Common Sense Health: Mental health: The missing pillar in universal health care

By Dr. Gifford-Jones and Diana Gifford-Jones on May 30, 2025.

Benjamin Rush, one of the signers of the American Declaration of Independence and often called the father of American psychiatry, pushed for more attention towards “diseases of the mind”. He published his observations in 1812, and here we are in 2025 – still playing catch-up.

For decades, we’ve been talking about universal health care. Canada, quite rightly, takes pride in a publicly funded system. But let’s be honest: the “universal” part has long had a blind spot – mental health.

The pandemic years pulled the curtain back. Suddenly, mental health wasn’t just something “other people” struggled with. Kids, seniors, healthcare workers, CEOs – everyone got a taste of anxiety, depression, burnout, or worse. And while the physical scars of COVID-19 may be fading, the mental ones are still fresh. What are we doing about it?

The good news is, things are starting to change. In the federal 2023 budget, Ottawa committed nearly $200 billion over ten years to improve health care in Canada. Of that, about $25 billion is tied up in deals with the provinces to improve access to mental health and substance use services. That’s progress. But it’s not a cure.

Half a million Canadians miss work every week due to mental health issues. That’s not a typo. Every single week. The cost to the economy? A staggering $51 billion a year. So yes, it’s a health crisis. But it’s also an economic one – and a social one.

Americans have been wrestling with this, too. The U.S. passed a law back in 2008 saying mental health must be covered the same way as physical health. But in typical American fashion, a law on the books doesn’t always mean it’s enforced. The U.S. tried holding insurance companies accountable, but lawsuits from big employers signalled they don’t want the extra red tape.

Therein lies the problem. We talk about mental health as though it’s just a matter of giving people more therapy or medication. But really, it’s about priorities. It’s about deciding that the mind is just as important as the body – and funding it accordingly.

Let’s not forget this is a global issue, too. The World Health Organization says mental health is a cornerstone of universal health coverage. But most countries still spend less than 2% of their health budgets on mental health. Imagine if we spent just 2% of our defence budgets on peace-building. Or 2% of our road budgets on sidewalks. We’d laugh, because it’s not enough to make a dent. And neither is 2% for mental health.

Some countries are leading the way. Chile, for example, has integrated mental health into primary care in an impressive way. They’ve made mental health part of a community care routine, not a luxury. It’s a model to look at seriously.

So where does that leave us? We can’t medicate our way out of a crisis. We can’t legislate compassion. And we can’t fix the system with Band-Aid solutions. What we can do is treat mental health as an essential service, not an optional extra.

That means putting real money on the table. It means training more mental health professionals. It means building care into communities, not just hospitals. And it means talking about mental health the same way we talk about heart disease, diabetes, or broken bones – with urgency, openness, and dignity.

Let’s not wait another century to listen to Dr. Rush.

If we believe in universal health care, then mental health has to be part of the package.