Evidence of meeting #63 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 40th Parliament, 2nd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was yukon.
Conservative
The Chair Conservative Dean Allison
When I say that jokingly, I'm hoping from what we're hearing that there's more and more activity with church groups and not-for-profits working together. We've been hearing some of those things, and I can't say that was always the case.
I know Mr. Savage talks a bit about how the individuals may have strong opinions about certain issues in church, but don't really see themselves as being an extension. I would agree with what he says about that, and I think it's good to see.
I have sort of two parts. How is the activity? We have heard from people this morning, but do you get a sense that you guys are able to work together in town with not-for-profits and local governments, business? Is that a bit of a challenge? Where do you guys go?
You talk, Kate, about how you receive all your funding from outside. It all comes from private donations, from businesses, I would assume, whatever. What's your sense on the cooperation as you work through some of these issues?
Then I've got a question for Nyingje.
Director, Maryhouse
I think the Yukon is really a unique place for people generally working together. I think it's always been really wonderful.
I was assigned here in 1979. I only got to be here for ten months and then I got reassigned a couple of years later. But I know when I was here in 1979 people still talked about coming in and going out. You pack in your groceries, a very interesting view. Also, you helped. It didn't matter where. It broached everything. The non-denominational organizations and the NGOs, we all help however we can.
It's like the women's shelter. You have Kaushee's Place. When they have something, they're free to call us, and if we can help them, we help them. If we can't, we try to find something else. Or they'll call different places. I've always felt there's been wonderful cooperation between the different organizations here in the Yukon and helping to respond to the needs of people and see what needs doing.
I know when we were asked to close our shelters in1997, many people went to the government and said, “You've got to do something. You've got to provide shelter. We have to do this.” So they did, in a manner of speaking, and then that kind of fell apart. So then the Salvation Army picked up what it could; they're not able to do a big amount, but they help. We do help each other.
We still get a donation of food, because the Salvation Army has very limited hours. Sometimes we get lots of donations, so we end up taking it over to the Salvation Army because the people who are giving to us can't. They don't have the time or they're not there when the program is open.
So I think here in the Yukon it is amazing. There's a lot of cooperation between the different organizations. Yes, it has always been wonderful.
Conservative
The Chair Conservative Dean Allison
Ms. Norgang, I know we heard it from a couple of people this morning, but if you could recap, you talked about the issue of women trying to come out of abusive relationships and the challenges of poverty. I know it has been discussed, but just refresh my memory in terms of what's available for them in terms of housing or lack thereof and the different needs. Obviously, shelter for a night is not nearly enough for women trying to get out of that situation. What types of housing do you have available or do you need?
Women's Advocate, Victoria Faulkner Women's Centre
I want to start by connecting that with what Kate was saying, because I find people are incredibly generous. People call my centre all the time. They hand-knit things for people to wear. They've been hunting and have extra meat to donate for the kitchen. If we have extra, we give it to Kaushee's. People are fantastic. It is really touching.
That's addressing problems, but we really do need help from the federal government to address the root of the problems. Otherwise, we keep handing out mittens and hot soups, but people's lives are still desperate. Housing is one of the most painful parts of my job. People ask the women's advocate on a daily basis for help with housing, and I don't have solutions for them.
I'll even be looking in a newspaper and calling places for some women. I know that those women are not looking as attractive to the person doing the renting, who has absolute freedom to pick the cream of the crop because housing is so short. The cream of the crop for the person doing the renting is what they call the professional. It's not the woman I'm trying to find housing for.
What does she do? She really is left in extenuating circumstances that place her at risk of violence, sexual assault, and exposure to the cold. People come in to get a hot shower to warm up. They slept outside overnight. There aren't solutions for me to find for them. I'm not able to do my job.
Liberal
Michael Savage Liberal Dartmouth—Cole Harbour, NS
In the course of this study or otherwise, I don't compliment the federal government very often. There hasn't been much cause to in this study that we've been doing. But one thing that it did get a good start on was the working income tax benefit. It is one thing that a lot of the social policy groups have said is a good start. It's a vehicle. It needs a lot more resources.
One thing it does is allow provinces and territories to tailor their specific social infrastructure to the federal infrastructure. I don't think Yukon is one of those yet. Nunavut is.
I want to follow up on what you were saying. You said that when somebody works who is on social assistance, they have to repay. Explain to me how that works.
Director, Maryhouse
I don't know about the women, but I know the single men who are on assistance. If they get a job, they have to pay back the assistance. They don't give them much time. They dun their paycheque, basically.
Liberal
Michael Savage Liberal Dartmouth—Cole Harbour, NS
If they're on social welfare or a social assistance program, they have to pay back for the period they weren't working?
Director, Maryhouse
I think they have to pay back quite a bit of it. They take a chunk out of their paycheques.
Liberal
Michael Savage Liberal Dartmouth—Cole Harbour, NS
This issue of clawback is something we need to address in the poverty study, particularly how it may be different jurisdictionally. I think we all agree Canadians can be a very generous people. One of the problems with that, both individually and collectively, is that we tend to be generous for specific events. If somebody has a fire, the community rallies and they build a house.
If there's a tsunami in Southeast Asia, Canadians get together. They throw a lot of money and say they're going to do that. When rock stars get involved with specific causes, people get involved. We're not very good at addressing the chronic underlying causes of poverty or the social determinants of health that cause poverty. People who live in chronic poverty don't get as much of that generosity as people who have specific incidents, it seems to me.
We're better at reacting to emergencies than we are to the chronic conditions. If poverty in Canada isn't an emergency, I don't know what is. Do you agree with me that we're better at being generous for specific causes than we are for chronic conditions?
Director, Maryhouse
Well, the people up here have been very steady, but I've found that they are, in varied instances. It's hard to go through a week without fundraising for someone who's in trouble, someone who needs medical care or something.
For us, for Maryhouse, throughout the year it's pretty steady. People are faithful, and they donate stuff. As you said, we're not trying to fix the problem--I don't know if you can fix the problem--and Maryhouse is really answering the immediate need.
In some way we hope to change that. When we had the shelters and we had men there, we would work with the guys. Some guys were able to change their lives and get on with it. We have a very good, faithful volunteer who's in his 70s now, who was probably one of the worst men on the street when we first met him. He was able to stop drinking, he was able to get of his life back together somewhat, and he comes and volunteers at our house. He's very faithful.
Part of it happened because he could come and we would take him where he was at, and eventually he was able to say, “Yes, I can change”. I think that's similar to the Victoria Faulkner Women's Centre. We can advocate for that change, but that one-on-one is what enables people to say “I have dignity and I can change; I can move” and then have people support them in doing that. I think that's one of the hard things here: when you get a break, what are the other supports that enable you to keep going?
Liberal
Michael Savage Liberal Dartmouth—Cole Harbour, NS
I think that in looking at poverty, we're at the point where we've moved away from charity and toward justice. Hopefully we'll get to the point where it'll actually be investment, and we'll look at the cost of poverty as opposed to the cost of not addressing it.
This morning, Charlotte Hrenchuk of the Yukon Status of Women Council gave us some specific recommendations. One of them was to give adequate funding to organizations working with the poor. Organizations that work with the poor at ground level don't get a lot of government help; they're putting these amazing programs together, they're the best people to deliver this service--and I'm sure it's the same with Maryhouse and with Victoria Faulkner--but we make it very hard. If you do qualify for government funding, you basically have to hire somebody to write grants and apply for a little bit here and little bit there, as opposed to A-base funding.
I think that's really important for us to understand, because we sometimes think that in the name of efficiency we have to have these big national programs, which in many ways don't address the needs of Whitehorse or Saskatoon or Sydney, Cape Breton, and places like that.
Director, Maryhouse
I think part of the challenge there--and I think this is a really honest thing for governments, whatever level they are--is where the revenues come from. They come from the people, and we do have to have accountability. When we're doing that, we have to have accountability.
When Maryhouse closed their shelter, people would still come, and they opened up another shelter. The government was spending $1,000 a night for an emergency shelter. They woke up and realized that they could put people in a hotel room more cheaply if only two people showed up one night needing shelter, so they were going to close that program and do that.
They asked us if we wanted to be a referral, so I asked what it would entail if we were a referral. The first thing they said was that we'd have to find out if they were doing this because they didn't have any money or if it was because they were on a cross-country hike and this was a good place to stay. It's that accountability for how we're spending money and their perception that they just don't want to throw it away.
It's hard. It's hard, and it's back to that question of who's poor and how we judge that, but it's also the responsibility in terms of stewardship: if you're getting the money and you're backing these things, then you want to see the value for your money, and that's a challenge.
Liberal
Michael Savage Liberal Dartmouth—Cole Harbour, NS
There are a lot of challenges. There are a lot of things that are difficult in addressing these issues of poverty, but one thing is very clear, which is that the heroes of the fight are the people on the ground, like you, who are doing this work because it needs to be done.
Some people are doing it because they see it as God's instruction to them as human beings. Some people are doing it just because they feel that there are people who need help. Not many of them are doing it for personal betterment or big salaries. We know that. So it seems to me, at the very least, that the government has to acknowledge that we have abandoned some of that field and that we need to resource those who are doing it, and that federal government money could be leveraged significantly by not disenfranchising people who are best able to do that work. It's not that you want to be doing this, but somebody needs to do it, and you're doing it.
Women's Advocate, Victoria Faulkner Women's Centre
Could I just respond to your comment about moving from charity to justice to investment? I think that's really beautifully put, and it comes to the basis of the issue.
I've worked in many places in Canada, as well as in the United States and in Thailand. I've never seen the extent of abuse and violence that I see here in Yukon. I think that's for two reasons: first, some particularly related to Yukon, but also, maybe some deterioration in different systems in Canada, so that things are getting worse than they were when I first started working maybe 30 years ago.
I now routinely see young women who are in very bad relationships. My role as a counsellor is to try to help them have some vision of something better for themselves. Often they have children. Often they have an awareness that their children are witnessing this and their children are going to grow up into the same situation.
When I ask them to imagine the ideal man they'd like to be with, they look at me like I just dropped in from la-la land. They think I'm really out of touch, and they say there are no men who are not like this. Every man in their life who they can think of is either abusing substances, abusing his partner, abusing his children, or damaging or unreliable in some way. When I ask them to imagine a better situation, they're just looking for the best of a bad situation, so they may be staying in a relationship that's bad because they can't afford housing on their own and because they know, on the street with their child or moving from place to place, they're even more vulnerable than they are with that person. Or they're staying with that person, and they say, “Okay, so he's drunk all the time, okay, so he's verbally abusive, but he doesn't beat me up”, and that's the best they can think of.
We need to address issues like providing counselling for women that gets to the root. If I can talk to a young woman for long enough, if we can work together, I may be able to light some spark that there can be a different future for her and for her children. It would help a lot if I could also tell her that there was housing and tell her that there was a future for her.
Conservative
The Chair Conservative Dean Allison
Thank you very much.
I just want to close off by saying thank you again to our witnesses for being here today and for sharing what you do. As Mike said, really the heroes are the ones who are on the front lines, and what we're trying to do is to leverage that the best way we can and make those recommendations, so thank you very much again for the work you do and for being here today.
Women's Advocate, Victoria Faulkner Women's Centre
Thank you all. You've been really attentive. I appreciate it.
Conservative
The Chair Conservative Dean Allison
Thanks.
We're going to suspend while we change to our last group of witnesses for today.
Conservative
The Chair Conservative Dean Allison
I welcome our last group of witnesses for today. Thank you once again for coming and taking time out of your schedules to talk to us about some of the things you deal with here in Whitehorse and in Yukon and to maybe make some recommendations for us as well to take back as a committee to the federal government.
I'm going to start with Brooke Alsbury, with the Fetal Alcohol Syndrome Society of Yukon.
In a second I'm going to let you make your presentations, seven minutes each, and then we'll go around and ask some questions. In case you didn't hear us before, we have been doing the study for a while. Has it been a year and a half, guys and ladies? It's been ongoing for a while. We went to the east, then we came west, and it was suggested that we should come north, and I'm very glad we did. There's been some great testimony today.
I'm just going to leave it at that and if any of the other MPs want to fill in, that's great.
Brooke, thank you for being here, and I'm going to turn the floor over to you.
Brooke Alsbury Executive Director, Fetal Alcohol Syndrome Society of Yukon
Great, thank you, and thank you for inviting me.
As I was scrambling to put this together, I thought, “Oh gosh, say something intelligent”, so hopefully I do.
I do represent the Fetal Alcohol Syndrome Society of Yukon. We provide direct support services to individuals with an FASD, as well as prevention and education, and we coordinate the adult diagnostic component for the Yukon.
Overall, and I'm sure you've heard this a hundred times, we know poverty is a multifaceted issue with a number of risk factors that include gender discrimination, racism, homelessness, lack of education, and reliance on social assistance. I think what is particularly important when we think about an FASD, is that all of those risk factors exist for individuals with an FASD, and many more.
When we're thinking about the complexity of individuals with an FASD, we look at both those who have an FASD already and the women who may be at risk for maternal alcohol use. And when we think about those women in particular, we see that substance use is intertwined with violence, housing instability, legal issues, and mental health concerns. And this really, for me, becomes where poverty is complex for individuals with an FASD, because we think about negotiating all of the systems and doing that when you have a cognitive disability as well.
Then for women who are experiencing poverty, homelessness, marginalization, and legal issues, trying to remain sober for that nine months of pregnancy, in environments that may or may not be supportive to that, becomes particularly complex. And so when we think about services, we need to think about services that are seamless rather than siloed. I think that becomes one of our biggest challenges here in the territory—the siloing of services across governments, both within the territory and then at the federal-territorial-first nations-community levels.
We may have an individual who has 20 or more services and individuals directly involved in their care, whether they're living with an FASD or they're pregnant at that point in time. So negotiating all of those systems, I think, for an individual who's also in poverty and trying to find a house is particularly complex.
We see in our organization a few numbers or statistics that are supported by general research as well—our numbers seem to be around the same. About 13% of our individuals are absolutely homeless and another 8% to 10% are relatively homeless, so we see that about one-fifth of our client population is homeless, and then they're experiencing substance abuse and also violence on a regular basis.
So when we intertwine those with poverty, and we note that maternal rates of alcohol use are much higher in the north—or at least evidence would show that—we start to see many, many, many risk factors for individuals.
Our diagnostic team shows that when an individual is diagnosed with an FASD, there are recommendations for supported housing, for ongoing mental health monitoring, for alternative approaches to drug and alcohol treatment, for external support for negotiating the judicial system. And what we see is that it is not possible to carry out many of those recommendations because we don't have the systems in place to be able to carry out all of those recommendations—the lifelong, seamless support services. So we see individuals going through transitions out of youth programs, out of the criminal justice system, into nothing. Someone leaves the criminal justice system and doesn't have a house to go to, doesn't have supports in the community. It's pretty difficult then to just have exited the criminal justice system, to be living in poverty, and to be living with a cognitive disability. We wonder why we see this revolving door.
The same could be said about substance abuse treatment. Most of the research suggests that traditional substance abuse treatment is not impactful or effective for individuals with a cognitive disability and an FASD. So again, someone exiting a 28-day treatment program without the ongoing after-care supports that are structured, including supported housing.... If housing hasn't been mentioned today, housing, housing, housing.
So we see about 65% of our clients have been involved with the criminal justice system or are currently involved with the criminal justice system, and research across Canada and the U.S. suggests that that number is fairly stable across populations with an FASD. So again, we need to look at the intersections of risk factors around poverty that lead to involvement in the criminal justice system.
There was a recent Institute of Health Economics consensus statement that said, “There should be ‘no wrong doors’ for people affected by FASD who need support.... Services should address cumulative risk...and not be based on silos of care.” I think, for me, that typifies what we need to look at for individuals who are living in poverty and also living with an FASD.
The two other areas that I think are particularly important are early intervention and prevention. Again, when we think about prevention, we need to think about women-centred approaches to prevention efforts that look at this complexity that women living in poverty who are also pregnant need seamless and integrated supports right across the services.
Thank you.
Conservative
The Chair Conservative Dean Allison
Thank you very much.
We're now going to move over to Susan Gwynne-Timothy, who is from Second Opinion Society.
Susan, we're looking forward to hearing a bit about some recommendations, as well as a bit about Second Opinion Society. The floor is yours for seven minutes.
Susan Gwynne-Timothy Administative Coordinator, Second Opinion Society
The Second Opinion Society is a non-profit that offers informal and seamless support to mental health survivors--psychiatric survivors, but also people who are just wondering about their mental health.
It's a drop-in centre. We offer services. We also offer a program in the summer, particularly for recreation, like canoeing and hiking, and then in the winter there's cross-country skiing. We have Thursday lunches. We also have talking circles and healing circles, and a library.
It was founded about 18 years ago. The founder was a German woman who had a master's in community health. She was very keen to come to the Yukon and take a community approach to the problem of psychiatric survivors being treated differently. She was very keen on integrative approaches and the normalness of an extended view of human nature, as opposed to a very straight, down-the-line version of what normalcy is.
She also wanted to have people not be treated within institutions, but instead find healthy lifestyle ways of making a difference for themselves. Research has shown that psychiatric drugs aren't all they're cracked up to be, and that if you improve your diet, if you have a good level of activity and so on, and if you have support from peers, in particular, you will actually do a lot to help your mental health. That's for everybody, including people who are on the other side of what is considered normal.
That is what we do. We supply that opportunity for people in Whitehorse. There are a lot of places like this around Canada in bigger urban centres. Whitehorse is very fortunate to have a place like this.
It is a good opportunity for me to be able to attend this panel today and tell you about the Second Opinion Society. Thank you.
I would like to make three main points. First is on supported housing. There's a need for supportive housing and other supports, such as counselling for those with mental health issues, to help them out of poverty. Number two is that informal and ongoing support is really much cheaper, and it also helps people with mental health issues avoid going into crisis. Treating crisis requires more costly interventions, like going to a hospital or having the RCMP come along. Number three is that peer support, which is the number one mandate of Second Opinion Society, is effective and inexpensive.
There is a big correlation between mental health and poverty. People with mental health issues are often either homeless or functioning at a much lower level than they could and should if there were better supports in place for them. As well, there are big gaps in the services that ought to be there.
A main service that needs to be improved is supportive housing. There was a report done in 2006 by somebody named Dr. Goldner, from Simon Fraser, on the Yukon mental health services. It states that there is virtually unanimous agreement that among the areas of high priority, substantial need exists for supportive housing for people with serious mental disorders and/or substance abuse disorders.
The value of supported housing has been well documented in the scientific literature and has been identified as one of the best practices in mental health reform.
Other support services that could improve according to the report are day treatment services for ongoing rehabilitation. This area, on an informal basis, is basically what we do at Second Opinion Society.
Similarly, advocacy and peer support to help people navigate the system in which they would otherwise often get lost is also a problem that we help people with a lot.
My second point is that with the insufficient level of ongoing services, the people who need them are more likely to go into crisis. They then require the much more expensive services, like hospitals and police. I don't know if you've already been to Vancouver, British Columbia, but the downtown eastside is famous, and 49% of police calls for service in that area involve at least one mentally ill person. Police who were interviewed there--this is according to an article in the Vancouver Sun last year, said that the situation is at crisis proportions due to the closing of institutions and cutbacks in government funding.
To repeat, emergency services all cost much more than ongoing low-level support. If people had better ongoing supports in place they wouldn't go into crisis and need the high end as much.
The third point I would like to make is that the Second Opinion Society offers many of the effective interventions that help people avert crisis--if you haven't gathered that already. As a small non-profit we operate on a shoestring, with a budget of about $100,000 a year. Even shoestrings get stressed, and we are currently very underfunded. In fact, our core funding from the Yukon government has stayed flat since the mid-1990s.
According to the Yukon Bureau of Statistics, if one compares the 1995 average prices to 2008 averages, costs in Whitehorse have gone up 26%. In this environment our flat funding has squeezed us to the point where we now have no extra room for anything. Yet we are still very proud that we offer an immense amount to our members.
We keep stats on how many people come and what they use here at our service--peer counselling, just chatting, or crisis support, as well as services like laundry, telephone, computer, and so on.
We have two main profiles: the homeless or street people, and social assistance recipients who live close to the poverty line, even if they have housing. Both groups need ongoing supports and advocacy, as well as just friendly interaction. Those who live rough really need and benefit from laundries, showers, and homey places to relax.
Meanwhile, with our activities of cross-country skiing, and so on, recreation is proven to improve anybody's mental health and is particularly beneficial to the stereotypical reclusive who sits, smokes, and watches TV in their apartment. Everyone enjoys our community luncheon get-togethers in talking or healing circles. It's a really wonderful, strong community.
These people are also intensely spiritual. I heard the last lady talk about the kind of despair expressed by a lot of people. I think where I work is a very hopeful place, but that's because we're kind of subversive and we have a good time being spiritual. It makes us feel better. So there's quite a high sense of community there, which is really nice.
I want to give you some individual stories. We have people who come to town and can't get a doctor. If they're on addictive meds, where can they can turn? We help advocate for them to get the care they need.
We have a client with whom I've been doing ongoing breath work over the phone because she's almost too scared to leave her house. She has improved immensely over the last half year. She was in crisis not too long ago with no housing, counselling, or doctor. She was in danger of being sent to hospital in Alberta against her will, because that's where people go. There's nowhere for them to go in the Yukon.
We were able to give her a friendly ear and practical support, to the point where she was able to find housing, a doctor, and a counsellor. Recently she moved to a new apartment without freaking out. She's not getting in trouble with the police and is almost living a stable life.
We have another member from a very stressed first nations family system. She's a psychiatric survivor due to the usual list of issues: residential school, abuse, suicides, and so on. She works and is a pillar of strength and health for her family. She's an admirable example to anyone of healing. She went to Ontario for a stay at a hospital, but since she's come back she's been a faithful member. She consults us when she gets into crisis, and she's a really remarkable person.
Finally, I'd like to draw to your attention the general significance of what we offer. I don't know if the lady outside gave them to you, but I have both American and Canadian articles indicating that peer support works, and government money would be well spent in that area.
An American article quotes psychiatrist Daniel B. Fisher, who himself is a psychiatric survivor and current member of the White House Commission on Mental Health. He said:
People with psychiatric illness get better care from other people with a psychiatric history than from traditional doctors and psychologists in a traditional medical setting.
He says, “We are not an overnight stay place”, and talks about overnight stay places. But it's something like 80% cheaper. There's a very big difference.
Then I have an article there from the Globe and Mail by a professor at the University of Toronto faculty of social work. He says:
According to a recent Canadian Institute for Health Information (CIHI) study on the cost of illness, we spend $8,000 to $12,000 each time a person living with bipolar disorder or with schizophrenia is admitted to hospital. We have made choices to spend these amounts of money for a 10-12 day hospital stay when the same amount of money would provide treatment and support services for a full year or more.
I can attest to that. I know exactly how many people we serve. If we had $8,000 to $12,000 per person per year, we'd be laughing. We'd be very happy.
This article also suggested that no less than 10% of mental health budgets should be spent on peer support centres. Of the top ten things this author suggests for the improvement of mental health care in Canada, number three is a friend. Many people living with mental illness want to connect with other people with similar experiences. They want to help each other. Mental health systems need to dedicate 10% of their spending to funding peer support programs for people living with mental illness in their families. They also need drop-in activity centres, community kitchens, and programs that foster a sense of community. I said that day treatment services offered by the Yukon government are seen as lacking. They're there. They're good. They're a good standard. But they're insufficient.
In sum, we would like to say that we are proud that Second Opinion Society, which is the kind of service that is more likely to be found in bigger centres, is in the Yukon and has been here for the last 18 years, despite the small population. We know we make a difference.
That's it.