Research confirms observations by many of NUPGE's front-line workers
Ottawa (17 June 2008) - A study published in the Canadian Journal of Psychiatry (CJP) has found that public mental health spending in Canada is below that of most developed countries and just short of what the European Mental Health Economics Network sees as a minimum acceptable level.
The National Union of Public and General Employees (NUPGE), one of Canada's largest trade unions, says the research confirms observations by many front-line workers in mental health services.
NUPGE presented a 14-page brief in May to the Mental Health Commission of Canada recommending broad change in key areas of the national public health care system, including health human resources, community-based social services and the criminal justice system.
"It is critical that people with mental health issues have access to a comprehensive spectrum of services from promotion through diagnosis, treatment and support. In particular, community-based social services such as employment assistance, safe and adequate housing, counseling, peer support services, income maintenance services, crisis intervention, women's services and emergency shelters are vital," the brief said.
"These community-based social services provide direct support and treatment to individuals and families and foster the social and economic inclusion of people with mental illnesses. They can also help identify the symptoms of mental illness and address the social determinants of health as they relate to people with mental health issues.
"Yet our members who work in this sector report that as a result of chronic under-funding by governments our system of community-based social services is fragmented, with services that are difficult to access and uneven in quality, and in many cases the services simply do not exist."
Public vs. private spending
The CJP report, entitled Expenditures on Mental Health and Addictions for Canadian Provinces in 2003/04, was published in the May 2008 issue.
The authors estimate that the country spends just over $5.5 billion dollars on mental health, a figure that rises to $6.6 billion when private expenditures are included. The national spending average was $172 per person. The lowest levels per capital were in Saskatchewan ($138), Newfoundland and Labrador ($143) and Ontario ($152). The highest were British Columbia ($230), Alberta ($207) and New Brunswick ($204). When public and private expenditures are combined, expenditures averaged $206 per person nationally.
NUPGE sees the increasing role of private funding in the sector as a worrisome trend.
"Private clinics, public-private partnership hospitals, and for-profit community-based agencies are becoming more common," the union notes.
"And yet, studies have repeatedly shown that competition and market forces are not the right models to provide services to vulnerable people. From traditional health care to social services we see that private provision leads to poorer service and higher costs. This is not the foundation for an effective and modern mental health care system.
"All levels of government must make public re-investment in mental health services a higher priority."Below similar developed countries
The fact that Canadian spending on mental health services is less than that of many other developed nations, including the United Kingdom and Australia, is worrisome. The research also highlights variations and inequities among provinces in accessing community care and medication.
"There are considerable variations between provinces in hospital and community care, and there is room for additional movements to community care," the report says. It also notes: "There is a considerable variation in per capita private drug costs between provinces, indicating a considerable private burden on younger psychiatric patients."
Demand has been growing in Canada for mental health services to be brought more into line with the national Medicare system.
"More and more Canadians are growing concerned about our inability or unwillingness to provide accessible and high quality mental health services to all who may need them," NUPGE president James Clancy said in a letter to commission chair Michael Kirby. NUPGEMore information:
Expenditures on Mental Health and Addictions for Canadian Provinces in 2003/04 Montreal coroner's report highlights crisis of mentally ill in jail NUPGE submission: No Health Without Mental Health - pdf NUPGE submission to Mental Health Commission of Canada