Evidence of meeting #10 for Status of Women in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was disorder.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Merryl Bear  Director, National Eating Disorder Information Centre
April S. Elliott  Paediatrician, Chief of Adolescent Medicine, Alberta Children's Hospital, Calgary Eating Disorder Program
Debra Katzman  Professor of Paediatrics, Division of Adolescent Medicine, Department of Paediatrics, University of Toronto

4:05 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Thank you, Madam Chair, and thank you to NEDIC for the tremendous work you do.

Before I start with the witness, I did ask for some very specific information to be tabled on December 10 and I have yet to receive it, so I hope that's forthcoming.

Dr. Bear, you said there are 800 service providers in the country. Do you have an exact number for what percentage of those are fee based, and if not, could you table it with the committee later?

4:05 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

I'd like to clarify that we hold a database of approximately 800 service providers. It is by no means exhaustive, because not everyone who practises in the field necessarily lists with us. We often have to go out and find individuals who are providing services.

In terms of a fee base, I can certainly get that information to the committee.

4:05 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

I'd appreciate that. Thank you.

Some people will require day treatment, some will be hospitalized, sadly, and some people will require long-term treatment. How many long-term treatment centres are there in Canada?

4:05 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

There are far too few.

I would also like to draw the attention of the committee to another area of treatment that hasn't been addressed. Before individuals get into hospital-based treatment, whether it is a day hospital, out-patient, or in-patient treatment, there are a range of other options that should be explored and that should be a part of every individual with an eating disorder's options, because that is often a less traumatic, less intense, and less invasive option for help in recovery.

4:05 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Yes, we would like to catch it early, but if we don't, do you know exactly how many long-term treatment centres exist in Canada?

4:05 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

May I send that information to the committee? I can also break it down by child, adolescents, and adults. Would that be helpful?

4:05 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

It would be extremely helpful.

If people require long-term treatment, and this may be something you want to table with the committee as well, what is the average wait time if they require that long-term treatment?

4:05 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

I think that Dr. Woodside spoke to the wait times for the Toronto General program. We are not always privy to how long the wait lists are in institutions across the country, and that does change depending on what resources they have at any one time.

4:05 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

If people can't wait and they require that long-term treatment, I understand they have to leave the country. Do we know what percentage of them are having to leave the country?

4:05 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

I don't have that information. That information is quite probably available from each of the provinces, because they're the ones paying for that treatment.

However, there is a vast number of individuals whose parents are mortgaging their houses in order to send their children to out-of-country programs, and those programs are generally not long term in the way that many of the in-patient programs in Canada are. They're potentially a month long.

4:10 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

I know that many people are asking for a national strategy. Some of the stakeholders I have talked to would like to see treatment as part of that.

I know there's a federal-provincial issue here. If you could make a recommendation regarding the various types of treatment, if you could have your wish list, what would you like to see in this report?

4:10 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

From my perspective, I'd like to see enough.

In terms of actually articulating the kinds of treatment and how they are best delivered, that is definitely not NEDIC's domain. I would refer you to the clinicians.

4:10 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Okay, that's fine.

You talked a bit about funding. You said that you used to be funded by the WHN, if I remember correctly, the Women's Health Network.

4:10 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

No. We partnered with them. They were funded by the women's health contribution program. They provided the initial women's health portal on Health Canada's Canadian health network, which was as well a valuable source of information, credible and timely information, for women and individuals with a food and weight preoccupation.

4:10 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Again, if you could have your wish list for the recommendation that you would like to see in this report regarding funding, what would it be? Would it be funding for awareness and education or something else? Could you break it down into exactly what you'd like to see?

4:10 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

I would like to see funding for health promotion which is population based. I would like to see funding for prevention. I would like to see funding for education in all of the institutions. That would be throughout the system of education, from prenatal education, quite frankly, all the way through to education for professionals who will go into education, health, justice, and the media.

I would like to see treatment options that include.... Well, I would like to see strategies for early identification of eating disorders and a streamed process for supporting those individuals to recover.

4:10 p.m.

NDP

The Chair NDP Hélène LeBlanc

Thank you very much.

I will let you just finish your thought and then we'll move on. Did you have something else?

4:10 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

Yes. It's intensive treatment, and it's not just to focus on the individuals who are severely ill, but also to focus downstream, so that individuals don't have to get severely ill in order to get treatment and help.

4:10 p.m.

NDP

The Chair NDP Hélène LeBlanc

Thank you very much again.

We will now start the second round of questions.

Ms. Ambler, you have five minutes.

February 5th, 2014 / 4:10 p.m.

Conservative

Stella Ambler Conservative Mississauga South, ON

Thank you very much for being here, Ms. Bear. We really appreciate someone with your number of years in the field coming to spend an hour with us this afternoon.

Over the holidays I read an article in Canadian Living magazine, one of my favourite magazines, about a teenage boy with anorexia, from the point of view of his mother. Did you see that? She blamed herself. Once the disease was diagnosed, she thought back to all of those times when she used to tell him that he shouldn't eat that plate of pasta because it was fattening, because she'd had weight troubles all her life and she felt she had passed that along. It made me think of something Dr. Woodside said, which is that families get a bad rap with this disease, and that it's not caused by dysfunctional families.

Would you consider that to be part of the awareness piece? Is that a valuable exercise, educating family members? As a mother I would want to be reassured that this is a disease like any other, and we tend to be hearing that.

Would you agree with that?

4:15 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

It's not a disease like any other. It has a cultural component that is challenging to address, and it is absolutely critical not to blame parents when their child develops an eating disorder. There is no one cause of an eating disorder. If every parent who made a comment about their child's weight, shape, or eating had a child who then developed an eating disorder, then we'd recognize that maybe that's.... It's just much more complicated than that.

I'm sorry, could you please repeat your question?

4:15 p.m.

Conservative

Stella Ambler Conservative Mississauga South, ON

Do you think that should be part of the awareness when we're reaching out, to make sure Canadians know that this isn't caused by something that parents do or don't do, or say or don't say?

4:15 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

Parents are perceived, both by most health practitioners and definitely by their child, even though they may be reluctant, as the biggest and most important support in the recovery process. It's critical for any awareness campaign to recognize the multi-determined nature of eating disorders, that not one thing causes an eating disorder.

4:15 p.m.

Conservative

Stella Ambler Conservative Mississauga South, ON

Earlier this week I met with representatives of the National Initiative for Eating Disorders, who were on the Hill this week. I know many other members of Parliament have been doing that as well. Again, on the awareness piece, they talked about the fact that when parents are given their child's diagnosis of an eating disorder, they're often relieved because they think, “Oh, thank goodness it's not cancer, or something worse.” Meanwhile they are completely unaware that the mortality rates for anorexia are actually twice as high as for many forms of, say, leukemia, which is not something I would have known either, until they told me.

Again, in terms of the awareness that you talked about earlier, do you think that should be a part? This is something that I think is valuable to tell Canadians. Do you agree?

4:15 p.m.

Director, National Eating Disorder Information Centre

Merryl Bear

Yes, I think it is important to put eating disorders into the context of other issues, but not to minimize those other issues. Eating disorders are deadly, and they need to addressed.