Health Committee on Sept. 24th, 2024

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

Thank you to all the witnesses.

I will also echo my colleagues in thanking you, in particular, Mr. Sword, for sharing your tragic story about your daughter.

On that theme, I'd like to begin by asking Ms. Kennell to consider the situation where a child is in distress, but not asking for help. Are resources in place? Are interventions in place to assist such a child, and what would you amplify to enable that child to be helped?

I'll ask you to keep it as concise as possible, because I have many questions.

[Sarah Kennell]

Thank you very much, Mr. Hanley.

The short answer is no. We do not have the necessary supports to help children and youth deal with the mounting mental health and substance use health challenges they are facing and are going to face as they age.

The solution, to echo Dr. Conrod's points, is building in upstream preventative and mental health promotion interventions that meet them along the way and create effective referral pathways into available, community-delivered, out-of-hospital treatment options. These could be early psychosis intervention or prevention programs that deal with addiction and substance use health, to name a few.

The issue is that everything is behind a paid door, not available or behind long wait-lists.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

Ms. Kennell, do you consider mental health care part of primary health care?

[Sarah Kennell]

I do, 100%. I would wager that it is core to what medical students learn every day.

The challenge, though, is that our health system is not equipped to deliver mental health and substance use health care that is on par with physical health care or primary health care. With the shortage of access to family physicians and the lack of adequate and robust training for medical health care professionals, the resulting consequence is that people don't know where to go to get help, they face long wait times or there are inadequate solutions when it comes to addressing their mental health concerns.

[Brendan Hanley, Liberal, Yukon, YT]

Dr. Conrod, I will ask you the same first question about the child in distress who is not asking for help.

Could you comment briefly on that and the availability of interventions?

[Dr. Patricia Conrod]

The best way to deliver services to that young person who might not be asking for help but is demonstrating signs of struggle is in a school—where the young person has to show up every day until the age of 16, where it is very easy to provide early upstream psychological interventions to young people, and where there are programs that have been shown to be effective in preventing mental health problems as well as substance use problems.

The challenge right now is staffing mental health teams in schools. There are some advantages to this model, though, in that they can be linked to community-based resources so that when the problem is beyond the capacity of the school, there's a way for a school-based team to interact with health services, for example, and rapidly refer that young person to more intensive care.

[Brendan Hanley, Liberal, Yukon, YT]

Excuse me, Dr. Conrod. I'm going to interrupt you there. I want to give a minute to my colleague Mr. Morrice to be able to ask a question.

Thank you very much.

[Mike Morrice, Green, Kitchener Centre, ON]

Thank you, Brendan. I appreciate it.

The situation in my community in the Waterloo region is dire. Over 63 folks have died from preventable deaths this year. We haven't seen organizations get renewed funding from the substance use and addictions program as of yet. We also have a premier who is looking to close safe consumption sites that are saving lives.

I guess my question is for the CMHA. I really appreciate that you've worked with Thresholds to launch an integrated crisis centre for mental health in our community. Thank you for that.

In your testimony, you talked about having Health Canada launch a new task force for a national strategy to address this crisis. In the time I have left, maybe 30 seconds or so, can you share just a few key points of what you'd want to see in that if we were to listen to the experts and not the partisanship?

[Sarah Kennell]

Thank you very much, Mr. Morrice, for the question.

I want to really reiterate that the view of the Canadian Mental Health Association is to provide comprehensive wraparound care that spans upstream interventions to help prevent the onset of crisis into more acute services, and then to really support people into their path towards recovery. I would be remiss if I didn't take a moment to really echo support for that wraparound long-term support, which is the social determinants of health. As my colleague Margaret mentioned, unless we have adequate housing and unless we have income supports, we will be facing a revolving door of a crisis.

Our recommendation to Health Canada and the federal government writ large is to develop a comprehensive and integrated plan that scopes out what existing programs are available for community providers like CMHA and others to do that life-saving work on the ground, fill the gap of what's being provided through the acute care system and then assess where there are additional gaps. Perhaps it's prevention in school-based prevention programs. Perhaps it's more investments in the social determinants. We need to take a whole-of-society and whole-of-government view of what the federal jurisdictional responsibility is. That begins with a plan.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Kennell, and thank you, Mr. Morrice.

Mr. Thériault, you have the floor for two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Ms. Eaton, witnesses who specialize in addiction and prevention have told us that 30% to 70% of people struggling with addiction have a primary mental health problem. That is not insignificant. We are also aware of the whole issue of access to mental health care.

What do you recommend so that we can help these people before they get to the point where they are self-medicating to try to relieve their suffering themselves? Would you agree with that statement?

[Margaret Eaton]

I'm going to turn to Sarah Kennell in the room to answer this one.

Thank you.

[Sarah Kennell]

Hello, Mr. Thériault. Thank you very much for the question.

The reality is that millions of Canadians lack access to primary care. The solution can't be solely hiring more family physicians. If we are going to address the health human resources crisis across the country, we need to look at expanding the health professionals who deliver mental health and substance use health to ensure that we are adequately resourced with social workers, occupational therapists and peer support workers. Those are the types of professionals we need in order to fund a robust and comprehensive mental health and substance use health system.

Sadly, many of those professions are being left out of national conversations regarding health human resourcing, coupled with the fact that those professionals, when hired outside of hospitals or doctors' offices, are not adequately paid for their services. In Ontario, for example, they make 20% to 30% less than their colleagues who are in other health industries, resulting in what my colleague, Margaret, spoke to, which is a high level of retention and recruitment issues, and burnout, given the moral distress they are witnessing on the ground.

Our solution is to amend the Canada Health Act, with a view to include those services and health care providers to ensure that they're adequately compensated, and covered within our public universal health care system.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Kennell.

Next, we have Mr. Johns, for two and a half minutes, please.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Thank you, Mr. Chair.

I've tried to delay tabling motions to get a first hour from witnesses, but I need to move some motions right now. The first motion I put on notice reads:

That the committee instruct the Chair to write to the Auditor General of Canada to recommend that a performance audit examining the federal government’s response to the opioid and toxic drug crisis in Canada, including but not limited to its management of programs identified in the Canadian Drugs and Substances Strategy, be initiated, and conducted on a priority basis.

I would like to briefly speak to the motion.

[The Chair, Liberal, Sean Casey]

The motion is in order as it relates to the subject matter at hand, so the debate is on the motion.

Is there any debate?

Go ahead, Mr. Johns.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Hopefully, we won't spend a lot of time on this motion.

By way of background, in December 2022, I wrote to the Auditor General to recommend that an audit be conducted of the government's response to the toxic drug crisis. At the same time, I received a response stating there was an intention to conduct an audit on the issue, but the work was not envisioned to begin in 2023.

On the Office of the Auditor General's website, there is a list of anticipated reports for 2024-25, which still doesn't include the toxic drug crisis. There have now been 15 Auditor General reports on elements of the government's COVID response, with two more on the way. An audit on the government's response to the toxic drug crisis is overdue. I hope members of the committee will support this motion.

I just want to mention that on Vancouver Island only one riding out of seven got SUAP programming. I know that my friend from the greater Waterloo region, Mr. Morrice, didn't get any. I think it's relevant that we write to the Auditor General, and ask this to be prioritized.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Johns.

Go ahead, Dr. Ellis, please.

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

Thanks very much, Chair.

The biggest problem I would have with this motion, of course, is that there's ample opportunity at other times to discuss extending the study on opioids, which, to me, this directly relates to it. We have witnesses here, and our friend from the NDP is bringing this forward now. This is a little ridiculous.

As I said, there is more than ample opportunity to bring this up on many other occasions. I'm not sure why this grandstanding is ongoing at the current time.

[The Chair, Liberal, Sean Casey]

Mr. Johns.

[Gord Johns, NDP, Courtenay—Alberni, BC]

It's not grandstanding. I'm trying to get this motion moved, so we can write to the Auditor General. I just put it on notice last week, so this is just timely. I'm trying to move it, so we can write to the Auditor General. I don't think there should be any objection to this.

[The Chair, Liberal, Sean Casey]

Is there any further debate on the motion?

Seeing none, are we ready for the question?

All those in favour of the motion presented by Mr. Johns, please raise your hand.

All those opposed?

(Motion agreed to)

Mr. Johns, you still have two minutes and 23 seconds.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Thank you.

Ms. Eaton, you talked about the fact that there's no plan.

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

I have a point of order, Chair.

[The Chair, Liberal, Sean Casey]

I have Dr. Ellis on a point of order.