If Canada had permitted medical assistance in dying (MAID) for mental health disorders back in 2005, Alexandra Shimo would have died twenty-one years ago at the age of twenty-six. At the time, she had recently relocated from London, England, to Toronto, driven by a romantic pursuit and a strong ambition to break into broadcasting. However, she was also grappling with severe, unmanaged anxiety that severely compromised her ability to maintain stable employment.
In those early days, her management of the condition fell into a frustrating and recurring cycle. Every month or two, she would return to her family doctor to experiment with a fresh drug combination. The regimen frequently shifted—more Olanzapine, less Lorazepam, or an adjustment to Effexor. Notably, both Effexor and similar pharmaceutical interventions have frequently been linked in clinical discussions to increased risks of suicidal ideation.
Because her condition made steady work difficult, private therapy remained completely out of financial reach. Her primary pathway to specialized care was through the public healthcare system, which meant being placed on a psychiatrist’s waitlist estimated to span five years. Without timely psychological intervention or adequate therapeutic support, her mental health began to spiral downward. She found herself increasingly consumed by intrusive thoughts and obsessions regarding how she might end her life.
Shimo’s experience reflects a systemic reality across Canada, where pharmaceuticals are frequently treated as the default frontline response for mental health patients. For the vast majority of individuals seeking help, family physicians serve as the sole source of medical support. Because general practitioners are often pressed for time and lack specialized psychiatric training, patients are routinely prescribed medications without the comprehensive, long-term therapeutic care that clinical guidelines typically recommend. This reliance on a medication-first model often leaves patients without the care they truly need—which generally involves consistent psychotherapy—and, in severe cases, can exacerbate their underlying struggles.
This dynamic leaves vulnerable individuals exposed to trial-and-error prescribing models with minimal oversight. Winnipeg-based book editor Michael Schellenberg, who lives with bipolar I disorder, describes the process with blunt candor. Being given powerful psychotropic medications without the necessary psychiatric supervision is terrifying, he notes, explaining that patients are often left feeling as though physicians are playing a high-stakes game of spin the wheel of fortune with their lives.
Whether personal accounts like those of Shimo and Schellenberg point toward a wider, systemic pattern across the country is a question the federal government has attempted to address in recent years. In search of policy solutions, Ottawa commissioned several independent reports to evaluate whether MAID protocols should be expanded to include individuals whose sole underlying condition is mental illness.
The findings of the government’s most recent report, published in June, painted a stark and damning picture of Canada’s mental health landscape. The review concluded that access to essential health services is deeply dictated by the social determinants of health, including systemic poverty, physical disability, social isolation, and inadequate housing. The report underscored a fundamental structural imbalance: while the public demand for comprehensive mental health care continues to accelerate rapidly, the actual service capacity of the healthcare system remains largely stagnant.
Subsequent data underscores the breadth of the shortfall. In 2025, findings from the Canadian Institute for Health indicated that 41 percent of Canadian adults living with a mental illness reported that their healthcare needs were either entirely unmet or only partially addressed. For young adults, the situation was found to be significantly worse, with an alarming 92 percent stating they received little to no meaningful help for their mental health conditions.
Faced with mounting scrutiny over these systemic deficiencies, the federal government ultimately suspended its controversial plans to expand MAID eligibility to include mental health conditions in early October. However, public health advocates and patients quickly noted that a critical element was missing from the government’s policy reversal: a concrete, adequately funded strategy to enhance access to life-saving, preventative mental health care.
When pressed on the issue by journalists and policy analysts, representatives for Health Canada deflected toward existing provisions, emphasizing that the federal administration remains dedicated to a broad strategy. The official response stated that the Government of Canada remains firmly committed to taking a comprehensive approach aimed at improving access to vital mental health services and supports, which includes ongoing collaboration with provincial and territorial jurisdictions to integrate person-centred care.
For individuals who remain stranded without care, however, such policy assurances offer little practical relief. Schellenberg points out that finding a permanent, accessible psychiatrist in Manitoba has proven nearly impossible, with waitlists remaining stubbornly fixed at around five years. From the perspective of a mental health patient, he notes, individuals are forced to navigate the system almost entirely on their own, as much of the necessary specialized help sits completely out of reach for ordinary Canadians.
More than two decades after her initial struggle in Toronto, Shimo faces a strikingly similar barrier to continuous care. To this day, she has been unable to secure a permanent psychiatrist to oversee and manage her treatment plan. The long-term consequences of this continuous systemic void have been multifarious and severe, including eight separate psychiatric hospitalizations, four involuntary job losses, and periods of profound family upheaval during which her spouse experienced clinical depression brought on by the relentless instability.
Today, Shimo notes that she remains anchored to life primarily through the support of a loving family, yet the ongoing chaos generated by the broader shortage of accessible mental health resources continues to test that foundation.