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A Snapshot of the Mental Health System in Canada

As someone who has been deeply impacted by mental health concerns personally, I’m always happy to speak on the subject to try to reduce the associated stigma. However, I want to start by saying I am not a licensed mental health practitioner. If you’re currently in crisis, the fastest and most effective way to receive public support is to get to your local emergency room. You can also text TALK to 686868 or call toll-free 1 (833) 456-4566 for 24-hour crisis support. 

Not in crisis but not feeling well? It might be more common than you think.

A 2020 poll undertaken by the Angus Reid Institute found that a staggering 50% of Canadians reported a worsening of their mental health since the onset of COVID-19 (and it’s truly frightening to imagine what those numbers would look like now, one year later). The federal government has provided $82 million for mental health since the pandemic began, so where has that money gone and have the results of their spending proved effective? 

Let’s start with virtual services, which have become the global norm over the past year.

A study undertaken in May of 2020 by the University of British Columbia showed that 65% of participants reported adverse mental health impacts related to COVID-19, yet only 2% reported accessing online mental health resources. So why is that? 

Trudging along alone in my government-mandated isolation, I turned to the Mental Health Commission of Canada (MHCC) for answers. But alas, I have never experienced the level of cognitive burden I sustained trying to make sense of this infographic from their PDF “Mental Health, Technology and You”. 

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No MHCC… making it look like a child’s board game does not make my mental health journey more “fun”; however, it does trigger the utter confusion that can accompany pre-pubescence and spark the seeds of mental health issues so… kudos?

Chugging along, I discovered Wellness Together Canada, a service that was introduced in April 2020 as a way to connect Canadians to professionals through confidential phone calls to help with mental health and substance abuse issues. Sounds great. But when I tried to make an account on their website, I was redirected back to the home page three times due to a technical glitch. It’s frustrating for anyone to come up against administrative barriers in daily life, but for someone with mental health concerns it becomes almost ironic. You begin to accept that it’s hard to get help. 

I decided to give it one more shot with MindBeacon, as the Ontario Government recently made their therapist-guided CBT program free to all Ontario residents. I made an account on the site and powered my way through a series of necessary- albeit difficult- questions about my mental health employed to ensure more personalized care. One feature that I really appreciated about the site was their auto-save function; I could close the browser and return when my mind was more refreshed. At the end of the assessment, I was assured that I would be contacted within five business days to initiate the process… So, naturally, three weeks later I was matched with a therapist to guide me through the CBT program. I have to admit I felt a flood of catharsis starting to dig into my mental health again after being away from therapy for a while. Although it’s too early in the program for me to speak definitively on it, I will say that there seems to be a high level of self-directed learning (so MindBeacon may not be effective for someone who experiences difficulties with motivation).

But what about in-person services offered prior to the pandemic?

My friends that have accessed in-person public care found it to be pretty effective… if they could make it through the wait. I commend them, because I know I couldn’t when I hit bottom. Back in 2015 I called CAMH upon recommendation from my general practitioner regarding my suicidal ideation, where I was told I was looking at a wait time of over three months for an appointment. “I have no idea where I’ll be by then” was the only response I could muster before hanging up (real answer: “I have no idea if I’ll be alive by then”). That experience drove me away from public care… but my mother, who has had clinical depression and anxiety for 30 years, stuck it out, and was kind enough to speak with me about it. She had this to say: 

“I was practically begging my doctor for a psychiatric referral. It’s very hard for someone who is mentally ill to advocate for themselves and you have to do that. I was in pretty bad shape, but you can’t be in terrible shape because then you can’t even cope and you need to be hospitalized. So, you have to be well enough to participate in group therapy, but in rough enough shape to need the group. […] Once you get into the system, you’re maybe okay but it’s really hard to get into the system”. 

My mother’s experience raises the question, how much advocacy is someone with mental health issues expected to undertake? And is there a way to make this process less difficult? 

The troubling answer is that it can be easier, if you’re able to pay for it.

The level of support provided through private care is unquestionably more specialized to meet the mental health needs of each individual and the wait times are considerably less. Period. Representations of therapy in media reflect the private care model: a patient sits across from a psychotherapist and receives a one-to-one, unique approach to care. But with hourly costs for these services averaging around $130 per hour, the likelihood of the average Canadian being able to afford this expense weekly is extremely low. This is especially troubling considering “poverty and the material and social deprivation associated with it is a primary cause of poor health among Canadians” (Dennis Raphael, Poverty and Policy in Canada: Implications for Health and Quality of Life). And what about those who are marginalized and face issues such as structural racism impacting their ability to find meaningful employment? How are they expected to pay for private care?

I went into debt to access private care in 2015 and it saved my life. After the swift rebuff from CAMH, I immediately sought private care in the form of art therapy with a practitioner who offered reduced rates for people like me who live paycheck to paycheck. She was amazing. I got the same low-cost deal for specialized relationship therapy three years later with a candidate therapist who had not yet completed all her hours at the Centre for Interpersonal Relationships. Although I couldn’t afford it in either case, it meant I could see someone right away for specific issues. The costs for their service were about half the average, at around $70 per hour, and I found them through googling “low-cost art therapy” and “low-cost sex therapy”.

I felt that level of care was worth going into debt for, but should those with mental health concerns have to take that on? Can there be a public answer that echoes the ease of private care?

The good news is that the federal government seems to be catching on to just how bad our mental health crisis is here in Canada, so we can only hope to see the effectiveness of public services rise in the coming years. CAMH was correct when they coined the phrase “Mental health is health”.

If you’re reading this and are struggling with mental health concerns, I hope you find comfort in the fact that you are not alone and that you feel able to start today in seeking treatment that is right for you. Know that therapies exist that will work for you and it is not uncommon to try a couple different therapists before you find the right fit. If you feel comfortable sharing your story, do it. Stigma has begun to slowly recede in recent years, but we still have a long way to go. Maybe if we all admit that we’re not okay sometimes, we can be there for each other a little bit better.  

And if you don’t struggle with mental health concerns and you still somehow found your way to the end of this article, I only have one piece of advice: Listen. Not to me but to those close to you who can admit they need support. Not to me but to the promises being made at a federal level and whether those promises are seen through. Not to me but to the person screaming down the sidewalk because they can’t keep it inside any longer and have nowhere else to go. These are the voices of the mental health crisis in Canada.

Cassidy Civiero