Status of Women Committee on Sept. 29th, 2022

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

Thank you very much.

I also want to acknowledge the Royal Ottawa. You are not in my riding, but your parking lot is the riding boundary, so I consider you mine. Frankly, a lot of the people who live in my riding, people I know and family members, have availed themselves of the supports and the help that you provide. It is life-saving help. I think everybody in Ottawa can attest to somebody they know whose life was transformed because of the Royal Ottawa, so I want to thank you for everything you do.

What I hear, though, is that while it is extremely transformative once people get in, getting in is the problem. You mentioned referrals. I think all of us know that, too often, when the person is presenting at emergency in a crisis—especially young women, young girls—that is their first entry point into that system. As you mentioned, by that time.... I've heard this consistently, and I think we're going to hear a lot of this. Prevention, early intervention, preventative care, that is really when it is needed, not at the point....

I can say that I had a family member who struggled for years until they got to the Royal. That was the first time when it just completely changed the situation in our family. I am somebody who is fairly empowered. I can navigate systems. I'm persistent. This family member had an advocate, and too many people don't. As I've said to others in my family, I can't even imagine what happens, especially to teens and young women, if you don't have that advocate who's just going to keep fighting for you to get the services.

I wonder if you can comment. I'll start with the Royal Ottawa, but I'll turn it over to the Boys and Girls Club. By the way, I could go on as well about the Boys and Girls Club's Ron Kolbus Clubhouse and the work you do.

How do we get past this situation where it is at the point of crisis that people actually get the help?

[Krystal-Jyl Thomas]

Unfortunately, I would put a caveat on that as well: Sometimes, even when people are in crisis, they still do not get the help. You mentioned that we have advocates. If somebody has an advocate, they may be able to navigate the system. I'm not going to go into my personal situation, but I had a personal situation this year. It was a women's health issue, and I could not navigate the system—and I run a women's mental health clinic. I was left for three months. So, it doesn't matter if you have an advocate or not. The system is very difficult to navigate.

I think that having some kind of standardized community meetings where we come together and learn about different organizations and what's actually available in our community could be really helpful. I hear of services that are underutilized because we know about the popular top-funded ones. They have wait-lists that are a mile long, and then we have other services that are underutilized.

I think if we started to have conversations and actually knew what was out there, what is available to us, that could make it easier to access that.

I don't know if Michelle wants to add anything.

[Michelle Jackson-Brown]

Yes, just to add to that, a huge, significant issue right now is access to primary care providers and family physicians. Again, I was working.... I'm doing outreach in the shelters. Our psychiatric outreach team is a team of 10 staff—seven nurses and three social workers—and we have psychiatrists we consult with. We were able to go into the shelters and allow people to get psychiatric assessments right away without a family provider. However, to access the majority of our services at the Royal, you need a family physician, and you need somebody who's going to be willing to follow you up. Accessing a walk-in clinic is not going to be adequate; you need a primary care provider.

Where we've had good success is with nurse practitioners who are trained; there are great community health centres and family health care teams. Then, also, we need to educate our family physicians and ensure that it's in the medical syllabus that substance use and mental health care are a standard part of the training so they feel competent when they're providing that care.

One of the things we've looked at with our perinatal health care programming at the Ottawa Hospital is a program where we can provide psychiatric consultation directly to primary care providers. If primary care providers are empowered to provide mental health care, people may not need to come to places like the Royal, and we can reduce wait times. That's the other piece.

If you're looking at mild to moderate mental illness, you can be supported and symptoms can be ameliorated with peer support and with psychotherapy. If we can have access to free psychotherapy, which we do not currently have on a national level, that could go a long way. The Ontario structured psychotherapy program has been wildly successful.

I have one last piece: The regional, coordinated access through AccessMHA has also been wildly successful.

[The Chair, Conservative, Karen Vecchio]

I'm going to be a pain in the butt. I'm going to throw a little chair's prerogative, if you don't mind. I see Gordon there with his hand up. He would like to answer this question, so, everybody, count Gordon's answer as part of my time that I don't get in the first place.

Go for it, Gordon.

[Gordon Matchett]

Thank you so much.

Take a Hike operates in partnership with public schools, and public schools have a very unique and interesting view into the lives of the youth they serve. What we find is that schools are full of caring adults who are really looking out for the mental health of young women and girls and all the youth they serve.

What I'm seeing in Ontario, as well as here in B.C. and also in my conversations with folks in the territories, is that they are building systems to be able to ensure that the youth are getting this care. They're able to identify them, but what the kids are saying is that they want to have the help available in school. That's where a program like Take a Hike is so important for the youth, because we're able to offer them a year's worth of a caring and safe environment. They're there all day, every day. They're not able to fall between the cracks, because we know who the kids are and we're able to follow up with them.

I'd encourage the committee to really think about how we can partner with school districts in providing this support. They're the ones who know the kids better. They don't know them as well as their parents do, but they're the ones who know them the best in the community.

[The Chair, Conservative, Karen Vecchio]

Thank you so much.

Thanks, everybody, for letting me take over.

Now I'm going to pass it over to Andréanne for two and a half minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Madam Chair.

Ms. Thomas, in your presentation, you spoke about delays and the federal government's obligations. Every minute counts when a person is in crisis, and every delay has an impact.

You said that health falls under Quebec's and the provinces' jurisdiction, but you also stated that the federal government has responsibilities in this area.

How we establish what falls under Quebec's and the provinces' jurisdiction and what the federal government's powers are?

You also spoke about delays. Were you talking about delays in transferring money to organizations who are working in the community? What did you mean exactly?

[Krystal-Jyl Thomas]

I think I can expand on what the delays do, which you captured briefly there. When our experiences are invalidated by appealing court rulings and things like that, this prolongs when the money is going to go, which prolongs when it's going to make its way into communities and into organizations to start to make frontline differences. It also reinforces stigmas and stereotypes about people.

I think we can do much better than that here in Canada, at the provincial and federal levels. When we know there are problematic issues, let's take responsibility and work together with our communities, consulting on what changes need to happen and how we can make them. I think consulting the front line, not just the workers but the people who are being affected by the issues, is how we can start to make real shifts with the help of our government.

[Michelle Jackson-Brown]

I can just add to that by bringing back the attention to the final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls. When we're talking about some of these delays, we're talking about court rulings and court processes that are delaying things. One of the highlights of the recommendations was asking for a federally coordinated cross-jurisdictional national plan to address some of these issues so that hopefully we aren't encountering issues with court proceedings.

On the other piece, too, when we talk about what the federal government can do, we can look at the health and social transfers and whether we can earmark some of that funding specifically for women's mental health care and research.

[The Chair, Conservative, Karen Vecchio]

Thank you very much. You had your two and a half minutes. We'll get back to you.

We're now going to pass it over to Leah for two and a half minutes.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thanks so much, Madam Chair. You're just great at what you do.

We're not all the same. We have intersecting identities. You brought up missing and murdered indigenous women and girls. We have the National Day for Truth and Reconciliation. For me, this is a difficult day, and tomorrow will be as well.

We have young people, women, Black, indigenous, people of colour, people with disabilities, people who identify as belonging to gender or sexual minority groups. Is there enough specialized mental health care to really reflect the diversity?

[Krystal-Jyl Thomas]

We're not even close.

One of the barriers I see constantly is language. In the program we run, we don't have enough funding to even offer services in French, which is part of our national languages; never mind if you speak Somali. Language is such a barrier if you want to engage.

I see Gordon nodding as well. I don't know if that's an issue he runs into in B.C. as well, but language is probably the first thing that I see. I would love to see more courses offered to offer versatile language—and not just so that white people can speak other languages. Let's make sure that people who are representing those needing the assistance are being trained and having opportunities to go to school and get the education they need, and are certainly capable of, to engage and be part of their community in a helpful way.

[Michelle Jackson-Brown]

I'm just going to add to that. We also need culturally responsive care. We need ongoing opportunities for the education of frontline health care providers and frontline service workers to ensure that we're providing culturally responsive care.

In addition, in terms of a gender diversity clinic, for example, we do have one in Ottawa at CHEO. We don't have something similar yet at the adult level. People have to come to Ottawa for that support and service. I was working with children who were involved in the children's care system, like CAS, who actually had to come from rural areas to Ottawa to get that service. We need to find ways, whether it's through virtual care or outreach, to get to those outlying rural areas.

The other piece is ensuring that we're working with the community. There are lots of folks who are already out on the ground doing this work. There are indigenous-led communities like Akausivik and Wabano. We partner with the Ottawa Black Mental Health Coalition to identify the agencies and organizations that are already on the ground doing this work. That's what we need to continue to do.

[The Chair, Conservative, Karen Vecchio]

Perfect. Thank you so much.

We're now going to go to our next round of five minutes. Actually, it's back to six minutes. I apologize.

Ms. Michelle Ferreri, you have the floor for six minutes.

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

Thank you, Madam Chair.

Thank you so much for the great information coming out of here from all of you.

Thanks to my colleague for bringing up a conversation that I wish we could do a whole other committee on when we talk about investing in preventing mental health issues. If we're going to be honest about preventing mental health issues, where are we putting that money? Where are we putting that education piece into it?

I'm going to go back to you, Mr. Charters.

I want to delve a little bit deeper, if we can, because we have a bit more time to do this, talking about the burden of the adult problems that are being transferred to the children and they are carrying this over.

When we look at this study in particular, we're looking at factors contributing to mental health issues experienced by young women and girls, including, but not limited to, eating disorders, addiction, depression, anxiety and suicide. I hear from kids. They will say that they didn't want to tell their parents they wanted to take hockey or they didn't tell their parents they wanted to do dance because they know they don't have enough money.

What do you think about that as a major factor? Where would that fall in what you're seeing in the Boys and Girls Clubs?

[Owen Charters]

Do you mean as a major factor in terms of the mental health challenge they have from that?

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

I mean the anxiety of worrying about adult problems, like money at home and financial stress.

[Owen Charters]

I don't know where it fits, but it's a big factor.

The reason I don't know is that we haven't asked the question specifically of what they think about that. Too often, kids who come from underprivileged homes or homes where there's a single parent take on a burden that is like that of an adult at a very young age. They worry about those adult issues. They may not always let their parents know, because part of being a responsible member of that family is not to let that burden fester on the other members of the family. We see that as part of single-parent families especially or families where the parents are dysfunctional. Of course that comes into clubs.

What our clubs do is try to take on those opportunities for those kids where the family can't provide it. We often hear—in fact, in London, at the club, at an event I was at—a family say that the club was the missing father in their family. It provided the balance those kids needed and couldn't otherwise access.

I think we don't understand how significant that is. There was a movie at TIFF called Scarborough. It came out a year ago, I think. It's well worth watching. It's not the real-life stories; it's a dramatized version, but it's the real stories of what our clubs see, of kids who take on the burdens of their parents, who are working through real challenges in their life, from putting food on the table to securing employment.

You talked about regulating emotion. There is the challenge of dealing with a parent who cannot regulate their emotion, and the kid becomes the antidote to that or takes on those challenges. I think those are pretty scary elements that live on in adulthood one way or another.

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

I would add that when we say “poverty”, I think what used to be low income has now become the middle class. It's not even just lower-income families anymore. This has become an everyday Canadian problem. People often write to me saying, “I make $100,000. That's a lot of money and I still can't make....” It used to be paycheque to paycheque, but now it's 10 days before paycheque.

That is trickling down to our kids. It's this anxiety, this worry, this fear, this burden and the long-term impacts of what's going to happen from COVID. Because the parents didn't have the tools in their tool belt to regulate their emotions, the stress comes onto the children and, bing, bang, boom, you have a domino effect. We're going to be seeing the impacts of this for decades, in my opinion.

We look at abandonment and coping mechanisms, or maladaptive coping mechanisms, for parents who just can't manage that stress. There's social media. We talk about kids being exposed to social media, but what about the parents who are on their phones trying to manage and self-regulate because they can? That's what we would call a maladaptive coping mechanism.

I would love your feedback. Maybe I'll throw it over to Michelle or Krystal-Jyl.

When I see what my kids do.... I think of myself, too, when I watch the news over and over again and how it starts to impact our mental state because it's negative. What do you think the impact of the media is on children?

[Krystal-Jyl Thomas]

It's definitely negative. Owen, you said this earlier—the bullies can now be there at 3 a.m. on your phone, and that can be for parents or children. Also, on algorithms, once we start looking at certain things, our phones will now reinforce those beliefs for us over and over. If you're looking at sad or depressing things, that's what's going to start to feed to you all the time. I think algorithms are a big part of the problem.

I have no idea what laws look like around that, or how we regulate things like that, but if the federal government does, I would love for them to pay attention to that.

You were mentioning that families now need a dual income. You both need to be working full time. That's now more time away from children. Children are isolating, so now they're spending more time on their phones, where those bullies are, to try to get that connection. It really is a continuous, self-perpetuating problem.

One of the things I think about—which I know is getting a little away from your question of social media but would be really beneficial—is peer support for families. Peer support for families is an avenue where we can actually look at equipping parents and children to understand what's happening. We talked about mental health first aid earlier. If you teach that to a child and they come home and say, “Listen, I'm depressed,” that can be really traumatizing for a parent, but if you teach the parents what that means as well, you can start to build community and relationship within the homes.

I tried to talk fast.

[The Chair, Conservative, Karen Vecchio]

It's all good. I know about talking fast.

Sonia, I'm going to pass it over to you for six minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Madam Chair.

Thank you to all the witnesses for your valuable input, and thank you for the work you are doing in the communities.

My first question is for Mr. Gordon Matchett.

You talked about school. I think school plays a big role when it comes to mental health promotion. BGC Canada can also provide valuable information. Do you think there are some approaches that teachers can take in the schools to prioritize mental health and wellness? What is a successful model? My colleague talked about social media literacy. If the teacher can teach about.... Cyber-bullying is also prevalent. How can we stop that disinformation? Can you talk about that?

[Gordon Matchett]

Yes, schools are a phenomenal place to provide that early intervention and prevention support for vulnerable youth.

I'm thinking about many of the programs that we see here in B.C., and we're seeing it right across the country and throughout North America, in fact. They're teaching social and emotional learning. There is an overwhelming amount of evidence showing that programs that focus on the social and emotional well-being of our youth produce wonderful effects, not only in their grades—we see about 17% increase in youth's grades when they participate in social and emotional learning—but in equipping them with resiliency so that, as they face mental health challenges, they are able to bounce back from them.

I'm also impressed by programs like Stan Kutcher's teen mental health literacy, which teaches youth as well as adults how to understand what mental health issues are and what they're not. Kids get nervous over tests. It's not anxiety; it's just being nervous over tests. It's really helping us to tease apart what is what.

We're also seeing that schools are a very important place to be able to go deeper with youth. As I said, schools are starting to look at ways in which they can look for youth who are having mental health concerns. We partner with school districts purposefully because we know that they know the youth. They know who's not accessing services, and they know who can benefit from them. We rely on them to help us identify those youth and bring them into the program that we serve together.

I would really encourage the committee to think about the place where youth spend most of their time, which is school, how we can help support them when they're there, and how we can support programs like Take a Hike that operate in schools.

I know that schools are not a federal mandate, but when we look at mental health that happens in the schools, that's where the kids want it. That's where they want to be able to get that help. They don't want to have to go somewhere else. They want it to be normalized. They don't want to have the stigma.

[Owen Charters]

I think everything Gordon said is absolutely true. I'm impressed with what I see in schools. I'd also add that we're adding new burdens into an under-resourced sector. I come from a family of teachers. There has always been the challenge of what else they need to do in the day, aside from deliver on the curriculum. Administrators are challenged to provide what they see as increasing connections to social services that are stretched.

I think the school is a wonderful place to do some of that work, and I think we need these wraparound supports. My answer to an earlier question about access is that the social safety net seems to be quite frayed. I think it was fraying before the pandemic, and it is increasingly frayed. School is part of that, as well as the health care system, as well as the social services that clubs, for example, provide. There are lots of families and kids, unfortunately, falling through the gaps. They're falling through the gaps at schools because of that under-resourcing. It's happening now because of staffing challenges in social services, and because of a lack of financial capacity.

That's something that I think as a society we're going to have to address one way or another. At some point, the bill will come due.

[Sonia Sidhu, Liberal, Brampton South, ON]

In the last meeting we heard from Jack.org that 16% of young women seek mental health support from a professional while 32% seek help just from friends. They just want to get some help. They don't want to go to the professionals. Why does this gap exist? How can we fill this gap?

This is for Ms. Thomas or Ms. Jackson-Brown.