Question Period Note: Canada Mental Health Transfer

N/A

• As the first Minister of Mental Health and Addictions, I am committed to ensuring that mental health is treated as a full and equal part of our health care system.
• At the November 7-8 Health Ministers’ Meeting in Vancouver we engaged provinces and territories on critical issues to improve health care, including addressing health workforce challenges, health data and digital health, and integrated mental health and substance use services.
• Our health system is experiencing significant challenges and it’s important that we work together to support better health care for Canadians. We have provided record federal investments, and this needs to be matched with the quality of care Canadians deserve.
• Canadians deserve better access to family health services as well as mental health and substance use services. That’s why I have been consulting with Canadians and people with lived and living experience on how to improve our system and inform a comprehensive strategy. The discussions at the Health Ministers’ Meeting are going to inform health funding discussions going forward.

IF PRESSED ON BILATERAL AGREEMENT FUNDING ON MENTAL HEALTH AND ADDICTIONS SERVICES
• Budget 2017 committed $5 billion over ten years to support provinces and territories to increase the availability of mental health and addictions services for Canadians.
• Budget 2022 reaffirmed our intention to engage provinces and territories on the development of a Canada Mental Health Transfer.
• As a result of the first five years of this investment, provinces and territories have implemented new initiatives to improve access, integrate service delivery and spread evidence-based models of mental health and addictions services.
• Our Government will continue to work closely with provinces and territories in order to improve access to mental health and addictions services for Canadians across the country.

The mental health needs of Canadians and priority populations (e.g., youth, Indigenous populations, racialized and LGBTQ2S+ communities), which were increasing pre-pandemic, have been further exacerbated by the pandemic. Moreover, persistent barriers to care remain and have worsened during this time. Some of these barriers include variability in service availability, fragmented care (i.e., lack of integration between mental health care/primary care/other services), lack of equitable access to care, including virtual care options, lack of culturally sensitive/appropriate services, lack of capacity and stigma.

These barriers have put increased strain on the healthcare system (e.g., increase in number of individuals in mental health crisis going to Emergency Departments for care). The pandemic is not yet over and experts predict that its impact will be felt for many years, if not decades to come.

Ongoing and pandemic-response measures while generally effective are not sufficient to address the increased demand and barriers. More support is needed to ensure that the mental health needs of Canadians are addressed while the strain on the health care system is lessened. Given this the government appointed the first Minister of Mental Health and Addictions. She is working to ensure that mental health is treated as a full and equal part of the universal healthcare system and that health equities are understood and addressed.

Ongoing Government Actions and Investments to Improve Access to Mental Health 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 and addictions 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.

Agreements outlining how provinces and territories applied federal investment over the first five years expired in March 2022. Work has begun to implement one-year extensions of the agreements, which provide provinces and territories the opportunity to evaluate current needs and adjust priorities as they plan for the remaining four years of targeted funding.

National Standards for Mental Health and Substance Use Services

Budget 2021 provided $45 million over two years, starting in 2021-22, to Health Canada, the Public Health Agency of Canada, and the Canadian Institutes of Health Research to help develop national mental health service standards, in collaboration with provinces and territories, health organizations, and key stakeholders.

On March 14, 2022, Health Canada announced a partnership with Standards Council of Canada (SCC) to develop national standards for mental health and substance use services, to help fulfil commitments made in Budget 2021. Standards will be evidence-based and developed through consensus-based processes that engage experts, health organizations, people with lived and living experience, and other key stakeholders. Standards are tools for supporting health providers in the delivery of high-quality and equitable mental health and substance use services, and will help to ensure a consistent level of care is provided. They will also help to formalize what Canadians can expect in terms of the quality of services, while providing an evidence-based framework for service delivery in priority areas.

SCC is coordinating the development of an integrated suite of national standards for mental health and substance use services in priority areas that align with the Common Statement of Principles on Shared Health Priorities (CSOP). The Government has emphasized the importance of engagement with diverse stakeholders and promotion of health equity principles, which have been incorporated into the development process.

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.

Suicide Prevention

The Canadian Radio-television and Telecommunications Commission (CRTC) recently announced that it will adopt 9-8-8 for Canadians to call or text when in need of immediate mental health crisis and suicide prevention support. This will be launched across Canada on November 30, 2023.

In parallel, the Public Health Agency of Canada (PHAC) is preparing for implementation of a three-digit number for suicide prevention from a service delivery perspective. On August 31, 2022, PHAC announced that the Centre for Addiction and Mental Health (CAMH) was selected to lead coordination of 9-8-8 service delivery, building on its experience delivering Talk Suicide Canada. As a first step, CAMH will develop collaborations with key organizations to start building capacity, and engage with stakeholders to inform the scope and requirements of a timely, quality service. In addition, PHAC is engaging stakeholders from a range of sectors, including Provinces and Territories, Indigenous partners, public safety officials, People with Lived Experience, on the scope and service delivery elements, including working to understand anticipated demand for 9-8-8. Finally, PHAC is learning from international experience, including the United States, which recently introduced 988 in July 2022.

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 with its partners. Talk Suicide Canada currently provides 24/7 suicide crisis support via the phone (1-833-456-4566), in English and French, 24 hours a day, seven days a week and by text (45645), in English and French, in the evenings, to people in Canada. 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 focuses 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.

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 invested $130 million from 2020-22 in Wellness Together Canada, an online mental health and substance use support portal, and received $140 million in Budget 2022 to support the portal for two more years beginning in 2022-23. 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.

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 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 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.

• Prior to the COVID-19 pandemic, the mental health of Canadians was in decline and needs were increasing. Positive mental health declined between 2009 and 2019, especially for children and youth, 63% of whom reported excellent or very good mental health in 2019 compared to 77% in 2009. 68% of adults reported excellent or very good mental health in 2019 compared to 73% in 2009. During this time, there was also an increase in Canadians reporting having been diagnosed with depression or an anxiety disorder. For youth, these diagnoses doubled, increasing from 7% to 15% in 2019, and for adults they increased from 10% in 2009 to 13% in 2019.
• The pandemic has further emphasized the need for increased mental health care. Positive mental health further declined throughout the pandemic, with only 60% of adults and 54% of children and youth reporting excellent or very good mental health in 2021. In fall 2020, one in five Canadians reported a need for mental health care in the past year. Of those, 45% reported that their needs were either unmet or only partially met. A delay in mental health support is linked to decreased positive health outcomes, therefore timely support is particularly important.
• Among other priority populations, Canadian youth, Indigenous and those identifying as LGBTIA2+ report greated need for mental health care than adults, non-Indigenous Canadians and those not identifying as LGBTQIA2+. Of those who need care, these groups are also more likely to report that their needs are unmet or partially met.