44th Parl. 1st Sess.
October 20, 2022 10:00AM
- 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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- 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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- 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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- 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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- 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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- 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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- Oct/20/22 7:48:58 p.m.
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Madam Chair, I heard what the member had to say, and I really appreciate it, but we do know that a lot of those frontline organizations are really struggling to keep their doors open. They do not have the resources, and so many people are losing their lives. They are losing their opportunities, and they are getting into cycles that continue to bring them down a path that is not good for their mental health. I wonder if the member could talk about the urgency that those organizations are feeling in requiring the funding to do the work they must do.
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- Oct/20/22 7:49:33 p.m.
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Madam Chair, there is no question that there is enormous urgency. This morning, I had a meeting with the YMCA in London, a virtual meeting of course, and we engaged in a conversation about some of the challenges they are facing. They are also an outstanding group that deserves attention and positive comments.
What I can say to the member is that, throughout the pandemic, this government stood up for frontline organizations like no other government ever had. It was truly impressive to see fundamental and emergency funding flow to organizations that helped Canadians through. Certainly, yes, they are faced with a difficult time right now, and government should continue to be there for them as much as possible.
There is a need for fiscal restraint, and I think we all should understand that, but that does not mean that organizations cannot continue to receive support. I think all of us can collaborate to find ways to ensure that outcome.
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- Oct/20/22 7:50:42 p.m.
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Madam Chair, I thank my colleague for his speech.
We know that having access to mental health services at the right time, when we need it, is important. During COVID‑19, we saw with Wellness Together Canada that there were more than two million visits to the portal we put in place.
Does my colleague think that working on accessibility to mental health services puts us on the right track to moving this important issue forward?
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- Oct/20/22 7:51:17 p.m.
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Madam Chair, I thank my colleague for the question. I know how passionate she is in her work as parliamentary secretary. I think that she was engaged in such issues before she became an MP and deserves a lot of credit for that work as well.
I think that accessibility is fundamental to the issue, and whatever government can do to further ensure that is very important. This is something that relates to stigma as well. I do not know if even 10 years ago we would have had these kinds of discussions or the sort of policies that bring to life what the member is talking about, so yes, there is more to do, but I am glad to see that we have, in many ways, gone in the right direction.
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- Oct/20/22 7:52:04 p.m.
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Madam Chair, it is a real privilege to be here today. I want to thank the member for Cariboo—Prince George for getting us on the right track with this discussion. For people at home, we call this a debate, but really it has been a wonderful discussion around a serious issue.
I think the fact that partisanship has been removed from this conversation, and we can actually sink our teeth into a very sensitive and very important issue, means a lot to me. This is one of the first times over the course of the year where I can say that it seems like we are all 100% on the same page, and that is to help people who need help.
We know that the world is becoming more challenging for people. We can see it outside. When we go to the grocery store and talk to people, we can see the stress people are having. It is up to us as parliamentarians to look for ways to find solutions.
I served as a school board trustee in Toronto. I was a youth worker. I was also the minister responsible for children and youth, so I was responsible for children's mental health in Ontario. From what I have seen over 20 years in politics is that it comes down to a disconnect between the entire system. In my city, at least a few years ago, there were 47 different providers in the city, and there was no coordination at the time. That is happening right across this country in many ways.
We need to look for ways to bring people together. The member for London actually spoke about his area which, in many ways, is getting it right because they have a collective impact model, where 170 youth-based organizations come together under an entity called the London Child and Youth Network. They work together by setting similar goals and looking for ways to work with each other to accomplish a set of goals. I think that we need to continue to look for ways to share best practices across this country, to build a framework that connects school boards, municipalities, the federal government and the provincial government together, and really look for ways to move forward.
I will not go through some of the numbers. We know the impact of mental health and its cost of billions of dollars. I think two members have referred to $50 billion in lost productivity in this country. There is a cost to standing still. If we do not continue to invest, it is going to cost more and more.
We know in a place like Ontario that the wait-list has grown to almost three years. Postpandemic, the wait-list has grown by three times. We have a crisis on our hands, and we need to look for ways to go back to our provinces, gather information and bring it back here. I do think we need to look for ways to work together. It is a key piece in this whole equation.
In addition to that, the member for Cariboo—Prince George said something that I thought was very important. There is not one solution for everyone. It is an important piece. If we look regionally or culturally, or look at different age groups and situations in life, there are so many different lenses that can be applied to looking for solutions when it comes to mental health. I know that in Ontario there has been funding that has gone specifically to culturally based groups because stigmas are very different in different communities.
We are in this room today. What may apply back in one person's community may not apply in someone else's community. We need to build that flexibility and that collective impact across this country and look for ways to build a flexible system that allows for regions to continue to build, share best practices and coordinate those services.
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- Oct/20/22 7:56:28 p.m.
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Madam Chair, like most Canadians, those in the mental health community are also divided on the issue of MAID. Does the member opposite believe that doctors should be forced to provide MAID referrals if they do not personally believe in it?
I would like to have the hon. member's personal views on this. Are his views in line with the views of the Liberal Party?
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- Oct/20/22 7:57:02 p.m.
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Madam Chair, this issue of mental health is such a complex issue. The layers of complexity go from very simple solutions to very complex solutions.
I will not stand here as a member of Parliament and give the member medical advice on what someone should be doing. That is up to doctors. What we need to do in the House is debate legislation that either allows people to legally do something or not, and that is what I am here to do.
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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 7:58:37 p.m.
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Madam Chair, if I heard the question correctly, and the member is asking if it is a matter of my applying pressure to the government to ensure more long-term stable funding, the answer is absolutely yes.
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- Oct/20/22 7:59:01 p.m.
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Madam Chair, I appreciate my colleague, whom I work closely with on the committee. We are in a crisis in this country. No family or community has been left untouched. As many have mentioned tonight, dozens of Canadians die every day as a result of the mental health and addictions crises. This is a crisis that has had a profound impact on so many families and so many communities.
The government acted so promptly for the banking sector when COVID hit, with $750 billion in liquidity supports. However, for this mental health crisis, which is an acute crisis that is killing Canadians, we have still not seen the Canadian mental health transfer. Why is the government so slow to provide those vital supports that so many Canadians need when it was so quick to meet the needs of bankers and the banking industry?
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- Oct/20/22 8:00:01 p.m.
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Madam Chair, the member and I do work on the committee together. I know his question is sincere, and he has a sincere approach to looking for solutions, so I want to thank him for the work he is doing.
The member has really spoken to an issue that is widespread. Not only in Ontario, across this country or in America, but also around the world, there is a stigma that has been traditionally attached to mental health funding. It was something that was hidden in most cases, and over the last few decades we have seen a transformation in the removal of stigma. Governments are now looking for ways to better position themselves to look for solutions in a very open and transparent way. I am proud to be part of a government that is taking this approach.
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- Oct/20/22 8:01:02 p.m.
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Madam Chair, I will be splitting my time with the member for Yorkton—Melville.
Millions of Canadians live with a mental illness. Tragically, each year more than 4,000 Canadians commit suicide, the vast majority of whom suffer from a mental illness. Concerningly, many more Canadians who suffer from mental illness will have their lives prematurely ended as a result of the Liberal government's ideologically driven, evidence-free expansion of MAID in cases where mental illness is the sole underlying condition.
It was not long ago that the Minister of Justice himself cautioned against expanding MAID in cases where mental illness is the sole underlying condition. In this very place, when Bill C-7 was debated, he said that there are “inherent complexities and risks with MAID on the basis of mental illness as the sole criterion, such as suicidality being a symptom of some mental illnesses”. What has changed? Those inherent complexities and risks remain. What has changed is purely political.
When Bill C-7 went over to the Senate, the Senate adopted a significant amendment to drastically expand MAID in cases of sole mental illness by way of a sunset clause that would come into effect in March 2023. Despite having spoken of “inherent complexities and risks”, the Minister of Justice, incredibly, did a 180° turnaround and accepted the Senate amendment, despite the absence of meaningful study and the absence of meaningful consultation. Then, the Liberal government shut down debate to ram through the bill and ram through this radical expansion of MAID.
By law, in order to qualify for MAID, it must be established that the patient suffers from a “grievous and irremediable” condition that is “incurable”, in which one is in an “irreversible” state of decline. In other words, in order to qualify for MAID, it must be established that one cannot get better.
The Special Joint Committee on Medical Assistance in Dying, of which I am a vice-chair, has heard testimony from medical experts, including psychiatrists, and the evidence is that it is not safe to move ahead. That is because it is not possible, or at the very least it is difficult, to predict irremediability.
Even the government's own expert panel concluded as much. On page 9 of the government's own expert panel report, the expert panel said, “it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient” in cases of sole mental illness. That means persons who are suffering from mental illness who could get better and go on to lead happy and productive lives will have their lives prematurely ended.
As such, I submit that it is reckless and irresponsible for the government to move ahead. What the government should do instead is take the evidence of the expert panel, listen to the experts who have come before the special joint committee and put a pause on this significant and, I would submit, dangerous expansion of MAID. Anything less would be a betrayal of some of the most vulnerable people in this country.
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- Oct/20/22 8:06:12 p.m.
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Madam Chair, I submit to my hon. colleague that he has spent quite a lot of time in rooms with experts discussing this issue, and far more than I have. I am new to this conversation. It is uncomfortable. It is intimidating. It is scary. We are not experts on mental health in this room, but my hon. colleague has heard from many.
I wonder if he can articulate to the chamber this evening what he has heard on the other side of the argument. I do understand that there is a valid case to be made, from medical experts, psychologists and psychiatrists, that it is discriminatory to withhold medical assistance in dying from people whose sole underlying affliction is mental health. For the purpose of a thorough debate, I wonder, given his expertise, if he could provide the House with some insight on what he disagrees with some of these experts on.
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- Oct/20/22 8:07:21 p.m.
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Madam Chair, the parliamentary secretary is right. There are those who would make the argument that he just made, on the basis of section 15, or that he asserts some who have come before the committee have made. That is fair. However, the issue is whether this can be done safely, and the balance of evidence before the committee is that it cannot, at least at this time.
What the government should have done all along is undertaken the appropriate review instead of rushing ahead and saying it was doing this and now we are going to study it. In short, I would submit that the government put the cart before the horse, and unfortunately vulnerable people are going to be put at risk. There is an opportunity still, because it is not March 2023 yet, for the government to—
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