The State and Community: Issues in Mental Health Reform in Ontario

Mental health reform in Canada is imperative. Evidence shows that nearly half of Canadians with mental health and addiction problems are unable to access the care they require. Inequities to mental health and addictions care have been created by the passive privatization of critical mental health and addiction supports and services, not protected under the Canada Health Act, such as psychological services. The two-tiered system of care fosters inequities, as individuals of lower income, often with poorer social determinants of health, are denied access. The public and personal costs associated with umnet mental health and addiction needs are too significant to ignore. Mental health and addictions cost the Canadian economy $51 billion annually, and rates of suicide and homelessness amongst individuals unable to secure access to care are high. Decades of policy reports have endorsed investing in community mental health to provide a comprehensive continuum of services for individuals with mental health and addiction problems. Despite an increase in mental health funding, investments in the community have not been prioritized. This paper explores transformations in forms of governance of the liberal state and the impact on mental health reform. Using Ontario as a case study, the paper employs the Power Resource Theory guided by Quality of Government to examine the neoliberal influence on welfare state retrenchment, in order to expose the delay in mental health reform and resulting inequities to care.