Abstract Our response to Romanow and Marchildon's (2003) article on the role of psychology in the Canadian health-care system focuses on two challenges that emerge from the article, namely the continuing marginalization of mental health services and the dominance of political considerations over compelling scientific evidence for the impact of psychological services on health and recovery from illness. We conclude our comment with calls for (a) continuing efforts to educate policymakers, the media, and Canadians about the value of psychological services and (b) active involvement from psychologists in efforts to develop new models of primary health care in Canada. Romanow and Marchidon's (2003) article is an unparalleled opportunity for Canadian psychologists to learn how the health-care services we provide are viewed by exceptionally well-informed and politically savvy health-care policy experts. Their article, along with (a) the submissions from various provincial and national psychology organizations, (b) the final report from the Commission on the Future of Health Care in Canada (CFHCC), and (c) CPA's analysis of the report should be required reading for years to come for psychologists interested in public health-care policy (links to these documents can be found on the CPA website). In our comment on Romanow and Marchildon's article, our main goals are to highlight two key conundrums professional psychology faces in attempting to achieve greater recognition in Canada's public healthcare system and to indicate possible solutions that could serve to advance professional psychology in Canada and, more critically, enhance the health and well-being of Canadians. The Marginalization of Mental Health Services For many years the federal and the provincial/territorial governments have stressed that indicators of population health must include considerations of mental health status and that mental health services must be included in our health-care system. Yet, as psychologists are well aware, mental health services tend to be marginalized and underfunded relative to the importance of mental health factors in determining the health and prosperity of our nation. As Romanow and Marchildon noted, the dominant focus of our health-care system is on physical diseases, especially potentially fatal diseases (p. 285). When viewed from a public health perspective, the folly of this emphasis is all too evident. This can be illustrated by taking depression as an example: In 2003, Statistics Canada reported that 4% of Canadians 15 years of age and older suffer from major depression in a given year and, as noted by Romanow and Marchildon, the total costs associated with depression and genera] psychological distress, alone, are estimated to be more than $14 billion. Based on recent data from England, the cost of depression to the nation's economy is likely to be more than 20 times the actual cost to the healthcare system (Thomas & Morris, 2003). Despite these clear indications of the economic costs of depression (to say nothing of the emotional costs to those suffering from depression and to their family and friends), there has been no systematic attempt in Canada to address this public health crisis. The lack of attention received by depression in the public health domain is just the tip of the mental health iceberg, for psychological services for other major mental health problems such as schizophrenia and substance abuse are frequently unavailable and, when available, are woefully underfunded. Although Romanow and Marchildon (2003) acknowledged the potential value of psychological services for mental disorders, it is tragic that so little attention was paid in the CFHCC report to the full range of effective treatments and services available for mental health problems. Indeed, it is doubly tragic, as psychology has never been better equipped to offer treatments with proven efficacy for these disorders (Chambless & Ollendick, 2001; Hunsley, 2003). …