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Time for an attitude shift on mental health: Senator Burey

In my decades as a practising pediatrician, I have seen a heartbreaking and frustrating scenario play out far too often: a frantic parent comes into my office with their child facing a mental health crisis. Perhaps it’s anxiety, or severe depression. The young person may be contemplating suicide. But I saw first-hand the difference in access, wait-times, and available acute and community mental health care, and the sometimes-devastating impact on children and families. 

If the child had a broken leg or a cancer diagnosis, they would get care immediately. That is what we rightly demand of our health system. Not so if it is a mental health issue, even if a life is at imminent risk. 

We have come a long way in acknowledging the importance of mental health. But the stubborn fact remains: the outcomes that all of us desire — universal and equitable access to mental health and addiction services, evidence-based treatment and support in the community, and better recovery outcomes — are increasingly out of reach. 

Canada is in desperate need of an attitude shift, a reorganization of priorities. It can start with a concept called “mental health parity” or “parity of esteem.” Already adopted in various forms in the United States and the United Kingdom, it is a recognition that people who suffer from mental health problems — including substance abuse — should receive the same level of care as people with physical ailments. 

Several mental health organizations have been advocating for years for parity of esteem. It is time that it get on the agenda of governments. 

That’s why I hosted a roundtable called “Mental Health, Substance Abuse and Addiction Parity Across the Lifespan” on September 20, 2024 in Ottawa. I invited legislators and ministers, eminent medical professionals, mental health organizations and policy experts, but — most importantly — individuals with lived experience in mental health. 

They spoke passionately about the many challenges and barriers to accessing mental health care in Canada, and about the costs, both human and economic. And about the importance of seeking parity.  Their comments and insights represent just the beginning. It is my intention to produce a paper summarizing the discussion and areas where there is agreement on actions to prioritize, and to act on them. 

I am also using a Senate inquiry to call attention to this issue in the Red Chamber. An inquiry is way of allowing senators to exchange views about an issue, calling upon their considerable expertise in health care, policy design, the economy, legal affairs, and business to help develop a wholistic approach to the pursuit of mental health parity. 

Ultimately, I hope to spark legislation that will make mental health parity a requirement. Recognizing that health-care delivery is largely within provincial and territorial jurisdiction, any federal legislation would have to do be done in consultation with provinces, territories, Indigenous governing bodies and build on the principles of shared priorities and agreements. 

It will be difficult, but it is necessary. Our continued neglect of mental health care comes with a steep economic and human cost. 

A report from the Mental Health Commission of Canada found that the annual direct and indirect costs associated with mental illness reached approximately $90 billion in 2021. Over the next 30 years, the cumulative economic impact of these costs is expected to exceed $2.53 trillion. Moreover, a submission by the Canadian Mental Health Association notes that “every dollar spent in mental health returns $4 to $10 to the economy.” 

Meanwhile, the number of people living with mental illness in Canada is expected to grow to almost 9 million within a generation. By 2050, one in two Canadians will have had a mental health problem before their 40th birthday. 

The federal government has recognized the need to act but has so far fallen short in delivering those funds they had pledged. The Youth Mental Health Fund announced in Budget 2024 was a good start, but $500 million over five years isn’t close to what is needed. 

I hope the roundtable and Senate inquiry will start to develop a strong consensus on how to make mental health parity a reality. 

All of us know someone who has suffered mental health problems and who had trouble finding help. We must do better. It’s time to do it. 

The Honourable Sharon Burey is a pediatrician who dedicated her career to children’s mental health, equity and social justice. She represents Ontario in the Senate. 

This article was published in The Hill Times on October 2, 2024.

In my decades as a practising pediatrician, I have seen a heartbreaking and frustrating scenario play out far too often: a frantic parent comes into my office with their child facing a mental health crisis. Perhaps it’s anxiety, or severe depression. The young person may be contemplating suicide. But I saw first-hand the difference in access, wait-times, and available acute and community mental health care, and the sometimes-devastating impact on children and families. 

If the child had a broken leg or a cancer diagnosis, they would get care immediately. That is what we rightly demand of our health system. Not so if it is a mental health issue, even if a life is at imminent risk. 

We have come a long way in acknowledging the importance of mental health. But the stubborn fact remains: the outcomes that all of us desire — universal and equitable access to mental health and addiction services, evidence-based treatment and support in the community, and better recovery outcomes — are increasingly out of reach. 

Canada is in desperate need of an attitude shift, a reorganization of priorities. It can start with a concept called “mental health parity” or “parity of esteem.” Already adopted in various forms in the United States and the United Kingdom, it is a recognition that people who suffer from mental health problems — including substance abuse — should receive the same level of care as people with physical ailments. 

Several mental health organizations have been advocating for years for parity of esteem. It is time that it get on the agenda of governments. 

That’s why I hosted a roundtable called “Mental Health, Substance Abuse and Addiction Parity Across the Lifespan” on September 20, 2024 in Ottawa. I invited legislators and ministers, eminent medical professionals, mental health organizations and policy experts, but — most importantly — individuals with lived experience in mental health. 

They spoke passionately about the many challenges and barriers to accessing mental health care in Canada, and about the costs, both human and economic. And about the importance of seeking parity.  Their comments and insights represent just the beginning. It is my intention to produce a paper summarizing the discussion and areas where there is agreement on actions to prioritize, and to act on them. 

I am also using a Senate inquiry to call attention to this issue in the Red Chamber. An inquiry is way of allowing senators to exchange views about an issue, calling upon their considerable expertise in health care, policy design, the economy, legal affairs, and business to help develop a wholistic approach to the pursuit of mental health parity. 

Ultimately, I hope to spark legislation that will make mental health parity a requirement. Recognizing that health-care delivery is largely within provincial and territorial jurisdiction, any federal legislation would have to do be done in consultation with provinces, territories, Indigenous governing bodies and build on the principles of shared priorities and agreements. 

It will be difficult, but it is necessary. Our continued neglect of mental health care comes with a steep economic and human cost. 

A report from the Mental Health Commission of Canada found that the annual direct and indirect costs associated with mental illness reached approximately $90 billion in 2021. Over the next 30 years, the cumulative economic impact of these costs is expected to exceed $2.53 trillion. Moreover, a submission by the Canadian Mental Health Association notes that “every dollar spent in mental health returns $4 to $10 to the economy.” 

Meanwhile, the number of people living with mental illness in Canada is expected to grow to almost 9 million within a generation. By 2050, one in two Canadians will have had a mental health problem before their 40th birthday. 

The federal government has recognized the need to act but has so far fallen short in delivering those funds they had pledged. The Youth Mental Health Fund announced in Budget 2024 was a good start, but $500 million over five years isn’t close to what is needed. 

I hope the roundtable and Senate inquiry will start to develop a strong consensus on how to make mental health parity a reality. 

All of us know someone who has suffered mental health problems and who had trouble finding help. We must do better. It’s time to do it. 

The Honourable Sharon Burey is a pediatrician who dedicated her career to children’s mental health, equity and social justice. She represents Ontario in the Senate. 

This article was published in The Hill Times on October 2, 2024.

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