Ontario’s “Roadmap to Wellness” continues austerity for youth mental health services even as demand spikes

Ontario's right-wing populist Progressive Conservative government released a “Roadmap to Wellness” on March 3 that is ostensibly aimed at improving young people's access to mental health services. In reality, the “roadmap” amounts to a continuation of austerity that will do next to nothing to improve access to the care and therapy that hundreds of thousands of children and youth urgently need.

The headline measure was the allocation of a paltry $20 million to offer free therapy to children aged 10 and over who confront depression and other mental health problems. The government also announced the creation of a Mental Health and Addictions Centre of Excellence, which it says will function as the central coordinating body for these services.

This is a drop in the bucket, given that in Ontario, as across Canada, mental health care is notoriously underserviced by the universal public healthcare system (Medicare), forcing those who can afford it to turn to private psychologists and other professionals.

A statement from Ontario’s Child and Mental Health Lead Agency Consortium, which includes 31 mental health service providers across the province, denounced the government proposal. It “contains little to nothing new for children’s mental health,” said a statement issued by the Consortium. “Nor does the strategy propose the level of additional funding investment needed to meaningfully enhance delivery of improved services for children and youth living with mental illnesses and addictions.” The statement added that if the new measures are implemented as planned, they will “not result in creating equitable and immediate access to mental health and addiction services.”

The Ford government’s continued commitment to austerity comes as demand for mental health services for children and adolescents is at an “all-time high,” according to a new report.

The report, released in late January by Children’s Mental Health Ontario and titled “Kids Can’t Wait,” notes that youth mental health treatment wait lists have more than doubled over the last two years. Currently, 28,000 children and youth are on wait lists across the province, up from approximately 12,000 in 2017. Delays for mental health services can be up to two and a half years, with an average wait time of 67 days for counselling and therapy, and 92 days for intensive treatment.

Such delays in treatment are driven by chronic underfunding of mental health services as well as a sharp increase in need. In Ontario, according to experts, approximately one in five children and youth have a mental health challenge. Throughout the province an estimated 200,000 kids with mental health issues have no contact whatsoever with mental health services. Critical programs for treatment of children with the most serious mental health issues do not even exist in many rural, remote and northern communities.

A tragic outgrowth of this deplorable lack of support is the rise in youth suicides. In 2005, 146 people between the ages of 8 and 24 died by suicide in Ontario. In 2016, the figure was 181. Nationally, more than 5,800 Canadian children and youth have died by suicide in the past 13 years, some as young as eight years old.

Canada has the fourth highest youth suicide rate among the 29 Organization for Economic Cooperation and Development (OECD) countries, yet Ontario has no strategy for suicide prevention.

Ontario’s growing youth mental health crisis is ultimately bound up with the stress and pressures produced by deteriorating social conditions and the brutalization of capitalist society. Children and young people are growing up in a world dominated by the threat of war and environmental destruction, precarious employment, poverty, social inequality, and the devastating consequences of decades of savage austerity measures that have gutted public services.

Ontario’s mental health crisis has been exacerbated by the austerity policies of Premier Doug Ford, who continues to starve mental health services of funding, even as he fraudulently claims that mental health is “a priority” of his government.

After taking office in June 2018, one of Ford’s first draconian measures was to cancel the previous big business Ontario Liberals' plan to provide a desperately needed $2.1 billion increase (over four years) in funding for mental health services, that was primarily aimed at providing better access to youth counseling in high schools. Even this funding package was hopelessly inadequate. It was announced in March 2018, fully eight years after a select legislative committee warned that more funding for mental health services was needed, and that a central agency should be established to coordinate them.

In truth, the Liberals offered the additional funding, which was announced less than three months ahead of the June 2018 provincial election, as part of a desperate attempt to distance themselves from the austerity policies they had implemented for the previous decade in order to avert an election debacle. This failed. The Liberals were reduced to just seven seats in the 124-member legislature.

Ford’s boast that his government will spend $1.9 billion on youth mental health services over the next decade is a fraud. Actually, it represents a massive rollback compared to the Liberal’s inadequate plan, with $335 million effectively cut from provincial mental health funding this year alone. Moreover, much of $1.9 billion is earmarked for “police initiatives,” that is, reactionary law enforcement programs.

The Patient Ombudsman—the provincial body tasked with investigating complaints related to Ontario's healthcare system—received more than 2,400 complaints last year. Limited availability of mental health and addiction services and a lack of home care for the ill and aged were key complaints. Significantly, Ford has not bothered to name a new head of the Patient Ombudsman's agency in the almost two years since he took office.

The Tories’ attacks on mental health services are of a piece with their broader campaign to devastate Ontario’s public healthcare system. One of Ford’s first measures upon taking office in 2018 was to consolidate Ontario’s healthcare system into one central authority, giving the government the power to push through job and service cuts in the name of “efficiency” and to contract out the administration of parts of the public health care system to for-profit enterprises.

Ford’s election promise to end the routine practice of “hallway medicine” within a year and his recent gloating over the “tremendous progress” his government is making on tackling hospital overcrowding are strongly refuted by the miserable conditions reported by hospitals throughout the province. In January, overcrowding and long wait times at Brampton Civic Hospital—Canada’s largest hospital—compelled city officials to declare a “healthcare emergency.” In the first six months of 2019, almost half of the province’s 169 hospitals and critical care facilities ran over capacity for at least a month.

These terrible conditions are set to worsen dramatically as the full impact of the coronavirus pandemic makes itself felt in Ontario and across Canada.

The healthcare cuts are an integral part of the Tory government’s class-war assault. As part of Ford’s drive to make Ontario “open for business” by boosting profits for the corporate elite through stepped-up exploitation of the working class, the Tory government has slashed billions from critical essential services, including public healthcare, education and low-income support services.

Previous governments of all stripes had equally deplorable public health records. Between 1995 and 2002, Mike Harris’s Conservative government laid off 6,000 nurses, closed 28 hospitals and eliminated over 7,000 hospital beds. During their 15-year rule, including almost three years between late 2011 and 2014 during which they were propped up by the New Democratic Party, the Liberals starved funding for mental health and addiction services, and froze hospital operating budgets for four years in a row.

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