Supporting the Cession to Canada’s Two-tiered Mental Health Care System

By Georgia McClelland

Depressed womanIt is by my understanding that Canada prides itself on having a free health care system — a fundamental value that is a main contribution to the pride that us as Canadians obtain towards our home country. With this being said, there is a matter that often gets lost under the main idea of free health care. The issue of Canada’s two-tiered mental health care system is becoming an increasing problem for our society.

Since the age of 10, I have been receiving private mental health care for mental health disorders including obsessive compulsive disorder, depression, anxiety and eating disorders. Though my mental illness history is rather intense compared to others, there are many individuals who have gone through the same treatment or more than I have. In fact, The Canadian Mental Health Association tells us that 20 per cent of Canadians will directly experience a mental illness in their lifetime while 100 percent of Canadians will indirectly experience a mental illness through association with friends and family. To put the numbers that treatment has cost me over the past four years, I have given a brief summary of the finances of private health care.

At age ten, I began seeing a psychologist biweekly at a rate of $150 per appointment in order to manage my obsessive compulsive disorder.

Upon being diagnosed with severe intrusive thought OCD, I was sent to a private psychologist located in Thornhill, Ontario where I received this immediate therapy treatment for six months. Although having the option to see a government-covered psychologist, the three-month wait list was not an option that my state of mental health was able to take. Throughout grades five, six and seven, the total cost of my therapy sessions was $8,700 with private medical coverage only covering $1,500. Throughout grades eight, nine, ten and eleven I was lucky to have benefited from the treatment I had gotten, and only saw my psychologist four times a year, calculating to a total of $2,560 with hourly session prices increasing. Each of these therapy sessions were completed in the private health care systems. Between the ages of ten and sixteen, my family had spent around $11,260 in order to treat my mental illness. Private medical coverage only covered $3,500 of these expenses. In grade twelve, my bulimia nervosa eating disorder was addressed in September. Due to the intensive treatment that eating disorders require, my family decided that for financial reasons, I would receive help through the public health care system. It was only until January when I had finally succeeded the waiting list and began public outpatient treatment at a hospital in Markham, Ontario.

Attending treatment biweekly for four months was enough for me realize that I was not going to be able to continue my treatment in the public health care system. Though the doctors and methods were feasible in granting me the initial treatment I needed, the help I was receiving was not helping myself in making progress I needed, and soon became something I hated. After my parents and I had discussed the importance of receiving adequate help that I trusted, I ended my time at the hospital and immediately was emitted to a clinic in Toronto, Ontario. This was a private eating disorder clinic that caused huge financial stress on my family. The weekly sessions that I have now attended for two months cost $200 per session, while monthly nutritional appointments are $250. Looking into how far I still have to go with my treatment, the expense that it has cost for me to receive this private health care is astonishing. As of now, $1,450 has been spent towards the 2016/2017 mental health care that I have needed. Needless to say, I have found myself making leaps and bounds in my recovery through the help of this private clinic. Evidently, the cost of private mental health care adds up immensely when receiving the proper adequate attention that individuals like myself are in need of today. For most, this total of $12,700 is a fee that is simply not affordable. I am one of the few people who are fortunate enough to be in a financial state that allows me to receive the health care I need. Unfortunately, this is only the case for the top one per cent of Canadians. Supplementary private insurance covers some costs of mental health care, but does not cover the long term demand that treating mental illness requires. This is where the problem stands.

The question that I often think about is this: What do individuals who are unable to afford mental health care do?

The answer is simple — they don’t do anything. Statistics from the Canadian Mental Health Association have shown that only one out of every five Canadian children are receiving the medical attention that mental disorders require. This means that 80 per cent of the children who are living under these life-threatening conditions are unable to receive help whether on due to lack of funds or public health care system wait lists. Timely access to services in Canada is a critical issue in consequence to the inconsistency between mental health and physical health services, along side the shortage of health professions. If families are forced to wait months before they can settle for public health care, while other families who have the finances to afford immediate private health care; the gap is inevitable. The services essential for recovery are being jeopardized as a result of the two tier health care system that separates Canadians based on their financial state. Demand for mental health care is exceeding the supply. Unfortunately, with mental health time is crucial. One day too long can lead to the loss of life and if the reason is simply because there were not enough resources to aid that individual, the system is inarguably corrupt. No individual should fail to receive proper mental health care based on financial state or unavailable hospital services. These are two inexcusable reasons that need to change.

The adverse statistics have proven that 20 per cent of Canadians will personally experience a mental health illness in their lifetime and while the numbers don’t stop there; mental illness will indirectly affect all Canadians through family and friends. It is estimated that 10-20 per cent of Canadian youth will be affected by mental illness while the number of 12-19 year olds who are at risk of developing depression is reaching over 3.2 million in the present day. Despite the increasing societal dilemma that these numbers reveal, the main issue is rooted in the fact that in Canada, only one out of every five children are receiving the medical attention that their mental disorder demands.

Though the government pays for the majority of all services delivered by physicians and acute-care hospitals, this is resulting in less money for other areas of healthcare such as mental illness. Unlike other countries with a more equally balanced public-private financing mix, Canada lacks private financing for hospital and physician services. Canada’s single-payer model for hospitals and doctors may be less expensive to administer than a mixed system with both public and private payment, but other countries’ mixed health care systems have proven long-term efficiency and equality. Ontario is the only province that prohibits private funding of medical services for physicians who opt-out. For physicians who have opted in, private funding of medical services have prohibited direct patient billing in Ontario. In Canada, 35 per cent of medical goods are publicly financed while 65 per cent of these goods are privately financed. Only one per cent of doctors of privately funded while 99 per cent of doctors are physically funded. Just eight per cent of hospitals are privately funded while 92 per cent of hospitals are publicly funded. These statistics were measured by the C.D Howe Institute in 2011, yet the patterns in Canada have not changed. As a result of the majority of Canadians being forced to receive care through the public health care system, demand is succeeding supply at a rate too fast to maintain. The C.D. Howe Institute report concludes that in comparison to the UK, Switzerland, Australia and the Netherlands, Canada has the vastest gap between public and private health care.

This article is meant to address the issue of Canada’s two-tiered mental health care system, specifically for the province of Ontario, and attempt to make a change for the future of Canadian individuals. It goes without saying that the health care system must change before this gap grows any larger.

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