Original language of petition: English
Petition to the Government of Canada
- Canadian citizens do not have equal access to the necessary care and supports required to meet their physical and mental needs, due to unequal economic and social conditions across our nation;
- The federal government is committed to making Medical Assistance in Dying (MAID) accessible to those with mental disorders as the sole underlying condition before addressing the clear gaps in support for this vulnerable sector of the population;
- Canadian citizens applying for MAID are required to give informed consent, which includes being made aware of alternative care options but does not include the government making such care accessible, timely, and affordable;
- In the absence of robust access to the basic necessities of life and mental health supports, the governmental expansion of MAID to persons whose sole medical condition is a mental illness creates societal circumstances wherein informed consent to MAID can no longer be discerned as free and voluntary;
- The Government of Canada has a duty to its citizens not only to prioritize their right to self-determination but also to create social conditions wherein this right can be freely and fairly exercised by all its citizens, particularly the most vulnerable;
Government response tabled
Response by the Minister of Housing, Infrastructure and Communities
Signed by (Minister or Parliamentary Secretary): Chris Bittle
Homelessness is a complex issue, and the Government of Canada is committed to continuing to work with partners and communities to move towards the goal of eliminating chronic homelessness in Canada by 2030. The Government of Canada is investing nearly $4 billion over nine years to address homelessness through Reaching Home: Canada’s Homelessness Strategy. Launched in 2019, this community-based program supports Designated Communities (urban centres), Indigenous communities, territorial communities, and rural and remote communities across Canada to prevent and reduce homelessness.
Reaching Home provides crucial funding to support services in activity areas such as: Basic Needs Services, Emergency Housing Funding, Prevention and Shelter Diversion. This funding can also support access to health and social services and improve overall wellbeing of those experiencing or at-risk of homelessness through the delivery of harm reduction activities and navigating access to clinical, health and treatment services (including mental health and addictions supports) through case management. Between April 1, 2019, and September 7, 2023, Reaching Home funding supported more than 6,700 projects to assist people experiencing and at risk of homelessness. Through these projects, 122,472 people received homelessness prevention support in rental assistance and landlord/family mediation, while 69,846 people have been placed in more stable housing.
Canada Mortgage and Housing Corporation
Our government believes that all people living in Canada should have access to safe and affordable housing. Launched in 2017, the National Housing Strategy (NHS) is a 10-year, more than $82-billion plan to give more people living in Canada a place to call home. The NHS recognizes the distinct housing barriers faced by vulnerable populations, including persons with disabilities and those dealing with mental health and addictions issues.
The NHS consists of complementary initiatives that aim to address needs across the housing continuum, prioritizing populations most in need. This includes the Rapid Housing Initiative and National Housing Co-Investment Fund, which provides funding for the creation, repair and renewal of affordable housing, transitional housing, and shelters, and the Canada Housing Benefit, which is delivered by the provinces and territories and provides funding directly to households in need to help them with their housing costs. The NHS is providing funding to protect and expand the community housing sector, which is home to many low-income and vulnerable tenants.
Response by the Minister of Employment, Workforce Development and Official Languages
Signed by (Minister or Parliamentary Secretary): Irek Kusmierczyk
3. Bolster supports that provide for the basic necessities of life, including housing, income assistance, prescription drug coverage, and mental health care.
Income security is a shared responsibility across different orders of government. As such, the Government of Canada recognizes the importance of working with the provinces and territories to find solutions to common challenges.
The Government of Canada has many programs in place that help individuals and families meet their basic needs. These include the Canada Child Benefit for families with children, and, the Old Age Security pension and the Guaranteed Income Supplement for seniors. In addition, existing programs, such as the Canada Workers Benefit and Employment Insurance, provide income supports for low-income individuals with labour market attachment or those with insurable employment. These programs exist alongside provincial and territorial social assistance programs.
Response by the Minister of Health
Signed by (Minister or Parliamentary Secretary): The Honourable Minister Mark Holland
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.
Response by the Minister of Justice and Attorney General of Canada
Signed by (Minister or Parliamentary Secretary): The Parliamentary Secretary James Maloney
Medical assistance in dying (MAID) is a deeply personal and complex choice that touches people and families at difficult and often painful times in their lives. Our Government is committed to ensuring our laws reflect Canadians’ evolving needs, protect those who may be vulnerable, and support autonomy and freedom of choice.
In June 2021, when former Bill C-7 expanded eligibility for MAID to persons whose natural death is not reasonably foreseeable, it also temporarily excluded from eligibility for MAID persons whose sole underlying medical condition is a mental illness for two years, until March 17, 2023. This was done in recognition that these requests are complex and require additional study. During this time, an independent expert review on MAID and mental illness was conducted by the Expert Panel on MAID and Mental Illness. Its final report was tabled in May 2022. A study of the Criminal Code MAID provisions and other related issues, including mental illness, was also conducted in Parliament during this time by the Special Joint Committee on MAID. Its interim and final reports were tabled in June 2022 and February 2023, respectively.
In March 2023, former Bill C-39 extended the temporary exclusion of eligibility for MAID of persons suffering solely from a mental illness by one year, until March 17, 2024. The extension allowed additional time for the dissemination and uptake of key resources by the medical and nursing communities to ensure healthcare system readiness. The extension also provided more time to consider the Special Joint Committee on MAID’s interim and final reports.
On March 27, 2023, the Government released the Model Practice Standard for MAID to provide clear guidance to clinicians and health professional regulators to help protect those who may be vulnerable, including those whose sole underlying medical condition is a mental disorder. Additionally, a Canadian MAID curriculum was developed by the Canadian Association of MAID Assessors and Providers with the support of Health Canada and was launched in September 2023.
On October 18, 2023, the Special Joint Committee on MAID was re-established to assess healthcare system readiness, in accordance with Recommendation 13 of that Committee’s final report. It must submit a final report no later than January 31, 2024.
Our Government continues to work with all partners, including the provinces and territories, as well as stakeholders, to ensure the safety and security of vulnerable populations on this deeply personal issue is prioritized.
- Open for signature
- September 13, 2023, at 1:27 p.m. (EDT)
- Closed for signature
- October 13, 2023, at 1:27 p.m. (EDT)
- Presented to the House of Commons
October 16, 2023 (Petition No. 441-01766)
- Government response tabled
- November 29, 2023
Only validated signatures are counted towards the total number of signatures.
|Province / Territory
|Newfoundland and Labrador
|Prince Edward Island