Evidence of meeting #131 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was mental.
A recording is available from Parliament.
As an Individual
Absolutely. I exercised every option I had. I went to hospitals. I went to mental health places. We went everywhere. We were basically told, “We have exercised all our options. We are sorry. We condole you. We're happy for your best efforts. Thank you.”
As an Individual
The only gift they gave us, really, was a Narcan kit. It's pretty alarming as a parent to receive a Narcan kit instead of, “Hey, here's a doctor's number. Maybe these people can help.”
Social workers didn't have a clue. Their answer to us was that their resources were so limited. Especially because of her age, there wasn't much they could do.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Do you think the services are more targeted towards adults than youth?
As an Individual
I believe that when the harm reduction stuff was brought in, children weren't really thought about at that point. Really, recreational drugs and stuff like that.... It was more of an adult thing. Now, however—I hate to say it—it's reaching our children at a very alarming rate, and the children are suffering. I don't think it's because they choose to do drugs; I think it's because their mental health is in the dumps.
Things need to change. Mental health needs to be changed, and so do these policies.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Thank you.
Mr. Kulmala, can you talk a bit more about the tool kit?
Chief Executive Officer, Vancouver Island Construction Association
Sure.
The tool kit was generated at a time when we were trying to do outreach to the construction sector. As I mentioned, about 52% of those workers who were employed came from our sector. When we started this back in 2017, the statistic was, effectively, that one in four of those dying were in construction. We generalize “construction”—it's the trades, and commercial and blue-collar workers.
Again, I'm not professing to have a health care background, but the idea was this: How can we convey information that allows people who would otherwise avoid it or not seek help to find information, or seek out attention and treatment? I initially had a harm reduction coordinator come in from the Island Health authority. We would do a lunch and learn—a one-hour session. You can imagine how, when we invited workers to come to us, we had zero people showing up. We found that a bit concerning, considering the statistics that were out there. There was also a perspective that this wasn't happening in our industry. There was denial. It's taken eight years for us to somewhat acknowledge that this crisis affects the construction sector. More than that, it's a social impact.
We're trying to do our part to reach out to construction workers. Through our strategy of outreach to companies, we also work with local community colleges that provide first- and second-year apprenticeship training. Our effort is in creating awareness. What's happened, Madame, is that we've had workers who would otherwise stand there with their arms crossed at a meeting in the morning.... For your information and for general awareness, a “tailgate talk” is something that happens all the time on a construction site. It's how they start their day. It's typically around the tailgate of a pickup. We say, “We're going to be doing this work. Stay away from this area. These deliveries are happening.”
Well, since we introduced this component, we've had workers who are clearly uncomfortable with the conversation but who, by the end of it, are saying they know somebody who needs to get this pamphlet, or who needs to come to that support group. We have a spectrum of care. It's even for people who have a heavy dependency on alcohol. We don't discriminate. It's not necessarily toxic drugs; we don't focus solely on toxic drugs. We focus on elements that would compel somebody to, you know, go out and party one night and start with a couple of beers. The next thing they know, they're having a hit of heroin.
You know, we find that the circumstances are there to suggest that there are ways to inform them about what they should be looking for, and also to coach employers to say, “Don't let people struggle in vain. If you see somebody who's clearly having challenges...." They may be sober or clear-eyed during the day, but at night, they go home and turn to a very dark place. They use drugs to cope, only to get up and do the whole thing over the next day.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Kulmala.
Monsieur Thériault, go ahead for six minutes, please.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Mr. Chair.
Ms. Macdonald, Mr. Charles, I join the committee chair in offering you my most sincere thoughts and my compassion. We are here to try to find solutions to situations that are extremely difficult in human terms. I have the impression that the further we get into this study, the more resources we may need ourselves. Indeed, the subject affects us enormously. People are dying on the streets every day as a result of the toxic drug crisis, leaving behind brothers, sisters and parents who are living through this tragedy. To date, there have been more than 45,000 deaths due to overdoses, and we are looking for solutions.
Because solutions must be evidence-based, I'd like to talk about some research I came across, Professor Larney. At the same time, I'd like to ask you to submit to the committee your study on trends in toxicological findings on deaths from involuntary intoxication by opioids and stimulants in Quebec. I want you to do this so that we can officially have this document in our hands when we try to make a report.
At the end, you say that there are a series of interventions to prevent and respond to acute overdoses, including supervised consumption, overdose prevention sites, prescribing a safer supply, medication verification—I imagine you're talking about drug verification here—the distribution of Naloxol, and opioid antagonist treatments as well. You go on to say that further research is also needed to establish, particularly with regard to drug verification and safe supply, whether there are results that can be considered conclusive, and to determine the effectiveness of these measures.
There is currently a marked tendency in Canadian politics to go backwards, to be skittish and, for purely electoral considerations, to say that we are going to put an end to certain measures. I'd like you to tell us more about that.
Associate Professor, Université de Montréal, As an Individual
Thank you for the question. I'm happy to share the paper you referred to with the committee.
One of the interventions that is being implemented across the country is safer supply. We are currently engaged in some work on reviewing the literature on safer supply.
There is evidence, particularly from Dr. Bohdan Nosyk's team, who I believe the committee has heard from, that safer supply prescribing or risk mitigation prescribing during the COVID-19 pandemic was associated with a reduced risk of death. This is very promising. More work—quantitative research in particular—on the impacts of safer supply is needed.
I think it's very important to say that lack of evidence around an intervention is not evidence of a lack of effectiveness. Where we are at with safer supply at the moment is a lack of evidence in many cases. We do need to see more quantitative work such as that done by Dr. Nosyk, which is very carefully designed quantitative studies evaluating safer supply programs across the country, the same way we would with any new medical intervention.
I think withdrawing those programs would have devastating consequences for people who are currently part of safer supply programs. We know that safer supply programs are helping people to regain some measure of control over their lives.
At the same time, though, I do believe that we need more studies of what the effective components of safer supply programs are and also consider the range of programs. At the moment, there are a lot of different models, so it's understanding these different models, coming to a clearer understanding of what we actually mean when we say safer supply, and understanding what the effective components of these models are.
Bloc
Luc Thériault Bloc Montcalm, QC
Some think that if we force people to undergo treatment, we'll be able to solve the problem expeditiously.
Based on what you know, do you think compulsory treatment would be effective? When you talk about in-depth reform of social policy, what exactly do you have in mind?
Liberal
The Chair Liberal Sean Casey
Give a brief response, if you could, please, Dr. Larney. We're out of time.
Associate Professor, Université de Montréal, As an Individual
Compulsory treatment has been studied in a number of settings and is very ineffective because treatment for a substance use disorder is not a one-off process. It is an ongoing and often relapsing condition that needs a more nuanced approach than a compulsory setting, which is typically one-size-fits-all.
In terms of social policies, I would argue that we need to look at the housing crisis. We need to look at income stagnation and income mobility, intergenerational income mobility, unemployment, all of these things that contribute to a strong social safety net, which Quebec had famously in a way that other provinces were often quite jealous of, but which has been somewhat—
Associate Professor, Université de Montréal, As an Individual
—damaged in recent years.
Liberal
NDP
Gord Johns NDP Courtenay—Alberni, BC
First, I want to thank all of the witnesses for their testimony, especially you, Ms. MacDonald and Mr. Charles, for having the courage to come all the way here and share your story. Hopefully it will help prevent deaths of young people that shouldn't be happening.
If a child broke their leg and they went to the hospital, they wouldn't be denied care because we don't have certain types of care for their broken leg. They would get the care. We don't have parity when it comes to mental and physical health, largely because of the stigma, I believe. Do you believe that we don't have parity because of the stigma in mental and physical health?
As an Individual
In my honest opinion, yes. I believe there's a big stigmatism against mental health, especially among youth. I believe it's been overlooked, and I believe it's been put on the back burner compared to, again, the safer supply and the harm reductions. It's almost like it's gotten lost in the wind.
NDP
Gord Johns NDP Courtenay—Alberni, BC
You mentioned that she was held for 10 days and then released. What type of care were you hoping she could receive instead of being discharged? What type of care do you think would have helped Brianna stabilize and recover?
As an Individual
I think if the doctors had taken the time to look into her mental health and actually assess her properly, they would have seen how many problems she actually had.
NDP
Gord Johns NDP Courtenay—Alberni, BC
You mentioned the lack of availability of mental health programs for youth. This is pretty clear. Do you think the government needs to increase funding for youth mental health supports? Do we need more education for health care professionals on youth mental health? I ask because, clearly, it sounds like the professionals demonstrated they weren't equipped.
As an Individual
I do agree, yes. There needs to be more education; there needs to be more training for doctors and nurses.
There was one time that a doctor actually told us that she's too young to diagnose, which I think is completely wrong, because in the States they are diagnosing children at very young ages, and the process is actually working.
There must be some kind of separation between the two, and I believe that lack of education and lack of.... There should be more funding towards treatments and education for health care providers.
NDP
Gord Johns NDP Courtenay—Alberni, BC
Having a child struggling with mental health and substance use issues is extremely difficult on your family and on you, as parents. Did you receive any support while you were dealing with these issues with your daughter? Are there supports that would have helped you and your children as you navigated the broken system when it came to dealing with Brianna?
As an Individual
We did receive a little bit of help, mostly from a few social workers here and there. They literally exercised all their resources. They even tried to pull some strings to make things happen outside the box. Their hands were tied because everything was so limited.
The few treatment centres that we would have had to pay out of pocket for wouldn't accept her because she wasn't of a certain age.
Yes, we did receive a little bit of help, but again, there were no programs or anything that were actually available for her and her situation.
NDP
Gord Johns NDP Courtenay—Alberni, BC
I'm sorry for your loss and for Chayton and his family, as well.