Question Period Note: Actions taken to improve access to mental health and addiction services

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• As part of the Budget 2017 commitment to improve access to mental health and addiction services, the Government is investing $5 billion over 10 years to increase supports for Canadians.
• As a result of this investment, provinces and territories have implemented new initiatives to improve access, and spread evidence-based models of mental health and addiction services, with a particular focus on strengthening supports for children, and youth.
• Through the renewal of bilateral funding agreements, provinces and territories will outline how they will use the $3 billion that remains available over the next five years.

Federal Investment:
On March 22, 2017, Budget 2017 committed to $11 billion over 10 years to improve access to home and community care and mental health and addiction services as follows:
- $6 billion over 10 years, starting in 2017-18, to improve access to home and community care, including palliative care; and,
- $5 billion over 10 years, starting in 2017-18, in support of mental health and addiction services initiatives.

Shared Health Priorities and Bilateral Agreements:
In August 2017, FPT Ministers of Health (except Quebec) agreed to the Common Statement of Principles on Shared Health Priorities (CSoP) which set out a shared agenda for improving access to home and community care and mental health and addiction services supported by federal investments (see sidebar). Based on the asymmetrical agreements of 2004, the Government of Canada and the Government of Québec agreed to an asymmetrical arrangement distinct from the CSoP.

Priority areas for investment:
• Expanding access to community-based mental health and addiction services for children and youth (age 10-25), recognizing the effectiveness of early interventions to treat mild to moderate mental health disorders;
• Spreading evidence-based models of community mental health care and culturally-appropriate interventions that are integrated with primary health services; and
• Expanding availability of integrated community-based mental health and addiction services for people with complex health needs.
Following endorsement of the CSoP, the Government of Canada negotiated and finalized bilateral agreements with each jurisdiction, which are posted publicly online (here). These agreements detail how each province or territory will use federal investments to increase access to services in the two priority areas. Each jurisdiction developed its own action plan, annexed to the bilateral agreement, which identifies the new or expanded programs in home and community care and mental health and addiction services to be supported by the federal investments.

The funding is allocated to each province and territory on a per capita basis. While bilateral agreements recently expired (March 31, 2022), federal, provincial and territorial governments are working together to renew agreements so that provinces and territories can use the remaining funding available over the next five years ($3 billion to support mental health and addiction services).

The Common Statement also includes a commitment for PT governments to work with the Canadian Institute for Health Information on a set of common indicators in these areas, to continue collaborating to advance work in health innovation and prescription drugs, and to engage with Indigenous leaders to improve health outcomes for Indigenous peoples. At the June 2018 Health Ministers’ meeting, Health Ministers (except Quebec) endorsed a set of common indicators, developed by CIHI and FPT governments, to measure and report progress to Canadians on shared priorities.

Indicators for access to mental health and substance use services
• Hospital Stays for Harm Caused by Substance Use
• Frequent Emergency Room Visits for Help With Mental Health and/or Addictions
• Self-Harm, Including Suicide
• Wait Times for Community Mental Health Counselling
• Navigation of Mental Health and/or Substance Use Services
• Early Intervention for Mental Health and/or Substance Use Among Children and Youth

Indicators for access to home and community care
• Hospital Stay Extended Until Home Care Services or Supports Ready
• Caregiver Distress
• New Long-Term Care Residents Who Potentially Could Have Been Cared for at Home
• Wait Times for Home Care Services
• Home Care Services Helped the Recipient Stay at Home
• Death at Home or in Community

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