Finding the money to make mental health care a priority has been a long-standing problem in Ontario and throughout Canada. Despite increased awareness to reduce the stigma, such as this month’s corporate initiative driven by Bell Let’s Talk, the realities of financing health-care delivery make it difficult to turn awareness into concrete public action.

The release of the latest Financial Accountability Office’s report paints a bleak picture for changing this course. It clearly states that, in order for the province to meet the spending targets in its last budget, $2.8 billion in cuts or efficiencies to the health-care system need to be made over the next few years. Thus, in order to fund mental health or any other new priority, money would have to come at the expense of another part of the already strained health budget.

The FAO report makes clear that when Ontario’s health minister and finance minister are arguing for more federal cash, what they’re really saying is not only a plea for help to fund health priorities but also help to balance the provincial budget. Anything less than the 6-per-cent increase they had been accustomed to since 2004 is simply insufficient.

The Trudeau government has basically maintained the Harper government’s line on any health spending increase, which was to maintain it at about 3 per cent annually. However, in addition, the Trudeau government has also earmarked money for home care and children’s mental health.

At first blush, the federal offer contained a $5-billion commitment aimed at reducing wait times for children’s mental health, much of which would have gone to reducing wait times for psychotherapy that Children’s Mental Health Ontario says is up to one-and-a-half years in some parts of the province. However, it was a $5-billion commitment over 10 years, meaning the annual increase was going to be $500 million across Canada, with Ontario qualifying for approximately one third of that amount. That’s still a fair chunk of change, but hardly transformative. Moreover, without a pre-holiday federal-provincial health accord, the federal government took that offer off the table.

What is most concerning about the whole ordeal is the symbolism. Think about it: The federal government is essentially telling the province "accept our insufficient 3 per cent offer or we won’t give you new mental health money." In other words, the mental health of our children is being used as a pawn in this trifecta of growing health care costs, an Ontario budget balancing act, and a heavy-handed federal government that’s trying to assert control in provincial jurisdiction. The new money for mental health will only arrive if the provinces accept a lower increase to health transfer payments that starve other health programs.

To put that in perspective, almost 1,000 Ontarians die of suicide each year. Suicide remains among the leading causes of death among children and adolescents. In the first half of 2016, five young people committed suicide in the town of Woodstock. Local officials suggested that many more attempts were made. So dire was the situation that the Canadian Mental Health Association declared the situation in Woodstock to be a crisis.

No matter. The feds will invest in mental health, but only if the province accepts even less money in the form of transfers. It is an evil false dichotomy. The provinces don’t have to agree to the lower increase since the federal government can unilaterally allocate whatever money it wants. And yet, in failing to agree to something that isn’t necessary, the federal government revoked its offer of cash for children’s mental health. The proposal for new mental health dollars is a carrot without a stick.

When the E. coli water contamination happened in Walkerton, seven people died and hundreds of others fell ill. The policy response was swift and sustained. This is not so with mental health – quite the opposite.

So on Bell Let’s Talk day, our politicians will be tweeting and texting about ending the stigma. And yet, there would be no more powerful message to ending the stigma than for the government to treat mental health as most other aspects of health care. As this latest federal-provincial faux squabble shows, we are nowhere close to ending the policy stigma.

Rob Leone was the PC MPP for Cambridge from October 2011 to June 2014 and served as the official Opposition critic for training, colleges and universities and education. He is currently an assistant professor of political science at Western University in London. He teaches and researches several topics related to Canadian politics, public policy and public administration at the federal, provincial and municipal levels.

Rob Leone
Assistant professor of political science at UWO
@robleone
http://www.robleone.com/

Leone: Time to end the mental health policy stigma

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