Human Resources Committee on April 30th, 2009

[The Chair, Conservative, Dean Allison]

Thank you, Mr. Pacetti. It's good seeing you here today.

We're going to go to Mr. Cannan, who has five minutes. We're almost done. There's been some great discussion. It's not like we can get you every day.

I'm going to have Glenn ask one question and Candice as well, just to round it out.

You have five minutes, Mr. Cannan, and then we'll go over here for one minute.

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

Thank you, Mr. Chair. Thank you to our witnesses.

Thank you, Dr. Kirby, for your outstanding work. In working closely with the Canadian Mental Association in my riding, as Glenn has alluded to, and the great work they're doing across the country and in the business community...the model after the Calgary strategy, which our own community is embarking on. It takes all levels of government, the community, the taxpayers--and the business community is a big component of that--to have a successful plan moving forward.

I just want to comment on an aspect of progress and change. In my own personal experience, my oldest daughter is going to be 24 this year and she has gone through a borderline personality disorder and had a breakdown after two years of university. I have had the opportunity to work with professionals. There are many out there in the community, and I appreciate their dedication.

My question to you is this. As far as your commission is concerned, what do you see as the definition for mental health illness, and what percentage of Canadians are affected by that?

[Michael Kirby]

Do you want to go ahead?

[Jayne Barker]

Well, there isn't one universal definition, but definitions of mental health usually encompass the idea that people can have successful relations with other people, that they can make contributions to society by holding down a job. How they think and how they feel allows them to function fully and engage in everyday life.

When you start talking about mental illness, then you're really talking about having how you think, how you feel, how you respond, and how you behave affected by your illness. So the symptoms are manifested through, as I say, how you think, how you feel, or how you behave.

[Howard Chodos]

Just to add to that, the working definition of mental health, at any rate, that we've used in the context of developing the mental health strategy comes from the World Health Organization. It says that mental health is:

...a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

That is a definition of mental health.

What we've tried to do is distinguish between mental health and mental illness, and to recognize that people who are living with the symptoms of mental illness can also experience a great deal of mental health, in the sense of having a positive outlook on life and having the resilience to cope with the symptoms of their illness.

So when we talk about mental health and mental illness, it is in fact two different things. Having positive mental health can contribute in ways, independently, of having the symptoms of mental illness. We would want to encourage the greatest degree of positive mental health for all Canadians, at the same time as we find ways to encourage people and to enable them to cope with the symptoms of mental illness when they experience them.

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

I think that's an excellent fact that we have to communicate to Canadians. You alluded to where we are with mental health in comparison to breast cancer 30 years ago. That is an excellent analogy. I believe individuals with mental illness deserve the services, support, and access to them.

The federal government is trying to provide those funds to the provinces and territories. I spent nine years in local government working at that level and getting the funds down, but the challenge we have jurisdictionally is ensuring that the provinces deliver the dollars where we'd like them to go. As you said, supportive housing is something we've heard from other witnesses who have come to the committee, and we'll continue to get that message to the provinces. Once again, each province and territory is unique.

I have a follow-up question about facilities for the individuals you mentioned. The police force has indicated that approximately 50% of 911 calls are due to mental health. How are you addressing networking with our judicial system and the Criminal Code? Are there recommendations coming forth from the task force?

[Michael Kirby]

Absolutely. The reality is that when we de-institutionalized in this country.... We closed the old asylums, as they were called when I was a kid, the mental hospitals. In theory, we were putting people out into community-based facilities, except that we didn't build the community-based facilities very fast. The result is that the streets and the prisons have really become the asylums of the 21st century, which is outrageous, frankly.

We are working not only with the Canadian correctional services—in fact, we're running a conference with them on this specific issue in about two months—but I think all of the people concerned with the justice system, beginning with the judiciary and the lawyers, recognize that we need to do two things. We have to start providing mental health services to people we incarcerate, which we don't do now. The result is that they're worse off when they get out than when they went in. More importantly, we have to start focusing on the broad question of how we stop them from going to jail in the first place. Having mental health courts is one way of doing it, but we think there may be other ways.

Our mental health and the law advisory committee is chaired by an Ontario judge, Ted Ormston, who created the first mental health court in the western world, in Ontario. He has some very creative ideas that we're talking to the provinces and the people who run the jail and penitentiary systems about.

[The Chair, Conservative, Dean Allison]

Thanks, Ron.

We're almost out of time, but I'm going to ask Glenn for one question, and then Candice; as you've been so gracious to be here, you'll get one question as well.

Glenn, go ahead.

[Glenn Thibeault, NDP, Sudbury, ON]

Thank you, Mr. Chair. I appreciate the question and I will try to keep it brief.

You mentioned the repatriation. I'm sure we could talk for an hour and a half about the repatriation and the term they use when they've taken individuals from institutions with no preplanning and put them into the community. Many of the issues we're talking about now could have been resolved if there had been a lot of preplanning.

We've talked a lot about “housing first”, and one of the things that I think is very clear that I would like to hear you explain is.... It's great when you get a roof over your head. That's an important piece in reducing homelessness and addressing mental illness. But as soon as they get a roof over their head, you can't wash your hands of the individual. There are so many responsibilities in becoming a tenant, and with mental health, all of a sudden you have to worry about paying all of your bills. The “housing first” strategy can't just be putting a roof over their heads. There have to be so many other support services in place. Is that correct?

[Jayne Barker]

That's absolutely correct.

One of the supports that is part of the program we're testing is the interface with the landlord. So when landlords feel frustrated, or when something happens, they have somebody they can call who will go and address the issues.

It's also about teaching people who have lived on the streets, who maybe don't have the skills to deal with landlords and have never had that opportunity to learn how to talk to a landlord. It's teaching them the kinds of things that are expected in keeping an apartment or a place to live. You're absolutely right, supports that help in dealing with a landlord as well as supports for dealing with health and mental health problems are crucial.

[The Chair, Conservative, Dean Allison]

Thanks, Glenn.

Candice, thanks for being here today. You have one question.

[Candice Bergen, Conservative, Portage—Lisgar, MB]

Thank you very much for the opportunity. I'm going to try to make this brief as well.

My question has to do with treatment. I know there are a lot of drugs that have been prescribed. Many times that contributes to or doesn't help the problem. I'm wondering if you have looked at faith-based communities and programs to help the mentally ill, more of a holistic approach.

[Michael Kirby]

Your question was, have we? We are so early getting going. The answer is, we have not, but we will. The answer is yes.

Let me tell you where my bias is on this issue. I had a sister who suffered for many years from severe depression, including a suicide attempt. She subsequently died of cancer. She would say to me that she felt she got more help from her spiritual adviser than she did from her psychiatrist. While that is anecdotal, it gives a little bit of bias on the question.

The reality is that the aboriginal Canadians have understood for centuries that you have to treat the whole person, and the whole person is not just the head and not just the physical body. It is the combination, and it has a spiritual element to it. I use spiritual rather than faith-based, which connotes a somewhat purely religious point of view. Spiritual need not be religious in the normal sense of the word.

Yesterday at a meeting Jayne Barker and I were at with CIHR, we discussed the question of how we get some evidence to establish empirically what appears to be anecdotally very true, which is that the spiritual element of treatment is a very important element.

[The Chair, Conservative, Dean Allison]

Thank you, Dr. Kirby and your colleagues, for being here today.

We are going to suspend for a couple of minutes just to go off camera, off broadcast. Then we are going to come right back to deal with some committee business.

[Michael Kirby]

If I could just say one closing comment to all of you, thank you for having us. I don't say this to flatter you. It's really important that Canadian leaders like yourselves get involved in this issue. If it is okay with you, Mr. Chair, we will come back to the members of the committee and through them their other colleagues in the House over the next little while to talk about events you could participate in with us.

If community leaders like you are prepared to stand up and be seen on the mental health front, that's a huge step forward in reducing the stigma. So thank you very much for inviting us. We were delighted to come.

[The Chair, Conservative, Dean Allison]

By all means, anything you send to the clerk, as you know, we'll make sure members get, in addition to any other meetings you have. Thank you very much.

We will suspend just for a couple of minutes.

[The Chair, Conservative, Dean Allison]

Could I get the members back to the table, please?

[Yves Lessard, Bloc, Chambly—Borduas, QC]

Mr. Chairman, while we are waiting for colleagues to come back, we might be able to revert to public meeting mode, because staff has set this up to be in-camera.

Thank you.

[Ed Komarnicki, Conservative, Souris—Moose Mountain, SK]

I think we left the last meeting, as I recall it, with a read-in amendment by me that was in the process of debate. That's my recollection. I don't know what the feeling of the committee is or whether we can come to any kind of consensus.

I know Mr. Lessard would like to have at least one meeting, maybe two, and his view is not at the end of the poverty study but maybe something sooner. I'm not sure where his head is at. I don't think he's finished debate, setting out his thoughts on that, as I recall it.

[The Chair, Conservative, Dean Allison]

Just so everyone knows, the amendment by Mr. Komarnicki that we're working on is that the motion be amended by adding between the words “examine” and “the” the following, “at the conclusion of the poverty study and for one meeting”.

That's what we're discussing right now, to be clear.

I have a list of speakers. I have Mr. Savage and then Mr. Lessard.

Mr. Savage, the floor is yours.

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Chair, I'd be prepared to go after Mr. Lessard, in case he answers my question as we go forward. Is that possible?

[The Chair, Conservative, Dean Allison]

Fair enough.

Mr. Lessard, the floor is yours.

[Yves Lessard, Bloc, Chambly—Borduas, QC]

Mr. Chairman, let us remember that this is a motion asking that the Committee study the way the Enabling Accessibility Fund has been managed. The purpose of this fund is to help organizations supervise their work, in particular with regard to the persons with disabilities aspect. The purpose of Mr. Komarnicki's amendment is to limit debate on this matter to a single meeting, once our work on the study on poverty is finished.

Mr. Chairman, I do not know if Mr. Komarnicki still wishes to maintain his amendment, but my suggestion, with all deference and much respect, is that we deal first with the main motion. We will then be able to decide how much time we want to devote to it. It seems to me that this motion has two elements to it. It would be difficult to determine now how much time we would devote to this. Furthermore, the matter to be discussed is sufficiently urgent for it to not wait until the end of our work on poverty.

That being said, once we have disposed of my motion, if the Committee agrees to it, I would suggest that staff provide us with scheduling options, in order that we not encroach on the time set aside for our study on poverty. My intent is not at all to delay the study on poverty. To the contrary, you know how much this is important to us. We must ensure that both issues are harmonized and are not in conflict one with the other. I am not excluding the possibility that we only devote one meeting to this matter. However, we must not limit ourselves. This would handcuff us at the outset and deprive us of a tool that might allow us to do our work properly. This is not something we should be doing, in my view.

[The Chair, Conservative, Dean Allison]

Thank you, Mr. Lessard.

Mike, I have you on the list here.

One of the things I'd suggest is that we are discussing the amendment, so we're going to need to deal with that before we go back to the main motion anyway. As a compromise, maybe we could look at—once again, you guys are going to vote on this at some point, I'd suspect—trying to fit it in either through a subcommittee meeting to discuss when we could look at it, realizing that you're suggesting we'd like to look at it before the end of the poverty study, but also realizing we have the ministers coming before us. Next week we're away for travel, so a subcommittee may need to talk about when that could take place. I don't want us to jump ahead of ourselves, but that may be a compromise.

Mr. Savage, you have the floor. That's all I have here right now.

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Thank you.

I want to thank Mr. Lessard. He has answered some of the questions I had.

When this first came up, I would have supported an amendment that said we would do this after the poverty study. I would no longer support that amendment. This is part of the poverty study, in my view. The way that persons with disabilities are being affected is very important.

I raised this issue in the House yesterday, as members know. There are some serious issues about this program, which started out very nobly but seems to have gone astray. We need to deal with this.

Mr. Lessard's idea, if I understood him correctly, is that we support this motion today and then ask the clerk and staff to come back to us with a recommendation.

I think we need to talk to officials. We may need some other witnesses as well. For today, I would certainly support passing this motion without a time allocation or limit, and let them come back to us with a recommendation.