Petition For National Perinatal Mental Health Strategy Tabled In House of Commons May 12, 2020

Here is MP Heather McPherson (Edmonton Strathcona) tabling our petition to the virtual House of Commons on May 12th, 2020 for a national perinatal mental health strategy.

MP Heather McPherson presents CPMHC petition to House of Commons, May 12, 2020

Prior to the presentation to the House of Commons, we needed to get 500 signatures in two months, so we launched the petition to the public on March 4th, 2020. The Standing Orders (the rules governing the House of Commons) require the government to respond within 45 calendar days to every petition presented to the House of Commons (June 26th).

Le CPMHC a lancé une pétition pour une stratégie nationale en santé mentale périnatale le 4 mars, 2020. Le premier ministre Justin Trudeau et le gouvernement du Canada doivent répondent officiellement.

Here’s what our petition said:

Petition to the House of Commons in Parliament assembled/Pétition à la Chambre des communes réunie en Parlement (e-2403)

Whereas/Attendu que:

  • Perinatal Mood and Anxiety Disorders (PMADs) are the most common obstetrical complication making it a significant public health concern; Les troubles anxieux et de l’humeur périnataux sont la complication obstétricale la plus courante, ce qui en fait un problème de santé publique important;
  • In Canada and worldwide, 20% of women and 10% of men suffer from a perinatal mental illness; Au Canada et dans le monde, 20% des femmes et 10% des hommes souffrent d’une maladie mentale périnatale;
  • Stigma, lack of public and professional awareness, and leaving the onus on the mothers and partners to reach out for help, results in only 15% of mothers who experience a PMAD receiving professional treatment; La stigmatisation, le manque de sensibilisation du public et des professionnels, et le fait de laisser aux mères et aux partenaires le soin de demander de l’aide, font que seulement 15% des mères qui souffrent d’un trouble anxieux et de l’humeur périnatal reçoivent un traitement professionnel;
  • Despite limitations in Canadian data, suicide is the fourth leading cause of death, with one in 19 maternal deaths in Ontario attributed to suicide; Malgré les limites des données canadiennes, le suicide est la quatrième cause de décès, avec un décès maternel sur 19 en Ontario attribué au suicide;
  • 85% of mothers are not properly treated with a resulting annual economic cost to Canada of approximately $11 billion dollars; 85% des mères ne sont pas correctement traitées, ce qui représente un coût économique annuel pour le Canada d’environ 11 milliards de dollars;
  • The UK, Australia, and parts of the U.S. have perinatal mental health strategies and screening guidelines in place; Le Royaume-Uni, l’Australie et certaines parties des États-Unis ont mis en place des stratégies de santé mentale périnatale et des directives de dépistage;
  • Canada does not have a nation-wide perinatal mental health strategy or services to provide equitable access to treatment; Le Canada n’a pas de stratégie ou de services de santé mentale périnatale à l’échelle nationale pour fournir un accès équitable au traitement.

We, the undersigned, citizens of Canada, call upon the House of Commons in Parliament assembled to create a national perinatal mental health strategy that will provide direction, policy, and funding to develop specialized, comprehensive perinatal mental health care services which include universal screening and timely access to treatment for all women and men during pregnancy and the postpartum period.Nous, soussignés, citoyens du Canada, demandons à la Chambre des communes réunie en Parlement de créer une stratégie nationale de santé mentale périnatale qui fournira une orientation, une politique et un financement pour développer des services spécialisés et complets de soins de santé mentale périnatale qui comprennent un dépistage universel et l’accès en temps opportun au traitement pour toutes les femmes et les hommes pendant la grossesse et la période post-partum.

Response by the Minister of Health

Signed by (Minister or Parliamentary Secretary): Darren Fisher

(July 20, 2020) – Across the Federal Health Portfolio, the Government of Canada is committed to improving the mental health of Canadians. We recognize that the availability of perinatal mental health resources and services may be impacted by the pandemic. To help provide rapid support for new parents, Health Canada and the Public Health Agency of Canada have recently developed two resources to support the mental health of pregnant persons who are expecting or who have recently had a baby, including:

In addition, we have launched a new online portal that provides access to a virtual network of psycho-social supports. This new portal, called Wellness Together Canada (https://ca.portal.gs/), provides 24/7 access to free evidence-based tools and resources for Canadians in all provinces and territories, in both official languages to help meet their needs for mental health and substance use supports. The portal will also connect Canadians to peer support workers, social workers, psychologists and other professionals for confidential chat sessions or phone calls.

The Public Health Agency of Canada (PHAC) is mandated to promote and protect Canadians’ health and is committed to promoting maternal and child health, which includes supporting positive parental mental health during the perinatal and postpartum periods.

PHAC invests over $115 million annually in the Canada Prenatal Nutrition Program (CPNP), the Community Action Program for Children (CAPC), and the Aboriginal Head Start in Urban and Northern Communities program (AHSUNC), which collectively serve over 280,000 prenatal and recently postpartum women, new parents and young children each year, through community-based projects across Canada. These programs reach populations vulnerable to health inequalities (due to low income, teen pregnancy, social and geographic isolation, recent arrival to Canada, substance use issues and/or family violence), and are in a unique position to offer mental health supports to women and families who may be less likely to participate in mainstream programming. Specific mental health components include:

  • promoting attachment and resilience;
  • increasing parent/caregiver coping skills;
  • enhancing peer and social support networks; and
  • providing opportunities for screening and referral to community services.

PHAC also supports the development of a number of specific resources promoting the positive mental health of families and children, including the:

In addition to the above:

The Government of Canada is investing $5 billion over ten years to improve Canadians’ access to mental health services. The investment is being provided directly to provinces and territories to help them expand access to community-based mental health and addiction services for children and youth, integrate services for people with complex needs, and spread proven models of community mental health care and culturally appropriate interventions linked to primary health services. In August 2017, an agreement was reached with the provinces and territories on a Common Statement of Principles for Shared Health Priorities that confirmed these priorities. Bilateral agreements have since been finalized with each jurisdiction that set out details of how they will use federal funding in future years, consistent with the CSOP.

Through PHAC’s Mental Health Promotion Innovation Fund, 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 populations susceptible to mental health inequities (e.g., low-income families, immigrants and refugees, First Nations, Inuit, Métis, the LGBTQ2+ community, people living with disabilities and people with other socio-economic risk factors).

Surveillance is a core function of public health. PHAC undertakes surveillance activities to provide information to guide policies, programs, and public health action. The Canadian Perinatal Surveillance System (CPSS) is a national surveillance program that monitors and reports on maternal, fetal and infant health. The CPSS also conducts targeted epidemiological analyses and research to address issues highly relevant to its mandate and organizational priorities. The CPSS tracks and reports on 15 perinatal health indicators, consisting of measures of maternal, fetal and infant health determinants and outcomes. Most recently, PHAC collaborated with Statistics Canada to conduct a rapid survey on maternal health, the 2018/2019 Survey on Maternal Health (MHS). The MHS provides a snapshot of the mental health of mothers who gave birth between January 1, 2018 and June 30, 2018. More information about the survey can be found at: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=5283#a1.

Our response to the petition response by the Government of Canada:

July 30, 2020 – Moms across Canada are feeling let down and ignored after the Government of Canada rejected their call for a national perinatal (pregnancy and postpartum) mental health strategy at a time when it’s needed the most.

“Sometimes I feel that women are just incubators,” says mom of two and Canadian Perinatal Mental Health Collaborative (CPMHC) member, Dr. Jodi Pawluski. “It’s a shame the government does not see the value in investing in perinatal mental health, especially during the pandemic when rates of postpartum depression are increasing.”

The petition was started by the CPMHC and presented to the House of Commons in May by Edmonton-Strathcona MP Heather McPherson. The government tabled its response in July.

“What was outlined in the government’s response is exactly representative of the problem,” says psychotherapist and CPMHC member, Rosa Caporicci. “Instead of addressing the need for a national strategy, they offered a hodgepodge of different sources, agencies, and information that is neither systematic or uniform, in other words, a dog’s breakfast.”

The petition called on the government to create a strategy that includes universal screening and timely access to treatment. In its response, the Minister of Health cited programs which do not include access to specialized perinatal mental health care.

“Some of the programs they identified do not even address mental health in their overall goals,” says CPMHC member, Dr. Sachiko Nagasawa. “This puts the onus on healthcare providers and individuals which perpetuates stigma” 

Mental health disorders, including depression are the most prevalent complications in the perinatal period, yet Canada does not have a specific national strategy to support mental health during these vastly important phases of a family’s life.

In Canada and worldwide, 20% of women and over 10% of men suffer from perinatal mental illness which can include depression, anxiety, obsessive-compulsive disorder, bipolar disorder, and psychosis in the pregnancy and postpartum periods. The prevalence is even higher in some marginalized communities such as recent immigrants, socioeconomically disadvantaged families, single-parent families, LGBTQ2 families, and Black, Indigenous, and People of Colour (BIPOC).

Stigma, lack of public and professional awareness, and leaving the onus on mothers and partners to reach out for help results in only 15% of mothers receiving professional treatment. One in 19 maternal deaths in Ontario is the result of suicide. Worse yet, Canada lags behind other nations as  the U.K., Australia and the U.S. have national perinatal mental health strategies in place, but Canada does not.

“The mental health of families in pregnancy is an important specialization,” states CPMHC National Committee Member, Dr. Laurel Hicks. “Without this knowledge and specialty existing, too many families fall through the cracks, which is what we have seen all too often in Canada thus far.” 

The women’s health priorities identified by Prime Minister Justin Trudeau in his mandate letter to the Minister of Health could be better served with a national strategy during a time when women are the most susceptible to new mental health disorders.

Despite the government’s lackluster response, the CPMHC continues to work towards fulfilling its mission of the development of a national perinatal mental health strategy. The grassroots organization has received ethical approval through the University of Calgary to launch a national survey this fall to learn what kind of perinatal mental health services are being offered by health practitioners across the country.

“Now, more than ever during COVID-19, Canada needs a perinatal mental health strategy,” says CPMHC Co-founder, Jaime Charlebois. “We still hope to work with the  government to make it happen sooner rather than later.”