441-01710 (Justice)

The Government of Canada recognizes that medical assistance in dying (MAID) is a deeply personal choice and remains committed to supporting eligible individuals in having their MAID request considered in a fair, safe and consistent manner, while supporting efforts to protect those who may be vulnerable.

Former Bill C-7, which received Royal Assent on March 17, 2021, included a sunset clause excluding persons with a mental illness as a sole underlying medical condition from seeking MAID until March 17, 2023. On February 2, 2023, the Government of Canada introduced legislation, Bill C-39, to extend – by a year – the exclusion of eligibility for MAID where a person's sole underlying medical condition is a mental illness, until March 17, 2024. Bill C-39 received Royal Assent on March 9, 2023, to allow time for broader dissemination of key resources and tools to support clinicians in administering MAID for complex cases, including for mental illness as a sole underlying medical condition.

The Government of Canada, in collaboration with experts and provinces and territories, has supported a range of initiatives guided by recommendations from the Expert Panel on MAID and Mental Illness and the Special Joint Committee on MAID. 

This has included development of a model MAID Practice Standard, as well as an Advice for the Profession document, designed by a group of experts for use by regulatory bodies and clinicians. The Practice Standard is designed for use by regulatory bodies and clinicians in addressing complex requests for MAID, including where mental illness is involved.

In addition, on September 13, 2023, the Government of Canada welcomed the release of the Canadian MAID Curriculum developed by the Canadian Association of MAID Assessors and Providers. This Curriculum is the first nationally accredited bilingual MAID education program available to licensed physicians and nurse practitioners and consists of seven modules addressing various topics related to the assessment of provision of MAID, including mental disorders and other complex chronic conditions. The goal of this program is to help achieve a safe and consistent approach to care across the country.

Other activities have included:

• regulatory amendments to the federal MAID monitoring system to enhance data collection and enrich research and analysis and reporting back to Canadians (enacted January 1, 2023, with new data to be reported in 2024);
• funding a Knowledge Exchange Workshop (June 2023) that included over 40 MAID practitioners, as well as psychiatrists, from across Canada to discuss roles and contributions to the proper assessment and management of MAID where mental disorders are involved, and support local training related to MAID for mental disorders; and,
• engaging with Indigenous Peoples through both Indigenous- and government-led activities.

Working to improve access to health care services, including mental health services, remains a priority for the Government of Canada.

The Government of Canada is investing close to $200 billion to support provinces and territories to strengthen Canada’s universal public health system. The Government continues to work closely with provinces and territories on our shared health priorities, including:

• access to family health services, including in rural and remote areas;
• supported health workers and reducing backlogs;
• access to mental health and substance use services; and,
• modernized health systems.

These investments, on top of already significant funding, will further help provide Canadians with health care that includes access to timely, equitable and quality mental health, substance use and addictions services to support their well-being.

As part of the investments, $25 billion over ten years is being provided by the Government of Canada to provinces and territories to support shared health priorities through tailored bilateral agreements. These bilateral agreements will also include the remaining years of funding from the Government’s previous investment in 2017 of $5 billion over ten years to improve access to mental health and substance use services for Canadians.

The Government of Canada recognizes that provinces and territories have their own unique circumstances. As such, the bilateral agreements are intended to be flexible so that provinces and territories can address the unique needs of their populations and geography. As part of these agreements, provincial and territorial governments are asked to develop action plans that will describe how funds will be spent (incremental to existing spending) and how progress will be measured. All action plans will include a description of how funds will be used to support better access to mental health services. As there is no health without mental health, integrated provincial and territorial investments in other priority areas, including family health teams, the health workforce, and data and digital tools, will also help to meet the health and mental health needs of Canadians.

In addition, 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, 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.

Through the Public Health Agency of Canada’s Mental Health Promotion Innovation Fund (MHP-IF), the Government of Canada is investing $39 million from 2019-2028 to address multiple risk and protective factors to promote mental health for children, youth, young adults, and caregivers. The MHP-IF aims to improve mental health for individuals and communities where interventions are delivered and to reduce systemic barriers for population mental health in Canada. Target populations include First Nations, Inuit, Métis, newcomers, 2SLGBTQI+, and other groups experiencing socio-economic risk factors.

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.