Blueprint to improve mental-health care looks to cancer for inspiration

OTTAWA – Planners at the Mental Health Commission of Canada are looking at the fight against cancer as an inspiration for their new campaign.

Their first-ever national mental-health strategy issued on Monday envisions a complete rethinking of how society looks at mental health — much like the revolution around cancer three or four decades ago.

Nowadays, there is little stigma in discussing cancer of the most intimate body parts. Finding funding for treatment is common cause for philanthropists and recreational joggers alike. The cancer research community is vibrant.

Advocates for better mental health can only dream of such national consensus and attention. But with a national strategy, there is a clear path to move those dreams closer to reality.

“The mental-health system should be there for everyone who needs it and now is the time to make this happen,” the commission’s lengthy report said.

The strategy would cost governments more than $4 billion over 10 years, if fully implemented, officials said Monday — although they backed away from saying who should cover specific costs.

The report is crammed with data and research about the extent of mental- health problems in Canada and a lengthy list of recommendations on how best to prevent and treat such problems so that they no longer take such a toll on society.

“Strategic investment, clear indicators of progress and a strong social movement are needed to drive change,” the report said.

It called for early intervention, stressing over and over that proper attention to children and youth will prevent major problems later. It also urged financial support for psychotherapy and counselling for children, so families don’t have to pay out of their own pockets.

It called on governments to increase mental-health services in the criminal justice system, to give prisoners have the same access as other people.

“Efforts to reduce the numbers of people living with mental-health problems and illnesses in the criminal justice system must be strengthened and the shortfalls in mental-health services, treatments and supports within this system must be addressed,” the report said.

And it laid out a plan for suicide prevention — an area the federal government is working on too. The idea is to improve awareness in families, schools and workplaces and to have family doctors and nurses screen for mental-health problems and suicide risk.

Almost all of the 4,000 Canadians who kill themselves every year have a mental-health problem.

But the strategy also asked for action on some of the fundamental risk factors — problems such as poverty, trauma, inadequate housing and homelessness.

The strategy also made a case to significantly boost funding for mental health research.

And it called for an overhaul of how patients get access to mental-health professionals. They need more help in navigating the system and the system should be set up so that resources are available in the patients’ own communities in a way they can understand, it said.

First Nations, immigrants, low-income families and marginalized groups all need extra attention, the strategy said.

It also highlighted the need for a unified, national approach to mental health, to end the patchwork of services that exists now. Officials recognize that many of the provinces are taking action of some kind and hope that the strategy gives them a point of common cause for the future.

But that would take national leadership that, so far, does not exist.

Prime Minister Stephen Harper has spoken emotionally of the need to overcome the stigma surrounding mental health.

And the Harper government commissioned the report in the first place — another signal that it is more than a passive onlooker.

“This report highlights that we all have a role to play in dealing with mental health,” Health Minister Leona Aglukkaq said in an emailed statement on Monday. “That includes all levels of government, non-governmental organizations, business and charities.”

She pointed out that the federal government invests in mental health, above and beyond transfers to the provinces for health care program.

Harper, however, has also signalled that he sees a minimal role for the federal government in health care in general. Federal funding is set to become less and less important to the provinces over the coming decade.

While the Mental Health Commission urged more spending, it didn’t provide many details.

“Given the historical neglect of the mental-health sector, the strategy recognizes the need to invest more so that mental-health outcomes can be improved,” it said.

Specifically, it urged decision-makers to increase the share of health spending devoted to mental health to nine per cent, from today’s seven per cent, over a period of 10 years.

The strategy also urged governments to put more of their social spending budgets towards mental health. Officials had no estimate for what this would cost.

And it called for more involvement from philanthropists and private donors — money that is already starting to flow into the mental-health system in growing amounts, officials said.