Human Resources Committee on Dec. 8th, 2016

[Ed Mantler]

As I indicated in my opening remarks, being able to sustain employment is absolutely key. There are a couple of factors that I think we've seen clearly impact one's ability to sustain employment.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Let me ask you more clearly. You mentioned those, and maybe my question wasn't as clear as I should have made it, but how do we get to that? We talk about this as the barricade, but how do we pull it down?

[Ed Mantler]

There are two very significant factors that we see as impacting the ability to earn a living. Number one, first and foremost, is the stigma that clings to mental illness. When I say stigma, what I really mean is discrimination. Tackling stigma, changing attitudes and beliefs about mental illness, and fostering a belief in recovery as an expectation are absolutely key to the second part of the equation, which is the workplace.

We know that most Canadians who work spend more time at work than they do at home with their families and that the workplace is highly impactful upon one's mental health in a positive or a negative way. The national standard of Canada for psychological health and safety in the workplace is a tool that's gaining traction with employers across the country—large, medium, and small, both public and private—to change the culture of workplaces and change the psychological factors within workplaces that impact people. Having workplaces that are inclusive, workplaces that accommodate mental illness, whether it's on a short-term or a longer-term basis, is absolutely essential to allowing people to make the most of their abilities and sustain themselves.

[The Chair, Liberal, Bryan May]

Thank you very much, sir.

We'll go over to the birthday boy for six minutes.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

Thank you, everybody, for coming today. It's a very interesting topic, very tough.

I'm going to ask Mr. Mantler my question. I'm glad that Mr. Zimmer brought up the question of stigma, because that's my biggest challenge right now. The passion that I have is for the youth. If we can figure out how to help them move forward, that's going to help us in the long run. With the programs we have, such as Bell Let's Talk, there's an awareness going out there, but I'm not sure how well it's working, because we come back to this challenge: are we getting anywhere?

My youth council, which met last week, specifically for two hours talked about youth mental health. I was surprised to hear that given all the programs the schools offer, they didn't feel that they did anything for them. They didn't think they were effective.

Trying to wrap this up, how do you envision the federal government embedding mental health and addiction into the national poverty reduction strategy, which remains in the federal jurisdiction? We all have different jurisdictions. How does this fit into the federal jurisdiction?

[Ed Mantler]

Thank you for the question.

I'm happy that you've targeted stigma in your question, because it is absolutely key. As a commission, we've had the opportunity to work with researchers across the country, particularly researchers out of the University of Calgary and Queen's. Through that extensive research, we know the key ingredients to programs that reduce stigma, so we know how to tackle the problem. There are some target populations that will be strategically most impactful, one of those being youth. Also, there will be media, health care providers, and particularly workplaces that involve first responders.

We've worked with a number of school boards and communities across the country on a program called Headstrong, which is specifically designed for high school age students. It's a process of going into the school, hosting summits that are educational and raise awareness of mental health and mental illness, and sending those students out to take a whole-school approach. It's been determined to be quite effective. This year, we focused on partnering with first nations communities to make Headstrong more available in those communities.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

I want to bring you back to the federal level. Is Headstrong provincial or federal?

[Ed Mantler]

Headstrong is a community-based program. It's one that requires some level of support through both policy and financial support. Embedding stigma reduction and mental health promotion in education policy is one step towards making them more of a reality across the country.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

Thank you.

You also mentioned different types of programs that are out there. Do you have a list of programs that are successful and some that are not successful?

[Ed Mantler]

We do, in fact.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

Because I'm short on time, can you send that to the clerk so we have that in our arsenal over here?

[Ed Mantler]

Yes, we can send you some information.

What we can provide that's perhaps even more relevant is that we've taken the best aspects of those successful ones and put them together in one package.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

Perfect. Thank you.

The other thing, and it's been mentioned over again, is if I have a problem with my heart, I go to the hospital. They don't even think twice; they try to fix me up. With mental health, we have a stigma, and when people do go to the hospital, they're just shooed away.

Can you elaborate a little bit more on the economic benefits of addressing mental health for low-income Canadians? There's a notion that we don't want to deal with this because it's going to cost us too much money. If we do deal with this, what are the economic benefits?

[Ed Mantler]

Your question is quite astute. In fact, people with lived experience of mental illness tell us that the time they feel most stigmatized or most discriminated is when they seek help, when they see their family physician, or when they go to the emergency department. Often, they do wait. Often, they are given cursory service and sent home without a longer-term plan.

Part of the reason for that is we hear from physicians that they feel ill-equipped to deal with the mental health problems that they face in their office or in the emergency department.

We have a document called “Making the Case for Investing in Mental Health in Canada” that I think will give you some significant detail on the economic impact. Rather than going into detail, I would be happy to provide that document to the committee.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

That would be great.

You talk about the “aspiring workforce”. Again, what specific steps do you think the federal government can take? Is it a policy thing that we put in? Give us some help here in trying to understand the role of the federal government.

[Ed Mantler]

To be quite—

[The Chair, Liberal, Bryan May]

Give a very brief answer, please.

[Ed Mantler]

To be quite frank, it's money.

We have a project that will demonstrate what works and what doesn't and help us put some science behind understanding the best practices in terms of what workplaces should be doing. We need to enact that demonstration project and put the research in place that's necessary.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

Thank you.

Can you forward the demonstration project to us as well, please?

[Ed Mantler]

Absolutely.

[Dan Ruimy, Liberal, Pitt Meadows—Maple Ridge, BC]

That would be great.

Thank you.

[The Chair, Liberal, Bryan May]

For six minutes, Ms. Ashton, please go ahead.

[Niki Ashton, NDP, Churchill—Keewatinook Aski, MB]

Great.

Thank you very much to all of our witnesses for being here today, either in person or by videoconference.

My first question today I will perhaps direct to you, Mr. Mantler, as well as to the team in Toronto who are working with the city.

Obviously the study is on poverty, but recent information, in terms of both our labour market and more broadly in the direction that our economy is taking in our country, is indicating that there is a rise in precarious work. One of the things I've been involved with is a national tour on the rise of precarious work in the millennial generation.

We've done consultations across the country, and while I'm an older millennial myself and know from my peers, from my friends, and from my family what this phenomenon looks like, I've been truly taken aback by how often the issue of mental health is brought up in the context of either living in conditions of unemployment or under-employment, and of course we're talking about a chronic, long-term situation here. Young people are making that very clear connection. Obviously we've heard some very heartbreaking stories, and they're calling for help.

One of the things I've heard extensively throughout these consultations is the need for a mental health strategy at the federal level, as well as pharmacare, recognizing that many young people are now in work where having access to benefits is but a dream.

I'm wondering if you've heard about some of these discussions that are emerging. Also, do you see an important role for the federal government in looking at a strategy in this area, obviously with resources backing it up, as well as a pharmacare strategy?

We'll begin with you, Mr. Mantler.

[Ed Mantler]

Yes. Thank you for a very relevant question.

About three-quarters of adults who experience mental illness tell us that their symptoms actually started in their teenage years, started as a youth, so clearly it's having an impact on those entering the workforce for the very first time.

We do, in fact, have a mental health strategy for Canada, called “Changing Directions, Changing Lives”. In that strategy, within its 109 recommendations, it does address poverty, it does address workplaces, and it does address stigma. We will ensure that you get copies of that sent over.

The pharmacare question is an interesting one, and I think the point you make is well made. I would stress, though, that although medication is a good intervention and often a necessary intervention, it is not the only intervention. Actually, access to psychological services—specifically, cognitive behavioural therapy—has been proven to be very effective, yet most individuals accessing psychological services have to do so through their work insurance plan because it's not publicly funded, and often those insurance plans don't allow for the level of psychological intervention over the period of time that would be required.

[Niki Ashton, NDP, Churchill—Keewatinook Aski, MB]

Okay, thank you, and thank you for being willing to share that information.

I'll turn to Mr. Tranjan and Ms. Murphy. Would you like to comment? We also recognize that in Toronto, in the GTA, the rates of precarious work, not just among young workers but all workers, are higher than in other parts of the country as well.