Horwath releases Universal Mental Health Care plan

TORONTO – An NDP government led by Andrea Horwath will deliver Universal Mental Health Care.

With Horwath’s plan, counselling and therapy will be covered by an OHIP card, not a credit card, and publicly funded mental health services will be expanded and more accessible. The NDP’s comprehensive plan includes a suite of investments and changes to give the mental health and addictions sector more staff, resources and coordination, including the creation of Mental Health Ontario.

“Never has the need been so great. A silent epidemic of mental health struggles swept in with COVID, exposing just how broken Ontario’s system is. Millions of people are dealing with anxiety, stress and fear for their loved ones, their health and their jobs. After two years of disruption, countless kids are struggling with personality changes and anxiety. Too many of us are coping with grief and loss,” said Horwath. “Too often, people who think they need help also think they’ll never be able to afford it. People are suffering with nowhere to turn.

“Mental health care is health care. And together, we can do so much better. We can take action to fix it — so in Ontario, you’ll get mental health care with your OHIP card, not your credit card.”

At least one in four Ontarians sought mental health or addictions help during the pandemic. Counselling is the service most commonly needed. Psychotherapists, psychologists, nurses and social workers can offer therapy, but unless they are part of a family health team it’s not covered by OHIP

Doug Ford’s Conservatives have cut more than $2 billion in planned mental health spending since 2018. Before that, the Kathleen Wynne government with Steven Del Duca froze mental health funding for youth for more than 10 years. For the bits and pieces of the mental health system that are free, the wait lists can be literally years long as a result of these freezes and cuts.

“No one should have to turn to the emergency room again and again for a mental illness that could be better treated and managed. And you shouldn’t have to rack up credit card bills for mental health care — not for yourself or for your kids,” said Horwath. “Guaranteeing mental health care without cost will relieve pressure on hospitals, emergency services and the justice system. But most importantly, it’ll help people live their healthiest, best life.”

In the days ahead, Horwath will announce further commitments to address the opioid and overdose epidemic.
The NDP’s Universal Mental Health plan is estimated to cost $1.15 billion when fully implemented.

Attachment: NDP Universal Mental Health plan

Plan

Background

Universal, Publicly Funded Mental Health Care
Andrea Horwath and the NDP will start by expanding access to counselling and therapy services across the province:

• As a first step, the NDP will ensure public access to psychotherapy for everyone.
• A Horwath government will introduce a minimum of six sessions for treatment through OHIP, rising to 12 sessions for patients who need it. This approach allows for people to start with six sessions and decide with their care provider to enroll in the second step, or move to more complex care.
• The NDP will fund primary care doctors, nurses, community health care workers, and social workers to be trained in Cognitive Behavioural Therapy to increase the number of available, affordable, and culturally appropriate CBT practitioners.
• The NDP will focus on expanding the existing Ontario Structured Psychotherapy Program working with existing community-based providers to bring them into the publicly funded system and grow networks of interdisciplinary teams for mental health care.
• The Ontario NDP will introduce legislation that recognizes mental health is as important as physical health and ensures that mental health services provided by qualified health care professionals and community health workers are insured through OHIP, whether they are provided in a hospital or community health centre.

Fixing the mental health system

• The mental health system is described by advocates as fragmented and disconnected. Vital information, oversight and planning needs to be in place.
• The NDP will create Mental Health Ontario, a new co-ordinating organization that will take the lead on identifying and publicly reporting on mental health needs, developing a comprehensive wait list for services, bring in province-wide mental health standards, creating a basket of services, and making sure that mental health and addiction programs are delivered comprehensively across Ontario.

Reduce the wait-list for children’s mental health to 30 days

• There are now over 28,000 children and youth waiting for mental health treatment, up from 12,000 in 2017. Children and youth can wait up to 2.5 years for mental health care. The average wait time is two months for counselling and over three months for intensive treatment.
• A Horwath government will implement the Make Kids Count Action Plan as laid out by the Children’s Health Coalition. The plan calls for an investment of $130 million over the next three years to build intensive treatment and specialized consultation services, increase access to psychotherapy and counselling, family therapy and supports and to scale 24-hour crisis support services to ensure children and youth experiencing a crisis have an alternative to going to the emergency department [1].
• Supportive Housing
• The Mental Health and Addictions Leadership Advisory Council has recommended that 30,000 new supportive housing units be built over 10 years for people living with mental health and addictions challenges.
• In the NDP’s Homes You Can Afford housing plan, Andrea Horwath lays out her plan to deliver these new supportive homes.

Strengthening the sector

• An NDP government will provide an immediate eight per cent funding boost for Canadian Mental Health Association branches and provide ongoing sustainable funding. This would equal a $24 million increase in 2022-23.
• The NDP will introduce targeted hospital funding to increase the number of Tier 5 treatment beds for people with complex needs. The high rates of comorbidity between serious mental illnesses and common physical health conditions and substance use pose additional risks [2].

Improving Crisis Response

• An NDP government will immediately invest $10 million more into mobile crisis services and $7 million more for safe bed programs to support mobile crisis teams.
• Then, work towards establishing 24-hour civilian community mobile teams across the province to operate in partnership with Mobile Crisis Response Teams and respond to low-risk crisis situations.

Costing

• Universal publicly funded mental health care: An NDP government will get to work immediately to expand therapy access with a $500 million investment. When fully implemented, the estimated cost of providing this coverage will be $1.15 billion annually.
• Reduce the wait-list for children’s mental health: The “Make Kids Count” Action Plan calls for an investment of $130 million over the next three years – starting at $15 million in annual funding this fiscal year and growing to $58 million by 2023-24.
• Strengthening the Sector: The annual funding boost for Canadian Mental Health Association Branches will require $24 million in annual increased investment.
• Improving Crisis Response: An immediate and ongoing annual investment increase of $17 million for mobile crisis teams and safe beds.
• Experts estimate that every $1 invested into a mental health care program would yield, on average, $2 in savings to society (from a low-end $1.78 to an estimated high of $3.15). The full economic impact of an investment in a universal mental health program has the potential to save the Ontario economy more than $10 billion over the next five years by the most conservative estimates [3]. Savings are realized in several areas, including social services, emergency services and justice.
• Because Andrea Horwath and the NDP are committing to a universal program, businesses that offer health insurance or health spending plans now will realize some savings, as well.

[1] Make Kids Count: Action plan from the Children’s Health Coalition to ensure hospital capacity and provide timely access to care both in the immediate pandemic response and through recovery
[2] Mental Health Commission of Canada. (2021). COVID-19 and people living with serious mental illness: Policy brief. Ottawa, Canada: Mental Health Commission of Canada.
[3] Vasiliadis, H-M. et al. (May 2017) Assessing the Costs and Benefits of Insuring Psychological Services as Part of Medicare for Depression in Canada. Psychiatric Services, 68 (9): 899-906. (available online)