Human Resources Committee on Jan. 31st, 2017

[The Chair, Liberal, Bryan May]

You have just under two minutes.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Thank you to my colleague and the chair.

I'll go back to Stats Canada. With respect to teenagers who have depression or are experiencing anxiety, what has Stats Canada done differently, say, over the last five years to make sure you are reaching or hitting that group? What innovation have you shown to try to hit that group?

[François Nault]

I think it's a good question. My colleague had started to talk about the methodology. We have implemented the best methodology possible. We have also very good interviewers who are convincing people to answer the questions. Obviously, these are very sensitive questions. There's no doubt about it. Is there under-coverage? We try to control it as much as we can. We have very consistent results over time, so we're fairly confident in our numbers. Recently we have tried all kinds of different techniques such as behavioural economics to nudge people, to convince people to respond. We've been phoning. We're very persistent, phoning about 25 times to try to convince people to respond to the question. But the response rates have been declining for sure, so it is a challenge to make sure there isn't under-representation of those people who are the most vulnerable.

[The Chair, Liberal, Bryan May]

Thank you very much.

Now over to Dan Ruimy for six minutes.

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

Thank you very much, Mr. Chair, and thank you everybody for presenting.

This is very tough. On paper, from what you guys are saying, the programs seem great. It's not what I'm seeing in my riding, and that's a big concern. Is that a question of our failing? Is that a question of programs not reaching people? These are the concerns that we're trying to address.

The unemployment rate among people with serious mental illness is 70% to 90%, and there is therefore a 60% drop in the family's income when the primary earner is diagnosed with mental illness.

I'd like to talk a bit about the current EI system, and how it responds to this and assists unemployed Canadians with appropriate services. This is directed to Mr. Murphy. How do they get back into the workforce? What are we doing to help them?

[Doug Murphy]

Is your question specifically related to people with mental disabilities?

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

Mental disability seems to be a major portion of the problem of poverty, and we know that they're closely interlinked. When we are trying to get people back to work, are we addressing that portion? Is Service Canada addressing that portion of the problem?

[Doug Murphy]

Yes. I apologize, but on that specific issue, I will have to get back to the committee with an answer.

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

Okay.

Service Canada right now has a skills link training program, for instance, for youth at risk. How do we get youth back into the workforce? One of the problems we see is that we take somebody who has had all these mental health challenges and is struggling and in this pit of despair, and then we say, “Okay, here, we're going to give you some money and you're going to go to skills link training.” Do you think that would be an effective approach, or do you find there's a better approach to take? It's a tough question.

[Doug Murphy]

It is a tough question and it's not my area of expertise, but I can certainly go back to the people in Service Canada and our employment insurance policy and raise those issues with them.

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

Okay.

I'm going to jump to Ms. Romano. Being with Health Canada, are you able to answer any of those questions? We're talking a lot about mental health, but we're not really doing a lot to help the ones who need it the most, especially the youth.

[Anna Romano]

Sure. I can maybe partially answer and then perhaps my colleague, Mr. Perron, can talk about some of the future investments we're thinking about making in the area of services.

Again, I want to make the distinction that at the Public Health Agency, we are trying to prevent people from becoming mentally ill. When I use the term “upstream”, I mean that many of the programs we have in place—you've probably heard the word “resilience” about eight times during our various presentations—are trying to get at the demand issue, decreasing the number of people who are actually trying to seek out those services once they're ill. I think it's widely recognized that.... My minister has made a big priority of improving access to mental health services. It's recognized that the demand is bigger than the supply.

I'll maybe have Sony speak to the health accord.

[Sony Perron]

To the extent I can.

[Anna Romano]

Yes, to the extent you can.

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

We're playing hot potato here.

[Sony Perron]

It's a bit beyond the mandate of my branch, but what I can say is that, as you all know, the Minister of Health has in her mandate letter negotiating with the provinces and territories to, among other things, improve accessibility to mental health in Canada, so these discussions are under way. I'm pretty sure all the members of this committee are aware of how this is progressing with various provinces and territories.

I think this is a true commitment. There is great interest. I've been able to witness, in the discussions with provinces and territories, that they are concerned about that. At this stage I cannot really go further about the outcomes of the negotiations. I'm not directly involved in those. This is clearly an issue that is not only a concern of this table here. We have heard the same thing from provinces and territories, of course, and they are very interested in advancing on this front.

If I can speak about what my area of action is, which is a bit more specific to a segment of the population, it's about building service closer to home that is controlled by the community and supports them in adapting the service, trying to undo the bads of the past when we were trying to impose a similar model that exists, for example, off reserve in the mainstream population and just changing a couple of words to make it first nations relevant or Inuit relevant. We have to think in terms of cultural adaptation. We have to think about cultural control over this, rebuilding the foundation. We have, and we are trying to put these measures in our new programs.

We have to think about cultural safety as well. Various members of the committee were asking me questions about how the province would play in this. I think we have a challenge in Canada, not only the federal government but all governments together, to build cultural safety. When it comes to clients who have been dealing with specific issues—I'm thinking of first nations and Inuit, who have different backgrounds—when they face institutional services, whether they're provincial or federal services, these have to be culturally safe; otherwise, they won't show up.

One member of the committee mentioned that people do not access. I think we have to question, always, is it adapted? Is this something that is relevant to me? Sometimes it's a bit beyond the control of institutions like departments to deal with, but on the front line we need to look at that.

On the first nations and Inuit side, I think there has been a really big push in the last 10 years to deal with cultural safety and to make sure that the service providers understand that the individual who comes in front of them comes with a background and a story. We talk a lot about trauma related to the legacy of residential schools and other really sad policies that have affected their lives in the past. We have to invest a lot in building cultural safety and cultural adaptation so that the services offered are relevant.

We have seen recently in the coroner's report an indication that people are accessing services, but basically they do not follow up on them because, probably, there is a problem with acceptance of the system or the adaptation of the system to be responsive to their needs. We have to really work on this. It's not always more services. Often, it's adaptation of services so they're relevant to this segment of the population.

[The Chair, Liberal, Bryan May]

Over to MP Poilievre, please.

[Pierre Poilievre, Conservative, Carleton, ON]

Thank you very much, everyone.

My first question is for Stats Canada. When will we get the 2015 LICO data?

[François Nault]

I'm not sure. I'll confirm that with my colleagues.

[Pierre Poilievre, Conservative, Carleton, ON]

We're only up to date to 2014 right now. The tables don't go any further. We're now in 2017. I would hope that we'd soon see 2016 data, but we don't even have 2015. I think anything you could do to clarify—

[François Nault]

Yes. Normally surveys come out about a year or so after the end of the reference period. There was a collection during 2015. Processing the data is not my area. Normally it takes around 12 to 15 months. I assume it will be soon, but I'll double-check.

[Pierre Poilievre, Conservative, Carleton, ON]

Thank you.

Page 9 of the Stats Canada deck here shows a very strong relationship between unemployment and mental and substance use disorders. Do you have any data that points to causality in that relationship?

[François Nault]

I don't think so. My colleague may.

Again, this is a cross-sectional survey. Typically, cross-sectional surveys are good for association. We know that the people who answered their employment status as such-and-such and their answers to disorders are such-and-such, so we can do the graph that you have in front of you. Causality really requires, as I said, going back to people so that we know what comes first and then we know the transition. If someone was in a given state of employment and—

[Pierre Poilievre, Conservative, Carleton, ON]

Is there a reason why we haven't done that yet?

[François Nault]

Generally, it's the cost.