Is it working now?
Evidence of meeting #41 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was children.
A recording is available from Parliament.
Evidence of meeting #41 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was children.
A recording is available from Parliament.
11:25 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Should I start again?
11:25 a.m.
Conservative
11:25 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Numbers have been coming down.
What I see typically is that every generation, every new wave of kids I work with seems more responsible, more connected, more socially engaged and more caring about outcomes. I know there's a feeling sometimes that things are getting worse and worse, but that's never been borne out in the data. This generation of kids use the least amount of drugs, have the least amount of sex under 13 and have the least amount of violence. Some of the moral tropes that go on about kids are not reflected in the data that we see with kids.
11:25 a.m.
Bloc
Martin Champoux Bloc Drummond, QC
Right.
I'm going to come back to the more specific question about youth mental health. You said you want there to be more mental health programs and standards everywhere in Canada. My colleagues and I regularly reiterate that health falls under the jurisdiction of Quebec and the provinces.
Dr. Black, I won't ask you to comment on all the provinces, but do you trust the British Columbia government to manage the health care system? How is it working in British Columbia?
11:30 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Every jurisdiction that I've known, including B.C., struggles with wait-lists and access to care. I don't think I'm aware of a Canadian jurisdiction that is completely nailing it. I do think, overall as a country, we spend less per capita on mental health than do most developed nations. Mental health especially for children is a foundational element that will impact the rest of their lives. It would be a really good return on investment for governments to put more money into the well-being of our children.
Generally, it would be hard to look at the wait times that families report and the lack of access to care that families struggle with and give any jurisdiction, including B.C., a high mark on a report card.
11:30 a.m.
Bloc
Martin Champoux Bloc Drummond, QC
Ms. Digout, how is it working in Nova Scotia? Do you trust the provincial government to manage the health care system?
11:30 a.m.
Psychologist, As an Individual
I agree with Dr. Black in that what we're seeing with the wait times is that things aren't being well managed. I think our government is trying hard to look at alternatives. One issue I'm seeing in colleagues, both within the formal mental health system in the hospital system and in private practices, is burnout. We need more bodies and we need more bodies doing the type of work that they are good at. Instead of throwing people in and expecting them to jump in, we need people doing what they are trained to do. I think that's one of the issues within the system.
11:30 a.m.
Bloc
Martin Champoux Bloc Drummond, QC
I could not agree with you more about that.
My question is for both of you, Dr. Black and Ms. Digout.
If the federal government gives money to Quebec and the provinces for health care with conditions attached, might that complicate things further? Would it not be simpler to do as all the premiers are asking? There are radio campaigns going on from one end of the country to the other begging the federal government to stop attaching conditions to health transfers and to increase them to 35%.
Would that not enable Quebec and the provinces to manage the money better and spend it on specific types of health care, in particular children's mental health, that are in urgent need of investments?
11:30 a.m.
Conservative
The Vice-Chair Conservative Stephen Ellis
I'll have to ask both the witnesses to keep it to two or three seconds each, or we can come back to it.
11:30 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
I'll leave those decisions to those with the expertise. I would say more money is good.
11:30 a.m.
Conservative
The Vice-Chair Conservative Stephen Ellis
Very well done. Impressive, in fact, I might say.
That being said, I'll try to avoid commentary here.
Mr. Davies, you now have the floor for six minutes. Go ahead, please.
11:30 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you, Mr. Chair.
Dr. Black, if I may I will start with you. In an August article in Scientific American you stated that pediatric suicide and mental health crisis rates increase sharply when school is in and ease when school is out. You noted that this pattern is also found in other jurisdictions such as Japan, Germany and Finland.
Can you explain to us why that is?
11:30 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
The why is always challenging. We notice this. Anyone who works with children knows that they are more busy during the school year. When school get's out, there's just less busyness. I think it has a lot to do with the fact that school is like a job for kids. School has your co-workers, your boss, your supervisor, your overtime, which is homework, and your hours. What you don't get often and what kids fail to recognize are the benefits, which are like wages.
School is a big deal. A study in 2014 showed that 84% of children reported that school causes them anxiety. There are so many things that schools could do better. There are things like changing the hours of service, lessening the amount of homework, providing access to mental health curriculum, creating safe spaces for kids who are neuroatypical and those types of things. There are so many things that schools could do.
I think you could just ask a random sampling of 10 kids what they think schools could do better and you would get a host of responses. School is just a really stressful thing for kids. We see a 60% increase in suicides during school days. In the ERs we see 100% to 150% more kids on school days than on non-school days.
11:35 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
In a 2018 “Ask Me Anything” Q and A interview, you said the following with respect to mental health wait times in Canada, and you touched on it in your testimony today. You said, “Your 6 months wait is unacceptable to see a psychiatrist if you are struggling with a possible illness”. Is there any research you're aware of on a connection between lack of access to care and increased suicide?
11:35 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
To develop evidence like that would be challenging. If we want causal evidence, we usually do things like randomized control trials, and it would be pretty unethical to put people on wait-lists and see. I think what we typically see, though, is that many of the patients I see in the emergency department had issues that.... Maybe I'm just coming off as an expert who looks backwards or something like that, but I always think, “You know, eight months ago, I could have really helped a lot easier with this than in the situation I'm in right now.”
What we know for sure is that unaddressed, untreated mental health issues, untherapized mental health issues...and for kids I have to say that therapy is super important and even harder to access than medications from a family doctor or psychiatrist. These things, if they're not addressed early, they fester. They grow. Many of us know adults who struggle with major mental health issues because of childhood issues that were never addressed. It's just one of those things that is really important.
11:35 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
It reminds me of that phrase that we don't need research to tell us that water is wet.
11:35 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Yes. It's challenging to do.
11:35 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
I guess you would agree with the proposition that the longer we wait and deny children access to necessary therapy.... I think as a general proposition it would increase the risk of suicide. Would that be a fair thesis to suggest?
11:35 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Absolutely.
11:35 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Okay.
Madam Digout, you touched on this. I wonder if you could outline how social determinants impact childhood mental health in Canada, maybe if I single out poverty as an example. Is there a link between poverty and mental health problems in children?
11:35 a.m.
Psychologist, As an Individual
I don't know the exact research studies, but I'm sure they're out there. I think that even just common sense.... I have families who have to make a decision on whether they can afford to take the afternoon off work to take their kid to therapy, or whether or not they can afford their child's medication, choosing between rent and medication if they don't have service, but I think just even accessing....
One anecdote is that I worked with a young adult years ago, and I remember that one day.... His parents were in survival mode. They literally were going day to day trying to get food on the table and trying to provide the basic necessities, and this kid was very engaged in therapy. I remember that one day he walked 20 minutes in the pouring rain, on his own, to get to his therapy appointment.
Kids want it. They don't always have the opportunity to get it, and the barriers are just huge when it comes to the poverty aspect. Nutritional food and the ability to get out and do active living is sometimes very difficult for families.