1. Economic Recovery and Growth
Given the current climate of federal and global fiscal restraint, what specific federal measures do you feel are needed for a sustained economic recovery and enhanced economic growth in Canada? The Canadian Alliance on Mental Illness and Mental Health (CAMIMH) strongly encourages the Federal Government to implement Canada’s first ever mental health strategy in Budget 2013. With national leadership and provincial partnerships it is possible to implement a coordinated national strategy for mental illness and mental health in Canada. Until recently, Canada was the only advanced industrial country without a national strategy or plan on mental health. At least one in five Canadians each year will be affected by a mental illness and it is estimated to cost the Canadian economy $51 billion dollars annually. These costs affect all Canadians —as employers, employees or taxpayers. Mental health problems and illnesses are estimated to account for nearly 30 per cent of short and long-term disability claims and $6 billion in lost pro¬ductivity costs. Young adults in their prime working years are also among the hardest hit by mental health problems and illnesses. CAMIMH believes that the federal government has a crucial role to play when it comes to funding health and health care, participating in innovation and by collaborating with the provinces and territories in the area of mental health. Solution: 1) Increase the proportion of health spending that is devoted to mental health from seven to nine per cent. 2) Increase the proportion of social spending that is devoted to mental health by two percentage points from current levels. 3) Set up an innovation fund to assist provinces and territories in developing a sustainable mental health infrastructure across Canada. The fund should be proportionate to the burden of illness in Canada. The fund could for example, be used by the provinces to expand the role of primary health care in meeting mental health needs, set standards for wait times for community mental health services for people of all ages and improve access to necessary mental health services. 4) The five key principles of the Canada Health Act (universal, comprehensive, accessible, portable, publicly administered) be applied fully and formally to mental health services across Canada. They are critical to achieving equity between mental health and general health services
2. Job Creation
As Canadian companies face pressures resulting from such factors as uncertainty about the U.S. economic recovery, a sovereign debt crisis in Europe, and competition from a number of developed and developing countries, what specific federal actions do you believe should be taken to promote job creation in Canada, including that which occurs as a result of enhanced internal and international trade?
3. Demographic Change
What specific federal measures do you think should be implemented to help the country address the consequences of, and challenges associated with, the aging of the Canadian population and of skills shortages? Canada’s aging population will mean that there will be increased pressure on the health care system. This demographic shift will have and is already having a significant impact on Canada’s health care system, and the mental health care system is arguably particularly vulner¬able. As the population ages it will become more and more important that we increase the capacity of older adults, families, care settings, and communities to promote mental health in later life, prevent mental illness and suicide wherever possible, and intervene early when problems first emerge. A whole of government approach which recognizes the interconnectedness of mental health with other health and social issues will be necessary to address this problem. 1) Implement the Mental Health Commission of Canada Strategy Changing Directions Changing Lives (2012): • Counter the impact of age discrimination on mental health. • Help older adults to participate in meaningful activities, sustain relationships and maintain good physical health. • Increase the capacity of older adults, their families, and those who work with them to identify mental illnesses, dementia, elder abuse, and risk of suicide, and intervene early when problems first emerge. Currently there are shortages of mental health professionals especially in areas such as child, youth, and seniors’ mental health. This shortage will likely get worse as the population ages. Providers are also not evenly distributed across the country affecting rural and remote regions in particular, and some services are not able to hire certain providers due to funding and remuneration policies. A pan-Canadian workforce education and development strategy could enable the development of core com¬petencies common to all mental health professional disciplines, shape interdisciplinary training guidelines, and help to build bridges to other sectors. In addition, such a strategy could create opportunities for people living with mental health problems and illnesses to take up positions at all levels of the mental health workforce. 2) Implement the Mental Health Commission of Canada Strategy Changing Directions Changing Lives (2012): • Strengthen pan-Canadian mental health human resources planning capacity to guide the development of a workforce that is the right size, has the right skills and the right mix of providers. • Develop a pan-Canadian mental health workforce development strategy, including core competencies for all mental health service providers.
With labour market challenges arising in part as a result of the aging of Canada’s population and an ongoing focus on the actions needed for competitiveness, what specific federal initiatives are needed in order to increase productivity in Canada? It is frequently noted that mental health issues are becoming, or have become, the most significant cause of disability claims in Canada. The workplace can contribute to mental well-being and play an essential part in helping people to attain their full potential and subsequently increase productivity in Canada. The costs of not addressing mental health issues in the workplace are significant: mental health problems and illnesses typically account for approximately 30 per cent of short- and long-term disability claims, and are rated one of the top three drivers of both short- and long-term disability claims by more than 80 per cent of Canadian employers. In 2010, mental health conditions were responsible for 47 per cent of all approved disability claims in the federal civil service, almost double the percentage of twenty years earlier. Mental health problems and illnesses also account for more than $6 billion in lost productivity costs due to absenteeism and presenteeism. As largest employers in their jurisdictions, The Federal Government can create psychologically effective work places for their employees which will in turn save tax dollars and improve the work force. Creating mentally healthy workplaces in the public service will benefits workers, their families, and employers, while contributing to the economic prosperity of the country. Solutions: 1) Implement the Mental Health Commission of Canada Strategy Changing Directions Changing Lives (2012): • Implement the Psychological Health and Safety Standard in the public sector. • Increase capacity to implement comprehensive approaches to mentally healthy workplaces. • Remove barriers to full participation of people living with mental health problems or illnesses in workplaces.
5. Other Challenges
With some Canadian individuals, businesses and communities facing particular challenges at this time, in your view, who is facing the most challenges, what are the challenges that are being faced and what specific federal actions are needed to address these challenges? There are a number of areas where the Federal government has a clear mandate to play a leadership role. As the fifth largest provider of health care in the country, the federal government has the opportunity to lead by example by improving its own capacity to develop mental health policy and deliver services in areas for which it has direct responsibility such as First Nations, Inuit and Metis, National Defence, Veterans Affairs, Royal Canadian Mounted Police, and Corrections. Solutions: 1) Implement the Mental Health Commission of Canada Strategy Changing Directions Changing Lives (2012): • Stop disclosure in ‘police records checks’ of apprehensions by police under mental health acts. • Reduce the over-representation of people living with mental health problems and illnesses in the criminal justice system, and provide appropriate services, treatment and supports to those who are in the system. • Improve mental health services and supports by and for immigrants and refugees. • Tackle the pressing mental health challenges in northern and remote communities. • Establish a coordinated continuum of mental wellness services (mental health and substance use services) for and by First Nations, which includes traditional, cultural, and mainstream approaches. • Establish a coordinated continuum of mental wellness services (mental health and substance use services) for and by Inuit, which includes traditional, cultural, and clinical approaches. • Build Métis capacity to improve mental health and to improve access to mental health and addictions services through meaningful, inclusive, and equitable engagement processes and research. • Improve collaboration and coordination among all levels of government regarding the mental health of First Nations, Inuit, and Métis, as well as other groups for whom the federal government has significant responsibilities for service delivery. • Improve mental health data collection, research, and knowledge exchange across Canada. • Gather and report to the public on data from the initial set of indicators for the Strategy while developing a framework for gathering and reporting on comprehensive data on outcomes over the longer term. • Develop a patient centered research agenda for Canada, encompassing psycho¬social and clinical research, neuroscience, as well as knowledge from lived experience and diverse cultures.