Manitoba lags in mental-health care

Opinion

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This article was published 27/01/2022 (1356 days ago), so information in it may no longer be current.

ACTIVITIES continue throughout the week surrounding Bell Let’s Talk Day on Wednesday, dedicated to raising awareness about mental health issues in an effort to fight social stigma. It is considered to be the largest corporate commitment to mental health in Canada. But, are stigma and lack of awareness the biggest problems impacting those with mental illness in Canada?

Up to 70 per cent of problems brought to family physicians in Manitoba have a mental-health component, suggesting people are already comfortable reaching out to discuss their mental health needs. It’s what comes next, the actual help that is required, that so many Canadians, especially Manitobans, are lacking.

A 2018 study found that 28 per cent of adult Manitobans have a diagnosed mental disorder, and this has only increased since the COVID-19 pandemic started. A national survey by Dr. David Dozois in 2021 found that the number of respondents who rated their anxiety as high to extremely high quadrupled (from five per cent to 20 per cent) and the number of respondents with high self-reported depression more than doubled (from four per cent to 10 per cent) since the onset of the COVID-19 pandemic.

And while family doctors are most commonly the first point of contact for those struggling with mental health concerns, these physicians do not typically have the time or training to treat such issues. Thus, individuals are left to navigate how to access mental-health practitioners such as psychologists, only to be met with significant barriers.

Psychologists have a doctoral degree involving 10 to 12 years of training, and are cost-effective health-care providers who assess, diagnose and treat a range of complex mental-health disorders, cognitive/developmental disorders and chronic physical-health conditions, like chronic pain and insomnia. They have a median of over 3, 500 hours of mental-health training in Canadian institutions. Here in Manitoba, however, we have the lowest number of psychologists per capita of any province in Canada.

Most of these psychologists are concentrated in Winnipeg, with only two publicly-funded positions in the Interlake-Eastern Regional Health Authority, two in Southern Health, and none currently in the Northern Health region. One reason for this is that while the rest of Canada spends 7.2 per cent of its health-care budget on mental health, Manitoba spends 5.1 per cent of its health budget on mental health, and this may be closer to four per cent in the rural regions. Many Manitobans have no, or limited, extended health benefits (i.e. $300 to $500), which is nowhere near enough for someone to get a course of psychological treatment.

This lack of access to mental health care has major impacts on people’s life satisfaction, their ability to work, and subsequently on our economy. A study from the Mental Health Commission of Canada revealed that mental-health problems cost $50 billion a year in Canada. Further, mental illness accounted for 52 per cent of federal employees’ disability claims.

A systematic review by Lewis and colleagues from 2018 revealed that reducing wait time from referral to first visit for community outpatient services may contribute to better health outcomes. Reduced wait times are also helpful for reducing burnout in mental-health care providers, as psychologists report struggling with the moral distress of continuing to place people on their wait lists rather than providing them with timely access to the services they know are effective and helpful.

The answer to these issues is not a highly publicized corporate anti-stigma campaign. The answer is for our governments and employers to invest in mental-health care for all. In Canada, every $1 invested in covering psychological services would yield $2 ($1.78 to $3.15) in savings to society. Other studies have shown a 7:1 return on investment for substance abuse treatment funding, suggesting that this investment in mental-health care is money well spent.

So, to government policy-makers and to employers, I say: it takes more than one day of talking to prevent suicide. It takes timely access to evidence-based mental-health care. This includes increasing publicly funded psychologist positions in mental health and primary care, with particular attention to areas that are especially underserved, such as child psychologists and those working in rural and remote areas.

This also means that employers need to step up their insurance benefits for employees, without a physician referral. With rates of addiction and mental health challenges on the rise, the time is now.

Now that’s something we should be talking about.

Julia Riddell, PhD, C.Psych, is the director of communications for the Manitoba Psychological Society.