44th Parl. 1st Sess.
February 15, 2023 02:00PM
- Feb/15/23 2:51:07 p.m.
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Mr. Speaker, invoking mental health is something that we should consider at all moments, but I will tell everyone what does not help mental health when the world is going through something as difficult as it is. It is to expand people's fears, to increase people's anxieties. The party opposite refuses to offer solutions. All it offers is fearmongering and pretending that Canada is an island alone while it goes through what the world is suffering.
That is not reality. That is not truth, and it certainly does not help those who are suffering from mental illness.
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Mr. Speaker, I would like to thank my colleague for a balanced presentation on this issue.
I think his concern about the availability of mental health services is entirely fair. However, I do take issue with one thing the member said, which is that he held open the possibility of medical assistance in dying being an option for someone with a treatable mental illness. That is not the legislation. The legislation limits the right to medical assistance in dying to those who have an irremediable condition. Therefore, the fear that someone with a treatable condition would be able to avail themselves of medical assistance in dying is one that will not materialize.
As for the availability of mental health supports, the member would be well aware of the successful negotiation between the Government of Canada and the provinces for a substantial infusion of cash. This will absolutely increase the level of service available to Canadians with respect to mental health services.
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Mr. Speaker, I thank my colleague for his question and comments. As he said, the report was tabled this afternoon.
During discussions at the Special Joint Committee on MAID, we heard from a wide range of partners, associations and people who had concerns. The discussions led us to make the decision to extend the delay for those whose sole medical condition is a mental illness. That way, we will have time to set things up properly and ensure that doctors and nurse practitioners are ready to provide MAID under these conditions. Things must be done properly to respect autonomy and freedom of choice.
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Mr. Speaker, I think a key distinction in this legislation is the difference between mental health and mental illness. People could have one or the other or both. Can the member opposite explain whether he understands this difference and why it is relevant to this legislation?
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Madam Speaker, I hope my hon. friend is aware of the simple fact that those who are suffering from mental illness, those who are in the darkest part of their life and whose government has abandoned them, do not have the capacity to choose MAID, because they are in desperate need of help that their government needs to provide. Those individuals need life and help over assisted dying.
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Madam Speaker, virtually all medical health experts contend that mental illness is not irremediable. Why the delay for a year? What is going to change in this next year that should not be dealt with right now?
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Madam Speaker, the beginning of his comments sounded almost like an S. O. 31, and I encourage the member to try to catch the Speaker's eye the next time he rises.
He is absolutely right. From what I can tell, at no time in the decisions of Truchon or Carter, and I have read both, did the government say there was a right to die in Canada because of an underlying mental illness as the only condition.
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Madam Speaker, we are here for what is really such a deeply personal and complex discussion on Bill C-39. I want to start by saying the discussion tonight is about Bill C-39, and it has been the discussion here for the last few nights. I say this because some time ago, and I believe it was in November, we had a one-night discussion in the House, a take-note debate on mental health, in which I participated. Frankly, there were very few participants in that debate. A number of colleagues were here for that.
However, the discussion tonight is not about mental health. It is about Bill C-39, the legislation before us, to delay the implementation of MAID as it pertains to mental illness by a year. The core of the crux is that there is a mental health literacy discussing this problem in the chamber, and perhaps even across the country.
I want to start by saying what mental health is and what it is not. Mental health is really, at its core, in the day-to-day for all Canadians and all of us in the House, who work really hard and have stress for ourselves and our constituents. We have been going through a really challenging time these last two plus years through COVID.
Mental health is the ability to navigate and recover from a challenging situation and to be able to move forward with a sense of self. It does not mean that when we are stressed, when we have anxiety or when we are facing a tough period where there may be ebbs and flows of depression, we are struggling from mental illness. That is mental health.
We really need to start the conversation there. Truthfully, for any human being, and I have two teenage daughters, day-to-day things are up and down. We are not meant to always be happy all the time. We are not always meant to be in a positive state of being. There are ebbs and flows to life, just as there are for every Canadian across this country. Having two teenage daughters, I am sure many colleagues in the House can relate.
The truth of the matter is that mental health is not the opposite of mental illness. When I talk about people being diagnosed with a mental illness, I mean people who are diagnosed by a physician, which means a psychiatrist, a medical professional who is familiar with the categorizations of diagnosis under the DSM-5.
There are individuals with mental illness who are treated for it who have good mental health. Can members imagine that? One can have good mental health while one struggles through mental illness. That is a reality for many, many individuals who deal with mental illness. About 15% to 20% are medically diagnosed with mental illness.
There is a mental health crisis for many Canadians in this country, with many social determinants, whether it be poverty, housing or inflation, that are impacting the mental health of many Canadians, but they are not struggling with mental illness. I really feel strongly that is where we need to start the discussion.
Bill C-39 is not about mental health. Bill C-39 is about mental illness and those who have struggled with mental illness who have been presented treatment after treatment, have tried everything imaginable to address their suffering, and have not found relief. They have not been able to find that ebb and flow of life many of us experience in mental health. We need to acknowledge that.
I heard a lot of disturbing statements in the House, such as this legislation being euthanasia or medical treatment by death. Shame on them for disparaging the DSM categorizations of medical professionals and using fast and loose language in the House on what is a profoundly serious categorization of suffering for individuals in this country.
Frankly, this is a hard issue. MAID is a hard issue for so many of us. It is so hard for us to know people we love may be suffering from a disorder or a terminal condition there is no relief from.
I want to move now into what Bill C-39 is, because we need to go over that.
Bill C-39 is asking for a year. It is asking for a year to pause on allowing for mental illness as the sole determinant for an individual requesting MAID, so that it can be reviewed and so that it can be put into place well. What do we mean by “well”? We have a health care crisis in this country. We have gone through two years of COVID. Doctors, nurses and health care practitioners are exhausted, and they need to be trained on this. They need to understand the DSM-5. They need to understand what the treatment protocols are for those who suffer with mental illness. We are not there yet. We want to ensure that the best practices are in place, and done with compassion and with a deep sensitivity for the individual suffering.
It is about the individual. Many of us in the House have beliefs, which may be religious beliefs or personal beliefs, about how they feel about MAID in general or how they feel about MAID in relation to this particular categorization of mental illness. At the end of the day, it is about the individual. It is not about us. It is about them. We need to remember who is at the core of this legislation and why it has been put forward, and the compassion and time that have been put in by medical experts. One can present me with one panel or another panel. At the heart of this is human suffering. I would not wish on anyone in the House to know what it is to have a loved one who suffers from mental illness, because I did.
I had a 15-year-old nephew who suffered from mental illness. Every treatment was offered to him, every treatment, and he refused. I lost my nephew to suicide, not because we did not have hope, not because there were no resources, not because we did not try, but because everything that was put on the table, and trust me, I am a fierce mama, did not help him. I have to live with that loss, and the grief of that loss, of his choice. He did not make his choice in a medically assisted format. He chose suicide. We need to understand the difference.
Why do I share this? I share it because this is a personal issue. I also have a dear friend who had ALS. She suffered for years, but we put into place protocols for her so that when she knew it was enough, we would be by her side in her choice. There were friends who did not show up for her choice. There were many of us who debated about her choice, that it was gut-wrenching. Each step of the way, we had check-ins with her, even when she could only communicate through her eyelids. Was she sure that this was what she wanted? Was she ready? It was heartbreaking to leave that room that day, but it was her choice.
At the core of this, as hard as it is for members of this House to understand, it is about the individual. We have an obligation to provide every guardrail to every professional framework that is caring and compassionate, and that is why we need time to build it and set it out.
At the end of the day, these are professionals. This is mental illness. To the degree that individuals are suffering at that level, one should never have to watch individuals suffer to that degree.
Even if they go and ask for it from their psychiatrist, even if they are contemplating this, that is the beginning of the process. It is not an automatic decision. Then, their entire history of treatment needs to be reviewed, every protocol questioned. Every stone needs to be turned and reviewed by another professional. This is not even sober second thought, as we would have in the Senate. This is sober after sober after sober, three times, four times, five times, until every check has been done with the individual who is truly suffering.
I want to get out of the speak of professionals and all of that because at the core of this is the human being who is suffering. We need to know our language and be clear about that.
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Uqaqtittiji, I had the wonderful privilege of welcoming the member for York Centre to my community in Iqaluit and we had a wonderful time there.
I want to ask the member a specific question about the “Final Report of the Expert Panel on MAiD and Mental Illness”, from May 2022, because I really appreciated the refocus on mental illnesses. In that report, “mental illness” is said to be for those who are “lack[ing] a standard clinical definition”. My concern is that there are a lot of first nations, Métis and Inuit who might not fit into this professional model. This panel recognized it as well and, in recommendation 14, said that there need to be consultations with first nations, Métis and Inuit on creating practice standards.
I wonder if the member could share her thoughts on that.
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Madam Speaker, this is exactly the reason why mental health literacy is so important, because those who suffer with mental illness are not necessarily, by default, suicidal. I would be more than happy to educate the member on the determinants of that.
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Madam Speaker, that is a very important question. Canada is facing huge challenges right now with respect to mental health. We should double down on this and make mental illness a priority, because it is affecting hundreds of thousands of Canadians.
There are plenty of ways to add more resources to our health care system. The government could speed up the approval process for certain drugs. We can all be more open to new ways of thinking, working and living in society that would alleviate this problem. Let us hope the government will see it and show a little leadership on things like that.
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