Closing the Mental Health Gap: The Long and Winding Road?

Abstract

With 5

A Fresh Approach to Reform? A Policy Analysis of the Development and Implementation of Ontario’s Mental Health and Addictions Strategy

“…Underpinning any approach to reform is a need to resource the system appropriately to undertake the reforms and deliver services that meet the needs of citizens. As identified by Bartram and Lurie (2017), and as alluded to earlier, Canada has a long-standing gap in mental health funding relative to the disease burden of mental illnesses and addictions. Any reforms identified through this approach will require appropriate financial investments to ensure success.…”

Making the most of the federal investment of $5 billion for mental health

“…Mental health services have been chronically neglected as health policy in Canada has evolved. 2 In 1957, whether or not to include mental health facilities in the Hospital Insurance and Diagnostic Services Act was the subject of fierce debate. The federal government argued that mental hospitals were already being funded by provincial governments and should not be included.…”

“…3 A recent analysis based on Canadian Institute for Health Information data from 2015 conservatively estimated that public funding in the form of government transfers would need to increase to $3.1 billion per year, with an incremental base funding increase of $310 million each year, to achieve the target. 2 In addition, to close the gap fully, provincial and territorial governments would need to come up with an additional $2.6 billion over and above the new federal transfer of $500 million per year. 2 Given the important role of social spending in supporting mental health, the Mental Health Strategy for Canada also called for a two percentage point increase in mental health's share of social spending, which, if added to the estimate, would further increase what is required to support effective mental health policy in Canada.…”

“…2 In addition, to close the gap fully, provincial and territorial governments would need to come up with an additional $2.6 billion over and above the new federal transfer of $500 million per year. 2 Given the important role of social spending in supporting mental health, the Mental Health Strategy for Canada also called for a two percentage point increase in mental health's share of social spending, which, if added to the estimate, would further increase what is required to support effective mental health policy in Canada. 3…”

“…1 This $500 million per year (on average) is a historic first step but falls short of closing the estimated $3.1-billion annual gap in funding. 2 Vigilance and a spirit of learning will be required to make sure that the new investment goes as far as possible to reducing unmet needs for and inequities in access to mental health services. At the same time, efforts must continue to reallocate current funding toward broader transformation of the mental health system.…”