Regrettably the funding allocated to reduce wait times in health care did not include funding to reduce wait times for psychiatric care and community supports. For example, in Ontario the government invested $16 billion in health care between 2004 and 2011, but only $200 million was directed towards mental health. Only 31% of child and youth mental health agencies are able to meet the Canadian Psychiatric Association benchmark for wait times according to a recent study. In Toronto there are 5800 people waiting for access to supportive housing and a recent study for the Mental Health Commission estimates that there are 520,000 people living with mental illness in Canada who are homeless or vulnerably housed waiting for access to housing and support services.
Mental health service capacity needs to be increased across the country as only 1 in 3 people in need are able to access care. This will cost money which is why Senators Kirby and Keon recommended the establishment of a mental health transition fund in 2006, and the Mental Health Commission recommended increasing the mental health share of health and social spending in their strategy released last year. We’re still waiting for governments to improve access to mental health services.
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It all started with a wicked problem and an ambitious goal.
In late 2011, the Mental Health Commission of Canada commissioned “Turning the Key,” a report designed to inform Canadians about the current housing and community support needs of people living with mental health challenges in Canada. The report’s findings were clear: There are too many Canadians with mental health issues who cannot find homes. Hundreds of thousands of our neighbours are inadequately housed, and 119,000 of our fellow citizens who face mental health challenges are homeless.
On January 16th Canada took an important step for mental health as the Canadian Standards Association (CSA) and the Bureau de Normalisation du Quebec (BNQ) released the country’s first-ever national workplace Standard, The National Standard of Canada – Psychological Health and Safety in the Workplace – Prevention, promotion and guidance to staged implementation. CMHA applauds the release of the Standard, which defines and sets a higher standard for workplace mental health.
Jane Wood’s compelling article on the lack of supports for families and children with autism is part of a bigger problem – our failure to provide adequate community care systems for the 6.7 million Canadians who live with mental illness every day. It is now seven years since Senators Kirby and Keon released their report on mental illness, Out of the Shadows at Last. While there has been increased public discussion and policy rhetoric by governments across the country, there has been very little investment in services. Most of the health care accord funding has gone to other areas of health care, even though the Senate proposal for a mental health transition fund would have added less than .029% to health care spending across the country, to improve access to community care and supportive housing. It is time to fix the deficit in community mental health care and lessen the burden on families.
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The verdict in Richard Kachkar’s case is a reasonable finding that is consistent with the standard set by our Supreme Court in Winko vs. BC (1999). Mr. Kachkar will be under the supervision of the Ontario Review board. He will remain in custody or community supervision as long as the Review Board finds that there is risk of substantial harm to the public based on his mental disorder. Recidivism rates are very low for people found NCR and he may be under supervision for longer than if he had been found guilty. The insanity defense has been part of our legal system since the 1840s. It would be best if we could focus the debate on ensuring that people have better access to services when they first experience mental health problems. Currently only one in 3 people do.
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While the Globe is correct in asserting that review boards are not omnipotent, the Supreme Court ruled in Winko vs. BC that there is an onus on the crown or review board to show serious risk of substantial harm, or grant an absolute discharge. Review boards must rely on expert medical testimony to assess this. While the government does not need to heed Justice Schneider’s reasoned opinion, they may find their legislation challenged at the Supreme Court on the basis of the Winko decision.
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Diagnosed with schizophrenia, Kit Skelly lived nearly five torturous years trapped in a broken mental-health system. Despite his family’s efforts to save him, the 23-year-old jumped off the Leaside Bridge.
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Our sympathies lie with Kit Skelly’s parents who have described their family’s struggle with schizophrenia (Pulling The Shroud Off Schizophrenia – March 16). Families often describe their difficulties finding services for their loved ones. In Kit’s case it is unfortunate that he was not connected with programs that are part of Toronto’s early psychosis network. Early psychosis intervention has been shown to lessen family burden and demonstrate good outcomes in terms of school, work, family relationships and symptom reduction. Efforts are under way to improve access to services in Toronto, but we need to do more to ensure people are able to access community mental health services. There are currently 5,500 people on the waiting list for supportive housing in Toronto, and wait times for other community services can be six months or more. We need to focus on the deficit in mental-health care and increase the mental-health share of health spending to make sure more families are able to get the help they need and deserve.
Steve Lurie, executive director, CMHA Toronto Branch
It is gratifying that one of the first acts of Premier Wynne’s government was to pick up the funding for the Mental Commission’s homelessness project which is helping 240 people living with mental illness and addiction problems avoid homelessness. Research from the project has shown that for every $2 spent on heavy users of mental health services, $3 is saved. However much more needs to be done to reduce homelessness among people living with mental illness. The waiting list in Toronto for supportive housing is over 5500 and some people have been waiting 10 years for housing. Let’s hope this is a down payment on future investments in supportive housing.