The Lancet, Volume 379, Issue 9829, Page 1862, 19 May 2012
Until May 8, Canada was the only member of the G8 without a national mental health strategy. However, the Mental Health Commission of Canada has remedied this shortcoming, releasing the first-ever national mental health strategy, entitled Changing Directions, Changing Lives.
The Commission describes the current state of the mental health system as “fragmented and underfunded”. One in five people in Canada has a mental health problem at a cost of more than CA$50 billion to the economy. This cost more than justifies the 2% increase in spending on mental health services (up to $18 billion per year) called for by the Commission.
A country as large as Canada faces many jurisdictional hurdles with regard to coordination of provincial and territorial policies, and the challenges of providing a service that caters for its diverse indigenous population, in which rates of mental health problems are much higher than in the general population. As the Commission concedes, “there will never be a one-size-fits-all solution”. However, the strategy goes a long way to try to overcome these barriers. It sets out six strategic directions, which attempt to deal with issues such as promotion and prevention, diversity, and access and delivery of services.
The access and delivery of mental health services will be vital in these times of economic hardship. Financial strain is likely to place people at heightened risk of mental health problems, and those who are poorest to begin with will be most affected. But by providing specific solutions to this problem, the Commission lays the foundations on which continuity of care can be improved and the mental health system can be strengthened. From this platform, issues such as mental health stigma and discrimination can be tackled.
Mental health seldom receives so much public and political attention, so the Mental Health Commission of Canada should be applauded for their impressive efforts. Their strategy provides a catalyst for change, but it will need support from all levels to be successfully implemented.