Health Committee on March 23rd, 2022

[Margaret Eaton]

No, I think most Canadians are concerned about their day-to-day lives: Do they have enough money to make ends meet? Can they see their family and friends? Can their kids go to school? A lot of these issues are provincial, in fact, and not federal. I think there is a little bit of relief of some of that stress now. As we've seen, most provinces are starting to open up. I'm hoping that will alleviate some of the stress.

In terms of chronic stress, I think we're going to have a kind of PTSD response to COVID-19. Some people will not even begin to experience some of the mental health impact until after things go back to normal. Then they'll start to feel the crushing weight. We'll also experience the long COVID impacts on mental health, which we're starting to see.

We believe that over the next two years we'll have to deal with more phone calls, more walk-ins and more concerns expressed by people about their mental health.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you for that.

You talked a bit previously about virtual care with respect to mental health services. If that was Dr. Cohen—I may have gotten it mixed up—I apologize.

Is it as effective as in-person service?

[Margaret Eaton]

There's lots of data now to suggest that virtual is very effective. Our only concern with virtual is that not everybody has access to broadband Internet, and not everyone has access to or can afford the devices that would be needed to actually take advantage of it.

I'll turn to Dr. Cohen, who has a comment.

[Dr. Karen R. Cohen]

Thank you.

I would agree entirely with Ms. Eaton that there certainly is evidence that for certain problems, care delivered virtually can be as efficacious as person-to-person care, but there are still huge inequities in people having access to not just technology but also the personal and private space to have that kind of care.

I'll make two quick points, if I may. One is around accessibility. I think there were huge inequities in terms of access to mental health services prepandemic. A pandemic that brought about all these mental health concerns only places a further demand on a system where people don't have sufficient access.

The second point is that we tend to treat mental health as if there's one problem and one solution. There is a great range of services. Some are delivered by community programming like the CMHA. Another person might need peer support. Another person might need assessment or psychotherapy. Canadians need better access to a range of solutions to a range of problems.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thanks to both of you for that.

I wonder, Dr. Cohen, since we have you on the hot seat, if you might comment on the three-digit suicide prevention hotline and the necessity and urgency to have that in place.

[Dr. Karen R. Cohen]

I think that any care we can offer people in distress is a good thing, but we have to be able to provide that follow-up care. Emergency response lines are important, but what's more important is the care that's delivered behind them. By and large, there aren't many mental health problems where there's a single session and it's resolved. We need to be able to provide that follow-up care.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Fair enough, and certainly I would suggest that there are significant inequities in terms of the system with respect to folks who choose to live rurally and often were disadvantaged previously.

Finally, if I might, maybe we should talk a bit about the opioid crisis, which certainly has accelerated during the pandemic and has caused significant problems. I'll leave it open, Dr. Cohen. I'm feeling magnanimous. Could you just give us some words on the opioid crisis?

[Dr. Karen R. Cohen]

Well, that's not my area of expertise, but I think we've certainly seen increases in the use of substances, particularly for people who may already have had concerns or issues with the use of substances. I would say that this kind of care, those kinds of interventions, both for mental health problems and substance use need more investment, and we need to invest in them with parity, the way we provide care for physical health problems.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Do I have any more time?

[The Chair, Liberal, Sean Casey]

No, you do not.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, sir.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Ellis.

Thank you, Dr. Cohen.

The last round of questions will be posed by Ms. Sidhu, please, for the next five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you to all the panellists for their testimony.

My question is for the CMHA. Thank you very much for the work you are doing for the community. You are reaching one million people with the 318 branches. Thank you to all the frontliners.

On May 3, 2020, a federal investment of more than $240 million was announced, including support for Wellness Together Canada. Health Canada reported that, as of January 2022, the Wellness Together portal had been accessed by over two million Canadians, with many people reporting positive changes in their self-assessment skills. Can you speak to the success of this system? What would you like to see improved, and what do you see that is effective?

[Margaret Eaton]

We were really delighted to see Wellness Together and see the federal government make that investment. It was very important. It provides a huge selection of virtual supports, and it even includes in-person support where there are a few hours of free psychotherapy offered to people.

We think it was an absolutely important and necessary response to the pandemic that the federal government could uniquely make to have a national service. We've been very pleased to see that it will be carried on.

The only enhancement I would make is that I think there needs to be more promotion of that service. More people need to know about its availability. I think it can really fill a gap and it will continue to. I know that the government is interested in seeing it carry on, and we are interested in seeing its continuance as well.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Dr. Eaton.

Dr. Cohen, you can take the next question.

Obviously we know that there's a lot of need and a lot of chronic stress out there, and we should also talk about seniors' mental health. The federal government recently appointed the first federal Minister of Mental Health, with the goal of creating mental health transfer payments, distinct from the existing Canada health transfer, with all of this in mind.

Do you feel that there needs to be more collaboration between mental health providers and the mainstream medical system? Or should there be more focus on community and peer support?

[Dr. Karen R. Cohen]

That's a great question.

One of the things I mentioned in my opening remarks is that we came together on a paper with our provincial psychological association partners to suggest how a federal mental health transfer could be invested in the provinces.

We strongly support the integration of mental health services and psychological services into primary care. That's the funded door. That's the door where most Canadians first have access to health providers. Integrating mental health services there makes a tremendous amount of sense, and doing it in such a way that there's some kind of parity in funding for services delivered.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

My next question is for Dr. Eaton.

In terms of virtual care, many physicians offered phone and online virtual appointments. These practices are also referred to as “telemedicine”. What are your observations with respect to the overall uptake and acceptance? Do you think it's helpful? I got lots of positive feedback from my residents.

[Margaret Eaton]

Yes, I believe it was very helpful. Many of our CMHAs pivoted to provide virtual services. It was hugely beneficial to people, especially seniors and people who were in lockdown and did not have access to in-person.

In fact, it's been so successful across the country that our branches are going to continue to provide virtual services, even while they're opening up their doors to clients once again on a more regular basis. We hope to continue to be able to provide that and to have funding for that—not just for the actual caregivers, but to actually place the technology into the hands of our clients, for those who need it, and to be able to provide that Internet access.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Eaton.

Thank you, Ms. Sidhu.

To our witnesses, that concludes our rounds of questions. I want to thank you for your patience in waiting on us while we exercised our democratic duty. Thank you for your professionalism and for the depth and breadth of the knowledge you contributed to this discussion today. It was a varied and robust panel. It will add greatly to the value of our work. We are extremely grateful for your being with us here today and for answering our questions so comprehensively, professionally and patiently. It's greatly appreciated.

Is it the will of the committee to adjourn?

We're adjourned.