Justice Committee on Oct. 26th, 2023

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Thank you, Mr. Garrison.

Are there any other comments? Can we start the first round?

We will go to Mr. Caputo for six minutes.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you very much, Mr. Chair.

I've already thanked our professor who is online. I thanked her for her time.

I thank you, Dr. Mausz.

Thank you, Mr. Hills. I'm a U of S grad, and it's good to see you here.

When we were talking—Mr. Hills and Dr. Mausz, you can feel free to jump in on this—I asked Mr. Doherty a question about the deterioration of respect when it comes to people in uniform. He touched on it. I believe you were here for his testimony. I understood that you wanted to weigh in.

The time is now if you want to weigh in on that issue.

[Paul Hills]

I appreciate that. Thanks very much.

I think it's pretty simple from what I've been seeing in my career even prior to COVID and during COVID and afterwards. Society as a whole has lost a piece of kindness. We stopped being kind to each other.

When I walk into someone's home, even just everyday Joe Blow's, there's a level of understanding and a lack of respect for the work we do. Sometimes we're just treated poorly. They're blaming the system on us rather than understanding what we're bringing to the table and being there to help them, being there to care for them, and it can be taken to the extreme.

Gang members and other people never used to really strike out at us, but now, with the amount of verbal abuse, the amount of threats and people banging on our ambulances, there's just a lack of respect and kindness, really, for people helping anyone. It's even in the hospital system, as well, people are screaming at nurses when they walk into the triage area. People are screaming at doctors.

We've allowed it to be okay to harm each other rather than just respecting and being kind to each other. That's all I really wanted to touch on. I don't know how to fix it. Calling a spade a spade, we're just not as nice to each other as we actually could be.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Dr. Mausz, do you have anything to add? I could move on to the next question.

[Dr. Justin Mausz]

We could all benefit from a little more kindness. I would say that when my team reviews the violence reports, the things that my colleagues are describing—using quotes—“shock" the mind. It's utterly reprehensible in many cases, and it troubles me deeply.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

That's where my next question goes. I apologize if this is a bit of a technical question, but it's something that's really lingering. It's this idea of reporting and charging.

My question is this: From your perspective, is the issue one where people who are subjected to threats in your industry just say they've been told it comes with the territory or that nothing is going to happen, so they don't report it? Or is it reported and nothing happens?

[Dr. Justin Mausz]

I think it's a combination of a few different things. I'm sure my colleague would echo the sentiments.

When we've talked to people who work as paramedics in the region of Peel and have asked them exactly this question, they've told us a few things.

First, the violence they are experiencing is so widespread that it fades into the background as another chronic stressor, particularly when we're talking about abusive comments. They tell me that for the people who are perpetrating these acts of verbal abuse, very often there are no consequences. It becomes perceived as being unpreventable.

If we take this series of things—widespread and chronic, without consequence, being perceived as unpreventable—to its logical conclusion, this expectancy for people to be able to just brush it off and move on from acts of violence as is necessary to function in the work just becomes part of the job. That's what we see empirically. I'm sure my colleague would echo some of these sentiments.

[Paul Hills]

Definitely.

In my lived experience, I've been called some of the nastiest things. I've been pushed. I've been shoved. But there's a big difference between me at six feet three, 250 pounds, versus another paramedic whose first day on the job.... My niece just started in the profession. Her experiencing that today versus me is a lot different. I'm sort of like the frog in boiling water. Over 25 years, you create a thicker skin.

In terms of longevity, she might not last in this career because she's facing these horrific statements and acts of violence at a much higher rate now.

You just get used to it. Me getting pushed is a lot different, again, than somebody else getting pushed. My tolerance level is there, based on experience and based on physical presence, but that doesn't make it okay. As you pointed out, it's a tolerance. Unfortunately, that's just something that we're all starting to wear, and it's starting to wear very thin.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

I understand that.

Even beyond the pushing—I mean, it's similar for correctional officers. They are verbally abused and the attitude is, “Well, what are you going to do—put me in jail?” That's not going to happen, right?

When it crosses the line into an assault or a threat—both of which are clear criminal offences—to me, it seems as though the way to address this, at least in part, is to take action. If you don't have action, there will be no consequences and it just perpetuates.... It perpetuates from the person committing the act, but it also perpetuates in the mind of the person who is the victim, as in, “This just goes without saying.”

Can I get your comments on that, please?

[Paul Hills]

If I may, I think we have no faith in the system. To be respectful to the chair, when she was talking about whether we trust the courts to do this, the courts right now have an opportunity to charge people that punch me or kick me in the face, stab me. They don't.

This adds a level of protection and a level of reasonability and puts something in law that says a first responder, paramedic, firefighter, will get their fair protection in the courts. Right now, they can be charged and they're just not charged. The prosecutors drop it. The police drop it. It's not taken seriously. We need something more than what exists.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

I know we have 10 seconds. I encourage—

No, actually, I have none.

Thank you.

[The Chair, Liberal, Lena Metlege Diab]

Thank you, Mr. Caputo.

Go ahead, Mr. Mendicino.

[Marco Mendicino, Liberal, Eglinton—Lawrence, ON]

Thank you to our witnesses, Mr. Mausz and Mr. Hills, and especially to Professor Donnelly.

Professor Donnelly, I hope you can hear me. I just want to acknowledge that you come from the great town of Windsor. It's where my wife's family is from. We'll find a way to make sure that your comments are fully reflected in our deliberations, and thank you for bearing with all of the technological deficiencies today.

I want to thank Mr. Doherty, as well, for advancing this private member's bill.

Mr. Hills, you said that this has been the subject of your advocacy now for about a decade. I believe there is a fairly strong consensus that making some of the modifications to the Criminal Code along the lines that have been proposed in this legislation would be another mechanism or another tool by which, one, we deter people from threatening or trying to do harm to people who work in your professions by specifically enumerating them, but, two—and this is a point that I thought Mr. Doherty made—by extension, showing that we value the work that you do.

I want to briefly dig into the scope of the challenge that we face. The trend lines are all very worrying. In the United States, the Centers for Disease Control and Prevention estimated recently that there are approximately 2,000 emergency medical services personnel injured every year in violence-related incidents. That's in their country.

Here in Canada, in 2019, the Canadian Nurses Association noted—and these are their words—“one-third of nurses worldwide [reported] being victims of physical assault”.

That is consistent, Mr. Mausz, with the statistics that you provided. We were talking about a range of about one in four paramedics being encountered with some kind of threat of or actual violence.

What I'd like to ask is, on the issue of reporting or under-reporting, you said that approximately 40% of people who have been either threatened or are the victim of an assault do not report it. That is significant. It's high.

What are some of the ways in which we can reduce the barriers so that the people in your profession feel they can step up, report the incident, be treated with dignity, be treated in a way that is trauma-informed—which is part of the line of the work that you do, coincidentally—so that we can shine a greater light on this problem?

[Dr. Justin Mausz]

It is an incredibly important question and I'm grateful you brought it up.

If you'll permit me, I would say that the figure you referred to earlier was one in four. One in four of our members in the Peel Region Paramedic Services had symptoms of PTSD, depression or anxiety just before the pandemic.

In regard to violence, it's one in two. Over a two-year study period, one in two of our members reported exposure to violence. In our earlier study, fewer than 40% of paramedics who had experienced some form of violence took any action to document it. With the changes we made in our service by introducing a new reporting system that eliminates many administrative barriers, and with the efforts of my colleagues—some of whom are here today, many of whom are not.... By changing the culture within our organization, I am pleased to say that willingness to report has more than doubled.

We've revisited this topic and, because of the changes we have been able to implement, paramedics are much more willing to come forward to report.

[Marco Mendicino, Liberal, Eglinton—Lawrence, ON]

Mr. Mausz, can you give me two quick examples of how you've reduced those barriers? That is a good sign of progress.

I'm going to ask Mr. Hills to chime in, then I have one last question.

[Dr. Justin Mausz]

Gladly.

We implemented a new reporting process. This is embedded in our electronic patient care record. After every 911 call, our members are prompted to fill it out if they experienced violence. That's the tip of the iceberg. This took a lot of time, and it took a lot of blood, sweat and tears behind the scenes to convince people, one person at a time, and—most importantly—to show them that, when they do file reports, they are taken seriously.

These are actioned by our leadership team in a trauma-informed way. In many cases, they have led to criminal charges where the threshold of criminality is met.

[Marco Mendicino, Liberal, Eglinton—Lawrence, ON]

Go ahead, Mr. Hills.

[Paul Hills]

With regard to reporting, he's the data guy. I'd say I'm the “bit more real” guy. We don't have time to fill out paperwork at work. Our guys are so tired and overtaxed by what they do every day, the last thing they want to do is fill out paperwork. Recently, the only time we've had people fill out paperwork is typically when they sought medical attention. I had two this weekend. People were assaulted and sought medical attention. Other than that, we have documentation. Our employer is fantastic. There are routes to do this. It is not heavily embedded in our culture.

I look at this situation like the five-minute mile. We don't think it's possible right now. With your help, we can run a five-minute mile. We need that first case. We need that first situation to happen. Someone will be held accountable, and that will spread like wildfire. Paramedics need a situation where they feel that decision-makers are taking their job seriously, protecting them and doing something to make their lives better at work.

[Marco Mendicino, Liberal, Eglinton—Lawrence, ON]

In my remaining time, I'd like to talk about the trends postpandemic.

Mr. Mausz, you said that, in the wake of the pandemic, the trend lines were all going in the wrong direction, which is up.

Do you think this has anything to do with misinformation or disinformation? Do you think any of this has to do with the prevalence of disinformation online? Have you seen anything you can offer to this committee, so we can talk about ways to prevent these incidents from occurring in the first place?

[The Chair, Liberal, Lena Metlege Diab]

Do you want to ask for a written submission?

[Marco Mendicino, Liberal, Eglinton—Lawrence, ON]

If time is constrained, but they could respond in a few seconds.

Madam Chair, obviously we'd be happy to take a submission.

[The Chair, Liberal, Lena Metlege Diab]

Time is up for that one, but perhaps another questioner can ask that question.

Go ahead, Mr. Fortin.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Thank you, Madam Chair.

How can I refuse our former public safety minister? Mr. Hills, would you mind answering Mr. Mendicino's question?

[Dr. Justin Mausz]

Thank you.

I will make it very brief.

I am hesitant to comment too far beyond the realm of my expertise.

I will say that, working clinically as a paramedic at the beginning of the pandemic, we were lauded as heroes. People were very kind. They donated things to us. They banged pots in the evening and thanked us for our service. At some point, that changed.

It's hard for me to say, within the limits of my expertise, exactly what caused it, but I am very much aware of a “felt” sense of what you're describing.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

I found it very troubling—and my fellow members would no doubt agree—when you said that a good many assaults against first responders simply go unreported. Would the passage of Bill C‑321 make a difference on that front, or are there other things we can do as well?

For example, do you feel as though you have adequate physical protection when you respond to a situation? First, is there additional equipment you should have? Second, do your superiors encourage you to report incidents? You said that there wasn't too much paperwork, but isn't there anything that could be improved on that end?

Do you think stiffer sentencing for those convicted of assaulting health care professionals or paramedics is enough to make a difference?