Health Committee on Jan. 29th, 2021

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order.

Welcome to meeting number 15 of the House of Commons Standing Committee on Health.

The committee is meeting today to study the emergency situation facing Canadians in light of the second wave of the COVID-19 pandemic.

Today's meeting is taking place in a hybrid format, pursuant to the House order of January 25, 2021; therefore, members are attending in person, in the room, and remotely, using the Zoom application. The proceedings will be made available via the House of Commons website. So that you are aware, the webcast will always show the person speaking rather than the entirety of the committee.

Today's meeting is also taking place in the new webinar format. Webinars are for public committee meetings and are available only to members, their staff and witnesses. Members may have remarked that the entry into the meeting was much quicker and that they immediately entered as an active participant. All functionalities for active participants remain the same. Staff will be non-active participants only and can therefore only view the meeting in gallery view.

I would like to take this opportunity to remind all participants in this meeting that screenshots or taking photos of your screen is not permitted.

Given the ongoing pandemic situation and in light of the recommendations from health authorities, to remain healthy and safe, all those attending the meeting in person are to maintain two-metre physical distancing. They must wear a non-medical mask when circulating in the room, and it is highly recommended that the mask be worn at all times, including when an attendee is seated. As well, they must maintain proper hand hygiene by using the provided hand sanitizer at the room entrance. As the chair, I will be enforcing these measures for the duration of the meeting. I thank members in advance for their co-operation.

For those participating virtually, I would like to outline a few rules to follow.

Members and witnesses may speak in the official language of their choice. Interpretation services are available for this meeting. You have the choice, at the bottom of your screen, of floor, English or French. With the latest Zoom version, you may now speak in the language of your choice without the need to select the corresponding language channel. You will also notice that the platform's “raise hand” feature is now in a more easily accessed location on the main toolbar, should you wish to speak or alert the chair. I caution that I actually don't see that on my screen, so that may be a promise yet to come.

For members participating in person, proceed as you usually would when the whole committee is meeting in person in a committee room.

Before speaking, please wait until I recognize you by name. If you are on the video conference, please click on the microphone icon to unmute yourself. For those in the room, your microphone will be controlled, as normal, by the proceedings and verification officer.

I remind everyone that all comments by members and witnesses should be addressed through the chair. When you're not speaking, your mike should be on mute.

With regard to a speakers list, the committee clerk and I will do the best we can to maintain a consolidated order of speaking for all members, whether they are participating virtually or in person.

I would now like to welcome our witnesses.

We have, as an individual, Professor Ehsan Latif, professor of economics at Thompson Rivers University, British Columbia. We also have, as an individual, Dr. Samuel Veissière, assistant professor at the department of psychiatry and co-director of the culture, mind, and brain program at the department of psychiatry at McGill University. From the Hospital Employees' Union, we have Ms. Barb Nederpel, president; Ms. Georgina Hackett, director of occupational health and safety; and Ms. Maria Dreyfus, care aide. From the Kids Help Phone organization, we have Ms. Katherine Hay, president and chief executive officer.

Each witness group will have six minutes to speak. We will have a single round of questions once all witnesses have given their statement.

I would also advise that I will be using cards. One is yellow and one is red. I will display the yellow card when you have one minute left, and I will display the red one when your time is up.

Thank you.

We will now go to our witnesses' statements.

Professor Latif, if you please, go ahead for six minutes.

[Dr. Ehsan Latif, Professor of Economics, Thompson Rivers University, British Columbia, As an Individual]

Thank you, Mr. Chair.

It is my honour to appear before you today. My name is Ehsan Latif. I'm a professor of economics at Thompson Rivers University in Canada. I will be talking today from the perspective of economics. I have done primal research on the impact of decisions on mental health in Canada. I will try to connect my research findings with the current situation and also talk about some policy issues.

An economic recession impacts mental health in a number of ways. Unemployed people suffer the most, because of financial stress and loss of social status. Employed people also suffer from anxiety and distress because they feel they can lose their job any time. The mental pressure during the recession period may lead to excessive drinking, smoking and drug abuse. These unhealthy behaviours often lead to chronic health conditions like cancer, stroke, high blood pressure and cirrhosis of the liver. The mental health impact of a recession may not end with the end of the recession. Sometimes people may suffer for an extended period of time.

Using large-scale Canadian data from the Canadian national population health survey, I conducted a couple of studies on the impact of economic recessions on mental health, drinking behaviour and smoking. In one study, I found that the unemployment rate had a significant positive impact on weekly alcohol consumption and the probability of binge drinking. The study also found that the unemployment rate had a significant positive effect on the number of cigarettes smoked by daily smokers. The results suggest that the impact of the unemployment rate on drinking and smoking behaviour was more pronounced for males than females.

In another study, I found that the provincial unemployment rate had a significant positive impact on depression. This study further found that females, individuals with post-secondary education, individuals with college or university education and individuals below 54 years in age were more likely to suffer from depression from an economic downturn.

In all these studies, I used data from 1994 to 2009, the past recession, so let me connect this to what is happening here now.

The recession due to COVID-19 had a disproportionate employment-related impact on Canada's service sectors, including transportation, restaurants, accommodation, and arts and entertainment. Females and young people were the hardest-hit groups, as they predominantly work in the service sectors. The other hardest-hit groups were visible minorities, new immigrants and indigenous people. Among the employed people, essential workers and health care providers were very much vulnerable to the negative mental health impacts of COVID-19. In particular, health care workers had a greater risk of exposure to the virus and had to work in very stressful conditions.

A recent study by Statistics Canada found that the pandemic impacted the mental health of all Canadians. However, youth experienced the greatest decline since the pandemic began. The study reported that women were more impacted than men. The study also found that visible minority groups were more likely than whites to report poor mental health. The study found that those already experiencing poor mental health before COVID-19 were impacted even more by the pandemic. Finally, the study found that a substantial number of Canadians reported increases in their alcohol, cannabis and tobacco consumption.

During this COVID-19 period of physical distancing, virtual mental health services play a vital role in providing mental health care. Virtual mental health services allow better access to care for people living in rural and remote areas. Young people who are avid users of the Internet may find virtual mental health care more comfortable and attractive. However, many rural and remote areas lack access to quality Internet access. Further, marginalized groups, such as homeless people, may not be able to afford Internet facilities. Some groups, such as older people, are not familiar with modern technology. For complex mental health problems, virtual health care may not be enough, and patients may also need in-person care. In the coming days, we need to expand virtual mental health services. However, at the same time, we need to make it accessible to all groups, including people in rural and remote areas, indigenous people, homeless people and the older population.

During the pandemic, the Government of Canada launched a web portal called Wellness Together Canada, focusing on mental wellness. This web portal connects to peer support workers, social workers, psychologists and other professionals for confidential chat sessions and phone calls to deal with mental health issues. This publicly funded tool was certainly helpful, but people may not be aware. A recent study stated that only 11% of the people used the online system. We need more research on the impact of this tool.

People may suffer from pandemic-related mental health trauma for an extended period of time. For this reason, federal and provincial governments need to work together to reduce financial and other barriers to access to mental health care. In a 2018 report on mental health care in Canada, the Canadian Mental Health Association pointed out the lack of resources devoted to mental health support. The report noted that Canadian people have significant financial barriers in getting access to psychological support. The federal government can seriously consider this issue because in the coming days we have to focus more on mental health care and tackle this issue.

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Professor.

We go now to Dr. Veissière.

Please go ahead, for six minutes.

[Dr. Samuel Veissière, Assistant Professor and Co-director of the Culture, Mind, and Brain Program, Department of Psychiatry, McGill University, As an Individual]

Thank you, Mr. Chair and members of the committee. It's an honour to be here.

I'm Samuel Veissière. I speak as a behavioural scientist and professor of psychiatry who specializes in the study of the impact of screen time on mental health and in youth mental health generally. I also speak to you as a parent and a professor who is very concerned for the mental health of our youth, as Professor Latif mentioned.

Because there is little time, I want to specify that the take-home message is that there are really two pandemics going on at the same time, with almost diametrically opposed risk and protective profiles. As we know, old age is by far the biggest risk factor for mortality and complications linked to the COVID-19 disease, while young age is the primary risk factor for poor mental health, but not for mortality and complications due to the COVID-19 disease.

In the acute early phase of the pandemic, I participated in a study led by Professor Rébecca Robillard at the University of Ottawa, where we surveyed 6,000 Canadians on pandemic-related stress, anxiety and worsened mental health. I'll mention some of the risk factors that we found, and then I'll go on to talk about some missing data that would really help us identify at-risk populations and also identify prevention strategies.

What we found is that the biggest risk factors for worsened mental health during the pandemic were, of course, pre-existing mental conditions and female sex, as Professor Latif mentioned, although it's important to point out that women are more likely to report mental health problems. Men, unfortunately, are less likely to report mental health problems until it is too late. We know that they suffer from significantly higher suicide rates, particularly in the context of an economic recession and job loss, but also divorce. We know that family relations have often been very negatively impacted by the pandemic. We also found that alcohol consumption and drug consumption were associated with worsened mental health. Certain personality traits like extroverts and people who suffer from neuroticism....

Interestingly, and very controversially, we found that a very strong predictor of more COVID-related anxiety was left-wing political beliefs. The point here is not a partisan political point. It is an empirical observation. The understanding of the crisis has unfortunately been very polarized and very politicized, with COVID-denying positions associated with the right, leading to a certain bias in the liberal media for more “alarmist” perspectives, thereby perhaps conferring higher anxiety for people who are on the left of the political spectrum. We know, however, that this is a predictor.

What else did we find? We found that poor family relations predicted worse mental health, as did less time spent exercising or engaging in artistic activities. We found, however—although we're still looking at the data—that socio-economic status did not necessarily predict mental health in the way that we thought it would. We found that people from the upper-middle class and higher, particularly younger people, often seemed to suffer from more anxiety, so it may be that people who are working remotely have a different sort of stress profile and perhaps worsened family relations.

That was an interesting finding, because we found that by far the strongest predictor was age. People under 40 and people in their twenties reported much worsened mental health. We also found that increased screen time and social media consumption—even reading political news—was associated with worsened mental health.

I will point out that many of us in the mental health research community were already very concerned with the mental health of our youth prior to the pandemic, in that a confluence of risk factors, many of which are associated with increased screen time and isolation, were a cause of major concern prior to the pandemic and have been gravely accentuated.

It would be very helpful for us in planning prevention strategies to have better public statistics on the incidence of suicide, of psychiatric emergencies, of drugs and alcohol consumption and so on.

To conclude, because I really want to leave time for discussion—I could go on at length to shed more light on these risk factors—given the diametrically opposed risk profile, it is important from a mental health perspective to find focused protection strategies and to restore opportunities for youth that we know are conducive to better mental health: human touch, participating in collective activities, participating in the community and in religious and athletic activities, finding safe ways for those who are not at risk to return to class, particularly for university-age populations. It has become a public health emergency.

I think that's about the gist of what I want to present. I'll be happy to answer any questions.

Thank you again, Mr. Chair and members of the committee.

[The Chair, Liberal, Ron McKinnon]

Thank you, Doctor.

We will go now to Ms. Nederpel, president of the Hospital Employees' Union.

Please go ahead for six minutes.

[Barb Nederpel, President, Hospital Employees' Union]

Good afternoon.

I am Barb Nederpel, the president of the Hospital Employees' Union, also known as HEU. Our union represents more than 50,000 health care workers across the province, including 20,000 who work directly in seniors care.

Joining me today are Maria Dreyfus, a care aide in a Fraser Valley long-term care home; and HEU's occupational health and safety director, Georgina Hackett.

Thank you so much for the opportunity to speak with you about the devastating impact COVID-19 has had on those working on the front lines of this pandemic, which is, in addition to everything we've heard so far, for the general public.

Health care work is largely women's work. About 85% of our members are women, and this workforce is also highly racialized. Our members were exhausted, stressed and at a high risk of injury well before the pandemic. COVID has shone a light on the very difficult working conditions in long-term care especially, and it has exacerbated this situation immensely.

On March 7, a resident at Lynn Valley Care Centre in North Vancouver passed away from the COVID-19 virus, the very first COVID-19-related death in Canada. Since then, there have been hundreds of outbreaks in B.C. care homes, and the majority of the 1,172 COVID-19-related deaths in B.C. have been of care home residents.

We know that the impacts of stress on mental health are cumulative, so 11 months of working long hours, being short-staffed, living in fear and in worry, and seeing so many of their residents die and their co-workers test positive for COVID have taken a serious toll on our members' mental health.

On top of everything else, our members in long-term care are working in a sector that has been racked by privatization and contracting out under the former B.C. Liberal provincial government. Wages and benefits vary greatly across the sector, a circumstance that forces workers to hold multiple jobs just to make ends meet. In fact, one in every five workers in our care homes holds two or more jobs in the sector. While the province has levelled up wages as part of its public health order to limit workers to a single site, many workers still have inadequate paid sick leave. Lack of access to decent-paying jobs and inadequate sick leave are also causing stress for our members.

As we saw with the SARS outbreak 17 years ago, we are seeing only the very tip of the iceberg at this time. Mental health impacts can last for years, and our members are really struggling. We are concerned about what the future holds for them, about our ability to retain workers in this sector, and about the impact on employee benefit costs.

Maria is here to tell you about her first-hand experience with being on the front line.

[Maria Dreyfus, Care Aide, Hospital Employees' Union]

Good afternoon. My name is Maria Dreyfus. I am a care aide in a long-term care facility in B.C., where I have worked for 12 years.

My facility has had two outbreaks during the COVID pandemic. The first one was in May and was very small. The second one was in November, when more than 150 people contracted COVID—93 residents and 63 workers—and 26 residents passed away.

It is difficult to describe how very scary it has been for all of us working in long-term care during the pandemic, but when the big outbreak hit our site, it was totally devastating. Residents whom we have known and cared for over many years were dying. We are their care providers, but also their family and friends, so this was very emotional and stressful.

I myself tested positive for COVID–19 and had to self-isolate. There are three other full-time workers living in my household, and they had to self-isolate as well. My biggest fear was that I was going to pass it on to my family. What were we going to do if we all had to be off work?

Fortunately, I had very mild symptoms and was eventually able to return to work, but not all my co-workers were so lucky. One of my co-workers who tested positive is a young mother. She infected not only her husband, but one of her young children. Another co-worker who tested positive recently found out after she returned to work that her internal organs have been badly damaged. This news was incredibly difficult for us to hear. We all cried when we received her text.

This cannot happen again. A quicker response was needed. There's so much fear and anxiety. We needed better communication about the virus and about the PPE required to protect us to the fullest, and we all should be able to apply for workers' compensation benefits and not have to worry about not having enough paid sick leave available to us.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Dreyfus.

We will go now to Kids Help Phone and Ms. Katherine Hay, president and chief executive officer.

Please go ahead. You have six minutes.

[Katherine Hay, President and Chief Executive Officer, Kids Help Phone]

Good afternoon and thank you, Mr. Chair and members of the Standing Committee on Health, for inviting us to speak here today.

I am going to start with a stark and sobering statistic for us all. Last year, Kids Help Phone conducted over 4,000 active suicide rescues. Research tells us that for every suicide, 125 people are directly impacted, so not only did we save over 4,000 youth in Canada, but we spared half a million people in Canada from traumatization from grief and loss of a loved one dying by suicide.

The reality of the first wave of the pandemic hit youth very hard. The second wave is just as difficult. The third wave is real—it's the mental health pandemic.

I am here because mental health is one of the most significant crises facing young people today. If we do not find solutions, if we do not ensure that young people can access support, we will lose multiple generations. The future of a strong Canada relies on the well-being of the youth of Canada today.

For over 31 years, Kids Help Phone has been Canada's only national 24-7 e-mental health service for young people in French and English, in every province and territory. In 2020, we interacted and connected with more than 4.5 million people in Canada, typically from age five to age 27, but also adults. That's an increase of 137% from 2019.

I do want you to remember that the clinical teams at Kids Help Phone are on the front lines 24-7 doing a tremendous job, and that is taking its toll.

In addition to being an essential service provider, we use real-time data to inform our decisions and the mental health landscape. We're the only mental health service in Canada combining clinical expertise with AI and machine learning for triaging to deliver better outcomes when young people reach out for support.

We see the impacts of COVID-19 every single day. Throughout the pandemic, conversations about grief have increased, as have conversations about eating and body image, by more than 80%; about gender and sexual identity, by more than 65%; about isolation, by more than 50%; about abuse, by more than 45%, and the list goes on.

I also want to take a moment to recognize that not all youth in Canada are equally served by this system. The underserved, remote, rural and racialized youth in Canada do not have equitable access, which is why Kids Help Phone is so important in addressing this reality.

We are especially worried about the far-reaching effects on some of our most vulnerable young people, including indigenous youth, Black youth, youth of colour, youth in rural and remote environments and youth identifying as LGBTQ2S+. We hear from them every single day. The percentage of young people reaching out to us about racism and discrimination doubled after the murder of George Floyd and the heightened social injustice.

These young people who text us every day are some of the most distressed young people, second only to those young people who fear harm from someone in their own home. When they speak about racism, they are also more likely to speak about suicide. We need to do more—Canada needs to do more—so that these young people do not get left behind.

I think we all agree that it is clear that COVID-19 has been profoundly hard on people's mental health—on youth in particular. At Kids Help Phone, it led to immediate record surges in demand back in March, and it has continued to do so to this day. There were 4.5 million connections in 2020.

Kids Help Phone faced enormous pressure to increase service, as well as grapple with uncertainty around our financial stability, similar to other charities. We are grateful to the Government of Canada, which, over two years, made a significant investment of $7.5 million in our essential services. That critical contribution has ensured that we remain open and that service has been uninterrupted even with record-breaking demands. We did not go dark, not for one minute.

Our work is nowhere near done. It will not be done when COVID-19 is a thing of the past, which we all hope is soon.

Everyone would agree that Canada's mental health sector is somewhat fragmented and struggles to meet the growing needs of Canadians. This is where Kids Help Phone can add value. We are pioneers in virtual care. We continue to expand our e-mental health platform to provide more youth with more seamless access to a continuum of virtual supports. We will work with our partners in the sector and governments to continue filling the gaps. We are leveraging our data, Canada's only real-time data showing what young people are facing, in their words. We speak to them every day. The reality is that we all know that the state of youth mental health was in crisis before the pandemic. It is exponentially amplified.

In closing, as I've said before and we all know, this pandemic will not come to an end when vaccines roll out, or even when the country returns to a new normal. There is no vaccine for the significant implications to our mental health. Canada must be ready to handle the long-term mental health effects of the pandemic.

Kids Help Phone is a trusted partner. Continued partnership between Kids Help Phone and the Government of Canada will play a critical role in providing e-mental health solutions for all the young people in Canada and in leveraging data to better inform policies and health system solutions. This is imperative. The future of Canada is anchored on the well-being and mental health of our young people today. It is on us to right tomorrow for them.

You need to know that Kids Help Phone will always be there for the kids who need us. We will be there 24-7, in every province and territory, in both official languages, for all who need us.

Thank you, Mr. Chair, members of Parliament and members of the standing committee.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Hay.

We will now start our questioning. We have time for one round of questions.

Mr. Maguire, please go ahead for six minutes.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Thank you, Mr. Chair.

I want to thank our witnesses for their presentations today.

To start, Ms. Hay, thank you very much for your presentation. These are pretty stark numbers. There's been a 137% increase from 2019. I wonder if you could comment on the emergency helpline my colleague Todd Doherty has brought forward in the House. It would be another opportunity to help in that regard.

Obviously, you're pointing out the use of your line and the fact that you've helped prevent 4,000 suicides. Can you expand on the mechanism that's involved there?

[Katherine Hay]

First of all, I do want to acknowledge the importance of increasing access for anybody in crisis, so a three-digit access point, where Kids Help Phone would most definitely be good partners too...through technology. It should not be the problem of someone in crisis to figure out where they need to reach out. We stand as partners with our colleagues for that.

You talked about our active rescue protocols and process. Kids Help Phone is national. We have professional counsellors in counselling centres, now remote, in Montreal, Toronto and Vancouver, as well as remotely in every province. We also have more than 2,200 active crisis responders every single month on our platform. I give you that background because it's not so easy to just call 911 for support. We might be in Toronto and the person in crisis might be in Sioux Lookout. We have an incredibly good relationship with the RCMP. That would be our first point of contact to connect us to local police services.

I also want to point out that we need to do work in this country, and we are doing work, on what the right step is for active rescues. It is sometimes not the right thing to do to send police into a highly charged environment. In some communities, it might not be the right thing to do. We're working in Saskatchewan right now with a pilot on wellness teams responding to active rescues.

[Larry Maguire, Conservative, Brandon—Souris, MB]

There are a lot of cases where it's very important to make sure you're sending the right people to the situation. You're absolutely right.

I want to touch base with you, Ms. Nederpel and Ms. Dreyfus. Thank you for your presentation. This is a highly charged area.

Ms. Dreyfus mentioned the PPE required for this process. Can you provide us with greater certainty about what the quality of PPE may be that the Liberal government is purchasing for front-line staff? Do you have any recommendations for the government in regard to a more thorough job of inspecting those shipments of PPE? You talked more specifically about shortages, so perhaps you could reply to that first.

[Barb Nederpel]

I'll pass that over to Georgina, as she's the expert in the OH and safety field.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Thank you.

[Georgina Hackett, Director, Occupational Health and Safety, Hospital Employees' Union]

To comment on the experience in British Columbia, one of the major challenges we found is that our long-term care sector is fragmented in terms of who owns, operates and runs those facilities. If you were working in a long-term care facility that was owned and operated by a health authority, there was greater coordination in terms of purchasing personal protective equipment and the standards that it came under.

In the early days, the privately run long-term care facilities and affiliate-run facilities were left to source a lot of their equipment. We had experiences where we needed to escalate PPE delivery to some of these facilities during outbreaks where they were caring for COVID-19-positive residents without the equipment they needed, or to facilities that found a source from a supplier that wasn't meeting the standards required for health care, and finding that we were even needing to ship this by taxi to those facilities.

One of the things that helped along the way was a centralized supply hub that the province set up, but again, the time it took for that to be established across all of the sector and all of the different owners and operators.... It took a significant amount of time during the crisis.

[Larry Maguire, Conservative, Brandon—Souris, MB]

You're basically getting into where I was going with this. In the early days, the government threw out the emergency stockpile of PPE that we had and then had a planeload of our PPE sent to China.

You've just made reference to the shortage of PPE in those early days. That caused a lot of stress and anxiety. I know that right here in my own constituency there were front-line care people phoning our office about that. Are you hearing any concerns from your members about shortages of PPE? You referred to the earlier ones, but where are we at now?

[Georgina Hackett]

We had concerns raised as recently as November, when different facilities were trying to access supplies: masks, non-medical masks, medical masks from different suppliers, goggles and glasses, and visors. It seems to have settled out in the last few weeks, but as recently as November there were issues.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Maguire.

Mr. Fisher, please go ahead. You have six minutes.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you, Mr. Chair. Six minutes are probably not going to be anywhere near enough with this group of witnesses.

First of all, I want to take a moment to thank all of you for being here. Ms. Nederpel, Ms. Hackett and Ms. Dreyfus, please take back to your membership the thanks of all the people on this committee for the incredible work that you and your members all do. We're so very thankful.

Ms. Dreyfus, I'm so glad you made a recovery from COVID. It is so nice to see you here, and thank you very much.

I'm going to go to you, Ms. Hay, if I could. Your statistics were alarming. The work you do is overwhelmingly impressive. Thank you.

I'm a father of two teenagers. When we think about how the schools and the programs for youth were all shut down during the first wave, I was so glad to see that we did invest over $7 million with the Kids Help Phone.

I also want to take a quick second to thank Tony Van Bynen, because we wouldn't be having these conversations if it weren't for Tony pushing so hard for this study, and it's so important. It's the pandemic within a pandemic.

I'm sorry that I'm taking so long before I get to a question, but this is pretty important stuff to me.

We see a light at the end of the tunnel with vaccines, but we're so far from being out of the woods yet. I think about social isolation, and I think about virtual-only learning for students across the country and the lack of in-person activity. It's a major issue. It was a major issue before COVID, and it's going to be a lingering issue long after COVID.

What can we do better to support this generation of youth right now and into the future?

[Katherine Hay]

Thank you for that question, Mr. Fisher. I could not agree with you more. You know as a father of two teenagers—I'm a survivor of the teenage years, thankfully—that what we are seeing right now with young people is an enormous amount of loss and grief.

My colleague from McGill University talked about touch and the lack of in-person interaction. It is important to create an environment where virtual care and virtual supports—multiple different ones, because one-size-fits-all doesn't fit anybody well—are integrated and seamless. I cannot say that enough, about the seamlessness. It is critically important that we build a system for young people where they are not left behind. For the work of this and other governments across Canada focusing on mental health and young people, the time is now, and we cannot let them get far behind.

I could give you a list of things that Kids Help Phone could partner with that would directly impact young people, but for today I just want to implore this committee to make sure that you push all of us in the sector, and yourselves, to make sure it's seamless, that we are not fragmented and that we're not assuming the gaps are small, because the gaps are large.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you for that.

This will probably run out my time, but as a parent I think about this a lot. Many parents wouldn't be able to tell the difference between a child just having a bad day and a child going through mental distress.

We talk about the virtual learning. We talk about Zoom life. As members of this committee, we all live on Zoom. We live in rooms with bad chairs and we live with bad lighting and bad backgrounds, but when we think about our children, this virtual learning is not working. I shouldn't say it's not working, but sometimes it's not working. My son did the first semester but wasn't willing to go back for the second semester and won't go back to school now until it's in person, because they're missing out on that quality of life, that touch, as the professor said earlier.

What are the signs that parents and guardians should look for when they're seeing a young person who may or may not just be having a bad day?

[Katherine Hay]

We need to remember that mental health did not begin with COVID. The things that worked for you before as a parent, teacher or community member are really important to put at the forefront now. Watch for a young person's change in behaviour. More isolation, distress or even overamplification of cheerfulness could be an indicator.

My best advice—it's Kathy Hay advice, not professional advice—is to be actively involved with your young person or a young person in your life. Watch what's going on. Don't assume everything is okay, because if you're feeling the stress of COVID, which we all are, I can assure you that young people are feeling it even more.

If I could put one final note forward, I would ask people in communities to please watch out for young people, because abuse is increasing. Kids are in homes that might not necessarily have been safe before, but they would have received support in their schools or community environments, which aren't available to them now. Keep your eyes open. Kids Help Phone does mandatory reports every day, and we work with young people and parents in those environments.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Excellent. Thank you so much.

Thank you, Mr. Chair. I know my time is up.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Fisher.

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