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

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

Oct/20/22 7:39:22 p.m.
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Madam Chair, the member for Courtenay—Alberni is my neighbour back home and I thank him for his incredible work on mental health, dealing with opioid addiction and all of the challenges we are seeing across Canada right now. The member mentioned something in his speech that is really important to me and the communities that I have lived in, which is indigenous mental health. We know what the reality is with all of the history that we have all been apprised of. Indigenous communities have a particular reality that they face every single day. We know that the deaths that happen by suicide in indigenous communities, especially by young people, are profound, far too numerous and leave a weight on communities. I remember speaking to one chief who felt that he was not getting a good deal from a level of government and he told a representative when they were discussing this that if the representative wanted any agreement from the chief, they were going to go to the bridge where more than one kid, unfortunately, had hanged themselves. When we talk about that, we must recognize this particular pressure. I am wondering if the member could talk about what resources are needed to be acknowledged in indigenous communities to make sure that these deaths stop, because they are happening far too often, and Canada is directly to blame.

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Mr. Gord Johns

Oct/20/22 7:40:44 p.m.
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Madam Chair, I think back to the community in my riding that was going through that crisis. It did not have mental health supports in place and was desperate. When I came here, I had to beg to get a mental health support worker for one year. The federal government and the minister at the time said it was not their problem and that it was the province's problem, but I explained that it was the minister's problem as she writes the cheque to the First Nations Health Authority in British Columbia. I asked her to pick up the phone, which she did, and it helped, but it is not enough. We need to listen to communities. We need to provide the resources for healing, and we need to ensure that there are mental health supports in community. We need to listen to them. That is part of reconciliation.

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Mr. Peter Fragiskatos (Parliamentary Secretary to the Minister of National Revenue, Lib.)

Oct/20/22 7:41:31 p.m.
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Madam Chair, I am thankful for the opportunity to speak about a vital issue, to put it mildly. I am glad that the House is taking up the issue of mental health tonight. I have enjoyed listening to the reflections of all members. I should tell you at the outset that I am splitting my time with the member for Don Valley East. Where I want to start is on the issue of stigma. I think it is fair to say that, as we discuss this tonight, I hope it adds to the lifting of stigma in some small way. Perhaps it could, depending on where things go. However, it is quite fair to say that over the years Canadians, through their discussions, openness and honesty, have been helping to lift the stigma in very significant ways. What does that mean for us in this House as parliamentarians? I think that very real phenomenon we have seen in Canadian society, where people are much more comfortable speaking about mental health and the particular challenges they face, has direct implications for us in politics. It is often said, and it is a truism, whether it is politics or specifically government, that the first obligation of government is to ensure the security of its citizens. With the lifting of stigma I think we take that insight and expand it to understand that mental health needs to be part of that conversation and that focus as well, because security, if it is to be ensured, must include not just the physical security of individuals but also their mental health. That is where I think government has a fundamental role to play. We have a short time to engage tonight. Usually, we have more than the five minutes that is allotted, but it is a take-note debate so I will keep my comments centred on one particular group that I think deserves a great deal of attention and that is youth. Young people in particular faced with poverty struggle with mental health issues. I do not think we can say that poverty in and of itself is the cause of mental health challenges faced by young people, but certainly it is a key factor. Added to that of course is the trauma that so many young people endure. When those two forces come together, the result is very real mental health challenges. I have mentioned already the importance of government, but community organizations play a fundamental role because they are on the ground and have wonderful staff members. I will speak about two organizations in London that I have a great deal of respect for, who have the expertise to engage youth and help them transform to something better. Over the years, I have had the chance to get to know the Youth Opportunities Unlimited organization in London. It is led by a wonderful leader, Steve Cordes, in London. This is someone who has devoted his life to helping young people. He has been the executive director for many years, but engaged and involved with YOU, Youth Opportunities Unlimited, since the early 1980s. The organization, through its work, through the work of the board and its staff, has focused on housing services. It has built a wonderful youth shelter. I was thrilled to see federal funding secured for that. It also provides job training, which the federal government assists to fund as well. There is another great organization, the Boys and Girls Club, in London. Its CEO, Chris Harvey, deserves enormous credit as well. It runs sports programs for kids. It runs art programs for kids, particularly drama, the visual arts and music as well. Importantly, it runs self-esteem programming. One of the programs that stands out in that particular category is the work it has done to help youth understand the importance of body image and the way that modern media helps to shape those notions. It is a very sad thing, to put it mildly, that the self-esteem of young people is so often negatively impacted by the images they see particularly on television, but these days it is online. Anything to counter those negative images is something that I think can further contribute positively to mental health. Organizations that take up that challenge I think need to be applauded, so I wanted to put that on the record tonight. There are many other organizations I could have talked about in London. There is such a great community there, but YOU and the Boys and Girls Club do outstanding work. I am thankful for the opportunity to engage. I look forward to further reflections from colleagues tonight. It is a pleasure truly to listen and participate on such a key issue.

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

Oct/20/22 7:46:47 p.m.
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Madam Chair, back in the summer, we learned of a veteran who had reached out to Veterans Affairs in a time of need who was counselled by a Veterans Affairs employee to perhaps consider medical assistance in dying. We know that recovery is always possible, and we have to manage through recovery, whether it is addictions or mental illness. I do not agree with our colleague from the Bloc. I believe that recovery is always possible. I wonder if our colleague across the way could comment on the issue of a Veterans Affairs employee counselling veterans in their time of need to perhaps consider medical assistance in dying.

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Mr. Peter Fragiskatos

Oct/20/22 7:47:51 p.m.
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Madam Chair, I did not have a chance to cross the way and shake my colleague's hand after the speech he gave earlier, but I think he touched everyone tonight in a very real way, and I say that to him sincerely. I am not sure of the specifics of the particular case the member raises. I am happy to have a further conversation with him and learn a little more about what he is talking about there. However, I have always said that medical assistance in dying, or MAID, ought to be, of course, a last resort. When people need help, it is incumbent that they receive the supports necessary for them to live a dignified life, and I think that everything the government has done as part of the MAID policy has been in that direction. Certainly, it is fundamental that people have access to those basic needs, particularly housing, to have that dignity which should be guaranteed to them. MAID must be a last resort, and I have always felt that way.

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