Health Committee on Oct. 17th, 2011

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much.

Earlier on, when we were talking about all of the aspects that lead to and impact on chronic disease and aging, we talked about the physical ailments and the neurological issues and part of the biological problems. We talked a little about the mental issues, but we didn't flesh out the mental issues.

For instance, it's my understanding from some of the recent studies that many seniors, because of isolation, etc., are quite depressed. In fact the suicide rate among seniors is extremely high, and when they attempt it, they usually are very successful. How do you see this?

As we talk about gaps in services, you mentioned that Canadians didn't want gaps in their services; they wanted to see it seamless. You can't just say “I'm sick; look at me now and then ignore me for the rest of the while, or only see this part of me and ignore the other part of me”. We know it's all a very interrelated and complex thing.

We don't have services for mental health. If you break your arm, you can go to an emergency room and get something. If you have a mental illness, you are struggling to find resources. So how do we look at this very at-risk group for mental illness, and how do we deal with this in a real way? What are the ways you see us dealing with the mental health component of this? Because we don't have a lot of psychiatric nurses in the community. We don't have a lot of psychiatric nurses, period. We don't have a lot of family doctors who understand how to deal with depression and aging. That's a huge gap. How do you see us filling it?

[Dr. John Haggie]

I think you have to take mental illness out of the closet, quite honestly. People go to work and they say they've taken three days off because they twisted their ankle or they've got a cold or a runny nose. No one's going to say they had a bout of depression and took to their bed for three days or they drank themselves into a stupor because they're depressed, they're unhappy. They're not going to do that.

Until you can start to destigmatize what is a huge issue for a lot of people, you can't even begin to talk about it. I think merely accepting and actually announcing it's an illness and actually acknowledging that we need to deal with it is a huge enabler—it's not because you're weak or spineless or you're just having a bad day. Really and honestly, it's not in the publicly funded system.

Unless you go and see a psychiatrist referred by your family doctor or you pitch up in the emergency department having slashed your wrists or taken an overdose, chances of your accessing acute psychiatric care are slim. So the first step has got to be acknowledging you've got a problem. There's an epidemic out there of people killing themselves.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Perhaps Barb might be able to do this, and maybe Dr. Molnar.

One of the things is that we're not trained. Very few people are trained to recognize early signs of depression, early signs of mental illness. Is there a training that is necessary? Is that a huge piece of it, training social workers, community care persons, nurses, family doctors, various other people that come into contact with a patient in the community?

[Barb Mildon]

Thank you so much for raising such an important issue, and I want to thank the federal government for its work with the commission on mental health. My day-to-day job is at Ontario Shores Centre for Mental Health Sciences, in Whitby, Ontario, so it's a subject that's very dear to my heart.

We know that one in five Canadians suffers from a mental health illness. We were having great success across the age continuum with using peer support in the schools. This week at our facility, we've partnered with Dr. Stanley Kutcher, from Nova Scotia, to put education modules into our public schools so we can begin the education and awareness raising right at that stage, and from there, right on up.

I certainly agree with you that there are other services that can be done, and there is more that can be done to raise awareness across the continuum.

[The Chair, Conservative, Joy Smith]

Dr. Ricketts.

[Dr. Maura Ricketts]

I want to mention three initiatives I have become aware of, to demonstrate that there is so much room for something to go so much better with mental health care. The first one is the understanding of how successful cognitive behaviour therapy is. That can be provided by non-physicians, yet we don't pay for the non-physicians to do that work. I think it's a big gap in our system.

The second thing is that when you have an integrated clinic and a number of different kinds of staff—some of whom are on salary and some aren't—you end up with opportunities, such as nursing staff, who can phone patients who haven't shown up for care to have them come in to make sure they're taken care of. I think that's a wonderful thing.

In terms of training, in Alberta—I'm not sure if it's Edmonton or Calgary—to train young medical students on how to better work with people with mental illnesses and how to avoid stigma, the evidence is that there is only one way to do that. You can't teach it by providing people with books. You have to get out, you have to actually work with people who have severe mental illnesses.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Ricketts. We only have two minutes more.

Mr. Brown, two minutes.

[Patrick Brown, Conservative, Barrie, ON]

I'll do a quick question that I wanted to touch upon.

Dr. Molnar, you mentioned the 500,000 Canadians, and 100,000 new ones a year, with Alzheimer's. I want to know where that figure comes from. I'm curious. One of the things the population study was asking for was that we were extrapolating our numbers; we didn't know for sure how many Canadians had fallen ill with this disease. One thing they said is that the study would give us a clear indication of how extensive it is. They said the numbers they were using were simply extrapolations based on U.S. numbers, given that Canada is 30 million.

Where are those figures from? It is a powerful reason for why there needs to be help.

[Dr. Frank Molnar]

It is an extrapolation from a number of studies, from American studies, from the Canadian study of health and aging, which is the largest study of dementia in the world. It is an extrapolation of those studies.

But I agree, the next step is to do the neurological study you're talking about to try to get harder numbers. The scale is probably not going to be that far off; I imagine it would be more precise than high.

[The Chair, Conservative, Joy Smith]

Thank you so much. Maybe that's something we can keep in mind and bring Dr. Molnar back again during our neurological studies.

This has been an extremely fruitful and insightful dialogue, and we want to thank you very, very much for bringing your expertise here today.

Ladies and gentlemen, the committee is adjourned.