Mental health worsening across Canada, access to care is uneven, report says

Kristin Pardy hid her bulimia for more than 10 years. 

When she finally mustered the courage to go to her local clinic in Cartwright — a community of about 400 people in southern Labrador — and share her "secret," the nurses were "amazing" and got her a referral to an outpatient eating disorders program in St. John's.

But St. John's is about 1,400 km away, and as a working mom, ”I couldn't leave my kids for that long. I definitely couldn't leave my job for that long," Pardy said. 

"Because it was going to be an outpatient program, I would still have to pay to find accommodations for the six to eight weeks that I was there. I'd still have to pay my bills while I was there. I'd still have to feed myself while I was there," the 38-year-old paramedic said in an interview by phone. 

"(With) the financial barriers and the logistical geographical barriers of the only treatment available to me, I just, I couldn't do it," said Pardy, who is a member of Nunatukavut, the southern Labrador Inuit population. 

Inability to get needed mental health care is a reality facing many people in this country, according to The State of Mental Health in Canada 2024, a report released Tuesday by the Canadian Mental Health Association. 

The report says 2.5 million people can't get the care they need, citinga variety of reasons, from unavailability of services to the out-of-pocket costs of seeing many mental health professionals whose services aren't publicly funded.  

It says 57 per cent of young people between 18 and 24 years old who have early signs of mental illness say they can't afford to get services.

The grim findings come when the need is greatest, as overall mental health across Canada is three times worse than it was before COVID-19, the report says.

Access to care varies widely across provinces and territories, with the biggest barriers in northern and rural parts of Canada, it says. 

That's certainly the case in rural Newfoundland and Labrador. 

During the pandemic, Pardy suffered from postpartum depression after the birth of her third child and was also diagnosed with anxiety and obsessive-compulsive disorder by a doctor visiting the community.

She was prescribed medication for her anxiety, but her husband's health insurance provider cut her off of his plan once they became aware that she had anxiety and bulimia.

The letter dated Dec. 16, 2021, which The Canadian Press has seen, said her eligibility for spousal coverage on the group plan had depended on her "providing evidence of good health." It said the company was unable to increase the premium to account for her new status of "above average risk" and advised her to seek insurance coverage elsewhere. 

For the next two and a half years, Pardy did the best she could to manage without any treatment,noting she probably wouldn't have been able to continue working if it weren't for the lighter workload in such a small community. 

Things finally took a turn last June, when Pardy went from being employed by a private company to working as an emergency medical responder with the Newfoundland and Labrador government, making her eligible for a new package of benefits. 

But the help she can get is still limited. 

”I'm kind of trying to patch together some sort of treatment that will work for me given my location," said Pardy, who is a member of the Canadian Mental Health Association's national council of people with lived experience.  

Pardy is on a new anxiety medication she said is helping and also talks to a therapist by phone.   

But the therapist is funded by her employee assistance program, which will only cover a total of eight sessions.

Sarah Kennell, the national director of public policy with CMHA, said the root cause of problems in accessing adequate mental health care is the fact that mental health isn't part of Canada's universal health-care system. 

Although hospital care and care by medical doctors, including psychiatrists, are paid for by government, people have to pay out of pocket or through insurance for most community-based mental health and addictions counselling, Kennell said in an interview.  

Mental health is currently “siloed” from the nation's universal health-care system, she said, and the federal government needs to either amend the Canada Health Act or create "parallel legislation" to make mental-health care accessible to everyone. 

"Our (mental health) system is a pay-to-play system whereby services like counselling, psychotherapy, addictions treatment, (and) treatment for eating disorders all fall outside of our public universal health-care system," she said. 

When people don't have insurance, they often can't afford mental health care, Kennell said, noting that the affordability crisis is making things worse.

"People are having to choose between rent and therapy, putting food on the table and addictions treatment and those are choices we don't think anyone in Canada should have to make,” she said.

Lower-income groups report higher levels of anxiety than higher-income people, Kennell said. 

The report calls on the federal, provincial and territorial governments to dedicate 12 per cent of their total health budgets to mental health — up from the current average of 6.3 per cent across the country.  

That figure is determined by the percentages of health budgets dedicated to mental health in peer countries, including France, Germany, the U.K. and Scandinavian countries, Kennell said.

The State of Mental Health in Canada 2024 is the first edition published by the Canadian Mental Health Association and will serve as a benchmark to measure progress in future reports released every two years.

The CMHA used data from Statistics Canada's community health survey, as well as qualitative measures including interviews with people who have experienced mental health issues. 

This report by The Canadian Press was first published Nov. 19, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.