Addictions
Provinces are underspending on addiction and mental health care, new report says
The Greta and Robert H. N. Ho Psychiatry and Education Centre, the HOpe Centre, a health care facility for mental illness and addiction in North Vancouver, B.C. (Dreamstime)
By Alexandra Keeler
The provinces are receiving billions in federal funds to address mental health and substance use. Why are so many spending so little?
The provinces are failing to allocate sufficient funding to addiction and mental health care services, a new report says.
The report, released Dec. 19 by the Canadian Alliance on Mental Illness and Mental Health, criticizes the provinces for a “long history of … demanding maximum cash for health care from the federal government with minimum accountability.”
The alliance is a coalition of 18 prominent health organizations dedicated to improving Canada’s mental health care. Its members include the Canadian Medical Association, the Canadian Psychiatric Association and the Canadian Mental Health Association.
On average, the provinces have allocated just 16 per cent of $25 billion in federal health-care funding toward mental health and addiction services, the report says.
“Given the crisis of timely access to care for those with mental health and substance use health problems, why are so many provinces and territories investing so little new federal dollars to improve and expand access to mental health and substance use health care services?” the report asks.
However, some provinces dispute the report’s criticisms.
“The funding received from the federal government is only a small part of Alberta’s total $1.7 billion allocation towards mental health, addiction and recovery-related services,” an Alberta Ministry of Mental Health and Addiction spokesperson told Canadian Affairs in an emailed statement.
“[This] is a nation leading level of investment response.”
‘Take the money and run?’
In 2023, Ottawa and the provinces committed to spend $25 billion over 10 years investing in four priority areas. These areas are mental health and substance use, family health services, health workers and backlogs, and a modernized health system.
The alliance’s report, which looks at provincial investments in years 2023 through 2026, says mental health and substance use are being given short shrift.
B.C., Manitoba and P.E.I. have allocated zero per cent of the federal funds to mental health and substance use, the report says. Three other provinces allocated 10 per cent or less.
By contrast, Alberta allocated 25 per cent, Ontario, 24 per cent, and Nova Scotia, 19 per cent, the report says.
The underspending by some provinces occurs against a backdrop of mental health care already receiving inadequate investment.
“[P]ublicly available data tells us that Canada’s mental health investments account for roughly 5% of their health budgets, which is significantly below the recommended 12% by the Royal Society of Canada,” the report says.
However, several provinces told Canadian Affairs they took issue with the report’s findings.
“Neither the Department of Health and Wellness nor Health PEI received requests to provide information to inform the [alliance’s] report,” Morgan Martin, a spokesperson for P.E.I.’s Department of Health and Wellness, told Canadian Affairs.
Martin pointed to P.E.I.’s investments in opioid replacement therapy, a mobile mental health crisis unit and school health services as some examples of the province’s commitment to providing mental health and addiction care.
But Matthew MacFarlane, Green Party MLA for P.E.I.’s Borden-Kinkora riding, says these investments have been inadequate.
“P.E.I. has seen little to no investments into acute mental health or substance use services,” he said. He criticized a lack of new detox beds, unmet promises of a new mental health hospital and long wait times.
The alliance’s report says New Brunswick has allocated just 3.2 per cent of federal funds to mental health and addiction services.
However, a New Brunswick Department of Health spokesperson Tara Chislett said the province’s allocation of $15.4 million annually from the federal funds does not reflect the additional $200 million of provincial funding that New Brunswick has committed to mental health and substance use.
In response to requests for comment, a spokesperson for the alliance said the federal funding is important, but “does not nearly move the yardsticks fast enough in terms of expanding the capacity of provincial health systems to meet the growing demand for mental health and substance use health care services.”
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‘Blaming and shaming’
The discrepancies between the report’s findings and the provinces’ claims highlight a need for standardized metrics around mental health and addiction spending.
The report calls on federal and provincial governments to develop national performance indicators for mental health and substance use services.
“At the end-of-the day you cannot manage what you do not measure,” the report reads.
It advises governments to communicate their performance to Canadians via a national dashboard.
“Dashboards are being used with increasing frequency in the health system and other sectors to summarize complex information and would be one way to effectively tell a story … to the public,” the report says.
It also urges Ottawa to introduce legislation — what it dubs the Mental Health and Substance Use Health Care For All Parity Act — to ensure equal treatment for mental and physical health within Canada’s health-care system.
This call for mental and physical health parity echoes the perspective of other health-care professionals. In a recent Canadian Affairs opinion editorial, a panel of mental health physicians argued Canada’s failure to prioritize mental health care affects millions of Canadians, leading to lower medication reimbursement rates and longer wait times.
The alliance says its call for more aggressive and transparent spending on mental health and addictions care is not intended to criticize or cast blame.
“This is not about blaming and shaming, but rather, this is about accelerating the sharing of lessons learned and the impact of innovative programs,” the report says.
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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Subscribe to get BTN’s latest news and analysis, or donate to our journalism fund.
From LifeSiteNews
Premier David Eby acknowledged that British Columbia’s liberal policy on hard drugs ‘became was a permissive structure that … resulted in really unhappy consequences.’
The Premier of Canada’s most drug-permissive province admitted that allowing the decriminalization of hard drugs in British Columbia via a federal pilot program was a mistake.
Speaking at a luncheon organized by the Urban Development Institute last week in Vancouver, British Columbia, Premier David Eby said, “I was wrong … it was not the right policy.”
Eby said that allowing hard drug users not to be fined for possession was “not the right policy.
“What it became was a permissive structure that … resulted in really unhappy consequences,” he noted, as captured by Western Standard’s Jarryd Jäger.
LifeSiteNews reported that the British Columbia government decided to stop a so-called “safe supply” free drug program in light of a report revealing many of the hard drugs distributed via pharmacies were resold on the black market.
Last year, the Liberal government was forced to end a three-year drug decriminalizing experiment, the brainchild of former Prime Minister Justin Trudeau’s government, in British Columbia that allowed people to have small amounts of cocaine and other hard drugs. However, public complaints about social disorder went through the roof during the experiment.
This is not the first time that Eby has admitted he was wrong.
Trudeau’s loose drug initiatives were deemed such a disaster in British Columbia that Eby’s government asked Trudeau to re-criminalize narcotic use in public spaces, a request that was granted.
Records show that the Liberal government has spent approximately $820 million from 2017 to 2022 on its Canadian Drugs and Substances Strategy. However, even Canada’s own Department of Health in a 2023 report admitted that the Liberals’ drug program only had “minimal” results.
Official figures show that overdoses went up during the decriminalization trial, with 3,313 deaths over 15 months, compared with 2,843 in the same time frame before drugs were temporarily legalized.
A Toronto park
Public disorder has cities crying out for help. The solution cannot simply be to expand our public institutions’ crisis services
[This editorial was originally published by Canadian Affairs and has been republished with permission]
This week, Canada’s largest public transit system, the Toronto Transit Commission, announced it would be stationing crisis worker teams directly on subway platforms to improve public safety.
Last week, Canada’s largest library, the Toronto Public Library, announced it would be increasing the number of branches that offer crisis and social support services. This builds on a 2023 pilot project between the library and Toronto’s Gerstein Crisis Centre to service people experiencing mental health, substance abuse and other issues.
The move “only made sense,” Amanda French, the manager of social development at Toronto Public Library, told CBC.
Does it, though?
Over the past decade, public institutions — our libraries, parks, transit systems, hospitals and city centres — have steadily increased the resources they devote to servicing the homeless, mentally ill and drug addicted. In many cases, this has come at the expense of serving the groups these spaces were intended to serve.
For some communities, it is all becoming too much.
Recently, some cities have taken the extraordinary step of calling states of emergency over the public disorder in their communities. This September, both Barrie, Ont. and Smithers, B.C. did so, citing the public disorder caused by open drug use, encampments, theft and violence.
In June, Williams Lake, B.C., did the same. It was planning to “bring in an 11 p.m. curfew and was exploring involuntary detention when the province directed an expert task force to enter the city,” The Globe and Mail reported last week.
These cries for help — which Canadian Affairs has also reported on in Toronto, Ottawa and Nanaimo — must be taken seriously. The solution cannot simply be more of the same — to further expand public institutions’ crisis services while neglecting their core purposes and clientele.
Canada must make public order a priority again.
Without public order, Canadians will increasingly cease to patronize the public institutions that make communities welcoming and vibrant. Businesses will increasingly close up shop in city centres. This will accelerate community decline, creating a vicious downward spiral.
We do not pretend to have the answers for how best to restore public order while also addressing the very real needs of individuals struggling with homelessness, mental illness and addiction.
But we can offer a few observations.
First, Canadians must be willing to critically examine our policies.
Harm-reduction policies — which correlate with the rise of public disorder — should be at the top of the list.
The aim of these policies is to reduce the harms associated with drug use, such as overdose or infection. They were intended to be introduced alongside investments in other social supports, such as recovery.
But unlike Portugal, which prioritized treatment alongside harm reduction, Canada failed to make these investments. For this and other reasons, many experts now say our harm-reduction policies are not working.
“Many of my addiction medicine colleagues have stopped prescribing ‘safe supply’ hydromorphone to their patients because of the high rates of diversion … and lack of efficacy in stabilizing the substance use disorder (sometimes worsening it),” Dr. Launette Rieb, a clinical associate professor at the University of British Columbia and addiction medicine specialist recently told Canadian Affairs.
Yet, despite such damning claims, some Canadians remain closed to the possibility that these policies may need to change. Worse, some foster a climate that penalizes dissent.
“Many doctors who initially supported ‘safe supply’ no longer provide it but do not wish to talk about it publicly for fear of reprisals,” Rieb said.
Second, Canadians must look abroad — well beyond the United States — for policy alternatives.
As The Globe and Mail reported in August, Canada and the U.S. have been far harder hit by the drug crisis than European countries.
The article points to a host of potential factors, spanning everything from doctors’ prescribing practices to drug trade flows to drug laws and enforcement.
For example, unlike Canada, most of Europe has not legalized cannabis, the article says. European countries also enforce their drug laws more rigorously.
“According to the UN, Europe arrests, prosecutes and convicts people for drug-related offences at a much higher rate than that of the Americas,” it says.
Addiction treatment rates also vary.
“According to the latest data from the UN, 28 per cent of people with drug use disorders in Europe received treatment. In contrast, only 9 per cent of those with drug use disorders in the Americas received treatment.”
And then there is harm reduction. No other country went “whole hog” on harm reduction the way Canada did, one professor told The Globe.
If we want public order, we should look to the countries that are orderly and identify what makes them different — in a good way.
There is no shame in copying good policies. There should be shame in sticking with failed ones due to ideology.
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