Thank you, Mr. Chair.
Hello. My name is Stephanie Woo Dearden. I am a registered psychotherapist, practising from London, Ontario.
I'm here to be a witness to the parts of Bill C-59 that pertain to the Excise Tax Act and amending it to expand the GST/HST exemption to services rendered to individuals by certain health practitioners to include psychotherapists and counselling therapists.
I am grateful to be here not only because I get to speak on this issue, but I understand that this moment of this committee considering and researching this legislation means a lot to the psychotherapists, counselling therapists and allies, who have been asking the Canadian government to remove this unfair tax since 2004. I, along with my professional peers and colleagues, am heartened that the Canadian government has listened and finally taken action on this matter after this time.
Firstly, psychotherapy and counselling therapy are the same profession with a different name, based on provincial preference. I call myself a “psychotherapist” rather than a “counselling therapist”, because I reside in Ontario and am registered with the College of Registered Psychotherapists. If I were to move to Nova Scotia, the equivalent professional and regulatory body there would be the College of Counselling Therapists. It's the same profession but a different name.
Our profession has met the criteria of being regulated in at least five different provinces and territories in order to be included in the Excise Tax Act among health care professionals.
I am not an expert in tax law, so I will be commenting based on my experience as a psychotherapist and what I see in my practice.
Psychotherapy and counselling therapy can be an integral part of an individual's overall health. Our bodies don't experience physical health and mental health as separate. There have been documented links between depression and inflammation, implicating the immune system; the HPA axis, which is our body's stress response system, in tumorigenesis in cancer; and cortisol release and Crohn's disease, just to name a few.
A health care system that divides between physical health care and mental health care is what we are familiar with, but health involves supporting and nourishing both aspects within us.
Examples from my practice involve working with individuals living with conditions such as endometriosis, adenomyosis, cancer, Crohn's disease and thyroid disease. I have seen, in sessions, the way psychological and socio-emotional pain contribute to physical symptoms that aggravate my client's experience of these conditions. Addressing this pain in a therapeutic, safe and compassionate way can lead to tension release, the ability to regulate emotions, to step out of isolation, to connect with community, to ask for help and to advocate for oneself in the health care system. It's by no means a cure, but it allows my clients to live with a better quality of life.
Removing this tax on counselling therapy and psychotherapy signals that the Canadian government understands that the health of Canadians encompasses physical health care and mental health care, and that this understanding is written in policy.
From a business and consumer perspective, amending the Excise Tax Act to include psychotherapists and counselling therapists allows choice and fairness for Canadians seeking psychotherapy. Currently, social workers, occupational therapists and nurses are among the practitioners who can provide psychotherapy services and refer to themselves as “psychotherapists”. They are exempt from charging GST or HST. It is ironic that counselling therapists and psychotherapists, who have specifically trained to practise psychotherapy, have to charge tax on their services.
If a Canadian is living in a rural setting, where a psychotherapist or a counselling therapist is their main option for accessing mental health care, they would have to pay HST. This puts them in an unfair situation compared with an urban counterpart, who may have their pick among professionals registered to different professional regulatory bodies and can choose one charging a lower fee and who doesn't charge tax.
This person—in an urban setting in our example—gets to keep an extra $10 to $20 in their pocket per session, compared to someone who's living in this rural setting and seeing a counselling therapist or psychotherapist. If both these individuals see a therapist biweekly, that would be an extra $240 to $480 saved over a year for our urban resident. There are many things they can do with that money—getting more sessions if they need it—so in my view this exemption is also about fairness for Canadians seeking mental health services across the country.
There is more I can say on this, but I am sensitive to my time. MPs from multiple major political parties have written op-eds and made statements declaring this tax to be unfair, so I think that it is straightforward, going forward, that amending the Excise Tax Act to include psychotherapists and counselling therapists is one step the Canadian government can take to make mental health care more accessible to Canadians.