Unexpected advancements often emerge from the turmoil of a crisis. Citizens, communities, and governments, faced with daunting challenges, have historically responded with innovation and investment.
World War II spurred the mass production of penicillin to address infections from battle wounds. The Vietnam War left thousands of soldiers physically disabled and they became critical advocates for disability rights. COVID-19 could be the crisis that forces Canada to face the truth about its publicly funded healthcare system – physical health and mental health are not supported equitably. Inadequate funding makes accessing appropriate mental health resources a privilege, not a right.
Our country’s universal healthcare system is a source of pride for many Canadians. The notion that access to healthcare services is based on need, and not ability to pay, is deeply rooted in our national identity. Certainly, it is not perfect with wait times for elective surgery, chronic shortage of primary-care physicians, and lack of a national prescription drug plan. However, perhaps the most important shortcoming is the stark disparity between resources for physical and mental health.
Sprained ankle, strep throat, irregular heartbeat? A provincial health services card will get you access to primary care and specialist physicians, walk-in clinics and hospitals at no cost. Depression, anxiety, addiction? Good luck with that! Publicly funded mental health resources are limited, and waitlists stretch months. There are too few psychiatrists and the services of independent, regulated mental health professionals such as psychologists and psychotherapists are not funded by provincial health plans.
As a result, most Canadians in need of non-medical mental health services are forced to reach into their own pocket or use an employer sponsored extended health plan or, sadly, go without treatment. While some companies have steadily increased the dollars attached to mental health benefits, many plans still only provide for $500 or $1,000 annually. This amount is insufficient to cover monthly therapy sessions, let alone more frequently. And so, Canadians must choose between self-funding or going without.
Even before the pandemic, 1 in 5 Canadians could expect to suffer mental illness over their lifetime. With the impact of COVID-19 rippling through their lives for years to come, this rate of occurrence will only increase. This pandemic is delivering a serious blow to mental health – virtually everyone is forced from her normal routine and off-balance. Given the uncertainty swirling around our health and the economy, anxiety and depression are far too common.
Mental illness was already a leading cause of disability in Canada, with a staggering cost of absenteeism and lost productivity estimated between $24 billion (RiskAnalytica, 2011) to over $50 billion (Lim et. al., 2008). In 2015, Canada’s public AND private sectors spent an estimated $15.8 billion on non-dementia-related mental healthcare, which represents only 7.2% of our estimated total health spending of $219.1 billion (Mental Health Commission). This level of investment is considerably below other western countries such as the U.K. where their mental health expenditures are 13% of total health spending.
It is time to recognize that our mental well-being is as important as our physical condition. It is time to ensure that access to mental healthcare is based on need, not on ability to pay. It is time for our government to continue what it started during COVID-19 – meaningful public funding of evidence-based resources for prevention, early intervention, and treatment of mental illness.
The price tag will be large – there is no getting around that – but this is an investment. An investment that will reap benefits in the years to come with a healthier population, lower costs in other parts of our healthcare system and improved productivity. Let us make the legacy of COVID-19 in Canada one of (finally) achieving mental health parity.
Post author: Sean Gjos
Date posted: May 2020
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