Canada’s mental health: time to commit to what we value

Canada has seen an increase in public awareness of mental illness. Conversation on mental health has never been more engaged. Public figures and private citizens have stepped forward to share their personal stories. Raised awareness, accomplished also by organizations like the Mental Health Commission of Canada and the Canadian Alliance of Mental Illness and Mental Health, has done much to decrease the stigma of mental illness, but there is more we must do. But to make a real difference, we must move from awareness to action. Psychologists are the largest group of licensed and specialized mental health-care providers in Canada. They have seven to 10 years of university study, which prepares them to develop and interpret psychological tests of emotional and cognitive functioning; to diagnose mental illness; to develop, deliver and evaluate psychological treatments like cognitive-behavioural therapy; and to do research. While medication is necessary for some kinds of mental illness, psychological treatments are also effective either alone or in addition to medication; especially for the most common of mental health conditions, namely depression and anxiety. People who receive psychological treatments for depression relapse at a lower rate than do people treated with medication. Psychological treatments are the treatments of choice for many anxiety disorders. Psychotherapy reduces depression and anxiety in people with coronary heart disease (CHD) and, when combined with the usual medical treatments for CHD, a reduction in cardiac-related death results. One in five Canadians will experience a mental health problem every year but only about one-third of those with a mental health problem receive help; because of stigma and because psychological services are not covered by our public health insurance plans. When psychological services are covered by private plans, the coverage is often too little for meaningful amounts of treatment. Without the means or the insurance coverage, many people who need psychological help just cannot afford it. Some insurance plans put family physicians as the “gatekeeper” to accessing the services of psychologists. This is not a legislative or health care requirement since psychologists can assess, diagnose and treat mental health conditions without medical oversight. This requirement, levied by private health insurers, has no health purpose. It puts another roadblock between Canadians and the care they need while at the same time putting a greater burden on an already taxed public health-care system. We would never envision a public health system that did not provide the services of a cardiologist for heart disease or an oncologist when it comes to cancer care. But we do have a system that does not provide access to the services of the country’s largest group of regulated health-care providers when it comes to mental illness and behavioural health. Stigma not only gets in the way of seeking help, it impacts whether or not help is made accessible. This year, CPA commissioned a report that offers recommendations to enhance psychological services for Canadians. The report, An Imperative for Change: Access to Psychological Services for Canada, proposes a number of different models that could be adopted by our provinces and territories, funded variously by public and private insurance systems. Canadians deserve access to effective mental health service on par with access to care for their physical health problems. They don’t have it now. Other countries are doing more about it. The United Kingdom has invested 400 million pounds over four years to make psychological treatments available to those who need them. Australia has provided access to psychologists’ services through publicly funded health insurance. In Canada, former Senator Michael Kirby is advocating for public funds to be invested in giving access to psychological and other mental health services to children and youth. Given that 70 per cent of mental health conditions begin before young adulthood, investing in the mental health of children and youth promises tremendous benefit to individuals, families, and communities. Mental health problems currently cost the Canadian economy $50-billion annually. Although there is great concern about containing health-care costs, when it comes to mental health, spending less on care costs more. We can and must do better for Canadians’ mental health. CPA has some concrete recommendations that will benefit individuals, communities, the workplace and the pocketbooks of mental health-care funders. It is time to commit to what we value. What can be more valuable than life lived experiencing the success of love, work and community? You need your mental health for that and psychologists know how to help. Dr. Karen Cohen is the CEO of the Canadian Psychological Association. news@hilltimes.com The Hill Times

Canada’s mental health: time to commit to what we value

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Canada’s mental health: time to commit to what we value

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