Thank you, Mr. Chair.
I appreciate the opportunity to address this committee on behalf of the Public Health Agency of Canada.
Let me begin my remarks with some important definitions that I think will illustrate the public health imperative of supporting and improving mental health. Mental health is defined by the World Health Organization as “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.”
Mental illness, on the other hand, refers to mental health problems that are typically diagnosed and treated by mental health professionals. They include depression and anxiety as the two most common mental illnesses, as well as other less common ones, such as schizophrenia.
We know that mental illness is a significant contributor to poverty. In turn, the experience of poverty can negatively affect mental health. The World Health Organization has recently highlighted that the experience of poverty, inadequate housing, and problems finding work or getting an education are risks for poor mental health.
Understanding the impact of social and economic factors on mental health is key to developing effective public health programs. At the Public Health Agency we work upstream to help strengthen protective factors that promote positive mental health by helping Canadians build resilience and coping skills and prevent mental illness. Alongside other poverty reduction strategies, strong mental health can help break cycles of poverty.
The agency's work to promote mental health includes surveillance, testing programs—also known as “intervention research”—and support to community-based programs for vulnerable populations such as children, youth, survivors of violence, and seniors.
I would like to spend the next few minutes telling you about some of the investments the agency is making in these areas.
Given our focus on prevention and promotion, supporting vulnerable children and youth is a public health priority. Our suite of prenatal and parenting support programs reaches 278,000 at-risk children and parents in over 3,000 communities across the country each year.
We invest about $112 million dollars annually in three programs: the Canada prenatal nutrition program, the community action program for children, and the aboriginal head start in urban and northern communities. Families using these programs are facing challenging life circumstances, such as low income, lone or young parenthood, social or geographic isolation, situations of violence or neglect, as well as substance abuse problems. These programs support positive parenting, parental involvement, attachment, resilience, and healthy relationships, all of which are protective factors associated with positive mental health.
We know from program evaluations and participant surveys that these programs have a significant positive impact on both parents and their children, including improving mental health.
The Public Health Agency is also evaluating mental health promotion interventions to understand what types of interventions work, for whom, and in which context. Specifically, we invest $1.5 million per year on projects focused on children, youth, and their families that increase protective factors for mental health such as social support for vulnerable parents, secure parent-child attachment, resilience, the ability to resolve conflicts, and the ability to create healthy relationships. For example, the fourth R is a school-based prevention program that promotes healthy relationships amongst youth. The program includes role modelling of relationship skills, peer mentoring, bullying prevention, sessions on safe use of social media, as well as lessons to address and prevent dating violence.
The agency also supports community-based projects that strengthen both the physical and mental health of survivors of family violence. Poverty, unemployment, and economic stress are among the many risk factors for family violence. Family violence can cause serious health and social problems throughout the lifespan of a victim, including increased risk of behavioural problems in children, drug and alcohol use and attempted suicide in teens, and mental illness.
The agency supports projects across the country that reach vulnerable populations including street involved youth, indigenous and northern populations, and parents and children affected by violence. These projects also test the effectiveness of innovative health promotion approaches by measuring changes in mental health outcomes such as anxiety, depression, and post-traumatic stress injuries.
Poor mental health can impact Canadians at every stage of life, and seniors are no exception. Seniors with low incomes are more likely to experience social isolation, loneliness, and depression as well as ill health and a shorter lifespan. As you have heard from other experts, poverty reduction is not just about income support. It is as much about strengthening the bonds of community and having the ability to access the social supports around you. This is why the Public Health Agency continues to work closely with provinces and territories as well as the World Health Organization on the age-friendly communities initiative. In Canada this initiative has strengthened social inclusion in over 1,000 communities by bringing together seniors, caregivers, governments, and other stakeholders to help seniors remain active, engaged, and healthy in their communities.
The agency also works with partners to raise awareness and develop resources on seniors' mental health. For example, the agency provided funding to the Canadian Coalition for Seniors' Mental Health in collaboration with Shoppers Drug Mart to develop resources for seniors and their families on a range of seniors' mental health issues and to provide continuing education to pharmacists to support the dissemination of this information.
I will conclude here by emphasizing that investing in mental health promotion can help contribute to the reduction of poverty, but breaking the cycle of poverty and poor health requires a multi-disciplinary approach, given the complexity of the challenge.
Thank you for your attention and the time and energy you're devoting to this topic. I'd be pleased to answer any questions.