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Federal Directions for Mental Health Reform

Senate Committee Final Report: “Out of the Shadows at Last”

In 2006, the Standing Senate Committee on Social Affairs, Science and Technology (Kirby Committee) released the final report of its three-year study of mental health, mental illness and addictions in Canada, “Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada.”

Two key recommendations were the development of a Mental Health Transition Fund and a Canadian Mental Health Commission. A federal government initiative, the transition fund would be in place for 10 years and would finance the transition from an institution-based system to a community-based mental health system. Two main components of the transition fund would be a Mental Health Housing Initiative and a Basket of Community Services. The housing initiative would involve both new affordable housing units and rent supplements for people with mental illness. The basket of services component would provide funding to provincial/territorial governments to add to the range of services and supports in the community for people with mental illness.

Among its 118 recommendations, the report called for the creation of a national mental health strategy and a national anti-discrimination strategy and the development of a Knowledge Exchange Centre, all under the leadership of a new Canadian Mental Health Commission.

Other recommendations cover a broad range of issues, including self-help and peer support, research, telemental health, addictions, employment and the workplace. The commission also looked at the needs of specific populations: children and youth, seniors, and populations for which the federal government is responsible (such as First Nations and the military).

A Mental Health Commission for Canada

In 2008, the federal government provided funding for an independent mental health commission with a mandate to develop a national mental health strategy, a 10-year anti-stigma strategy and a knowledge exchange centre. The Mental Health Commission of Canada is also conducting housing research and many other projects through its advisory committees. The commission is chaired by Michael Kirby, who chaired the Standing Senate Committee on Social Affairs, Science and Technology.

Canada’s first national mental health strategy, entitled “Changing Directions, Changing Lives: The Mental Health Strategy for Canada”, was released in 2012 by the Mental Health Commission of Canada (MHCC). The strategy, launched during Mental Health Week, seeks to improve mental health and well-being for all Canadians and to build a mental health system that meets the needs of all individuals living with mental health conditions, and their families.

The document centres on six strategic directions:

  1. Promote mental health across the lifespan in homes, schools and workplaces, and prevent mental illness and suicide wherever possible
  2. Foster recovery and well-being for people of all ages living with mental health problems and illnesses, and uphold their rights
  3. Provide access to the right combination of services, treatments and supports, when and where people need them
  4. Reduce disparities in risk factors and access to mental health services, and strengthen the response to the needs of diverse communities and Northerners
  5. Work with First Nations, Inuit and Métis to address their mental health needs, acknowledging their distinct circumstances, rights and cultures
  6. Mobilize leadership, improve knowledge and foster collaboration at all levels

Action on these six directions is needed across and beyond the health system; it is acknowledged that policies and practices of a range of government departments impact on mental health, including education, justice, corrections, social services and finance.

In addition to government, the strategy identifies an action role for workplaces, non-governmental organizations, media, and others.

Key recommendations include ensuring that:

  • People living with mental health problems or illnesses and families are engaged in planning, organization, delivery and evaluation of mental health services, treatments and supports
  • Mental health service providers work with planners, funders and service users to identify and examine the changes needed to develop a system integrated around needs and recovery
  • Governments take a comprehensive approach to address mental health needs, focus spending on improving outcomes, and address the underfunding of mental health
  • Senior executives in the public and private sectors build workplaces that are mentally healthy, and that
  • All Canadians promote mental health in everyday settings and work together to reduce stigma.

The strategy proposes that funding inequities be addressed by:

  • Increasing the proportion of health spending allocated to mental health from seven to nine per cent over 10 years
  • Increase the proportion of social spending for mental health by two percentage points
  • Identify whether current mental health spending needs to be reallocated to improve efficiency and outcomes, and
  • Engage the private and philanthropic sectors to contribute resources to mental health.

For more information, visit theMental Health Commission of Canada website