Medical Groups Tell Senate Canada Needs a National Action Plan on Mental Health

On March 31, Dr. Blake Woodside, chairman of the Canadian Psychiatric Association (CPA) Board, appeared before the Senate Committee holding hearings on mental health care in Canada and urged the Committee to recommend that the federal government act now and take the lead in framing a national action plan for mental health that includes all stakeholders and jurisdictions. He emphasized the need to give mental health care its place as a basic part of overall health care. Dr. Woodside was part of an invited medical panel to explore system issues through the eyes of front-line clinicians. Dr. Sunil Patel, president of the Canadian Medical Association, and Dr. Paul Garfinkel, who spoke on behalf of the hospital community, joined him.

The Standing Senate Committee on Social Affairs, Science and Technology heard how a national framework would provide the impetus for concerted action in the mental health area across the lifespan, across different types of communities and across the full continuum of disability and morbidity severity. Dr. Woodside pointed out that one of the most difficult challenges facing psychiatrists today is the “snakes and ladders” that they negotiate to access services for their patients and that their patients face to access treatment—a symptom of a fragmented system lacking clarity and consensus on direction.

He addressed how psychiatry fits into the national action plan for mental health put out by the Canadian Alliance on Mental Illness and Mental Health (CAMIMH). CPA is one of the founding members of CAMIMH and supports the plan that identifies four action areas: public information, research, a national database and a policy framework. Dr. Woodside identified three areas psychiatry needs to tackle and in which the federal government can assist: awareness, access and accountability.

Awareness encompasses combating societal discrimination and stigma, generating knowledge and research capacity in Canada and transferring that knowledge into practice, he said. Improved access includes removing barriers to making the mental health system more community-based, removing barriers that deny funding for medications to treat mental illness, and establishing minimum standards for care—a national psychiatric and mental health educational strategy and a human resources strategy not only for psychiatry but for all mental health providers.

Dr. Woodside underscored that solving Canada’s human resources problems by recruiting physicians from other, poorer nations is immoral and that Canada needs a sustainable, made-in-Canada solution. Supporting innovations that improve access to specialized care to underserviced populations, such as the shared care initiative, is also important, but “It is not a panacea,” explained Dr. Woodside. This initiative, focused on helping psychiatrists and family doctors work together, recently expanded to include many disciplines involved in mental health care—but these too suffer from shortages and cannot solve the problem.

“Resources need to be applied to this problem,” said Dr. Woodside. “We’re talking dollars and cents, and there must be accountability mechanisms.” This requires a better surveillance system for mental health—beyond the length of stay in hospital—as well as surveillance of clinical practice and dissemination of information to both professionals and the public about effective treatments for mental disorders.

Dr. Woodside concluded by reiterating the need for a national plan that includes an evaluation framework and new investment. The federal government can also act directly on mental health issues by investing in public education, by building research capacity, by establishing national cross-jurisdictional data collection and reporting systems, by setting standards for best practices and by leading a national, cross-jurisdictional, independent, long-term, sustainable human resource plan for mental health practitioners.

Dr. Woodside recommended that the federal government publicly declare mental health a national health priority in Canada and announce that it intends to move forward on a national action plan. He also suggested developing an interim, independent, integrative body accountable to the Minister of Health to oversee this transformative change. The new public health agency should include elements of mental health as part of its mandate, and Health Canada should develop the capacity to assist in developing an action plan. HC