The establishment of a Mental Health Commission of Canada (MHCC) by the Harper Tories in 2007 has been seen as a progressive step towards ensuring that those with mental illnesses begin to receive the same level of health care as those with other illnesses. But, in my opinion, it was nothing more than a clever ploy to make it look like something positive was finally being done.
In the past, I've criticized the MHCC because they lack jurisdiction as health care is a provincial matter, and that fact was recognized by the Standing Senate Committee on Social Affairs, Science and Technology headed by former Liberal Senator Michael Kirby.
It was their 2006 report Out of the Shadows At Last that recommended the establishment of the MHCC. That report stated that the Federal Government cannot effect change in areas like health which are the jurisdiction of the Provinces but they can influence it with grants. They said that "the provinces and territories receive federal grants in exchange for agreeing to respect certain conditions on how they use these transfers. This is how federal legislation such as the Canada Health Act works." (Sec 16.1.1). Therefore, improvements to mental health care in the provinces could be encouraged by providing the provinces with funds specifically for mental health.
Consequently, the Senate Committee recommended that:
The creation of the Mental Health Commission is, in the Committee's view, one of the two key components of what could be called a "national strategy" contained in this report. The second involves the creation of a Mental Health Transition Fund. If agreed to by the federal government, this Fund will permit the transfer of federal funds to the provinces and territories for their use in accelerating the transition to a mental health system predominantly based in the communities in which people with mental illness and addiction live. (S16.1.4)
And that key piece of the solution was never done as Liberal Senator Catherine Callbeck complained in a press release she issued on March 20, 2007. She said "This Transition Fund would be one-time federal investment to assist provinces, so that they can provide a range of services and supports in the community. The Fund would also provide for the development of new affordable housing units and for rent supplements, so that people living with mental illness can access safe and acceptable housing."
The role of the MHCC was to administer that fund as well as to work on anti-stigma, a knowledge exchange and to develop the national strategy. For that, they were to receive $17 million a year for 10 years. But that was only a very small portion of the total monies recommended. The Transition Fund was to have in each of 10 years: $224 million for a housing initiative, $215 million for a basket of services for those with mental illness, $50 million for those with both a mental illness and addictions, $2.5 million to provide telemental health in remote areas, $2.5 million for peer support and $25 million for research. The total annual expenditure was recommended at $536 million a year for 10 years. The MHCC did get an extra $110 million for housing research in addition which will be a topic of a future blog post.
Providing funding of $17 million a year out of $536 million a year (3.1 per cent of recommended) is not very progressive and goes nowhere near achieving what was hoped for and needed. And, while there has been increased funding in health care over the past 10 years, a paper by Steve Lurie of the Canadian Mental Health Association Toronto states that very little was allocated to mental health. Using Ontario as an example, he states that between 2004 and 2011, Ontario invested an additional $18.5 billion in health care. This works out to a per capita investment of $1361 in new health care compared to $16.45 for additional mental health. The Federal government spends $5.22 on new mental health care initiatives per capita.
By comparison, increased per capita expenditure on mental health in Australia is $98.13, the U.K.'s is $62.22 and the top is New Zealand at $198.93.
Let's put this lack of proper services into the most extreme of human terms. We are all familiar with the case of Vince Li who beheaded Tim McLean on a Greyhound Bus in Manitoba. Before that horrific event, Mr. Li was in a Toronto hospital in 2005 but left against medical advice because the law in Ontario is so weak that he could not be held and he was not provided with any followup. Had there been proper services and had he been held, Mr. Li would have been treated and not left in a psychotic state to deteriorate.
He would likely not be in a forensic facility, Mr. McLean might be alive and the poor RCMP officer who was first to respond would likely not have suffered with such severe post traumatic stress that he took his own life.
But Harper's solution is to toughen the Not Criminally Responsible provisions when he should be providing the money that was recommended to improve the system for those with mental illnesses.
Those who suffer from mental illness deserve the same level of care and treatment as those who suffer with other illnesses. No society can call itself progressive when it allows such needless suffering as those with mental illnesses, addictions and their families do.
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