I wanted to die at 26. At 47, I’m still waiting for mental health care.

If Canada had allowed medical assistance in dying (MAID) for mental health issues in 2005, I would have died 21 years ago, at age 26. I had just moved from London, U.K., to Toronto, chasing a boy and eager to find broadcasting work. But I was also extremely anxious, which made it difficult to hold down steady employment.

Each month or two, I returned to my doctor to try a new drug combination: more Olanzapine, less Lorazepam or more Effexor — the latter two of which have been linked to increased suicidal ideation. He put me on a waitlist for a psychiatrist, which was about five years. Since I didn’t have a steady job, private therapy was out of reach. I began to spiral downward and became obsessed with how I should take my life.

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Even though pharmaceuticals aren’t considered the gold standard of care for mental health patients, they are still the default treatment given by many family doctors, who are the sole source of support for most people seeking mental health care. This often leaves patients without the care they need (which usually involves therapy) and, in some cases, may even make their situation worse.

“You are given drugs without the necessary supervision, and it’s terrifying,” says Winnipeg-based book editor Michael Schellenberg, who has bipolar I. “You feel that the doctors are playing spin the wheel of fortune with your life.”

Whether stories like mine and Schellenberg’s represent a larger pattern is a question the federal government has set out to answer. As a possible “solution,” it commissioned several reports to determine whether MAID should be expanded for mental illness alone. The findings of its most recent one, published in June, were fairly damning: access to necessary services was shaped by social determinants of health, including poverty, disability, isolation and inadequate housing. “Demand for mental health care continues to grow while service capacity does not,” the report found.

In 2025, the Canadian Institute for Health found that 41 percent of adults with a mental illness said their needs were either not met at all or only partially met. Young adults fared worse, with 92 percent claiming they received little or no help for their mental illness.

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While the government ultimately suspended its plans to expand MAID for mental health in early October, noticeably missing from its decision was a plan to enhance access to life-saving care. When questioned, Health Canada focused on existing provisions. “The Government of Canada remains committed to taking a comprehensive approach to improve access to mental health services and supports. This includes working with provinces and territories to improve access to mental health services as part of integrated person-centred care.”

Those assurances offer little to those still without care. Schellenberg has found it near impossible to find a permanent psychiatrist in Manitoba and has been told the waitlist is five years. “As a mental health patient, you are almost entirely on your own. So much of the necessary help is out of reach for ordinary Canadians,” he says.

Twenty-one years later, I also haven’t been able to find a psychiatrist to manage my care. The consequences are multifarious: eight psychiatric hospitalizations, four job losses and periods when my wife became depressed due to the upheaval. Right now, I am anchored to this side of the life-death divide by a loving family, but the ongoing chaos created by the lack of help is constantly testing its hold.

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Alexandra Shimo is a journalist and writing coach in Toronto.