Health Committee on April 11th, 2024

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

I'm leaving it to you, Jeanne and Linda, to talk about trauma. The first time I met you was during COVID. We talked about a young woman being tied to a radiator; I think that was one of the first stories you shared with me.

When we're looking at counselling, what is available? You can't even get into a counsellor for simple mental health issues, whether it is anxiety or.... I know anxiety is not simple. However, when we're talking about complex trauma from human trafficking, what is available? Who is educated to help with counselling? What do we have here in Canada to help save some of these young women from the mental torture they're going to continue to have for the rest of their lives?

What can we do?

[Linda MacDonald]

With regard to torture and human trafficking, the only place we know of that took on the model we created is the London Abused Women's Centre.

Other than that, we have emails. I answered an email this week from a woman whose daughter was tortured in trafficking. I had to tell her that, where she lives in Canada, there's no one I know of who can help—not in the way she needs.

I want to tell you some of the reasons why victimization- and trauma-informed care is so important. Things disappear. People stop being suicidal. They stop being triggered. They stop disassociating. They're able to sleep at night. They go off medication. They go off disability. They get a quality of life where they can have fun and joy, and just be free to be themselves.

I know it's hard to read at night, Anna, but the story is a good story. It's a positive story if we embrace their reality and know that, if they can heal from torture, they can heal from anything. It's the worst crime on the face of the earth. There's no place for them in this country yet, because we don't have the law. Of course, because we don't have a law, we don't have the care they need and deserve.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thank you so much.

[The Chair, Liberal, Sean Casey]

Next, we have Dr. Hanley.

Go ahead, please, for five minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you so much, all of you, for being here.

I'm going to start with Ms. Enright.

You talked about not having funding for the under-16 age group at your centre. Could you briefly talk about what is available in your area for that age group—children and younger youth?

[Jocelyn Enright]

Unfortunately, there's not a lot.

I think the assumption is that, because we have a duty to report, the police and CAS are the appropriate services when somebody under 16 has been harmed. It's assumed that we call them and let them handle that. We know a lot of those scenarios, again, are incredibly harmful and come with a lot of stigma. People might not be treated in the right way.

Yes, of course I can call the police for something when it's somebody under 16. If they decide there's not enough evidence, I can't offer counselling. I'm stuck saying, “Here is a child and youth centre that has a one- or two-year wait-list, potentially.” I don't know if it's changed, but over COVID, in Peterborough, we were looking at at least two years for most of our child and youth service wait-list. I cannot guarantee the workers—who I am sure are wonderful at their jobs—have the specific training to work with survivors of sexual abuse, which often needs different ways of looking at it. We often can't use a particular modality without making some changes to make it more trauma-informed.

Unfortunately, those are our options right now. We're left in a position of not having a lot for people.

[Brendan Hanley, Liberal, Yukon, YT]

Speaking of funding, you talked about where the federal government might have a role. I think part of it was engaging with the provincial government on core funding and boosting other sources of funding. A pre-budget announcement recently from Minister Saks was pretty good news: $500 million dedicated towards youth mental health.

Let's say you had a slice of that funding. Where would you put it in your community? Where would you go first? I know it may depend on how much, but let's say you had a chunk.

[Jocelyn Enright]

I was told that our dream is for $700,000 more. That would be the bare minimum for us to have core funding to support who we're supporting and who we're missing. That's the huge thing. We could do as much as we could to create as safe a place as possible. I'm trying to provide my voice for that. We're missing a lot of people who are falling through the cracks.

Yes, I understand the need for all sorts of childhood mental health...but looking at all those different sections.... It's not just saying, “mental health”. Okay, we could mitigate a lot of those mental health things by putting the money into centres like ours. That's great. Let's do that. However, I think, a lot of times, we don't consider children who are coming from domestic abuse situations. It's not as simple as saying, “Leave the situation.”

“Well, can I go to a shelter if I have my children? Is the shelter low-barrier? What if I'm using substances to cope with that sort of stuff? What if my children are using substances to cope with it?" There's putting funding into that, as well. A lot of that could be getting people those basic necessities as they're leaving those situations.

Also, there are organizations people don't think of right away. We might think about putting it into mental health, but if it's put into different forms of things—into torture or into the work we're doing with sexual assault—chances are we might see decreases of further mental health disorders.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

I'm going to move to Dr. Galea. I have so many questions for you.

You talked about getting women's health studies published. Is it about the content? Is there any role in being a woman doing the research? Does that play into it at all, as a female researcher?

[Dr. Liisa Galea]

Yes, it does—100%. We tend to research what we are interested in, and we're interested in things that we've experienced.

I'll give you a really good example of this. I experienced nausea and vomiting very badly during pregnancy. I was told it was just in my head. I want to make it clear that I had a fantastic health care provider. They just hadn't had the schooling, because we don't have the research in knowing some of these things. She told me not to worry about it, that she could admit me to hospital, but it would go away. I just sucked it up, because that's what you do. My son is now 27 years old, so fast-forward 27 years, and we now know that there's a hormone called GDF15.

I'm sorry, but I've forgotten the name, but it was discovered by a woman in the States. She suffered very extreme nausea and vomiting during pregnancy, and actually ended up losing her baby. The other thing we were told was that it was fine and really safe—but actually not for some people. She was a geneticist. She started to look for a genetic factor for it and found this hormone. Now there are some putative treatments that we can use for people who have really severe nausea and vomiting during pregnancy.

When she told her lab that this was what she wanted to start studying, they laughed at her. She persevered, because this was an experience she had. She wanted to know what this meant and why it was happening.

Women scientists are more likely—the data is not 100%—to work on the issues that matter to them. It's important. As you probably know, like in many areas, we don't tend to move up the ladder as well.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Galea.

It is now Ms. Larouche's turn for two and a half minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you, Mr. Chair.

For this turn, I want to come back to Ms. Galea.

Again, I don't understand why there is such a difference in funding between research on women's health and diseases and research on men's health. The figures you gave are really alarming.

Can you go back to the reasons for this investment gap and tell us what more can be done?

You also mentioned that higher investments in research on women's health would lead to savings. You talked about a trillion dollars in savings, if I understood correctly. I would like you to come back to that figure and tell us which organization provided it.

[Dr. Liisa Galea]

I'll answer the last question first.

I'm sorry, my French isn't very good.

The $1 trillion worldwide that we could save if we achieved more knowledge in women's health research is from the World Economic Forum's report that was just released a month ago or so.

One of the major federal funding agencies is the Canadian Institutes for Health Research. They have something like 58 committees. They'll be on neuroscience, and biological and clinical aspects of aging. None of them is for women's health in particular. There is one on maternal and child health. I've tried to get funding through them. I can't get funding through them, because it's mostly on the child, as you might imagine.

There's another one called gender, sex and health, GSH. That's where I tend to get my funding. If you look on Twitter/X you'll see my pinned rant. I was really angry, because in that committee I put in a grant five times on looking at how pregnancy affects the aging brain, and they kept asking me to add males. Males don't get pregnant. I couldn't do the work that they wanted me to do. Also, there is a lack of research and publications in this area. There is this mistaken belief that girls, females and women are harder to study, because they're more hormonal. We have these menstrual-cycle phases, so we're more difficult to handle or interpret. However, just for a little bit of levity, human males have a 50% decline of testosterone that occurs daily. I have one little thing that I say: Given the monthly fluctuation in females and a daily fluctuation in males, who's more hormonal now?

There have been many studies done to show that there's no difference in variability within each sex. I can't tell you. I wish I knew the answer.

[The Chair, Liberal, Sean Casey]

Thank you. I interrupt with great reluctance.

We'll go to Ms. Gazan, please, for two and a half minutes.

[Leah Gazan, NDP, Winnipeg Centre, MB]

I'm not sure if anybody can answer this, but I was really shocked. Two days ago there was a woman from Mexico who was denied a C-section in Edmonton until she came up with $5,000 to do so.

I've been really pushing for status for all for these kinds of reasons, safety factors for women.

You spoke a little bit about mental health. I'm wondering if perhaps Madame Enright, Dr. Fairbrother or Dr. Galea could answer how that places women's health at risk, a current, systemic racism within our system—I call it systemic racism.

Can somebody answer that?

[Dr. Nichole Fairbrother]

I can say just a little bit about that from my own experience.

I've had a number of conversations over the past 10 years with indigenous women who have spoken to me about mental health concerns. When I hear their stories of some of their experience within the health care system and within psychiatry, the feeling I have is surreal. I feel like they are reading from a recent news article describing the problem. It sounds like—and I don't mean this in the trivializing sense—a cliché.

What they're describing is what we've all received notification about or we've seen headlines talking about, and then they're telling me these stories that map on exactly to that, and it feels extraordinary to me.

I think I had the hope or the impression that, given that this has become better known, it would not still be happening, and clearly it is still a very serious and ongoing concern.

[Leah Gazan, NDP, Winnipeg Centre, MB]

I appreciate that because, as I asked you on break, we know that forced sterilization of indigenous women continues to happen in this country. Discrimination is certainly not new in our health care system.

I was horrified. I just thought, “Oh my goodness, what she must have been going through when she was denied the ability to deliver a baby in a hospital”. How can this be allowed? Do you have any comments?

[The Chair, Liberal, Sean Casey]

Be very brief, if you can. We're out of time.

[Jocelyn Enright]

I'm not as well versed with the health care system, but certainly, we work with women all the time who discuss how they don't feel comfortable going to the hospital for anything related to any health issues because of the systemic discrimination they face.

It's being denied something that you think is just a basic human right in Canada, to be able to go in and have this procedure. It seems so simple, but it's not happening. We see a lot of the same with our survivors going in for anything related. As they soon as they identify as being a woman, as soon as they identify going through any sort of trauma or sexual violence, they are treated incredibly differently.

[The Chair, Liberal, Sean Casey]

Thank you.

Next is Mrs. Goodridge, please, for five minutes.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

I really appreciate all of the witnesses being here.

I'm going to focus some of my questions specifically to Dr. Fairbrother and Dr. Galea.

I shared with you before committee started that I am a mom to two little boys. Specifically on the perinatal mental health and the anxiety piece, that wasn't something I even knew existed.

When I had my first son, I didn't have any of those experiences. Very shortly after having my second son, I realized that my anxiety was crippling, out of control. I felt like there was something wrong, and he was born a month early. There was a lot of extra stress, so I just assumed that, clearly, I was anxious, and there was something to be anxious about.

It took finding some of your research that helped me realize, “Hey, wait. This is just a normal phenomena. This too shall pass. I am fine. It's all good.”

I share that because I didn't even know that it existed. I was wondering what recommendations you would have that we could put forward on improving this aspect.

[Dr. Nichole Fairbrother]

You're absolutely right.

Major depression and postpartum psychosis are probably the two mental health conditions that have received the most media attention, the most research, etc. They are the two conditions that people know the most about. Postpartum depression, as a major depressive disorder, affects approximately 6% of new moms, versus anxiety disorders, which affect 21%. All of the research and attention that have been given to depression and to psychosis are well deserved. That's lovely. However, we have not spent any amount of time really giving attention to these anxiety difficulties that are much more common.

A starting point is even just naming this. I will often speak to people who say they had postpartum. They don't even qualify what kind of postpartum. There's the assumption that it was depression. If you go into a physician's office and they start asking you about depression and you have some elevated symptoms of depression, it is quite possible the reason you're depressed is because you're suffering from an anxiety disorder that nobody's asked about and nobody has talked about, and yet you're being diagnosed with depression because a consequence of that disorder is depressed mood, but it's not on anyone's radar.

We need some increased public information about that so that people are more aware that it exists. Someone earlier spoke about prenatal education. Information about what that looks like is really important, as is additional dedicated research so we can learn more about this. It's important to look at whether people are informed and what we can do to ensure that new parents come into this with better information.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Dr. Galea, go ahead.

[Dr. Liisa Galea]

I was writing down a whole bunch of things. Obviously, my big message here is research, research, research. We know so little about what happens to the maternal brain. As I said, there are a number of biological signatures that occur across pregnancy and postpartum. I would love to make some jokes, but I know I don't have time for them. Those signatures mirror what happens in a number of psychiatric disorders, including depression. I probably disagree with my colleague a little bit on the numbers, but that's not the point. The point is that it is a time of really great susceptibility, and we need to provide people with the tools they need to understand this.

There's a great new discovery that just came out of CAMH from Jeffrey Meyer. He's looked at some supplements and at evidence-based information on what's missing, what the biological signals are and how we can better serve people.

On psychosis, I would disagree. I don't think most people know that you can get thoughts, psychosis and schizophrenia-like symptoms after giving birth. Only about 1% of people will have that, but it's pretty significant.

Patricia Tomasi has a really great article. They did a big piece on her in Toronto Life if you want to take a look at it.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you.

I appreciate it, and if you can table any of that extra information with the committee, that would be very useful.

I would like to move a motion that I have put on the Order Paper, and I think it's very timely, considering we're studying women's health. Mr. Chair, it is:

That, pursuant to Standing Order 108(2), the committee undertake a two meeting study on breast cancer screening guidelines in Canada, including but not limited to, an examination of (a) current breast cancer screening guidelines, (b) Breast Cancer Canada’s recommendation to lower breast cancer screening guidelines to begin at age 40, (c) Breast Cancer Canada’s recommendation that Canadian guidelines for the screening, detection, and treatment for breast cancer be updated every two years, (d) best practices in treatment and options to improve health outcomes; that the committee report its findings and recommendations to the House; and that, pursuant to Standing Order 109, the committee request that the government table a comprehensive response to the report.

I am moving this in this space because April is cancer awareness month. I am also doing it for people like me. I lost my mom to breast cancer in 2010. She was 49 years old. I know that, had earlier breast cancer screening been available, I might have been able to talk to my mom when I was going through postpartum anxiety and see if that was something she had. However, I didn't have that resource.

As a direct result of these screening guidelines' not being in place, many women don't have this. I am doing this in honour of my mom and of all of the women who will benefit, as well as their families and society.

Mr. Chair, I will move my motion and I hope everyone will support it so we can get a study on this very important topic.