Prime Minister Justin Trudeau has agreed to add health care to the menu at this week's gathering of first ministers, a concession to the provinces who want Ottawa to pick up a greater share of health-care spending.
The increase in federal health transfers to the provinces will be held to three per cent this year instead of six per cent — a cost-saving measure introduced by the previous Conservative government that the Liberals are keeping as they try to negotiate another health-care accord.
But that's not the only discussion health professionals want the prime minister and premiers to have around the dinner table Friday. Members of the Canadian Alliance on Mental Illness and Mental Health, a coalition of 16 organizations, are urging them to immediately commit more resources to battling mental illness.
"If we don't start dealing with this sooner rather than later, I think we'll have a generation of young adults and children who are quite stressed out, with increasing rates of anxiety and depression across the board," said Dr. Raj Bhatla, chief psychiatrist at the Royal Ottawa Hospital.
According to the Mental Health Commission of Canada, one in five Canadians suffers from some form of mental illness each year. Put in perspective, that's roughly three times the number of people with Type 2 diabetes.
About 70 per cent of young adults living with mental health problems report the symptoms started in childhood. Nearly a third of all hospital stays in Canada are due to mental disorders.
The prime minister is aware of the impact of mental health issues on families. His mother, Margaret, wages a very public battle with bipolar disorder.
"There is no Canadian who doesn't have a friend or family member affected by mental health," Trudeau said last month. "We know the challenges to communities, to families and our economy. It is long past time Canada stepped up."
The Liberals have promised to make mental health services more accessible, but progress appears to be stalled by the larger federal-provincial negotiations for a new health accord.
Still, there is a potential road map. The mental health coalition released a five-point plan this fall of what it says can and should be done now.
It includes increasing the amount Ottawa transfers to the provinces for mental health by an additional $777.5 million a year to improve access; creating a five-year, $100-million Mental Health Innovation Fund; and expanding public health insurance coverage to include treatment by psychologists and therapists so patients and their families don't have to pay thousands of dollars out of their own pocket for the help they need.
'We can't afford not to do it'
Karen Cohen, CEO of the Canadian Psychological Association, says the first ministers can agree to pay more now to improve early diagnosis and treatment or pay even more later in increased hospital stays and the lost productivity of people who can no longer function.
'There is no Canadian who doesn't have a friend or family member affected by mental health." - Prime Minister Justin Trudeau
"Nobody would argue that we shouldn't give cardiac care to people in need, or we shouldn't replace their hips or we shouldn't attend to the health needs of children," Cohen said. "But somehow, when it's mental health, it seems to be OK to say, 'Well, that's something we can't afford to do now.'
"I think we can't afford not to do it."
A report by Children's Mental Health Ontario found in 2015 there were 6,000 children who had waited a year for treatment. This year, the number has doubled to 12,000.
The challenge for policy-makers is that mental health issues are connected to so many other social problems, including addiction and homelessness.
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And not all of the provinces have the same challenges. In some, the focus needs to be on seniors. In others, it's trying to prevent suicides among Indigenous children.
B.C. Premier Christy Clark says the connection between mental health and addiction is one area where her province needs more help from Ottawa.
"We can take that money, we can put it into recovery beds," she said after a meeting in Ottawa two weeks ago to discuss Canada's opioid crisis.
"One of the things that happens is that people who are living with a drug addiction and a mental illness find their way to hospital, they get treated for the addiction and their lives might be saved and then they leave. And we don't have the resources to support them after that."
But after months of haggling over health-care spending, is it realistic to expect the first ministers can deal with mental health funding over dinner?
Dr. Bhatla of the Royal Ottawa says he believes the prime minister is prepared to act, in part because of his mother's struggle with bipolar disorder, which she chronicled in her 2010 book, Changing My Mind.
"You have a prime minister now who is energetic, who understands the problem. And the expectation is that more will happen, and sooner."