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

• The Government remains committed to supporting Canadians with their mental health and substance use challenges as well as increasing access to services so that Canadians can get the help they need, when they need it.

KEY MESSAGES
• 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 a suite of measures to improve access to quality and timely mental health supports:
o $45 million to develop national standards for mental health;
o $100 million to support projects that promote mental health and prevent mental illness in populations disproportionately impacted by the pandemic;
o $50 million to support projects to address posttraumatic stress disorder (PTSD) and trauma in frontline workers;
o $10 million for the Mental Health of Black Canadians Fund; and,
o $13.5 million to provide timely evidence to decision makers on mental health and substance use responses.
IF PRESSED ON THE DEVELOPMENT OF NATIONAL STANDARDS FOR MENTAL HEALTH…
• 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.
• Health Canada is working with the Canadian Institutes of Health Research and the Public Health Agency of Canada to implement this commitment, and will promote engagement with a broad range of stakeholders to inform standards development.
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. As well, Kids Help Phone continues to develop new training tools to better equip their frontline staff and volunteers to support youth.
• We are also investing $7.5 million in Kids Help Phone to support their mental health services for children and youth during the pandemic.
• 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 and targeted mental health and substance use supports for frontline workers and healthcare personnel.
• Frontline workers can also access free counselling, peer support groups, and a range of completely anonymous, self-guided programming on the portal anytime at their convenience. This includes co-designed mindfulness sessions for health care workers to reduce stress and support coping with work/life demands.
• The portal also 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 SUPPORTS 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.
• The Promoting Health Equity: Mental Health of Black Canadians Fund is investing $10 million to support community-based projects across Canada.
IF PRESSED ON PREVIOUS INVESTMENTS…
• 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.
• 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.
• 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.
IF PRESSED ON THE UTILIZATION OF WELLNESS TOGETHER CANADA…
• As of November 29, 2021, over 1.9 million individuals across all provinces and territories have accessed the Wellness Together Canada portal in over 5.5 million web sessions since launch.
• Approximately 39% of site visitors are men, which compared to other services is higher than usual male engagement.
• Approximately 47% 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, 85% 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.
• Health Canada will continue to 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 applicable privacy and health information standards to maintain the security and confidentiality of personal information. Vendors are bound by the privacy protective terms that are inserted in all contracts that involve 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.

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.

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

Government Actions and Investments to Improve Access to Mental Health Services and Address the Impacts 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 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.

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.
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 support projects that promote mental health and prevent mental illness in populations disproportionately impacted by the COVID-19 pandemic, including health care workers, front-line 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 posttraumatic stress disorder (PTSD) and trauma in frontline workers and others who are most affected by the COVID-19 pandemic.
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.
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 Fund 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. PHAC is administering an initial round of grants to 57 distress centres in winter/spring 2021. A portion of funds will support an additional round of grants in fiscal year 2021-22. In addition, $2 million of this funding will support the development of resources to assist distress centres in meeting the needs of diverse and vulnerable populations.
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.
CIHR provided the Canadian Research Initiative in Substance Misuse with a $1 million directed grant to undertake urgent activities to support people who use drugs, decision-makers and care providers in light of COVID-19. This includes the creation of six national guidance documents and a rapid assessment of the challenges faced by people who use drugs during the COVID-19 crisis to guide future policy decisions.
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. In addition, in collaboration with Statistics Canada, PHAC funded two cycles of data for the Survey on COVID-19 and Mental Health to better understand the wider impacts of the pandemic on mental health in Canada. A special collection of research articles based on the first cycle of data was released in the Health Promotion and Chronic Disease Prevention Journal on September 27, 2021. The Canadian Community Health Survey also resumed in September 2020. The Canadian Community Health Survey provides data on a variety of mental health indicators, and has been collected for many years prior to the pandemic. It will allow for ongoing measurement of changes in mental health of the Canadian population as the pandemic continues and as Canada recovers.
Suicide Prevention
The Government of Canada is investing $21 million over five years in 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. By 2023, 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 2022. In response to motion M-174, which called on the Government of Canada to establish a national suicide prevention action plan and was unanimously supported by parliamentarians in 2019, the Public Health Agency of Canada is developing an action plan that aligns with the Framework.
Posttraumatic 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. The Government of Canada is now working with partners on the implementation of the Framework. The Act requires the Public Health Agency of Canada to report on the effectiveness of the Framework within five years of its release (by February 2025).

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 over two years to develop national standards for mental health, in collaboration with provinces and territories, health organizations, and key stakeholders.
o $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, front-line workers, youth, seniors, First Nations, Inuit and Métis, and Black and other racialized Canadians.
o $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.
o $10 million for the Mental Health of Black Canadians Fund to support community-based projects across Canada.
o $13.5 million through the Canadian Institutes of Health Research and partners for the COVID-19 and Mental Health Initiative to provide timely evidence to decision makers on mental health and substance use responses in the context of COVID-19.

• As of November 29, 2021, over 1.9 million individuals across all provinces and territories have accessed the Wellness Together Canada portal in over 5.5 million web sessions since launch. Approximately 39% of site visitors are men, which compared to other services is higher than usual male engagement. Approximately 47% 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, 85% 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.