Three years ago, Canada took an important step towards transforming mental health care in this country by creating a Minister of Mental Health and Addictions.
Prior to 2021, only a few provinces had local-level mental health ministers to advocate for people living with mental illnesses. Ottawa’s decision to create a cabinet position dedicated to mental health signalled its growing recognition of the importance of this area.
But further change is needed.
A patchwork of mental health services across the country is leading to inconsistent care and inequities in services and treatments. In particular, inconsistent drug coverage across provinces and territories, and between those with and without private workplace coverage, exacerbates our mental health-care crisis.
One year ago, Mood Disorders Society of Canada, a non-profit advocacy organization, published a report showing many Canadians wait too long or face inequities to accessing needed medicines.
Specifically, their report showed it takes more than 2.5 years for medications for mental illness to become publicly accessible. And the vast majority of Canadians waited more than a year longer than people in some comparator countries — such as Australia and Scotland — to access publicly funded medications for mental illness.
Data from global life sciences firm IQVIA, presented by the society and a panel of experts at a national symposium in September, painted a similarly distressing picture. Medications for mental illness were approved for public reimbursement at a significantly lower rate than medications for physical health disorders, excluding oncology.
These shortcomings prolong or worsen the suffering of the approximately 20 per cent of Canadians who struggle with mental illnesses.
As front-line physicians, we treat patients who could dramatically benefit from the right medication, yet who are often stuck in limbo — waiting for approvals from public reimbursement bodies or employers, struggling with unaffordable costs, or being prescribed inferior medications due to a lack of medication access.
This failure to provide appropriate access to treatments comes with enormous human, health-care system and economic costs to individuals, employers and taxpayers.
We continue to raise our voices for patients. In 2023, we urged the newly-formed Canada’s Drug Agency to include better representation of patients and psychiatrists in the drug reimbursement process.
Canada’s Drug Agency subsequently committed to adding a psychiatrist to its deliberative committee. It also recently announced the addition of a patient advocate to its board of directors.
These are positive steps. But they only scratch the surface of the action that is required.
We urge the federal and provincial governments to improve their drug reimbursement processes for mental illness medications, ensuring equitable access for all Canadians regardless of where they live or their employment status.
Given the diverse and chronic nature of mental illnesses, patients need a broad range of treatment options available to them, especially newer medications that have fewer side effects. Inconsistent drug coverage, stigma surrounding psychiatric treatments, and a lack of understanding about meaningful mental health outcomes leave many without access to all the approved medications they may need.
We call upon the federal Minister of Health and the Minister of Mental Health and Addictions, along with their provincial and territorial counterparts, to take immediate action to improve access to psychiatric medications across the country. Canadians living with mental illness cannot afford to wait any longer for the health-care system to work for them.
Signed,
Dr. Diane McIntosh, BSc Pharmacy, MD, FRCPC; Psychiatrist; Clinical Assistant Professor at The University of British Columbia; Dr. Pierre Blier, MD, PhD, FRSC; Professor, Department of Psychiatry and Cellular/Molecular Medicine, University of Ottawa; Dr. Atul Khullar, MD, MSc, FRCPC; Community Psychiatrist; Director, Northern Alberta Sleep Clinic; Associate Clinical Professor, Department of Psychiatry, University of Alberta; and Dr. Valérie Tourjman, MD, PhD, FRCPC; Psychiatrist; Institut Universitaire en Santé Mentale de Montréal, Department of Psychiatry, Université de Montréal
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