441-01266 (Justice)

Medical Assistance in Dying (MAID) is a complex and deeply personal issue. The Government of Canada recognizes and respects the diverse views on whether MAID should be permitted for persons suffering solely from a mental illness. The safety and security of the most vulnerable Canadians remains at the forefront of our actions as we take a careful and considered approach on the implementation of MAID for persons living with a mental disorder.

On March 9, 2023, through the passing of Bill C-39, the Government extended the temporary exclusion of eligibility for MAID for persons whose sole medical condition is a mental illness until March 17, 2024. This extension will allow more time for:

• Consideration of any recommendations arising from the Special Joint Committee on MAID’s final report, tabled in February 2023, alongside the recommendations of the Expert Panel on MAID and Mental Illness; and,
• Dissemination and uptake of key resources, such as the Model MAID Practice Standard (released March 27, 2023) and a nationally accredited MAID curriculum, by the medical, nursing, and health provider communities.

We believe that a one-year extension, until March 17, 2024, will provide sufficient time to ensure health system readiness, to disseminate and promote uptake of key resources by the medical and nursing communities, and to fully consider the recommendations in the Special Joint Committee on MAID’s final report. It is imperative that MAID assessors and providers be ready to assess requests for MAID for persons suffering solely from a mental illness in a safe and consistent manner across Canada by the time the extension is over.

Health Canada, provinces and territories, and other stakeholders have already made significant progress to prepare for eligibility for MAID for persons whose sole medical condition is a mental illness.

On March 27, 2023, a Task Group of experts convened by Health Canada (chaired by Dr. Mona Gupta, former Chair of the Expert Panel) released a Model Practice Standard for MAID. The Practice Standard will help clinicians align their practice with clear guidance and will assist regulators to ensure the protection of the public in the context of more complex cases. Ultimately, this will help ensure MAID practice in Canada operates in a consistent and safe manner across the country.

In addition, the Canadian Association of MAID Assessors and Providers is developing and implementing an accredited Canadian MAID curriculum to support clinician education and training, and to address various topics related to the assessment and provision of MAID, including mental disorders and other complex chronic conditions. The curriculum will consist of seven modules. A rolling launch of modules will begin in the late summer of 2023, including a module on MAID and Mental Disorders, with the aim for all modules to be available by the end of 2023.

The Model MAID Practice Standard and its supporting documents, along with the MAID training curriculum, will provide valuable resources for regulators and practitioners in interpreting and applying the legislative framework safely in different clinical situations.

Supporting the mental health and well-being of Canadians is a priority for the Government of Canada.

Through Budget 2021, the Government of Canada is providing $100 million to support projects that promote mental health and prevent mental illness in populations disproportionately impacted by the COVID-19 pandemic, including youth, older adults, First Nations, Inuit and Métis, and Black and other racialized Canadians. The Government is also providing $50 million to support projects that address post-traumatic stress disorder (PTSD) and trauma in health care workers, front-line and other essential workers and others affected by the pandemic.

Health Canada invested $130 million from 2020-22 in Wellness Together Canada, an online mental health and substance use support portal, and received $140 million in Budget 2022 to support the portal for two more years beginning in 2022-23. Launched in April 2020, Wellness Together Canada provides free and confidential online mental health and substance use supports accessible 24/7 to individuals across Canada in both official languages.

Through the Mental Health Promotion Innovation Fund (MHP-IF), the Public Health Agency of Canada (PHAC) is investing $4.9 million annually in community based mental health promotion projects that focus on reducing systemic barriers. The MHP-IF encourages mental health and well-being during the early years of life by promoting protective factors and addressing the underlying determinants of mental health and health equity for children, youth, young adults, and their caregivers.

Budget 2023 confirmed the Government’s commitment to invest close to $200 billion over ten years, starting in 2023-24, to improve health care for Canadians, including $25 billion to Provinces and Territories (PTs) via tailored bilateral agreements which will focus on four key priorities, including improving access to mental health and substance use services and the integration of these services in community family health services.   This investment will build on the Budget 2017 investments, which include $2.4 billion from 2023-24 to 2026-27 still available to PTs for mental health and addictions services.

Budget 2023 committed $158.4 million over three years to support the implementation and operation of 988. The introduction of 988 will provide people across Canada with easy-to-remember access to immediate and safe support for suicide prevention and emotional distress. The creation of the 988 service in Canada builds on existing investments received through Budget 2019 for the Pan-Canadian Suicide Prevention Service, where PHAC received $25 million over five years, with $4.2 million per year ongoing. With this funding, the Centre for Addition and Mental Health (CAMH) currently operates Talk Suicide Canada. Talk Suicide Canada provides people across Canada with suicide prevention crisis support from trained responders via phone (24/7) at 1-833-456-4566 and text (evenings) to 45645. Residents of Québec can also call 1-866-277-3553, text 535353 or visit suicide.ca for support by text and online chat.

Mental health remains a priority for the Government, and we will continue to invest in it and work with Provinces, Territories, and key stakeholders to support the needs of individuals and communities across the country, now and in the future.