Agriculture committee  It's distributed across the age groups among farmers and within rural and remote communities. As in other countries, the mental health challenges for the younger generation are somewhat different because they are addicted to their phones and screens. There is that kind of capacity, but it also creates another opportunity for us to reach out to people who are in rural and remote communities.

Agriculture committee  That's a very good question. I recently had the opportunity to join the Canadian delegation to the United Nations. There was a side meeting on mental health. We can look to other jurisdictions that have similar federal, provincial, state...different ways of structuring. The U.K. did their parity of esteem act when the Honourable Norman Lamb was the minister of health.

Agriculture committee  That's right.

Agriculture committee  Absolutely. What I think we're all saying is that it needs to be by the people for the people. One thing the Canadian Mental Health Association.... It's not hospital units. It's not fly-in teams. It's people in your community on the ground who work that is bedrock. We're celebrating our 100 years this year, as you may know.

Agriculture committee  Thank you, Mr. Chair. Good afternoon, members of the committee. Thank you for inviting me here today. I'm Dr. Patrick Smith, the national CEO of the Canadian Mental Health Association. CMHA/ACSM is a Canada-wide organization with divisions in every province and the Yukon territory, soon to be in the Northwest Territories.

Justice committee  Thank you. I wish I could provide you with some virtual cake.

Justice committee  I would probably prefer the latter. Instead of “mental condition” even, we would say “mental health condition”, or—

Justice committee  I think because “disorder” is such a charged word, even though I grew up in the medical world and understand that it comes from the diagnostic manual [Technical difficulty—Editor], others aren't.

Justice committee  There you go. It's a deal.

Justice committee  Well, that's a very, very good point, and I think that's the point we're making when we talk about our historic investment of about 7.2% of our health care budget in comparison to others that are doing 13% and 14%. It's a good question. The judge at least has the option. We know from some of the early data around diversion programs, such as mental health court and drug courts, that it can have a huge impact for individuals but also significant cost savings for Canadians.

Justice committee  Absolutely. One of the things our field is great at is debating language. We debate what we think about the words “mental disorder”. It come from a DSM diagnostic category that physicians are taught, which is to put things into a disorder—substance use disorder, depressive disorder—yet people in my own organization at the Canadian Mental Health Association sometimes bristle when they hear “mental disorder”.

Justice committee  I enjoyed hearing that conversation, because I kind of understood where you were coming from. Again, we have the same debates. The word “treatment” in the field of mental health has historically been equated to beds, especially with substance use disorder: “Oh, to go to treatment, go to your 28-day program.”

Justice committee  My understanding is that if it's at pre-sentencing, they haven't met with a physician within the correctional facility yet. These pre-sentencing reports would be based on information the probation officers have, and the diagnosis or the background information they have could come from hospitalization, from their own physician, or from a community-based program.

Justice committee  I think it's our understanding that it would positively impact marginalized communities more than anyone else, because I think they are also disproportionately experiencing many negative outcomes because of social and health inequities. For example, in B.C., while only 3.4% of the population is indigenous, over 10% of the overdoses from opiates are in that community.

Justice committee  Yes.