Thank you.
Good morning. My name is Dr. Karen Cohen. I'm the chief executive officer of the Canadian Psychological Association. CPA is the national association of Canada's psychologists.
The federal government has an important role to play in Canada's mental health. We're pleased with its commitment to making high-quality mental health services more available to Canadians. If we want a health care system that will deliver cost and clinically effective care, then we must revisit policies, programs, and funding structures through which health care is delivered.
Mental illness affects one in five Canadians and costs the economy $50 billion a year, yet no province currently pays for assessment or treatment by psychologists outside of publicly funded institutions.
Research has found that psychological treatments are less expensive than and at least as effective as medication for the most common mental health conditions, and in some cases, work better. Psychological treatments do a better job for depression than medication in preventing relapse.
Psychological treatments work, but unfortunately only some Canadians have access to them. Access to effective health treatment should not depend on your employment benefits or income level. Those who cannot afford to pay for treatment end up on long wait lists, have to depend on prescription medications, or simply do not get help at all.
We have some solutions to this problem.
The CPA commissioned a report from a group of health economists that proposed several models of delivering enhanced access to psychological services for Canadians. The report provides a business case based on demonstrating positive return on investment and desired clinical outcomes.
In the past decade, the United Kingdom and Australia have made huge investments in publicly funded therapy. The U.K.'s improving access to psychological therapies program provides treatment to people with depression and anxiety disorders. The new health accord could improve access to psychological services by adapting similar programs here in Canada.
I also want to bring your attention to an issue that is extremely important to psychologists and their patients.
Budget 2013 included an unclear statement about changes to the GST on what is and is not considered a health service. Because of this change, psychologists and other health care providers have to charge their patients GST for some services. The new tax came into effect immediately and the government predicts that it will collect only $1 million in 2015-16 and $2 million in 2016-17. This tax policy runs counter to the government's agenda to advance mental health in Canada.
Despite the fact the tax came into effect three years ago, it remains unclear what services should be taxed and which are exempt. Advice provided to our members from the Canada Revenue Agency has been inconsistent and contradictory. For example, we are fairly certain that an assessment to determine the impact of child sexual abuse in adult survivors for the purposes of civil litigation is now subject to tax. Also taxed are evaluations for the purposes of establishing eligibility for disability, fitness to stand trial, and mediation in a divorce proceeding. In the spring of 2015, we were told by CRA that additional clarification was coming, but none has materialized. We hope that this situation can be rectified in the upcoming budget.
Investment in psychological research is also paramount to Canada's social fabric. Psychological research has broad and significant application to the well-being of Canadians and their communities, creating an understanding of people, human problems, and the many environments in which we live.
Finally, as has already been mentioned, a strong science culture relies on the availability of national statistics with common data points. The cancellation of national surveys, such as the university and college academic staff system and the survey of earned doctorates, to name just two, has left significant gaps in our ability to track the number and demographic distribution of academics in Canada, psychologists among them. Without such surveys, we don't know how many people have attained graduate degrees in psychology, who is working where, or if there are enough psychologists to meet current teaching, research, and health service needs of Canadians.
In closing, I will sum up our recommendations.
One, make access to psychological services the priority of the new health accord.
Two, target funding to assist the provinces and territories to improve access to psychological services. The funds could be used by the provinces and territories to adapt the U.K.'s improving access to psychological therapies program here in Canada.
Three, remove the new tax on psychological services. All psychological services have a health purpose and should remain exempt.
Four, invest in psychological research with continued, increased, and balanced funding for research via base funding for the granting councils, as well as stabilized funding for operating and infrastructure support.
Finally, we hope that this budget will include funding for Statistics Canada to reinstate the surveys that are critical to the development and maintenance of good programming and policy.
Thank you.