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Recommendations for Improving Access to Mental Health Care Services for Victims and Survivors of Crime

December 5, 2019

The Honourable Patty Hajdu
Minister of Health
House of Commons,
Ottawa, Ontario K1A 0A6

RE: Recommendations for Improving Access to Mental Health Care Services for Victims and Survivors of Crime

Dear Minister Hajdu,

Firstly, I would like to offer my congratulations on your re-election to Parliament and your appointment as Minister of Health. For your information, this letter was sent to your predecessor on August 8, 2019, but she did not have the opportunity to respond so we are resending it to you as the new Minister.

As you may know, the Office of the Federal Ombudsman for Victims of Crime (OFOVC) is an independent resource for victims in Canada. It was created in 2007 to ensure that the federal government meets its responsibilities to victims of crime. An important part of my mandate as the Federal Ombudsman for Victims of Crime is to identify systemic issues that negatively affect victims and survivors of crime, and recommend ways that the federal government can make its laws, policies and programs more responsive to their needs.

I am writing to you as I am very concerned about the prevalence of violence, abuse and trauma in Canada, how this violence affects Canadians’ mental health and the lack of access to publicly funded treatments. Your background in public health has no doubt familiarized you with the challenges victims and survivors of crime face in terms of their mental health and wellness following victimization.

According to Statistics Canada research, approximately 1.6 million people in Canada will suffer violent victimization, indicating robust associations between child abuse and mental health, including conditions like attention deficit disorder, suicidal ideation and suicide attempts. Mental health remains a growing concern in Canada, and like most Canadians, victims face a fragmented mental-health system in which the care patients receive is too often determined by what they can afford, or where they live, or what supports they may be savvy enough to access on their own. The lack of mental health care services available to victims and survivors of crime and violence is a systemic issue. This is particularly true in the rural and remote areas of our country, and especially so in Indigenous communities.

At the Office of the Federal Ombudsman for Victims of Crime (OFOVC), we hear continuously from victims across Canada that:

  • Victimization affects their overall health. Victims regularly report physical disabilities, as well as mental health conditions such as, depression, anxiety, panic disorder, eating disorders, self-injury, substance use disorders and suicidal ideation.
  • Victims and survivors cannot afford psychological or psychotherapy services and many do not have coverage through private insurance;
  • Wait times for counselling at community-based services that treat violent victimization can be up to one, or even two, years; and
  • Referrals to psychiatrists through family doctors are not easily available.

Given the role of social determinants in contributing to health inequities, I believe it is necessary to adopt a public health approach that seeks to improve the health and safety of all individuals by addressing underlying risk factors that increase the likelihood that an individual will become a victim or perpetrator of violence. I am thus writing to you to make recommendations for the development of a framework to deliver universal mental health care access across the country. I am suggesting an integrated approach – using a public health model that incorporates awareness, prevention and care in the community.

While I applaud the federal government’s 2017 injection of $5 billion over 10 years to support mental health initiatives, I recommend that Health Canada:

  1. Provide permanent public funding for the provision of universally accessible mental health treatments to Canadians.
  2. Develop and fund a public health action plan to address and prevent violence.
  3. Make the provision of funds earmarked for trauma- and violence-informed training of mental health care professionals to provinces and territories a priority in the immediate future.
  4. Work with partners and stakeholders in the public and private sectors to utilize technology to deliver mental health treatments and clinical care that will reach Canadians across vast distances.

While health care is a provincial/territorial responsibility, it is imperative that the federal government provide leadership and funding to support the development of a national public health action plan to address violence. The benefits of immediate attention to the mental health needs of victims are well documented. The Canada Health Act specifically mentions the importance of mental well-being of Canadians as a primary objective.

Experts across a broad spectrum agree that the combination of the deleterious effects of poor mental health on Canadian society, and the associated costs to the criminal justice system, mean that it is time to take a new approach to mental health in this country, and to make universal or publicly funded access to mental health care a priority.

I have attached a position paper laying out a summary of the research and recommendations from the Canadian Mental Health Commission, the Canadian Medical Association, the Canadian Psychiatric Association and the Canadian Mental Health Association, together with my own detailed recommendations above for the development of a framework to deliver mental health care services to Canadians (see Annex A).

Federal leadership is urgently needed to better support the resilience of Canadians impacted by trauma caused by violence and abuse. Canadians deserve access to publicly-funded mental health treatment. I would appreciate the opportunity to meet with you to discuss this further. I look forward to your response.


Heidi Illingworth
Federal Ombudsman for Victims of Crime

The Honourable David Lametti, Minister of Justice

Encl: Annex A



Response from Health Canada:

Ms. Heidi Illingworth
Office of the Federal Ombudsman for Victims of Crime
240 Sparks Street
P.O. Box 55037
Ottawa, ON


December 9, 2019

Dear Ms. Illingworth:

We are writing in response to your letter of August 26, 2019, addressed to former Minister of Health, Ginette Petitpas Taylor concerning improving access to mental health services for victims and survivors of crime and regret the delay in responding.  We are writing on behalf of the newly appointed Minister of Health, the Honourable Patty Hajdu.

Thank you for your thoughtful recommendations for improving mental health care access in Canada and addressing and preventing violence. As noted in your letter, through Budget 2017, we provided provinces and territories with $5 billion over 10 years to improve access to mental health and addiction services.  Provinces and territories are using this funding to support a variety of initiatives that address key access gaps in their respective jurisdictions.

The Government of Canada recognizes the need for a comprehensive approach to mental health, one that embraces promotion and prevention alongside treatment and recovery. In addition to the $5 billion, we are investing in range of programs that promote mental health and build resilience.

For example, the Public Health Agency of Canada (PHAC) invests over $6M per year through the Supporting the Health of Survivors of Family Violence investment. Projects funded through this investment are delivering and evaluating health promotion interventions designed to improve the physical and mental health of survivors of intimate partner violence and child maltreatment.  The projects incorporate research to measure changes in health outcomes including anxiety, depression and post-traumatic stress disorder. This investment is also supporting projects that build the capacity of health and social service professionals to work safely and effectively with survivors of family violence. Funded projects reach children, youth and families affected by violence, as well as professionals and service providers, while helping to l earn and share "what works" in this emerging field.

Through its Mental Health Promotion Innovation Fund, PHAC is also investing $39 million from 2019-2028 to address multiple risk and protective factors to promote mental health for children, youth, young adults a nd populations susceptible to mental health inequities (e.g., low-income families, immigrants and refugees, First Nations, Inuit, Metis, LGBTQ2+, people living with disabilities and people with other socio-economic risk factors).

Please be assured that mental health is a priority for the federal government, and we will continue to work with our partners to make improvements in this area. The challenge of addressing mental health issues requires the combined efforts of all levels of government and many stakeholders. We are optimistic that this collaboration will lead to improvements in the availability and quality of mental health services.

Thank you for writing on this important issue.


Strategic Policy Branch
Health Canada