Evidence of meeting #32 for Status of Women in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was around.
A recording is available from Parliament.
4:35 p.m.
Conservative
The Chair Conservative Karen Vecchio
Jenna, you never know with me. I think I have cut you off for the last three months on your questions.
We will now go to Andréanne Larouche.
As a reminder, there are two and a half minutes for this round.
4:35 p.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
Thank you very much, Madam Chair.
I would like to discuss an important matter that was mentioned in the opening remarks.
Ms. Andrich, you talked about the importance of the Truth and Reconciliation Commission and the 94 calls to action. There is clearly a link between mental health and the violence to which women can be subjected, especially sexual violence.
You mentioned calls to action 21 through 24 and 40.
Please tell us more about how these calls to action can help women and how they could be linked to mental health.
4:35 p.m.
Counselor, Klinic Community Health
Thank you so much for that question.
Calls to action 21 through 24 are around our medical system and training around that. Call to action 41 is the one that directly addresses missing and murdered indigenous women, and the investigations around that. That is extremely important because part of the barrier—
4:35 p.m.
Conservative
The Chair Conservative Karen Vecchio
Excuse me, there is no interpretation. If you could hold on for a moment, I am going to reset the time so that Andréanne will be able to hear the answer.
Do we have interpretation now? Can you hear us, Andréanne? We're good. Okay.
If you want to begin that answer again, I will give you back that time. Go for it.
4:40 p.m.
Counselor, Klinic Community Health
Thank you.
Calls to action 21 through 24 refer to training in the medical system and making sure there are indigenous folks represented as medical practitioners. Call to action 41 speaks to missing and murdered indigenous women, the investigation into that and the prevention of that in our society.
They're specifically important, I think, because part of the barriers to accessing help are the systemic injustices that indigenous people face in our communities. It would make a difference to have people who are aware of indigenous traditions, who have been educated as to the harm of colonization as the ones facing the indigenous people when they first go to seek help. I think it will make a huge difference to the retention of people, accessing services and the efficacy of those services as well, if people believe they are understood and seen.
4:40 p.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
If I understand correctly, you think this report is important. It is crucial, in fact. There is a direct link with mental health, particularly in indigenous communities.
I could draw the same parallel with LGBTQ+ communities, since they are also subject to various prejudices. Do you have anything to add in that regard?
4:40 p.m.
Conservative
The Chair Conservative Karen Vecchio
Excellent. We won't have time for that, but when we come back to Andréanne, I'm sure we will have time.
I'm going to pass it over to Niki.
Niki, you have two and a half minutes.
October 6th, 2022 / 4:40 p.m.
NDP
Niki Ashton NDP Churchill—Keewatinook Aski, MB
First I would like to ask Ms. Andrich to expand on a point that she raised earlier about the lack of resources in what Klinic does.
Obviously, anyone who lives in Manitoba and works anywhere close to the field of trauma and mental health supports is aware of the important work that Klinic does for all of us, and I want to thank you for that. I'm wondering if you could tell us also clearly the kinds of resources that you would need to meet the need that you're dealing with.
4:40 p.m.
Counselor, Klinic Community Health
It's probably payroll, as Alisa talked about earlier. Our wait-lists are hugely long, and we just don't have enough counsellors to take everybody on in a timely manner. Unfortunately, the pandemic has only made this worse. I know that in my program, the sexual assault crisis program, our wait-list almost doubled in terms of wait time between 2020 and the present day. So, yes, it is payroll—more people. We're all burning out.
4:40 p.m.
NDP
Niki Ashton NDP Churchill—Keewatinook Aski, MB
Yes, for sure, and I appreciate your being very clear on that. Again, I want to underscore the life-saving work that you do here in Manitoba. Thank you.
My next question is for Dr. Van Lieshout around perinatal care.
I really appreciate the critical points you've raised. Here in northern Manitoba we have an added issue where a number of women have to leave their home community to give birth and are ripped away from their support network. In some cases it's quite recent. I'm thinking of Flin Flon, a major hub in our north, that had its entire obstetrics ward shut down, and hearing the harrowing stories about what moms from there were dealing with before they gave birth and certainly after as well. I'm also thinking of all of the indigenous women forced to leave their communities to give birth.
I'm wondering if we should be addressing that piece when we're talking about perinatal care.
4:40 p.m.
Perinatal Psychiatrist and Associate Professor, McMaster University, As an Individual
Absolutely. One thing the pandemic showed us was the importance of supports, family supports, community supports, networks of support people, so when people are taken away to give birth to their children, it disrupts that. It disrupts the birth process. It disrupts the experience. It increases the likelihood the births will be traumatic or will be experienced as traumatic by people.
Absolutely that's an issue that is prominent among the clinical work that we do and something that hopefully we'll take into consideration. We're looking at quality standards around perinatal mental health if we get that far.
4:40 p.m.
Conservative
The Chair Conservative Karen Vecchio
That's awesome. Thank you so much.
We'll be getting back to Niki, I'm sure. I'm going to pass it over to Dominique Vien.
Dominique, you have six minutes.
4:40 p.m.
Conservative
Dominique Vien Conservative Bellechasse—Les Etchemins—Lévis, QC
Thank you very much, Madam Chair.
Thank you all for being here this afternoon. These conversations are very informative.
I will start with you, Dr. Van Lieshout.
You said we need to work to make Canada the best country in the world for our women and girls. I thinking everyone shares that wish.
You suggested that such well-being starts long before the baby is in the cradle.
I am concerned about women who suffer from postpartum depression. What are the potential negative effects for newborns when their mother suffers from postnatal depression?
How long does it affect the child? What effects have you observed?
4:45 p.m.
Perinatal Psychiatrist and Associate Professor, McMaster University, As an Individual
Thank you.
Over the past few decades considerable evidence has accumulated to suggest that the risks associated with being born to an individual who struggles with postpartum depression are myriad. Children who are born into this setting are about three times as likely to experience a grade failure and significant school problems. They are four to five times as likely to develop clinically significant emotional and behavioural problems, and about four times as likely to develop depression in their lifetimes. These problems can begin as early as toddlerhood. The research that has followed individuals the longest suggests that this can persist well into adulthood.
Postpartum depression keeps individuals from becoming the parents they want to be. It disrupts the detachment bond. It makes it difficult for parents to respond in the ways they want to the cues of their children and it has a lifelong effect. The number I quoted earlier was from the United Kingdom. Each case of postpartum depression is associated with $125,000 in costs over the lifespan, 70% of which are due to these difficulties in offspring.
4:45 p.m.
Conservative
Dominique Vien Conservative Bellechasse—Les Etchemins—Lévis, QC
Can we now more quickly and readily recognize those women? Is it more apparent than it was a few years ago?
I remember being like Superwoman was when my son was born. I should mention in passing that I am older than many of you.
That is my second question: can it be readily recognized?
It is clear that action is taken after the fact for women in that predicament. Is it easier to identify those women now?
4:45 p.m.
Perinatal Psychiatrist and Associate Professor, McMaster University, As an Individual
I smiled when you asked your question, because we used to call the shower in our house Clark Kent's phone booth when our daughter was born. My wife would go up there, take a shower and come back out as superwoman.
We've had the tools to detect postpartum depression for some time. We know what questions family doctors and other primary care providers should ask. We have easy questionnaires that can be completed. Lots of people go undetected, but it's a little easier to detect because of the good work that people have done around awareness.
More people are aware. Reducing stigma has helped people come to ask for help. I think we've improved outcomes for mothers and families as a result of that, but there's still a general lack of awareness and we can still improve that and improve these pathways to increase the likelihood that these individuals will be detected so that we can treat them easier.
4:45 p.m.
Conservative
Dominique Vien Conservative Bellechasse—Les Etchemins—Lévis, QC
The mothers, grandmothers and sisters watching can no doubt help a great deal.
Thank you, Dr. Van Lieshout.
Dr. Elliot, you talked about malnutrition. That is worrisome. I think that self-mutilation can be linked to malnutrition. I have noticed that clothing manufacturers are increasingly using ads that feature diverse bodies. This will be more positive. There will be more cultural diversity, and more body diversity as well.
Is this a good thing? Are we on the right path? The image depicted of a perfect girl or woman can be hard on the morale of young girls.
4:45 p.m.
Adolescent Paediatrician, As an Individual
Thank you.
Those are a lot of ideas at once. I would say that eating disorders have increased exponentially. There are so many factors.
I will say that back in 2014 when I testified at status of women around eating disorders, at that time Spain had just announced that models could not have a BMI less than 18.5, and that was a law. That is a law. When we look at that and we look at the models who are out there, I'm not saying there's a direct correlation with eating disorders, but if that's the image young women see, that can contribute to eating disorders, but obviously, there are many other factors as well.
4:50 p.m.
Conservative
The Chair Conservative Karen Vecchio
Thanks very much. I know the time is up, but I just want to clarify.
You said it's the law in Spain that the body mass index must be.... It's the law?
4:50 p.m.
Adolescent Paediatrician, As an Individual
Yes. It's the law. It's a law.
4:50 p.m.
Conservative
The Chair Conservative Karen Vecchio
Okay. Thank you.
We'll turn it over to Marc Serré.
Marc, you have six minutes.
4:50 p.m.
Liberal
Marc Serré Liberal Nickel Belt, ON
Thank you, Madam Chair.
Many thanks to all the witnesses for being here.
My questions pertain to national standards. We all know of course that health is a provincial matter, but I want to state clearly that the federal government also has a role to play. We have to find a way to work with the provinces and reach bilateral agreements, which are currently under negotiation. These agreements represent $4.5 million in funding over five years.
We heard from the Royal Ottawa Health Care Group a few weeks ago. You touched on that briefly today, namely, that the system has gaps and it is very difficult for parents and individuals to navigate through the system.
I am trying to get a better understanding of certain aspects, specifically services relating to community expansion, mental health, addictions, youth aged 10 to 25, and early intervention. I am not necessarily asking all four witnesses.
Dr. Van Lieshout, you also mentioned the lack of coordination among the various organizations. For example, I was in Sudbury with Minister Bennett for a round table discussion. The groups in attendance said there were about 6,000 organizations—an exaggeration—and very little coordination.
I'll start with Dr. Ryan Van Lieshout and then go to Dr. Elliott.
What can you inform this committee about on best practices, evidence-based, to finalize these bilateral agreements so that the money could flow with the provinces and the federal government? Maybe you could answer in a minute each.
4:50 p.m.
Perinatal Psychiatrist and Associate Professor, McMaster University, As an Individual
It's an interesting conundrum to negotiate these agreements between the provincial and federal levels, but I do believe that the federal government's creating quality standards and discussing with the provincial governments their needs and what they can help with will be helpful. There are many community organizations doing great work. We once surveyed them, because we created an app to try to help people with postpartum depression, and there were so many doing such great work that's so diverse.
I think quality standards will help us to then say, “This is what we're going to do”, and we can inform the organizations and the provinces. Then people can get together under an umbrella to do the fantastic work that we know they do in isolation. We can get so much more efficiency out of it and probably save a great deal of money.
I'll turn it over to Dr. Elliott.
4:50 p.m.
Adolescent Paediatrician, As an Individual
Thank you very much. I really appreciate the question.
We have to look at where the most expensive care is, and the most expensive care is in hospitals.
When we can work with community to make guidelines that include the amazing work they do, move things into community and partner with community agencies, such as for community beds, or beds where young people do not need to be in a clinical setting but maybe still need some high-level care, those are the places I think we need to start.
We need to have a national standard for that, so that each program in each province isn't developing their own standards, because it's costly. I think this is essential.