Mental Health Service Gaps in Canada

7 pages
1691 words
Middlebury College
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Case study
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The spectrum of disorders associated with mental challenges ranges from anxiety and depression to psychiatric illnesses of psychosis and related conditions. In Canada, recent statistical findings indicate a very high population of the disease. A report by Wild, Wolfe, Wang, and Ohinmaa (2014) on Gap Analysis of Public Mental Health and Addictions Programs, indicates that the disease accounts for nearly 30% of cases of debility, and 70% of the disability-associated costs. The problem seems to be worse in teens and young adults compared to older adults. Waddell, Shepherd, Schwartz, and Barican (2014) observe that 12.6% of children and young adults (12-17 years) manifest mental illness symptoms any time, while about 29% of them qualify for two or more disorders at any moment. Although specific findings regarding the prevalence of the issue in Canada are somewhat varied, anecdotal reports and other literature reviews posit that one in five Canadians may be experiencing one or more conditions associated with mental illness. The possible burden posed by the disorders calls for the immediate reforms in the mental health system in Canada.

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Mental Health System Gaps

Despite existing statistics indicating a huge disease burden because of mental illness, there is a vast disconnect between service delivery and accessibility, which is mainly mediated by limited public funding (Anderssen, 2015; Birak, 2016; Cohen, 2014; Wild et al., 2014). The above implies that out-of-pocket payments are numerous, and fee-for-payment service is a commonality. Even though funding is the biggest health challenge, the problem of information sharing among the health professionals is another impediment. Glauser (2013) highlights that in Canada, for instance, a mental health patient can be admitted and discharged without consulting the primary care provider. The disconnect arising from the above discrepancy implies that those handling the patient have inadequate information to warrant proper treatment. Notwithstanding the gaps as mentioned earlier, the post-intervention paucity of information among the patients is also another problem. Wild et al. (2014) note that information about mental health issues, available treatments and services are some of the commonly reported unmet informational needs among those who have been treated. Information availability and its subsequent accessibility by mental health patients are crucial for their recovery and integration into the wider society. The lack of such information means that individuals risk relapse and exacerbations of their conditions.

Key Gaps in Mental Health

Mental Health Needs versus Existing Funding

Several reports indicate that insufficient funding plagues the Canadian mental health system. Anecdotal reports, health findings, and other literature reviews have shown a huge prevalence of the mental illness in Canada. This burden points towards increased health care needs for those suffering from various disorders. Apparently, the government has been too slow to recognize the debilitating nature of mental health, and in the process has overlooked the most important aspect of the care spectrum: spending. An observation by Cohen (2014) indicates that the public health system in Canada is a medical system, where funding and service delivery payments are directed towards physicians in the provision of medical services. The focus of healthcare on the medical model, as shown above, tends to overlook the input of mental well-being on Canadians. Perhaps the focus of attention towards physical health and less on mental fitness is one of the drivers for the significantly huge prevalence of the problem in Canada. Pearson (2015) notes that increased prevalence of mental illness among Canadians impacts almost every household, making the problem a leading cause of disability. The lack of public health funding through health insurance or some other plans tends to inflate out-of-pocket payments.

Addressing the above problem is crucial in the realization of the goals of the Canadian health system. It is imperative that the government recognizes that 15 to 25% of its population have experienced a mental health episode in their lifetimes, and the likelihood of second and subsequent bouts are high (Butler & Pang, 2014). With an inadequate funding, it means that such people will have to seek out-of-pocket treatment or part with massive amounts to incorporate mental health in their private cover. When citizens opt for the above, their household income dwindles further, which, in turn, affects their purchasing power and accessibility to other goods and services. I am aware that the government offers mental health services in some of its tertiary institutions. This gesture is good. However, considering the huge number of patients demanding for the same services, it means that those hospitals will be overwhelmed, forcing them to schedule appointments, which will amount to enormous backlogs (Birak, 2016), notwithstanding the urgency with which such cases should be handled. The reduced government expenditure has also forced psychologists into the private sector because of limited reimbursement in public facilities. Consequently, those who lack adequate payment for the services will be turned away, thereby exacerbating their conditions. The seriousness of some disorders shows that a delay in treatment has the consequence of worsening the individuals physical health, disrupting their normalcy, and predisposing them to possible incarceration (Butler & Pang, 2014). Therefore, addressing funding gaps will accord the necessary treatment to the affected persons and prevent adverse prognoses of their conditions.

Limited Collaborations and Information Sharing among the Health Professionals

Healthcare exists in a continuum and the need for professional collaboration is an essential ingredient to better patient outcomes. According to Ness et al. (2014), the mentally ill patients are active partners positioned at the center of the healthcare processes of the inter-professional collaboration framework. The above statement implies that health workers comprehensively partner among themselves by working synergistically with all the stakeholders in that spectrum. However, this is sadly not the case in Canada. Limited aspects of collaboration are present in the mental health system, an attribute that impedes essential information sharing for the patients benefit. Gauser (2013) highlights that it is not uncommon to find primary care providers unaware of their patients admission and discharge from the hospital. This disconnect fragments the kind of care that patients are supposed to receive, thereby worsening the recovery patterns and disease prognoses. The collaboration targets the realization of unmet needs in the course of the delivery of care to minimize hospital stays and general wellness (Supper et al., 2014). Because of this reality in Canada, the police have been involved in the arrest of mentally ill patients and forcing them to hospitals because their essential information indicating their sickness is missing. As a result of this, the patients suffer additional stigma that could worsen their already bad state of being.

Tackling the issue of professional partnership and information sharing is essential to mental health. According to Gauser (2013), these types of patients exhibit unique challenges that require concerted efforts in their intervention. Some of the disorders are spontaneous, while others may have an aura. Once the symptoms start, the patient and their families first contact the primary caregiver, whom upon evaluation of the subject, forwards them to secondary or tertiary institutions. However, a breakdown may sometimes occur when this practitioner is sometimes bypassed or ignored altogether because they have vital therapeutic information that could provide insightful information to other professionals (Ness et al., 2014; Supper et al., 2014; Thota et al., 2012). There is a consensus that a collaborative model improves routine screening, increases the provider use of evidence-based protocols in management, and enhances community and clinical support for patient engagements. The above is made possible by information sharing, and the ability to address the inadequate collaborations in the Canadian mental health system will facilitate better patient care (Jones & Delany, 2014).

Strategies for Addressing the Gaps

Funding Challenges

Expanding access to publicly funded therapy

As at the moment, mental health funding is limited in Canada. There is no public insurance system to cover for mental illness. The best probable response for this problem is to increase funding to ensure that patients access to care within the confines of the existing health system. As Anderssen (2015) notes, no provinces are currently covering for therapy delivered outside of the public health system, yet psychologists, social workers, and psychotherapists, among other professionals, are found in the private sector. The above observations call for investment into mental health by increasing GDP spending. The government can do this by increasing the capacity of the existing health insurance or subsidize the cover offered by private companies. According to Anderssen (2015), Australia and Britain had similar challenges and opted to increase public access to healthcare by increasing government spending, enabling them to become model countries. The extra funding will go towards revamping the entire health care infrastructure including mental health.

Engaging Non-Government Entities

It is undoubtedly true that the government alone cannot solve the issue of limited funding. Inviting other stakeholders into the equation is likely to lessen the burden on taxpayers and an increased budgetary allocation. These parties include private foundations, non-governmental agencies, personal contributions, and business partners. Although these entities will reduce the overall governmental expenditure, their financial contributions will help offset Canadas protracted role in mental health care. Anderssen (2015) notes that the governments collaboration with private entities offsets its overall burden in the cost equation, thereby allowing it to carry out its mandate efficiently. Organizational and personal foundations play crucial roles towards increased expenditure on mental health.


Expanding the existing healthcare insurance to accommodate mental health. The government can expand the current coverage for medical care by formulating policies regarding the entrenchment of mental health as a tenet in the existing coverage. This way, it will be cheaper to revamp the current system instead of setting a parallel one because all the services will be modeled as a bundle (Cummings, Wen, & Druss, 2013; Knickman et al., 2016; Thomson, Chaze, George, & Guruge, 2015).

Revamping the existing health infrastructure. Since mental health has been a relatively neglected tenet, its incorporation into the existing health insurance cover requires infrastructural improvement on the demand side. Many of the professionals attending to patients are in the private sector, and attracting them requires incentives and refurbishing the capacities of hospitals to accommodate them. Increasing the training of specialists in mental health will bridge personnel deficits and minimize patient-to-practitioner rations.

Providing adequate reimbursements to mental health professionals. The reason for attrition rates into the private health system emanates from small payments for services rendered in the public system compared to the private sector. Additional incentives will pull the practitioners towards the government facilities.

Limited Collaborations and Information Sharing among Professionals...

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