Failing Grade – For a second consecutive year, access to mental health and substance use health services received failing, or poor grades across Canada

BY SIMONE J. SMITH

“It’s time for governments to accelerate their response to what is important to the people of Canada and invest now to improve outcomes for those looking for help.” Anthony Esposti, CAMIMH Co-Chair

I want to live in a country where an emphasis on prevention means that fewer mental health problems develop. A country where problems are detected and treated early—with the benefit of a full range of psychological services that are fully funded by the public purse. A country where fewer people are sidelined from the workforce in the prime of their career. A country that leads not just in word, but in deed.

In today’s hyper-connected world, a cacophony of voices clamours for our attention. From the constant scroll of social media to the 24-hour news cycle that floods us with stories of: Trump, tariffs, and what Kanye West’s wife is wearing, distractions abound, vying for our time and focus.

Amidst this digital deluge, a critical issue, often relegated to the background noise despite its prevalence, continues to silently erode the well-being of Canadians: mental health. While initiatives like Bell Let’s Talk and government-funded programs have brought the topic into sharper focus, a significant gap in care persists. This deficit isn’t due to a lack of resources or awareness, but rather, a pervasive distraction fostered by the very media that should be amplifying the conversation. We’ve become so engrossed in the noise that we’ve lost sight of the silent struggles happening all around us, leaving a critical need unaddressed and countless individuals without the support they desperately require.

For the second consecutive year, mental health and substance use health services across Canada have received failing grades, highlighting the persistent gaps in access to care and the lack of substantial progress by provincial and federal governments.

Overall, Canada’s mental health grades have seen little change over the past year, with only the governments of: British Columbia, Manitoba and Ontario improving their rates from ‘F’ to ‘D’, while only Nova Scotians rated access to substance use health services as slightly better than last year (from ‘F’ to ‘D’).

According to the latest National Report Card survey from the Canadian Alliance on Mental Illness and Mental Health (CAMIMH), six of nine provinces and the federal government received a failing grade of F, raising alarms about their lack of action, and Canada’s ability to meet the growing demand for mental health and substance use health care services.

While British Columbia, Manitoba and Ontario have shown slight improvements and received marginally passing grades for mental health (D), the overall picture remains bleak despite the majority of Canadians expressing dissatisfaction and demanding action:

• Nine-in-ten Canadians (90%) consider timely access to mental health care services to be important, with two-thirds (67%) rating it as “very important”– yet there has been no meaningful progress made since last year.
• The majority of Canadians (83%) believe their provincial government must hire more mental health providers to address this gap.
• Canadians feel governments are not doing enough to evaluate whether current mental health and substance use health services are working.
• Timely access to substance use health services is increasingly important

An estimated 21% of Canada’s population will meet the criteria for a substance use disorder or addictions in their lifetime. The report also found that three-quarters (75%) of Canadians believe access to substance use health services is important, with 46% saying this is very important, up slightly from last year’s survey. A similar proportion (73%) believe it is important for the government to support access to education for the health workforce on substance use.

A notable 64% believe access to substance use health services should be on par with access to mental, or physical health care, reflecting a growing recognition of the need for parity in care delivery.

The survey findings reflect Canada’s chronic underfunding of mental health and substance use health services. Provinces allocate only 6% of their total health budget to mental health care—in stark contrast to other G7 nations like: France (15%), Germany (11%) and the United Kingdom (9%) and CAMIMH’s call for 12%. There is a clear need for improvement.

The consequences of this systematic underinvestment are devastating:

• Untreated mental illness costs the Canadian economy an estimated $50 billion annually.
• More than 1 in 2 Canadians struggling with mental health say they are not receiving the help they need.
• Canada continues to face a substance use crisis, with an average of 20 opioid-related deaths occurring each day.

The results leave no room for complacency and Canadians have made their priorities clear:

• Governments must increase public investments to improve timely access to effective mental health and substance use health services.
• Hiring more mental health and substance use health providers is essential to address shortages and ensure Canadians get the help they need when they need it.
• Parity between mental health, substance use health and physical health services must be enshrined in federal legislation with targeted funding.

I had an opportunity to speak with Anthony Esposti, CAMIMH Co-Chair, and he was eager to share his thoughts with me.

“The pandemic had an enormous impact on our mental health,” Anthony began. “Now more than ever, people are in need of substance use health. Our generation never went through something like this. Households were locked up with each other in isolation, which is not good for anyone. Some of us found ways to cope during the pandemic, and some of us did not. Regardless, there has been no investment in improving our mental health programs, and most of them remain largely underfunded.”

I had noted in the report that underfunding was a major barrier.

“All in all, 5% of Canada’s budget goes to mental health. Other countries put in 10 – 14%. Although there is funding, it is not enough. The reality is that when the community attempts to use these services, there are high wait lists. There are high level quality services, unfortunately, these wait lists continue to grow. So, people resort to going to the emergency, which is an expensive way to deliver health care.”

“Place the money in the hands of service community providers. They do a lot with very little. They are able to deliver the service very efficiently. We are talking about an equitable solution.”

“What are the psychological impacts of working in a chronically underfunded and under-resourced mental health system on healthcare providers,” I asked?

“With an overwhelmed system, you end up with overwhelmed people. You have a group of professionals who want so desperately to help and are not given the tools to do so. It creates a lot of frustration. The equity and pay is way off kilter, and well below physical care. Underpaid, overworked does not make a happy system. The system is not designed to support the people they serve.”

“It is deadly! Our mental health has an incredible impact on our physical health. When services are not being provided the whole person suffers. We need to recognize that there is a disproportionate impact for equity seeking groups especially when it comes to access to services.”

The Canadian Mental Health Association (CMHA) Toronto has just launched a new, free grief support program. The program fills a gap in bereavement provisions available in the city, removing the barriers to accessing psychological treatment in a country experiencing an alarming increase in mental health issues, without proper infrastructure in place.

The program offers a variety of services designed to help participants navigate their grief and build resilience. Through this program, CMHA Toronto offers workshops and grief support groups that focus on emotional regulation, healing, and building resilience. The program includes two grief seminars, followed by dedicated support groups tailored to the individual’s specific needs:

• Survivors of Suicide Loss – Weekly for 6 sessions
• Grief Recovery After a Substance Passing (GRASP) – Weekly for 4 sessions
• Adult Education Support Group (Loss of Mother/Father/Sibling/Friend/Grandparent) – Bi-weekly for 6 sessions
• Parents of Older Children – Weekly for 5 sessions
• Loss of Client/Compassion Fatigue – Bi-weekly for 4 sessions
• Spousal Grief Group – Weekly for 4 sessions

CMHA Toronto’s Grief Support Program is available online and in-person across the Greater Toronto Area. Everyone is welcome and no referral from a doctor is necessary. Explore this further by visiting https://cmhato.org/programs/grief-support-program/

Until mental health is understood as being of equal importance to physical wellness, we have work to do. The parity we seek goes above and beyond just dollars and cents. Mental illness is legitimate and treatable and must be respected as such.