Evidence of meeting #33 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was dave.
A recording is available from Parliament.
As an Individual
Sometimes people even mistook you for him a little bit, and vice versa.
Conservative
Colin Carrie Conservative Oshawa, ON
Actually that is it, and I think that caused Dave a lot of distress. He kept telling me how much better looking he was than I was.
He was a courageous guy. We all miss him.
I want to thank you for your courage, especially about getting the message out. That's what I want to talk to you about first.
How important is it to be open about mental illness, especially with family members?
As an Individual
I think it's extremely important. It encourages that person who's in this terrible frame of mind to speak about it, and when they start to speak about it, that's likely when help will occur.
As well, I know from different support groups I've been involved in since Dave passed away that it's also very important to be open about the fact that a death is by suicide.
I mean, everyone handles things differently. I've had support group members tell me, “You know, my loved one died a few months before Dave and we lied about it. We said it was a stroke. We said it was a heart attack—something like that. We didn't feel we could properly grieve until we started telling the truth about how that person died.”
I think openness is very important.
Conservative
Colin Carrie Conservative Oshawa, ON
Thank you.
I am wondering what advice you would give spouses who have a husband or a wife who suffers from anxiety and depression. How can you communicate to them the warning signs?
As an Individual
I'm certainly not a doctor, but at the same time it's trying to keep them speaking about it, and open. Isolation is something that draws them further inward and makes them also think there's no other option.
That is the timeframe when usually hope.... As long as you can try to preserve hope. Hope is the main thing for these people. If they have hope, they can go on another day. If they lose hope...you don't have much if you don't have hope.
As far as advice that I would give, keep the communication as open as you can, so that person knows they can speak to you about it and they don't have to feel judged. Especially for men, they're used to being, in a lot of cases, the main salary of the family. They're used to being the ones taking charge. They don't want to feel weak or unmanly.
Like I said in the video, this is not about being weak or unmanly; this is a health issue. To me, it's no different than if you have cancer.
Conservative
Colin Carrie Conservative Oshawa, ON
You speak about hope. I wonder if you could elaborate a little bit more about the golf tournament. We saw the video that you produced. Where do the funds go that you raise through the golf tournament? Could you elaborate a little more on that?
As an Individual
We've set up a bank account. It was all very low key. It was just a few of my friends and Dave's friends. Andrew Scheer, who is now Speaker Andrew Scheer, was actually one of the people who helped organize the golf tournament.
We just decided to do this, and then I said, “Let's have the money go to something that would help somebody like Dave.” I really had it in my head that I wanted to do a TV commercial. I was just thinking about times when somebody like Dave was likely to be at his or her lowest. It's fine for people to say, all you need is exercise or fresh air, that'll make you feel better. But if someone is in a deep depression, they probably cannot even get out of bed or off their couch.
So I thought about those kinds of people, and I thought maybe it was a situation where all they're doing is blankly looking at a TV screen, maybe not even paying attention to what program is on. But perhaps if they see this commercial, it would kind of twig with them because it's a guy they can relate to—both the actor in the commercial, and then when Dave's picture is shown at the end—and that just seems familiar to them and they realize they can talk about it with their friends. If their friends ask them, sincerely, “Are you all right?”, they can admit, “No, I'm not all right.” To me, that's the main part of the commercial. When one sees it, that's the major focus of the commercial, which is the man admitting that no, he's not all right.
As an Individual
I wanted to add just one other short thing about that. For me, the story that happened with Dave is such a tragedy that to not have some good come out of it is not the ending he would have wanted and that I want for him.
Conservative
Colin Carrie Conservative Oshawa, ON
I think his legacy lives on through you and all the work that you do, and we do sincerely thank you for that.
I wonder if I can ask Dr. Heisel as well, since you are here.... I spoke to Denise, and Denise said she's not a doctor, but I know the work you've done. I wonder if you can elaborate. I know you were cut off a little bit in your opening comments, but could you elaborate on some of the warning signs that we should all be looking for, especially among the older adults who suffer from depression and anxiety?
Associate Professor and Research Scientist, Department of Psychiatry and Department of Epidemiology and Biostatistics, University of Western Ontario
Thank you.
We know there are a variety of warning signs and things to be aware of. Certainly, signs and symptoms of depression can be an indicator that somebody is at risk. It can include somebody appearing depressed, down, sad, having concentration difficulties, missing appointments, no longer appearing interested in things that used to be of interest to them, and related things like that.
We know, however, with older adults specifically, many older adults can experience a major depressive disorder or a clinical depression without appearing sad or without necessarily feeling sad. We know that with older adults, rather than through psychological symptoms like sadness, depression, loss, etc., many will tend to experience depression through bodily symptoms like aches, pains, and those sorts of difficulties. So certainly we encourage providers who are working with older adults, who are appearing, say, in a primary care medical practice repeatedly for sort of vague symptoms, to begin asking questions about what sorts of things are going on in their lives, how they're feeling, how they're doing, and that sort of thing.
Conservative
The Chair Conservative Joy Smith
Thank you, Dr. Heisel.
With the permission of the committee, Mr. Albrecht would like to ask one question.
Is that okay with the committee?
Conservative
Harold Albrecht Conservative Kitchener—Conestoga, ON
Thank you, Madam Chair, and my thanks to all the witnesses for your expertise and for being here today.
You folks are the ones who have been on the front lines of this for years. I simply have the honour of being the parliamentarian who happened to be in the draw of private members' bills in the order of precedence.
Dr. Mishara, one of your concerns was that if there isn't a specific para-government agency charged with the responsibility of taking this task on, it might get lost again. I share your concern, but I need to make you aware that a private member's bill doesn't have teeth. A private member's bill cannot compel the government to spend money. I was trying to get a foot in the door. I am saying this is something the Government of Canada, through one of its agencies—perhaps Health, perhaps the Mental Health Commission—needs to take responsibility for. At some point, the government will charge a specific subagency within that responsibility. That's my hope and my goal. Just to clarify, we're not able to actually set up a commission from a private member's bill.
Jennifer, I share your concerns about not having identified specific groups. I need to tell you it was my intention not to do that, primarily because I was concerned that somewhere down the road we may have neglected a number of groups that were at significant risk. We all know that the aboriginal community is at high risk. You mentioned the LGBT community. We know that the military, and in fact my former profession of dentistry, is at very high risk. We did not address some of those, but we share your concern and we're hopeful that the group who is charged with this will put into place targeted initiatives that will be of help to those specific communities.
Denise, I wanted to thank you for being here. Thank you for talking about your journey and mentioning hope. I certainly agree with Dr. Margaret Somerville, who said,“Hope is the oxygen of the human spirit; without it our spirit dies.” I want to applaud you for talking about it. I can say that speaking openly about our grief is one of the most healing things. I think it's counterintuitive for everybody: they don't want to talk about it. We can say this is one of the most healing opportunities we have, so thank you for that.
Dr. Mishara, you mentioned a number of public health initiatives that could be helpful in reducing suicide. You mentioned Tylenol packaging as an example. You mentioned drugs in the home. I was interested to hear Dr. David Goldbloom say that something as simple as eating with your family can be a long-term protective factor. I think these are the kinds of stories we need to be sharing in our research, in looking at how to carry our long-term strategies into effect.
Dr. Mishara, you mentioned Tylenol and drugs in the home. Could you share two or three other quick examples of public health initiatives that we could be implementing to reduce the incidence of suicide?
Director, Centre for Research and Intervention on Suicide and Euthanasia, Université du Québec à Montréal, As an Individual
I think we've touched upon some of these things in some of the comments. For example, the highest-risk group for suicide is middle-aged men. Middle-aged men call suicide prevention help lines less often. They don't talk to their doctors about feeling depressed. If they seek mental health services, they wait until it's really severe instead of acting immediately. There's been research showing some public health campaigns with some of our male heroes doing what Denise Batters and others have done, that is, coming out and saying, “I was feeling depressed. I was feeling suicidal. I got help.” There's that sort of campaign, which the government does very well when it promotes exercise and other things.
The other area is in mental health promotion, which can start very young in life. Teenagers who kill themselves have a smaller number of coping mechanisms available to them when they're faced with difficult and stressful situations. This is something we don't teach. There are programs running around the world that have proven to be effective in helping children learn how to cope with everyday problems. So promoting these types of programs in schools can be very helpful.
Some of the things...they're just free. If you can buy only 10 Tylenol at a time, instead of getting a bottle of 50 or 100, you're going to save lives in Canada. And the drug companies will make more money. There are things the federal government can do at almost no cost, but it takes knowledgeable people who have the responsibility for making those sorts of proposals.
Conservative
The Chair Conservative Joy Smith
Thank you so much.
I want to welcome Mr. Hsu to our committee. I don't think you've been here before. We're very pleased you're here. You're up next.
Liberal
Ted Hsu Liberal Kingston and the Islands, ON
Thank you, Madam Chair.
I understand this is a private member's bill and there are certain limits on what can be called for in terms of expenditures. As you know, it's not unheard of for the government to take up a private member's bill and turn it into a government bill.
My question is to Ms. Damstrom-Albach and others. Let me thank you all for coming here to testify today.
I'd like you to elaborate on what would be missing if we didn't adopt some of the amendments that have been suggested. In particular I'm interested in collecting data, keeping data, and asking whether we have enough good data—also in not only doing the research to collect data, but having objectives that are measured carefully and monitored to see if policies are working or not.
I invite you to comment on what will be missing if we don't adopt some of these suggested amendments.
President, Canadian Association for Suicide Prevention
You mentioned data. We know that if we were able to provide data on risk, death, and the kinds of impacts on Canadians in a more timely fashion than we're currently able to do, and share that data all across the country, we could see changes in risk factors and in what was going on for people. If there were a way to make sure that was broadly available, I believe it would make a difference.
For example, in Vancouver, where I work on a daily basis in a suicide prevention agency, although we used to think that women were less likely to use what we call “immediately lethal means”, we're seeing the families left behind by young women who are more frequently dying by hanging. Our sense is that's probably going on in other places across the country, but we don't actually have the data on that readily available. It is important to be able to compile that kind of information, share it broadly, and see if that is what's going on, so we can think about what we can do about this.
Another thing we're aware of—and I'm sure many members are aware of this—is that information is now regularly put forward on the Internet that advises people very specifically about how they can kill themselves, what would be lethal for them, and that suggests that people practise. When we look at what's going on for people who die by suicide, it would be really helpful to know in what circumstances people are actively researching lethal methods. Are there ways that have been developed, in Canada or other countries, to intervene effectively in that whole area of social networking and share that knowledge across the country?
The real challenge is that although an enormous amount of good research is being done in Canada and around the world, the mechanisms for making that research broadly available, particularly to grassroots organizations, are not necessarily consistent across the country. Work needs to be done so that front-line providers can take that research and figure out the best way to implement it into practice on the ground where change is necessary. When we focus on knowledge exchange, we have to look much more broadly at the work we do to determine how it's supported so that knowledge gets down to the front line where it can be used.
I think that's where a national coordinating body comes in that is charged with figuring out the best way to make that available to front-line providers and make sure that people on the front lines are learning what they need to learn to make evidence-based changes in practice that will make a difference. That's across the board, whether you're working with older adults, adults, or young people.
Those are some of the key things that I think we need to address in the bill.
Associate Professor and Research Scientist, Department of Psychiatry and Department of Epidemiology and Biostatistics, University of Western Ontario
I might add a few comments as well, speaking as a researcher and as an empiricist. Without clear data, we don't know where we are now. If we don't know the scope of the problem, the full range of the problem now, how will we know if we've had a positive effect or if we've had no effect whatsoever?
Really, in order to be able to assess and then demonstrate the effectiveness of whatever it is we do with our strategies, our approaches, our framework, we have to have a good sense of where we are. And that requires better surveillance, better data collection than we have now.
Director, Centre for Research and Intervention on Suicide and Euthanasia, Université du Québec à Montréal, As an Individual
I could just add that Canada is now moving in the right direction in terms of knowledge application. There's a big emphasis at the Canadian Institutes of Health Research on knowledge application.
The issue, again, is leadership and knowledgeable leadership. The example is that there's $300,000 that I feel is wasted, with good intentions to do some literature reviews, which already exist and which other people have done in the last year. It's just a question of not making strategic decisions in leadership.
Canada exports its expertise in suicide prevention. When the United States government, which supports a national network of suicide prevention help lines, was looking to have those evaluated, our university in Quebec got the mandate to do this, and from our offices in Quebec we listened to 2,611 telephone calls to stress centres across the United States.
But we don't have a national network in Canada to evaluate, and the government does not support such a network. It's a question that whatever funds are already out there should be used strategically to do things that will have an impact. As I mentioned, a lot of the things we can do don't cost anything.
Conservative
The Chair Conservative Joy Smith
Thank you, Dr. Mishara. Those are very good comments.
I will now go to Mr. Brown.
Conservative
Patrick Brown Conservative Barrie, ON
Thank you, Madam Chair.
Denise, it's great to have you before the health committee. I had the pleasure of sitting on the health committee with Dave during my first term for a few years, and he was always hilarious. He always made meetings entertaining, regardless of the subject. It certainly is a tremendous loss to not have him.
I know you mentioned that he talked about stigma, and that seems to be one of the biggest obstacles when we discuss mental health.
I had the pleasure of attending a mental health meeting in Barrie last week because they're planning a golf tournament fundraiser in June, where they're going to have Shayne Corson, the former hockey player, talk about his depression as a means to.... Their slogan is “Let's Talk”; there needs to be more discussion around mental health. My question is this. What can we do to encourage those discussions? Obviously dialogue is going to help to bring down stigma.
I was thinking back to last summer. I know Mark Strahl mentioned Rick Rypien's death at our last meeting. I know there were also Derek Boogaard and Wade Belak who were front-page stories. If there's a silver lining in those tragedies, it's that it put more awareness than I can recollect on mental health. It was a front-page story for several days in the Toronto area with Wade Belak. It shocked people, because you saw people who were successful, talented, like Dave, who you'd have never thought in your wildest dreams would be suffering from mental health challenges.
What do you think we can do, as a federal government, to try to break down this stigma in particular, to make people more comfortable with having those conversations and asking those questions and seeking help?