Health Committee on Dec. 4th, 2020

[Ron Gravel]

Okay. Is that good?

[The Chair, Liberal, Ron McKinnon]

Let's give it a shot.

Thank you.

[Ron Gravel]

Overall, immigrants reported more concern about their health and social consequences of the pandemic than did Canadian-born individuals. These concerns are about issues such as their own health, household members' health, risk of civil disorder, violence in the home, family stress from confinement, and maintaining social ties.

On slide nine, turning to the health of Canadians designated as visible minorities, we see signs of poorer mental health compared to those identifying as white Canadians. Almost 28% of those designated as visible minorities reported fair or poor self-rated mental health compared to 23%. Reporting of moderate or severe symptoms of anxiety was also higher for visible minority Canadians than for those identifying as white Canadians.

On slide 10, crowd-sourced data also indicates more impacts of the pandemic on first nations people, Métis, and Inuit. The slide reflects mental health disparities between indigenous and non-indigenous people, with higher percentages of indigenous participants reporting worsening mental health, high stress and symptoms of anxiety. When asked how their mental health has changed since physical distancing began, 60% of indigenous participants indicated that it has become somewhat worse or much worse. A higher percentage of indigenous women also reported worsening of their mental health.

Slide 11 shows some of the factors that influence the mental health disparities, observed on the previous slide, between indigenous and non-indigenous Canadians.

I'll skip now to slide 12. On that slide, the final group that we will profile today are Canadians living with long-term conditions and disabilities. Using crowd-sourced data, we see that over half of the participants with long-term conditions or a disability reported having worse mental health than they had before the start of the pandemic. During the June-July collection, more than half reported that their mental health was fair or poor.

On the last slide, slide 13, the data presents a relatively consistent picture of how the pandemic has had negative impacts on the mental health of Canadians as a whole and has had greater impacts across a range of already vulnerable groups in Canada.

Statistics Canada is committed to working with partners to increase the information available on the impact of the pandemic on mental health. To showcase some of how we're moving forward, I've listed here a few examples of initiatives: the two independent waves covered by the Survey on COVID-19 and Mental Health, the survey of mental health and stressful events, as well as our active participation in Health Canada's expert round table on mental health data needs and related challenges.

Thank you very much.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We'll start our questioning now, beginning with Mr. Barlow.

Mr. Barlow, please go ahead for six minutes.

[John Barlow, Conservative, Foothills, AB]

Thank you very much, Mr. Chair.

Mr. Trainor, I can attest that people are finding the outdoors to be the best relief for COVID. My riding is in the foothills of southwest Alberta, where all the hikers from across western Canada spent their summer, which was great to see, but I've never seen numbers quite like this before.

Mr. Gustafson, I really appreciated your presentation today. You're very passionate, obviously, as a business owner and with what you've endured.

I'd just like your opinion. You talked about that lack of information. This week we've heard the United Kingdom announce that it has a COVID vaccine and will start distributing that to its citizens. The United States has mass access to rapid testing and home-based testing. They are now reducing their quarantine times. Australia has now announced its COVID vaccine distribution strategy. But here in Canada, we don't have any of those answers. What kind of stress is that putting on business owners—not knowing how long this will go on or being able to make those plans?

[Andrew Gustafson]

It's significant stress. My industry was welcomed into a town hall discussion, on the phone, with the Alberta government, with Deena Hinshaw, the chief medical officer for Alberta. She was very clear in her presentation to us in that town hall meeting that we will continue to see restrictions on our businesses and we will continue to see the threat of lockdowns until we have mass vaccinations. What she said was that that is just a reality that we're going to have to deal with. She said that will continue at least through the winter and possibly through the summer. We should probably be prepared for this into the fall, so for another year. I just don't know that my business can suffer that. I don't know if my members and my staff will be patient for that. Is that impactful to me? Yes. I need a timeline, and then I can plan for it, and hopefully the timeline is as short as possible so that I can see a little bit of recovery sometime soon.

[John Barlow, Conservative, Foothills, AB]

Yes, I can sense your frustration there when we are asking for a vaccine strategy and how that vaccine will be distributed, and we keep getting different answers and different timelines. I think it's frustrating because I don't think that elected officials understand, oftentimes, the ramifications and the implications of these delays. They say “We'll have it, we'll have it”, but when we see the stats that came out from the Canadian Mental Health Association yesterday—40% of Canadians have said that their mental health has declined and one in ten Canadians is having suicidal thoughts—the implication of these delays is profound.

You had a really good point, Mr. Gustafson, about how even if you had a vaccine today and you had mass vaccinations, and your business was able to open, you have seven years of recovery ahead of you financially. Do people understand that and the financial strain of these past eight or nine months and the damage this has done to your business and your mental health? The anxiety is not going to be done when a vaccine is available. This is ongoing.

[Andrew Gustafson]

It is ongoing, and your question is, do people understand that? I suppose that I can't speak fully to what other people are feeling, but I don't get the impression that people are understanding that.

I get the comment quite frequently that I got a $40,000 loan and if I pay it back in time I get $10,000 free and it's interest-free until that point and whatever, but people don't recognize that it was already a fairly lean business before COVID-19 struck, and now I have to cash-flow that. At some point along the way, I have to figure out how to find more cash flow in my month, on top of the already tight business that I run, to come up with that over the next couple of years, which means that other debt servicing and other projects are going to be put on hold until after that.

Yes, right now, for our borrowing and whatnot, I'm looking at about a seven-year payback. That's if we go back to our pre-COVID numbers today, and I just don't believe that we're going to do that, because I don't believe the confidence is there right now in the public.

[John Barlow, Conservative, Foothills, AB]

Mr. Gustafson, when the Prime Minister comes on and says that we need to lock down so that our economy can come back stronger, does it make sense to you as a business owner that with a lockdown and more lockdowns, especially through Christmas, the economy would come back stronger? Would businesses be there after another lockdown?

[Andrew Gustafson]

No. It might make sense to me if the numbers for where the transmission of COVID-19 is happening supported it. Our premier has said that 0.7% of COVID transmissions are traced back to restaurants and group fitness programs, but on November 13, he put further restrictions on restaurants and group fitness programs.

I immediately said that this was not going to solve the problem, that this is a solution that's targeted at—“targeted” measure is the word he keeps using—0.7% of the transmission. I said that the numbers were going to continue to go up, and they did, so they put more restrictions on us. The targeted measures needed to be put on social gatherings. I think that's where the numbers are. They've done that now, but I think it's too little, too late.

[John Barlow, Conservative, Foothills, AB]

For the representatives from StatsCan, I'm not sure which one would answer this question, Mr. Latimer or Mr. Gravel. In your studies and your results, I didn't see this in the documents. In the work that StatsCan is doing, has there been any polling on the mental health impacts on small business owners ?

[Jeff Latimer]

Thank you very much for the question.

Actually, unfortunately, I am not aware of any of that. I think it is a gap in our information at this point in time.

[John Barlow, Conservative, Foothills, AB]

Thank you very much, Mr. Chair. I appreciate the opportunity.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Barlow.

We go now to Ms. Sidhu.

Ms. Sidhu, please go ahead. You have six minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair, and thank you to all the witnesses for being here with us.

It is a very important issue that we're talking about. First, I would like to acknowledge that our government takes Canadians' mental health very seriously. That is why our most recent health accords specifically allocated over $5 billion in additional funds to provinces and territories for mental health. However, today the context is the pandemic.

My first question is for you, Dr. Trainor. As we know, seniors are now even more at risk of social isolation than they were before the pandemic. My region of Peel is under the lockdown, and there are regulations preventing visitors from seeing parents and grandparents in long-term care. That's combined with the fact that some seniors are not tech savvy, so there is loneliness, with less access to technology. It is a serious issue in terms of staying in touch.

Can you let us know what is the impact of social isolation on seniors and if any of the impacts are unique to that population? What actions can be taken by the federal government to assist seniors with mental health conditions?

[John Trainor]

That's a big territory to think about. I certainly agree with you that seniors, and especially seniors in care homes, have been unusually hard hit by this, both in terms of isolation and the physical risks and high rates of death.

I don't have specific data on that from our polls, but, from my own experience and people in my own family, there's been a major effort to build the social connections through digital means. Even in cases where seniors themselves are not so savvy, it's proven possible to connect people through social media and other things that seem to have a good effect.

It's very difficult to weigh the difference between increasing social isolation, which of course has its own negative health outcomes, and limiting it due to your attempt to stop the spread of COVID. That's a difficult balancing act.

I think that the main thing, from our work overall, would be that seniors need to know that there is a way forward from this. The rolling out of the vaccine was mentioned, and I think that's interesting because we are looking at our next survey, which is rolling out now. What is the impact of this news? What is the impact of the good news that something is coming? We think it will be dramatic, but we really don't know. I think seniors will be among the chief recipients of that. Also, of course, in most discussions, they will be early recipients of the vaccine, because of their high risk levels. I think that will make a big impact.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Mr. Trainor, a few weeks ago, it was revealed over 600,000 Canadians across the country have used a new federal virtual mental care portal, Wellness Together. This free portal has been developed with experts and has a variety of resources available to Canadians.

In your view, are virtual platforms like this effective means of providing support to individuals in need of mental health supports? What are the barriers that you're aware of to Canadians using these platforms?

[John Trainor]

I couldn't agree more that this is a very important platform, and it's interesting that Canadians who are using it are looking for two things. They're looking for help for themselves and support in various ways, and are also asking the question and wanting advice on how to effectively help others. Frankly, for your own mental health, helping others is a very good strategy.

What we found in looking at that—and we've been in close contact with and working with Wellness Together Canada—is that one of the barriers is people's concern about privacy and how their digital information will be used. I think that Wellness Together Canada has taken steps to allow people to come in and get information, without having to identify themselves or take too many steps that share their own information.

That's the biggest barrier we've seen, a general distrust of a digital platform. I guess it's because of all the things we hear in the news about hacking and that sort of thing. It's an effective tool, and I think it's a useful one in this context.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

I have one more question for you. You spoke about your organization's study that suggests that the best activity to support positive mental health is being outside with winter approaching. This will become less of an option as seasonal depression typically begins.

Can you offer any suggestions for how Canadians can cope with COVID-related mental health issues as we head into the winter months?

[John Trainor]

It's interesting. I can give you one example from where I live in Toronto, and that was a major announcement by the municipal government that they are going to be opening more trails, they are going to be keeping rinks open, they're going to be taking a whole series of steps so that going outside safely and maintaining distance is going to be much easier.

When we found that this was emerging as the number one thing that Canadians were reporting as helpful, we moved to share those results with parks and recreation departments, municipal governments and provincial parks associations, so they could take active steps so the barriers to getting out there and enjoying our winter are reduced.

That will be very important. Canadians are pretty good at handling winter.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Sidhu.

Mr. Thériault, you have six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Mental health and mental illness have always been the poor relations of the health care system. We must be careful not to make the mistake of failing to learn from this pandemic. Once people have been vaccinated, once we get our heads out of the barrel and the pandemic is behind us, we shouldn't think that we don't need to invest more in mental illness prevention and mental health promotion. This is a great opportunity to re-prioritize and invest where we can save money in the long term, as Ms. Waddell said.

It was a general comment.

In addition, experts who appeared before us in committee spoke to us about the increased challenges to the mental health of staff in the health care field. We know that 82% of the health care workforce in Canada is female. During the first wave of COVID-19, the situation of health care employees really deteriorated because of the longer working hours and stressors associated with the pandemic.

Mr. Trainor, I'd like to hear your opinion on this. Do you feel the health care staff are receiving adequate support?

How could we make this support better? How can we make these people less stressed and less affected by the pandemic?

[John Trainor]

Well, I certainly think you're right. Our polls have shown that health care workers are extremely strongly impacted by this and have experienced one of the highest levels of increase of mental distress. I think at the beginning of the pandemic there was a great deal of anxiety generated by the fact that we weren't really ready. There were shortages of various kinds of protective equipment. I think felt they were being put into very dangerous situations. Now that the situation has become more stable and the supplies and that sort of situation are better, I think people are doing better.

We found that people are afraid of becoming ill themselves, but are even more afraid that illness will strike their families. You hear many stories of health care workers who come home and before they come into the house are changing their clothes, putting everything in the wash, and that sort of thing.

Generally speaking, in situations like that people need a work environment that recognizes what they're going through and provides supports and opportunities for counselling and for people to be able to come forward and talk about what's happening to them without fear of reprisals in the workplace. They need a mentally healthy workplace. I think they also need what is now coming—messages of hope and messages of support that will affect their own lives. Most health care workers are very anxious about people who don't maintain social distancing and act in ways that make the illness more common. We see across the country now that the pressure on the health care system and the rates in emergency rooms of serious illness are rising very quickly, and in some cases reaching the breaking point.

Like everybody, I think, health care workers need that message of hope, but they need a supportive workplace and the kind of recognition I think they often get publicly, that they are really appreciated as some of the heroes in this whole enterprise.

[Luc Thériault, Bloc, Montcalm, QC]

As part of your series of national polls on the effects of COVID-19 on the mental health of Canadians, your second poll, released on October 1, indicates that the number of Canadians reporting high levels of anxiety or depression has remained stable even though restrictions were eased over the summer.

Why do you think the anxiety level hasn't gone down? We might have thought that the relaxation of measures and vacation would have lowered the anxiety level. The anxiety level was probably quite high.

How do you envision the post-pandemic period? Do you think it will be difficult to quickly return to normal anxiety levels, so to speak? How long might it take?

[John Trainor]

Is that for me? I'm sorry, I'm having a little trouble with my sound.