Question Period Note: MENTAL HEALTH BUDGET 2021 COMMITMENTS

• Our Government is concerned about the impacts that the COVID-19 pandemic has had on the mental health of Canadians, which continues to be a source of stress, anxiety and isolation for many Canadians.

KEY MESSAGES
· Our Government is concerned about the impacts that the COVID-19 pandemic has had on the mental health of Canadians, which continues to be a source of stress, anxiety and isolation for many Canadians.
· That is why, through Budget 2021, the Government committed to a suite of measures to improve access to quality and timely mental health supports:
o $45 million to develop national standards;
o $50 million to support projects to address posttraumatic stress disorder (PTSD) and trauma in frontline workers;
o $62 million for the Wellness Together Canada portal to continue to provide mental health tools and services; and,
o $100 million to support projects that promote mental health and prevent mental illness in populations disproportionately impacted.
IF PRESSED ON THE DEVELOPMENT OF NATIONAL STANDARDS FOR MENTAL HEALTH…
• Many Canadians who struggle with mental health disorders are unaware of where and how to seek supports. Service availability varies across the country and some people experience barriers to access, and available supports often do not meet the unique needs of diverse populations.
• We allocated $45 million in Budget 2021 to develop national standards so Canadians can get fast access to the support they need, when they need it.
• Our government is committed to working with stakeholders, provinces and territories to set national standards for access to mental health services.
IF PRESSED ON WELLNESS TOGETHER …
• The COVID-19 pandemic continues to create stress, anxiety, and isolation for many Canadians. That is why the Government moved quickly to create Wellness Together Canada, which provides 24/7 access to free and confidential mental health and substance use supports.
• Through Budget 2021, the Government committed to providing further support of $62 million for the Wellness Together Canada portal so that it can continue to provide Canadians with tools and services to support mental health and well-being.
IF PRESSED ON THE NEED TO PROVIDE SUPPORT FOR FRONTLINE WORKERS …
• During the pandemic, frontline and essential workers have experienced higher workload, stressors and new challenges. These workers are at risk of anxiety and posttraumatic stress disorder (PTSD).
• Our Government has responded by providing $50 million over two years, starting in 2021-22, to support projects to address posttraumatic stress disorder (PTSD) and trauma in frontline workers and others who are most affected by the COVID-19 pandemic.
IF PRESSED ON THE NEED TO SUPPORT PRIORITY POPULATIONS …
• Our Government recognizes that the COVID-19 pandemic has had disproportionate impacts on the mental wellness of Canadians. We have responded by establishing funding to address the mental health needs of priority populations in the context of COVID-19.
• Through Budget 2021, the Government of Canada is providing $100 million over three years, starting in 2021-22, to support projects that promote mental health and prevent mental illness in health care workers, frontline workers, youth, seniors, First Nations, Inuit and Métis, and Black and other racialized Canadians.
• We will continue to work with our partners to supports populations in need of mental health care.
IF PRESSED ON PREVIOUS INVESTMENTS (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.
• 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 mental health support for children and youth during the COVID-19 pandemic.
• CIHR’s COVID-19 and Mental Health Initiative (in collaboration with PHAC and Health Canada) supports 101 research projects, representing a total investment of $13.5M from CIHR and partners. The grants focus on a number of priority populations, including: healthcare and public safety personnel, older adults and residents of long-term care homes, people who use drugs, women and indigenous populations.
IF PRESSED ON PREVIOUS INVESTMENTS (PRE-PANDEMIC & ONGOING) …
• The Mental Health Promotion Innovation Fund is investing $4.9 million annually to support community-based mental health promotion projects and an associated Mental Health Promotion for Children & Youth Knowledge Development and Exchange (KDE) Hub.
• 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 Fund is investing $10 million to support community-based projects across Canada.
• Through Budget 2017, the Government of Canada committed to provide $5 billion over ten years to provinces and territories to increase access to mental health and addictions services. Five-year bilateral agreements are currently being renewed for 2022-23, providing opportunities for provinces and territories to refocus their action plans for the next five years.

The COVID-19 pandemic has had significant impacts on mental health across the population, with concerns about the virus itself compounded by impacts on work and routines, financial stress, social isolation, grief and bereavement, and reduced access to services and supports. These impacts have been particularly acute for certain groups, including children and youth, older adults, First Nations, Métis, Inuit, and Black and other racialized populations.

During the pandemic, frontline and essential workers (e.g. health workers, public safety and social services providers and long-term care workers) have experienced higher workload, stressors and new challenges. These workers are at risk of stress, anxiety, vicarious trauma, moral injury, and posttraumatic stress disorder (PTSD).

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 Impacts of COVID-19 on Canadians’ Mental Health

PHAC Investments

The Government of Canada has responded by establishing time-limited funding for the Public Health Agency of Canada (PHAC) to address the mental health needs of priority populations in the context of COVID-19. Through Budget 2021, the Government of Canada is providing:

· $100 million over three years, starting in 2021-22, to support projects that promote mental health and prevent mental illness in populations disproportionately impacted by the COVID-19 pandemic, including health care workers, frontline workers, youth, seniors, First Nations, Inuit and Métis, and Black and other racialized Canadians
· $50 million over two years, starting in 2021-22, to support projects to address PTSD and trauma in frontline workers and others who are most affected by the COVID-19 pandemic
· $3 million over two years, starting in 2021-22, to support indicator development to monitor national standards for mental health and substance use services

As a part of Budget 2021’s investments towards a National Action Plan to End Gender-Based Violence, PHAC will receive $50 million over five years, starting in 2021-2022 ($27.9 million in existing funds, $22.1 million in new funds) to design, deliver and test public health interventions that promote safe relationships and prevent family violence.

HC Investments

National Standards for Mental Health and Substance Use

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 standards for mental health, in collaboration with provinces and territories, health organizations, and key stakeholders, so that Canadians can access timely care, treatment, and support. This language was interpreted broadly to include standards for substance use due to its close relationship with 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 augments existing provincial and territorial services, and does not replace them.

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.

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 $500 million 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.

Mobilizing Data and Evidence

Between 2015-16 and 2019-20, the Canadian Institutes of Health Research (CIHR) invested over $333 million in mental health and behavioural disorders research. This represents more than 1700 projects led by experts across the country.

CIHR is also leading the COVID-19 and Mental Health Research Initiative (CMH) in collaboration with PHAC and Health Canada. This initiative currently supports 101 research projects, representing a total investment of $13.5 million 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.

Election 2021 Platform Commitments for Mental Health

The Government of Canada is working to initiate and implement mental health commitments made during the 2021 election. These include:
• Establishing a new federal transfer - the Canada Mental Health Transfer - to provinces and territories to expand the delivery of high-quality, accessible and free mental health services. This includes a commitment to permanent, ongoing funding for mental health services under the Canada Mental Health Transfer, with an initial investment of $4.5 billion over 5 years;
• Introducing a new fund for student well-being to improve wait times and increase access to mental health care at colleges and universities, including by hiring up to 1,200 new mental health care counsellors, including those who can support the needs of Black, Indigenous, and racialized students;
• Fully funding a national, three-digit mental health crisis and suicide prevention hotline;
• Committing an additional $1.4 billion for a co-developed mental health and wellness strategy with First Nations, Inuit, and Métis Nation partners;
• Undertaking a comprehensive review of access to the Disability Tax Credit, Canada Pension Plan disability benefits and other federal benefits and programs to ensure they are available to people experiencing mental health challenges;
• Working with community partners on the design and establishment of a fund to support the mental health of Black Canadians in the public service; and,
• Including mental health as a specific element of occupational health and safety under the Canada Labour Code, and requiring federally-regulated employers to take preventative steps to address workplace stress and injury.
The COVID-19 pandemic has had significant impacts on mental health across the population, with concerns about the virus itself compounded by impacts on work and routines, financial stress, social isolation, grief and bereavement, and reduced access to services and supports. These impacts have been particularly acute for certain groups, including children and youth, older adults, First Nations, Métis, Inuit, and Black and other racialized populations.

During the pandemic, frontline and essential workers (e.g. health workers, public safety and social services providers and long-term care workers) have experienced higher workload, stressors and new challenges. These workers are at risk of stress, anxiety, vicarious trauma, moral injury, and posttraumatic stress disorder (PTSD).

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 Impacts of COVID-19 on Canadians’ Mental Health

PHAC Investments

The Government of Canada has responded by establishing time-limited funding for the Public Health Agency of Canada (PHAC) to address the mental health needs of priority populations in the context of COVID-19. Through Budget 2021, the Government of Canada is providing:

· $100 million over three years, starting in 2021-22, to support projects that promote mental health and prevent mental illness in populations disproportionately impacted by the COVID-19 pandemic, including health care workers, frontline workers, youth, seniors, First Nations, Inuit and Métis, and Black and other racialized Canadians
· $50 million over two years, starting in 2021-22, to support projects to address PTSD and trauma in frontline workers and others who are most affected by the COVID-19 pandemic
· $3 million over two years, starting in 2021-22, to support indicator development to monitor national standards for mental health and substance use services

As a part of Budget 2021’s investments towards a National Action Plan to End Gender-Based Violence, PHAC will receive $50 million over five years, starting in 2021-2022 ($27.9 million in existing funds, $22.1 million in new funds) to design, deliver and test public health interventions that promote safe relationships and prevent family violence.

HC Investments

National Standards for Mental Health and Substance Use

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 standards for mental health, in collaboration with provinces and territories, health organizations, and key stakeholders, so that Canadians can access timely care, treatment, and support. This language was interpreted broadly to include standards for substance use due to its close relationship with 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 augments existing provincial and territorial services, and does not replace them.

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.

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 $500 million 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.

Mobilizing Data and Evidence

Between 2015-16 and 2019-20, the Canadian Institutes of Health Research (CIHR) invested over $333 million in mental health and behavioural disorders research. This represents more than 1700 projects led by experts across the country.

CIHR is also leading the COVID-19 and Mental Health Research Initiative (CMH) in collaboration with PHAC and Health Canada. This initiative currently supports 101 research projects, representing a total investment of $13.5 million 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.

Election 2021 Platform Commitments for Mental Health

The Government of Canada is working to initiate and implement mental health commitments made during the 2021 election. These include:
• Establishing a new federal transfer - the Canada Mental Health Transfer - to provinces and territories to expand the delivery of high-quality, accessible and free mental health services. This includes a commitment to permanent, ongoing funding for mental health services under the Canada Mental Health Transfer, with an initial investment of $4.5 billion over 5 years;
• Introducing a new fund for student well-being to improve wait times and increase access to mental health care at colleges and universities, including by hiring up to 1,200 new mental health care counsellors, including those who can support the needs of Black, Indigenous, and racialized students;
• Fully funding a national, three-digit mental health crisis and suicide prevention hotline;
• Committing an additional $1.4 billion for a co-developed mental health and wellness strategy with First Nations, Inuit, and Métis Nation partners;
• Undertaking a comprehensive review of access to the Disability Tax Credit, Canada Pension Plan disability benefits and other federal benefits and programs to ensure they are available to people experiencing mental health challenges;
• Working with community partners on the design and establishment of a fund to support the mental health of Black Canadians in the public service; and,
• Including mental health as a specific element of occupational health and safety under the Canada Labour Code, and requiring federally-regulated employers to take preventative steps to address workplace stress and injury.

KEY FACTS
• Through Budget 2021, the Government committed to a suite of measures to improve access to quality and timely mental health supports:
o $45 million to develop national standards;
o $50 million to support projects to address posttraumatic stress disorder (PTSD) and trauma in frontline workers;
o $62 million for the Wellness Together Canada portal to continue to provide mental health tools and services; and,
o $100 million to support projects that promote mental health and prevent mental illness in populations disproportionately impacted.