Health Committee on Feb. 9th, 2023

[The Chair, Liberal, Sean Casey]

If you could, please give us a succinct answer. Go ahead. Take 30 seconds.

[Carrie Foster]

Go ahead, Lindsey.

[Lindsey Thomson]

Have an oversight committee, some kind of structure and oversight to actually have accountability, to see where the money is flowing and ensure that it's not being left in the pot and leaving Canadians high and dry, and have different hubs in different locations—rural and urban, right?—and some kind of structure to be able to look into that.

[The Chair, Liberal, Sean Casey]

Thank you.

We have Mr. van Koeverden, please, for five minutes.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you very much, Mr. Chair.

Thanks to all the witnesses. I echo the earlier condolences of my colleagues about yesterday's tragic crash.

I'd like to start by saying that I've emailed back and forth with a practitioner named Kevin Greene, who is a big advocate for the removal of HST on psychotherapy in Canada. I've read his emails and the deck that he sent me.

I've also had some conversations with folks in Finance, trying to understand the costs. Any time that a tax is eliminated, it is an obvious cost to government, and sometimes the cost to government is way bigger than the amount they invested. I think that's an important consideration, if we're talking about millions or billions of dollars here or there. I think personally that social costs in the long term greatly outweigh any investments we can make in kids today.

My questions are going to be primarily around resiliency and building resiliency in the early years for children.

First, is there any research indicating the impacts of access to sport, physical activity and recreation and positive team experiences for kids? Is there any research that indicates a positive influence on children and their resiliency, particularly around mental health, when they have access to sport, physical activity and recreation programs?

[Lindsey Thomson]

Yes. I can speak to research in terms of the impacts that recreation and movement have on our mental health in general. I'll have to find you the exact reference for this so I can send it to you after.

Research has demonstrated that if we do a control group and an experimental group looking at the impacts of taking, let's say, medication for depression, versus a group to look at the impacts of movement, in the long term, sustaining regular movement—you don't always have to be going to the gym, just getting out for a walk—is actually more effective than medication alone. We can naturally translate that to the importance of being able to have recreation for kids.

[Adam van Koeverden, Liberal, Milton, ON]

I might turn to the researchers on Zoom for that same question.

[Dr. Tracie Afifi]

I've done work in that exact area, looking at what protective factors might be related, for those who have experienced trauma and adversity, to better mental health and substance use outcomes. We look at protective factors at the individual level, school, family and community as well.

We found in a number of studies that physical activity and a sense of belonging—it could be belonging to a sports team, having that sense of community—does have an impact on reducing poor outcomes. We see it for kids who have experienced trauma and maltreatment, but sometimes the effects can be greater if you have also experienced that trauma and maltreatment.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Dr. Afifi.

I'd note that it's Winter Health and Fitness Week right now. Tuesday was Ski Day on the Hill. I skied with...I would guess a 13- or 14-year-old girl named Ella. I asked her why she loves physical activity. She said exactly what you just said, that it helps her deal with anxiety and helps her set goals. She's met all of her friends through sport. It is that protective mechanism which I drew from that conversation.

Secondly, anecdotally, so perhaps more towards the clinicians—less on the research side, more in your experience—in dealing with kids who have equitable access to sport, physical activity and recreation, do you see better outcomes for those kids?

[Carrie Foster]

I worked at the Jewish General Hospital in Montreal, running a group at their day care program of 10-year-old boys using drama therapy. Definitely, the ongoing improvements that were seen by their teachers were clear.

I've also done drama therapy online, with young adults who were depressed during the pandemic. We did MRI scans through the University of Toronto. Those MRI scans proved that the work we were doing online, just the connection, was in fact effective. That's really great to hear.

I do somatic work as well. A lot of the somatic work that I do is actually getting people into their bodies so that that anxiety comes down.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you.

Briefly, would you consider drama a form of recreation?

[Carrie Foster]

Drama, yes. Drama therapy has a therapeutic focus.

[Adam van Koeverden, Liberal, Milton, ON]

Very quickly, Dr. Afifi, you mentioned the legality of corporal punishment. You mentioned that the only legal way in the Criminal Code that people can hit each other is when parents hit their children.

I'd also note that there is a social permission in the game of hockey...which we're all allowed to watch and see. A lot of young kids really love hockey, and there's bare-knuckle brawling in the game. That's the main reason I don't watch NHL hockey generally. I find it incredible that grown men are punching each other and it's totally normal. If it happened in front of a bar, then they'd probably both be arrested. It's an interesting thing.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

What about boxing?

[Adam van Koeverden, Liberal, Milton, ON]

That's not bare knuckle. Thank you for the commentary, though.

Anyway, how does that impact young boys who watch hockey and love the game?

[The Chair, Liberal, Sean Casey]

Answer very briefly, please, Dr. Afifi. We're out of time.

[Dr. Tracie Afifi]

Very briefly, I agree.

It is assault on the ice in some cases, and it affects all people who watch hockey. I hate it as well. I wish that could be changed, but I guess that's up to the NHL and the NHL Players' Association at this point.

I completely agree. It's still assault on the ice, and it's violence that we shouldn't be watching.

[The Chair, Liberal, Sean Casey]

Thank you.

Go ahead, Mr. Garon. You have two and a half minutes.

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

Thank you, Mr. Chair.

Mr. Georgiades, you mentioned earlier that this study was a good initiative and that we would then have a document that could guide policy. Do you have any other standards, documents, reports, studies of bills or other documents produced by the provincial governments—which are responsible for health in this area—that could be submitted to the committee to guide us in our thinking?

[Dr. Stelios Georgiades]

I am sure that we can identify those and submit them to the committee.

I'm going to go back to the example of autism, where I think the model there can be used for the development of a national strategy for child health more generally. That is based on consultations with provinces, with—

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

Allow me to interrupt.

We've been told that this has never been done, that this is the first time a study has been done, that this is the first time a committee and a government have taken an interest in children's health. That's normal; we're in Ottawa, and it's not Ottawa's business. An expert comes and tells us that in committee.

He's before the committee, and I'm asking him if there are other documents, reports or studies of bills. Earlier, I referred to the Quebec government's 140‑page document entitled Plan d'action interministériel en santé mentale 2022-2026 — S'unir pour un mieux-être collectif. The answer I get is that he could look at that eventually, when it suits him and, incidentally, it takes national strategies for this and for that.

So I'll ask the question again to get a yes or no answer: before telling us that the work has never been done by anyone, including the governments whose jurisdiction it is, have you done the research? What is the basis for what you told us earlier?

[Dr. Stelios Georgiades]

Absolutely. Many provincial studies and governments have produced guidelines for child health. I think what we're lacking in Canada is learning from each other across provinces and regions in a national scope.

That's what's lacking here, and I think that's why this committee is here today.

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

So the provinces have already done some of the work we're doing today, contrary to what you told us earlier.

[Dr. Stelios Georgiades]

The different pieces may be there that we can build on. The committee is here today to learn from each other, so that all kids across Canada can benefit from evidence and learning. That is my point.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Georgiades.

Next we'll have Mr. Davies, please, for two and a half minutes.