Mental health is an important aspect of public health in Canada, impacting individuals across all demographics. Each year, around 1 in 5 Canadians experience a mental health or addiction issue, and by age 40, about half the population will have encountered a mental health challenge (2021; https://cmha.ca/brochure/fast-facts-about-mental-illness/?utm). There is broad recognition of the importance of mental health and its relevance to public policy and community well-being.
Mental health affects a large portion of Canada's population with significant impacts on individuals, families, communities, and the health care system. Analyzing key statistics can help guide policy decisions in terms of funding and the allocation of mental health services.
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Mental health policy in Canada has evolved significantly over the past two centuries, reflecting changes in societal attitudes, medical advancements, and government priorities. This timeline highlights key milestones that have shaped mental health care in Canada. Understanding this progression helps identify achievements and ongoing challenges in building equitable mental health care.
The first ‘lunatic asylums’ were established in New Brunswick and Quebec. This marked the start of institutionalized care for individuals with mental illnesses. However, these asylums operated with limited funding and were often overcrowded which lead to poor conditions of care. (2015; https://scidoc.org/articlepdfs/IJBRP/IJBRP-2332-3000-03-902.pdf, 2014; https://www.thecanadianencyclopedia.ca/en/article/mental-health#:~:text=Asylums for the insane were,were initiated by Dorothea L).
Dr. Clarence Hincks founded the Canadian National Committee for Mental Hygiene (CNCMH). The CNCMH sought to improve mental health care through education, prevention, and early treatment. The inspections of early Canadian asylums exposed poor working and living conditions which led to significant reforms. This initiated a shift toward community-based care and prevention (2014; https://www.thecanadianencyclopedia.ca/en/article/mental-health).
WWII marked a shift in attitudes toward mental health. Medical examinations of recruits highlighted that mental health issues were prevalent among seemingly healthy adults. The results also emphasized the role of stress in deteriorating mental health and the importance of understanding the emotional needs of children. Ultimately, this encouraged research toward treatment and preventive measures ( 2014; https://www.thecanadianencyclopedia.ca/en/article/mental-health).
The shift toward deinstitutionalization was marked by the advent of psychotropic drugs, which allowed individuals to manage mental illnesses outside of institutions. This transition was further fueled by economic pressures, overcrowding, and reports of poor conditions in asylums, prompting a move to community-based care. In Quebec, the Quiet Revolution accelerated this process by replacing religious-run facilities with secular, government-led systems (2004; https://journals.sagepub.com/doi/pdf/10.1177/070674370404900405).
The Canada Health Act (CHA) was established which aimed to set national standards for healthcare. However, its exclusion of community-based mental health services (e.g., psychotherapy) limited federal support for these services. This contributed to fragmented accountability and a decline in mental health spending from 11% to 7% by 2014 (2020; https://www.sciencedirect.com/science/article/abs/pii/S0277953620302264?fr=RR-2&ref=pdf_download&rr=8e122ffa2bfd605e).
The Ontario Mental Health Act was amended to introduce Community Treatment Orders (CTOs), enabling certain individuals with severe mental illness to receive mandatory, supervised treatment in the community. This marked a significant shift from hospital-based care to community-based mental health management for high-risk patients (2007; https://www.cambridge.org/core/journals/health-economics-policy-and-law/article/mental-health-service-delivery-in-ontario-canada-how-do-policy-legacies-shape-prospects-for-reform/5C66BBDFB7EA5AD3991D32ACA4570198).
The Kirby Report called for the establishment of the Mental Health Commission of Canada (MHCC) to develop a national mental health strategy, emphasizing community-based support and collaboration across sectors (2016; https://sencanada.ca/en/sencaplus/news/why-the-kirby-reports-on-mental-health-still-matter-senator-jane-cordy/#:~:text=The final report%2C called Out,that still guide policy decisions).
Following the Kirby Report, the MHCC was established to oversee a national strategy for mental health and to coordinate efforts across provinces. It focused on recovery-oriented approaches and multi-sectoral collaboration (2024; https://mentalhealthcommission.ca/about/#:~:text=Improving mental health outcomes for all people in Canada&text=At the Mental Health Commission,as their families and caregivers).