Question Period Note: MENTAL HEALTH AND SUBSTANCE USE TOOLS DURING COVID-19

• What is the Government’s plan to enhance access to mental health care to support Canadians through the pandemic and recovery period?

KEY MESSAGES
• COVID-19 continues to create stress, anxiety, and isolation for many Canadians, particularly those who do not have access to support networks. That is why the Government launched an online portal that provides access to mental health and substance use supports.
• Wellness Together Canada is the first national program of its kind, providing 24/7 access to free and confidential evidence-based tools and resources.
• Through Wellness Together Canada, individuals across the country can access supports ranging from self-assessment, self-guided programming, and peer support, to confidential sessions with social workers, psychologists and other professionals.
• Wellness Together Canada supports existing provincial and territorial services, and does not replace them.
• All services are available in both official languages, and phone counselling sessions are supported by instantaneous interpretation in 200 languages and dialects.
• To date, the Government of Canada has invested $68 million in Wellness Together Canada. Through Budget 2021, the Government has allocated an additional $62 million in 2021-22 towards this initiative.
IF PRESSED ON PREVIOUS INVESTMENTS
• As part of the Safe Restart Agreement in July 2020, $500 million was also provided directly to provinces and territories for immediate mental health and substance use service needs.
• On March 29, 2020, the Prime Minister announced an investment of $7.5 million to Kids Help Phone to provide crisis supports for children and youth during the COVID-19 pandemic.
• The 2020 Fall Economic Statement announced a $50 million investment to bolster the capacity of distress centres, which are experiencing a surge in demand during the COVID-19 pandemic.
• The Government of Canada is investing $21 million over 5 years for the Centre for Addiction and Mental Health, and its partners, to implement a fully operational pan-Canadian suicide prevention service.
• The Promoting Health Equity: Mental Health of Black Canadians Initiative is investing $10 million to support community-based projects across Canada.
IF PRESSED ON THE DEVELOPMENT OF NATIONAL MENTAL HEALTH AND SUBSTANCE USE SERVICE STANDARDS
• Our government is committed to working with stakeholders, provinces and territories to set national standards for access to mental health services so Canadians can get fast access to the support they need, when they need it.

• Through Budget 2021, the Government will provide $45 million over two years to help develop national mental health and substance use service standards, in collaboration with provinces and territories, health organizations, and key stakeholders.
IF PRESSED ON THE NEED TO PROVIDE SUPPORTS TO YOUTH AND FAMILIES…
• The COVID-19 pandemic is particularly challenging for families who may be especially vulnerable to stress given the uncertainty and disruption to their daily routines.
• As part of the Consortium managing the Wellness Together Canada portal, Kids Help Phone is providing support to young people via phone, text and live chat.
• We are also investing an additional $7.5M in Kids Help Phone to support their ongoing services for youth, as a leader in responding to the needs of young Canadians.
• In addition to these actions, the Government of Canada is investing $5 billion over ten years to provinces and territories via negotiated bilateral agreements to help them expand access, which includes community-based mental health and addiction services for children and youth.
IF PRESSED ON THE NEED TO PROVIDE SUPPORTS FOR FRONTLINE WORKERS…
• Health care workers and other front line personnel are an important population for Wellness Together Canada. That is why the portal features a dedicated text line for frontline workers that provides immediate access to supports.
• Frontline workers can also access free counselling and a range of self-guided programming on the portal anytime at their convenience. This includes resources tailored for healthcare workers.
• In addition, the portal features Program Navigators that can assist frontline workers and other Canadians in accessing portal resources appropriate for their needs.
IF PRESSED ON THE NEED TO PROVIDE SERVICES TO DIVERSE POPULATIONS…
• Wellness Together Canada continually enhances the portal based on client feedback to ensure an inclusive portal experience, tailored to meeting the needs of varying age groups and diverse populations.
• Phone counselling sessions are supported by instantaneous interpretation in 200 languages and dialects, which includes 24 Indigenous languages.
• The portal features contact information for Hope for Wellness, which provides Indigenous peoples with access to immediate mental health counselling and crisis intervention.
• The portal also supports populations with barriers to care, including those in isolation or remote areas, facing stigma or financial difficulties, and official language minority communities.
IF PRESSED ON THE UTILIZATION OF WELLNESS TOGETHER CANADA…
• As of June 1, 2021, over 1.3 million individuals across all provinces and territories have accessed the Wellness Together Canada portal in over 4.1M web sessions since launch.
• Approximately 40% of site visitors are men, which compared to other services is higher than usual male engagement.
• Approximately 46% of individuals that have created an account are under the age of 30, an age group that tends to be underserved by traditional mental health services.
• For phone sessions, 89% felt better after speaking with a counsellor. For text sessions, 86% of texters were highly satisfied with the service.
• Based on a client feedback survey, 24% indicated they have no other options for support, if not for the portal.
• WTC is currently working to develop an app that will facilitate access to the portal and ease of use. The app is scheduled to be available by the end of June 2021.
• Health Canada will monitor the WTC portal by supporting data collection, reporting and evaluation to ensure the portal’s value and impact to Canadians.
IF PRESSED ON THE COLLECTION OF PERSONAL INFORMATION WITHIN WELLNESS TOGETHER CANADA...
• The portal strictly adheres to all privacy and health information legislation and standards to maintain the security and confidentiality of personal information.
IF PRESSED ON HOW WELLNESS TOGETHER CANADA CAN SUPPORT INDIVIDUALS WITHOUT INTERNET ACCESS…
• For individuals without internet access, confidential chat sessions with social workers, psychologists and other professionals can be accessed by phone and text.
IF PRESSED ON HOW WELLNESS TOGETHER CANADA CAN SUPPORT INDIVIDUALS EXPERIENCING GRIEF…
• Wellness Together Canada provides a range of mental health supports, which includes access to 24/7 counselling by phone and text. All service providers are able to support individuals with the grief they face.
• The portal also features new dedicated grief content, including informational resources and a telephonic 1-on-1 Grief Loss and Coaching Program, provided by Homewood Health.

BACKGROUND
Pressure on Existing Provincial/Territorial Mental Health Services
With Canadians physical distancing and isolated, there is an unprecedented need for virtual services, such as telehealth and other information lines (e.g., 811), and provinces/territories are not able to absorb the increased demand.

It is critical that Canadians have access to effective tools to self-monitor, promote their mental well-being, obtain credible and reliable information, and access services when deemed necessary. Canadians need to be re-assured that there are supports available to help alleviate their stress, fear and anxiety.

Government Actions and Investments to Improve Access to Mental Health Services and Address the Impact Of COVID-19 On Canadians’ Mental Health
Wellness Together Canada
Health Canada has invested $130 million over two years in Wellness Together Canada, an online mental health and substance use support portal. Launched in April 2020, Wellness Together Canada provides free and confidential online mental health and substance use supports accessible 24/7 to individuals across Canada in both official languages. Interpretation services are also available during phone sessions in over 200 languages and dialects. Through Wellness Together Canada, individuals in all provinces and territories have immediate access to supports ranging from self-assessment, educational content and self-guided programming, to peer support and confidential sessions with social workers, psychologists and other professionals. Supports are provided online as well as by phone and text for those without internet access. There are dedicated text lines for youth, adults and front line workers that provide immediate access to support. There is also a dedicated phone line for accessing Program Navigators that can assist with finding resources on the portal.
Wellness Together Canada is led by a consortium of three organizations:
• Stepped Care Solutions is an interdisciplinary and cross-sector team of clinician-researchers, leaders and pioneers in the areas of Stepped Care 2.0 and e-mental health.
• Kids Help Phone is Canada’s only 24/7 national service offering support to young people via phone, text and live chat, and is a global leader in developing and delivering virtual mental health solutions.
• Homewood Health is a Canadian leader in the development and delivery of national, evidence-based mental health, trauma, and addiction treatment and services.

National Mental Health and Substance Use Service Standards
To fulfill commitments made in the Minister of Health’s mandate letter, the Government of Canada will “set national standards for access to mental health services so Canadians can get fast access to the support they need, when they need it”. Through Budget 2021, the government has allocated $45 million over two years, starting in 2021-22, to help develop national mental health and substance use service standards, in collaboration with provinces and territories, health organizations, and key stakeholders, so that Canadians can access timely care, treatment, and support.
Support for the Mental Health Needs of Those Most Affected by COVID-19
Budget 2021 provides support for populations most affected by COVID-19 in dealing with mental health challenges. The government will provide:
• $100 million over three years, starting in 2021-22, to the Public Health Agency of Canada to support projects for innovative mental health interventions for populations disproportionately impacted by COVID-19, including health care workers, front-line workers, youth, seniors, Indigenous people, and racialized and Black Canadians
• $50 million over two years, starting in 2021-22, to Health Canada to support a trauma and post-traumatic stress disorder (PTSD) stream of mental health programming for populations at high risk of experiencing COVID-19 trauma and those exposed to various trauma brought about by COVID-19.
Funding to Provincial and Territorial Governments
The Government of Canada is investing $5 billion over ten years to improve Canadians’ access to mental health services. The investment is being provided directly to provinces and territories via negotiated bilateral agreements to help them expand access to community-based mental health and addiction services for children and youth, integrated services for people with complex needs, and spread proven models of community mental health care and culturally appropriate interventions linked to primary health services.
In addition, on July 16, the Prime Minister announced a federal investment of more than $19 billion to help provinces and territories safely restart their economies and make our country more resilient to possible future waves of the virus. As part of this investment $500M targeted immediate mental health and substance service needs, including strengthening the service infrastructure (workforce, targeted programs) to manage post-pandemic demands that have been exacerbated due to the pandemic by providing wrap-around care, harm reduction and evidence-based treatment services and programs.
Promoting Mental Health and Preventing Mental Illness
Through the Public Health Agency of Canada’s (PHAC) Mental Health Promotion Innovation Fund, the Government of Canada is investing $39 million from 2019-2028 to address multiple risk and protective factors to promote mental health for children, youth, young adults and populations susceptible to mental health inequities (e.g., low-income families, immigrants and refugees, First Nations, Inuit, Métis, LGBTQ2+, people living with disabilities and people with other socio-economic risk factors).
On March 29, 2020, the Prime Minister announced an investment of $7.5 million to Kids Help Phone to provide crisis supports for children and youth during the COVID-19 pandemic.
$9 million is being provided to the United Way (through New Horizons) for practical services for seniors.
The Promoting Health Equity: Mental Health of Black Canadians Initiative is investing $10 million to support community-based projects across Canada.
In addition, the 2020 Fall Economic Statement announced a $50 million investment to bolster the capacity of distress centres, which are experiencing a surge in demand during the COVID-19 pandemic.
Mobilizing Data and Evidence
The Canadian Institutes of Health Research (CIHR) is currently leading a COVID-19 and Mental Health Research Initiative in collaboration with PHAC and Health Canada. This initiative currently supports 101 research projects, representing a total investment of $13.5M from CIHR and partners. This work is guided by an Expert Advisory Panel composed of leading Canadian experts in mental health and substance use. New knowledge generated through these projects will be mobilized to ensure it will inform policy making in a timely manner.
Statistics Canada developed and administers a web panel survey, the “Canadian Perspectives Survey Series”. Each month, approximately 4,600 people in the 10 provinces have been responding to the new iteration of the survey. The Canadian Community Health Survey also resumed in September 2020.
Suicide Prevention
The Government of Canada is providing $21 million over five years to the Centre for Addiction and Mental Health (CAMH) to implement and sustain a fully operational pan-Canadian suicide prevention service in partnership with the Canadian Mental Health Association and Crisis Services Canada. This service will provide people across Canada with access to 24/7/365 bilingual crisis support from trained responders, using the technology of their choice (voice, text or chat). The Federal Framework for Suicide Prevention was released November 2016. It focused on raising public awareness, reducing stigma, disseminating information and data, and promoting the use of research and evidence-based practices. Progress Reports on the Framework are available on Canada.ca, with the next report planned for release in December 2020.
Post-Traumatic Stress Disorder
Pursuant to the Federal Framework on Post-Traumatic Stress Disorder Act, Canada’s first Federal Framework on Posttraumatic Stress Disorder (PTSD) was tabled in Parliament on January 22, 2020 and made public on February 13, 2020. To inform the development of the framework, in accordance with the Act, the Minister of Health convened a National Conference on PTSD in April 2019 with the Ministers of National Defence, Veterans Affairs, and Public Safety and Emergency Preparedness, partners and stakeholders, including people with lived-experience.

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