I can't speak for them, but I will tell you what my guess is, and it's probably pretty accurate. The stigma that is attached to mental illness and substance abuse is sufficiently strong that most of them don't even necessarily provide services to those people. In other words, there is a feeling that if you have a mental illness and a substance abuse problem, you're kind of “over there”, and we will deal with the broader population of poor or low-income Canadians.
I don't know that this is the answer, but I will tell you that the way the system is structured, it's what happens.
In fact, it even happens between substance abuse and mental health. If you have both problems, which is not uncommon, and the first person you go to for help is a mental health worker, it's not uncommon to be told, “Go and fix your substance abuse problem and come back and see me”, or the other way around, if your first stop is related to substance abuse. The reality is that the two problems are so intertwined you can't separate them.
So I would suspect that the real issue is that people are trying to pretend it's not out of the shadows for them.