Yes, you do.
Evidence of meeting #12 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was teachers.
A recording is available from Parliament.
Evidence of meeting #12 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was teachers.
A recording is available from Parliament.
December 7th, 2020 / 11:45 a.m.
Executive Director, Overdose Prevention Society
Yes, you do.
11:45 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
I'm a big believer that the social determinants of health—having access to secure, affordable housing, basic income, nutritious food, etc.—are very important components to overall physical and mental health.
My first question is about housing. Have you seen any significant increase in federally funded affordable housing since 2014?
11:50 a.m.
Executive Director, Overdose Prevention Society
No, I have not. There are so many empty buildings on our block. I think there are about 800 units that were formerly available with the region—with The Balmoral, with The Stanley, at 58 West—that are now gone.
Also there's the fact that people generally stay with each other. A lot of people in social housing will have a guest who is homeless come and stay with them. They help each other. But now, because of COVID, people aren't doing that and sometimes aren't allowed to do that. It makes it more difficult.
11:50 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Right.
In terms of your overdose prevention site facility, has the federal government provided any funding or other resources to assist in the work that the OPS is doing?
11:50 a.m.
Executive Director, Overdose Prevention Society
We haven't received any money for our site.
11:50 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Has the federal government provided any resources to support the mental health and well-being of you and other harm reduction workers that you are aware of, either in Vancouver or anywhere else?
11:50 a.m.
Executive Director, Overdose Prevention Society
No, we haven't had any support; we're pretty much on our own. To be honest, it's very challenging because we just know we have to go on and there's no choice. We don't think about our mental health, really, unfortunately.
11:50 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
I know that dealing with the trauma that you're dealing with on the street is equally as affecting for those who are working as for those who are suffering. I think it's a community trauma we all experience.
Ms. Blyth, have you seen an increase in the number of people who are using drugs alone since the outbreak of COVID?
11:50 a.m.
Executive Director, Overdose Prevention Society
Yes. We've definitely seen people.... At the very beginning, a lot of people stayed home. They're starting to come back out again, just because the numbers are so high in overdoses compared to COVID deaths. I haven't heard of anyone dying of COVID in the Downtown Eastside—well, maybe a few people.
However, there are hundreds of people—thousands of people—who have died of overdoses, so we're trying to make sure that message gets across to drug users that actually you're more likely to die of an overdose than you are of COVID, and that using together in a safe manner, and teaching people how to use in a safe manner, is really important.
We saw that with the—
11:50 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
I'm going to end with a three-part question and let you answer.
You referred to the toxic street supply, and I think you mentioned Vancouver city council. Here's my three-part question. Why has the illicit drug supply become increasingly toxic during the COVID pandemic? How important is it that we decriminalize all of these drugs so that people don't have to get their drugs from organized crime on the street? Finally, do you have any advice to the federal government about the request from the Vancouver city council to issue a section 56 exemption to allow the decriminalization of possession of all drugs in Vancouver?
11:50 a.m.
Executive Director, Overdose Prevention Society
I think that right now we have to do something really serious in order to stop these deaths. Really, if we don't, people will continue to die.
The drug users and community groups—people who are on the front lines—have all come together and said that decriminalization is one of the things that are really going to save lives. It's now up to you to make those changes with section 56. I think if you make those changes, you're going to be changing the way we do things, which will actually save lives and make a huge difference in what happens in the future.
I think, again, that if we don't do something significant, people are going to continue to die. Really, you may not see it yourself, but I see it with parents every day. I have mothers and family members contacting me every day with their relatives dying.
Decriminalization is something significant, as is safe supply. Getting people something that's not going to kill them is hugely significant, especially with COVID. The contamination is way worse, because they're not getting the drugs they used to, which were brought into Canada. Now they're just using whatever is under the kitchen sink, and if doesn't kill them, it damages them and could cause long-term health problems and mental health problems that are going to cause more problems in the health care system. Long-term costs are going to be huge.
I think we can do a lot to change things.
I'm sorry. I think we're out of time here, and I'm sorry if I didn't answer all the questions.
11:55 a.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Davies.
That does wrap up our questions.
I want to thank the witnesses, all of you, for sharing your time with us today and for sharing your expertise and your knowledge. I wish everyone well going forward.
With that, we will suspend and bring in the next panel.
We are suspended.
11:55 a.m.
Liberal
The Chair Liberal Ron McKinnon
We will now resume the meeting.
Welcome, everyone. We are continuing meeting 12 of the House of Commons Standing Committee on Health. We are meeting today to study the mental health aspects of the emergency situation facing Canadians in light of the second wave of the COVID-19 pandemic.
I'd like to thank all the witnesses for appearing today. You will have seven minutes for your presentations.
I'll go over a few housekeeping items. You may certainly speak in the official language of your choice. Interpretation services are available for this meeting. You have the choice, at the bottom of the screen, of floor, English or French. Before speaking, click on the microphone icon to activate your own microphone. When you are finished speaking, please put your microphone on mute to minimize any interference.
Just as a reminder, all comments by members and witnesses should be addressed through the chair. When speaking, please speak slowly and clearly. Unless there are exceptional circumstances, the use of headsets with a boom microphone is mandatory for everyone participating remotely.
For this hour's panel we have, as an individual, Dr. Nick Kates, chair of the Department of Psychiatry and Behavioural Neurosciences at McMaster University; from the British Columbia Teachers' Federation, Teri Mooring, president; and from the Canadian Association for Long Term Care, Jason Lee, treasurer.
Thank you, all.
Dr. Kates, we will start with you. Please go ahead. You have seven minutes.
Noon
Dr. Nick Kates Chair, Department of Psychiatry and Behavioural Neurosciences, McMaster University, As an Individual
Thank you very much, Mr. Chair.
I speak today as a psychiatrist as well as chair of an academic department. COVID-19's second wave is posing some different challenges from wave one for the mental health and well-being of Canadians who are already feeling tired, frustrated, angry, scared, depressed or anxious. It is placing additional demands on health and mental health systems that are already having difficulty coping and where demand outstrips the available supply.
While we are better prepared for wave two and have learned much that has helped us to lay a foundation for what lies ahead, including our rapid adoption of virtual care, many Canadians are tired. The longer the pandemic and the isolation, distancing, lockdowns and uncertainty continue, the more the symptoms of stress become anxiety and the losses lead to depression.
Noon
Liberal
The Chair Liberal Ron McKinnon
Pardon me, Dr. Kates.
I wonder if you could lift your microphone a little bit. We're getting popping noises.
Noon
Chair, Department of Psychiatry and Behavioural Neurosciences, McMaster University, As an Individual
Sure. Is that any better?
Noon
Chair, Department of Psychiatry and Behavioural Neurosciences, McMaster University, As an Individual
Peter Piper picked a peck of pickled peppers.
Noon
Chair, Department of Psychiatry and Behavioural Neurosciences, McMaster University, As an Individual
It has created stress in many areas of our life, and we have experienced multiple losses, including of loved ones under circumstances that have made grieving more difficult. It has changed our family and social relationships and social cohesiveness, led to a deterioration of pre-existing mental health problems and led to worries about our physical, emotional, financial and social future well-being. There are also some specific syndromes that have been identified, such as lockdown fatigue, COVID anxiety, COVID insomnia and, in a different context, Zoom fatigue.
For some, these have been transient and we have adjusted and moved on, but almost 50% of us are reporting significant changes in our mental health. For many, they have led to clinical symptoms of depression, anxiety and even suicidal ideation, while pre-existing mental health and addiction problems have worsened.
Of particular concern has been the impact of the trauma experienced by so many Canadians in many different walks of life, including the moral injury from being forced to make decisions that are incompatible with one's values, beliefs or culture. These have often been exacerbated by pre-existing inequities in income, housing, education, employment and work conditions, history and culture, race or ethnicity, family situations or stigma, and it is the overlap of these factors, often referred to as intersectionality, that further increases the risk of developing mental health and addiction problems. This happens at a time when the pandemic has exposed gaps in our existing mental health services and reduced access to many supports.
It has affected different populations in different ways. First nations, Inuit and Métis communities face particular challenges, often resulting from pre-existing inequities such as inadequate housing, lack of services, lack of public health infrastructure or existing mental health services, geographic isolation and stigma. Members of racialized communities are also likely to experience additional issues because of systemic racism or bias.
Children may be at particular risk as they may be dealing with anxiety about going to school, making a relative ill, loss of contact with their friends or valued family members. We've seen child maltreatment rates increase. One of the greater long-term concerns is that adversity in childhood increases the likelihood of physical and mental health problems in later life and highlights the importance of early years interventions.
Young adults are likely to be struggling with limitations based on social activities and often feeling like their future has been put on hold or even taken away. Seniors, whether living in congregate living situations or living on their own, are showing increased cognitive decline and increased symptoms of depression and anxiety only highlighted by the isolation and concerns about going out.
We've witnessed an increase in alcohol, cannabis and other drug consumption, as well as opiate-related deaths, and in compulsive gambling. Other populations are at risk: those who've lost their jobs, because we know the psychological impacts of unemployment; those who are homeless, already dealing with multiple social and economic challenges; and individuals living with significant psychiatric and physical disabilities, like autism spectrum disorders, and their families. Services and supports have been closed. Access to treatment is more difficult and in-house supports have often ended.
In terms of the impact of gender, we're seeing an increase in intimate partner violence, perhaps inevitable when individuals often living in dysfunctional relationships are on top of each other 24 hours a day without the normal outlets of social activities, and this is often fuelled by increased access to alcohol. A second gender-related issue is increased child care demands, where the bulk of responsibilities still fall to the mother. Many working parents are anxious about children being back at school, but even more so about what might happen if the schools were to close.
The evidence also suggests that in terms of virtual care, whether by video, audio, email or even text, both providers and patients find it more convenient with equally good outcomes, but we need to remember that many individuals still don't have access to computers or even phones, and we also need to identify for which clinical situations and populations and for which therapies virtual care is superior to face-to-face.
When we look at how we respond to these unprecedented demands, while there is no single situation, we are looking at common approaches that could benefit all. We need to think about smaller changes, which could be introduced more easily, and also about targeting our interventions at particular populations.
I have divided my suggestions into three areas.
The first are services and supports for individuals and families. First, we need to strengthen our existing mental health systems. Ways to do this would include developing a plan in conjunction with the provinces and territories that outlines shared purpose, guidelines and goals to guide the work taking place across the country; gathering data on the current needs to inform future service priorities; developing a mechanism to share ideas that are working in different parts of the country that could be adapted or adopted elsewhere; and continuing and formalizing billing codes for virtual care.
There is also going to be a need for existing resources to support targeted interventions. We need to adapt our models of care to respond to the current challenges with a focus on early recognition and also on prevention and proactive screening. For example, in primary care, family physicians could be calling seniors to find out how they are doing and identify those who may be at greater risk. We need to emphasize shorter-term care—including single-session treatments—a wide range of treatments for PTSD, and system navigation.
We need to build new partnerships across the system, with our systems working more closely together to pool their resources and support one another, and we need to better support self-care and management by providing resources and assistance for individuals to better look after their own well-being. This can include access to interactive or curated educational resources, developing a list of most useful sites for providers, developing accessible guides and blogs about specific—
12:05 p.m.
Chair, Department of Psychiatry and Behavioural Neurosciences, McMaster University, As an Individual
Sure.
There are two last points I would like to highlight. One is the importance of expanding the capacity of our mental health system by increasing training for front-line providers, expanding the role of primary care and also providing peer support, looking at the model that is currently being piloted for the RCMP.
The other is to continue to address systemic and socio-economic changes, inequities, systemic barriers and stigma. We need to provide additional supports for families and children, maintain income for low-income Canadians while the pandemic affects their work, and expand access to high-speed broadband to remote or isolated communities.
I thank you for your time.
12:10 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Doctor.
We go now to Ms. Mooring, president of the British Columbia Teachers' Federation.
Please go ahead, Ms. Mooring, for seven minutes.