Health Committee on May 14th, 2015

[Dr. Padraic Carr]

For psychology, psychiatry, and mental health teams, the whole gamut. It's all important and we all work together.

[Terence Young, Conservative, Oakville, ON]

Because I've seen many times that they make patients wait six months to talk to somebody when they really need talk therapy.

[Dr. Padraic Carr]

We need more timely access to health care, no question.

[Terence Young, Conservative, Oakville, ON]

Yes.

Thank you, Chair.

[The Chair, Conservative, Ben Lobb]

Thank you, Mr. Young.

Next up is Mr. Bevington.

Go ahead, sir.

[Dennis Bevington, NDP, Northwest Territories, NT]

Thanks, Mr. Chair.

I have a couple of topics I want to talk about and I have five minutes, so it's going to be pretty quick.

PTSD is in the news today because many soldiers are self-medicating with marijuana. The minister has said that she doesn't believe that this is good or that it works. What are your opinions on this? Also, how should we come to a conclusive understanding of the nature of this particular drug for mental health issues?

[Dr. Padraic Carr]

At present, medical marijuana is not indicated for any specific psychiatric illness. For PTSD, the standard treatment is usually specific serotonin reuptake inhibitors and psychological and social therapies.

All I can say is that it's not indicated at the present time.

[Dennis Bevington, NDP, Northwest Territories, NT]

Right now, 6,500 soldiers are using it under medical licensing.

[Dr. Padraic Carr]

All I can say is that there's no medical indication for that.

[Dennis Bevington, NDP, Northwest Territories, NT]

Do you think there should be a process to understand it?

[Dr. Padraic Carr]

You know, I think it bears study. There are difficulties with doing those studies in terms of making sure that the product is uniform throughout the study and that the methods of implementation of it are uniform, but it would have to be done under very controlled circumstances and by professionals.

[Dave Gallson]

I was diagnosed with PTSD in 1990 after I was hit by a car. It took me eight years to acknowledge that I had a mental illness. It took me a lot more years after that to go for treatment.

My treatment of choice was not marijuana. At that time, it was alcohol. It wasn't because I wanted to get high or anything like that. It was just because I wanted to bury the thoughts and just pretend I didn't exist. That, from my experience in working with many, many people with PTSD, is often the root cause of being on marijuana or anything else. It's that they want to hide their feelings just for a little while and just escape for the time being. There are a lot of things at play, I believe. That's the way I felt about it.

[Dennis Bevington, NDP, Northwest Territories, NT]

Well, after the Second World War, the Legions, with their alcohol on a Friday night, worked very well to give relief to many veterans with PTSD, which we didn't recognize. You can be sure of that.

[Dave Gallson]

Yes.

[Dennis Bevington, NDP, Northwest Territories, NT]

That was one of the key treaters of our veterans from that conflict.

Now, when it comes to suicide in the north, there's an epidemic of suicide up there. There's one statistic that I note from the north. When you look at the per capita expenditures on health throughout the north, especially in Nunavut, per capita expenditures on drugs are less than half the national average. The national average is between $1,000 and $1,200. In Nunavut, it's between $400 and $600.

Has any work been done on the correlation for remote and isolated communities where they simply have no access to the kinds of drugs you're talking about? They have no access, no follow-up, and no kind of treatment at all. Could we recognize that as a potential problem in this epidemic of suicide, where the rates in Nunavut are 10 times the national average?

[Dr. Padraic Carr]

I'll start. I don't know of any specific study looking at the north and lack of access to drugs. Certainly there are a lack of resources in the north. That doesn't include medications only, but also lack of psychological services. It includes lack of health care teams in the community. That's understandable. They are isolated communities and there aren't the same resources as there are in the city. When people have fewer resources, they certainly tend to do less well.

I also used to work in Yellowknife on a part-time basis, as a consultant psychiatrist. The federal government paid a lot of money to sometimes transport people to Yellowknife to be assessed by me and to be seen, but really that access isn't there for everybody. It's very difficult for people to get a lot of the services they need.

I can't speak specifically to a lack of access to drugs. I'm really not aware of the entire scenario there, but I know their services are less and they can experience more difficulties as a result.

[Dave Gallson]

We get emails from people almost daily, and they don't have to be all the way up there. I received one the other day from Gillam, Manitoba, complaining that they have absolutely no service, no access to care, and so on.

I think we also have to look at care as being more than just going to see your doctor, or more than just seeing a psychiatrist or psychologist; it's also peer support, it's also access to people who have been through it themselves and are there to listen.

A lot of times a person will really benefit from hearing somebody, being allowed to share their experiences with another human being who has been through the same thing. So I think we have to expand our concept of what care is.

[The Chair, Conservative, Ben Lobb]

Ms. McLeod, we have about a minute and a half or two minutes. Would you like to add a question?

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

Absolutely.

[The Chair, Conservative, Ben Lobb]

Okay. Great.

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

Thanks.

First I want to make a note. I think there was a comment made about research. Many of my colleagues had a chance this morning to attend a special breakfast by CIHR, which was honouring four people from McGill who had done absolutely amazing work. It was quite eye-opening in terms of the optimism that we can feel as we look toward ultimately to finding some real cures, opportunities.

Another trip I have made recently was to UBC's Centre for Brain Health, where I again saw the work that's being done. We're really on the cutting edge, I hope, in terms of some really positive things into the future.

I only have about a minute so I'll make it a quick question. Mr. Phelps, you talked about how we should implement the workplace standards, and I don't disagree because I was really significantly involved with the psychological health and safety in the workplace.

Sometimes, should we not wait until these...? We have 40 organizations who are doing a study. Are you saying that people should be doing lots of uptake now, or should we really be asking, how is this standard working for those 40 that have embraced it, and to wait for the actual results of the study?

I guess that's my quick question.

[Fred Phelps]

It's a very good point. I think the Mental Health Commission of Canada has done a lot of work to get the workplace mental health standards into place. I think there was research in developing them, and I think because they are there, implementing them as best practices would be what we would like to see....

I could see some research coming from those organizations that are doing it, but I would think the uptake and the recommendation from CAMIMH would be that the uptake be taken now, yes.

Glenn.

[Glenn Brimacombe, Chief Executive Officer, Canadian Psychiatric Association]

The other piece is that the Public Health Agency of Canada is already looking at how they can take those standards on a pilot basis. You can't boil the ocean in the sense of having those standards driven across the government en masse, but you can start somewhere, and a good place to start, it seems, is the Public Health Agency.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

This will conclude our first round, our first panel. We'll suspend for a couple of minutes to allow you folks to leave. You can stay if you want. We'll bring in our next panel, and we'll be back in a couple of minutes.

[The Chair, Conservative, Ben Lobb]

Welcome back. We have another panel to go.

First up, we'll have Mr. Marks from the International Association of Fire Fighters.

Go ahead, sir.