SoVote

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

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

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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Mr. Peter Fragiskatos

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

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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Mr. Clifford Small (Coast of Bays—Central—Notre Dame, CPC)

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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Mr. Michael Coteau

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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Mr. Luc Thériault (Montcalm, BQ)

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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Mr. Michael Coteau

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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Mr. Peter Julian (New Westminster—Burnaby, NDP)

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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Mr. Michael Coteau

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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Mr. Michael Cooper (St. Albert—Edmonton, CPC)

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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Mr. Adam van Koeverden (Parliamentary Secretary to the Minister of Health and to the Minister of Sport, Lib.)

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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Mr. Michael Cooper

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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The Assistant Deputy Chair

Oct/20/22 8:08:25 p.m.
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The hon. member for Montcalm.

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Montcalm

Mr. Luc Thériault (Montcalm, BQ)

Oct/20/22 8:08:29 p.m.
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Madam Chair, although I do respect my colleague, he has some gall to have made that speech. First, when parties were discussing the deadlines for the committee's work, it was the Conservatives who refused to have the committee continue its work past the date set at the outset. Then they accepted June 6. We finally agreed on February and today they are saying that we must take the time needed. Meanwhile, they were not open to immediately planning the work to be done up to that point. Second, I listened to the same experts and read the same expert report. Even though at the beginning I was not at all convinced about accessibility when mental illness is the only reason given, that is not what the experts stated in this report. We will continue our work and our soul-searching. My colleague says that the government is ideologically driven, but the government can speak for itself. I believe that my colleague's speech is very ideological because he cites just one part of the report. When we examine the set of criteria to be met for someone with a mental health issue to gain access, we see that it is available to a very small number of people. People with suicidal ideation do not fall into that category.

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Mr. Michael Cooper

Oct/20/22 8:10:03 p.m.
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Madam Chair, I respect the member for Montcalm, who has made many important contributions to that committee, but I have to say that I am confused as to what he is saying, as if we are somehow delaying this. The committee agreed that we needed more time to study the many complex issues, and now what we have is a sunset clause that will expire at the same time that we are tabling a report. That is incredible when we are talking about an issue like life and death. It underscores the need for why the government needs to extend the sunset clause so that we protect vulnerable people, ensure that we get this right and ensure that people do not fall through the cracks. After all, we are talking about life and death.

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Mr. Peter Julian (New Westminster—Burnaby, NDP)

Oct/20/22 8:11:01 p.m.
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Madam Chair, we would all agree in the House that we are in a mental health crisis. We would all agree that there have been no federal government resources applied to provide supports for Canadians who are suffering from this mental health and addiction crisis, dozens of whom are dying every day. Would my colleague agree, as a representative of the Conservative Party, to having the House move unanimously to direct the government to provide the $4.5 billion in support for the Canadian mental health transfer immediately?

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Mr. Michael Cooper

Oct/20/22 8:11:42 p.m.
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Madam Chair, I would concur with the member for New Westminster—Burnaby that there is inadequate federal funding. Only about 10% of all health care funding relates to mental health, so what is important is for the government to work to step that up and work collaboratively with the provinces to ensure that gaps are closed.

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Mrs. Cathay Wagantall (Yorkton—Melville, CPC)

Oct/20/22 8:12:10 p.m.
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Madam Chair, I am so pleased to have the opportunity to speak in this take-note debate on mental health this evening. I will focus my comments on the challenges that our Canadian Armed Forces and RCMP veterans, and indirectly their families, face with mental health injuries. Our veterans have unique challenges to their mental health that very few civilians face. They embody the emotional and mental toil of having been deployed to many theatres where they or their comrades face peril, injuries and death. They participate in and witness violence that they cannot and do not want to begin to share with anyone outside of those who have also lived that experience. Many have experienced mental, physical and sexual abuse from those they thought were their mentors or had their backs no matter what. Many come home with physical and/or mental and emotional injuries after serving and struggling to cope. They struggle on a whole other level, as they know they are failing in their relationships with their spouses and children. Many struggle with trying to fit into a civilian world, where, from their life experience and perspective, they struggle to find their place. Then there is a challenge that is so counterintuitive and disturbing to me. Having served for seven years on the veterans affairs standing committee in this place, this is something that grieves my heart and keeps me awake, as I think of the added injury sanctuary trauma inflicts on so many of our veterans. Sanctuary trauma is what happens to the spirit and mind of a veteran when they experience the failure of the government to fulfill its promise to take care of them and their families. The number of veterans who take their own lives is a significantly higher percentage than that of the civilian population. These are the ones who have been failed the most. The recent revelation of a VAC employee pushing a veteran to choose MAID to end his struggles with a brain injury and PTSD shows just how broken our duty to care is. I will share only one of so many instances where the needs of the veteran are undervalued because those who are making the decisions about their care failed—

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The Assistant Deputy Chair

Oct/20/22 8:14:02 p.m.
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I need to interrupt the hon. member. Is there a problem with the interpretation?

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Ms. Monique Pauzé

Oct/20/22 8:14:08 p.m.
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Madam Chair, the interpreter is saying that the member is speaking far too quickly. As the member is also holding the paper near the microphone, the interpreter cannot provide the interpretation.

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