situation her child was going through where she has a physical health condition that she is attempting to get resolved. The mom says her child is dealing with mental health issues of depression and suicidal thoughts because of bullying due to her physical conditions. This is just one of many situations people have brought to my attention, and we need to do everything possible to ensure that people and families have access, in a variety of ways, to mental health services.

Right now, looking at attempted suicide rates and deaths, societally we are paying for mental anguish in the most extreme way possible. It is clear from the numbers that many people are waiting until the point of crisis. That can mean too many hospital stays and perhaps cycling through our criminal justice system instead of receiving treatment, or worse. As we heard recently, a woman came forth publicly in August to explain how she was having a mental health crisis and a clinician at Vancouver General Hospital shockingly suggested medical assistance in dying, MAID, as an option.

Bill C-323, an act to amend the Excise Tax Act, works to put health service providers on equal footing when people come to them for mental health assistance. I am proud to second this bill and speak to it today. This legislation sets to end the charging of GST or HST upon the services of psychotherapists and mental health counsellors. For context, psychotherapists and mental health counsellors are currently the only regulated mental health service providers who must remit GST or HST tax on their services. This would put them on equal footing with other health professionals.

Psychotherapy and mental health counsellors often are also not covered by many insurance providers, and the additional cost of the GST or HST on their services limits their capacity to serve many Canadians in the time of need, especially at this time of high cost of living, when paycheques are so stressed. It makes no sense for fully regulated psychotherapists and mental health counsellors to be subjected to this type of taxation when physicians, psychiatrists, registered nurses, registered psychiatric nurses, psychologists, occupational therapists and social workers are all exempt.

Health Canada has reported that 24.7% of Canadians over the age of 15 report having unmet mental health needs. We need to do everything possible to get help to people so they are not living in mental anguish and so families are not heartbroken when getting devastating phone calls no one ever wants to get, like 12 families a day do in Canada, who hear loved ones died of suicide.

The Conservatives are offering tangible solutions within federal jurisdiction to help people. This is a compassionate common sense bill.

Not only are there costs to the federal government associated with this legislation by it not happening, but any loss in tax revenue resulting from the tax exemption would likely be inconsequential in the greater scope of federal budgets. Many organizations and stakeholders, like the Canadian Counselling and Psychotherapy Association, have spoken in favour of removing the GST or HST taxes from the services of psychotherapists and mental health counsellors.

The Standing Committee on Health heard extensive testimony from Dr. Carrie Foster, president-elect of the Canadian Counselling and Psychotherapy Association at the time, and Lindsey Thomson, director of public affairs for Canadian Counselling and Psychotherapy Association earlier this year. Both witnesses expressed that this policy would help to alleviate Canada's mental health crisis.

The Liberal government has failed Canadians when it comes to supporting their mental health. As of last fall, the $4.5 billion in Canadian mental health transfer funds promised by the Liberal government in its 2021 campaign platform had yet to be fully committed. The Conservatives have taken action and continue to fight for the mental health of Canadians.

In 2020, the Conservatives successfully passed a motion to create a national three-digit suicide prevention hotline, which was put forth by our Conservative colleague, the member for Cariboo—Prince George. The 988 hotline will apparently finally be launched in November of 2023 by those slow-to-do-anything-in-government Liberals.

I recently put forth a private member's bill, Bill C-283, the end the revolving door act, which sought to get mental health assessments and addiction treatment and recovery in federal penitentiaries, as determined and offered by a judge at the time of sentencing. It would have expanded and focused the mental health and addiction recovery services available to those who found themselves repeatedly entering and exiting our criminal justice system.

It is well known that mental health and addiction issues are leading causes of recidivism in Canada. Better provision of mental health assessment and curative treatment while inside a federal penitentiary is a common sense approach to tackling this issue, helping not only those who are incarcerated but also to help the communities they go back into after their release. I was proud to have a wide base of support for this, including those confronting our mental health crisis on the front lines and who work in criminal justice.

Unfortunately, though this was a non-partisan common sense bill, the end the revolving door act was voted down by the Liberals and their NDP partner, as well as half the Green MPs, and it did not proceed. I hope the members in those parties will not waste this new opportunity we have before us today to take action for those in need of mental health services.

I was happy to see this legislation to amend the federal taxation regime on mental health professional services from my Conservative colleague as another tool to help people. The Conservatives are the ones bringing practical mental health initiatives forward with compassion and common sense. On this side of the House, the Conservatives will continue to advocate for people to fight Canada's mental health crisis.

In summary, the bill is an important step in tackling Canada's mental health crisis by removing barriers to mental health services, putting psychotherapists and mental health counsellors on equal footing with other regulated health professionals and helping to alleviate financial burdens by those struggling. That is why I am proud to support the bill, and I call on all members of the House to support this compassionate common sense legislation.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Mr. Speaker, I thank my colleague for Cumberland—Colchester for tabling this important bill, Bill C-323, an act to amend the Excise Tax Act, mental health services.

As members know, the bill would expand the category of health care services exempt from point-of-sale taxes to include psychotherapy and mental health services. Members also know that physical health services, such as chiropractic and physiotherapy services, are already exempt from federal sales taxes. Eliminating that sales taxes from psychotherapy and mental health services would be one step further and would only be fair, because there are so many other services that are so similar that do not have to provide that federal sales tax on their services.

There should not be any health care service taxes in this country. Furthermore, all services, be it mental health care, dental care, pharmacare, physical health care, need to be covered in a way that is universal and free for all people in this country. A tax exemption is a small step in the right direction, which would reduce the cost of these services directly and increase access to them, so this is an important bill.

In December 2021, I had the honour of introducing my private member's bill, Bill C-218 in the House. Interestingly, my bill would also have amended the Excise Tax Act to exempt psychotherapeutic services delivered by psychotherapists and counsellors from the goods and services tax. They say imitation is the highest form of flattery, so once again, I thank the member for Cumberland—Colchester. Ultimately, Bill C-323 is so similar to my own bill, but as someone who is 175th on the list of precedence in private members' bills, I am happy to see this bill being brought forward. I am happy to support it.

I want to bring a little bit of historical context for the introduction of why I introduced Bill C-218. It was because of a local psychotherapist in London, Stephanie Woo Dearden, a registered psychotherapist, who asked me to take action on the issue. She contacted me in the fall of 2021, and so I did my research. I discovered that this bill had actually already been previously introduced by an NDP MP, Pierre-Luc Dusseault, in 2017, and I would like to thank him for his work on this issue. Like Bill C-323, our private members' bills work to ensure that psychotherapists are treated fairly, the same as their fellow practitioners in other health care fields. This bill would work to create equality among those who do the same kind of work and are exempt from the excise tax.

I was very happy to hear my colleague's speech earlier saying that the Liberals will be supporting the bill to go to committee. However, I urge them to fully support this very simple but necessary bill so that they can rectify the blatant tax inequality that has occurred. The government says that Canadians' mental health is a priority, and this is a key opportunity for it to do something that is very easy to do to ensure that something good is done for Canadians' mental health.

Just this past March, I presented a petition in the House of Commons to remove GST from counselling therapy and psychotherapy services, and that petition received over 14,000 signatures. I thank Barbara MacCallum for bringing that forward. There were so many signatories, 14,000, because they saw that the government must act to rectify this error, and it is quite a simple thing that the government can do.

According to the Canada Revenue Agency, if a profession is regulated as a health profession by at least five provinces or territories, the services of that profession are exempt from GST/HST. Now, the profession of counselling therapy or psychotherapy meets this criteria, and it has for some time. However, a tax exemption was refused because the provinces regulating the profession had different titles, but counselling therapy and psychotherapy are the same profession, as demonstrated by a shared scope of practice, comparable qualification requirements and aligned codes of ethics. They are also recognized under the Canadian Free Trade Agreement. The federal government must respect the expertise and practices of provinces and territories in the health care field with regard to naming their professions. My bill, Bill C-218, as well as Bill C-323, demand just that.

We all know the impact that COVID-19 has had on people's mental health, and it was certainly a crisis before the pandemic. However, we are seeing the consequences on folks now, and I see it my riding.

People are stressed out, and they are worrying increasingly about their skyrocketing mortgage payments, the increase in food prices and increases of the climate crisis. All of this stress builds up, and people need more and more support. The bill is a small but good first step toward helping people, but there are a lot of barriers that get in the way of the availability of psychotherapy and counselling to the degree people need it.

As we know, right now in Canada, provinces are spending about 5% to 7% of their budgets on mental health. Some percentages, sadly, are even lower. In my province of Ontario, it is at 3% under the Conservative government, yet many OECD countries spend about 12% to 14%. In the U.K., it is higher than that.

We have a two-tiered health care system in this country when it comes to mental health. This is a huge part of the problem. Getting help should not be dependent on how much money one has. New Democrats believe that everyone should have access to mental health supports, including psychotherapy, and we believe everyone deserves timely access to a full range of mental health treatments and services.

Last spring, I held a round table and a town hall in my riding, and I would like to thank the member for Courtenay—Alberni for joining me in that discussion to discuss those key issues around mental health care. I was honoured to speak with key community leaders and hear about their challenges. We talked about the need for parity between physical and mental health in our country.

According to the report by the Mental Health Commission of Canada, fewer than one in three people with current mental health concerns is accessing mental health services. Key barriers to accessing these services are, of course, financial constraints and long wait-lists. The people around that table spoke to me about the need to meet people where they are in this discussion, so just like everyone is an individual, their mental health journey is an individual journey. Just because one form of help is right for someone, it may not be something that someone else needs, and we need to work together to figure out all those different layers and forms of help people need.

Another thing we need to change in our system is how we treat key people who are delivering the mental health care we need. Many of those frontline professionals are in jobs that do not pay them a living wage. Because they are providing urgent care or social work, they told me, they felt less valued by the system. They also felt that governments do not fund those programs adequately. Governments think these workers do these jobs solely because they want to help people, as though that altruism should be free and as though those workers do not have student loans, mortgages or bills to pay.

Many attended that round table, and they warned us that, like the frontline workers we see in the health care sector right now, mental health care workers are leaving their professions in droves because they do not have adequate pay, stable pensions, the benefits they need or safe working conditions. These services are critical, and it is up to governments to ensure that those workers have the supports they need to be able to provide the services others need.

Other mental health care workers told me that, while they see people in extreme crisis, mental illness is not the sole cause. Yes, there are people who live with a number of diagnosed psychiatric ailments, but so many whom they treat now are dealing with prolonged stress and post-traumatic stress disorder. These are caused by other factors, such as homelessness, physical sexual abuse and poverty, and these are things that the government has to address as well. The workers demanded that the government deal with these problems so that people could move away from relying so heavily upon mental services while dealing with the man-made stresses we create, ensuring that people live in these debilitating cycles.

In conclusion, the bill is a good step forward, as I have said. It is a small step, but a good step forward, and I support it because I support my own bill, so I support this one.

Canadians who are seeking help with mental health services should not be reliant upon the fact that they cannot pay for them, so I and New Democrats support the bill. I want to thank everybody who helped me to develop Bill C-218 and who will continue to work to force things such as this bill and this issue to move forward.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Mr. Speaker, I am very excited and very proud to rise today, for the first time since Parliament resumed, to represent and defend the interests of the people of my riding, whom I always represent with pride and dignity. I am talking about the good people of Rimouski-Neigette—Témiscouata—Les Basques, whom I salute.

The subject we are talking about today is very important to us. Mental health affects every Quebecker and every Canadian. In today's complex, extremely demanding and ever-changing world, more and more people are experiencing mental health problems.

In recent years, the COVID-19 pandemic has led to an explosion in the need for mental health care among Quebeckers and Canadians. Some people are even talking about a mental health crisis. The uncertainty, the anxiety and the hardship caused by this unprecedented situation have largely contributed to this secondary epidemic, which often slips under the radar. The Bloc Québécois will be supporting Bill C-323, an act to amend the Excise Tax Act (mental health services), precisely because we believe in the importance of facilitating and promoting access to mental health care. This measure is designed to improve the affordability of psychotherapy and mental health counselling services by exempting them from the GST, the goods and services tax.

As we go through the worst inflationary crisis in 40 years, it has become hard for middle-class people to make ends meet. Times are tough for many people. Everything is more expensive, including mortgages, rent, groceries, gas and equipment. When forced to choose between feeding their children or going to psychotherapy, pretty well everyone will choose the former. In that context, the Bloc Québécois believes that it is a good idea for the federal government to waive the GST on those services in order to give everyone a bit of breathing space. Investing in our mental health is always a win-win and is something to be encouraged.

Before going any further, I will answer a simple question: What is psychotherapy? Psychotherapy is a type of psychological treatment that aims to bring about changes in a person's attitude, behaviour or way of thinking so that person can feel better, find answers to their questions, solve problems, make decisions and understand themselves better. It has been regulated in Quebec since 2012 under Bill 21 from 2009, guaranteeing Quebeckers quality services.

Although mental health counselling is not a regulated profession or one subject to legal guidelines, it can be a meaningful and useful form of therapy. However, the Quebec psychologists' association points out that it is essential to check the service provider's training credentials before choosing that option, as counselling can be offered by individuals with widely varying levels of expertise and ethical obligations.

Quebec has long been a pioneer in social and health care policy. Our legislation in the field of psychotherapy in particular has been emulated by several provinces, including Ontario. We have always taken Quebeckers' well-being seriously, and that is reflected in our commitment to providing quality mental health services.

Because mental health issues are invisible, because prejudice about them persists, and because they are often taboo, mental health services are undervalued compared to other health services. However, mental health is just as essential to our health as physical health, which is why it is important to end some of the tax inequalities that still exist with respect to mental health services. For example, many health services relating to physical health are already zero-rated, such as optometry, nutrition services and occupational therapy. There is also a disparity between the various professional orders that can provide psychotherapy services. For instance, psychotherapy falls within the areas of expertise and practice of both physicians and psychologists. Since all their services are zero-rated, psychotherapy provided by a physician or psychologist is already zero-rated. If, however, it is provided by a member of one of the seven professional orders authorized to offer psychotherapy, it will be taxed.

We need to update our tax legislation to reflect the progress made in regulating psychotherapy in Quebec. Mental health services are just as essential as physical health services and it is time we treated them the same way in the tax system. Bill C-323 meets this need by levelling the playing field for all by completely eliminating the tax on these services, regardless of who provides them.

When it comes to access to mental health services, we cannot ignore the elephant in the room any longer: The inadequacy of the federal health transfers has a significant impact on our health care systems in the provinces and in Quebec.

On April 1, 2023, more than 20,400 people were waiting for mental health services in Quebec. Our public system is under pressure and, unfortunately, it will not improve any time soon because there is not enough money in the system.

We must keep in mind that Quebec and the provinces asked for $280 billion over 10 years but only received a fraction of this amount, a meagre $46 billion. This funding gap compromises our ability to meet the mental health needs of our citizens.

The Bloc Québécois would like to remind the federal government that it is still difficult to access mental health services in the public system. This is largely due to the inadequacy of health transfers.

When it comes to mental health, Quebec is not simply asking for additional funding. Since the 1980s, the Quebec government has developed mental health policies aimed at increasing access to and improving the quality of services provided to our constituents. These policies have evolved over time to adapt to the changing needs of society. We have integrated mental health care and prevention in a health and social services network since 1998. Successive action plans have strengthened this integration, fostering collaboration between health care stakeholders to speed up the healing process.

We understood that quick intervention could prevent the need for more specialized care. The most recent action plan, known as “Le Plan d’action interministériel en santé mentale 2022-2026 — S’unir pour un mieux-être collectif”, shows our ongoing commitment to mental health. This plan was developed in consultation with various community groups, researchers, workers and civil society groups. Several departments are involved, and the total investment in the plan has reached $1 billion over five years. The Quebec plan covers seven key areas and focuses on promoting mental health, improving access to care and preventing mental disorders. However, the needs are greater than ever, and we need to keep doing more.

In my riding, in the Lower St. Lawrence, requests for mental health counselling have doubled in recent years. In response to the reality of rural life and the lifestyle of agricultural workers, a farm outreach service was created by the Union des producteurs agricoles du Bas-Saint-Laurent. I am proud to support this initiative, which helps us take care of our people.

In conclusion, Bill C-323 is an important step in improving access to psychotherapy and mental health counselling services in Quebec and Canada. In keeping with Quebec's reputation as a pioneer in the field of mental health, the Bloc Québécois will be supporting this bill.

We believe in a strong, innovative, united Quebec, where everyone has access to quality mental health care. That is why we will continue to press the federal government to increase health transfers, because Quebec and the provinces need more resources to meet the rising demand for mental health care.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, it is quite difficult to deliver this intervention after the conversation we just had in the House. However, the business of the government has to continue.

I appreciate the opportunity to take part in today's second reading of a private member's bill, Bill C-323, an act to amend the Excise Tax Act in relation to mental health services. As we know, this bill would exempt supplies of psychotherapy and mental health counselling services from the goods and services tax and the harmonized sales tax, or the GST/HST. At the outset, I am pleased to announce that the government and I will be supporting this private member's bill to go forward to committee for further study.

Our government has a proven record of supporting the delivery of mental health services for Canadians, and we look forward to building on this record with Bill C-323. At the same time, my colleagues will know that our government also likes to ensure that we get things right.

The creation of tax legislation is an area of public policy where we certainly do not want to get things wrong, as the results can be particularly costly and unfair to Canadians. That is why our preference is ordinarily that tax changes, such as those proposed in Bill C-323, be undertaken through the budget process. This enables us to fully consider trade-offs, balance priorities, close potential loopholes and undertake new fiscal commitments only to the extent that they are fair and affordable.

This sort of policy safeguarding is typically undertaken by the tax professionals and lawyers at the finance department. However, when it comes to this private member's bill, Bill C-323, this responsibility will fall to us as parliamentarians. There are some important considerations that we will need to address in this regard before moving the bill past the House.

As I am not sitting on the finance committee, and I understand this bill would go to the finance committee, I would like to talk about some of the policy considerations regarding Bill C-323. I hope my colleagues, especially the member proposing the bill, whom I have the honour and privilege of sitting with on the health committee, will take note of this.

We know, for example, that the policy underlying the GST/HST treatment of the health care sector generally exempts basic health care services from the GST/HST. We also know that, to determine which services should be considered basic health care services for the purpose of ascertaining eligibility for this exemption, the federal government looks to provincial funding and regulatory practices as key criteria. This is appropriate, since they are on the front lines in delivering health care to Canadians. More specifically, if a service is covered by the health care plan of two or more provinces, it may be exempted from the GST/HST in all provinces. Likewise, if a profession is regulated as a health care profession by at least five provinces, the services of that profession may be exempt from the GST/HST in all provinces.

Under the status quo, psychotherapy and mental health counselling are not covered by the public health insurance program of any province and are not regulated in at least five provinces; this is why they are not eligible to be considered for a GST/HST exemption. Psychotherapy services provided by a psychologist or other health professional, such as a physician, nurse or social worker, are already exempt if the services are within the scope of practice of their profession.

In short, provincial policies currently determine what medical services should be considered for a GST/HST exemption, and it is based on these policies that psychotherapy and mental health counselling are not currently exempt from the GST/HST. I think we have to bear this in mind and remain sensitive to the fact that we are doing a bit of an end run around this process as we move forward with Bill C-323.

Exempting the GST and HST on psychotherapy and mental health counselling services, as proposed by Bill C-323, could undermine the long-standing criteria established by deciding whether services of recognized health practitioners should be GST and HST exempt. This, in turn, could make it more difficult to make objective decisions on any future requests to exempt other services.

There are important questions related to this bill that must be examined more closely at committee. The most fundamental one is whether this bill will apply in the same way in each province. This is a basic question of fairness for all Canadians. I think we need to also better understand how each province regulates the health care practitioners this bill targets and how each province defines the services it provides for the purpose of health care.

Should this bill make it to the finance committee, with our government's support it is our hope that provincial health officials, mental health service providers, mental health advocates and other experts can testify to shed light on these issues that I have discussed.

On a completely personal note, since 2015, I have had the honour and privilege of being a member of this House. I have always advocated for parity when it comes to mental and physical health. I believe this might be a gateway for us to open that conversation. Although I know this is a narrow passage, I think it is a great opportunity for us to engage in a broader conversation. Naturally, it will not be at the finance committee. However, it is something we should consider.

I just want to quickly talk about a few of our government's achievements and focus in support of mental health since 2015. Canadians can rest assured that our government has already made it a top priority to invest in mental health services for Canadians and will move forward on this basis.

I want to talk about the most recent budget, budget 2023, which proposes to provide a total of $359 million over five years starting in 2023-24, with $5.7 million ongoing, and a $1.3-million remaining amortization in support of the renewed Canadian drug and substance strategy, which will guide our government's work to save lives and protect the health and safety of Canadians. Also, our government has provided about $158 million over three years, starting in 2023-24, to the Public Health Agency of Canada to support the implementation and operation of the 988 suicide prevention line.

In conclusion, I would like to highlight the fact that we are making investments because a strong and effective public health care system is essential to the well-being of Canadians, which includes mental health care. It is also an important foundation of a growing, healthy economy. Our economy is stronger when people are healthy and can get the care they need before a complication arises or they are in crisis. Our government will move forward in supporting Bill C-323 on this understanding, but we also want to make sure that we get it right. We look forward to hearing from key stakeholders at the finance committee.

Once again I thank my colleague for bringing this bill forward. Many constituents in my riding are looking forward to having this bill passed, and hopefully amended, to address the concerns we have so they can get the services that are much needed in the community. I look forward to the debate on the bill at the finance committee.

The House resumed from April 25 consideration of the motion that Bill C-323, An Act to amend the Excise Tax Act (mental health services), be read the second time and referred to a committee.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Thank you, Mr. Speaker.

Today feels somewhat exciting because what my colleague has put forth is a simple, tangible action item that will move the needle in opening access to mental health supports. The member for Cumberland—Colchester, who also happens to be a doctor, has put forth a private member's bill, Bill C-323, An Act to amend the Excise Tax Act (mental health services).

Currently, many health services, including optometry, chiropractic, physiotherapy, foot care, acupuncture and many other services, are exempt from charging goods and services taxes. That means GST or HST depending on which province someone lives in.

However, psychotherapy and mental health counselling are not exempt, meaning the service provider must charge tax. If we remove the tax, that would work out to about every eighth appointment being free. The reality is many Canadians do not have coverage for psychotherapy and mental health counselling. This would make a difference.

This would also help alleviate the administrative stress on the providers. As I outlined earlier, these professionals are already managing an incredible workload to meet the demand. This would be a small but important step in making things more manageable.

According to the Centre for Addiction and Mental Health, or CAMH, psychotherapy is a general term used to describe a form of treatment that is based on talking work done with a therapist. The aim is to relieve distress by discussing and expressing feelings; to help change attitudes, behaviours and habits that may be unhelpful; and to promote a more constructive and adaptive way of coping. Successful psychotherapy depends on a supportive, comfortable relationship with a trusted therapist.

Psychotherapy can be life changing for many people. It can be maintenance of one's mental health, like visiting the gym to keep one's body healthy. One of my favourite sayings is by Fred Rogers, that anything mentionable is manageable. That is exactly what psychotherapy provides: the ability to identify and name behaviours and feelings so people can better manage them.

I would love to see everyone have access to psychotherapy. This bill is a great stepping stone to making that happen, by making it more affordable and also highlighting how important and valuable this service is.

One of the biggest hurdles in accessing support is asking for help. We have come a long way in how we talk about mental health, but we have a lot farther to go. Acknowledging access to mental health counselling and psychotherapy is a healthy and credible way to take care of oneself and it is wonderful, but now we must ensure people have access when they ask for it and ensure those services are affordable.

The president of the Canadian Paediatric Society said that behavioural and psychosocial problems “serious enough to disrupt functioning and development affect approximately 1.2 million youth in Canada” and “fewer than 20%...receive appropriate treatment.” Furthermore, he told the committee that support services can be very difficult to access and that sometimes this lack of access to specialized services results in a doctor prescribing medications. We have an addiction crisis. We should not discount how much this is connected.

I want to leave everyone with a message from Dr. Stuart Shanker, another witness from the status of women committee. Dr. Shanker studies neuroscience and is a leader in teaching thousands of people about self-regulation. In his testimony, he said, “You can change every single kid's trajectory”. This goes for adults too.

The science shows it takes a lot of different ingredients, but when someone is able to access them, the results can be wonderful and life changing.

I would say to everyone at home that wherever they are in their mental health journey, it is not permanent. There are amazing resources and people to help. Their life matters and they matter.

Today, I ask every member in this House to support Bill C-323, a private member's bill which says to Canadians that this House cares about mental health, that this House recognizes the value of psychotherapy and mental health counselling, and that this House is making it a priority to make it easier to access and to make it more affordable.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Mr. Speaker, before I get started, I want to spend a minute thanking my colleague from Cumberland—Colchester for tabling this important bill, Bill C-323, an act to amend the Excise Tax Act for mental health services. As we know, this bill would expand the category of health care services exempt from point-of-sale taxes to include psychotherapy and mental health services. As I stated earlier, my colleague from London—Fanshawe tabled a very similar bill a while ago, and I was glad to see that my Conservative colleague stepped forward and moved forward with this bill, because he is much higher in the order of precedence.

We know that physical health services such as optometric, chiropractic and physiotherapy services are already exempt from federal sales taxes. Eliminating federal sales taxes from psychotherapy and mental health services would be a step forward, but, really and truly, there should be no taxes on any health care in this country. A tax exemption would reduce the cost of these services directly, by increasing access to them, but it is not the complete solution, as I stated earlier. Taxes are certainly a barrier, and it would help with that, but many Canadians still cannot afford these services, which are critical, especially in the crisis that we are seeing right now with mental health. In terms of increasing the availabilityof these services, it does not do that, but it does reduce barriers for those who can afford, or barely afford, to access these services.

As we know, right now in Canada, provinces are spending about 5% to 7% of their budget on mental health. Actually, some are even lower. Ontario is at 3%, under its Conservative government. OECD countries are at 12% to 14%. The U.K. is at the higher end of that.

We know we have to do more to create parity between mental and physical health in this country. We have a two-tiered health care system when it comes to mental health in this country; we truly do. We know that Conservatives believe that we should have a two-tiered health care system when it comes to our physical health in this country. As New Democrats, we believe that everybody should have access to mental health supports, including psychotherapy, and we believe that everybody deserves timely access to a full range of a mental health treatments and services regardless of their ability to pay. We talked about the need for parity between physical and mental health in our country and the importance of that.

Like I said, my colleague from London—Fanshawe tabled Bill C-218 to take a step forward and to remove barriers. According to a report by the Mental Health Commission of Canada, almost 35% of respondents report moderate to severe mental health concerns. Fewer than one in three people with current mental health concerns are accessing mental health services. A key barrier to accessing services includes financial constraints and long wait-lists, so this does move a few people along. It is really important that we move forward. We know that counselling and psychotherapy are the most unmet needs of Canadians seeking help with mental health care. We are very appreciative of this bill.

My colleague highlighted earlier, and I really appreciate his doing this, that Canadians' mental health concerns have worsened throughout the pandemic. We have seen that. Again, Canadians are experiencing more and more difficulty making ends meet as they deal with increased inflation, a cost of living crisis and stagnating wages, so reducing the cost of access to services and, of course, treatment is important. Increasing the access to treatment for all Canadians who need it, by reducing financial barriers, is critical. We just want to highlight that one in four Canadians cannot pay right now for a $500 emergency. Mental health treatment can easily far exceed this cost.

I want to talk a bit about our party's history on this. A 2017 NDP-sponsored bill would have removed GST from psychotherapy services. Bill C-218, sponsored by my colleague from London—Fanshawe, would also have removed GST from psychotherapy services. It is currently out of the order of precedence, so, again, we commend our colleague for moving this forward. The same colleague from London—Fanshawe presented a petition to the House of Commons to remove GST from counselling therapy and psychotherapy services. That petition received over 14,000 signatures.

When the Conservatives' order of precedence comes forward, we do like it when they take NDP bills. This is something we are just starting to get used to.

Members will recall that Scott Duvall, my friend from Hamilton, a former MP for Hamilton Mountain, brought forward a bill on pension theft to protect pensioners and their pensions from corporations that were going after their pensions. We were glad to see that a Conservative colleague took his bill and advanced it. The Conservatives had voted against a very similar bill when they were in government before the current Liberal government.

Also the small business transfer really started with the late Jack Layton. He brought that idea forward. It was carried by Guy Caron. We were glad to see the Conservatives advance another NDP bill.

These are important bills. I really think that is the spirit of Private Members' Business, members working collectively together trying to find pathways to support Canadians. This is another example of that.

A 2023 finance committee report included the following recommendation:

Recommendation 32

Exempt counselling therapy and psychotherapy from the application of GST/HST.

This is something that was supported at finance committee and now is being advanced here in the House. This is great news.

We hear from stakeholders who are concerned about the lack of access to mental health services and the lack of availability. As New Democrats, we want to increase both. I stated that this bill might not increase availability, but it will certainly increase access to services by reducing costs.

Almost all Canadians support publicly funding mental health care, making it the same as physical health care, creating parity. Ninety-four per cent of Canadians think that provincial and territorial government health plans should cover mental health care. This was according to a study done as recently as 2019.

My colleague talked about New Democrats always going for the home run. If we want to talk in baseball terms, I would say this is a bunt. It is getting some people to first base. We actually could go for the home run. As New Democrats, we have proven that with our dental care plan to make sure that children under 12 get access to dental care. We hit second base this year with seniors and people living with disabilities. Next year we hit third base with all families that earn $90,000 or less.

We are going to hit a home run. Some day I hope that everybody in this country has access to dental care. If we brought forward a bill saying that we were going to remove GST from teeth cleaning, I do not think many kids would get their teeth cleaned. I will be really honest, it might be a step forward, and maybe a few might get their teeth cleaned, but we believe, as New Democrats, that we actually can hit some home runs in here.

I want to work with my colleague, and I hope he wants to work with me too, to hit a home run when it comes to mental health and making sure that people get access to treatment. I believe we can do it. I think we can do better than a bunt. We can get to first base, second base, third base and a home run, if we set out a plan and if we work together, which is really important.

One thing I was really disappointed about, and I have heard this from my colleagues on this side, is that the Liberal government is trying to find barriers to supporting this bill on a definition, on terms of what identifies psychotherapy and mental health. We have some really well-paid public servants who I am sure could make some recommendations at committee. Let us get the bill to committee. Let us do the right thing and work collectively.

This is a step. I support the bunt all the way. Let us get to first base. Let us get this to committee. Let us move this forward. However, the government has to get behind this. It always tries to find a barrier. I do not know what it is about Private Members' Business. Maybe the government feels like it is not going to get credit for it and it just wants to go out and oppose it. There are a lot of really smart people in this House. I want to thank my colleague, because he is one of them. He is a physician. He has experience in this, and he is trying to move things forward.

I want to support him. My team wants to support him. This is supported by a tax-free therapy campaign. This is really important. It is supported by mental health providers.

Also, when it comes to gender parity, women and gender-diverse people are disproportionately impacted by the costs of and barriers to health care. They would benefit from this bill. It is really important that we support the bill.

In closing, I want to thank my colleague. I hope all members in this House will get behind this bill, a bill that we clearly support. We tabled a bill almost identical to it earlier in this Parliament. Let us start removing more barriers from people getting access to mental health care in this country.

[Claude DeBellefeuille, Bloc, Salaberry—Suroît, QC]

Mr. Speaker, I am very pleased to rise in the House this evening to speak to Bill C-323, which was introduced by the member for Cumberland—Colchester. I know that my Conservative colleague is a physician and, quite honestly, he is to be commended for introducing this bill. Sometimes we wonder whether we can really make a difference in people's lives as members of Parliament. This evening, I get the feeling that, yes, by supporting this bill, the Bloc Québécois will be helping improve the lives of people who need it.

First of all, it is important to point out that, right now, only physicians and psychologists have the right to GST exemptions. That does not make any sense, because we know that psychotherapy is now carefully regulated in Quebec and that there are professional bodies that have the right to regulate the professional service of psychotherapy using very strict criteria.

When a person in Quebec has a problem, their first instinct is not necessarily to call the federal mental health help line. If a person needs help in Quebec, they will first turn to their local community service centre, or CLSC, which helps people with anxiety, or they will turn to a support group. I am lucky because there are three great mental health support groups in my riding, namely Psycohésion, Ancres et Ailes and Le Dahlia. These groups help people every day and welcome them into their organizations to give them support and foster a feeling of solidarity with others in the group. These services are provided by community groups specializing in mental health, which, by the way, are not funded by Ottawa. They are entirely funded by Quebec.

As far as psychotherapy services are concerned, it may be worth repeating that Quebec passed legislation in 2009 that very clearly regulates psychotherapy. First, psychotherapists are required to be members of a professional association. Having spoken to osteopaths in Quebec, I can say that obtaining a professional designation is an exceedingly long and demanding process. Osteopaths are required to charge GST because their services are not considered psychotherapy. What is more, since they are not yet members of a professional body, they cannot make representations or participate in negotiations. It is very hard to become a member of a professional body. Professional designations are very strictly regulated.

Furthermore, to practise psychotherapy, a person needs to have a master's degree. That means doing an undergraduate degree first and then a master's in a very specific field related to psychotherapy. The person also needs to have 765 hours of training in psychotherapy at the university level. That is a lot, because added to that is 600 hours of a work placement, where the student provides psychotherapy consultation services under the supervision of a psychologist or a member of another professional body that is eligible to provide psychotherapy. In Quebec, it is very strictly regulated. The member introducing this bill is right to introduce it, because the current situation is unfair. It is not right.

As I often mention, I am a social worker and a member of my professional association. If I were to take all the required courses and complete a work placement, I could become a psychotherapist, but my clients would pay the GST. However, if they go see the psychologist in the office next door, they would not pay the GST. That is completely unfair and unjust.

I have a great deal of respect for my colleague, because, as a physician, he has the humility to say that other professionals besides doctors and psychologists have the ability, the intelligence, the competence and the knowledge required to support people through psychotherapy, and he agrees that these people should have the same privilege as he does of not having to charge the GST.

It is very difficult to access mental health services. If these services were provided only by psychologists and doctors, many people in Quebec would not get help. That is why it is a shared responsibility.

Social workers and psychologists may take different therapeutic approaches, but both are equally effective for supporting someone who has a problem or who wants to be supported in a certain decision in his or her life plan, someone who is experiencing upheaval, shock or trauma and who wants to be supported and treated by professionals. The bill recognizes that this professional association has the right to provide psychotherapy based on the criteria I mentioned earlier.

We hear a lot about mental health. I heard the member for Sherbrooke praising her government, but one thing is certain. Our support for this bill is meant as a concrete gesture to make a difference for people who seek help from various professionals who are able to support them in their psychotherapy. It is also our way of telling people that if they need help, there are many professions that can help them and that are all equally professional.

Mental health is a professional field, an action, that belongs to the provinces. Local community service centres and community groups are in the best position to lend support to people in distress. Having a federal crisis line that competes with the Quebec crisis line will not provide better support. It is just confusing.

Go to our ridings and ask anyone who is depressed and thinking about ending their life who they will call first. If they need help, their thoughts will turn to crisis lines like Tel-Aide, Kids Help Phone, or other community agencies in their riding. They will think about the social worker they visited at the local community service centre or the psychoeducator at their community support group who talked to them and treated them like someone who is different, but who has problems.

If a person is really in a bind and really in distress, they would never think to call a federal help line. I have looked at the federal portal that my colleague from Sherbrooke was talking about. It is true that there is a lot of information available there, but Quebec already has a help line. I do not know whether the other provinces do or not, but we have many different help lines for all sorts of people.

I am sure members will understand that I am not thrilled to see the federal government infringing on Quebec's jurisdiction when it comes to mental health, because all that is going to do is cause confusion in Quebec. When someone is not doing well, they do not need a whole bunch of telephone numbers and a big directory to know who to call. They really need to be connected to their community. The best place to be and the best support a person can get in their community is from their family, friends, local community service centre and community groups. Those are the people who will help the individual move forward and get through difficult times.

The Bloc Québécois is really pleased to support Bill C‑323 to make a real difference in the lives of those who need help and to offer them a GST exemption.

[Élisabeth Brière, Liberal, Parliamentary Secretary to the Minister of Mental Health and Addictions and Associate Minister of Health]

Mr. Speaker, I am pleased to be able to take part in today's debate on Bill C‑323, an act to amend the Excise Tax Act with regard to mental health services.

I want to thank the member for Cumberland—Colchester for bringing forward this important subject. The MP for London—Fanshawe also introduced a bill on this subject.

The bill would exempt psychotherapy and mental health counselling services from the goods and services tax and the harmonized sales tax.

I would begin by pointing out that our government has been taking meaningful action to support mental health care services for Canadians since 2015.

These investments include $5 billion over 10 years to provinces and territories starting in 2017 to improve and increase the availability of mental health and addiction services.

The toxic drug and overdose crisis claims the lives of 20 Canadians a day, on average. Many of them are homeless and have mental health problems. That has a major impact on our communities, our health care systems and our social services.

To address this crisis and save lives, we have invested more than $800 million since 2017. We have restored harm reduction as an essential pillar of our strategy and work to support a compassionate and evidence-based response to the overdose crisis and the stigma associated with it.

Since 2020, we have also invested over $270 million in the Wellness Together Canada portal, which gives Canadians free tools and support for their health and well-being.

Starting in 2021, we began delivering $100 million over three years to support projects for innovative mental health interventions for populations disproportionately impacted by COVID, including health care workers, frontline workers, youth, seniors, persons with disabilities, indigenous people and racialized communities.

Since last year, we have begun investing $1.5 billion over six years to support trauma-informed, culturally appropriate, indigenous-led services to improve mental wellness, including over $825 million through budget 2021 and budget 2022 to support distinctions-based mental health and wellness strategies with first nations, Inuit, and Métis peoples.

Building on these historic investments, budget 2023 proposes significant new funding to build upon and complement the substantial existing investments for mental health and substance use supports for Canadians.

On February 7, we announced an investment of nearly $200 billion over 10 years to improve health care services for Canadians, including mental health care services. This commitment includes billions of dollars in additional federal funding transferred to the provinces and territories to improve health and mental health care over the coming years through a combination of an increase in the Canada health transfer and an additional $25 billion over 10 years to support bilateral agreements with the provinces and territories.

The new FPT bilateral agreements include an integrated inclusive approach to mental health in family health services, the health workforce, as well as data and digital tools. These investments will support the health and mental health needs of Canadians and will require provinces and territories to produce detailed action plans.

This approach is the most effective way to integrate mental health and substance use services into the health care system, including primary care, and to ensure transparency and accountability on the part of the provinces and territories as to how this funding is spent and where it is spent.

In addition, budget 2023 proposes to provide a total of $359.2 million over five years starting in 2023-24 to support a renewed Canadian drugs and substances strategy.

Budget 2023 also proposes providing $158.4 million over three years, starting in 2023‑24, to support the implementation and operation of the new national suicide prevention line, 988.

We have partnered with CAMH to oversee the implementation of this new crisis line and we are working closely with our U.S. counterparts to learn from their four-year implementation process for the similar service they launched last year.

We know that the fundamental principle of Bill C‑323 is to make mental health services more accessible and that is a principle we support.

However, our government also appreciates that tax changes, like those proposed in Bill C-323, should ideally be undertaken through the budget process, extensive debate and in discussion with provinces and territories. This enables us to fully consider trade-offs, balance priorities, close potential loopholes and undertake new fiscal commitments only to the extent that they are fair and affordable.

In short, this approach ensures consistency with the tax framework and the uniformity of the entire tax system. Making a tax exemption through the ad hoc passage of a private member's bill such as Bill C-323 has the potential to undermine this process.

Viewed through this lens, this bill raises a number of issues.

Because health care is essentially a provincial responsibility, the federal government uses provincial funding and regulatory practices as criteria to determine which services should be considered basic health care services for taxation purposes.

In this regard, if a service is covered by the health care plan of two or more provinces, it may be considered basic health care and exempted from the GST/HST in all provinces. Likewise, if a profession is regulated as a health care profession by at least five provinces, the services of that profession may be exempted from the GST/HST in all provinces.

However, psychotherapy and mental health counselling are not currently covered by the public health system in any province and are not regulated in at least five provinces.

This means that exempting the GST/HST on psychotherapy and mental health counselling services as proposed by Bill C-323 could undermine the long-standing criteria established for determining the GST/HST status of health care services.

Consequently, this could make it more difficult to make objective decisions about any possible future efforts to exempt other services.

While psychotherapy and mental health counselling services do not currently meet any of the long-standing criteria that were established to determine which health care services supplied by health care practitioners should be exempt, psychotherapy services provided by a psychologist or other regulated health professional such as a physician, nurse or social worker do meet the criteria and are already exempt if the services are within the scope of practice of their profession.

We look forward to exploring these issues through the legislative process. In particular, whether the bill would apply in the same way in each province is an important issue to be explored through debate. This is a basic question of fairness for Canadians.

We look forward to exploring these issues through the legislative process and, in particular, whether the bill would apply in the same way in each province. That is an important issue that should be discussed in this debate.

Canadians deserve to have access to the mental health services they need.

Canadians deserve to have access to the mental health services they need. That is why our government is committed to ensuring that mental health care is treated as an equal and integral part of Canada's universal health care system.

While we do support removing barriers to Canadians' access to mental health support, it is my hope that the considerations that I noted earlier will be addressed through parliamentary debate and review.

[Élisabeth Brière, Liberal, Parliamentary Secretary to the Minister of Mental Health and Addictions and Associate Minister of Health]

Mr. Speaker, I thank my colleague for his speech and for introducing Bill C-323.

The basic objective of the bill is to expand access to mental health services, and we agree with that. However, given that the majority of provinces do not yet have a definition for psychotherapy and mental health counselling services, how can we ensure that the bill will be applied in the same way in every province?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

moved that Bill C-323, An Act to amend the Excise Tax Act (mental health services), be read the second time and referred to a committee.

Mr. Speaker, it is a pleasure to be here this evening to introduce this bill, which would exempt psychotherapy and mental health counselling services from the goods and services tax. There is a mental health crisis in Canada. Unfortunately, these problems affect 33% of Canadians, from the youngest to the oldest. This is serious. It is a very serious problem.

This evening I rise to address an extremely troubling issue for Canadians, which is mental health. It is very difficult to capture exactly what we are talking about when we speak of mental health. I will talk a bit about it, as we go forward, in multiple areas, using my experience as a physician over the last 30 years, and about what it means to me and those folks whom I have had the opportunity to treat with respect to their mental health.

Before I start that, though, I want to read a letter I received today:

Good morning Dr. Ellis,

We met in April last year...and had a memorable discussion about the impact of the tax on psychotherapy and counselling therapy services on your constituents. I am now a full-time clinician working with children and youth, and our conversation especially touched on the main barriers to mental health care for these vulnerable young people in Canada.... I have followed this issue closely. I appreciate that you called [the Canadian Counselling and Psychotherapy Association] to speak before HESA, and your commitment to rectifying this issue through your Bill C-323.

As you likely know, our parliamentary petition e-4126 [has] been rejected by the Government due to semantics over the different regulatory titles of our profession in the various regulated provinces. Unfortunately, I now need to increase my fees in order to account for this unfair tax. I am deeply concerned about the financial strain it will have on my clients, and clients of all clinicians across Canada and in your constituency. Inflation has significantly increased the cost of psychotherapy and counselling therapy services.

It causes me considerable discomfort to have to read that here and underscore the importance of the need to change the unfair Excise Tax Act. We know that many therapists who help to look after the mental health of Canadians do not charge tax on their services. For instance, psychologists, psychiatrists and family doctors do not have to charge HST on their services.

The difficulty here is access. We all know that when someone is referred for treatment for mental health issues in Canada, it takes an inordinate amount of time to access those services. That is one of the things I have learned, having been a family doctor. Actually, I graduated from medical school 30 years ago this year, which is shocking since I was 12 when I graduated. Doogie Howser was my name. I am just joking; this is a serious subject.

That being said, I think it is important to say that, as clinicians, one thing we understand is that when someone comes into our office and has finally made the decision and realized that they are suffering with a mental health problem, they want treatment and they want it now. The sad state of affairs that exists in Canada is that we are not able to provide that. Of course, delays may easily mean someone does not get the treatment they need, only to then slip further into the issues they have. That presents a significant difficulty.

We know there is a significant range of mental health issues we can see from a clinician's perspective. Whether it is an issue with a young person whose relationship is breaking up, more severe depressive type symptoms or generalized anxiety disorder, there is a whole host of issues, all the way to schizophrenia and depression in later years in seniors. All of those things form the basis of what we understand as mental health.

There have been considerable efforts made around the world, and in Canada in particular, to look at mental health issues and make it more acceptable to speak out loud about mental health so that people know speaking about it is what will allow them to seek out the help and services they need. However, those services may not be available. It would be an absolute shame if someone has made that decision and then is unable to receive the services they need.

Mental health, of course, affects our physical health. Often, as a family physician, I would spend a lot of time in the office trying to understand exactly what was wrong with someone. A common presentation, like maybe insomnia, a lack of ability to sleep or feeling tired all the time, requires a significant amount of workup to ensure there is no physical health problem.

Oftentimes, I would go down that road of understanding and try to convince somebody that their problem lies with an illness such as depression. Once they are convinced of that, which is not always the case, then of course the treatment regime is what follows. It could be medications, but counselling is an essential part of treatment to help people begin to undo some of the negative thought processes they have and help them with a more resilient type of thinking for the future.

We know that those two things go hand in hand. They are essential. Again, there is a multitude of ways to receive that type of treatment, but we know that psychotherapy and mental health counselling can be a significant part of it.

With the letter I read, we know very clearly that there is a significant financial burden on folks who are working in this industry and how difficult it is for people who are coming forward. Oftentimes, psychotherapy services and mental health counselling services, for those fortunate enough to have a health care plan, have a limit within a plan. Often there is no coverage, of course, for those not fortunate enough to have a health care plan.

That means, specifically for these two types of services, that people are paying GST or HST on top of a significant amount, perhaps $150, $175, $200 or $250 an hour, to receive those types of services. Of course, as we all know by doing simple math, that can add up fairly quickly, which becomes a disincentive. If we do the math quickly, we can understand that if we remove this tax from these services, almost every eighth visit will be free for a person. To me, that is a significant issue.

Another thing I want to mention is the breadth of Canadians who are affected by mental health issues. I had the opportunity to speak to some international medical graduates this past week in the Toronto area who were in this country from two years to 28 years. Unfortunately, as we know, with the systems that exist, all 15 folks I had the opportunity to speak with were unable to gain licensure here in Canada as physicians. They worked as lab techs, security guards and physician assistants, and some of them had moved on. One guy rose through the ranks to be vice-president of a company. They were all very well-educated and hard-working folks.

The other part of this is that sadly, Canada, in the international medical community, has become known as the graveyard for doctors. That is the term they use. When they come here, they get in an interminable cycle that does not allow them to practise. Why am I talking about this? It is not because we have this great program called the blue seal program, which would eliminate these problems. It is because of the heart-wrenching stories I heard from these international medical graduates, who were very well trained in their own country.

One of the telling stories I heard was of a gentleman who said his children knew that he was a physician, but when he went to work, they asked why he was dressing up in a security guard uniform. When we hear that, we can understand the heart-wrenching nature of the amount of effort that all of these folks put into their work, into their profession, which they are unable to practise here. I could tell that the tears were very close to the surface and ready to flow.

That is an important story because we know, as I said at the beginning, that mental health can affect people of younger ages all the way to the end of life. We know that is a significant issue. We also know that there are other significant groups, such as racialized minorities, immigrants and people who identify as part of the LGBTQ community, that suffer with more mental illness than other portions of the population. We need to understand that mental illness affects everybody across every spectrum of the population in Canada. It is a very important thing we need to underscore.

We also need to understand that the health care system is failing us. We know that in Canada, some services in mental health care are paid for, such as in my province of Nova Scotia, but we also know that for expenses in health care, Canada is ranked first among 30 OECD countries in percentage of health care spending as part of the economy. We know that we are severely lacking in doctors per 1,000 people, in specialist wait times and in access to resources. For this reason, we know that when the government has the opportunity to make changes on some very specific things, that could perhaps cross party lines if there is something we can significantly do about it.

It behooves us to look at a few things regarding the way the pandemic has impacted the mental health of Canadians.

We certainly know that youth have been significantly affected, more so than other segments of the population. Since COVID-19, fewer Canadians report having excellent or very good mental health. It was 68% in 2019 and it was down to 55% in July 2020. Prior to COVID, youth aged 15 to 24 were the least likely to report excellent or very good mental health, a sad state in and of itself, but they reported the greatest decline, a 20 percentage point reduction, from 60% pre-COVID to, sadly, 40% in July 2020. Inexplicably, it appears that seniors age 65 and older have not experienced declines in mental health since the pandemic began. As I mentioned previously, women continue to report lower levels of mental health compared with men, from 52% to 58%.

Another very important thing to note is that there are groups in Canada doing very good work. I will give a shout-out to my daughter, Allison Fitzgerald, who was on TV this morning talking about Kids Help Phone, which has done excellent work. It has some shocking numbers, though, when we think about it. Since the pandemic began, it has had 14 million interactions with youth in Canada. We know that is a significant issue that continues to come forward.

The Canadian Paediatric Society put out policy briefs with respect to child and youth mental health, recognizing the significant issues associated with it. It said, “Accessible, evidence-based treatments can help mitigate long-term disabilities and support academic and occupational success.” It also said, which we again need to underscore, “Those under the age of 25 have been uniquely impacted by the pandemic.” They have had stress, anxiety, disrupted access to learning and identity-affirming activities, and reduced academic and economic opportunities.

In conclusion, what can we do to help support all Canadians? We can modify the Excise Tax Act and eliminate the taxes on psychotherapy services and mental health counsellors. Even though we may say this is not a huge issue, we have an opportunity to do something. The government needs to look at opportunities so we can stop talking, make a difference and do something to help the health of Canadians.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

moved for leave to introduce Bill C-323, An Act to amend the Excise Tax Act (mental health services).

Mr. Speaker, it is always a pleasure to rise here in the House. I thank my friend and colleague from Peterborough—Kawartha for seconding this bill. It is very important.

We know that 25% of Canadians have unmet mental health needs, and we know that one in three Canadians will suffer with mental health issues throughout their lifetime.

We also know the Liberal government has promised, many times, $4.5 billion in transfers under the Canada mental health transfer, but sadly none of it has materialized. Therefore, we on this side of the House want to do something to operationalize the ability for Canadians to receive mental health help, which they so desperately need.

We know that with this bill, by removing the GST and HST portions from psychotherapists and mental health counsellors, it would allow Canadians to then have approximately one in eight sessions for free, as we might say. That is important.

It is very important that we are seen to be doing things in the House, that we actually are doing things and not just seen to be doing them. That is one thing that we know is very important for Conservatives on this side of the House.

As we move through this bill, it is going to be very important for Canadians. I know there are thousands of psychotherapists and mental health counsellors out there who would realize the importance of this bill and would get behind it. It is important for the mental health of Canadians, who we know are suffering during this time, certainly through the pandemic and at the current time.

It is an absolute pleasure to bring this bill forward and to be out there helping Canadians.

(Motions deemed adopted, bill read the first time and printed)