Canadian organizations representing mental health consumers and health professionals applaud the 118 recommendations in a new Senate report, and are optimistic that the federal government will act on its key recommendations by autumn.
The Senate Committee on Social Affairs, Science and Technology report, Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada, reflects a powerful need, committee's Chairman Senator Michael Kirby, told CMAJ. “We managed to ignore the issue of mental health for a very long time. If you look at the services on the ground, they are hugely fragmented. There is no cohesive, patient-oriented system. Mental health has not been at the top of the political agenda. The overwhelming reason for that is the stigma of mental health, which is the reason it has never had the kind of public support that other health issues, such as cancer, have had. The second reason is that services for the mentally ill do not fall under a single department — some aspects address health, others relate to housing or training.”
“Other countries have made a start to overcome the stigma surrounding mental health. Canada is the only remaining G8 country without a national mental health strategy.” Mental illness affects 1 in 5 Canadians during their lifetime.
The report calls for the establishment of a National Mental Health Commission by fall to pave the way for a national action plan. During the federal election, the Conservatives agreed to set up such a commission. According to Phil Upshall, national executive director of the Canadian Alliance on Mental Illness and Mental Health, which represents 18 national organizations, such a strategy is “a very important step in recognizing the significant personal costs and economic burden of mental illness in this country.”
Upshall said the committee's recommendation for targeted transfer payments to the provinces and territories will pay for a community-based approach to service delivery that will “be the key to ensuring that services are delivered where, when and how they're needed.”
Connie McKnight, executive director of the National Network for Mental Health, a national consumer coalition, was especially pleased with the importance the report placed on the ability of people with mental illness to retain employment, and that community programs be put in place to support this goal. She also noted that, since the report came out, Canada Revenue Agency has decided to revisit its disability tax credit to “make it more user friendly, so that persons with mental illness can access it.”
The report estimates that as a result of the deinstitutionalization of patients suffering from mental illness, at least 140 000 people do not have adequate housing. According to Penny Marrett, chief executive officer of the Canadian Mental Health Association, “we were thrilled when we saw housing addressed as a key determinant of health in the committee's report. In the end, if you don't have a roof over your head, how can you have mental health?” The 2006 federal budget set aside approximately $800 million for affordable housing, in cooperation with the provinces.
Dr. Ruth Collins-Nakai, president of the Canadian Medical Association, called the report a “visionary roadmap” and said that Canada's doctors support the recommendations as being “both practical and strategic.”