Human Resources Committee on April 2nd, 2009

[Maurice Vellacott, Conservative, Saskatoon—Wanuskewin, SK]

Well, it's one of many, but anyhow, carry on.

[Ruth-Anne Graig]

My biggest problem with the new disability savings program is that it is great for people with resources. Unfortunately, it leaves a lot of people who are dealing with mental illness out of the picture--people who have become disenfranchised from their family and natural support networks. It is great for people who can access it.

[Maurice Vellacott, Conservative, Saskatoon—Wanuskewin, SK]

There's not a great deal of knowledge out there on this right now, but a person doesn't even have to have...and I guess you're right in that, if they're connected or disconnected from family and so on. But they don't even have to....

In fact, when you get to age 18, if you have this plan or this fund open, without even contributing on your own, the government will contribute significantly; it's a means basis. That's as I understand it; we've gone through some of the fine print.

So you don't even have to have family with significant wealth or means or anything--

[Ruth-Anne Graig]

But you have to have some wealth to match it.

[Maurice Vellacott, Conservative, Saskatoon—Wanuskewin, SK]

No, you don't, actually. No, that's not correct.

[Ruth-Anne Graig]

Okay.

[Maurice Vellacott, Conservative, Saskatoon—Wanuskewin, SK]

That would be good for people to read up on pretty carefully, because we did check it out with the bank. When he's on his own without any resources at age 18-plus, he can still be a beneficiary of this. In terms of the amount, it will be entirely the government contribution kind of thing.

Anyhow, I've run out of time. I was going to ask you about Hansen trusts. I was going to ask you about the Ontario disability program and many other things. A competitive minimum wage was a question that I wanted to ask Don about.

If I can cheat from my colleagues here later, I might get those in. If not, we'll ask them of you personally.

[Ruth-Anne Graig]

Thank you for that information.

[The Chair, Conservative, Dean Allison]

We're going to move to a second round.

I want to welcome Ms. Coady to the committee.

You have five minutes.

[Siobhan Coady, Liberal, St. John's South—Mount Pearl, NL]

Thank you very much.

First of all, let me thank you all very much for your very comprehensive presentations here this morning. You have obviously put a lot of time and consideration into your presentations. It certainly showed in the presentations and the number of suggestions that you have made, and we certainly appreciate that.

Secondly, I want to thank you as well for all that you do in the community for mental health. It is certainly a very serious issue for Canada, for Canadians, and for individuals. Anyone in this room at any given time could be utilizing your services, so I appreciate that very much. There but for the grace of God, right?

Those were just some opening remarks. I want to talk a little bit about the hierarchy of needs.

Many of you talked about housing. I have two questions to formulate, so I'm going to start with the first one on housing.

I'd like to get specifics on what we should be doing on housing. As you know, the Canadian government over the last number of years put a significant amount of money towards housing initiatives. I am going to be holding in the next week a round table in my community about housing issues and concerns. I've been to a lot of the places where those with mental illness live, and it's not pretty.

Will any of you make suggestions on what we should be doing specifically for housing at this point in time? It's a very serious issue.

I want to get to my second question, because we only have seven minutes. Are you seeing an increased demand for your services because of the downturn in the economy? For example, I think Mr. Palmer talked about the availability of jobs. Has that been decreasing? Are we having more serious impact? What I'm concerned about is prevention and early intervention and the spiralling effect, because it's a spiralling effect. We could all have mental illness today and find ourselves in poverty, it's that serious of an issue.

I have many questions, but I'll start with those two.

[Carmela Hutchison]

We must look at the hierarchy of needs in the first place, and I'm really glad you brought it up. Abraham Maslow's hierarchy of needs is a wonderful place to begin. Shelter is on the base level. It's with food, water, air, and the basic things we need to just survive as an organism.

Having said that, in terms of the issues around housing, I think the private landlord rent subsidy is one very concrete program that could be enhanced that would really help a lot of people. Many mental health consumers who have the ability to access it really express its benefits.

Also, in terms of preventing homelessness in emergency situations, when a person starts to not meet their payments, there could be some kind of assistance there. I think also that income protection as preventive medicine cannot be overstated. That has to be seen as one of the forms of preventive medicine.

We have a city of homeless people in Calgary and another city of homeless people in Edmonton, and that's just those two communities. So there are about 4,800 people homeless in Calgary right now, and 50% of them are actually employed. Then there are another 3,000 in Edmonton. This is something that has to been seen...and I know it's across the country. This is a national crisis.

For a flood or a disaster, we would be rolling out emergency measures. I am begging our governments--provincially, locally, federally--please, this is a crisis. This is an emergency. Respond accordingly. This is an epidemic.

There's already enough research out there to talk about what needs to be done. I suggest that one of the first priorities of the research department of the Mental Health Commission is to mine that research and only address gaps. I think this is one thing that's really important because the answers are already in those files and that's crucial.

On the increased demand for service, I live 45 miles in the country from Calgary. There are people who access me on a daily basis over the Internet, over the telephone, who drive out to my house, and it's never-ending. We eat it, live it, breathe it, sleep it. It never ends. I know that many organizations that have a mandate perhaps to do an educational program end up trying to solve the basic needs of the individuals.

So again, the fact of crisis cannot be overstated.

Thank you.

[Margaret Singleton]

Perhaps I could just comment.

You asked about specific things that could be done. I think the comments that are being made about how we already have a lot of knowledge are very appropriate, but I also think it's important that there is no one solution. It's not one size fits all. People are different. Whether they have mental illness or not, people are different. One solution can be good for one person and not for another.

The rent supplement model has been talked about. Certainly it's very positive, but for many of the clients we work with, it would not work well. They need the community base of a supportive housing community. An integration can happen in small supportive housing communities within the larger neighbourhood.

Those are just two things, but I think it's really important not just to focus on one solution.

[The Chair, Conservative, Dean Allison]

Thank you.

Mr. Cannan.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Thank you, and my thanks to our witnesses.

This has been a compassionate, compelling talk, and it is something close to my heart. I spent nine years on Kelowna city council, and worked on the committee for community housing and the board for social planning. As we've said in this committee, poverty is something that crosses all party lines, ages, and social, economic, and demographic sectors. Each of us has a story to tell about individuals we know in our communities. I have an adult daughter who has a borderline personality disorder, and it's been a real challenge. We who have worked with the Canadian Mental Health Association appreciate their efforts. With the street programs and with our homelessness partnering strategy, we've had quite a number of success stories in our home community.

And Carmella, like Calgary, they're working on a 10-year capital plan. Two of the problems are knowing where to start and how to know if you're making progress. That's what we're embarking on right now. There's no silver bullet. It's multifaceted, all levels of government, non-profit and private sector. Everybody has to work together. We respect the hard work of Senator Kirby's report and the commission on mental health. The 2007 budget put in over $130 million over 10 years; the 2008 budget called for $110 million over five years.

At the end of the month, this committee is going to be travelling to Vancouver, where we will see first-hand some of the work that's being done and needs to be done in the community. Coming from British Columbia, I've seen it many times, first-hand.

As to where we go with housing, I know we talked about a national housing strategy, but somebody from Ottawa telling us what to do in our community doesn't go over well out in British Columbia. In the 30-year plan that our government signed off on in 2006, we invested $2.2 billion. The plan works with BC Housing and CMHC, partnering in the community. So we're having some success.

I'd like to get your comments about giving long-term funding to the provinces and working with local communities, versus having a national program with no capacity for making local decisions. What would you favour?

[Carmela Hutchison]

I think a blended approach is absolutely essential. To echo and support our colleagues from Salus, it is true that supported housing for many people living with mental illness is essential. I myself could use housing supports that aren't otherwise readily available to us. Home care is one of those unfunded issues, and home care and housing supports are often the first things to go. The first thing to go is the supported component—they might do the nursing care, but they're not going to help with the shopping, getting to appointments, or house-cleaning. Yet these things are profoundly needed, as is basic life planning. Housing has to have a supported component, along with other components.

It's important for the federal government and the local areas to work together, allowing communities to come together. A recent CMHC paper demonstrated that giving users a role in designing and planning their housing projects is fundamental to the projects' success. It is also important to assist beleaguered municipal and provincial governments through federal transfers.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

I agree. I also agree with my colleague Mr. Ménard that the closer you get to the problems, the better the chance of finding a grassroots solution.

My brother works with mentally challenged adults, trying to find employment for them. In British Columbia, they experimented with taking individuals out of institutions and attempting to integrate them into society. Do you think that was a mistake?

[Don Palmer]

No, absolutely not. The technology has been there for 30 years. The number of people who have been taken out of institutions and integrated into the community, who have been provided jobs and have kept those jobs successfully, is significant. It does take some initiative and it does take some skills, but it certainly is a way we should be going.

On the issue of whether it's employment or housing, I think we need national standards. Your point is well taken. Local solutions are what we need. We need innovation. We need our hands freed to be innovative, but we do need national standards so we don't see the erosion from province to province or area to area.

[The Chair, Conservative, Dean Allison]

Thank you, Mr. Cannan.

Madame Beaudin, five minutes.

[Josée Beaudin, Bloc, Saint-Lambert, QC]

Thank you, Mr. Chair.

Thank you so much to the witnesses for being here today. Thank you for the work you do. I imagine that you are as impatient as I am to see the results of your work.

You have identified so many factors this morning that I will probably seem a little disorganized as I deal with several of them.

Among other things, you talked about everything that is being done provincially. Of course, mental health is in provincial jurisdiction, but we cannot forget all the work that is done at local level by community organizations. I heard you all talk about local initiatives that provide help and support to people with disabilities. I assume that you have constant funding problems there. How can we help you with all the work done by local organizations on the ground in your areas?

You also talked about priorities. Housing is likely a major priority. I would like to know about the priorities that could come next. Given the economic situation, if we were in a position to do something quickly that would produce quick results, what would it be? I know that we have to understand the big picture, but what measure or measures would you like to see put in place?

[Ruth-Anne Graig]

I think one of the most profound ways that we could increase people's salaries would be to provide resources to people on low income, such as we're doing for the OAS and the guaranteed income supplement at this time. That would put money into people's pockets right away.

Another thing you were saying is that the government needs to work with the non-profit sector more. We were just talking about deinstitutionalization a couple of minutes ago, and one of the biggest problems is that those funds are not being transferred to the community, where everything is happening.

[Dr. Taylor Alexander]

I would just like to add that the community-based services are the least well funded of all the mental health services. For example, in Ottawa right now they are having great difficulty attracting home support workers into the home care system, because they don't pay them enough. Home support workers are the backbone of home care, so we have a catch-22. The human resource issue has to be addressed.

Just to come back to a comment of the other member, there's an urgent need for a national human resources strategy in mental health on both the supply and demand side. I think that's a really important area of research that we need to look at.

In terms of funding, we had on the books at one point a mental health transition fund. That seems to have gone by the boards. That kind of federal fund would go a long way to making funds accessible to community-based services across the country. I think at one point there was a half-billion dollars in the mental health transition fund. It would have to be revisited. But there's a good example of how the federal government could show leadership, yet the provinces could use those funds in appropriate ways.

Just to deal with the other issue of the federal-provincial dynamic, I think what the federal government can do very well is to set those national standards. But the provinces, obviously, have the responsibility to implement these programs. I think one of the downfalls with the health funding a few years ago was that it remains important to have accountability on the provinces' side of how those funds are spent.

In terms of a housing strategy or a mental health funding strategy, yes, make the funds available, give the provinces the freedom, but have some accountability mechanisms built in for their use so these funds don't go into general revenues, for example, as has happened in the health care system.

[Carolyn Buchan]

From a Salus point of view, I think we would agree completely with the last speaker. Earlier, when we were in the hall waiting to come into the committee meeting, Gillian Mulvale from the Mental Health Commission asked us where our funding came from, and we had to say to her, well, it has a mixed history. Over the 30 years, it has come from all levels of government at different times, depending on which level was more active in the field at the time.

At the end of the day, as Margaret said earlier, to our clients, it doesn't matter where it comes from. We are pretty adept at working with every level of government. But I think from an administrative point of view, what was said earlier would be the way we would like to see it go.

[The Chair, Conservative, Dean Allison]

Thank you.

That's all the time we have for this round.

We're going to finish up with Mr. Lobb, and you have about five minutes.

[Ben Lobb, Conservative, Huron—Bruce, ON]

Thank you very much. I'll try to ask these questions as quickly as I can.

My mother-in-law has worked in the mental health profession for over 30 years in southwestern Ontario, so I'm kept well apprised of the situation there.

We talked about gaps in rural Canada. Being from rural Ontario or rural Canada generally, I was happy to hear Carmela say she was from rural Alberta near Calgary. I'm curious to know from your perspective where you see some gaps in mental health care in rural Canada that you'd like to see improved.

[Carmela Hutchison]

Actually, when I was injured, I was working in a rural mental health clinic in Hanna. I was injured in a rollover car accident on my way to a team meeting. So I can certainly speak to this issue quite extensively.

The gaps for people living in rural areas are just tremendous. The human resources issue is profound. That is certainly one thing. Also, we can't attract clinicians in the same way you can't attract home support, because of the lack of wages necessary to sustain the employment of people.

As we're all NGOs here at this table, we're also employers, and it's very difficult to find quality staff when you're trying to hire people. In the mental health consumer movement, that's also a huge problem, because we're trying to get staff who have lived the experience of mental illness. If the wage isn't commensurate with meeting their basic needs, then it's really not something that, ethically, we can do. In the Alberta Network for Mental Health, in particular, we have operated without staff for the past two years, because we cannot pay somebody a wage that would allow them to even afford housing. Ethically, as a board, we feel we can't do that.

So that's where we're at. Right across the board, human resources is an absolutely profound issue.

Access to treatment has been helped by telehealth, but that really isn't the only thing that people need. In rural hospitals, there need to be at least one or two beds for some of the less severe, and perhaps shorter-term, mentally ill persons who don't necessarily need the big infrastructure of a city psychiatric ward, for example.

Sometimes transportation to treatment is an issue. If somebody has to go out of the community for treatment, there often isn't disability transportation. One example is that there is actually an allotment given in Alberta to rural municipalities for transportation. The problem is that this disability transportation money is not designated. Any dollar that goes to people with disabilities that is not designated often very quickly finds its way absorbed into general revenues. That practice must be stopped.