Public Safety Committee on Oct. 29th, 2009

[Don Davies, NDP, Vancouver Kingsway, BC]

I respect very much the discussion around stigma. I think it's been mentioned a lot in this discussion here, and I think it has its place, particularly in the general population.

But I also want to shift the focus a bit, because when I've spoken with a lot of inmates over the last several months, to be quite frank with you, I didn't detect a real stigma barrier, nor did I detect that when I spoke with the professionals working in prisons. What I heard from the inmates was that they did recognize they had problems and wanted access to treatment, and couldn't get it.

From the professionals, what I heard repeatedly—it didn't matter which institution I went to—was that there was inadequate diagnosis. When people are entering the federal corrections system, the professionals are saying that what's really needed is front-line, accurate, and comprehensive diagnosis at that point so people can be identified and get treatment.

So if wasn't necessarily for lack of people wanting to say they have a problem, although I'm sure that's prevalent and I'm not denying it. But I'm just wondering what you think about that in terms of the diagnostic resources in our system, and whether we should be putting more focus on them.

[James Livingston]

I can certainly speak to that, being a stigma researcher. I think you raise a really important point. The fact that someone has a mental illness does not mean they're stigmatized. They're perhaps diagnosed with a stigmatizing condition, but the literature reveals there's a range: people can fall along a stigma continuum, ranging from feeling empowered to feeling indifferent.

The fact that someone is using mental health services or is diagnosed with a mental illness does not mean they experience stigma. In my own research, as I described earlier, to my surprise, only 11% of my population has high experiences, quantitatively measured, on internalized stigma measures. So there's a great range of experiences when it comes to stigma.

Often, when we talk about stigma, it's being used very atheoretically in current culture, without attending to the complexity of the issue, as well as the range of people's personal experiences. So I take your point regarding the range of experiences. It's certainly reflected in the research literature around stigma and in my own research and experience as well.

[Gail Czukar]

I think you were also asking if we need to have sufficient resources for assessment, diagnosis, and identification of people, who can then get access to services, because if you're not identified as needing those services, you're not going to get access to them.

So, absolutely, having good assessment is key. We spend a lot of time developing assessment tools that assess both substance use and mental illness, so it's key that we have those. I don't know what the current resources are in the system for this, but if that's what you're hearing from inmates, it would certainly merit following up.

[The Chair, Conservative, Garry Breitkreuz]

Okay, thank you very much.

Ms. Glover, can you wrap this up?

[Shelly Glover, Conservative, Saint Boniface, MB]

This is going to be a quick question, and it's actually directed to you, Ms. Czukar.

We talked a lot about the stigma associated with the professionals as well. So I just want to add a question as to the availability of professionals, because, as was indicated, there are vacancies that haven't been filled. There was one explanation that it may be related to the pay scale, and another explanation was there is some stigma associated with that. But we have a national problem with the shortage of nurses graduating, for example.

Does this affect this problem? Is there in fact a shortage of mental health professionals or health professionals in the forensics area to fill those vacancies, which might also explain why those vacancies exist?

[Gail Czukar]

I think I did say there are human resource problems in the health system generally for everyone, and we know these are going to increase over the next five to ten years as a lot of people retire—or maybe fewer people are going to retire sooner now. But certainly building the capacity of the system and training people to work in hospitals, community services, and with this population is a high priority. It has to be done. Specific forensic training that addresses criminogenic needs, as well as the health needs of people in the system, is also seriously needed.

[Shelly Glover, Conservative, Saint Boniface, MB]

Thank you.

And I want to thank you, Mr. Livingston. I found your work very interesting. I know that I made an announcement in my riding of Saint Boniface about funding to study or to do research at the St. Boniface General Hospital Research Centre on the link between mental health and addiction, and so on.

I congratulate all of you for your work, and encourage you to continue and work with us to help solve this.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much. We're wrapping up just on time.

I want to thank the witnesses. This has been a very good session. You've really added a lot to our knowledge base, and we appreciate that very, very much. So thank you once again.

This meeting stands adjourned.