Question Period Note: Funded Mental Health and Addictions Research

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• Our government continues to recognize the importance of funding innovative and timely research that will improve health outcomes for people with mental illness and substance use disorders.

• That is why, over the last five years, through the Canadian Institutes of Health Research, we have invested over $333 million in mental health and behavioural disorders research and over $110 million in research on addictions.

• Additionally, in Budget 2021, we committed $45 million over two years to develop evidence-informed national mental health service standards.

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

For example, CIHR, in partnership with the Graham Boeckh Foundation, is supporting ACCESS Open Minds, a national project that is transforming the way youth aged 11-25 access mental health care by developing and testing evidence-informed approaches. There are currently 17 sites operating in 7 provinces and one territory. These sites have transformed youth mental health services in diverse ways based on local context. For example, in Ulukhaktok, a remote community in the Northwest Territories where professional service providers are not always available, the site is evaluating a model where lay health workers are trained to provide support to youth in distress.

Between 2015-16 and 2019-20, CIHR invested over $20 million dollars in research related to suicide prevention. This research will lead to the discovery of new, effective solutions for better prevention.

The impacts of COVID-19 on mental health, substance use, and addiction are also being measured, offering new evidence-based treatments and services to all Canadians. Recent findings identified that substance use is likely increasing during COVID-19, and that treatment disruptions can cause relapse, withdrawal and the restart of risky injection behaviours. While caregivers themselves and older Canadians require additional supports.

COVID-19 and Mental Health Initiative (CMH)
The mental health of Canadians has worsened during the pandemic. As noted in the brief submitted to HESA on March 4, 2021, in April 2020, CIHR launched the CMH initiative to provide timely evidence to decision makers on mental health and substance use responses in the context of COVID-19. To date, CIHR has launched four funding opportunities under this initiative, supporting a total of 101 projects for a total investment of $13.7M from CIHR and partners, including:
1. Rapid synthesis and knowledge-to-action funding opportunity for current evidence on mental health service needs, delivery and guidelines, practice and related issues, in the COVID-19 context.
2. $1M directed grant to the Canadian Research Initiative in Substance Misuse (CRISM) to undertake urgent activities to support people who use drugs, decision-makers and care providers in light of COVID-19.
3. COVID-19 Mental Health & Substance Use Service Needs and Delivery funding opportunity to advance research on understanding rapid system transformations, developing innovative adaptations of services and/or delivery and matching access to service with needs.
4. $191K to four CMH grantees to accelerate rapid research related to emerging SARS-CoV-2 variants and generate timely evidence relevant to biological, clinical, health system, and public health strategies.

Budget 2021
Highlights with respect to mental health research and services from Budget 2021 include:
• $45 million/2 years, starting in 2021-22, to Health Canada, PHAC, and CIHR to help develop national mental health service standards, in collaboration with provinces and territories, health organizations, and key stakeholders.

Substance Use
CIHR supports researchers across Canada that aim to address various issues related to substance use and has invested more than $110M in the area between 2015-16 and 2019-20.

In 2014, CIHR established a national research network in problematic substance use called the Canadian Research Initiative in Substance Misuse (CRISM). CRISM is composed of four large regional nodes (British Columbia, Prairies, Ontario, Québec/Atlantic) that connect researchers, service providers, decision makers and people with lived experience from across Canada. CRISM is recognized as a critical network that responds to the policy and evidence needs of decision-makers. CRISM activities include:

• The OPTIMA Study (2016-ongoing) – a national multi-site clinical trial involving over 270 participants recruited from all four CRISM Nodes to compare and evaluate two models of care for the treatment of opioid use disorder. (~$4.4 million over 4 years).
• National Treatment Guideline – CRISM has developed a National Guideline for the clinical management of opioid use disorder, which was published in the Canadian Medical Association Journal on March 5, 2018.
• Implementation Research Program – On September 14, 2017, CIHR announced a new investment of $7.5 million over six years for CRISM to conduct a national research program for effective implementation of evidence-based interventions into clinical and community.

On April 16, 2021, CIHR launched CRISM Phase II: Regional Nodes funding opportunity. This funding opportunity represents a total investment of $17M over 6 years, beginning in 2022-2023, and looks to build and expand on the successes of the Initiative’s first phase by increasing the number of Regional Nodes to enhance geographic coverage while maintaining the “Network of Networks” and expanding capacity.

In addition to priority-driven investments to CRISM, CIHR also invested $1.5 million to support evaluation of interventions implemented across Canada in response to the opioid crisis through the Evaluation of Interventions to Address the Opioid Crisis Funding Opportunity.

In March 2020, CIHR supported 7 projects on methamphetamine and related psychostimulant use, totaling $700,000. This funding supports research in diverse areas including effectiveness of existing treatment options, harm reduction strategies, sociocultural impacts of methamphetamine use and epidemiology of methamphetamine use and associated disorders.

Best Brain Exchange (BBE)
In November 2020, CIHR hosted the ‘Innovations in Virtual Care for Mental Health and Substance Use’ BBE in collaboration with the British Columbia Ministry of Health, British Columbia Ministry of Mental Health and Addictions, and Michael Smith Foundation for Health Research. This BBE brought together provincial policy and decision makers, researchers and implementation experts, non-governmental organizations and other key stakeholders to gain an understanding of how virtual care can meet the unique and evolving mental health and substance use service needs of British Columbia’s diverse population during and after the COVID-19 pandemic.

CONSIDERATIONS
The Liberal Party’s election platform included the following commitments related to mental health and substance use:
• Establish a new federal transfer to provinces and territories—the Canada Mental Health Transfer—to assist jurisdictions to expand the delivery of high-quality, accessible, and free mental health services.
• Commit 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.
• Fully fund a national, three-digit mental health crisis and suicide prevention hotline.
• Work with partners to ensure timely access to perinatal mental health services.
• Commit an additional $1.4 billion for a distinctions-based mental health and wellness strategy with First Nations, Inuit, and the Métis Nation, expanding on the recent commitment of $597.6 million, for a total investment of $2 billion over five years.
• Introduce a comprehensive strategy to address problematic substance use to end the opioids crisis.
• Invest $25 million for public education to reduce the stigma associated with problematic substance use.
• Invest $500 million to support the provinces and territories in providing access to a full-range of evidence-based treatment, recognizing that successful treatment is not determined by long-term abstinence.
• Support provinces and territories in creating standards for substance use treatment programs so that Canadians can access quality and evidence-based support when they need it most.

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