44th Parl. 1st Sess.
May 1, 2024 02:00PM
moved that Bill C-277, an act to establish a national strategy on brain injuries, be read the second time and referred to a committee.
He said: Madam Speaker, it is indeed a great and rare honour to be able to stand in the House of Commons to sponsor and present a piece of legislation for all of my colleagues to consider. With that being said, I am pleased to kick off the debate respecting Bill C-277, the national strategy on brain injuries act. Before I get into the details of the bill, I want to start by sharing three personal stories so members of the chamber who are listening can get a real sense of why the national strategy is so important.
I want to tell the story of Kyle Mockford from my riding, who in 2012 was brutally attacked from behind, being struck up to 20 times in the head before collapsing, unconscious. For months after, he experienced severe headaches, balance problems, fatigue, poor coordination, and reductions in reasoning skills, concentration and memory. This was followed by bouts of depression, anxiety, compulsive-aggressive behaviour and PTSD, all of which got progressively worse after the attack. In his words:
I expect I’ll never get back to being completely normal, but I’m finally doing the proper things to get back to normal as much as is possible after falling through the cracks for so long. I want to shine a light on how serious brain injuries can be, and that they can and will have long-lasting consequences and effects on a person’s life.
I also want to tell you the story of Derrick Forsyth from Victoria, a man who has 85 criminal convictions and who was caught up in a vicious, repeating cycle of doing time in prison, getting out and doing time again. A series of undiagnosed brain injuries dating back to his childhood led to frequent interactions with our criminal justice system and to an addiction to drugs. However, with proper support, he has turned his life around. Derrick still faces symptoms of brain injury, including extreme fatigue, which will never go away, but he says that dealing with the injury has taught him how to be more giving, understanding and compassionate.
Finally, I want to tell you the story of Abbotsford resident and school trustee, Shirley Wilson, and her late son Jacob:
Jacob suffered a traumatic brain injury after he was struck by a pickup truck in August 2018 at the age of 21 while he was walking along Marshall Road in Abbotsford.
He was resuscitated three times by medical teams that night.
Over the last years of his life, the devastating injuries he sustained led to isolation, psychosis, drug addiction and [eventually] his death by an accidental fentanyl overdose on Nov. 11, 2021.
He was just 24 years old.
Here are the statistics. Brain injuries are often known as the hidden epidemic because the people who have them do not always bear physical scars. Acquired brain injuries can very generally be separated into the traumatic and the non-traumatic kind. Traumatic brain injuries can come from assault, from playing sports or from motor vehicle accidents. Non-traumatic acquired brain injuries can come from strokes, overdoses and aneurysms.
It is estimated that over 160,000 new cases of brain injury happen annually in Canada, and that there is an estimated national prevalence of over 1.5 million cases. Traumatic brain injuries are 44 times more common than spinal cord injuries, 30 times more common than breast cancer and 400 times more common than HIV/AIDS. In fact the incidence and prevalence of brain injuries surpass that of HIV/AIDS, spinal cord injury, breast cancer and multiple sclerosis combined.
We know that brain injuries contribute to homelessness, incarceration, substance use and mental health issues. We know that brain injury survivors face a 200% increased risk of struggling with addictions, and their risk of suicide increases by 400% after a brain injury.
Despite these stark statistics, funding for awareness, prevention and treatment pales in comparison with that of many other ailments impacting the health and well-being of Canadians. We all know about Heart and Stroke Foundation of Canada and the Canadian Cancer Society, and the good work that they do, but knowledge of Brain Injury Canada and how common brain injuries are in Canada pales in comparison.
The rate of traumatic brain injury increases in older groups. We do have an aging demographic, and we know that those over 60 account for 29% of all head injury hospitalizations. We also know that seniors with brain injuries can experience accelerated aging effects and that there can be an increased risk of Alzheimer's disease and dementia.
In response to all of these facts and to the many champions who are working to get this strategy into place, I worked to introduce Bill C-277, the bill that we are considering this evening.
This bill did not develop in a vacuum. I want to single out a particular individual from my riding, from the city of Langford, Janelle Breese Biagioni. I have known her for quite some time. She is a very persistent constituent who is very passionate about these issues. It was through conversations with her that I first came to develop the idea of putting in place a national strategy to address brain injuries. Her story is very personal. Her late husband, Constable Gerald Breese, was once a member of the RCMP. While he was on duty on his motorcycle he was involved in a motor vehicle accident. He went into a coma and unfortunately, eventually, succumbed to his injuries. For her, this is very personal.
This eventually led to my introducing the original Bill C-323 in the previous 43rd Parliament. It was then that it got the attention of Brain Injury Canada. I really want to recognize the people at Brain Injury Canada, especially Michelle McDonald. It is a tremendous organization. It does such incredible work from coast to coast to coast. Through consultations with Brain Injury Canada, we developed the bill we see today. This bill was very much co-written with Brain Injury Canada. I cannot thank it enough for its valuable input and the stakeholders it has reached out to.
Truly, this bill has taken on a life of its own. There are so many people with lived experience and so many organizations and people working in research who have reached out to my office and who are mounting a campaign outside of my efforts inside of the House of Commons to raise awareness. I think of March of Dimes Canada, all of the provincial injury associations, the Cowichan Brain Injury Society from my own riding of Cowichan—Malahat—Langford, the Concussion Legacy Foundation of Canada, but also prominent individuals like Dr. Gabor Maté, who has also lent his support to this bill. What an honour to have such a learned individual, who has been so active in this field, lend his support.
Now, to the language of the bill, essentially this is a national strategy that is going to require the Minister of Health to consult with representatives of provincial governments, with indigenous groups and with relevant stakeholders to develop this strategy to support and improve awareness, prevention and treatment as well as the rehabilitation of persons living with a brain injury.
The strategy includes a number of measures, 11 in total. I will not go through all of them in detail, but very briefly, they include measures like identifying the training, education and guidance needs of health care and other professionals who work in this field; promoting research and improving data collection on the incidence and treatment of brain injuries; promoting information and knowledge sharing; creating national guidelines on the prevention, diagnosis and management of brain injuries; and also fostering collaboration with and providing financial support to those associations that do this important work.
However, there are two items I really want to highlight. The bill would ask the Minister of Health to encourage consultation with mental health professionals, particularly in educational institutions, sports organizations and workplaces, to provide persons who are suffering from the effects of a brain injury, including mental health and addiction problems, with a support system within the community. It also asks the minister to identify challenges resulting from brain injury, such as mental health problems, addiction, housing and homelessness issues and criminality, including intimate partner violence, and to work to develop solutions in collaboration with stakeholders.
I think if we canvass members in the House, we can all agree that those are issues affecting all of our ridings and all of our communities within them.
Let us get to why we need this bill. I first want to apply a gender lens to this bill. Professional sports get a lot of attention with respect to head injuries, but I want to leave people with this startling fact: For every NHL hockey player who suffers a concussion in sport, more than 5,500 Canadian women sustain the same injury from domestic violence. Women in families also tend to have a disproportionately higher burden in terms of the responsibility of providing care to loved ones.
I also think we need to spend time talking about the intersection of brain injury with our criminal justice system. Brain Injury Canada has done a lot of work on this. Evidence shows that sustaining a traumatic brain injury increases the risk of involvement with the criminal justice system. There are many common cognitive, emotional and behavioural symptoms or impairments that can increase the chance of a negative interaction with police and the justice system. These can include anger management issues, challenges with processing information, engaging in high-risk behaviours, inappropriate emotional responses, lack of impulse control, memory impairments and poor judgment.
I know this from speaking to police in my role as the public safety critic. I have also spoken with members who work in our federal correctional system, both the program officers within and the parole officers who work on the outside. Certainly, their first-hand accounts of undiagnosed brain injury within our prison system was absolutely startling testimony to hear directly. Therefore, it is a very real problem, and if we want to be serious about addressing some major societal issues, such as criminality, addressing undiagnosed and even diagnosed brain injuries is going to go a long way to helping these people lead productive lives.
I also want to talk about the intersection with opioid use in our communities. One existing challenge with the treatment of substance use and brain injury at the same time is that current programs are not equipped to handle both. The majority of brain injury rehabilitation, community and support programs require participants to be sober. Similarly, the centres and programs that specialize in addiction support are not able to handle the complex needs of someone who has a brain injury. Again, these are two very real problems that are often interconnected, but we do not yet have adequate support and treatment systems to deal with them at the same time. I know this is an issue in the communities I represent, and I think it is the same right across Canada.
I want to wrap up by saying that there is very much a poor understanding of brain injury and its consequences in both the health and social care systems. I think it is well-known among some segments of the population, but I do not think we have a firm grasp on the situation policy-wise. I believe that, by legislating this requirement for a national strategy, we can truly start treating this major societal problem with the urgency and resources it needs. I hope all members will support me in this. It is a bigger problem than any one province or territory can handle on its own. We know that, with proper treatment and support, many people with brain injuries can return to productive and engaging lives.
It is amazing that I already have support from the cities of Victoria, Langford, Nanaimo and the municipality of North Cowichan. I think many more municipalities are going to follow suit, given the problems they are dealing with in their populations.
I sincerely hope all colleagues are going to join with me in supporting the principle of this bill and send it to the health committee where it belongs.
I want to end with a quote from Dr. Gabor Maté, who stated:
Brain injury is one of the hidden epidemics, too often unrecognized, that exacts a heavy toll on sufferers and their families and caregivers. It has many health implications, which may last a lifetime. Children with brain injuries, for example, are at elevated risk for depression. Other potential consequences of traumatic brain injury include loss of behavior control, aggression, memory loss, dementia and, potentially, substance abuse. Nearly half the homeless population have endured brain injury. A national strategy that entails the proper education of health personnel, teachers, social workers, law enforcement people, service providers and policy makers at all levels is urgently needed. Based on my clinical work and on my extensive reading of the research literature, I fully support this initiative.
I urge all members to listen to those wise words. I would ask the many people campaigning for this bill to give their support to send it to the standing committee. I thank all members in the House for their consideration.
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- May/1/24 7:07:00 p.m.
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Madam Speaker, I will end the suspense by announcing right away that the Bloc Québécois will be voting in favour of the bill. Still, I would like to emphasize our reservations regarding the creation of multiple national strategies. First, they often disregard the jurisdictions of Quebec and the provinces. Second, they sometimes seem to disregard, or at least fail to take into account, what is already being done in Quebec.
The bill seeks to make the federal government the puppet master, when Quebec already has its own unique approach to treating traumatic injuries, which include brain injuries. We did not wait for a federal brain injury strategy before taking action. Let us look at what is in the bill. Let us examine the points one by one:
(a) promote the implementation of preventive measures to reduce the risk of brain injuries;
That is a good thing. Specifically as an employer, but also as a contributor to a number of organizations and events, the federal government must ensure that brain injuries are prevented as much as possible.
(b) identify the training, education and guidance needs of health care and other professionals related to brain injury prevention and treatment and the rehabilitation and recovery of persons living with a brain injury;
Training health care professionals falls to the provinces, to professional associations. Furthermore, brain injuries are treated by hospitals, which are also under provincial jurisdiction. Therefore, the federal government cannot identify anything, but it can certainly help identify needs and participate in the collective effort to address the concussion epidemic.
In order to address brain injuries, Quebec has its own organizational model, known as the trauma care continuum. This model has four objectives: accessibility, efficiency, quality and continuity of care and services. The program was implemented in the early 1990s and continues to evolve by encouraging co-operation mechanisms, research and an assessment process implemented with trauma care continuum assessment functions. This involves collaboration between Quebec's ministry of health, the Institut national d'excellence en santé et en services sociaux or INESSS, the Société de l'assurance automobile du Québec, and the Commission des normes, de l'équité, de la santé et de la sécurité du travail or CNESST.
Regarding brain injuries more specifically, Quebec also has an action plan for the prevention and management of concussions in sports and recreational activities, and it has had a concussion management protocol since 2019. The protocol includes a tracking sheet for recording information to be shared with participants, parents, and recreational, school or sports organizations, as well as health care system personnel. It outlines the steps to take based on a participant's condition after an incident, though it should not be used to diagnose a concussion and is not a substitute for a medical opinion.
I also want to note that Quebec and its specialists, like all the provinces of Canada, train their workers and establish guidelines for their professionals in the treatment of brain injuries. For example, INESSS partnered with the Ontario Neurotrauma Foundation to publish the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to Severe TBI. The INESSS even has a tool called “Decision Algorithm for Serious Neurological Complication Risk Management Following MTBI, Adult Clientele” to assist professionals with their decision-making.
(c) promote research and improve data collection on the incidence and treatment of brain injuries and on the rehabilitation and recovery of persons living with a brain injury;
Promoting research is an essential role for the federal government. It is something the government is doing and should be doing. One example is Université de Montréal's research centre in the psychology department.
This Canada research chair in paediatric traumatic brain injury does rather extraordinary work and she does indeed receive funding. The chair is trying to better understand traumatic brain injury in young children.
(d) promote information and knowledge sharing with respect to brain injury prevention, diagnosis and treatment and the rehabilitation and recovery of persons living with a brain injury;
The promotion of information and knowledge here and abroad is a mission the federal government is asked to do and is participating in. For example, it is working with the Parachute organization on the publication of the Canadian guideline on concussion in sport.
(e) create national guidelines on the prevention, diagnosis and management of brain injuries in all communities, including recommended standards of care that reflect best methodological, medical and psychosocial practices;
As previously mentioned, Quebec already does this with its own model. As long as the federal government is trying to collaborate and not establish or impose, then we support the initiative.
(f) promote awareness and education with particular emphasis on improving public understanding and protecting the rights of persons living with a brain injury;
For an awareness campaign to be effective, it must be adapted to its context. Given that the Quebec government provides the services and resources, it is in the best position to run those campaigns. In fact, it is already doing just that. There are many websites and brochures available to the public that are designed to prevent or recognize the symptoms of brain injuries.
(g) foster collaboration with and provide financial support to national, provincial and local brain injury associations and brain injury service providers to develop and provide enhanced and integrated mental health resources for persons living with a brain injury and for their families;
If the federal government wants to use tax tools to help families facing additional costs or loss of income because of a brain injury, the Bloc Québécois invites Ottawa to do so. I would add that the EI reform promised by the Liberals has yet to happen.
(h) encourage consultation with mental health professionals, particularly in educational institutions, sports organizations and workplaces, to provide persons who are suffering from the effects of a brain injury, including mental health and addiction problems, with a support system within the community;
Encouraging consultation is all well and good, but where mental health is concerned, access is the problem. Quebec lacks the resources needed to train more psychologists and social workers. It also needs resources to provide better working conditions for its professionals to retain them in the public system and in community organizations. If the federal government wants to financially support our health care systems, it will come as no surprise to anyone that increasing health transfers is the way to go about it. The Bloc Québécois supports that.
The Bloc Québécois would remind members that one of the major problems with Canada's health care systems is federal government under-investment. The federal government needs to increase transfers to 35%.
(i) identify challenges resulting from brain injury, such as mental health problems, addiction, housing and homelessness issues and criminality, including intimate partner violence, and work to develop solutions in collaboration with stakeholders;
Health, including mental health, falls under provincial jurisdiction. The same goes for addiction, housing and homelessness. If the federal government wants to fund research on those topics, then we invite it to do so. When it comes to criminality and violence, that is an area in which the federal government can and should take action.
(j) maintain, in collaboration with Brain Injury Canada, a national information website providing current facts, research and best practices related to the diagnosis and management of brain injuries, as well as other relevant resources;
When I read that, I found it a bit strange that a bill would explicitly give an organization the responsibility to maintain a website on brain injuries. In any case, we believe that Quebec and the provinces are in the best position to inform people of the resources that are available and of the action they should take if they experience a brain injury.
(k) establish a task force to include policy makers, stakeholders, community agencies, brain injury associations and Indigenous groups, as well as persons who have experienced a brain injury and their families, to make recommendations in relation to the national strategy.
We agree on that, and as I said earlier, we look forward to taking this to committee so we can make some adjustments. Then we can vote in favour of the bill.
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