Thank you, Madam Chair.
In my opening comments, I would like to share my thoughts on several topics, including mood and anxiety difficulties in girls and young women, the challenges of being a young woman today and a little about substance use, as well as my concerns regarding psychiatric research and knowledge translation.
Many have discussed the epidemic of mood and anxiety, particularly in young people, attributed to the COVID-19 pandemic. However, as a psychiatrist, and as evidenced by some of the testimony you've already heard, I feel that youth mental health has been a significant issue for many years.
Several times a month a colleague reaches out for help because of mental health needs within the family. I noticed very quickly that, about 90% of the time, it was a case of a daughter or a niece with anxiety difficulties. This is not a study but rather my own experience. It is particularly concerning when a 16-year-old often faces an 18-month wait to see a psychiatrist. Recently, I've been asked to help care for a young woman sexually assaulted after being slipped a hypnotic during a university social event.
There's an interesting double-edged aspect regarding psychological difficulties in young people. Never have we had a generation with such a positive attitude towards mental health and help seeking. Our generation struggled with stigma. Programs such as the military's road to mental readiness and Bell Let's Talk helped destigmatize and to some extent normalize mental health and help seeking.
This generation of young people does not need encouragement to talk. They have spoken and feel much less shame in raising their hands. While this is an encouraging societal trend, it results in even greater need overall in the system and a worsening need-care gap. Vast numbers of young women and girls acknowledge not feeling right but are unable to have timely access to evidence-based care.
My second general observation is the amplification of peer pressure, bullying and so on that social media allows. There are undeniable pluses to social media platforms. They have allowed us to stay connected, celebrate birthdays and even attend funerals during the lockdowns and the pandemic. However, there are also studies suggesting that, for some young women and girls, social media can make individuals feel more isolated and exacerbate mental health conditions such as depression and anxiety. There's a suggestion that some aspects of social media may increase the sense of inadequacy about one's life or appearance.
Online bullying also, to some extent, is traditional bullying on steroids. Depending on the study one reads, about 40% of young people under 19 years of age report being the victim of bullying online. Interestingly, girls are most likely, in most studies, to be both victims and perpetrators of cyber-bullying. Victims of cyber-bullying are at increased risk of both self-harm and suicidal behaviours. Most who witness cyber-bullying do not intervene, and perhaps only one in 10 report the bullying to a trusted adult.
I also wish to switch and just briefly address recreational and social use of substances. Clearly, the opiate crisis warrants attention, and young people are not spared. However, we also need to address the most common substances abused by young women and girls, namely alcohol, cannabis and tobacco.
We can educate regarding alcohol's potential harms, but it may also help women to understand how we can separate having a drink with friends celebrating a birthday from drinking alone when feeling sad, lonely or anxious. The effects of alcohol on cognition, consent and capacity must also be ingrained.
As a society, Canada has done a great job educating our youth about the risks and harms of tobacco, and a consistent downwards trend of smoking tobacco continues among our youth, including girls. However, cannabis use among young Canadians finds our youth—depending on the study again—typically as the number one, two or three consumers in the world. While decriminalization, legalization and medical use of cannabis increases worldwide, we require a study with respect to the health of girls and young women.
There are many active ingredients within cannabis, some which can aggravate mood and anxiety and even cause psychosis. We have learned some important lessons from smoking tobacco and its impact on one's health, respiratory and otherwise. However, according to some sources, about half of the cannabis used in Canada is smoked.
There is confusion and blurring between medical use and recreational use. I will not discuss the limited evidence supporting the medical use of cannabis, although I encourage the ongoing high-quality studies that need to be done. I do, however, feel that recreational and medical use of the same substance creates an attitude that sometimes this naturally occurring plant is either good for you or at least not harmful.
My final point is—