Improving mental health in Canada: It’s not academic

  • From the Canadian Mental Health Association

    The Mental Health Strategy for Canada and the 2007 Senate report Out of the Shadows at Last, make specific recommendations to all governments to increase funding for mental health and mental illness in Canada.

    CMHA’s National CEO, Peter Coleridge, writes in this opinion piece that what is needed now is investment in improving people’s mental health and timely access to effective mental illness and addiction supports and services.

    In his unpublished autobiography, C.M Hincks, founder of the Canadian Mental Health Association (CMHA), remarked that, “Program planning without money is academic […]

    Almost 100 years ago, C.M Hincks started the conversation about mental health needs in Canada and since then, there has been a lot of talk about how to improve people’s mental health and timely access to effective mental illness and addiction supports and services.

    We have seen laws, strategies, and action plans adopted – not just here in Canada but also around the world – to improve mental health outcomes. But in most cases, the well-intentioned legislation and plans are not supported with the necessary resources to make them a reality.

    Case in point:

    Almost 70 years ago:  2500 delegates of the International Committee for Mental Hygiene (later the World Federation for Mental Health) met in 1948 and  agreed that the “time had come to enlarge the concept of medicine to include mental ills and their systematic prevention” and recognized that this effort would require unprecedented collaboration.

    60 years ago:  the Mental Health Study Act, 1955, was passed by the United States Congress.  This legislation was a bold, if not singular, reflection of the global, post-war debate surrounding mental health and mental illness in society.  That same year a Royal Commission on Canada’s Economic Prospects heard about the importance of “promoting and maintaining mental health of the workers if production were to continue at a satisfactory level”.

    Approximately 50 year ago: CMHA published in 1963, “More for the Mind”, which outlined an ambitious framework for mental health reform in Canada.  This report was based on five years of work completed by the Committee on Canadian Psychiatric Services established by CMHA. The keynote of all recommendations in the report was that “mental illness should be dealt with in the same organizational, administration, and professional framework as physical illness.” It was believed that only in this way would a patient suffering from mental illness receive the same excellence of medical care and ancillary health services as quickly and easily and efficiently as the patient suffering from physical illness. That same year, Action for Mental Health was published by a Joint Commission established by an Act of the U.S. Congress, and the U.S. Community Mental Health Act was passed. These key legislative actions marked the beginning of closing “insane asylums” or mental hospitals in favour of providing care closer to home. The great promise of “deinstitutionalization” to community mental health across North America was underway…or was it?

    30 Years ago: the New Brunswick Mental Health Commission recognized the disparity between physical and mental health conditions, and deliberately shifted resources from hospital and acute care settings to address people’s needs in the community.  The New Brunswick Mental Health Services Act facilitated this change and remains somewhat of an anomaly in Canadian mental health policy (as it specifically addressed funding disparities).

    Approximately 20 years ago:  theU.S. Mental Health Parity Act and Addiction Equity Act werepassed; however, “equality of treatment or opportunity for all” continues to challenge people with mental health and/or addiction problems.  The same can be said in Canada, which has human rights legislation making it illegal to discriminate against someone based on a physical or mental disability. Legal discrimination persists, sadly, in the form of eligibility requirements that treat people very differently depending on whether they have a physical or mental illness.

    Over the last 10 to 15 Years: on a more positive note,the profile for mental health and mental illness, including addiction, among governments, corporate Canada, the media and the public is unlike anything we have experienced ever before in the history of Canada. We have seen a sea-change of public attitudes and consciousness regarding mental health and mental illness.  In addition, Canada has a Mental Health Strategy and all provincial governments now have Mental Health and Addiction Action Plans or Strategies.  These plans are based on the needs of Canadians and evidence of what works, and provide a road map to improve the mental health outcomes of the Canadian population.

    Today: There was a time when the passage of legislation or government Strategies or Action Plans offered the most hope for change, for the allocation of resources to meet the objectives set out in Law. We know, however, that legislation and government action plans over the last 70 plus years have not brought about the action for mental health described two generations ago.

    The Future: On the other hand, we know that people – you and I – have been and continue to be the one constant that create the action needed for mental health. People are the guarantors of social change. What was once a patchwork of compassionate, informal and professional efforts, aimed at providing mental health care for the mentally ill, has transformed conversations into more collaborative, albeit still modest, actions. It’s time for mental health and addiction strategies and plans to include targets and sufficient resources so they are not academic. The Mental Health Strategy for Canada and the 2007 Senate report Out of the Shadows at Last,make specific recommendations to all governments to increase funding for mental health and mental illness in Canada. Let’s not wait another 100 years to write a similar chapter in this story. Take action now.

    Peter Coleridge
    National CEO
    CMHA