Health Committee on June 15th, 2022

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

I wish I could spread it around, but I don't have time. In December 2021 PHAC released modelling that projected that toxic drug supply-related deaths may remain high and possibly even increase through the first half of 2022. At the time, PHAC released a backgrounder that said, “As opioid use and related harms have changed significantly over the past years, and especially during the COVID-19 pandemic, this model will be updated on a quarterly basis.”

Despite that statement, no updated modelling was published in March, as anticipated. In fact, the updated modelling still has not been published. On June 1 MPs voted on my private member's bill proposing a health-based approach to substance use, without having access to the latest modelling to inform their decision. Why did the agency not fulfill its commitment to provide this modelling on a quarterly basis?

[Heather Jeffrey]

The Public Health Agency is indeed conducting modelling, and I will pass the floor to my colleague, Candice St-Aubin, to speak to the data.

[Candice St-Aubin]

The Public Health Agency did, in fact, release its modelling projections in March, and we'll be releasing in the upcoming quarter as well, I believe in the next five or six days. I'm happy to provide the link to where the modelling is posted publicly on our website to the honourable members here at the committee.

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

We don't see it. I look forward to finding the link to it.

How many people are you forecasting are going to die in the next half of the year from a toxic drug supply?

[Candice St-Aubin]

Out of toxic drug supply—not to get ahead, of course, of the modelling that's happening—I will again have to provide that in writing because, again, this has not yet been released publicly, and we're still analyzing the data and the modelling.

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

What we can find is that you provided the updated number of deaths, but not the projected moving forward. I look forward to getting that sent to this committee.

Last week, in the supplementary estimates presented to the committee on government operations, the agency requested $1.4 billion for the procurement of additional COVID-19 therapeutics and related costs. Has the agency discussed or sought funding for the procurement of pharmaceutical-grade alternatives to controlled substances?

[Candice St-Aubin]

Honourable member and Mr. Chair, this is not part of my area of expertise. I'm happy to talk about mental health programming and programming to support mental health promotion, but I can refer and defer to provide information in writing on that from the doctors within the agency.

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

Here's a question on the perinatal mental health strategy: What is the timeline for delivery on that?

[Heather Jeffrey]

For the perinatal mental health strategy, I will refer to our colleague Eric Bélair, who is from mental health.

[Eric Bélair, Associate Assistant Deputy Minister, Strategic Policy Branch, Department of Health]

As you know, this is a key commitment in the mandate letter of Minister Bennett. She has started to engage with stakeholders on some of the models of care that we can spread and scale across the country to help improve perinatal mental health services. This is an area that will be part of our broader action plan to help improve mental health services in Canada. There has already been one round table that Minister Bennett has held with experts and stakeholders, and she's going to be building on that to develop further measures to improve care.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Johns, and thank you, Mr. Bélair.

Next we're going to Mr. Jowhari for five minutes, please.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

Thank you to the officials for staying back with us, and thank you for the work you're doing.

I'm going to focus my questions on youth mental health. I'm not sure who would be the best person. Let me ask the question, and I'm sure Madam Jeffrey will guide us through who would be the best person to answer.

As you know, the pandemic has hit every Canadian and everyone across the world, and, especially among youth, it's exacerbated in the worst way. We know that there were issues before for adolescents, and we know that isolation and lack of social activities have heightened some of those mental health issues.

Can you tell us what the government is doing to address the increasing mental health needs of young Canadians?

[Heather Jeffrey]

Yes. Thank you, Mr. Chair.

As already discussed, the mental health of Canadians definitely has been adversely impacted by the strain of the pandemic.

Health Canada is providing core funding to the Mental Health Commission of Canada to establish national standards for the mental health of post-secondary students.

In budget 2021, we also provided $100 million over three years to address the mental health impacts of the pandemic, particularly on vulnerable groups, including youth.

We've provided additional resources for Kids Help Phone, a crisis line that our Public Health Agency colleagues can comment on further, which provides additional support to children in crisis.

We have also provided funding for a campus peer support program at post-secondary institutions, to provide direct peer support to students in need.

We have held extensive consultations with universities and colleges this year and are working with different youth groups, including through integrated youth services and organizations such as the Foundry, to talk about the full suite of wraparound supports. It's not just mental health services and counselling that are required, but a full suite of supports in areas such as housing and other social supports for students in crisis.

The needs vary across the country, so it's a comprehensive approach that we've been taking, and this is definitely one of our top priorities in the transfers that we provided to the provinces. In their agreements, they've all committed to invest in integrated youth services as a matter of one of the three priorities for those transfers, and we're midway through that 10-year transfer process.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you for that explanation.

Can you explain how the funding that was announced earlier in Ontario this week through the mental health promotion innovation fund will support children's mental health?

[Heather Jeffrey]

I'll turn to my colleague, Candice St-Aubin. The Public Health Agency administers that fund.

[Candice St-Aubin]

This funding will go to support youth at risk, be it LGBTQ2+ youth or racialized and other vulnerable youth, including indigenous youth. They will be developing interventions and supports directly at the community level.

We look forward to providing or coming back with more information, including some key indicators and outcomes of success for these projects as they begin to roll out and we monitor and look for those impacts.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you.

With about a minute and 15 seconds left, I am going back to Madam Jeffrey.

Can you expand on the innovative and particularly successful model for supporting youth mental health? I understand that there has been significant success with integrated youth services.

I think the minister also mentioned that, not only in her opening remarks but also in response to some of the questions that my colleagues raised.

Can you explain why this approach is so promising?

[Heather Jeffrey]

Indeed, the standard on integrated youth services and the work that is being done from coast to coast to coast in this country on integrated youth services is extremely promising.

It isn't enough just to provide addiction supports. We also need other kinds of public health supports. We need social supports. Youth need counselling. They need access to peer groups. They need a variety of training and educational supports. All of those things need to come together to help an at-risk youth or child.

I'd like to turn briefly to Dr. Strong at CIHR, which is funding a lot of the work and leading the work on standards for integrated youth services.

[Dr. Michael Strong, President, Canadian Institutes of Health Research]

Thank you very much, Mr. Chair.

You are quite correct. There have been some really impressive outcomes through the integrated youth services, beginning, really, since its inception in 2012.

Just to give a measure, it's a unique way of reaching out to adolescents and children with mental health issues, with over 7,500 interventions even as of 2020 and, from that, a 70% reduction in stress for children and young people, a 66% reduction in the degree of severity and, actually, by using those routes, almost a 10-fold savings in terms of the costs of bringing young people in for services where they can be dealt with and treated closer to home. It's an incredibly successful program.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Strong and Mr. Jowhari.

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

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you very much, Mr. Chair.

I will let you redirect my question to the person who can best answer it.

In August 2020, the director of the Public Prosecution Service of Canada introduced a guideline on simple possession of a substance. She invited prosecutors to limit prosecutions to more serious cases. One of the arguments put forward was the savings that could be made in the legal costs of administering justice. This is also one of the central arguments made in favour of diversion.

With respect to Bill C‑5, I would like to know if an assessment has been made as to the court costs associated with the administration of justice.

Has an assessment been made of the savings that could be made in this area as a result of the potential implementation of the bill?

Are there any figures in this regard?

[Heather Jeffrey]

In regard to Bill C-5, this is a Justice-led bill. It's not really within our purview.

What I can say from a public health perspective is that we certainly support an approach that takes a public health approach to addictions as a public health challenge and not as a criminal one. That was reflected in the action that the minister took in approving the exemption for B.C.

Unfortunately, I'm not in a position to comment on Bill.

[Jean-Denis Garon, Bloc, Mirabel, QC]

I understand, but, the principle of diversion is to move the problem from the judicial domain to the health domain. So it becomes a public health issue.

Do you think it might be appropriate for the Department of Health to try to assess what savings might be made?

At the end of the day, care will have to be provided to these people by the Quebec and provincial governments, which will have to incur additional expenses.

[Heather Jeffrey]

In our discussions on decriminalization, specifically on the section 56 exemption in B.C., certainly one of the views expressed by law enforcement colleagues at those consultation tables is that decriminalization of small amounts for personal possession allows law enforcement to redirect resources where they are most needed, in particular to focus on trafficking and some of the other serious criminal harms that come as a part of drug trafficking. Decriminalization in that sense allows law enforcement to focus their resources where they are most needed.

I can say that in terms of the public health approach, that's really the area of focus we look at when we're considering applications for exemptions.

[The Chair, Liberal, Sean Casey]

Thank you very much, Ms. Jeffrey.

Thank you, Mr. Garon.

The Conservatives will now take us to the top of the hour. I believe Mr. Vis will lead off.

Mr. Vis, welcome to the committee. It's good to see you again. You have the floor.