Health Committee on Dec. 14th, 2010

[Tim Wall]

I don't know the specifics. Again, all I can point to is I think the U.S. is a real leader in that regard. They've had a national strategy now for over ten years, and they're just in the process of reviewing it and updating it. Part of the impetus around the new investments that the U.S. is making in suicide prevention is coming from the military, so I think the U.S. has been doing a lot of research. I don't have that handy, but I would certainly look to them for examples as to what they've done and what they've learned.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

Could you comment on the direct link between neurological conditions and suicide, particularly for young people with ADD or ADHD, fetal alcohol syndrome, FASD, mood disorders, or brain injuries? Then I want to make sure my colleague has time. Maybe I should turn it over here.

[Tim Wall]

That's not my area of expertise.

Perhaps Louis might be able to comment on that.

I would quickly say, though, that when it comes to suicide there is a misunderstanding that suicides are always about mental illness. In fact, the majority of people who die by suicide did not have a mental illness. People like myself and Louis and Paul are in the highest-risk group. It's men and older men. As our population ages, the problem is only going to get worse. I'll just throw that in.

Maybe Louis can comment.

[Dr. Louis Hugo Francescutti]

There is definitely a link between brain injury and fetal alcohol syndrome and suicide. Once you start teasing apart what happens to an injured individual, a lot of them are not able to reintegrate back into society. A lot of them we see start falling into substance abuse and then you get a vicious circle. When they end up in substance abuse, either the criminal system has to deal with them or they get injured. And then it's a vicious circle.

[The Chair, Conservative, Joy Smith]

Thank you very much, Doctor.

We will now go to Ms. McLeod.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you, Madam Chair.

Thank you to all the witnesses.

Hopefully I'll have time to focus on three areas.

First, a number of years ago now I was working in a rural emergency department, where of course we saw everything. At the same time I ended up getting involved in local municipal politics. It was through that connection that we would frequently see a number of children come into our emergency facility with injuries from our dock. It was a little lake. Only because I was involved in municipal politics were we able to quickly say this dock is creating a lot of injuries and we need to fix it.

Do we not need to, to some degree, empower our hospitals to be analyzing what's happening in their communities around accidents and injuries and actually create that connection at that level? We have huge opportunities, a community base in injury prevention.

I just wanted to throw that out. We talk a lot about a national perspective. I always like to believe in the power of community.

[Dr. Louis Hugo Francescutti]

There's an actual program that Canada developed under the directorship of Dr. Barry Pless called CHIRP, the Canadian hospital injury reporting program. It doesn't exist in every hospital, but in the ones that do have it--primarily children's hospitals--they do collect the data. Once again, they're under-resourced to be able to take that information, package it, and give it with some prevention strategies to the people who can make the difference. You're absolutely correct. Other countries that have done this successfully have very robust surveillance systems. In Iceland, what they actually do is assign a bar code to every injury, and everything related to that injury is assigned to that bar code so they can actually quantify the costs of it. Your thinking is absolutely correct: a robust surveillance system. What's missing now is that information needs to be analyzed and then fed back to the community.

Ideally, if we had Paul Kells in every community, it would save communities, and that would be the group that would receive that information, do something, and then the surveillance group could measure if it's having any impact.

[Paul Kells]

We do that. There are 16 designated safe communities in Canada, and we have an authenticated community injury-priority-setting session. The data is so much better now, but it's still not close to being good enough. Within four hours we can build consensus. We can put 250 people in Winnipeg around the table and they'll have a unified consensus on what injury issues are the major ones, what are the interventions that are required, and what's already going on that could do it. There are actually tools in place to make that happen. It's just limited in terms of its expansion and scope.

I would also say, finally, there are a lot of things going on at the local level in terms of investment that the federal government makes: economic development, infrastructure support, sports funding. You issue contracts and workplaces have to deal with this. You could begin picking through each one of those, setting standards for what you could tie your investments to and the conditions under which you'll give that money in terms of safe practices.

In the skate park that you helped build in Halifax, across from the CBC, no kids are wearing helmets because the cops don't go by. You could tie a condition to the development or the funding of that to say we'll do this providing it's operated safely. There are literally hundreds of things that can impact people locally at the community level, and communities are willing to help you do that if you organize them.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

The second thing is some sort of discussion around what is ultimately achievable. You gave an very powerful example of WestJet and every five days, and now as I reflect, I think yes, we can certainly reduce morbidity and mortality. What are the best countries in the world doing? Is their WestJet comparably every 10 days or every 15 days? It's probably a hard question to answer, but--

[Dr. Louis Hugo Francescutti]

No, that's a simple question.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Okay.

[Dr. Louis Hugo Francescutti]

It's Sweden. Canada has this many deaths per 100,000 and Sweden has that many deaths per 100,000. It's a rarity when a child is traumatized in Sweden. Sweden, nationally, set as their objective.... In Sweden, their parliament actually passed an act that said “We want zero injuries on Swedish roadways”. That's zero injuries on Swedish roadways. And we have plenty of examples of people who are far more sophisticated than we are.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

In any time I have left, I'd love to hear international examples.

[The Chair, Conservative, Joy Smith]

You only have about 25 seconds.

[Dr. Louis Hugo Francescutti]

We can do that offline.

[The Chair, Conservative, Joy Smith]

What do you want to hear?

[Dr. Louis Hugo Francescutti]

That's what it looks like, by the way. We have a graph.

[The Chair, Conservative, Joy Smith]

We can see a picture.

[Dr. Louis Hugo Francescutti]

You can pass it to the vice-chair.

[The Chair, Conservative, Joy Smith]

Thank you very much, Doctor.

Thank you, Ms. McLeod.

Monsieur Malo, excuse me. I understand the Bloc does not want to ask any questions. This is your opportunity.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Madam Chair, I do not have any questions. Thank you.

[The Chair, Conservative, Joy Smith]

Monsieur Dufour, you're the same...?

[Nicolas Dufour, Bloc, Repentigny, QC]

Same for me.

[The Chair, Conservative, Joy Smith]

You're going to chill out today. Okay.

We'll go to Mr. Uppal.

[Tim Uppal, Conservative, Edmonton—Sherwood Park, AB]

Thank you, Madam Chair.

Thank you for coming.

I just want to start off from more or less a personal experience. My daughter is almost three years old. We have been thinking about the winter and talking about skating and skiing for her. We've gone to a few different department and sporting goods stores, and we're getting different answers from everybody about when is the right time to start and what types of skates are good starting skates with regard to the different models.

Is there a way to educate the people who are actually giving out the information? I've been to a few websites, and they're giving out different information on what direction to head down when children should start into the sports. Anyone?