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.
President-Elect, Canadian Counselling and Psychotherapy Association
That's my dream. I think absolutely that's what we would hope for.
NDP
Director, Public Affairs, Canadian Counselling and Psychotherapy Association
Yes, one hundred per cent.
NDP
Don Davies NDP Vancouver Kingsway, BC
Other witnesses, I'd like to open that up to you.
Dr. Afifi, would you agree with that?
Professor, University of Manitoba, As an Individual
Absolutely, we need to do that.
Director, Offord Centre for Child Studies
Thank you for your comment. I think the big question is why wouldn't we include it?
NDP
Don Davies NDP Vancouver Kingsway, BC
Interestingly, there was a large cross-sectional study conducted in 2020 of Canadian children, youth and parents, where 67% to 70% of children and adolescents experienced deterioration in at least one mental health domain: depression, anxiety, irritability, attention hyperactivity and OC disorders, but 19% to 31%, depending on the age group, experienced improvement in at least one domain.
Do any of the witnesses have any comment—perhaps, Dr. Afifi—on what factors might explain this heterogeneity of experiences among Canadian children?
Professor, University of Manitoba, As an Individual
I can speak to that. It depends on what outcome you're looking at.
For some children, the home environment they were captured in, for lack of a better phrase, may have improved. They may have received one-on-one, undivided attention from their parents, who were able to stay home and take care of their needs. Some things may have increased. For some children, their needs might have improved being in the home environment through the pandemic and home-schooling.
When we think of the families with the least amount of resources who couldn't provide that and were struggling, trying to do their job and to find adequate care and education for their children, those children would have suffered the most during the pandemic and perhaps have been left behind.
I think it depends on the circumstances and what outcomes you're specifically looking at then saying what went up and what went down.
Liberal
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Thank you, Mr. Chair.
Thank you, everybody, for taking the time to be here today.
I'm hoping to get to at least two themes in the five minutes I have here, so I'll start with the first one.
Both you, Ms. Thomson and Professor Afifi, touched on the importance of intervention with our children and the reasons for doing that at an early stage. I've had discussions with some policy-makers about things like ADHD and dyslexia and whether or not certain education systems should be looking at making screening for that mandatory.
From your research, Professor Afifi, and then to you here in the room, I'm wondering if there is some of it that falls into your realm and that you have seen has been a success. It may not necessarily be here in Canada; it could also be elsewhere. Since Ms. Thomson is writing, I'll go to you first, Professor Afifi, and hopefully get some of your thoughts.
Professor, University of Manitoba, As an Individual
I think we need to be careful with universal screening and not just implement it for a variety of things unless there's a proven reason that we should. First of all, screening needs to be done if we can adequately identify what the problem is.
Then, most importantly, if we're screening children, then we are obligated to connect those children who screened positive, for whatever it was, to services. If we don't have those services readily available and in place, the screening is for nothing, and it could cause more anxiety for families, because now we've identified that their child may have ADHD, but we don't have the resources at the school, in the province or in the community to support that, so now they have to wait two years to get access to care.
I think we need to think that through carefully. If early intervention connects to screening, then, yes, we should do it, but we should only do it if we are able to connect those services.
Think about for screening for cancer, for example. Imagine being screened for cancer, and you're told you have cancer, but then you're told that we can't give you services for two years and that you're going to have to wait. Imagine how much worse that situation is.
There's an obligation there, when we screen, to connect to services and make sure they're there. Again, all the recommendations tie together. Data, evidence-based...and translating the information into policy and practice. Train and retain people in an integrated system that talks to each other. Then make sure all of these services are accessible to every single child, not just a certain child or certain children, so that no one is left behind.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
I don't think we're going to unpack all of that in the five minutes I have, but before I go to Ms. Thomson, I see Dr. Georgiades nodding.
I fear I might not get to you in this round, Dr. Georgiades, but certainly if there is more of that I welcome its being submitted to the committee. As a philosophical and ideological conversation about the importance of what we do, do we just live not knowing that a kid has ADHD, then, because we don't have the services for it? That also seems like it's not necessarily the compassionate answer.
Before I take up more of the time I'll turn to Ms. Thomson to perhaps finish this theme.
Director, Public Affairs, Canadian Counselling and Psychotherapy Association
Absolutely. Thank you.
I definitely echo what Dr. Afifi is saying.
To add to that, among the psychological tools that are available for doing different mental diagnoses, we see that they're not all appropriate across the different cultural experiences and ethnic backgrounds. That's something we have to bring extra attention to. If this is something that would be implemented, we have to look at the makeup or the grouping of the children and their background. Is this going to be appropriate? Are we going to be pathologizing their experience that they might not necessarily identify with?
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Great.
Maybe I do have time for Dr. Georgiades.
Do I have 30 seconds, Mr. Chair? Okay.
If you can wrap all of that up in 30 seconds, Dr. Georgiades, it would be great.
Director, Offord Centre for Child Studies
If we think in a limited way in terms of controlled capacity, resources and strategy, I completely agree with Dr. Afifi that we should be very careful.
In the Canada that we all envision—especially those who are here today—capacity, resources and a clear evidence-placed strategy would be in place where screening is as much a part as a diagnosis, as timely interventions, so that our children and youth can reach their full potential.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Jeneroux and Dr. Georgiades.
Next we'll go to Dr. Powlowski, please, for five minutes.
February 9th, 2023 / 12:15 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Thank you.
We're here to talk about child mental health, and we've already talked about some of the barriers.
I'm going to build on Don's question. Don had two and a half minutes and he got right to the punch line, but I'm going to provide some of the buildup to that.
What percentage of children you treat have the cost of that treatment paid directly by government-provided services?
President-Elect, Canadian Counselling and Psychotherapy Association
Maybe 10%....
Liberal
President-Elect, Canadian Counselling and Psychotherapy Association
That would be under IVAC, victims of criminal violence. It's a provincially run program. That would be under the NIHB program. That would also be under the program for the Kahnawake Social Services Resource Center.