Evidence of meeting #55 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was trauma.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Anne-Marie Ugnat  Executive Director, Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada
Jitender Sareen  Professor of Psychiatry, University of Manitoba, As an Individual
Natalie Harris  Advanced Care Paramedic, County of Simcoe, As an Individual

1:15 p.m.

Liberal

Darshan Singh Kang Liberal Calgary Skyview, AB

I agree with you, but my concern is that we don't want to do this piecemeal. If we can broaden it as much as we can now, we won't have to come back and maybe address this issue in the near future. There may not be another opportunity for a long time to come.

If we could broaden it and include other people who could be suffering from PTSD, I think that would be a good idea, and I would request Mr. Doherty to look at that.

That's my concern. Do you agree with me on this?

1:20 p.m.

Professor of Psychiatry, University of Manitoba, As an Individual

Dr. Jitender Sareen

I don't know enough about the process, but I agree with you that PTSD affects many Canadians, and limiting it in some ways can be a challenge.

I think one of the important things to consider is that this is a work-related mental health issue. It brings a different framework to it if the violence or assault is not at work. I think it really advances, step by step, moving from military and veterans to public safety officers. I'm all for recognizing the importance of PTSD across the different groups, but I think the challenge there could be that if you're trying to bring together indigenous groups and refugee groups, and you're looking at trauma and PTSD, it requires a different approach than if you're just dealing with issues from around the workplace. That's why I'm seeing it as requiring that level.

1:20 p.m.

Liberal

The Chair Liberal Bill Casey

Now we'll go to Mr. Davies for three minutes.

1:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Dr. Sareen, I want to pick up on that. I think everybody around this table is very supportive of this bill. What is becoming somewhat clear to me is that there's a discrepancy between whether this bill is meant to create a federal framework on post-traumatic stress disorder for work-related PTSD or whether it's to create a federal framework for post-traumatic stress disorder, period. There are indications of both in the bill. The description of the bill indicates that it's for all Canadians who suffer. Then there are certain limiting words that seem to indicate that it's only for people who experience work-related PTSD. That's something that I think this committee will have to go one way or the other on.

It seems to me that there may be some differences between, for instance, first responders or paramedics or firefighters who experience trauma daily, weekly, or on an ongoing basis versus someone who may have an episodic PTSD function—a woman who's raped, a child who witnesses her parents being murdered. It is no less traumatic, I would imagine, and it can lead to the same condition, but I would imagine that perhaps there are some separate considerations.

Can you help me understand whether these things ought to be separated or whether a federal framework can be constructed to broadly encompass all of those different causes of PTSD?

1:20 p.m.

Professor of Psychiatry, University of Manitoba, As an Individual

Dr. Jitender Sareen

I think a broad framework can cover the range. There is now more recognition in the American Psychiatric Association's diagnostic and statistical manual. The most recent edition added the criteria of trauma exposure related to work. Before that, it wasn't really recognized. Repeated trauma exposure among paramedics, firefighters, or the police wasn't part of the criteria. They've now added that because it's recognized.

You're absolutely right that it can have different impacts if someone is exposed to repeated trauma as part of work and if someone has a motor vehicle accident, and they're reliving the experiences. I'm—

1:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Dr. Sareen, could I interrupt? I'm going to run out of time.

I want to get your views on a third category. I'm thinking of refugees and veterans, refugees who are often fleeing conflict or war zones. I'm thinking of someone in Syria who has been in Aleppo for three years and who would have been subjected to exactly the same kind of trauma and violence as a veteran or a soldier would have been. That would not be work-related trauma, would it?

1:20 p.m.

Professor of Psychiatry, University of Manitoba, As an Individual

Dr. Jitender Sareen

No.

This goes back to the point that PTSD is PTSD across the different populations, but certain types of work put the person into the situation over and over again.

Senator Roméo Dallaire talked about the helplessness in observing and not being able to respond to the terror he saw in Rwanda.

I think there is a bit of a difference with a worker exposed to trauma and feeling survivor guilt or responsibility for doing something, or not doing something, that could have prevented death or injury.

1:25 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you, Dr. Sareen.

1:25 p.m.

Liberal

The Chair Liberal Bill Casey

Time is up.

That completes another amazing meeting of our health committee. We appreciate the witnesses very much for their contribution.

I want to clarify a few things with Ms. Harris. You have a uniform. Are you sure you want to part with it?

1:25 p.m.

Advanced Care Paramedic, County of Simcoe, As an Individual

Natalie Harris

Absolutely.

Again, it is an honour for me to choose where I hang up my uniform. It's a part of my recovery. It's really an honour that I have that opportunity.

1:25 p.m.

Liberal

The Chair Liberal Bill Casey

Our esteemed messenger Mr. Dan Dumais has proposed.... He has a bag for it, a container for it. He has proposed that all the members of the committee sign it. Then when the bill passes, we will present it to Mr. Doherty, at your request.

1:25 p.m.

Advanced Care Paramedic, County of Simcoe, As an Individual

Natalie Harris

That is wonderful. That would be great.

Thank you.

1:25 p.m.

Liberal

The Chair Liberal Bill Casey

We'll do that, if all members are in agreement, and I think they will be.

I have one question. You talked about your treatment. I know it must be a complicated treatment. What's the one single thing that helped you the most?

1:25 p.m.

Advanced Care Paramedic, County of Simcoe, As an Individual

Natalie Harris

It was being able to freely talk about needing help and not feeling embarrassed by it, feeling empowered eventually. That's what talking and raising awareness, decreasing the stigma, is. In my experience, with so many different people who battle the same injury and illness, it's feeling that they're not alone, that they can talk about it, and that there is hope.

1:25 p.m.

Liberal

The Chair Liberal Bill Casey

Thank you very much for all of your contributions.

Thank you for contributing from Manitoba. I appreciate it very much.

That will bring our first part of the meeting to an end. I'm going to take a two-minute break, and then we'll come back. We have a little bit of committee business.

1:30 p.m.

Liberal

The Chair Liberal Bill Casey

We're going to reconvene for a few minutes.

We have a few business items here to deal with.

Our next meeting is on June 6. We need witnesses for Lyme. The clerk would like to have proposed witnesses by this Friday for the Lyme disease study, the framework.

The amendments for Bill C-211 should be in immediately. We're going to do clause-by-clause on Thursday. If you have any amendments to propose, you should let us know and get them in.

We have a public health effects of pornography, M-47, bibliography of studies and sources submitted by Mr. Viersen, but it wasn't translated into French. Is it all right with the committee if we accept it only in English? Do I have consensus for that? Okay.

Mr. Kang.

1:30 p.m.

Liberal

Darshan Singh Kang Liberal Calgary Skyview, AB

Would there be any issue with just accepting it in English?

1:30 p.m.

Liberal

The Chair Liberal Bill Casey

I don't think there's an issue because it's just a bibliography, just the names of the articles and the dates. It's not even text, really.

1:30 p.m.

Liberal

Darshan Singh Kang Liberal Calgary Skyview, AB

As long as there are no issues.

1:30 p.m.

Liberal

The Chair Liberal Bill Casey

Thank you very much.

The meeting is adjourned.