The Walk Has Yet to Follow the Talk: Liberals Are Failing on Mental Health.
Budget Special: The 2023 budget does not fully address Canada's mental health treatment gap.
By Harshini Ramesh and Sandrine Desforges
The COVID-19 pandemic exacerbated already existing mental health challenges, and its effect was particularly notable on the youth. This group experienced the largest drop in their perceived mental health after the onset of the pandemic, with only 40 percent of youth aged 15 to 24 reporting having an “excellent” or “very good” mental health in early Spring 2020, compared to 62 percent in 2018.
Additionally, recent evidence [1] [2] [3] shows that the current inflationary context and increasing costs of life contribute to worsening Canadians’ mental health and well-being, by increasing anxiety, depression and suicidal ideations, and by limiting their ability to afford healthcare.
Canada’s Prime Minister seemed to recognize the ongoing mental health crisis and the urgent need to address it when he created the new Ministry of Mental Health and Addictions in 2021, with the mandate to establish permanent health transfers to provinces and territories to expand the delivery of mental health services.
However, the 2023 budget fails, again, to uphold this promise. Almost two years later, the walk has yet to follow the talk.
Current State of Youth Mental Health
It is known that 75 percent of mental health disorders will have their first onset before the age of 25, and the state of youth mental health has declined since the early 2000s, especially for females. Currently, approximately 1.2 million children and youth across the country experience mental health disorders. However, the treatment gap remains inappropriately high: an approximation of only 20 percent of those experiencing mental health challenges will receive adequate treatment and support.
Youth from traditionally marginalized communities face disproportionate mental health impacts and additional barriers to accessing mental health services. Immigrants and refugees, members of the LGBTQIA2S+ community, faith groups, people living with differing abilities, members of Indigenous communities, and those living in the North or in remote communities, experience additional discrimination and stigma, and lack access to culturally responsive services and supports. Additionally, youth living in lower-income households generally report lower mental health and well-being, and higher rates of suicide ideation.
With the negative effects of the pandemic and social media only worsening for youth mental health, advocacy and government action is critical.
Advocacy and Budget Pre-Submission Asks
Advocacy efforts on youth mental health issues, including pre-budget submissions and open letters [1] [2], highlighted the following needs:
A Canadian Mental Health Transfer. While listed in the Minister of Mental Health and Addictions’ mandate letter, it has not yet been implemented. The Transfer would expand the healthcare systems’ capacity to deliver accessible, high-quality, and free mental health services.
Universal mental health care. Currently, mental health care provided in the community is neither free nor covered by public insurance. Families must wait for a crisis to happen to rely on hospitals’ emergency services. There is a need to shift from costly and tardy interventions to preventative ones.
Dedicated and permanent funding for community-based organizations. Mental health organizations argue that they don’t see the impacts of the latest federal mental health investments on the ground. Bilateral agreements with provinces and territories are a step forward but aren’t enough to ensure access to community services that meets various mental health and substance use needs.
2023 budget and Investments in Youth Mental Health
The budget has outlined the following actions for critical mental health support:
Allocated $3.7 billion until 2026-27 and $2.5 billion in 2027-28 as a part of the Health Agreements with provinces and territories with the new Tailored Bilateral agreement, for home care and mental health agreements;
Asked provinces and territories to develop plans to measure and report progress on mental health and substance use services;
Asked provinces to provide fair, equitable, and culturally safe health care services for Indigenous Peoples in their commitment to reconciliation;
Committed $158.4 million over three years to implement the 988 Suicide Prevention Line to support various populations including youth, who experience higher rates of death by suicide.
The federal budget, however, does not address the mandate letter and critical mental health system needs. Indeed, there are no requirements to ensure that the investments are targeted at community-based organizations. As long as provinces and territories don’t receive the necessary funds to have the means to provide free, quality mental health care to all, the treatment gap will continue to persist, especially impacting members of at-risk populations who are more likely to fall into the cracks of the system.
While the requirement to measure and track progress on the use of services is a great step forward in order to increase transparency and accountability, clear targets and a coordinated strategy with provinces and territories are missing, especially in regard to how to better support underserved communities. This is despite providing evidence of differential and disproportionate mental health impacts on youth within the accompanying “Statement and Impacts Report on Gender, Diversity, and Quality of Life”.
What Is the Way Forward?
Two years into its current term, the Liberals have yet to meet the agreements listed in the Prime Minister’s mandate letter and as such, have failed to respond appropriately to the calls of mental health advocates.
The budget emphasizes scaling back government spending. Fiscal prudence is needed to ensure we are prepared for spending down the line, in critical areas which will require public investments. Achieving net-zero emissions by 2050, an ageing population, and future economic crises are some examples of upcoming challenges for Canada. However, a critical factor of economic health is the health of the population, especially the youth. Mental health issues cost the Canadian economy $50 billion a year, including health care costs, lost productivity, and reduced quality of life. Investments in mental health programming reap long-term benefits for the economy and the population’s overall well-being.
If the mental health and well-being of Canadians is truly a priority for Trudeau’s government, it’s time it provides the country with the means to achieve its ambitions. To protect the well-being of future generations, it must invest in a national mental health strategy that significantly integrates provinces and territories, recognizes the crucial contribution of community organizations, and approaches mental health and well-being needs from an intersectional lens.
Harshini Ramesh (she/her) is a Master of Public Policy Candidate with the Max Bell School for Public Policy at McGill University. She is interested in climate and environmental policy, as well as advancing innovative solutions that reimagine policy and governance responses to climate change.
Sandrine Desforges (she/her) is a Master of Public Policy Candidate with the Max Bell School of Public Policy at McGill University. She has experience working in policy-making in the fields of mental health and well-being, post-secondary education, and prevention of gender-based violence.