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Despite election promises, Ontario's mental health system is 'not just a simple fix'

All three major political parties are pledging billions to fix Ontario's mental healthcare system, but the trouble, according to those who navigate the system, is the solution doesn't fit into a neat political slogan.

People who use the system say patients often fall through cracks and only get help when it's too late

According to Toronto's Centre for Addiction and Mental Health, Ontario's mental health care system is chronically underfunded to the tune of a $1.5 billion, leaving many people with few options. (Shutterstock / Novikov Alex)

After decades of navigating Ontario's serpentine, sometimes baffling and often difficult to use mental health system, it was the courts that delivered the most help. 

"At 22, it was the first time she's actually got the help that she needed," said Chris Moss of her daughter Kyla, who, in 2017 was charged with assault in London, Ont. after she told a cabbie she thought she would be sick in the back of his car. 

"You have to hit rock bottom to get help." - Chris Moss

He tried to get her out, which triggered a panic attack that ultimately led her to strike him. 

"Because of that she ended up with an assault charge," Moss said, noting that through the courts, her daughter's challenges were quickly identified and addressed by the justice system, something she couldn't get through the conventional system. 

'You get bumped around like a ping pong ball'

At an early age, Kyla was diagnosed with anxiety, depression and attention deficit hyperactivity disorder and the combination of all three made getting help a difficult task.
Chris Moss poses with her daughter Kyla. Moss says there are too many cracks in Ontario's mental health care system where people like her daughter can easily fall through. (Supplied)

Moss remembers waiting, sometimes for years, just to see a certain doctor only to be told the combination of Kyla's conditions or a certain medication disqualified her for treatment. 

"You get bumped around like a ping pong ball," Moss said. "For example, we waited for a psychiatrist review for a year and when we got in, because it's complex and there's drug and alcohol abuse as well, they weren't even able to give us a diagnosis." 

Help always seemed just out of reach, until Kyla lashed out. 

"She was allowed to go through the mental health diversion program where she finally got into programs that could help her," Moss said. "You have to hit rock bottom to get help." 

Today, Kyla is living in CMHA assisted housing and is receiving the treatment she needs, but others aren't so lucky.

They can end up in hospital, jail, or dead. According to the Centre for Addiction and Mental Health in Toronto, 4,000 Canadians die by suicide each year, an average of 11 deaths a day.

Cash strapped mental health system

Beth Mitchell is the CEO of the Middlesex branch of the Canadian Mental Health Association in London, Ont. (Colin Butler/CBC News)

It's an unfortunate reality of a chronically cash strapped system, as it grapples with how to deliver limited services amid surging demand.

"Formerly people really wouldn't talk about a mental health issue," said Beth Mitchell, the CEO of the Middlesex branch of the Canadian Mental Health Association. "We're really starting to see a change in that."

"The difficulty is our system wasn't developed for that," she said. "The way that things were set up a couple of decades ago really wasn't there to support that kind of attitude to mental health." 

The current system is built on the foundations of an old institutional model, where there were few choices when it came to mental healthcare in Ontario. Because of stigma around mental health, people often didn't come forward and when they did, it was with hesitancy and often only when it was too late. 

Ontario's changing system

Many of Ontario's former mental hospitals, like this one in London, Ont. have been abandoned along with the old stigma of mental health that went along with them. (Wikimapia)

"They had no alternative. The best choice was to go in hospital," Mitchell said. "At that time people stayed in hospital a long time and maybe they never came back to the community or reunite with their families or go back to work." 

Since then, not only has Ontario closed many of its old mental hospitals in favour of a more community-based approach, the public has also changed the way it recognizes and perceives mental health. 

"Now people are coming forward with mild to moderate symptoms, much more treatable, much better for people to come forward and get help, they can stay with their family, stay with their job, but the system hasn't balanced out in terms of where the services are," she said. "Funding hasn't kept pace with the demand and the need." 

While mental illness accounts for 10 per cent of the total share of the health care system resources in Ontario, according to CAMH, it only gets seven per cent of the funding, which works out to a $1.5 billion shortfall. 

Parties pledging billions for mental health

Ontario's three main parties have each pledged billions of dollars to address mental health problems in communities across the province. (Chris Young/Canadian Press, Michael Charles Cole/CBC and Carlo Allegri/Reuters)

A gap like that could explain why mental health is one of the single biggest issues in this provincial election, according to many people who wrote in to CBC News.

The parties know it too, it's why they're pledging billions of dollars to fix the problem. However none of them match the sum CAMH says the province needs. 

The Liberals are committing $2.1 billion over four years to "rebuild" the mental health care system, including hiring more mental health care workers in secondary schools and increasing access to publicly funded psychotherapy.

The PCs are promising $1.9 billion over 10 years, pledging to cut waiting times for youth who need mental health treatment.

Meanwhile, the NDP has marked $2.4 billion over four years for mental health and addictions funding. Their promises include starting a new ministry of mental health and addictions and hiring 2,200 new mental health care workers.

'The systems, they need to talk to each other'

The trouble though, according to Chris Moss, who struggled for 22 years to find her daughter help, is that the solution doesn't fit into a neat, political slogan. 

"It's not just an easy fix," she said. "It's awful... the systems, they need to talk to each other."

"The school system, the regular healthcare system, the mental healthcare system and the criminal system, they all need to know about each other and work together," Moss said.

About the Author

Colin Butler

Video Journalist

Colin Butler is a veteran CBC reporter who's worked in Moncton, Saint John, Fredericton, Toronto, Kitchener-Waterloo, Hamilton and London, Ont. Email: colin.butler@cbc.ca