Thank you. Would you like me to repeat the last paragraph? Would that be helpful? Okay.
As I was saying, a new review on the research literature found no evidence to suggest it is possible to reliably distinguish between the factors underlying a request for MAID and those underlying suicide intent. While the CPA's first edition of MAID clinical guidance includes a section on managing suicide risk across all phases of the MAID pathway, it does not provide concrete methods for helping clinicians determine if the request for MAID is due to acute distress, a symptom of a mental disorder or an enduring desire to die.
Finally, but of utmost importance to extending MAID to people whose only medical condition is mental illness, there is the state of mental health care in Canada. We've heard that mental health has been and continues to be significantly underfunded compared to physical health care in our country, making it difficult for people to get the right care when and where they need it.
Demand for care continues to grow, while service capacity does not. One in three Canadians reports that their needs for mental health care are unmet or only partially met. In Ontario alone, over the last four years, mental health service volumes have increased by 66%. Access to mental health treatment also remains inequitable. That is why investing in mental health care and support should be the priority before any consideration is given to moving ahead with implementing a track to choose MAID.
In sum, only when we have evidence-informed, consensus-based criteria for determining the irremediability of a person's mental illness and for distinguishing between a request for MAID and suicide intent—and only when such criteria can be introduced into a well-resourced mental health system—would it be possible to offer safe, adequate and equitable MAID services to people whose sole underlying condition is mental illness. That is why CAMH recommends that the federal government delay indefinitely the extension of MAID eligibility to people whose sole underlying condition is a mental illness.
CAMH is happy to offer expertise to government, including sharing our recent evidence synthesis on irremediability, suicide and MAID and the gaps in the evidence base, when it's available.
Thank you.