Recommendation: the Province of Manitoba increase mental health spending by 40 per cent over three years with priority given to community based mental health services.
In Manitoba, mental health care is estimated to be 5% of the healthcare budget. International and national research bodies say it should be at least 9%. Long term, a doubling of mental healthcare expenditures is needed. Federal commitments are essential to reaching this goal.
In the meantime, the Province of Manitoba should commit to increasing the range and availability of mental health services that people living in poverty can access. Manitoba should increase funding for mental healthcare by 40 percent over three years, so that it reaches seven per cent of the total healthcare budget by 2018. Of this increase, priority should be given to community based mental health services and mental health services offered through community based organizations.
The Mental Health Commission of Canada says 1 in 3 adults and as few as 1 in 4 children receive mental health treatment and support when they need it. This is a direct result of inadequate funding for mental health and addictions in the health care system.
All Manitobans need better mental health care. But Manitobans who live in poverty have fewer options for accessing care. Most do not have access to privately funded mental health services, which can speed up access to treatments provided by psychologists by up to 24 months. People who live in poverty are more likely to encounter institutional discrimination in the health care system, and studies have shown they receive fewer referrals to specialist care and fewer treatment options than their wealthier counterparts. For many people living in poverty, the public healthcare system is the main provider of mental health services. An increase in mental health funding targeted to people living in poverty is essential to promote equity within the underfunded mental healthcare system.
Investments to increase the range and availability of mental health services for people living in poverty should be used to reduce health equity gaps and more efficiently spend healthcare dollars. Currently, people living in poverty do not access mental health care until their needs are acute, leading to an unnecessary drain on health care resources. For instance, the Canadian Institute for Health Information reports that people living in poverty outstrip the use of emergency and acute care for mental health than all other users. In Manitoba, people whose income is in the lowest quintile used an average of $822 of services compared to $640 and $567 of those with average and high income (2004). In Winnipeg, people living in poverty are 3.9 times more likely to be hospitalized for anxiety disorders; 2.1 times more likely to be hospitalized for affective disorders; 3 times more likely to be hospitalized for mental health (acute care hospitalizations, not including psychiatric hospitalizations); and 5 times more likely to be hospitalized for substance-abuse disorders than people who have a higher incomes (2008). Investments in community mental health organizations and other community-based organizations to deliver education, prevention and early intervention services would stem the tide of services needed in acute care.
Indigenous Manitobans are disproportionally affected by poverty and impacted by intergenerational trauma. We advocate that investments in programs and services to serve this population also be prioritized. Successful strategies to improve mental health equity include funding community partners and staffing mental health workers directly in the community, increasing the number of Indigenous people working in health care and social services, and providing culturally relevant supports.
Total health spending in Manitoba in 2015/16 is forecast at $6.1 billion. We estimate spending on mental healthcare at approximately $300 million. Increasing mental healthcare spending 40% will bring mental healthcare spending to seven percent of the total healthcare budget.