Health Committee on Nov. 30th, 2020

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Yes, I hear you.

I wanted to explore a little bit more your recommendations around family reunification for compassionate visits. I was particularly moved by a case in Manitoba recently. After months of begging and procedural work, somebody was granted an exemption to come to Canada to see a family member who was in the hospital, but then couldn't reunite with them before they passed because there was no exemption to quarantine, even if a test was administered.

Are there other countries around the world that are doing this and that we should be looking to for best practice?

[Dr. David Edward-Ooi Poon]

There are many countries in the world without the particular border standards or restrictions that Canada has. The compassionate exemptions have been worked in through different family reunifications on a case-by-case basis in other countries. For example, in the U.S. you can actually just fly over right now to see a loved one who might be passing away.

Donna's rule, which I am suggesting, must be a federal government mandate to prioritize family reunification in times of crisis. We must not have a family say goodbye to their mother through FaceTime when she is dying. There must be Donna's rule to prioritize family reunification at a time of crisis.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

I think personal stories are important right now.

You're a clinician. Can you summarize what it's like, on behalf of everyone in your group as well as your experience, to be separated from a loved one for over half a year or for months at a time?

[Dr. David Edward-Ooi Poon]

I ask members of the committee to consider this: If there's a worldwide pandemic, who do you want beside you? The answer is, uniformly, your family.

Imagine the moments lost. How many miscarriages were taken alone? How many deaths were felt by oneself? How many tragedies were faced without the support of loved ones?

We understand that this level of pain needed to be worked out, but now that we are here and we are preparing for the second wave, we must not allow the mistakes that happened earlier in the year to create further family separations as we approach the second wave.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

How critically do rapid testing and widespread availability of testing play into this?

[Dr. David Edward-Ooi Poon]

Rapid testing and rapid availability of testing are just more tools to allow family reunification, whether or not that's a mixture of quarantine and testing at the border or point of care. Anything we can do to bring families together on a case-by-case basis through broad exemptions is of the utmost importance during the second wave of COVID.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Thank you for everything you've done. My heart is with everybody in your group.

Thank you, Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

We go now to Mr. Kelloway, please. You have six minutes.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Mr. Chair. I'll share my time with MP Van Bynen.

I want to thank all the witnesses for being here today. When we talk about mental health, it's usually talked about as a blanket subject that affects everyone the same.

As my colleagues know, I represent the wonderful people of Cape Breton—Canso. That riding encompasses the island of Cape Breton and northeastern Nova Scotia, which is predominantly rural. I know that many rural Canadians experience unique challenges when it comes to mental health. Other groups are impacted differently as well, such as seniors, women, indigenous groups, racialized Canadians, children and so forth.

This question is for Dr. Cornish. What can we do to ensure that mental health support in Canada is intersectional, to better support all Canadians, especially those with unique needs and challenges?

[Dr. Peter Cornish]

Thank you for that question. It's an excellent question.

Our current system has a one-size-fits-all approach. You can go to a physician, psychologist or psychiatrist. What we're learning with opening up the buffet of options is that it fits much more with the reality of our society that has people of all kinds of different identities and intersections on gender and race. What we find is that the typical access to care is often blocked by protocols that triage or try to diagnose at the front end and do a lot of heavy assessment, in which case, during a first point of contact, whether it be by phone or in a consultation room, the person doesn't walk away with any care at all because they're busy answering questions.

I have a personal story. My daughter tried twice, when she was a teen and in university, to get access to care. She walked away from the counselling centre saying that all they did was ask her their questions. They never actually asked her what she wanted. Then she went to the private sector, thinking she would get better care. Again, it was the therapist's questions. The therapist thought they knew better and they thought they had to ask everything, turn over every stone and ask every question to find out everything that was wrong with my daughter before they could help.

Physicians don't do that. When I go to my physician, they don't ask me about everything that's wrong with me. They ask me why I am there and what I want, and they make sure that I walk away with something useful.

We've never done that with mental health. We assume that experts know what questions to ask, and this is not appropriate, given that we have people of different gender orientations and different cultural backgrounds. We shouldn't make any assumption about what they need. We should start by asking, “What would be helpful today?” and trust that people in most cases can answer that question better than we could as professionals.

That's what we are doing with stepped care 2.0. That's what we are doing with Wellness Together Canada. We are giving mental health back to the people who are seeking support, rather than keeping it to a secret professional sort of assumptions about what will work for whom.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Dr. Cornish. Thank you so much for all the work you do.

I'll hand it over to MP Van Bynen for his questions.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you, Mr. Chair.

First, let me thank Michelle Rempel Garner for sharing her personal situation with us. I'm a member of the all-party mental health caucus, and each and every one of those individuals was brave enough to share their personal experience with us. I have to say it's heartbreaking, so it advances my commitment and emphasizes the importance of what we're discussing now.

My question is for Dr. Cornish. There are many people who do not normally experience mental health challenges who are reporting them because of the impacts of the COVID-19 pandemic, but some may not feel comfortable asking for help in these challenging times. How can we break some of the stigma associated with mental health issues and encourage them to seek help?

[Dr. Peter Cornish]

I think that, again, the one-size-fits-all thing has to be abandoned. What we're finding with veterans, first responders and front-line workers is that quite often the culture in these workforces is such that you shouldn't ask for help or your job might be in danger if you disclose a vulnerability.

What's proving to be very successful with those populations is peer support, communities of support. What I think the federal government can do is set up an infrastructure. Peer support works with the support of technology, because you can scale it. You can scale it in a way that's anonymous, because part of the concern when reaching out for care is that it might be somebody you know in the neighbourhood or rural area, especially with peer support, but with technology, you can make that anonymous, and you can also scale it to the point that there are enough people available to provide support and a listening ear.

What we find with peer support programs in volunteer workforces is that the turnover is high. This is not a problem, because when you train a peer support workforce, they may not work for a long period of time, but they're still within our population, able to provide informal support because they've learned skills on how to help each other.

The point of scaling, because the turnover is high, is that you need to have an infrastructure in place that continually replenishes and teaches mental health first aid for peer support workers.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Dr. Cornish and Mr. Van Bynen.

Mr. Thériault, you have the floor for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

I would like to thank all the witnesses for their valuable co-operation and their enlightening testimony. Having said that, we have received few briefs and speaking notes. I invite them to submit them, since they will be very useful to us.

Ms. Ouimet, you indicated at the outset that your organization is working to create, develop and strengthen mental health, particularly in the workplace. However, I am concerned about a new reality that is affecting workplaces as a result of the pandemic. I am talking about telework.

One study was conducted at Laval University by Caroline Biron and her collaborators. It is based on a sample of 1,259 people who were employed in Quebec during last spring's lockdown. The study found that 55% of the female workers and 41% of the male workers were suffering from psychological distress. Clearly, being able to work is better than being unemployed. I'm not talking about health care and doctors, but many companies are celebrating telework. However, we can see that telework has imposed and intensified isolation.

Could you tell us about that?

[Renée Ouimet]

I would like to clarify that Ms. Biron's research was not only about telework. That said, telework isolates workers a great deal. They receive less social and technical support. Therefore, new ways of doing things need to be established.

Workers can no longer talk to their colleagues about the difficulties they face or about a host of other situations. They find themselves more isolated. There are no more breaks together, no more opportunities for conversation, apart from general meetings. In addition, there is significantly less technical support. So we must create new structures, provide time for conversation between colleagues and determine what support they need. They need to be able to talk about what they are experiencing, not only about the technical aspects. It is important to check what technical support they need.

We need to create new meeting rituals between workers and managers. We also know that, even for those who physically come to work, the reality is more difficult because of the distancing and all the ensuing demands.

[Luc Thériault, Bloc, Montcalm, QC]

The percentage is 55% for women and 41% for men. Is that difference a constant? Is the variable always the same?

Do you have any answers to that?

[Renée Ouimet]

I did speak with Ms. Biron. She said that there had been no specific research on that. However, we know that women still carry a heavier burden at home even today. The work-family balance is more challenging for them. There is a great deal of responsibility. This affects women's mental health.

[Luc Thériault, Bloc, Montcalm, QC]

Is that what is called the “mental load”?

[Renée Ouimet]

Yes.

[Luc Thériault, Bloc, Montcalm, QC]

So we are talking about the workplace, which is also the environment in which we live, experience the mental load, the isolation and the lack of tools to express the pressure. The person is isolated, but must still perform as required.

[Renée Ouimet]

Yes, and women work more often in supportive, service settings, which has an effect on their mental health.

[Luc Thériault, Bloc, Montcalm, QC]

Under the circumstances, a lack of resources increases the tension.

[Renée Ouimet]

There are also concerns related to the pandemic. When you provide care or when you work in public services, such as grocery stores, you are in environments where you are confronted with it on a daily basis.