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8. Socio-economic status, mental health and addictions

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What has allowed for my accomplishments and some semblance of a quality of life distinctly relates to supportive family and class… But take that security away and my mental health would deteriorate very fast. I could very well be homeless – there were periods of time when I couldn't organize my thoughts to eat properly. The fact that in a province like Ontario people with invisible disabilities can be penalized for being ill is in itself a poor testament to our human rights. – Survey respondent

Many individuals and organizations talked about people’s experiences with poverty. Poverty is a significant concern for people across Ontario with psychosocial disabilities. Unemployment, underemployment, discrimination and the lack of affordable housing for people with psychosocial disabilities were identified as major factors contributing to poverty. Statistics Canada data from the 2006 Participation and Activity Limitation Survey (PALS) shows that 27% percent of people in Ontario with “emotional” disabilities[43] live with low income[44] compared to people with other types of disabilities (10%) and people who did not report having disabilities (11%).

We were told that disability-related discrimination in housing, education and employment contributes to having low socio-economic status and fewer life choices. The Advocacy Centre for Tenants Ontario (ACTO) and many individual consultees explained how living in poverty leads to further experiences of discrimination or social exclusion, and affects people’s physical and mental health. We heard how policies that affect people living with low income (for example, needing to use a telephone to contact a service provider) will often have a negative effect on people with psychiatric disabilities or addictions more than others. We heard that people living with low incomes have a much harder time accessing services, housing and employment than other people.

There are clear links between poverty, mental health, addictions and other Code grounds. In general, people identified by Code grounds are more likely to have low incomes than other people. The Registered Nurses Association of Ontario (RNAO) identified groups who are particularly at risk for low income, and the negative health effects associated with it: lone parents (most frequently mothers), recent immigrants, persons with a work-limiting disability, Aboriginal Peoples, women, people who do not complete high school, and racialized people.[45] Because of the close connection between low social and economic status and membership in a Code-protected group , measures that subject people with low social and economic status to inequitable treatment may raise human rights concerns. Government, policy-makers and organizations should make sure that their policies and practices do not have an adverse impact on people identified by Code grounds.

We heard concerns that Canada is not meeting its international obligations to protect the right to an adequate standard of living, one of the social rights included in the International Covenant on Economic, Social and Cultural Rights (ICESCR). The Registered Nurses Association of Ontario (RNAO) said this failure, by the federal and provincial governments, has been well documented by the UN Committee on Economic, Social and Cultural Rights, and by the UN’s Human Rights Council’s Special Rapporteur, who reported concerns on the state of adequate housing in Canada in 2007.

In 2004, the UN Committee on Economic, Social and Cultural Rights (CESCR) identified high rates of poverty for marginalized people in Canada, including people with disabilities.[46] The Ontario Hospital Association (OHA) said that Ontario and Canada should continue to invest in efforts to eliminate social disparities, which are viewed as the root of a majority of health care issues, including mental health issues and addictions.

The Convention on the Rights of Persons with Disabilities recognizes that people with disabilities tend to live in poverty. Article 28 outlines the right to an adequate standard of living and social protection, including food, clothing and housing, without discrimination because of disability. By ratifying the CRPD, Canada has made a commitment to safeguard these rights, including ensuring access to poverty reduction programs, retirement benefits and programs, appropriate and affordable services, and financial assistance.[47]

ACTO and the RNAO called for explicit protection for people with low income in existing human rights legislation by adding “socio-economic status” as a prohibited ground of discrimination in the Code.

In 2009, the Ontario Legislature passed the Poverty Reduction Act2009[48] which commits the Government of Ontario to implementing its poverty reduction strategy (launched in 2008) and measuring and reporting on its progress. The Act says the poverty reduction strategy must recognize the heightened risk of poverty for people with disabilities, among other groups, and that people with disabilities must be regularly consulted on the strategy.[49] Although the province created a primary focus on reducing child poverty, including increasing access to mental health services for children and youth, it is not yet clear if these measures have made a difference in the lives of people with mental health issues and addictions. The recent economic downturn has meant cuts and budget freezes for housing and services that assist low-income Ontarians that will likely have an impact on poverty-reduction measures.[50]

On the low income provided by social assistance you can’t get proper food. Proper nutrition is especially important for people dealing with mental health challenges. – Participant in North Bay roundtable session

We were told that that low incomes cannot keep pace with the real cost of living. ARCH pointed to the difference between the shelter allowance provided by Ontario Works and Ontario Disability Support Program, and the actual rents charged for adequate housing around the province. CMHA Ontario said that a large number of Ontarians with mental health issues receive social assistance benefits that place them well below the poverty line.[51] Consultees told us that when receiving social assistance, people have very little left after paying for rent and other basic needs, such as food.

The social assistance system in Ontario is currently (2012) undergoing a review – one of the commitments made in the Poverty Reduction Strategy. In its 2008 report on its human rights and housing consultation, Right At Home, the OHRC recommended that the Government of Ontario review and improve funding rates, programs, laws and regulations to make sure that low-income tenants are able to afford average rents, food and other basic necessities. People with low income, including people with psychiatric disabilities and addictions, must be able to afford the necessities of life. 


4. The Government of Ontario, whenever considering budget restraint measures that affect services, housing and employment for people with low income, should particularly take into account the goals identified in the Poverty Reduction Strategy and the needs  of people with psychosocial disabilities, people living in poverty, and other groups protected by the Code.

5. The Government of Ontario should enhance and improve social assistance, including reviewing and improving benefits, to make sure that people can afford the necessities of life such as food, clothing, adequate shelter and other needs.

[43] To determine respondents with “emotional” disabilities, PALS survey respondents answered the following question: Do you (Does ( … ) have any emotional, psychological or psychiatric conditions that have lasted, or are expected to last, six months or more? These include phobias, depression, schizophrenia, drinking or drug problems and others. Statistics Canada, Participation and Activity Limitation Survey – 2006 (Adults 15 years or older) (2006) online: Statistics Canadaête%20sur%20la%20participation%20et%20les%20limitations%20d'activités%20-%202006%20(Adultes%20-%2015%20ans%20et%20plus).

[44] Statistics Canada, in its PALS data provided to the OHRC, defines low income as, “Member of low income economic family or low income unattached individual (after tax).”

[45] For a review of the research, see Registered Nurses Association of Ontario, Creating Vibrant Communities: RNAO’s Challenge to Ontario’s Political Parties 2011 Provincial Election, Technical Backgrounder, (Toronto: RNAO, 2010) online: RNAO, at 9; In several decisions, the Human Rights Tribunal of Ontario, as well as the Courts, have recognized the connection between membership in a group identified under the Code and the likelihood of having low income: see, for example, Kearney v. Bramalea Ltd. (No. 2), (1998), 34 C.H.R.R. D/1 (Ont. Bd. Inq.).

[46] Concluding observations of the Committee on Economic, Social and Cultural Rights: Canada ESC 1-19 May 2006, UN ESCOR, 36th Sess., UN docs. E/C.12/CAN/CO/4 & E/C.12/CAN/CO/5, online: United Nations$FILE/G0642783.pdf at para.15.

[47] CRPDsupra note 9, Article 28(2) a-e.

[48] S.O. 2009, c.10

[49] Section 2(2) of the Act, Principle 3. Section 5(2).

[50] In its initial 2012 budget proposal, the Government of Ontario did not propose any increases in social assistance rates, and delayed increases to the Ontario Child Benefit. Strong Action for Ontario, 2012 Ontario Budget, Budget Papers (Toronto: Queen’s Printer for Ontario, 2012), at 44-45. At the time of writing this report, the final provincial budget has not been passed. Several reports comment on the link between decreased funding to services, poverty reduction and the impacts on the health and food security of low-income Ontarians. See Wellesley Institute, Ontario Budget 2012: Austerity is bad for our Health, 2012, online: Wellesley Institute; 25 in 5 Network for Poverty Reduction, Common Ground: A Strategy for Moving Forward on Poverty Reduction. Third Annual Progress Report on Poverty Reduction in Ontario (December 2011), online: 25 in 5 at 5; Social Planning Network of Ontario, A recovery-free zone: the unyielding impact of the economic downturn on non-profit community social services in Ontario (July 2010) at 5; Social Planning Network on Ontario, Hard hit: Impact of the Economic Downturn on Nonprofit Community Social Services in Ontario (October 2009).

[51] In their second discussion paper, the Commission for the Review of Social Assistance in Ontario stated that of the 27,600 ODSP applications granted in 2009-10, about 60% involved a mental illness as either a primary or secondary condition. Commission for the Review of Social Assistance in Ontario, Discussion Paper 2: Approaches for Reform (Toronto: Queen’s Printer for Ontario, February 2012) at 9.


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