It's encouraging that people of the caliber of David Goldbloom are speaking about this stuff. But is the private sector listening? They have the money and the employees - work is the centre of life these days, not family. It's in the workplace that these changes must be lead.
In any given year, one in five people in Canada experiences a mental health problem or illness – that’s nearly seven million Canadians, each with family, friends and colleagues.
This past May, I had the honour of launching Changing Directions, Changing Lives, the first mental health strategy for Canada developed by the Mental Health Commission of Canada. Implementing its recommendations will improve the health and well-being of tens of thousands of Canadians, contribute to our economic prosperity and help sustain our health-care system.
This national strategy calls on us all to do everything possible in everyday settings to prevent mental health problems from emerging. When prevention is not possible, help must be available as early as possible.
We can and should provide intervention and treatment earlier. As much as 70 per cent of young adults tell us that symptoms of mental health problems began in childhood. By intervening earlier, through programs in schools and for parents of young children, we stand to avoid significant downstream costs. For example, preventing conduct disorders in just one of the 85,000 Canadian children currently affected would result in lifetime savings of $280,000.
The strategy focuses on enabling people with mental health problems and illnesses to recover a meaningful life with less reliance on acute care, and with less risk of developing complex and expensive social problems that can land them in jail or on the streets. This means strengthening services, treatments and supports in the community and expanding the capacity of primary health care. It also means doing more to increase the availability of housing, employment options and peer support. Over time, this will result in a more sustainable health system by reducing demand on its most expensive parts, as well as generating cost savings in schools, workplaces and across the criminal justice system.
A report this month from Public Health Ontario and the Institute for Clinical Evaluative Sciences indicates that the burden of mental illness and addictions in Ontario is more than 1.5 times that of all cancers combined, as reflected by premature mortality and reduced functioning. It’s not surprising that costs to the economy in direct services and supports and in lost productivity have been pegged at more than $50-billion a year – this figure does not even include money spent on mental health by the criminal justice system, the education system and social services.
Canada spends considerably less on mental health than several comparable countries, with seven cents out of every public health-care dollar (7 per cent) going to mental health. This is far below the 10 per cent to 11 per cent of public health spending devoted in countries such as New Zealand and Britain. That’s why our strategy doesn’t only call for making better use of current investments in mental health. It also calls for Canada to support the transformation of the mental health system by increasing the amount spent from 7 per cent to 9 per cent of health spending over 10 years.
A sustainable health-care system is one that addresses key cost drivers effectively and efficiently. The Mental Health Strategy for Canada lays out a plan. Now we need the will to do it. The argument that mental illnesses deserve equal priority, understanding and treatment to physical illnesses makes sense to every person, family member and friend who has seen their impact. And in a world in which prosperity depends increasingly on brain power and on a productive and dynamic work force, Canada can’t afford not to invest in the future mental health and well-being of its population.
David Goldbloom is chair of the Mental Health Commission of Canada and senior medical adviser at Toronto’s Centre for Addiction and Mental Health.