44th Parl. 1st Sess.
October 20, 2022 10:00AM
- Oct/20/22 6:32:17 p.m.
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Madam Chair, listening to the minister gives one the impression that the federal government is reinventing the wheel and starting from scratch in Quebec. No one is against virtue. On November 23, 2023, the CRTC is going to launch the 988 hotline. However, Quebec organizations are concerned because Quebec already has its own lines, 1-866-APPELLE and 1-855-CRAQUER. The organizations therefore want to be assured that their resources will be able to continue to act and that their equipment will be updated somewhere along the way so as to be able to connect to this new service.
Can the minister assure these organizations that are concerned that a lack of coordination will prevent them from being able continue to offer their services in Quebec?
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- Oct/20/22 7:00:49 p.m.
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Madam Chair, I would like to begin with an aside because I was deeply touched by what my colleague said. If anyone in the House is keenly aware of mental health and illness issues, it is me.
My colleague talked about stigmatization. Michel Foucault's monumental work, A History of Insanity in the Age of Reason, made it clear that mental illness had to earn its legitimacy. In other words, mental illness had to be construed as a medical condition. Nowadays, we say “mental health” because we want to avoid the term “mental illness”, but mental illness is an illness like any other. Unfortunately, people with mental illness were locked up, excluded, exploited, put in circuses, put in cages of put on the Ship of Fools. They were dispersed all over the place, set adrift. Foucault's account of the history of madness and how those afflicted were treated paints a dismal picture of human beings.
I rise today to point out that it is not our concerns about mental health and mental illness that divide us. It seems to me that, if we really look at this properly, we would see that this is not the right legislature for taking effective action in this area.
As I said earlier in the preamble to my question, I sometimes get the impression from the minister that we have to reinvent the wheel. Of course, this matter is of particular concern right now, especially because of the postpandemic situation. Mental health has always been the poor cousin of physical health, and there are challenges to be met. Moreover, mental health is one of the weak links in our health care systems, and this became abundantly clear as the pandemic crisis played out. However, none of this justifies the federal government's interfering in something that is none of its concern.
I want the well-being of anyone struggling with illness or mental health problems to be a priority. No one wants that more than I do. Ottawa has to be careful, however, because it is not doing any good or making things better when it meddles in action plans that are already in place. I do not know if the minister is familiar with the 2022-26 interdepartmental mental health plan that was recently adopted by Quebec.
At one point, I had a glimmer of hope. She talked about bilateral child care agreements. I thought that perhaps the minister would be willing to look at what Quebec is doing. Then she would see that the problem in Quebec is not the policies, the goals or the organizational structures, but the money. It is the financial resources that are lacking. There is a lack of resources to hire competent employees and to support certain frontline workers who care for people. I am thinking about employees in community organizations, to name just one sector. I will return to this later.
That was just an aside, and I will now go back to my speech. That said, there are issues there, and I sometimes get the impression that my colleagues are in the wrong legislature. The responsibilities were divided in 1867. It is clear that the federal government currently takes in much more money for its responsibilities than it offers in services. It seems to want to give in to a temptation that has been denounced by every premier who has served the people of Quebec, who form a nation.
That is why we often refer to Quebec's strategies as national strategies. It is not to insult Canada, which is officially recognized as a country. It is just that Quebec is a nation by virtue of its National Assembly, which put strategies in place. Do members know when the first national mental health strategy was implemented? It was in 1980, and it was the first national strategy in the world.
The people of the Quebec nation, through their National Assembly, have been trying to meet mental health needs since 1980. Over time, Quebec has developed its expertise and various national strategies and action plans with the help of many stakeholders, but what it is currently missing is financial resources. When we talk about the interdepartmental plan, that includes a large number of departments. With regard to the consultation that took place in the development of the most recent plan, or the new strategy, we spoke to community groups, researchers, stakeholders, and all segments of the population, including youth, adults, seniors, minority groups and indigenous peoples. We developed that plan in conjunction with many departments and many members of Quebec's interdepartmental working group on homelessness and mental health, including the director of criminal and penal prosecutions, which is important when it comes to Bill C‑5. When we say that we are not going to penalize or incarcerate people because they have addictions, then we need to make sure that part of our informed and comprehensive strategy on mental health involves making sure those individuals do not go to prison, because we know that addictions are often related to mental health. We need to help these people.
Other contributors included the ministry of education, the ministry of advanced education, the ministry of immigration, francization and integration, the ministry of culture and communications; the ministry of families, the ministry of justice, the ministry of public safety, the ministry of agriculture, fisheries and food, the ministry of municipal affairs and housing, the ministry of finance, the ministry of transport, the youth secretariat, the indigenous affairs secretariat, the ministry of labour, employment and social solidarity, the Office des personnes handicapées du Québec, the Régie de l'assurance maladie du Québec, the status of women secretariat, Quebec's treasury board secretariat and the Société d'habitation du Québec.
In Quebec, for the people of Quebec, for our nation, which speaks through its National Assembly, there are at least 10 departments involved in this action plan. We see mental health as an interdisciplinary challenge. Now along comes this government, no doubt well intentioned, with a mandate letter for a minister who wants to help the Quebec nation, the people of Quebec and all the stakeholders I talked about implement this action plan. I hope we will not have to wait long for the money to come through. We have been waiting for health transfers for too long. In my opinion, if the federal government had invested its fair share in health care over the past 30 years, then all of Quebec's existing action plans would probably have strengthened the weak link that was exposed during the pandemic. That is the issue. Our mental health initiatives have to complement one another.
That is why I am asking the minister to work in concert with Quebec rather than exploit mental health just to exert her spending power—
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- Oct/20/22 7:12:07 p.m.
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Madam Chair, my colleague from Joliette has a great sense of humour.
As I said at the outset, just because someone wants to do good does not mean they are doing good, especially if they are infringing on someone else's autonomy. Usually, this applies to an individual, but it can also apply to a national government that has already thought things through and developed action plans to improve its performance and its mental health care in collaboration with community groups.
I want to acknowledge community groups since this is autonomous community action week. These groups are underfunded, but they are propping up the front lines. If we want to reinvigorate these essential mental health resources, then we need to offer these people decent wages and not let them burn out because of the pandemic, which exacerbated mental health needs. I commend the people working on the front lines in community action, because fixing this issue will certainly take concrete action at every level. In my opinion, these people are keeping the system going.
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- Oct/20/22 7:13:54 p.m.
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Madam Chair, at least 10 departments helped develop this plan, which was divided into seven pillars. In fact, the Government of Quebec is investing $1 billion in this plan.
The first pillar is promoting mental health and preventing mental illness. The second pillar is prevention and crisis intervention services. The third is partnerships with community organizations. The fourth pillar focuses on actions aimed at young people, their families, their loved ones and their inner circle. The fifth pillar is improving access to mental health care and services. The sixth pillar is prevention and alternatives to hospitalization in psychiatric care, and the seventh is consultation and improving practices.
I think the federal government could contribute to research.
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- Oct/20/22 7:15:59 p.m.
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Madam Chair, obviously that is important, but the money needs to be there. I am not saying that we do not need to talk about or collaborate on mental health. On the contrary, I am saying that we need to do so within the limits of our responsibilities and jurisdictions. We need to take a complementary approach.
Quebec already has national standards, by the way, because it is a nation. We do not need more layers of bureaucracy. What we need is money at the ground level to take care of people.
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- Oct/20/22 7:17:38 p.m.
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Madam Chair, I agree with the idea that we must take a holistic approach to mental health. In some cases, it is the chicken or the egg conundrum. Someone's mental health will deteriorate because of a physical problem and vice versa. We must therefore look at the person as a whole. I do think that both legislatures must take a complementary approach.
In order to give more help to people, to strengthen and reinforce the weak links in the health care systems from coast to coast to coast, including in Quebec, the federal government must give us the necessary financial resources and ensure that we have substantial, and above all recurring, health transfers. Even the Canadian Mental Health Association says that the problem is that the government makes one-time investments. It takes stability and predictability to rebuild the system and make action plans that will actually be effective in helping our people.
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- Oct/20/22 7:19:52 p.m.
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Madam Chair, I do not know whether my colleague remembers what I said about my NDP colleague's bill, but the Bloc Québécois is very much in favour of approaches designed to divert those cases. The purpose of diversion is not solely to free up space in courts and jails, though. Diversion will only work with adequate funding and the concerted action required to ensure that these people do not wind up out in the streets with their problems. Decriminalizing drug dependency is not enough to clear anyone's conscience. That is not what this is about.
That is why Bill C‑5 is a step in the right direction. I do not know if the Conservatives voted in favour of Bill C‑5, but it seems like a step in the right direction to me. With that and the necessary resources, we will make progress in dealing with this issue, but there has to be money for this. To me, the leader in best practices for drug dependency is Portugal.
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- Oct/20/22 7:35:39 p.m.
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Madam Chair, first of all, my colleague is a real humanitarian, and I commend his compassion. He has done some very interesting work on drug addiction. His bill was very interesting.
Now, on the subject of mental health, some experts who appeared before the Special Joint Committee on Medical Assistance in Dying talked about mental health and the chronic suffering associated with certain mental illnesses. Some people may be struggling with intolerable suffering that cannot be treated with therapy. The experts told us that it might be better to give these people autonomy and the right to decide what to do about their suffering, as well as extending MAID to these individuals, who are few in number, rather than leaving them to contemplate suicide.
I know my colleague is a great humanitarian. I wanted to hear his thoughts on this, because, in the long run, if we cannot do this, people will slip through the cracks. Not everyone with mental illness can be cured, because there are illnesses that are incurable and irremediable. I would like to hear his opinion on this.
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- Oct/20/22 7:57:36 p.m.
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Madam Chair, in his speech, my colleague across the way talked about the fact that the longer we wait to fund the services, the worse the situation will become. In the middle of the third wave, experts came to the Standing Committee on Health to tell us that we absolutely needed to quickly shift from one-time funding to ongoing, stable and predictable funding to reinforce our health networks. There is consensus not just in Quebec, but in every province. Quebec is certainly advocating to have health transfers increased to 35% with 6% indexing.
Will my colleague pressure his government to get that money on the ground as soon as possible? As he said, the situation is deteriorating day by day.
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- Oct/20/22 8:08:29 p.m.
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Madam Chair, although I do respect my colleague, he has some gall to have made that speech.
First, when parties were discussing the deadlines for the committee's work, it was the Conservatives who refused to have the committee continue its work past the date set at the outset. Then they accepted June 6. We finally agreed on February and today they are saying that we must take the time needed. Meanwhile, they were not open to immediately planning the work to be done up to that point.
Second, I listened to the same experts and read the same expert report. Even though at the beginning I was not at all convinced about accessibility when mental illness is the only reason given, that is not what the experts stated in this report. We will continue our work and our soul-searching.
My colleague says that the government is ideologically driven, but the government can speak for itself. I believe that my colleague's speech is very ideological because he cites just one part of the report. When we examine the set of criteria to be met for someone with a mental health issue to gain access, we see that it is available to a very small number of people. People with suicidal ideation do not fall into that category.
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