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.
11:35 a.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
You actually anticipated where I was going next.
Dr. Black, I just wanted to ask you, are you aware of any research on the connection between poverty and childhood mental health issues?
11:35 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Absolutely. We know that the socio-economic determinants of health are correlated. I'm happy to forward some links to the clerk to share with the committee. There's recently been a study even linking suicide rates in children and adolescents to poverty. It is a variable that we consider.
Again, will we ever establish cause with evidence? Probably not, but it will be compelling evidence when it's seen.
11:35 a.m.
Conservative
The Vice-Chair Conservative Stephen Ellis
Thank you, Mr. Davies.
Thank you, Dr. Black. That ends the first round of questioning.
I will just bring to the attention of the witnesses that there are differences in time. I will make you aware of that as the members begin their rounds. For round two, I would like to welcome Mr. Vidal to our committee on health.
Mr. Vidal, you have the floor for five minutes.
November 3rd, 2022 / 11:35 a.m.
Conservative
Gary Vidal Conservative Desnethé—Missinippi—Churchill River, SK
Thank you, Chair. Thank you for having me here today.
Like Dr. Powlowski, I typically sit at the INAN committee, so I am bringing that flavour to this.
I quickly looked at the motion last night and the sense of disparity in access to health service for rural, indigenous and lower-income folks. As an MP who serves the northern half of the province of Saskatchewan—71,000 people over about 350,000 square kilometres or about the size of Germany—I think I bring some of that flavour to the table. I appreciate the opportunity today.
I appreciate the witnesses and their testimony. There are a couple of quick question that I would like to get to in my time.
Obviously, remoteness and distance from services are a big deal to communities like mine, and access to professional services. One thing I heard last week from some leaders in my riding is that during the pandemic they had access to remote mental health services. They were doing it via virtual meetings and that type of opportunity, and they're very concerned that it is going to end.
My question for you is a bit twofold.
Is that concern valid in the sense of losing that? Obviously that's significant. Can you speak to the opportunity, or the quality or ability, to actually provide those services virtually? That's a big deal deal when you're six or eight hours away from the nearest professional.
I would quickly go to both of you, if you don't mind.
11:40 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
I'll try to be very quick, to give time for our other witness.
The virtual care is crucial. We had it generally before the pandemic. Obviously, the pandemic forced us all to be doing it. In 2022, despite most of our patients having the physical ability and COVID ability to come in, many patients still choose virtual because of the ease for them.
In psychiatry, there are occasions that I need to do physical exams, take measurements and see people in person. I will always need an office to be able to do that, but the delivery of virtual care safely is really important. It would require making sure that we have the infrastructure, that patients and families understand the importance of privacy during those times, and that we have good audits to make sure that the quality of care doesn't decrease.
However, I can say without question that most of my patients and families prefer virtual appointments in 2022 over in-person appointments. I think we have to consider why that is.
11:40 a.m.
Psychologist, As an Individual
I would agree that many of my clients are continuing to request virtual. Some kids are just more comfortable with the screen as well, which I think is important when we're doing assessments and working with kids.
I don't know, in terms of the formal systems, whether or not they will be continuing. I hope they will, because I think it's become vital for accessibility.
11:40 a.m.
Conservative
Gary Vidal Conservative Desnethé—Missinippi—Churchill River, SK
I appreciate that, because that confirms for me the sense of advocating for those two remaining.... That was the purpose of my question.
Ms. Dugout, I have a quick question for you.
You talked about food security in your comments. Again, I'm going to reference this particularly to my riding. I have communities where they pay $14 for a gallon of milk, $9 for a dozen eggs and $12 for a kilogram of apples. It's obviously a huge issue in some of the very remote communities, because of freight and those kinds of costs.
Can you make the link for me...or flesh out a little bit of the food security connection to mental health and how that might affect people in those more remote regions who face those very high food costs?
11:40 a.m.
Psychologist, As an Individual
I think food security is an issue in all communities. I think it's probably worse in remote communities like yours, where it's much more expensive.
I go back to the idea that a calorie is an energy unit. We need to provide kids with energy and the nutrients they need to grow. Their brains need it. Their bodies need it. To me, it's integral to good mental and physical health to be able to have food.
Families are not always able to.... There are some great community opportunities to provide community fridges and things, which can help as well.
11:40 a.m.
Conservative
Gary Vidal Conservative Desnethé—Missinippi—Churchill River, SK
Thank you.
Dr. Black, I have a really quick question, because the chair is going to cut me off.
You talk about this ASARI tool that you developed. I'm really curious if that is able to be used—I don't know much about it—in rural and remote settings virtually. How can that be used by other people?
11:40 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
The ASARI is different from a lot of assessment tools. It's not intended to score risk. What it is intended to do is to allow the clinician to completely document what they're thinking and to communicate what they're thinking about suicide risk.
It's accredited. It's used in places all over Canada, and it can be used in any location. It's available for free at the website that I set up at ASARI.ca.
11:45 a.m.
Conservative
The Vice-Chair Conservative Stephen Ellis
Thank you, Dr. Black. I appreciate that.
Thank you, Mr. Vidal.
We'll turn now to Mr. van Koeverden.
You have the floor, sir, for five minutes.
11:45 a.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Thank you, Mr. Chair.
It's nice to follow Mr. Vidal, as I used to when we were on INAN together. I hope his work continues to be rewarding and productive on INAN. I'm sure it is.
Thank you to our witnesses today, not just for being here and providing really good testimony but also for your extraordinary work. I don't need to tell you, but I do want to emphasize, how important your extraordinary efforts are in society. You save lives every day. Thank you.
My first question is for Dr. Black.
It's about the first thing you mentioned with respect to the attacks you've experienced with respect to misinformation and disinformation. I think misinformation and disinformation should be differentiated. There's intentional misinformation. There's information that goes out because people are ill-informed. There's a very important divide here based on intent. A lot of people who are spreading misinformation are doing it in an effort to help. A lot of others are doing it with the intent to harm. I think those need to be differentiated.
I was hoping you could elaborate a little bit on your experiences and on what our government could do to counter misinformation, disinformation and malinformation. What do you think our obligations are in that regard?
11:45 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
Thank you so much. This is a question I've thought a lot about. I've been in the online space doing advocacy. Online the amount of disinformation and misinformation is tremendous. I think we have to start really considering the weaponization of disinformation as a threat to Canadian lives. Many people have died of COVID because of disinformation about COVID and the vaccines. Many people have not done what they could to protect themselves due to disinformation that was spread.
Disinformation on vaccines goes back well before COVID, when intentional actors chose to spread disinformation for either personal gain, political disruption or anti-authoritarianism and those types of things. The threat is to people who are marginalized and who don't have the ability to know what all of the latest science shows. Disinformation online can be very compelling. I think the government has a strong obligation to fight disinformation.
I'm part of a group called ScienceUpFirst, which is led by Tim Caulfield at the University of Alberta and Senator Stan Kutcher. We work really hard to distribute information that counters disinformation. I think the government does have to take seriously—knowing that we have freedom of expression and not freedom of speech—the threats associated with disinformation. As far as misinformation goes, you know, people will think things. I'm used to myths. It's okay to battle myths. Disinformation is intentional. It's subversive and it's extremely alluring to people for very important psychological reasons.
11:45 a.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Can I just ask one specific question about that?
When I think about misinformation and disinformation, I also consider the relationship between an act of omission and an act of commission. An act of commission is saying something vis-à-vis how vaccines are very good and you should get vaccinated—I just made an appointment for my flu shot today—whereas an act of omission might be a reluctance to say such a thing, given an extraordinary platform.
Can you speak to that at all?
11:45 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
It's challenging.
What we do and what we don't do obviously impact the outcomes we care about.
Many physicians, unfortunately, have chosen to be silent in the face of disinformation. I think disinformation requires us to be active in fighting it, not just by putting out pamphlets or saying, “I'm a doctor. Come talk to me”, but by actually fighting disinformation.
I think there need to be serious ramifications for doctors who use disinformation. We're starting to see doctors having judgments in the United States. I think there have been some interesting developments in Canada. It's very important.
11:45 a.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Thank you.
I have one quick last question. It's around physical activity. I'm an advocate for kids getting enough physical activity. I see the rates of that declining.
This is for both Dr. Digout and Dr. Black. I recognize and appreciate your pragmatic optimism with respect to the state of affairs of Canadian kids. Have mental health practitioners investigated things that you can perhaps prescribe in the meantime when there is that unfortunate lag time around physical activity and being able to get outside? Can you speak for as long as you can about the positive impacts physical activity has on youth and mental health?
Go ahead, Dr. Digout. I don't have long.
11:50 a.m.
Psychologist, As an Individual
Again, there's tons of research on this. We do know the importance of getting out and being active. I think for some of our neurodiverse clients it's even more important to be able to get out, get active and get moving.
11:50 a.m.
Conservative
The Vice-Chair Conservative Stephen Ellis
I'll stop you there, Ms. Digout. Thank you for that.
Thank you, Mr. van Koeverden.
The next round of questions goes to Mr. Champoux.
I'll underline for our witnesses that it's for two and a half minutes.
Mr. Champoux, you have the floor.
11:50 a.m.
Bloc
Martin Champoux Bloc Drummond, QC
Thank you, Mr. Chair.
Two and a half minutes is very short, so I'm going to try to ask a question that won't call for too long an answer.
My question is for both witnesses.
Do you draw on practices in other countries?
Do you think other countries are having better success than Quebec and Canada when it comes to mental health and prevention, particularly among children and youth?
Could you give examples of countries that are having better success?
What are they doing differently?
11:50 a.m.
Clinical Assistant Professor, University of British Columbia, As an Individual
I'll quickly go and then give Ms. Digout a chance.
For me, I care about standards. Many nations have taken the issue of health standards more seriously. In fact, often we borrow from U.K. and Australian guidelines because Canada doesn't have it's own specific.... We provide health care, yet we leave it very much open to health care providers on how to do so. It's very important that we have standardization.
When I think about NICE in the U.K., for example, it's something that really helps guide people for treatment, and it's very scalable. That would be one example.
11:50 a.m.
Psychologist, As an Individual
I don't really.
I often go to the U.K. psychological.... I can't remember the name of the website. I continually look at their standards, and there are a few programs in the U.K. that I often turn to when I'm looking for ideas for things.
However, I really don't know much about other countries and what they're doing right now.
11:50 a.m.
Bloc
Martin Champoux Bloc Drummond, QC
I will continue with you, Ms. Digout.
Do you think the schools are playing their role well enough? Do teachers have the right tools for providing children with information?
11:50 a.m.
Psychologist, As an Individual
Many teachers do. Certainly, Senator Kutcher has done a lot of work, working with schools in Nova Scotia. He's set up some great programming for teachers to learn about mental health and the language around mental health.
It's coming. I think it's a matter where some teachers are very comfortable talking about mental health and some are not.