Top 10 Funding Ideas Steve Lurie, Executive Director CMHA Toronto Branch, Adjunct Professor Factor In entash Facu!

t" of Socia! #or$ Remarks delivered at the Graham Boekh Foundation Workshop: How can we increase pu lic spending in !ental Health in "anada to #$ o% total health care spending& 'pril ()* (01+* !ontreal, M" ee$end horosco%e said& '(ou are entit!ed to "our o%inions, )ut "ou are not entit!ed to ex%ect that ever"one i!! a*ree ith "ou+,Facts: Canada and its %rovinces !a* other hi*h inco.e countries ith res%ect to .enta! hea!th, and over the %ast /0 "ears far .ore as invested in other areas of hea!th care, than .enta! hea!th 1 des%ite the fact that disease )urden is /,2 x that of cancer and over 3x *reater than infectious disease, Menta! Hea!th s%endin* has )een dec!inin* as a share of hea!th s%endin* over the %ast 40 "ears, des%ite an annua! 520 )i!!ion cost to our econo.", and esti.ates that the costs i!! increase to 56,2 tri!!ion over the next 40 "ears, des%ite the $no !ed*e that suicide is the !eadin* cause of death a.on* Canadians )et een /7 and 42, and the $no n )urden of .enta! i!!ness on fa.i!ies, So ith a%o!o*ies to David Letter.an 8 and %ossi)!" David 9o!d)!oo.: here are ." to% /0 ideas to *et Menta! Hea!th fundin* on the federa!; %rovincia! a*enda, /0, The MHC strate*" *oa! 860/6: is& The .enta! hea!th share is a tar*et of <= of hea!th s%endin* and an increase of 6= of socia! s%endin*1 this i!! ensure invest.ents in housin* and e.%!o".ent across the countr" as e!! as invest.ents in .enta! hea!th services, <, It>s a)out access1 60= of us ex%erience .enta! i!!ness each "ear )ut on!" /;4 of us *et the care e need 7, ?eco*ni@e the costs of not investin* 1 520 )i!!ion annua!!" in !ost %roductivit", costs esti.ated to rise to 56,2 tri!!ion if e don>t chan*e, There is evidence that hi*h cost service users can )e he!%ed in the co..unit" for !ess cost1 for ever" /5 s%ent e save 56 )ased on At Ho.e; Che@ Soi findin*s1 Antario ACT data sho ed a net savin* of 5/,7 .i!!ion %er tea. in reduced hos%ita!i@ation da"s, 3, Cautious incre.enta!is. on>t or$1 research on Antario>s 5600 .i!!ion invest.ent at the turn of this centur" in co..unit" .enta! hea!th sho ed the %ro*ra.s or$ed )ut the invest.ents ere insufficient to drive chan*e at the s"ste. !eve!, B, #e need annua! s%endin* and service tar*ets for at !east /0 "ears, The #HA notes that countries ith tar*ets and dedicated fundin* ere .ore !i$e!" to sho %ro*ress,

2, S%endin* shou!d )e )ased on thin*s e $no that or$ such as& Housin* First, ACT ear!" %s"chosis intervention, %eer su%%ort, e.%!o".ent su%%ort, and there shou!d a!so )e fundin* to encoura*e and test innovations such as e .enta! hea!th, It shou!d a!so inc!ude Pri.ar" Hea!th Care1 strate*ies to i.%rove access to MH services, as e!! as strate*ies; *uide!ines to reduce %re.ature death a.on* %eo%!e !ivin* ith serious .enta! i!!ness such as schi@o%hrenia, There are .an" %ro.isin* %ractices across the countr" that can )e sca!ed, C, Fundin* invest.ents to chan*e to a co..unit" focused s"ste. shou!d inc!ude a ro)ust eva!uation strate*" that inc!udes a for.ative and deve!o%.enta! a%%roach1 exa.%!es of !o cost hi*h i.%act research exist& CMHEI, SEEI, At Ho.e;Che@ Soi, And e need a strate*" to co!!ect co.%ara)!e data on $e" indicators at !oca!, %rovincia! and nationa! !eve!s, The DPI %roject in EF is a *ood exa.%!e of this, 4, #e need to .a$e the case to Pre.iers, Finance Ministers as e!! as Ministers of Hea!th and e need at !east a /0 "ear, rin* fenced co..it.ent, Focusin* on!" on Ministers and Ministries of Hea!th is insufficient, #e need to en*a*e the centra! a*encies of *overn.ent as e!! as individua! .e.)ers of federa! and %rovincia! %ar!ia.ents, 6, #e need a nationa! .enta! hea!th 8transition: fund of at !east 52,4 )i!!ion incre.enta! s%endin* over /0 "ears that drives service tar*ets and the deve!o%.ent of at !east 23,000 units of su%%ortive housin*, #e can afford to invest at !east 5240 .i!!ion %er "ear1 this is !ess than 0,6<= of our hea!th care s%endin* in Canada, Accordin* to the Par!ia.entar" Bud*et Afficer1 the federa! *overn.ent i!! have fisca! roo. for this1 the %rovinces i!! not )ased on the chan*es to fisca! transfers that co.e into effect in 60/B, The #HA notes that hi*h inco.e countries ho are s%endin* <= or .ore on .enta! hea!th have 9DPs of at !east 566,000 %er "ear1 Canada>s is 5CC,000, Besides the 9DP rationa!e, e can ar*ue that ver" !itt!e of the Canada Hea!th Transfer ent to .enta! hea!th services, there fore e need a dedicated fund for /0 "ears, /, #e need to .ove fro. rhetoric to action1 or as an Irish co!!ea*ue characteri@ed their !ac$ of i.%!e.entation of the 600B Irish Menta! Hea!th Po!ic"1 ' I thin$ e are sufferin* fro. i.%!e.entation deficit disorder-, So is Canada, Fina!!", e need to .a$e sure e aren>t %racticin* Hac$er>s La of Inverse ?e!evance 8(es Minister: hich states1 'the .ore e ta!$ a)out so.ethin* the !ess e intend to do a)out it-