SoVote

Context: House Hansard - 114 - Oct/20/22

Oct/20/22 6:58:36 p.m.
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Madam Chair, I appreciate that from the minister. I am 54 years of age. I had my birthday just the other week. I am ashamed to say that this is the first time I have spoken publicly about this. For many years, I did not even tell my wife and my kids about this. I just knew that each and every day I wanted to live, not to perpetuate the dysfunction. I did not want to talk about it. As I said at the start of my speech, we did not talk about this stuff. I am tired of hiding it. I phoned my brother Trent just before this and said, “This is our story. I hope you're okay with my sharing this.” It was 2020, so I was 52, and my brother Trent is seven years younger than me. We never talked about this, but there was something that was a catalyst to this and members will have to wait for the book to come out to read what the catalyst was. We sat in a White Spot in British Columbia, and we both started shaking and we both started crying. I was 52. He was around 47. I have a stepbrother by the name of Elvis. He messaged me last week. He is 54, the same age as me. He shared something with me. We have never talked about this. I thought I was the only one. He messaged me and he said it has been eating him up all these years and he has never talked about it. That is what we need to break. Even as brothers, we never talked about this stuff. As families, we never talked about this. We are afraid to talk about it. The first step in doing anything is being open and honest, and it is dialogue. That is the only way we are going to right the ship and do well for Canadians: being open and honest and having that open and honest conversation. We do not need the partisan politics. We all agree that the ship is broken right now and we need to do whatever we can to help put it back afloat.

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Mr. Luc Thériault (Montcalm, BQ)

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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The Assistant Deputy Chair

Oct/20/22 7:11:04 p.m.
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Questions and comments. The hon. member for Joliette.

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Mr. Gabriel Ste-Marie (Joliette, BQ)

Oct/20/22 7:11:16 p.m.
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Madam Chair, I would like to congratulate my colleague for his very interesting speech. We obviously have the same values. I would like to remind him that the French author Michel Folco wrote a novel about a sad character in a book called Même le mal se fait bien, or even bad things can turn out well. A question comes to my mind when I hear my colleague's comments and when I look at everything that is being done in Ottawa. It could apply to passports or to any issue. Ottawa wants to meddle in health care without adequately funding the provinces and without respecting constitutional jurisdictions. Does my colleague agree with me that, in Ottawa, even good intentions can turn out badly?

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Mr. Luc Thériault

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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Mr. Todd Doherty (Cariboo—Prince George, CPC)

Oct/20/22 7:13:42 p.m.
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Madam Chair, I wonder if our hon. colleague could tell us exactly what Quebec's provincial mental health plan is.

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Mr. Luc Thériault

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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Mrs. Élisabeth Brière (Parliamentary Secretary to the Minister of Mental Health and Addictions and Associate Minister of Health, Lib.)

Oct/20/22 7:14:54 p.m.
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Madam Chair, I thank my colleague for his speech. I am working with mental health organizations in Quebec and I, too, am willing to acknowledge Quebec's leadership in this area. That is why it was recognized in the federal-provincial bilateral agreement and the action plan my colleague was talking about. A total of $11 million was announced in the 2017-18 economic and fiscal update, and that amount was increased to $20 million in 2018-19 for the subsequent years in order to support the implementation of this action plan. I would like to know whether my colleague agrees that discussions between the provinces and the federal government are important in order to properly address the crisis and mental health needs.

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Mr. Luc Thériault

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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Ms. Rachel Blaney (North Island—Powell River, NDP)

Oct/20/22 7:16:52 p.m.
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Madam Chair, as we are talking about this issue, it is very important that we focus on the fact that stigma is blocking so many people from getting the necessary help they need. Anyone who has done any work on trauma and the impacts it has not only on a person's emotions but also on a person's body would know that those two things must be integrated, and not see what is happening within somebody's mental state as separate from their physical state as they are together and the same. Can the member talk about ways that all of us in this place can start to fight stigma in a meaningful way collaboratively so that we can see that change across this whole country?

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Mr. Luc Thériault

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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Mr. Todd Doherty

Oct/20/22 7:19:14 p.m.
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Madam Chair, I apologize to my friend, but perhaps he could state this one more time. I just want to know again the amount of money that Quebec has committed to its mental health plan, as well as the seven pillars. I am not quite sure I heard that there was anything in them for addictions or recovery. I wonder if Quebec is seeing the same things that the province of British Columbia is seeing in terms of the opioid crisis that is spiralling out of control. Perhaps our colleague could take the next minute and a half to speak to that.

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Mr. Luc Thériault

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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Mr. Gord Johns (Courtenay—Alberni, NDP)

Oct/20/22 7:21:12 p.m.
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Madam Chair, we know the mental health crisis has been referred to as the parallel pandemic. This House has not had a debate on how to respond to this. Earlier this month, I rose and sought an emergency debate on Canada’s mental health crisis, but unfortunately it was denied. I want to thank the minister, as she acknowledged tonight we have never had this conversation about mental health until tonight and we have never had a proper debate. I want to thank the Conservatives and the Bloc and their House leaders for agreeing to have this important conversation, because it took all parties to agree to do this take-note debate. Over the last two and a half years, the mental health of Canadians has been negatively impacted by the loss, social isolation and financial strain the pandemic has brought. We all have constituents struggling with their mental health, and many of us have loved ones who are as well. My good friend from Vancouver Kingsway always says that there is not a family not touched by the mental health or substance use crisis in this country. I really want to thank my colleague from Cariboo—Prince George for sharing his personal story about his brother Kevin and his brother-in-law. We hear those personal stories from our constituents every day as parliamentarians, and it is painful to hear. We know we are going into a period where we are seeing a lot of impacts right now on people's health. The cost of living is rapidly rising and likely we are going to see a recession. The stress Canadians are facing has not abated. Just yesterday, the Minister of Finance warned Canadians of difficult days ahead and suggested the federal government might not be there to help. Now more than ever we must recognize that mental health is health, and we need to take steps to ensure Canadians have equitable access to the services they need. This month, the Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction released a joint report on the continuing impacts of the COVID-19 pandemic on the mental health of Canadians, which detailed some alarming findings. According to polling conducted for the report, 35% of respondents reported moderate to severe mental health concerns. We see that as parliamentarians. It also found that fewer than one in three people with current mental health concerns accessed services. That is alarming. The report identified key barriers to accessing services as “financial constraints, not having readily available help, not knowing how and where to get help, and long wait-lists.” The report identified financial concerns as a top stressor during the pandemic and discussed the links between income and unemployment with mental health concerns. Given the current economic forecast, there is a real risk the mental health and substance use crisis will worsen in the months ahead. That is scary. As my colleagues have identified, 10 Canadians die a day from suicide and 21 from a toxic overdose. We also know health care workers and first responders have been raising the alarm that our health care system is under tremendous pressure. Unfortunately, too many people struggling with mental health issues are left with nowhere to turn but crowded emergency rooms. A worsening mental health and substance use crisis will only push our health care system closer to collapse. It is clear we need to make sure people can get help in their communities before they are in crisis. While there are many great organizations working hard to support Canadians struggling with mental health issues, we know they are running on fumes. The demand for mental health services has increased since the onset of the pandemic, but that demand cannot be met under the current system when frontline organizations are having to worry about keeping the lights on. They need help and they need help now. We need system change that will finally bring mental health care fully into our universal public health care system once and for all. We need sustainable funding to ensure all Canadians have access to services when they need them. In the last election, the Liberals made a promise to Canadians that they would take steps to improve access to mental health care in Canada. A cornerstone of the Liberals’ promises on mental health was to establish a new permanent transfer to the provinces and territories to expand publicly funded mental health care and address backlogs. Canadians were told an initial investment of $4.5 billion over five years would be made in the Canada mental health transfer. Now, $250 million of that funding was supposed to be delivered in 2021-22, with an additional $625 million in 2022-23. To date, of that money, no funding has been delivered. There has been no transparency from the government on when the money would get out the door. Last week the Canadian Alliance on Mental Illness and Mental Health, with the support of 65 organizations from health and allied sectors, wrote an open letter to the minister expressing concern about the delay in establishing the mental health transfer and calling on the government to take immediate steps to fulfill this important and critical campaign commitment. The minister has taken the position that national performance standards must be developed prior to the creation of the Canada mental health transfer. However, the open letter I referred to demonstrated there is a clear consensus from the mental health community that the development of these standards should not delay the Canada mental health transfer. There is an urgent need for increased mental health services in communities right across the country. Wait times for publicly funded mental health services are unacceptably long. In Ontario, where we are right now, there are more than 28,000 children on wait-lists for community-based mental health services. The wait could range from 67 days to more than 2.5 years, depending on the service, exceeding clinically appropriate wait times. For children and youth, delays in accessing care could have lifelong impacts for them, their family and society. Tragically, it could also be a matter of life and death. According to Stats Canada, suicide is the leading cause of death among youth and young adults aged 15 to 34. This has touched my life and those of many people here in this chamber, as we have discussed tonight. UNICEF has reported that Canada has one of the highest rates of youth suicide in the world. We heard my colleague from Nunavut just two days ago share that tragic story of someone who could not find housing. This is unacceptable in a wealthy country like Canada. It is preventable. For those struggling with substance use disorders, waiting could also be a matter of life and death. Across Canada the average wait time for adult residential treatment for substance use is 100 days. Every day that someone must wait for access to treatment or harm reduction services, they are put at risk because of the toxic drug supply. The Canada mental health transfer would provide an infusion of money for services that could save lives now. It is urgently needed, but there is other critical work that must be done to transform mental health here in Canada. Beyond the mental health transfer, mental health advocates have been long calling for legislation to enshrine law parity between mental and physical health. Last month I tabled private member's Motion No. 67, and I hope my colleagues will second it, calling on the government to finally develop that legislation and urgently fulfill its promise to establish the Canada mental health transfer. I hope all members of the House will recognize the crisis we are in and support these urgently needed calls to action. Untreated or inadequately treated mental health carries significant social and economic costs. The Mental Health Commission of Canada estimates that mental health issues and illnesses cost Canada at least $50 billion a year, not including the more than $6 billion in lost productivity. Relative to the disease burden caused by mental health and compared to our G7 and OECD peers, Canada is underspending on mental health. France spends 15% of its health care budget on mental health, whereas the U.K. spends 13%. Canada, depending on the province or territory, spends between 5% and 7%. We are falling way short. For the well-being of Canadians, for our economy and our communities, mental health cannot wait. It is time to invest in the care Canadians deserve, and to truly treat mental health like health. We need to listen to the experts. We need to listen to the expert task force on substance use. We need to listen to the 67 organizations. I hope that together we can do that.

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Mr. Michael Coteau (Don Valley East, Lib.)

Oct/20/22 7:30:56 p.m.
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Madam Chair, what can we do as federal members working with municipalities, provincial bodies and organizations to better coordinate our efforts? That is one of the biggest challenges that we have, I believe, as parliamentarians: provincial, territorial and federal government coordination. Does the member have any advice for the House on what we could be doing differently?

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Mr. Gord Johns

Oct/20/22 7:31:32 p.m.
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Madam Chair, that is an excellent question. I want to thank my colleague who had the courage to support my bill and listen to the experts on substance use, Bill C-216, a health-based response to substance use. We need to listen to the experts, listen to the local knowledge in this country and listen to indigenous knowledge about how we move forward. Those 67 leading organizations are ready to deliver mental health now, but they are running on fumes as I stated. Injecting the mental health transfer, getting it out the door to those local experts, will save lives. We have an opportunity to save lives right now if we come together, collectively, and not wait for everything to be perfect. It will not be. What we do know is that those organizations save lives now and they can prevent the loss of further life. We need their help and we need to listen to them.

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Mr. Todd Doherty (Cariboo—Prince George, CPC)

Oct/20/22 7:32:34 p.m.
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Madam Chair, I want to thank our hon. colleague from Courtenay—Alberni for his speech and his passion in this area as well. I know we share that. One of the very first debates I took part in after being elected in 2015 was in 2016 on the Attawapiskat First Nation and the suicide epidemic it had there. I remember standing up and saying in my speech how suicide had negatively impacted my life. One of the members from the Liberal Party, the government, stood up. He was a member for 28 years. One of the very first debates he had was on the suicide epidemic in first nations communities. Sadly, all these years later, we are still so far behind and there is still so much more to do. I struggle that, even in the seven years that I have been elected, we have made some ground, but sadly, we are still seeing children as young as four take their lives and take part in suicide pacts. There is so much more to do. Would my hon. colleague like to talk about the suicide epidemic we see in first nations and marginalized communities?

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Mr. Gord Johns

Oct/20/22 7:33:51 p.m.
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Madam Chair, I want to thank my colleague for his really important work on the three-digit hotline and on PTSD. I worked with him on the PTSD bill right after we got elected. We are both from the class of 2015, and I really appreciate his leadership when it comes to mental health and working collaboratively. It is not something that I have not been a witness to. I do not have a lived experience of living as an indigenous person or in an indigenous community, but I do live in a region that has been heavily hit with suicide. I have not been to Attawapiskat, but certainly, watching that, it brought me back home. Part of the reason I ran for Parliament back in 2015 was that I had been to, I think, 15 funerals in my region for people who had passed from either substance use or suicide. When we go to a funeral for someone and we know it is a preventable loss of life, there is just an empty feeling. We know that we need to do better. Certainly, there are not enough supports. As a parliamentarian back in 2016, one of the Nuu-chah-nulth nations was going through a suicide crisis. I had to go home and be with the people there. They do not have adequate supports. They need resources. They have solutions. They have healing journey solutions that they want to implement. They just need resources. We are failing when it comes to mental health, and we are failing on reconciliation. We really need to listen to the communities themselves. Each community has ideas on how its members can heal from the trauma endured in residential schools and the colonial laws that were implemented and forced upon them.

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Mr. Luc Thériault (Montcalm, BQ)

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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Mr. Gord Johns

Oct/20/22 7:37:24 p.m.
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Madam Chair, I have worked with my colleague. He as well had the courage to support moving forward on substance use with a health-based response and listening to Canada's leading experts. The Bloc voted for Bill C-216. I am very appreciative of the opportunity to work with my colleague, who cares. He is open to learning and working together. We may not agree on everything, but he is trying to find ways to work together and we can do a lot more. We are just embarking on that conversation. When it comes to people making decisions about suicide or suicide by accident when they are really struggling and maybe using substances, we have all heard of those stories or know somebody who has been impacted by that. We need to provide people with supports so they have a pathway out. We talk about the stigma. When people cannot get help in their own communities, they are going to make bad choices. There are 500,000 Canadians right now who are off work due to mental health alone, and it is getting worse. We need to make sure we are providing supports and services for people. That is what we are calling for, to ensure that we get the $4.5-billion transfer in place and get the resources out to community-based organizations so that they can provide the supports and people can access the help they need. Do I think it is perfect? Do I think everybody can get all the help they need? That might not be possible, but I can assure everyone that if we do this transfer, we are going to save thousands and thousands of lives. We know it is the right thing to do because mental health is health, and we need parity between physical and mental health.

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