Evidence of meeting #138 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was gay.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Travis Salway  Post-doctoral Research Fellow, School of Population and Public Health, University of British Columbia, As an Individual
Alex Abramovich  Independent Scientist, Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, As an Individual
Greg Oudman  Executive Director, Health Initiative for Men
Tristan Coolman  President, Pflag York Region

4:20 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

Okay.

I'm struggling to understand how parents can do this. How can they expel their loved ones like this? I don't grasp this. Could you give me some insight?

4:20 p.m.

Independent Scientist, Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, As an Individual

Dr. Alex Abramovich

Sure, absolutely.

It's really tough to wrap your head around this, absolutely, especially given how high the rates are.

We know that family conflict is the number one cause of youth homelessness across the board, regardless of a young person's identity, but for LGBTQ2S youth, it has to do with identity-based family conflict. For a lot of these young people, perhaps they were living in a home where there was family conflict for years, and then as soon as they came out as trans or lesbian or gay or bi, it came to a situation where either they were kicked out or were forced to leave home because of the conflict. It's really about identity-based conflict when a young person comes out. That is the leading cause.

4:20 p.m.

Liberal

The Chair Liberal Bill Casey

Okay, we have to move to Ms. Gladu now, for seven minutes.

4:20 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Thank you, Chair, and thank you to the witnesses.

I'm going to start with Alex.

You talked about a program that was in place in Toronto at the YMCA's Sprott House.

4:20 p.m.

Independent Scientist, Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, As an Individual

4:20 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Can you describe what that looks like and how it's different from what everybody knows as the YMCA?

4:20 p.m.

Independent Scientist, Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, As an Individual

Dr. Alex Abramovich

Yes, absolutely.

Sprott House is a 25-bed facility. It's a transitional housing program. It's more of an independent-style housing program. It's not an emergency shelter. If a young person has just been kicked out of the home, finds his or her way to Toronto and needs a place to sleep right then and there, that's not what Sprott House offers. You have to apply for the program. You have an interview, and then you come to the program. It's not as quick as an emergency shelter. There are currently no emergency shelters for LGBTQ2S youth.

Young people can live at Sprott House for up to two years. They have case management and a variety of different life skills programs that young people are able to attend. All of the staff who work there are either LGBTQ2S-identified or have a very strong understanding. They have received quite a bit of training.

All of the programs they have designed are really focused on an LGBTQ2S lens. For example, the forms that are filled out when a young person enters a shelter or a housing program generally do not include LGBTQ2S youth, but that's a difference at a place like Sprott House where everything is really done with the idea of LGBTQ2S youth at the centre of all the services, all the forms, everything they offer.

4:20 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Okay, very good.

Did I understand you to say that there are 40,000 homeless LGBTQ folks across the country?

4:20 p.m.

Independent Scientist, Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, As an Individual

Dr. Alex Abramovich

No. There are 40,000 young people experiencing homelessness across the country, and 25% to 40% of those youth identify as LGBTQ2S.

4:20 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Okay, very good. Thank you.

Greg, I want to talk about your comment that if the STI clinics had mental health supports there, people would feel comfortable to talk to them. What kind of mental health supports are you recommending, and what's the state of the nation in terms of the number of STI clinics across the country?

4:20 p.m.

Executive Director, Health Initiative for Men

Greg Oudman

Health Initiative for Men operates five health centres throughout the Lower Mainland that provide HIV and STI testing. We've developed an integrated approach at our health centres where access to our mental health programming, which I've described as well, is available through those health centres. I believe Travis undertook a study that included the health centres that Health Initiative for Men operates, as well as some other STI clinics in the Lower Mainland, and found that 28% of the respondents identified as having an unmet need, and 83% of those identified as being open to accessing mental health programming.

I think what we saw through that study was that because STI clinics are already in existence, it's a perfect opportunity to expand the purpose of those health centres or those clinics to potentially provide access to mental health supports through those health centres as well. We've done that within our five health centres in the Lower Mainland, and the response has been overwhelmingly positive.

4:25 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

We heard this same comment when we visited the Nine Circles clinic in Winnipeg.

You talked about queer-focused suicide prevention. How is the suicide prevention training different from what would be suicide prevention training rolled out across the board?

4:25 p.m.

Executive Director, Health Initiative for Men

Greg Oudman

Actually, I'm going to see if Travis would speak to that because that's his area of expertise rather than mine.

4:25 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

He was my next stop anyway, so sure.

April 9th, 2019 / 4:25 p.m.

Executive Director, Health Initiative for Men

Greg Oudman

I can speak about it a little bit.

You've heard mention both today and from the other presenters who have spoken to your committee about the specific, unique needs of LGBTQ-identified folks. I think those same unique needs also apply to the sphere of mental health. We have found, again through research and through practice, that suicide prevention programs that have a specific focus on LGBTQ2 folks, even in terms of increasing the level of competency among mental health service providers in terms of their counselling, have proven to be more effective.

4:25 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Travis, do you want to chip in?

4:25 p.m.

Post-doctoral Research Fellow, School of Population and Public Health, University of British Columbia, As an Individual

Dr. Travis Salway

Yes, absolutely.

Of course, suicide in particular and other mental health topics as well are stigmatized for everyone. There is a reluctance to open up. There is a reluctance to confront it head-on. You might imagine that for folks like sexual and gender minorities who have a history of feeling the need to hide, conceal or withhold, you have a double layer of stigma. What this means is that both where we end up, in terms of migrating to communities that are more sexual or gender-minority affirming, and where we turn up for services will look very different. This means that sometimes we need tailored strategies.

I work as part of a study team in Vancouver called Still Here. It's a study of experiences of suicide with LGBTQ2S people. It's led by my colleague, Dr. Olivier Ferlatte. In that study we found that when we actually did photo exhibitions with art-based approaches and got LGBTQ2S people together, there was a little more comfort in talking about the levels of suicide in the community.

Apart from those spaces, or apart from queer-focused or queer-affirming suicide prevention services, there is a tendency to want to withdraw, to be reluctant. In fact, when we talk about some of these statistics within LGBTQ2S communities, often people are either surprised or want to shy away from it, maybe because they feel like there's already a point against them, and they don't want to be doubly stigmatized.

4:25 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Right, but do you think that people would go to suicide prevention if it were—I don't know how you'd call it—a queer-oriented suicide prevention? Would there not be fear, for those who are afraid of coming out and all that kind of stuff?

4:25 p.m.

Post-doctoral Research Fellow, School of Population and Public Health, University of British Columbia, As an Individual

Dr. Travis Salway

Yes. The way to deal with that is to have that training led by organizations with strong histories of doing good work with queer communities.

You're right, though. We need both approaches. It won't reach everyone, so we need a general suicide prevention approach—a universal prevention strategy and a targeted strategy. With both of them we would hope to reach the people who need them.

4:25 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Thank you.

4:25 p.m.

Liberal

The Chair Liberal Bill Casey

Thank you very much.

Now we go to Mr. Davies.

4:25 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you.

Mr. Coolman, we were in Calgary, and I was struck by the words of one of our witnesses. He said that he hasn't come out once; rather, he has to come out 10 times every day. He was talking about the fact that every time he or friends of his in the gay men community intersected with the health care system, there was always this trepidation or feeling that they had to reveal something. In particular, he said that once it was revealed that they were gay, they were often asked stereotypical, assumptive and presumptive questions that were actually inappropriate for the malady they were presenting with.

Do you have anything to tell the committee about that?

4:25 p.m.

President, Pflag York Region

Tristan Coolman

Yes. It makes me think of a story that was shared with the committee in February of someone who went to a clinic and asked for their chosen pronouns to be used. They weren't used and they were not respected.

There is a variety of reasons this could be happening, whether it's a lack of respect for the community or for how people identify themselves. The motivations behind that are 100-fold. That's why I spoke to allyship today. It's because those behaviours really shape how you interact with anyone in your daily life. That's something that really needs to be promoted. In addition to all the recommendations we talked about today, those behaviours are really what are going to drive change.

4:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Is the experience you described common?

4:30 p.m.

President, Pflag York Region

Tristan Coolman

Oh yes. For me, I come out every day at work. I'm an IT professional. I take appointments to fix people's devices. Once a day there's someone who asks me if I have a girlfriend or kids. I come out unabashedly to them to prove the point that there's really no reason to assume that nowadays.