Status of Women Committee on Sept. 29th, 2022

[The Chair, Conservative, Karen Vecchio]

I call this meeting to order.

Welcome to meeting number 30 of the House of Commons Standing Committee on the Status of Women.

Pursuant to Standing Order 108(2) and the motion adopted on Tuesday, February 1, the committee will resume its study on the mental health of young women and girls.

Today's meeting is taking place in a hybrid format, pursuant to the House order of June 23, 2022. Members are attending in person in the room and remotely using the Zoom application.

I would like to make a few comments for the benefit of the witnesses and members.

Please wait until I recognize you by name before speaking. For those participating by video conference, click on the microphone icon to activate your mike, and please mute yourself when you are not speaking. For interpretation for those on Zoom, at the bottom of your screen, you have the choice of floor, English or French. For those in the room, you can use your earpiece and select the desired channel.

This is a reminder that all comments should be addressed through the chair. For members in the room, if you wish to speak, please raise your hand. For members on Zoom, please use the “raise hand” function. The clerk and I will manage the speaking order as well as we can. We appreciate your patience and understanding in this regard.

Regarding briefs, before we welcome our witnesses, I would like to seek agreement from the committee on accepting briefs until November 1 for the study of the mental health of young women and girls. Is it the will of the committee that briefs be accepted until November 1?

[Some hon. members]

Agreed.

[The Chair, Conservative, Karen Vecchio]

I see a lot of support for this, so we will allow briefs. For anyone who would like to submit a brief, you have until November 1. That gives everybody a month to get that in. Thank you so much, everybody.

I would like to give a trigger warning. It was very obvious as we were sitting here at our meeting this week that this is going to be one of those studies where we need to support one another. I would like to provide this trigger warning: This will be a difficult study. We will be discussing experiences related to mental health. This may be triggering to our viewers, members or staff with similar experiences. If you feel distressed or if you need help, please advise the clerk. As everyone knows, if there are problems, just reach out to me too. Whatever we can do to support one another is the best way we can try to be there for each other.

I would now like to welcome our witnesses. Today, we have three different groups here with us.

For the Boys and Girls Club, we have Owen Charters, president and chief executive officer. I give a little shout-out to the city of London. Also, we have Gwendolyn Moncrieff-Gould, director of public policy and engagement.

From the Royal Ottawa Health Care Group, we have Krystal-Jyl Thomas, social worker, women's mental health program, and Michelle Jackson-Brown, who is a registered social worker.

Also, online today we have Gordon Matchett, who is the chief executive officer for Take a Hike Foundation.

For all our panellists, we'll be providing five minutes for opening statements. At around four minutes and 30 seconds, I will be letting you know that you should start to wrap up your time. For those of you on Zoom, keep an eye out for me if you can.

I'm going to look to the committee as well, as there's a discussion I would like to have for about five minutes, briefly, at the end of the meeting. I would like to add about five minutes for committee business, with some information coming in. The clock up there is about five minutes off, so if you're looking at the clock, we'll probably end our questioning when there are about five minutes left in the meeting and go into two or three minutes of committee business.

I would now like to pass it over to the Boys and Girls Club. Owen and Gwendolyn, you have the floor for five minutes.

[Owen Charters, President and Chief Executive Officer, BGC Canada]

Thank you, Madam Chair.

Thank you, committee members, for having me. My name is Owen Charters. I'm the president and CEO of BGC Canada. We've been known for many years as Boys and Girls Clubs of Canada. We now increasingly go by our acronym.

My colleague with me is Gwendolyn Moncrieff-Gould, whose name does not fit on a name tag, apparently, but questions can be directed to either of us.

For over 120 years, BGC Canada and our clubs have been creating opportunities for millions of Canadian kids and teens. We are Canada’s largest child- and youth-serving charitable organization. Our clubs serve over 200,000 children, youth, teens and their families at almost 800 locations across the country, many in your ridings. I noticed some acknowledgement of recognition when our name came up.

During vital out-of-school hours in small and large cities, in rural and indigenous communities, our trained staff and volunteers provide programs and services that help young people realize positive outcomes in self-expression, academics, job readiness and—most relevant today—mental health.

Our clubs have seen an increased need for mental health supports for young girls, women and workers in the youth sector for quite a number of years, and that trend has only been exacerbated by COVID-19.

A recent Statistics Canada report that you are likely familiar with shows that youth saw the most significant drop in self-reported mental health since the pandemic. One in two young women now says their mental health is fair or poor. That's compared to 27% of young men. It's almost double in young women.

We've also seen this disproportionate impact in our workforce. The vast majority, 96%, of early childhood educators in Canada are women, and child and youth workers are also disproportionately women. They have faced additional burdens during the pandemic, including providing essential services, as well as the extra burden of unpaid caregiving. Two-thirds of our staff are also youth themselves.

We recently conducted a study on the mental health of frontline staff working with children and youth with several other national charities, including the YWCA, CMHA, and the Canadian Child Care Federation. We found that frontline staff are struggling with their mental health and are experiencing burnout at much higher rates. Yet, only one-third of these employees have access to programs to prevent burnout, and only one-third say they would feel comfortable talking to their supervisor about mental health issues. Without additional support for frontline staff in programs—most of whom, again, are young women—children and youth will be unable to receive the highest quality of care.

The undervaluing of child care work has meant a steady decrease in the number of people entering the child and youth sector. Approximately 50% of early childhood educators leave the field within the first five years. This staffing shortage only adds to additional stress for existing staff—because of additional workloads—and many frontline staff report feeling guilty for taking days off because of the impact it would have on their co-workers, who are already overworked and stretched.

Multiple governments across the country recognized the importance of investment in mental health for frontline health care workers over the course of the pandemic, and now we are calling for similar investments and supports for frontline workers and organizations in the child and youth sector. Investing in mental health services not only supports young women and girls today, but will have long-term impacts in the future.

One study has found that there is a $23.60 return on every dollar of investment in preventing and treating mental illness in adolescents. Our recommendations for how government can address these pressing workforce issues and address mental health for young women and girls include funding to support organizations that work in the child and youth sector, like our clubs; ensuring that every child, youth and caregiver can access evidence-based, culturally safe and responsive community-based mental health supports; and funding to organizations for frontline staff working with children and youth to access mental health first aid training so staff can better support the mental health of children and youth in their programs.

Allow me a quick anecdote that came from one of our clubs recently that I think really demonstrates the story of how this impacts families, children, youth and workers. It's a story of a family arriving at a club, including a single mom, who staff reported had a car accident, unfortunately, in the parking lot of the club. When they went out to see if everyone was okay, the mother was unconscious. Unfortunately, as you may have seen in today's Globe and Mail, the opioid epidemic is getting into a worse stage in terms of numbers. This young mother was under the influence of opioids and was practically unconscious.

When the club takes care of these kids and tries to get them into care with children's aid services, they have responded that there's really no capacity left in the system for them to provide support.

What you have in these sorts of situations is a family that's traumatized, a young mother who is struggling, a family whose children need support and have experienced trauma, and the colleagues, the workers, who are experiencing that trauma first-hand and don't have the supports they need. I think that perfectly illustrates the challenges we're talking about.

Thank you.

[The Chair, Conservative, Karen Vecchio]

Thank you so much for sharing that story today.

I'm now going to pass it over to the Royal Ottawa Health Care Group.

Krystal-Jyl and Michelle, you have the floor for five minutes.

[Krystal-Jyl Thomas, Social Worker, Women’s Mental Health Program, Royal Ottawa Health Care Group]

Thank you very much.

My name is Krystal-Jyl Thomas. I am a social worker focusing on the field of mental health, psychotherapy and family intervention services. Joining me today for the question and answer period is my colleague Michelle Jackson-Brown, also a social worker and peer support worker, focusing on mental health, perinatal and peer support services. Together, we lead the women's mental health program at the Royal Ottawa mental health centre, located in Ottawa.

Before I continue, I think it is important to highlight the current situation in Iran in regard to the rights of women and human rights. The Canadian government, as a world leader, has the responsibility to stand with and support the freedom of choice for the women and girls in Iran.

Since January 2021, almost 500 youth aged 18 to 24 have been referred to the Prompt Care Clinic at the Royal, a clinic designed to meet the rapidly growing mental health concerns since the beginning of the pandemic. Of those referred, 67% were women and 65% were assessed with mental health care for the very first time. Additionally, of those referred, 17% were at high risk and 22% were at moderate risk for suicide.

Women continue to make up the majority of frontline child, family, elderly and home care workers, while simultaneously facing sexism, gender inequality, discrimination and violence. We can do better for those who identify as women in this country.

Our first recommendations include ensuring that each province and territory has protected funding for targeted girls' and women's mental health programs and tailored programs for women belonging to the BIPOC and 2SLGBTQ+ communities, as well as required services that address language, travel and wait-time barriers. Hand in hand can be national standards for screening tools to assist in early intervention, such as perinatal mental health concerns and gender-based violence.

To expand, sexism and inequalities are amplified with the indigenous population of Canada. To move forward, it's imperative to cease challenging various court rulings in relation to the obligations of the federal government. Continuous delay increases poor mental health and perpetuates a message of undervalue for the communities that indigenous girls and women belong to, and it is an obstacle to creating self-determined grassroots indigenous programs.

Next, our current system continues to be focused on crisis intervention, meaning that many services are not available until the point of crisis or emergency. In most cities, police are used for intervention. Creating mandated programs for mental health training for police or programs that support trained mental health professionals to be deployed independently or with police can yield better outcomes of de-escalation and connection to appropriate services.

Assisting with easing crisis-focused services would include expanding transitional services for youth as they age out of programs—so, violence against women shelters, perinatal mental health programs, abortion and miscarriage supports, as well as mother and baby health outreach teams and psychiatric units.

Public schools can be a primary goal for implementing preventative educational programs that focus on the empowerment of girls, along with how to care for and address mental health. Normalizing these conversations with children and their families about sexism, women's rights and mental health can help equip them to grow into adults that lower stigma and create equitable societies.

Lastly, the International Initiative for Mental Health Leadership has deemed peer support as the fastest-growing workforce in the mental health field. Peer support workers can be key in bringing experienced learning through personal and valuable connection. Peer support is an untapped workforce available to assist in various vacant clinical positions. Utilizing peer support skills benefits both clients and families through lived shared experience, resilience and strength. In the U.S., there are federal requirements to state plans to ensure peer support programs. Canada can look to provinces and territories to do the same.

Thank you. Merci. Meegwetch.

[The Chair, Conservative, Karen Vecchio]

Thank you so much, and thanks for your presentation.

I'm now going to pass it over to Gordon Matchett at the Take a Hike Foundation.

Gordon, you have the floor for five minutes.

[Gordon Matchett, Chief Executive Officer, Take a Hike Foundation]

'Uy' skweyul siem. It means “Good day, respected ones” in Hul'q'umi'num.

My name is Gordon Matchett and I use the he/them pronouns.

Today I'm Zooming in from downtown Vancouver. I'm surrounded by the beauty of the Salish Sea and the North Shore mountains. It's the traditional home of the Musqueam, Squamish, and Tsleil Waututh people since time immemorial.

Land acknowledgements are so important to us at Take a Hike because one-third of the women and girls we serve self-identify as indigenous. It's one of the more visible parts of our organization's commitment to reconciliation and helping young indigenous people find success, however they define it.

Right now I'm thinking about Kishi. She's a young indigenous woman who found herself in Take a Hike because she was masking the pain of intergenerational trauma with substances and skipping school. In Take a Hike, Kishi found a safe and caring environment with safe and predictable adults who were able to form relationships with her, improve her connection to school and find healthy ways to cope with what is happening in her life. Today Kishi is working as a support worker in the Downtown Eastside of Vancouver, which is the epicentre of B.C.'s homelessness and opioid crises.

Kim is a trans youth who's in their second year of Take a Hike. Kim was assigned female at birth and, like about 10% of the youth we serve, is questioning their gender identity. Kim used to face bullying in their previous school and constantly fought with their family. There was really no place they felt safe. In Take a Hike, they found adults who provided continuity of care for both Kim and their family. Last year, they were able to rebuild the relationship with their family and for the first time found community at school. We're so happy to be able to provide this continuity of care for Kim, so that they are able to continue the good work they started last year.

Kishi and Kim are just two of the young women we've worked with at Take a Hike. Their struggles and successes are reflective of the overall population we serve.

Over the years, we've seen an increasing number of young women attend the Take a Hike program. They present with a variety of mental health and substance use concerns. The women we're working with this year are presenting with eating disorders; self-harm, including cutting and hair-pulling; very high and debilitating anxiety and mood disorders; intense gender dysphoria and expressions of themselves leading to debilitating anxiety; and negative impacts from their online reality. They're internalizing the “norm” of oversexualization and we're seeing a great deal of body image concerns.

We're also seeing mental health disorder self-diagnoses becoming a major part of the young women's identities and lives. As they seek to live out these self-diagnoses, it becomes increasingly difficult to shift the manifestation of the diagnosis.

What we're hearing from the young women and girls we serve is that they want mental health services delivered right in their schools, where it reduces barriers related to stigma, availability, affordability, transportation, the inability to build relationships with a new counsellor, and continually being bounced between counsellors.

Take a Hike is a unique, innovative and evidence-based program that partners with public school districts in B.C. to identify underserved youth and provide mental health services embedded right in the classroom. We use the outdoors to build relationships, engage with youth, and learn on and from the land. Therapy happens in the classrooms, on the basketball court and on the hiking trail, and it's normalized.

School districts provide everything that they are provincially mandated to deliver. Take a Hike layers on top mental health supports and covers the costs of outdoor activities. These things are above and beyond the mandate of the public school system.

Take a Hike has seen some incredible success over the last 22 years. In the last three years, we've more than tripled the reach of the organization. We're now serving 220 youth in multiple regions of B.C. In the 2020-21 school year, at the height of the pandemic and the last year that we have results for so far, we saw 75% of the youth we serve improve their mental health. I'm super impressed because I know my mental health did not improve during that time.

Take a Hike is poised to grow at an exponential rate. One barrier to growth we are experiencing is accessing government funding. As an innovative program, we don't fit into any of the traditional government funding options. We're continually bounced between ministries and jurisdictions. We know that there are not enough mental health commissions in our country to meet the increasing demands of the mental health crisis.

Thank you for the opportunity today to share the mental health challenges we're observing in the young women and girls we serve, the barriers to accessing support and our innovative model of serving youth. We encourage you to find ways that the government can support innovative and evidence-based programs that remove barriers and help young women and girls improve their mental health.

Thank you.

[The Chair, Conservative, Karen Vecchio]

Excellent. Thank you so much for that.

We're now going to start our rounds of questions. The first round of questions are six minutes each.

We'll start off with Michelle Ferreri for six minutes.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Thank you, Madam Chair.

Thank you to all of our witnesses today. It's a super important topic that all of us are very passionate about.

Owen, thank you for your testimony. Our Boys & Girls Club in Haliburton—Kawartha Lakes—Brock is fabulous, so I'm happy to be speaking on behalf of it. It's just outside of my riding.

You really touched on what I would like to expand on. You talked about the mental health of the frontline workers. I'm curious if there's any data or if you guys have invested in any data about the increase in children, young girls, who are having mental health concerns or issues that are developing into illnesses where the parents are struggling at home.

What I'm trying to draw a connection to here is that we have an affordability crisis right now. We have four out of five people who are sometimes using food banks or saying they're going to. There's a lot of stress in the home right now with inflation and housing. I'm wondering if there is data to show that impact on the kids and how it's transferred.

[Owen Charters]

I wish I could say I had data. Unfortunately, we don't. We have multiple anecdotes, and multiple anecdotes don't make data, but we have multiple anecdotes of families who are reporting increased stress. We're hearing it from the kids. So, whether it's Amy Terrill at the Kawartha Lakes club or clubs across the country.... We're actually meeting with our clubs in the next two weeks, and I think we'll hear more of those stories where they've said food costs are a problem.

However, prior to that, the pandemic has led to all sorts of situations at home that have exacerbated what have been incidents, for instance, of domestic violence. Kids come to the club reporting that there is greater unsafety or uncertainty and, I think, risk when it comes to economic safety at home.

I'm sorry that we don't have the data. It might be something that would be great to connect. Our challenge is often one of resources and capacity to get validated data from the youth about what that kind of impact looks like, unfortunately.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

It's always critical when we're looking at that funding. You need the data to support it, but you need the funding to get the data, so it's kind of a chicken-and-egg situation. If we can look into the impact on children when the rise of adult mental health concerns is high, which correlates with your frontline workers, that's where I'm coming back to that point.

I was going to chat with the other witnesses here about this. There's a lot of research around neuroscience and co-regulation. We can't show up and be the best parent or the best employee or the best frontline worker when we are so distracted. So, we're taking away from children's ability to be children, basically, which is detrimental to their long-term health and these long-term issues that we see.

I would love to see in this committee if we can start to focus on data, because I think it will give you more opportunity to access funding, quite frankly, because that's what we need to see.

If I could turn to Krystal.... I really loved what you were talking about with regard to the education system. When we look at mental health, in children and young girls in particular, there's the prevention, the end of things that really saves us those dollar-figure amounts here in our health care system.

Are you familiar with the work of Dr. Stuart Shanker or self-regulation, co-regulation and its being offered as a...? Would you support its being offered as a federally funded program, or more federally funded programs that teach children to recognize their emotions, their responses to their emotions, their feelings, and give a name to them so they can better self-regulate?

[Krystal-Jyl Thomas]

I'm not really familiar with the work, but the description that you just gave I would absolutely support. Anything that, again, is going back to those preventative measures is really going to save dollars down the road, but it's also going to save a lot of crises and internal conflict for the women and young girls. The earlier we can get programs like that in, where we can start to understand our own mental health....

At the Royal, we have a program, mental health first aid, and it's now being offered to everybody in the city, in the different components, which is great, but why not have this for children? Why not have this in schools and start this early so that we can start to recognize this, especially as we're going through transitions into the teen years and whatnot? It's definitely something I would support.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mental health first aid is a great point that you brought up, and I would love to see it mandatory, much like CPR, where it's implemented from that very young age without burdening children with adult problems. There is a very grey area that we have to be extremely mindful of, and it's that we are not putting adult-age problems onto children. I think there's a delicate dance here because sometimes we give them too much information, and we don't let them be children, either. I think mental health first aid, age-appropriate, is absolutely critical.

I saw you shaking your head about Stuart Shanker, so can I assume, Owen, that you are on board with his work?

[Owen Charters]

We're more than on board. We've been asking kids to identify their emotions. Dysregulation is a challenge for children when they come in after school, so it has been something the clubs have worked on forever.

To your point about programs, a lot of what we realize is that children don't engage in formal or traditional mental health programs. We have several programs, such as Flex Your Head and Bounce Back League, that use recreational programs—a lot like what Gordon spoke about—to talk about mental health issues in a context that, I think, is appropriate for where kids want to talk about things, not because they are talking about mental health. It makes an enormous difference. We, too, would echo the need for mental health first aid.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Thank you so much.

When we have mentally healthy children, we have mentally healthy adults.

[The Chair, Conservative, Karen Vecchio]

Awesome. Thank you so much.

Michelle, we're going over to our next set of questioners. Then we'll make sure you have an opportunity.

I'm going to pass it over to Jenna Sudds.

Jenna, you have six minutes.

[Jenna Sudds, Liberal, Kanata—Carleton, ON]

Thank you, Chair.

Thank you to all the witnesses who have joined us today, not only for being here, but for the incredible work they do every day.

I'll direct my first question toward Ms. Thomas.

First of all, the work of Royal Ottawa, and in particular women's mental health, is phenomenal. As an Ottawa MP, I can attest to that. I have stories, and I'm sure MP Vandenbeld also has many stories, of lives you have changed and touched with your work here in our city. My thanks for that.

You made a few recommendations. There were two I would love to hear more about. I'm wondering if you can expand on that. One of them was about expanding transitional programs for youth. I would love it if you could expand a bit on your thoughts about that piece first.

[Krystal-Jyl Thomas]

Absolutely. This is a big problem that we see often. We have a youth program within the Royal. This is happening across the city, not just within the Royal. When a young person turns 18, they are now aged out of the program. Then they have to go all the way back to the start of the race line to try to get back into services that are appropriate for them.

On top of that, the wait is so long for services that sometimes by the time they get to that service, the needs have become so acute that they no longer qualify for that service. They need another service, so they are left waiting more. This is detrimental to their health. It's detrimental to the workers. It's very hard to continuously have to turn people away and have completely full caseloads.

We could create either buffer programs that are in the middle, or some kind of case management where we come in and don't just discharge somebody out—we're actually there and we're holding them through until the next secured program for them. We would like to see more of that.

[Michelle Jackson-Brown, Registered Social Worker, Royal Ottawa Health Care Group]

Yes, I can speak to that. I worked on the psychiatric outreach team prior to my work on the women's mental health team. It was quite common that somebody would be referred at the age of 17 and then they would age out before they even qualified for the youth services program. What we need is bridging services so that as people are aging out at 17 years old, they are coming straight into a program at the age of 18.

The other issue is that the wait-lists are so long that people are waiting anywhere from three to six months for just a primary psychiatric consult, which is an issue. It's typically supposed to be a three-month caseload. I had to keep people on my own caseload for up to a year so that they could access services. We had people in our young women's shelter. Two years ago, I could get them connected to services within a month. It has now grown to two years in a young women's shelter.

To add to that piece, I should highlight that our women's mental health program has been entirely funded by philanthropic donations for the past 10 years, so we have to carve out of the mental health envelope of funding for our program. We rely in our program on peer support to expand our capacity. However, it would make a significant difference if we had targeted and earmarked funding specific to women's mental health care.

[Jenna Sudds, Liberal, Kanata—Carleton, ON]

Excellent. Thank you for that.

I noted that this was another one of the recommendations, ensuring protected funding specifically for women's mental health. The other one I wanted to touch on was a recommendation you made with respect to national standards. Can you speak to that?

[Krystal-Jyl Thomas]

There are some things that can be standardized. I understand that different provinces and territories may have different communities and different needs, so I don't want to take away from the fact that we do need to differentiate in different places, but there are some national standards that we could look to, again coming back to that protected funding, where we could have a national standard that there's so much funding for peer support going into Canada, and there's so much funding that's allotted to women and young girls.

Again, looking at peer-reviewed studies of what that would mean specifically, I'm not sure and I'm not prepared to answer that today, but I would like to see that we do have something along those lines that we're drawing from.

[Michelle Jackson-Brown]

I can add to that. The Canadian Perinatal Mental Health Collaborative, which some of you may be familiar with, released a report in May 2021, “Time for Action: Why Canada Needs a National Perinatal Mental Health Strategy Now More Than Ever”. It identifies that we should have universal screening, training and stepped care for perinatal mental health. I would recommend that report.

In addition, I think is also important having universal screening for gender-based violence. We don't currently have that. Again, that's where earmarked funding would make a difference. For example, on the psychiatric outreach team I was on, I did outreach into the shelters, but we did not have funding to do outreach into the violence against women shelters. That is a very important time in a woman's life to get in and to provide support. If they are at a shelter, that is a crisis situation and an opportunity for us to get them connected to the right supports and care.

One other thing I'd like to bring attention to is that the Mental Health Commission of Canada, in February 2022, released a report, “The Time is Now: Considerations for a National Psychotherapy Program”, which would also, I think, go a long way toward easing the burden of mental health care across this nation, providing access to free psychotherapy for anybody who is starting to demonstrate mental health concerns.

[The Chair, Conservative, Karen Vecchio]

Thank you so much, Michelle.

We're now going to pass it over to Andréanne for six minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Madam Chair.

I would like to thank the witnesses who are here today to help us with our study.

Obviously, this is a topic that concerns everyone to varying degrees. We have all seen the stats on mental health during the pandemic. Mental health issues have really been exacerbated during this period. We will come back to this later.

I would like, however, to remind us all, as did Ms. Thomas, of the plight of women in Iran. Last week, our party, the Bloc Québécois, presented a motion at the House of Commons, which was unanimously passed and supports Iranian women in their fight for freedom and respect.

Sometimes, we get the impression that the fight is over. Some politicians are saying that the feminist cause and conflict between men and women are things of the past. This study shows that actually the opposite is true. There is still inequality between men and women.

My first question is for Mr. Charters.

Statistics show that there is a gap between the suicide rate of young men and that of young women, but that this gap is closing. Is that with you're seeing? How do you explain this phenomenon?