I'm going to be taking her time.
Evidence of meeting #15 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pandemic.
A recording is available from Parliament.
Evidence of meeting #15 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pandemic.
A recording is available from Parliament.
2:30 p.m.
Conservative
January 29th, 2021 / 2:30 p.m.
Conservative
Chris d'Entremont Conservative West Nova, NS
Thank you very much.
I want to start with the Grief Alliance for a moment.
Nova Scotia is the province I live in, and I know there are a number of us who are Nova Scotia-based: Mr. Fisher and Mr. Kelloway. Nova Scotia has been experiencing a lot of grief, whether due to the Portapique murders, or the six people we recently lost here from the southwest in a vessel, and we just lost a couple down in our neck of the woods as well. So, it's been a lot.... Even beyond the COVID issue, there's been a lot of very public grieving—or the lack thereof.
I want to understand what a grief service might be, because we don't have one here. Beyond the community and a few community members coming together to bring families and groups together, I don't know what a grief service actually is.
2:30 p.m.
Member, Canadian Grief Alliance
Thank you so much for that question.
There are definitely organizations across the country. I know that there's a wonderful provincial bereavement lead in your province, actually, as well. They are people who have the specialty and expertise and who are serving people on the ground. I'm from Toronto, and I can tell you that there are organizations such as Bereaved Families of Ontario, and a lot of hospices offer bereavement support.
You're right. There's a patchwork of grief services across the country. This is an under-resourced area that really has affected all of humanity prior to the pandemic. You can imagine that this patchwork of services that has been there pre-pandemic is just bursting at the seams, as I said, because they are hidden. They're things that people don't know about or access until they are affected.
When someone dies in a long-term care home, as so many thousands of people are doing across the country, there is no follow-up bereavement support. When someone dies in a hospital, there is no follow-up bereavement support. I will say, as a proud member of the palliative care community and as a hospice social worker for the past 10 years, that in most palliative care contexts there is no follow-up bereavement support. Hospices are one of the sole places where that happens, for about a year, but any grieving person can tell you that one year is not sufficient in many instances, and with the immense amount of grief and loss happening in your province, that's what we're thinking about when we think about complicated grief.
Complicated grief happens when a person, a community, or a family experiences multiple losses in a short amount of time or a long amount of time. Loss upon loss gets amplified. In many ways, I would never want to project onto your community, but I imagine that there are some manifestations of complex and complicated grief because of these multiple instances of trauma and loss happening around you.
Those are the examples we're speaking of, but, yes, I can look at my list to see who we have. Hospice Halifax would be offering bereavement support, but you're right, it's not like a grief service.
2:35 p.m.
Conservative
Chris d'Entremont Conservative West Nova, NS
We're three hours away from that, so it's a big challenge.
2:35 p.m.
Conservative
Chris d'Entremont Conservative West Nova, NS
It's a big challenge, and since COVID is here, we're not travelling as we should be and we're not going to get the services that we should be getting, so that's adding to it.
In the three-point plan that you have, or the request you have, have you gone to governments? I'm going to guess that it's a health issue, and each province is a little different and there's a federal component. Who have you gone to and what kinds of commitments have you gotten at this point?
2:35 p.m.
Member, Canadian Grief Alliance
We have been meeting with some MPs who have been open to that. One of my colleagues within the CGA has met with the Minister of Health in Thunder Bay. I think all of us have been working off the side of our desks as a volunteer effort in trying to get attention for this urgent need.
I'm happy to have my colleague Paul add to that in any way, if that would be helpful.
2:35 p.m.
Member, Canadian Grief Alliance
We've interacted at the moment principally with the federal government. We've been trying to get our message out through media.
What you were saying really touched me. I lost my wife four years ago to cancer. I was able to be at her bedside. We had a funeral. Family and friends came. We were able to travel to be with other family members. All of these things are denied people. As you were describing, in a situation of irregular and really profound loss, it's very difficult to imagine that people have the resources at hand to get through this.
2:35 p.m.
Conservative
Chris d'Entremont Conservative West Nova, NS
I have a minute left. I want to go to Dr. Lalonde for a minute.
When we talk about the transfer of doctors and locums and being able to at least transfer these experts from one province to another, does it not sometimes fall upon the shoulders of the self-regulated college of physicians or what have you? How do we deal with that as a country when we have so many of these self-regulated organizations or colleges?
2:35 p.m.
Executive Vice-President of National Medical Services and Chief of Staff, Homewood Health Centre Inc.
I think it's a great question, one that I don't have a simple answer to. One of the few benefits of the COVID situation currently is that it has increased the sense of community and collaboration across the country and between organizations and such. This is a topic that's been spoken about for years, and, again, even prior to this pandemic there was talk by some about a pan-Canadian licence.
It would require collaboration and communication amongst the different provincial colleges, whether we're talking about the college of physicians for the various provinces or other professional governing bodies, to essentially communicate and collaborate. It wouldn't be that difficult because we already have to register most of our documents and most of our other qualifications online. It would essentially just be a matter of provincial colleges co-operating and coming up with some type of formula to be able to make this work. It is something that could happen very quickly. Take a process that takes currently a couple of months and whittle it down to something that could take a couple of weeks, or maybe even a couple of days. The requirements are almost identical across all provinces. These boundaries that we've formed over time just need to be broken down so we will be able to provide the services to the people who need them.
Again, there was a survey last year of Canadian physicians, which showed that 90% of the doctors in Canada thought it would improve access to care across the country if we were able to do this, and about 50% of those physicians would be willing to do locums in various provinces, with a similar number of people willing to do virtual care.
2:35 p.m.
Conservative
2:35 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. d'Entremont.
We go now to Mr. Van Bynen.
Mr. Van Bynen, please go ahead for six minutes.
2:40 p.m.
Liberal
Tony Van Bynen Liberal Newmarket—Aurora, ON
Thank you, Mr. Chair.
I want to start off by saying that I will be sharing my time with my colleague Mr. Kelloway.
Dr. Lalonde, thank you for joining us and thank you for the important work you do. My understanding is that you're providing support and health care support for many of our health care workers. Based on what we heard in the previous setting, there's a critical need.
We've already seen everybody spending a lot of time projecting what our COVID virus cases will be. We're all talking about how serious mental health is. Frankly, I believe the next wave is going to be much greater, and a big role for this committee is going to be to identify the gaps going forward so the government can respond.
Is there any way we can project the trajectory of mental health needs and mental health cases going forward so we can start preparing now to have the resources we're going to need?
2:40 p.m.
Executive Vice-President of National Medical Services and Chief of Staff, Homewood Health Centre Inc.
I think there are ways, and I think some people are working on those specific projections. Again, as this pandemic has continued, we know the rates of depression have increased further, and the rates of anxiety have increased further. It's one thing to be able to deal with a stressful situation for a short amount of time, but we know the cumulative effective of this type of scenario tends to continue to raise various rates of all sorts of different conditions.
Again, we know that those who are most under-serviced will probably be most impacted. Folks who already have medical and psychiatric conditions, folks who are already on the cusp of poverty, people who don't have access to those resources, people who are losing their jobs and don't have the financial resources otherwise—those populations will continue to get worse, as is the case for all of us. However, again, proportionally we know certain populations are likely to be more affected. Women seem to be at slightly increased risk over men at this point. As well, there are families with young children under the age of 18, those in marginalized communities, racialized people and members of our LGBTQ community, and people who are the most financially impacted.
We know which populations are at greatest risk. We know the rates are rising and we know that given the difficulty of predicting what's going to happen moving forward with this pandemic, rates of various mental health and addiction conditions will continue to rise.
2:40 p.m.
Liberal
Tony Van Bynen Liberal Newmarket—Aurora, ON
Many points were raised about a pan-Canadian data system. If we could do that with respect to mental health as well, it would help us identify the gaps and the areas where the gaps are the greatest.
2:40 p.m.
Executive Vice-President of National Medical Services and Chief of Staff, Homewood Health Centre Inc.
Yes, absolutely.
2:40 p.m.
Liberal
Tony Van Bynen Liberal Newmarket—Aurora, ON
There's another wave I'm concerned about. Every year, Canadians show symptoms of seasonal affective disorder, or SAD. With winter just starting and as the post-holiday depression kicks in, we now have a pandemic on top of that. I know it's still early in the year, but is there any data so far that shows how this pandemic has impacted people who are experiencing SAD?
2:40 p.m.
Executive Vice-President of National Medical Services and Chief of Staff, Homewood Health Centre Inc.
That's a good question, but it's very difficult to tease out. In truth, I haven't looked at the data on rates that could distinguish between those two conditions. We know that for many people, particularly in certain parts of the country where there is far less sunlight, the winter months are much more difficult. We know that for these winter months in particular the rates are far higher than before, but it is difficult to distinguish how much of that is related to SAD and how much of that is related to the pandemic. Realistically, compared with last year, given other conditions being the same, the rates are much higher in relation to the pandemic.
It's of less importance to tease out what the causation is than it is to recognize that the rates are higher, identify those most in need of treatment of severe depression, whether it's SAD or otherwise, and connect them with the appropriate resources—and not only counselling. Again, we need to go beyond counselling. When you get to the point of meeting criteria for certain conditions, you need more specific evidence-based therapies, including, potentially, a SAD light for some people, evidence-based psychotherapies, measurement-based care and, again, sometimes medications. That requires that human resources be available for those people to access.
2:45 p.m.
Liberal
2:45 p.m.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
Thank you, MP Van Bynen. I appreciate it.
My question is for Dr. Lalonde. Homewood Health is a partner in the mental health portal Wellness Together Canada. My question for you—or one of them, anyway—is, has this portal been useful? Has it been a useful resource for you and the people you work with?
On my second question, thank you so much for the four pragmatic areas to look at. I will need to call you or do a Zoom to unpack all of it, because I'm very interested in that.
2:45 p.m.
Executive Vice-President of National Medical Services and Chief of Staff, Homewood Health Centre Inc.
Absolutely.
2:45 p.m.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
If there is one area to start with in those four, where would it be and why?
Thank you so much.
2:45 p.m.
Executive Vice-President of National Medical Services and Chief of Staff, Homewood Health Centre Inc.
In terms of the first part of your question on whether it has been helpful to people within certain organizations or nationally, I do think that it has been helpful. I think it has been very helpful, just by simply looking at the number of people who have accessed this service. I can't give you the specific number. I think Ms. Bradley mentioned earlier that it was over 500,000. I believe it's actually closer to 800,000 or so at this point, but I could be mistaken on that. We know that quite a number of Canadians have accessed that resource.
Again, in trying to provide the most appropriate level of care based on that individual's needs, whether it's connecting with certain online resources for education, iCBT, peer support or up to four sessions of one-to-one counselling virtually, we know that many Canadians have benefited from this service, but we know that it can only go so far. Again, if certain people have more severe conditions, that's when this service starts to be insufficient.
In terms of what I would do first, again, in terms of what can be done right away, I think the co-operation of various colleges across Canada can happen very quickly, and it would very suddenly increase access for a whole lot of Canadians to psychiatrists, other physicians, psychologists and other mental health professionals if we were able to break down those interprovincial boundaries.
2:45 p.m.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
Thank you so much. I will be reaching out to you.
Thanks to the witnesses. It has been very illuminating.