Health Committee on Nov. 1st, 2023

[Ya'ara Saks, Liberal, York Centre, ON]

I thank the member for the question.

I'll say, if I may just share personally as the mother of two teenage daughters, that being pregnant with them was one of the most exciting times in my life and also in many cases the most terrifying. That is the case for many individuals who go through pregnancy and then birth as well as for many families. That's why we understand that perinatal health, which follows a woman through the course of her pregnancy and afterwards, is a critical part of ensuring not just her mental health but also the best success for the child.

We've taken on an approach, working with the Public Health Agency of Canada, to develop a national strategy of having good interventions that medical communities can use in guiding their patients through the perinatal process to ensure the best outcomes for both parents and their children.

[Sonia Sidhu, Liberal, Brampton South, ON]

I just want to know how we are working with them and whether there are culturally sensitive mental health services. How are we providing those? There's a stigma out there.

Can you elaborate on that, especially on the culturally sensitive mental health services we are providing?

[Ya'ara Saks, Liberal, York Centre, ON]

I can absolutely.

As I mentioned in my opening remarks, we have to make sure that mental health services are accessible to people when they need them and where and how they need them.

We're so fortunate in Canada to be multicultural and diverse and also to recognize rural and remote communities, our indigenous communities, Black communities and LGBTQ2SI people. In order to be seen and to embark on the brave journey of getting mental health supports, you need to know that those who are serving you truly see you and understand you. That's why culturally appropriate supports are really important.

One of the programs we're actually quite proud of is the funding support we've provided to Black Canadians through the Black Canadians mental health program, through the Public Health Agency of Canada. We hosted a summit here just last week on indigenous wellness, with indigenous mental health care providers from throughout our first nations communities. Just this past weekend I was up in Markham for the South Asian Health Alliance forum to understand the important need for advocacy within our South Asian communities throughout this country when it comes to their mental health and health care.

That's something I think we can be proud of as Canadians—that we really make sure there's a diversity and equity lens on all the health services we provide, including mental health services.

[Sonia Sidhu, Liberal, Brampton South, ON]

I just want to ask about virtual care. It was an important tool to mitigate the additional strain during the pandemic.

Can you elaborate on virtual care and how it is important for mental health?

[Ya'ara Saks, Liberal, York Centre, ON]

Absolutely. I want to thank the member for her question.

During the pandemic, the federal government made a bold move, understanding that Canadians were struggling with their own mental health, and opened the Wellness Together portal. This not only included online services with tools and resources for self-assessment, but also online services for counselling and other important evidence-based and comprehensive tools for mental health. We know it was a lifeline for many.

Just today, I was part of the Frayme forum, which is a youth mental health network that works specifically in the digital space. Going back to your question about youth, youth are accessing their information and their health care through digital platforms. We have to make sure that those spaces are safe and evidence-based and, again, meet our young people where they are.

I think virtual care is a key component in how we are forward-thinking in how we deliver health care services and mental health services. However, it also means that we can service rural and remote communities that wouldn't necessarily have the opportunity for in-person clinicians.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Thank you, Ms. Sidhu.

Mr. Thériault, you have the floor for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Good evening, Minister.

Let's try to have a six-minute conversation.

Do you know what jurisdiction was the first in the world to develop a mental health plan?

[Ya'ara Saks, Liberal, York Centre, ON]

You're asking about the first authority to elaborate on a mental health plan. Is that your question?

[Luc Thériault, Bloc, Montcalm, QC]

Yes.

[Ya'ara Saks, Liberal, York Centre, ON]

I'm afraid I don't know.

[Luc Thériault, Bloc, Montcalm, QC]

It was Quebec in 1989.

With all due respect, I would say that Quebec did not wait for the creation of a position of minister responsible for mental health to work on this issue.

Are you familiar with Quebec's interdepartmental mental health action plan 2022‑26?

[Ya'ara Saks, Liberal, York Centre, ON]

I recently met with my counterpart, Monsieur Carmant, on the Quebec plans. We discussed a comprehensive approach to mental health services that includes the social determinants of health in the consideration of helping those, particularly, with substance use.

[Luc Thériault, Bloc, Montcalm, QC]

It's a good plan, and it's going to last until 2026. I imagine you would describe it as very good, since, in addition, it is interdepartmental, which means that no one is working in a vacuum and that it is agreed that mental health is a cross-cutting issue.

Do you think that's a good plan? Is it an excellent plan?

[Ya'ara Saks, Liberal, York Centre, ON]

I'll say two things.

One is that having previously been the parliamentary secretary for families, children and social development and having worked on the national child care system for Canada, we look to Quebec for our best lessons learned after its 25 years of ensuring that there was high-quality, affordable child care. I'm not surprised that Quebec is forward-thinking in the model and plan it has put forward.

As a matter of fact—

[Luc Thériault, Bloc, Montcalm, QC]

Do you think it's a good plan, or an excellent plan, or not?

[Ya'ara Saks, Liberal, York Centre, ON]

I think an integrated approach to health care in government plans is important.

[Luc Thériault, Bloc, Montcalm, QC]

Okay.

Quebec will invest approximately $1,152,950,000 to update its plan. There are 43 measures in seven areas of development. We will agree that it is a good plan.

In a unanimous motion passed across party lines in the National Assembly, Quebec told the federal Government of Canada that it would be entitled to unconditional compensation for any new federal program.

First, why isn't there already an agreement? Why is there still no money coming to Quebec out of the $25 billion set aside for bilateral agreements with the provinces?

Second, since Quebec is a world leader in mental health and is far ahead of the federal government, why should it not be allowed to have its own money and manage its own affairs?

Money is lacking for mental health. That has been the case for years.

[Ya'ara Saks, Liberal, York Centre, ON]

As the member well knows, there are ongoing discussions with each province and territory, as health is under their jurisdictions. I agree that an integrated approach to health is an important lens to have. Each province and territory determines how they want to see that integrated approach.

I know Minister Holland continues his conversations with the Minister of Health in Quebec to ensure that the proposal and agreement Quebec will have are the ones they want and that work with the federal government's commitments.

[Luc Thériault, Bloc, Montcalm, QC]

What is your real intention when it comes to mental health care? What expertise do you have in this area to tell Quebec that you know better than it does what it has to do, when we've just agreed that the plan extends until 2026? A lot of money has already been invested in that, and more is needed.

So why not simply send the money to Quebec and let it manage its services?

[Ya'ara Saks, Liberal, York Centre, ON]

As the member would know, in the previous rounds of funding, SUAP, for example, in Quebec, was given its per capita sums to determine how best to utilize the funds within its province.

We admire the work Quebec is doing. Like every other province, it is their jurisdictional purview to ensure they are prioritizing the health of their residents. We work collectively and positively, and with the shared principles that were mapped out. They include mental health as a priority. It is also embedded in the other four priorities of the principles set out in February. Quebec was a part of that.

[Luc Thériault, Bloc, Montcalm, QC]

I don't think you're really answering my question.

Would you agree that Quebec, as a forerunner with an excellent mental health plan, as you said, but needing more resources and money, should receive the money it is owed right away so that it can manage its programs as quickly as possible? I won't list all of that, but what do you think?

Why isn't there already an agreement and why isn't the money already on the ground? I get the impression that a double structure is being created. When it comes to mental health, the money has to be on the ground, don't you agree? In fact, that is what the action plan provides for. So why create a double structure? Soon, at the federal level, we're going to get bogged down in national strategies and it's going to take a national strategy to manage the national strategies.

[Ya'ara Saks, Liberal, York Centre, ON]

What was committed to in February, as the member well knows, was $131.8 billion.

What I will say to the member is that each province and territory has an allocated amount as part of the bilateral agreements. It is not for the federal government to impose its position on how the Province of Quebec would like to utilize its mental health funding. We applaud the efforts and work the Quebec government is doing to ensure Quebeckers have high-quality mental health. As with many things, Quebec is a wonderful model for other parts of the country.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Thank you, Mr. Thériault.

Next, we have Mr. Johns for six minutes.

[Gord Johns, NDP, Courtenay—Alberni, BC]

First, I want to thank all of your staff and team for being here and for the hard work they do.

I congratulate you, again, Minister, on your new appointment.

Minister, do you have a new mandate, or do you have the old mandate? I haven't seen a mandate letter come up for you. Are you basing your mandate on the 2021 mandate letter?

[Ya'ara Saks, Liberal, York Centre, ON]

At this time, I'm continuing with the mandate letter that was provided to my predecessor.