Health Committee on May 12th, 2015

[Louise Bradley]

We don't. The commission does not have that. The indicators report that I was talking about earlier is us more or less mining the data that is existing in the country.

Your point is certainly well taken about first responders. We are targeting that group and are doing interventions with regard to that, so I can speak to that quite well.

[Murray Rankin, NDP, Victoria, BC]

Okay.

We had testimony this morning from the Public Health Agency of Canada. In their report they say that the agency invests $112 million a year in community-based programs. We've heard from Health Canada about some of the programs they are running, and there's Veterans Affairs on post-traumatic stress. Now we have the Canadian Mental Health Commission and its attempt to create a national strategy, if I'm understanding you properly.

To what extent will your work supplant the work that's already being undertaken by these other agencies? In other words, do you see yourself within the Government of Canada playing a coordinating role?

[Louise Bradley]

Well, we already are playing a coordination role, and the strategy is well in place. It is now reflected in approximately nine of the thirteen provinces and territories, so that work is well under way.

The strategy was actually developed with the consultation of thousands of people, including our important stakeholders, such as the Public Health Agency, Health Canada, and others.

One of the key pieces of the work we do is that everything we do is done in collaboration or partnership with somebody else. In fact, we have well over 250 partnerships. We have been asked to continue that role by our stakeholders, and by the provincial and territorial governments.

We have only been in existence for eight years. We've achieved a great deal, but I think we're headed in the right direction.

So the short answer is yes, there is a strong coordinating role for the commission. It's one we've begun and we hope to continue.

[Murray Rankin, NDP, Victoria, BC]

You're doing excellent work, and I commend you for it.

I want to ask you to speak a little longer, in the one minute I have left, about the important analysis you did on the At Home/Chez Soi program and housing first, which is hugely important in the community I represent. Could you talk a little more about some of the insights you've gained?

[Louise Bradley]

This was the largest research demonstration project in the world on homelessness and the mentally ill. I could take up the rest of our time here and then some talking about it, but one of the key pieces we have learned from that is the idea of recovery. My colleague from Public Health commented earlier on the whole issue of recovery and hope, and that is nonetheless important, in fact, even more so in our northen communities.

We have certainly learned, because we studied, that these were probably the most chronically ill people in this country. We had close to 2,000 participants in the program. It was highly successful. If we can show that there is hope and support and a change in the way that people live their lives in that population, then there surely is the same for the rest of the country.

[Murray Rankin, NDP, Victoria, BC]

Thank you for your excellent work.

[Louise Bradley]

Thank you.

[The Chair, Conservative, Ben Lobb]

Next up is Mr. Young.

Sir, go ahead.

[Terence Young, Conservative, Oakville, ON]

Thank you for being here today.

Ms. Bradley, any discussion of mental health ends up being about suicide and also ends up being about substance abuse, addiction, and prescription drugs. There is a whole range of prescription drugs that are known to cause suicide. The acne drug, Accutane, is one of them, but most of them are antidepressants, and all the big pharma companies have at least one SSRI and SNRI.

Antidepressants are well known to cause serotonin syndrome, which is agitation, rapid heartbeat, seizures, and death, if you happen to suffer from that. They cause alcohol and drug abuse. They cause suicide. They cause bizarre acts of violence. In every school shooting that I have researched, the shooter was either on antidepressants or was withdrawing from them. These things generally do not get covered in the news. In fact, the German pilot who just crashed a jet into a mountain in Europe was taking antidepressants. He intentionally did that.

The U.S. military in Afghanistan had more suicides than soldiers who died in battle. That was also true of the British military in 2012, more soldiers dying of suicide than being killed in battle. It was the same with the Australian defence force, more suicides than soldiers dying in battle. U.S. veterans coming back from Iraq at one point were committing suicide approximately one every hour, so it was about 22 a day, and apparently, one out of four soldiers in Iraq was actually on antidepressants while in battle or they had been taken off the battlefield.

During that time, which was 2001 to 2009, the military orders for antidepressants from the drug companies went up 76%.

These are pretty stunning figures, and of course, no previous wars had any number of suicides like this. Of course, they didn't have antidepressants during the Vietnam War or World War II. However, the correlation between antidepressants and suicide is quite obvious, yet no one is talking about it and no one is doing anything about it.

Our authorities are sitting back and watching it happen. Our military doctors are dishing out these drugs and watching the soldiers go into battle on drugs that say right on the label they might make you suicidal or violent, and they cause psychotic reactions that result in suicides and murders, especially when soldiers come home. The most dangerous time is when you stop taking the antidepressants or when you increase the dose, which I guess sometimes happens when soldiers come home.

Now antidepressants are prescribed very widely in Canada. In some age groups, one out of four Canadians is on an antidepressant. We're the third-highest users in the world of antidepressants.

I want to ask you whether anyone has, to your knowledge, conducted research on the correlation between people who are on antidepressants or have been on them and are withdrawing from them and suicide.

[Louise Bradley]

I can't really speak with any authority on this specific topic. My background is mental health nursing, but I can say just as my own personal opinion that it's not surprising that people who die by suicide have been taking antidepressants, since there's such a large correlation between people who are depressed and who die by suicide. So that isn't—

[Terence Young, Conservative, Oakville, ON]

Well, I've heard this argument before many times. It's what the doctors say. I'm talking about a product that says right on the label.... If it was in plain language it would say, “This drug might make you want to kill yourself”. One of them, I think it's Effexor, says that this drug can cause homicidal ideation. In plain language that is that this drug might make you want to kill others.

They're dying of suicide after taking drugs that warn of suicide, and everybody says, “Oh, they were depressed.” It just doesn't make any sense, so I wanted to ask you, why the denial?

[Louise Bradley]

I'm not aware of any particular studies. That isn't to say there isn't one occurring, but that isn't part of the specific mandate of the commission. But if it is part of the cause of suicides in this country and elsewhere, you're right that it has to be studied.

I will add also that I have seen people very close to me as well as people I have had as patients whose lives have been saved through the use of antidepressants.

[Terence Young, Conservative, Oakville, ON]

That's the drug company line. That's what they always say: they save a lot of lives. They can't prove it, but they say it, so I've heard it a lot.

I knew Sara Carlin, who in 2007 started taking Paxil, reacted to it, and started taking drugs, which is part of the abnormal behaviour listed right on the label of the drug. She quit her hockey team, quit university, and got into cocaine. One night she came home at two o'clock after a drinking bout and hanged herself in her parents' house. There was no doubt that Paxil was the contributing factor. In fact, right on the label it says that Paxil might cause suicidal ideation.

[Louise Bradley]

I think your point is well taken. Part of the study that we are recommending, or part of the project that we are looking at implementing, looks at the whole issue of access—

[Terence Young, Conservative, Oakville, ON]

Access or—

[Louise Bradley]

Access to means, so it's anything from bridge structures to—

[Terence Young, Conservative, Oakville, ON]

Okay, I'm talking about how doctors hand it to people, tell them it's safe and effective, and they commit suicide.

I'd like to make a recommendation for consideration by you today, that you investigate anything you're involved with. You have this situation, investigate it thoroughly from unbiased sources, not doctors who work for drug companies or get paid on the side from drug companies, look at the correlation with suicides. I think, and I've been studying this for 14 years, there's a direct correlation. I think it's obvious, and the people who are prescribing the drugs and the people who are selling them are in denial because they're making so much money selling those drugs.

[Louise Bradley]

Okay, the issue of suicide is certainly a very complex one and a very important one, and we'll certainly take that into consideration as we go forward. Thank you.

[The Chair, Conservative, Ben Lobb]

Thank you, that's right on time.

Ms. Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Before I ask any questions, I want to congratulate the Mental Health Commission of Canada on the excellent work you've done in eight years. In eight years you have improved outcomes in mental health more than any other thing that has ever been done in this country in the last eight years.

I was going to ask you a question about a 10-year renewal of your mandate, whether or not you knew what resources were going to be given to you, and how you were going to be able to move forward on that. You say you are currently speaking with the government, so I won't put you in the difficult position of asking you a question like that.

Again, At Home/Chez Soi and all the work you've been doing in decreasing stigma has moved things miles in the last few years. Do you do any work on bipolar disorders with groups like the Schizophrenia Society and work with people who have a pathology? If so, perhaps you can tell me what you see as the next step that one should take in dealing with not simply the hospitalization of people with pathological problems, but also the ability to look at how we can support them instead of—as we know some provinces are considering doing—going back into institutionalization, which everyone knows was not the answer. Have you done any work on that? What do you see as good recommendations with these particular groups?

The second thing I want to ask you about is the absolutely severe policy with respect to the very few people in this country who are in prison because they committed a crime of violence because of mental illness, and the whole concept that these people should be locked up and the key thrown away. Have you done any work with people who are in correctional institutions and who have a concurrent mental illness?

I wonder if you could tell me about anything you know about both of those areas and what you see as a recommendation for dealing with them, and what you see as the biggest challenges right now to moving that agenda forward.

[Louise Bradley]

With regard to the Schizophrenia Society of Canada and the various ones in each of the provinces, we do work quite closely with them. We work very closely with the Mood Disorders Society of Canada along with the, I think, 17 members of CAMIMH, the Canadian Alliance on Mental Illness and Mental Health, and I know that you're familiar with that. So, yes, we work very closely.

We have stayed away to some degree from specific diagnoses, although there's a recognition that schizophrenia and bipolar disorder are among the more complex and more difficult diagnoses to deal with. The one thing all of these have in common are issues like stigma, and so they have been part and parcel of the Opening Minds initiative that we've been carrying on since the beginning of the commission. We are continuing to do so with a focus on children and youth, the workplace, health care professionals, and the media. Certainly the way that media reports deaths by suicide and so forth is something that impacts all of these organizations. While we haven't taken a particular diagnosis or diagnostic category, we do work very closely with all of them and we know them all extremely well.

With regard to corrections or prison health, which I think you were referring to, and concurrent disorders, we know there is a much higher incidence of people with mental illnesses and substance use problems in the corrections population both provincially and federally. I'm hoping that during the next phase of the commission we may have an opportunity to look at that a little more closely. As I mentioned, we do have a large number of stakeholder groups. We've made more progress with some than with others. Going forward, that is a very large number, when you combine all of the provincial and federal institutions and then the people in the community who it impacts. We do recognize that it's an important area. We haven't really made that much headway, but we have been devoting our efforts to other areas. Certainly with At Home/Chez Soi, we followed the progress of that population as they went through the justice system including corrections, so in that one area I would say we have made some progress, but we do need to do further work.

[Hedy Fry, Liberal, Vancouver Centre, BC]

What do you see with regard to the challenges facing a lot of people with psychoses who are coming out of, say, hospitalization and needing support systems in the community? What is your recommendation with regard to that? Institutionalization is not it.

[Louise Bradley]

I think I mentioned the three areas that we need to focus on. One is the integration of services and I think that's true for anybody who's coming out of a program, particularly an institutionalized one. There needs to be a conduit and a clear handover to community services. You'll note that in the strategy, the last part deals with access. Certainly that is something that I think, as a commission, we are going to have to pay more attention to going forward. It's one thing to say that these people should be referred to a community program or community service, and because we're breaking down the barriers of stigma that people are going for services more, but if they don't exist, they can't access them. It is an extremely important integration so that it isn't broken and so that they are able to follow up their care in the community, be it through primary health care, collaborative care centres, mental health centres, or otherwise.

[The Chair, Conservative, Ben Lobb]

Mr. Albrecht, go ahead sir.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Thank you to the commission for your work and for being here today.

Before I get into my questions, I have noticed an error. On page 3 of your briefing notes, I think there's a word that should not be there. In the passage “reducing suicide prevention by 24%”, the word “prevention” does not fit in that sentence. It should be “reducing suicide”, not “reducing suicide prevention”. That's just in case it's in the record forever.