Canadians endure long waits for mental health care

World Mental Health Day this year was met with the usual pronouncements of commitment to a high-quality mental health care system, by both federal and provincial governments. No doubt many Canadians were appreciative of these statements, for a category of illnesses that may affect as many as one in five Canadians in any year. Sadly, for those actually seeking professional help for their mental illness, there’s a notable lack of access to that promised care in Canada.

Delays in accessing mental health services in Canada have grown to nearly six months from general practitioner referral to treatment by a psychiatrist. That’s up from a little over four months back in the early to mid-2000s.

General practitioners, who often serve as the first point of contact for those seeking mental health care, are also less accessible in Canada than in other developed countries with universal health-care systems. That’s true whether we look at the availability of same-day or next-day appointments, the availability of care after hours, or same-day callbacks for concerns phoned in during regular hours. So it’s not surprising that Canadians who reported a mental health need were more likely to use the emergency room for care that could have been provided by a regular doctor than patients in other universal access countries—in emergency rooms that tend to have longer wait times than in these other countries.

That poor access is paired with a lack of practitioners and facilities generally in relation to what other countries with universal access health-care systems provide their populations. Canada has fewer psychiatric care beds (ranking 22nd of 28), psychiatrists (16th of 28) and psychologists (15th of 26 countries with available data) per population than the average developed country with universal health care. Canada ranks above the average only in the number of mental health nurses per population (6th of 17), though Canada also has a higher share of psychiatrists in the physician population than the average universal access developed country (7th of 28).

These are not the only shortcomings of Canada’s current approach to mental health care. Other research has found not only significant delays in accessing services for both adults and children, but also a lack of access to appropriate treatments, low rates of post-hospitalization follow-up, relatively low access to care in rural areas, and concerns around physician preparedness for dealing with mental illness and mental health conditions.

All of this underperformance does not come with a low-price tag—Canada also ranks above average in estimated mental health spending as a percentage of total government health spending. In 2018, an estimated 10.6 per cent of government health spending in Canada focused on mental health, compared to an average of 7.4 per cent among countries with available data.

Clearly government commitments to timely, widely available mental health care for those in need are less commitments today and more hoped for promises for the future.

While many mental illnesses can be treated effectively through either pharmaceutical or professional interventions or a combination of the two, patients must first have access to these treatments and the professionals that deliver them. Canadians in need deserve better than they’re getting today.