Evidence of meeting #53 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was child.
A recording is available from Parliament.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
Dr. Afifi, you touched on this issue of the exposure of people to imagery.
I'm curious about the association, if any, between the Internet and social media exposure of children to, say, age-inappropriate images, acts or concepts, and whether there's been any work done to link that to increased mental illness or psychological dislocations in children.
Professor, University of Manitoba, As an Individual
Is that in terms of the social media content that they see generally or in terms of bullying via social media? I just want to clarify that.
NDP
Don Davies NDP Vancouver Kingsway, BC
Anything, I suppose.
I'm just wondering about this one difference between children growing up today and most of us in this room—if not all of us—in that children today are growing up with access to the Internet and exposure to images, acts and concepts that may be age-inappropriate.
I wonder if there's any link between that and—
Professor, University of Manitoba, As an Individual
Yes.
There's research on content that they see that has an impact on self-image, which is not my research. There's research showing increases in anxiety and depression related to content that they see on social media.
The work that we've done in my lab is looking at how social media is related to peer victimization and bullying. If they see and hear bullying online, whether that's through texts or through social media, all of those things increase poor mental health and substance use among youth and children.
NDP
Don Davies NDP Vancouver Kingsway, BC
To the association, I'm curious as clinicians what trends in childhood mental illness you're seeing. Are there any significant increases in disorders that you're able to tell us about?
President-Elect, Canadian Counselling and Psychotherapy Association
There's ADHD and eating disorders, definitely. There's also compulsion. I have a lot of clients with OCD, aged five to 12. There's also depression and anxiety.
Director, Public Affairs, Canadian Counselling and Psychotherapy Association
Absolutely, there are eating disorders. I work with women who experience eating disorders on the spectrum. From the clients who I've worked with, they said they've struggled with this from a young age. Bringing that back to social media, social media is a huge cause of eating disorders amongst young women.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Davies and Ms. Thomson.
Next is Dr. Ellis, please, for five minutes.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you very much, Chair. I appreciate it.
I really appreciate the interesting discussion around the table.
I had a question for you, Dr. Georgiades.
My colleague talked a bit about transparency and accountability in funding, and its being the reason, of course, why $4.5 billion has not been sent with respect to the Canada mental health transfer. Anyway, I have a whole bunch of comments about that. I'll keep those to myself.
That being said, do you believe that at the current time we can find areas of interest in place that have enough data whereby we could actually stream funding to them that would make sense? Obviously, there's a significant need for funding in mental health. I find it difficult to believe that there are no mental health areas in the country that are transparent and accountable that could actually use money. I think there are lots out there that could, and they could fill that bill very quickly.
Do you have comments on that, Dr. Georgiades, please?
Director, Offord Centre for Child Studies
In principle, I think that making sure funds are allocated to address the needs of children across the country should be a priority.
I understand the point about transparency and accountability, but I don't see those as limitations. That is something that can be worked on. There are definitely ways—if there's will and collaboration—for us to increase the resources and take targeted steps so that we can actually support children and families on the ground.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Dr. Georgiades, to be clear, at the current time if the government said, we're going today to fund the Canada mental health transfer to $4.5 billion, you feel there are systems out there that could readily accept that money with transparency and accountability?
Director, Offord Centre for Child Studies
I would say there are stakeholders that could come together and form a network of systems that could actually implement something like that, with a rigorous way in transparency and accountability.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Through you, Chair, Dr. Afifi, we talked a bit about violence in hockey in particular. That is interesting. There are many other sports that are violent.
One of the concerns I've had as a family doctor for many years is the violence in video games. I would suggest that many more children are exposed to violence in video games, especially and, very sadly, in an isolated setting. What I mean by that is they would be playing video games and be often alone experiencing those things.
I'm certainly not sitting here arguing for violence in sports. That's not what I'm suggesting.
What I would suggest is that experiencing that very graphic violence in an isolated setting is perhaps something that is even more damaging, if there is such a thing.
Do you have comments on that, Dr. Afifi, please?
Professor, University of Manitoba, As an Individual
I understand how violence in video games can very commonly be accessed by children and that many children do play those games, whether it be in isolation or online with their friends. These can be very graphic and real in certain cases.
Whether or not one is worse than the other in terms of watching hockey versus video games, we don't know. We don't have data. We couldn't comment on that.
I think most importantly it's really about understanding home environments. That's what I mentioned in my opening comments. We have to do all of this work within the context of understanding the environment in which a child lives, works, learns and plays. That is included in that. We need to understand the relationships and focus on not only the violence they witness or are exposed to, but more importantly we need to focus on violence they experience at the hands of caregivers and other people in their lives. The entire context of violence is important.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you very much, Dr. Afifi.
Through you, Chair, the other day I was watching television in French. I noticed very clearly that on French television, there were commercials talking about violence in the home. Normally, I watch English television. I live in Atlantic Canada, and we don't see any of that advertising there explaining the inappropriateness of it and seeing the very straightforward messaging.
Do you think that style of messaging is important? Should that be something we see in both official languages, and of course in languages that would be appropriate for marginalized and racialized communities as well?
Professor, University of Manitoba, As an Individual
I think we need a multi-faceted approach. That could be a universal approach to explaining what is and isn't appropriate. Connecting families to resources that support them would be great. Repealing section 43 is one part of that. There are many things that we need to do. Education is one of those things.
So yes, I think it would be helpful along with many other things that would be needed for violence prevention. I think we could actually make great progress with a national plan. Over time, I think, if we could reduce or eliminate violence in childhood, that alone would show improvements in child health, both mental and physical, over the long term.
Liberal
February 9th, 2023 / 12:40 p.m.
Liberal
Brendan Hanley Liberal Yukon, YT
Thank you.
I want to thank everyone for coming today. This has been a really interesting discussion.
I want to pick up on the funding question and how that might follow through. We know that with the previous $5 billion transfer...or we don't know; I think the question is that we don't know a lot about where that money went. I haven't heard anyone, including the Prime Minister or the Minister of Health, say that we don't need more funding into mental health. It's a matter of how we ensure that it gets there and gets to where it's needed.
I for one am really looking forward to the bilateral health negotiations. I imagine that mental health will be identified as a priority area for most jurisdictions, if not all, when it comes down to that.
I'd like to follow up on some of the discussion about coverage with a question for Ms. Foster and Ms. Thomson, very briefly.
Do you think it would be reasonable to have access to counselling and psychotherapy on the table as part of what should be covered in universal health coverage when it comes to bilateral health negotiations?
Liberal
Brendan Hanley Liberal Yukon, YT
It brings up another question. I know that when I talk to some clinics in my jurisdictions in the Yukon in settings that are similar to yours, they are facing similar circumstances. People who do not have coverage are taking a hit. That in turn seems to affect their ability to resource themselves. If they did have access to increased public health coverage, it might enable them to increase and build their capacity to meet the needs of the community—in other words, hire more people and have a fuller roster, as it were.
Would that reflect your own experience?
President-Elect, Canadian Counselling and Psychotherapy Association
Yes. I would also add to that “appropriate”, especially in the Yukon and northern territories where there are a lot of indigenous folks. It would be really important to be able to have a good fit therapy-wise to allow people to then be able to re-engage in community and be functional.
Liberal
Brendan Hanley Liberal Yukon, YT
Thank you.
That anticipates my next question. I think it would really bring into importance the concept of both mental health literacy and tiered care. Who gets what level of care? How do people know how to access that? How do we have the most efficient delivery of mental health care and also tools for self-management and family management?
I wonder if you might comment on that area, just briefly.
Director, Public Affairs, Canadian Counselling and Psychotherapy Association
Stepped care is a model that is currently being implemented. I can speak to at least the context in Ontario.
A lot of research has been done in the U.K. to be able to determine where someone is in terms of their needs. Can they do bibliotherapy, which is maybe doing self-directed learning? Do they need to work with a psychotherapist or a social worker for talk therapy? Do they need medication management for a more severe mental health diagnosis?
That's absolutely something that we would like to see as part of that system.
Liberal
Brendan Hanley Liberal Yukon, YT
Thank you.
You brought up the subject of NIHB. Of course, that's a very important area in my jurisdiction. You mentioned there is coverage during the pandemic for psychotherapy and mental health services—