Thank you, Mr. Chairman.
Good afternoon, members of the committee.
Thank you for inviting me here today. My name is Dr. Patrick Smith. I'm the national CEO of the Canadian Mental Health Association.
Celebrating 100 years in 2018, we are a Canada-wide organization, with more than 15,000 staff and volunteers, in every province, in more than 300 operational locations across the country. We're often described as the community-based mental health organization with boots on the ground.
The Trudeau government has demonstrated unprecedented leadership in recognizing and working to redress dramatic gaps in mental health. Prime Minister Trudeau has signalled his understanding of the whole-of-government approach, with specific mental health deliverables included in multiple ministers' mandate letters.
The 2017 budget demonstrated a commitment to beginning to close the many gaps in proportional funding and to begin to transform our country's response to mental health and mental illness.
CMHA called on the federal government to target and earmark dedicated funds for mental health in its transfer of funds to the provinces. With budget 2017, CMHA was pleased to see funding through the Canada health transfer earmarked for mental health and to see this government's targeted funding for high-need communities, such as veterans, active duty military and military families, indigenous peoples, caregivers, children and youth, and individuals living with substance-use disorders. However, there is still some way to go before mental health care is funded on par with physical health care in Canada, and in proportion to the burden of illness.
Canada spends the lowest proportion of its health spending on mental health among all G7 countries. This historic underfunding has led to significant gaps in access to basic mental health services and supports. This gap wasn't created overnight, and it will take concentrated effort and ongoing commitment to address it. The Canadian Mental Health Association calls for continued investment in mental health, especially in community-based services and supports, to bring Canada in line with other G7 countries, where it still lags behind. We’re calling for dedicated funding to be focused on five key fundamental areas in which we are furthest behind other G7 countries and where, with targeted investment, will achieve the greatest impact on people's lives. These investments in community-based services and supports will improve outcomes and reduce the need for hospital beds and acute care services.
There is one fundamental issue in Canada that needs to be immediately addressed, and that is who is funded or covered in our publicly funded system. I’m going to shamelessly quote two of my well-respected colleagues here today. Dr. Karen Cohen has helped us to understand that, in Canada, we have universal medical care, not universal health care. When it comes to primary mental health care, the very basic evidence-based services such as counselling, widely accessible structured interventions based on cognitive behavioural therapy and other psychotherapies, and other basic community-based mental health services and supports that other G7 countries take for granted and rely on as fundamental to their mental health response are mostly not available in Canada unless you can pay.
Starbucks Canada made the news when it modified its coverage for its employees and moved from $400 per employee to $5,000 to cover basic mental health services. In a country that has universal health care, you get basic mental health care if you're lucky enough to be a barista at Starbucks Canada.
Ian Boeckh says that mental health reform is a team sport. He's right, and he's one of the best role models for that, but in Canada the vast majority of the most valuable team members that other developed countries have in the game are sitting on the sidelines. Psychologists, social workers, specialized peer support workers, addiction counsellors, we have them here in Canada, but they're mostly sitting on the sidelines outside of the publicly funded system. Most Canadians are surprised when they find that out. Getting them in the game, as they are in other developed countries, practising to their full scope of practice and funded to do the work they're trained to do, will have a dramatic, immediate and formidable impact.
CMHA acknowledges and applauds this government's proposal to support the services of traditional indigenous healers to address mental health needs. We also call upon the federal and provincial governments to work together to ensure that primary mental health care professionals are also included and supported.
I'm hoping that we'll have a chance to more fully discuss the stepped care model that you see today, but in a nutshell, the tiers at the bottom, the foundational components of a properly resourced mental health system, are the most dramatically underfunded in Canada. Earlier access to services at the lower tiers is more cost-effective and can prevent individuals from needing more cost-intensive and time-intensive intervention. We treat cancer before stage four.
Better outcomes are possible with earlier intervention. We need to do the same in mental health; hence, for targeted mental health funding, we're not talking about building more mental health hospital beds. If that's all we have in the system, it's no surprise to think that we need more. Instead, what we need to do is to invest in the basic services in the community and redefine primary care when it comes to mental health to include primary mental health care providers.