Columns, Opinion

BHATIA: Canadian access to mental health treatment is unfairly demonized

Canada is a nation that legally recognizes mental illness as a form of illness and requires insurance and healthcare to cover psychiatric care. Even though mental health is not completely destigmatized, it is not a huge deterrent to treatment, unlike in India, China and Nigeria, as discussed in previous weeks. Access and affordability are the bigger challenges facing Canadians seeking treatment.

Canada’s healthcare system is either highly exemplified or highly demonized by Americans when discussing the implications of having universal healthcare in the United States. It is a publicly-funded system that provides coverage to almost all Canadian citizens, regardless of their medical history and income level. It covers preventative treatment and care from physicians as well as access to hospitals. It is not, in fact, a socialized medical system, since the doctors do not work for the state. They run their own private practices, but all the insurance is handled by the provincial government.

This system of healthcare falls prey to the same critiques that are levied on any form of publicly-funded system — efficiency and quality. Political debate about this system is very heated with opponents lamenting the long waiting periods for treatment, and proponents fearing the unequal access that would come with privatization.

When it comes to mental health treatment in particular, people argue that unequal access based on income is already prevalent, even with this public system. It is widely reported by citizens that unless a mental health concern is severe and requires urgent care, the wait to see a doctor can be months long. Access to specialists takes a long time as well, considering the lack of competition as an incentive. Currently, there is about one primary care doctor for every 1,000 Canadians. Lack of access seems to be especially true for children suffering from depression. This creates a divide between those who have the ability to pay versus those who don’t.

However, statistics show that for those with depression, more than 55 percent of Canadians use mental health services covered by their healthcare. Additionally, more U.S. citizens without insurance claim to have unmet mental health needs than Canadian citizens in general. Roughly the same percentage of Canadian citizens report that their needs are not met as those U.S. citizens who have insurance. What this shows is that the inequality of access, while theoretically compelling, might be overstated by the opponents of universal healthcare. Medical insurance in the United States is a huge factor in terms of access to mental health care. The divide is hence more prevalent in countries that do not have Canada’s system of Medicare.

Canada’s problem seems to come from unequal resource distribution amongst the provinces. Access to specialists, waiting times and the number of doctors available per capita varies greatly from province to province. Some provinces have a dearth of doctors, and a disproportionately high demand for medical services. This increases wait times for treatment. More hospitals are concentrated in the southern parts of the country, with the more rural north having less access to resources.

One of the ways to solve this is to increase spending on healthcare. That, however, is a whole different debate — are citizens willing to pay higher taxes for greater coverage? As of now though, their main problem seems to be wait time, which is more easily solved than something like inability to afford insurance, like it is in the United States. As much as American conservatives like to demonize the Canadian health care system, they are overstating the cons and overlooking the solutions Canada could work toward to create a more efficient healthcare system.

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