CMHA believes that all residents of Canada have a right to mental health care[i] services that are universal, comprehensive, accessible, portable and publicly administered. These Canada Health Act principles should be applied fully and formally to mental health care across Canada. Mental health care must be available[ii] to the public as a component of Medicare and aligned with social programs we know influence social and environmental factors related to our mental health and our physical health. Achieving equity between mental health and general health services is critical to improving the health outcomes of Canadians.
Income security is a key determinant of health related to the mental health of communities. Canadian and international studies support the role income security plays in defining the socio-economic status and its relation to health outcomes. Those representing higher social and economic strata are more likely to experience more positive states of (mental) health and well being than those in lower strata. Additionally, evidence indicates that as the gap between rich and poor increases, the health of the population suffers.
Mental illness is a major health issue for society and for government. Discrimination persists in the organization and provision of hospital care and community health care for people with mental illness. The Canadian Mental Health Association is working actively to maintain and to improve a health care system in which the principles of universal access, uniform terms and conditions, comprehensiveness, portability and public administration are upheld.
Mental health professionals require better training to respond to women’s mental health needs. Most training programs presently do not require coverage of gender issues nor do they even attempt to address how women’s experiences are different from men’s. Women’s biological, psychological and social needs are not part of the curriculum in professional schools, and most therapy and research are premised on male experience. Mental health research by women receives only 6.05% of all mental health research funds in Canada and only 0.42% of all health research funds.
The Canadian Mental Health Association (CMHA) is a strong supporter of the need for a strong consumer voice in all aspects of mental illness/mental health policy, planning, and delivery – from participation to decision-making to choice.
For some time now, the CMHA has struggled with the issue of community committal or compulsory community treatment. Proposed as an alternative or a supplement to involuntary hospitalization, community committal has strong support from family groups and the psychiatric profession. Many consumer groups are as strongly opposed. Views on community committal are influenced by personal experiences. Family members see their loved ones rejecting treatment and support, especially medication, and are naturally distressed by the suffering which is the usual result. Many consumers, on the other hand, have had very negative experiences with involuntary treatment. Ironically, both consumers and family members have experienced great frustration with obtaining adequate services, including hospitalization, on a voluntary basis.
The Canadian Mental Health Association recognizes that sexual exploitation and abuse by mental health service providers takes place. The Association also recognizes that without fail such exploitation and abuse are harmful to mental health consumers. Evidence has come from anecdotal reports, complaints to professional associations, and more recently from surveys of the general public and professional groups.
In 1993 CMHA conducted a cross-Canada study of violence towards people with mental health problems. The study focused on people who had experienced violence after becoming consumers of mental health services. It identified that the homes, public places and hospitals are the places where violence is most often experienced by people with mental health problems, and that family members, mental health service consumers and service providers are those most likely to be violent towards them.
Since its inception over seventy years ago, the Canadian Mental Health Association has been a unique advocate for the chronically mentally ill. During the past decade, CMHA has expanded its mandate from promoting service delivery to active support of self-help initiatives and the community resource base. The protection of individual rights in therapeutic programs and in the community has become a major focus.
A number of studies on women’s health have demonstrated strong links between health status and socioeconomic factors affecting women. Limited participation in public life, restricted decision-making, devalued role expectations, poverty, violence and sexual abuse encumber the potential for mental well-being. Social and economic stresses, coupled with the inequitable burdens imposed by role expectations, often have a negative impact on women’s health, happiness and potential for personal fulfillment and achievement.