Good morning, Mr. Chair and committee members. My name is Dr. Chris Summerville, and I am co-chair of the Canadian Alliance on Mental Illness and Mental Health, also known as CAMIMH.
Established in 1998, CAMIMH is the collective national voice for mental health as an alliance of 16 national mental health groups comprised of health care providers and organizations that represent people with mental illnesses, their families and their caregivers.
Continued economic growth in Canada will depend on having a productive workforce, so investments made in mental health will help ensure Canada's competitiveness in the future. The costs of mental illness to the economy and the workplace are significant when considering Canada's economic competitiveness. For example, 500,000 Canadians are unable to work due to a mental illness in a given week. The economic cost of mental health problems was measured in 2011 at $51 billion. Mental health issues account for more than $6 billion in losses due to absenteeism and presenteeism. Thus, while the cost of mental health and addiction problems on productivity in the workplace alone is about $20 billion annually, one third of this cost could be recovered if working Canadians had access to illness prevention as well as early identification and treatment.
Now, the stigma and discrimination associated with mental illness has decreased in recent years, but we still have a long way to go. As stigma is being reduced, we are seeing more people come forward for help. Unfortunately, mental health services and supports continue to be in short supply due to a lack of resources and a lack of capacity. Currently, those who cannot afford to pay for treatment end up on long wait-lists or do not get help at all.
CAMIMH believes the federal government has a role and responsibility to ensure that the people of Canada get better access to the mental health services they need to enjoy life satisfaction. In budget 2017 the federal government took a very important step in addressing the funding gaps between physical and mental health by targeting $5 billion over 10 years for mental health. CAMIMH is highly supportive of this commitment, yet we believe that long-term, sustainable and predictable funding is required to realize parity between physical and mental illness in Canada.
As the Mental Health Commission of Canada has discovered, mental health funding should be increased from 7% to 9% of total public health spending. CAMIMH agrees that 9% is the minimum level of public investment required to improve health outcomes and access to a range of public mental health programs and services. Some countries, in fact, spend 12% on mental health.
CAMIMH believes the federal government, in its national leadership role, should contribute a minimum of one out of every four health care dollars to the provinces and territories specifically to mental health. With the federal share increased to 25%, the annual federal investment to support increased access to mental health services would be an additional $777.5 million. CAMIMH strongly recommends that increased transfers be earmarked through a mental health transfer or a dedicated envelope to maximize accountability, transparency and impact.
Arguably, when it comes to accessing mental health services across Canada, the Canada Health Act is not being upheld. The capacity to deliver timely access is hampered by fragmented and poorly coordinated services and supports. Thus, the mental health system is in urgent need of improved integration. People with lived experience and their families and caregivers must be involved in the design and evaluation of an improved and recovery-focused mental health system.
An expanded use of collaborative care team-based practice has the potential to substantially increase the capacity of the system to see more patients across their lifespans and to deliver care where and when needed. This model, sometimes known as the “collaborative shared care model”, includes the service of not only physicians but also other mental health care providers, such as psychologists, social workers, peer support workers, psychiatric mental health nurses, counsellors and psychotherapists. Together, they work as a team to offer complementary services and supports to ensure that individuals receive the evidence-based care they need with a minimum of obstacles.
Accordingly, we believe the federal government should engage the provinces and territories in thinking through the system change that will deliver effective mental health care to more Canadians. Work has been done to consider how the successful innovations from countries like the United Kingdom and Australia could be adapted to Canada. These models have taken a more systemic approach to redressing needed mental health service gaps with promising results. Therefore, CAMIMH makes the following three recommendations.
One, the federal government should embrace the principle of mental health parity by assessing the equity of funding and delivery of mental health services against mental illness in areas of fiduciary and primary responsibility, including service delivery to indigenous peoples, veterans and Canadian Forces, federal inmates, Royal Canadian Mounted Police and public servants. The federal government should introduce what is known in many other countries as a “mental health parity act”. A mental health parity act affirms that mental health is valued and esteemed equally with physical health. Such an act guarantees parity for mental health and substance use disorder benefits by specifying that coverage must be provided at the same level as mental health coverage. A mental health parity act would help ensure that communities and workplaces through their policies, programs and benefits attend equally to mental and physical health.
Two, in light of the 2017 investments in mental health, the federal government funding for mental health should increase from 7.2% of total public health spending to at least a minimum of 9%. That would be 25% for the federal government's share. As I mentioned, that would mean additional support of $777.5 million annually to provinces and territories to improve access to a range of mental health programs and services. CAMIMH strongly recommends that the funds be earmarked through a mental health transfer or through a dedicated envelope to maximize accountability, transparency and impact.
Finally, the federal government should engage the provinces and territories in thinking through the system change that will deliver effective mental health care to more Canadians by enhancing the capacity of mental health resources on primary care teams, or collaborative shared teams, and augmenting fee-for-service models through private and extended health care insurance. Thus, incentives should be created for employers to provide increased private and extended health care insurance.
Thank you.