Hon. Tracy Muggli: Honourable senators, Senator Burey’s motion asks us to consider what it would actually mean to treat mental health and addiction care on an equal footing with physical health care. I immediately felt compelled to speak to this motion. I think about the many steps we’ve taken toward destigmatizing mental illness and how far we have come on mental health in my lifetime — even in my child’s lifetime — but we are still a long way from where we need to be.

At a talk in Manitoba, Michael Landsberg, who started the #SickNotWeak campaign, put this question to the audience. He said:

What if we treated mental health the same way we treat dental health? No shame. No hesitation. Just care when it’s needed.

Canadians, at least those I speak to, seem to largely agree, but I also know that our health system doesn’t situate it in the same way. Mental health care and physical health care simply do not exist on an equal footing.

I took some time this summer to think about how I could lend my voice to this debate. I reflected on my time in the mental health and substance use space, as a care provider, as a friend to people who sought care and as a daughter of an aging parent. In that reflection, I think the most obvious and probably one of the most insidious examples of this unequal footing is the way we care for our elderly, and specifically those requiring support to remain independent and those who require increasing levels of care right through to long-term care.

In our society, we understandably pay attention to the physical health and safety of elderly folks. We monitor so many signs and symptoms regularly because it’s essential to preserve life. But how much attention do we pay to the quality of that life and to things like depression, anxiety and social isolation? An elderly person can be medically stable, fed and medicated while at the same time experiencing significant depression, anxiety and other psychological challenges. They may have excellent blood pressure management while remaining disconnected from people and without a sense of purpose. Physical health care may maximize the number of years someone has left, but what do those years contain?

A 2024 review of 48 studies and more than 28,000 nursing home residents found approximately 53% of patients reported depressive mood and 27% incidence of major depressive disorder.

I’m going to quote that same study to make my next point too, which is that the division between physical and mental health is essentially artificial.

The research linked depression in residential care with pain and functional disability among other circumstances. We know pain can worsen depression. Depression can reduce physical functioning and participation in rehabilitation. Social isolation can affect physical well-being. In long-term care, these risk factors are all connected. When we separate out mental and physical well-being in our policies, we ignore science and deny the reality experienced by the elderly.

If our objective is to improve the quality of life of people living in long-term care, then addressing their mental health is foundational.

I want you to really think about this for a moment. Ask yourself these questions: Why do we seem to accept that depression, anxiety and loneliness are the inevitabilities of getting old? And why don’t we do more to support people through these supposed inevitabilities so that they are not inevitabilities?

I want you to think about it this way: If your child lost a spouse or were forced out of their home, would you be worried about their mental health? If your child lost their ability to walk or lost several of their closest friends this year, would you worry about their ability to process these experiences in a healthy way?

Age is not an excuse to ignore the impacts of those circumstances. We would not say that the physical distress of an 88-year-old no longer matters because pain becomes more common with age. We should not say the same about psychological distress, especially, colleagues, when we know that many non-medical interventions can help and do.

A 2025 review of 182 studies of depression treatments among older adults living in long-term care found benefits for patients from things like cognitive behavioural therapy, horticultural therapy, exercise, socialization and other approaches that do not rely on pharmaceutical interventions. These alternative approaches are relatively low in risk and inexpensive compared to pharmaceuticals as well.

This brings me to my final point. I want to talk about the care we want for ourselves.

Imagine two elderly folks receiving the same physical care. I am thinking of medication management, nutrition, bathing assistance, mobility support and care for chronic disease. But one of these folks is otherwise left to their own devices while the other has access to activities to give them purpose — maybe a group social program, gardening or some time with a social worker or counsellor to talk when things are hard.

Which position would you rather be in? When we stop to think about it, we know intuitively that these things affect quality of life because we know we would want them for ourselves. We know they impact well-being, and we know we feel better physically when we feel better psychologically.

Senator Burey’s motion asks us to call on the federal government to establish a legal framework that places mental health and substance use care on an equal footing with physical health care. This is a big ask. It’s aspirational, but it is also grounded in science and common sense.

I could provide hundreds of examples of inequities across the age span but felt it necessary to focus on a population that is often not heard or does not have a voice.

Whether someone has 50 years, 5 years or 5 months remaining, those moments matter. Canadians deserve comparable access and appropriate treatment for ill health, whether it is physical or mental, and it must be available at any age.

I want to conclude by thanking the people who work in our publicly provided long-term care facilities across the country: the incredible care aides; licensed practical nurses; registered nurses; recreation therapists; dietary staff; social workers; occupational, physical and speech-language therapists; pharmacists; doctors; environmental services; and maintenance and administration staff who work tirelessly and creatively to ensure our loved ones are cared for.

I also wish to give a special shout-out to St. Ann’s care home in Saskatoon, where my 83-year-old mom resides, for the compassionate care that they provide to her every day.

I support this motion and will join Senator Burey in calling on the government to act. Thank you. Meegwetch.