Status of Women Committee on Dec. 10th, 2013

[Marla Israel]

The opposite.

[Terence Young, Conservative, Oakville, ON]

What's the opposite of the hospital?

[Marla Israel]

Staying out of the hospital.

[Terence Young, Conservative, Oakville, ON]

But where are the investments made?

[Marla Israel]

The investments are being made in a variety of community areas dealing with, for example, like I said, children and at-risk parents. You have investments being made in facilities that help ensure that there are education, awareness, tools, and changing behaviours and attitudes. This impacts, for example—

[Terence Young, Conservative, Oakville, ON]

Okay. Thank you.

[Marla Israel]

I'll give you a very tangible example: some of our prenatal nutrition programs. If these programs were not in play, then you'd have a population of mothers, for example, of teenage parents, who would probably end up in hospital with underweight babies and with babies who could suffer multiple birth defects.

Through not a great deal of investment, we have evidence to suggest that for these babies who are served by our programs, their health outcomes are much better than those of the average population after having been exposed to our programs—

[Terence Young, Conservative, Oakville, ON]

Thank you.

I'm going to try to get a couple more questions in, so I'm going to ask you to end there. Thank you.

I'd like to focus for a second on psychosocial causes. We know that the fashion industry, the clothing industry, is fixated on thin models, models who are artificially thin. Many of them diet severely in a highly competitive profession. Some of them smoke tobacco, or do cocaine, or actually do heroin in order to keep their weight down.

I was shocked to find out about eight years ago that in some of the images in magazines that girls see, the models are made up to look like they're on cocaine or on heroin. That's some kind of style or something.

It was naive of me, I guess, but I discovered—also years ago—that some women's clothing stores don't sell sizes for girls who aren't small. I thought that was pretty mean-spirited. That's kind of reckless, with a disregard for the mental health and the happiness of those who could be their customers. They have these great styles and they have these great labels, but if your BMI is average or higher, you can't buy those clothes.

Do you have any ideas for the fashion industry or the magazine industry, or suggestions that we might make, that they might do cooperatively? Because they have loved ones who might suffer from eating disorders, and they want to help deal with it too. Are there things they might do to reduce this negative influence, this artificial influence on girls with regard to their body image?

[Linda Savoie]

We have worked with groups sporadically over the last few years that have brought this to our attention, and we funded a handful of projects over time where groups are trying to get the fashion industry, for instance, to set standards and self-regulate around that.

[Terence Young, Conservative, Oakville, ON]

Have there been any successes with that?

[Linda Savoie]

Very limited, because no one wants to be the first one to do this, because then you're at a disadvantage with your competitors and with other labels. Our projects of course are small scale. We try, in some circumstances, to generate knowledge and identify things that would work.

[The Chair, NDP, Hélène LeBlanc]

Thank you very much.

Thank you, Mr. Young. That was a very interesting question. Maybe in the further answers we will be able get to the bottom of it.

Ms. Duncan, for five minutes.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair.

Dr. Joy, could you tell us what's the evidence base regarding the challenges in terms of diagnosis, treatment, and preventing relapses here in Canada?

[Dr. Joy Johnson]

I think that it's an interesting conundrum, because none of us want research to sit on the shelf. I've been guilty of feeling like my work is done when I've published a paper. I think we're all recognizing that we need a new way of doing research, in that we need to bring practitioners and researchers together from the very beginning. In that way we know that practitioners are going to be more likely to take up and utilize research, and to be involved from the very beginning. So that's one thing.

But other decision-makers as well are very important—

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Sorry, Dr. Johnson, can I just.... That should be a recommendation for the report. We know that in other...you bring the clinicians and the researchers together. So should that be a recommendation of this report?

[Dr. Joy Johnson]

I think that would be a fabulous recommendation, and I think that in some ways there's a tool there in relation to the strategy for patient-oriented research. I hate to keep beating that drum. But that's what it's about, because we know that's a huge problem right now in Canada, that whole issue.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I agree, and I like people-centred and bringing clinicians and the researchers together. So those are two recommendations.

But what are the challenges that you see in diagnosis, treatment, and preventing relapses in this country?

[Dr. Joy Johnson]

I think we have recognized—and I think the expert you heard from before has said this—that primary care providers are not screening. They don't have the tools and they haven't been well trained.

I think, again, there are materials out there that could be disseminated and utilized, we could do a better job. We could partner, for example, with the Canadian Medical Association and the Canadian Nurses Association, and find ways to disseminate information to on-the-ground practitioners.

At least they ask the questions, have you lost weight in the last year, and has your weight fluctuated?

We could talk to parents about the eating habits of their children. These are all part of some of these guidelines that have been developed and I think are fairly simple and could be used.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Okay.

So a third recommendation you would have is dissemination of the guidelines through partnering. Is that correct?

[Dr. Joy Johnson]

It is one of the best mechanisms to use.

I cannot speak on behalf of those organizations, but they do have a mandate to provide professional materials and best practice guidelines. I think there are some there, and we could find ways to partner with those organizations.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I really appreciate that. This is very helpful.

Can I ask about the challenges around treatment and what we can do better? I come back to there being Canadian who are hurting.

[Dr. Joy Johnson]

The tragedy is that many of us have met those individuals.

I totally agree; it's a dire situation. But as dire as it is in Toronto, try going to Fort McMurray and finding mental health services. We also have an issue around geographic challenges that we need to be thinking about.

I think there has been recognition that mental health services, in general, for children and youth, are not adequate in this country. That's why we need to find better ways to disseminate and provide treatment services.

It might not simply be through very specialized services. We know that some individuals will require that, but we need to think across a variety of areas, from recognition of early symptoms.... We heard about cognitive behavioural therapy being one of the best treatments for some of the eating disorders. We need to train people and make them available. They don't always have to be delivered in a face-to-face way. There are new technologies that can be used. We should be thinking about them, testing them, seeing if they're efficacious, and doing a better job of developing them.

One of the biggest challenges, and we've talked about this a bit, is the federal, provincial, and territorial mandates of health delivery. You have to work with the provinces around this.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Sorry, can I jump in? I just want to make sure I'm reflecting your recommendations. We do have a geographic challenge. We do have a youth challenge. You're saying to use new technologies to find different ways of delivering them. You raised the conundrum in health—federal, provincial, territorial.

Do we need a strategy that would allow us to bring the provinces and the territories together with all the stakeholders, to find a way of doing diagnosis, treatment, and prevention better?

[The Chair, NDP, Hélène LeBlanc]

Very briefly, Dr. Johnson.

[Dr. Joy Johnson]

I'm not an expert in terms of how to actually shift this policy. I think there are a lot of strategies that have sat on shelves, I guess I would say.

I want to be very careful about any recommendation that I might make in regard to that. I think there are a lot of smaller great initiatives that could be developed that could begin to address this issue in very, very clear ways.