HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Thursday, April 6, 2000

• 0917

[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, I call this meeting to order.

I understand we have a reduced quorum. In fact, we don't have a quorum at all. But having said that, we will proceed. There are no votes. There are no decisions to be taken. It's simply an information meeting, and at the end of that time we will have transcripts and we'll make sure everyone gets those transcripts. If at the next meeting we need to review anything that was done here today, obviously we will. More to the point, if there are any questions or comments arising out of what we do today, by way of information—again, it's only information—then we'll be happy to take as much time as is required. In fact, if we have to review the whole meeting, we'll do so.

Having said that, we're not going to waste the committee's time. We are going to move on and we are going to try to accomplish the things that should be accomplished. So we're going to start with item number one, the proposed outline for a mental health study.

Incidentally, I would like to propose a change, that instead of mental health study, we call it mental illness and mental health study. I think that more captures where we're going and I don't think that will be a problem. So we'll say mental illness and mental health. I think that is in fact a more encompassing term that captures the essence of what we're doing. So we'll make that adjustment, and the researchers will note it accordingly.

In terms of the proposed outline, I would like to call on Nancy Miller Chenier to perhaps give us a few comments about what she thinks might be appropriate given the kind of work she's done for us, along with Tim Williams—two of our very competent researchers in the Parliament of Canada. I'd like to see what they've had to say and what they've done over the last couple of days since we last met. Based on our last meeting, I think they have probably very quickly pulled together some thoughts, so I think we should hear those now.

• 0920

Ms. Miller Chenier.

Ms. Nancy Miller Chenier (Committee Researcher): Thank you, Mr. Myers.

You have in front of you a proposal for organizing a mental health and illness study. Just to give you some background, Tim and I looked at the minister's letter and at the key dimensions that had been emphasized in the letter and in the suggested terms of reference. Out of that we have suggested for your consideration a possible way to organize a study on this topic.

I'll skip the terms of reference because I think I'll have to make the assumption that the committee is planning to follow fairly closely those terms of reference.

I would note, however, that with the reporting date of October, you may want to think about whether or not you can accomplish everything in the time that's left. We've made a note that from now until June, when the House rises, there will be approximately 16 meetings. We know a couple of those meetings will be taken up by the Auditor General and the minister on estimates. So we have a reduced time from now until the end of June. Then in the fall there's again a set number of weeks available for meetings.

Based on the terms of reference, we have envisioned three major parts to the proposed study. If the members of the committee agree, we thought you could start with a national overview. In other words, get a sense of the big picture from coast to coast. To do this, we've suggested that you could start by hearing officials from the five major branches at Health Canada.

The reason for that proposal is that the letter that came from the minister suggests that there are already activities going on in the department. We thought you could perhaps hear from the Health Promotion and Programs Branch because they have very specific divisions related to mental health and I understand are taking the lead in following through on this study.

The Medical Services Branch, of course, has responsibility for first nations health. The Health Protection Branch has a lot of surveillance and obviously some drug responsibility. The Information, Analysis and Connectivity Branch on research and information dissemination and the Policy and Consultation Branch, which has specific areas that are looking right now at home care and pharmacare issues, are of particular relevance to mental illness in the community.

There are other federal departments. There was a concern by members that the committee look at those areas of federal jurisdiction. So we've suggested other departments that have responsibility in relation to mental health, disability pensions, immigrant and refugee health, male and female inmates in correctional services, and current and ex-military personnel. If the committee chooses, they can hear from representatives of those departments at some time, in terms of federal jurisdiction.

It would be very important also in this national review to hear from national organizations. The federal government of course works quite closely with a variety of national organizations working in this area, and we've suggested a few names but there are many others. I'm sure members will have some suggestions of their own.

The provincial governments have taken various action on mental health strategies over the last decade. It might be important to hear from them or at the very least to hear from some federal-provincial-territorial committee members. There are a couple of initiatives in that area as well.

The second part we propose for your consideration is a look at what we call specific perspectives, perhaps some specific populations. The committee could hear from panels of people who could talk about specific concerns of aboriginal peoples, children, youth. There was a focus in the letter on workers and stress in the workplace, inmates in the criminal justice system—there's a list there. You could have a number of panels and combine them in different ways.

• 0925

Specific disorders: The minister's letter estimated that approximately 20% to 30% of the general population have had mental health problems and gave an estimated cost of $11.7 billion. There are a lot of specific associations that deal with specific disorders—Alzheimer's, depression, schizophrenia, bipolar disorder. You could hear from those organizations as well.

We also thought you might want to look at some of the specific outcomes. We know they can include homelessness, suicide, violence, substance abuse, eating disorders. These outcomes have been well studied, and there are a lot of organizations and individual experts that are knowledgeable about the link between those kinds of outcomes and mental health.

To finish up, if the committee wanted to develop a national strategy, there are at least three areas where we thought we could see a role for the federal government. The first is obviously in research and data collection; the second is in areas of funding; and the third is in areas of programs and services, especially those that promote mental health or prevent mental illness. There are a number of ongoing things that I'm sure we'll hear about, but there may be some new initiatives that the committee would want to suggest.

The Chair: Thank you very much.

Are there any questions for Ms. Miller Chenier?

I think that's very thorough. I appreciate that document because it gives us some food for thought between now and the next meeting, and we'll make sure that all members are circulated with this. We can then come back...and there might be further questions at the next meeting.

Thank you very much, both to you and Mr. Williams, for getting this together in such a quick fashion. I think it captures the essence of what we should be looking at and the direction we should be taking. So it's greatly appreciated. I think it's always appropriate that we have that kind of framework to at least think about.

Moving on to scheduling dates and time lines, we have the tentative agenda, the April, May, and June calendar, in front of us. Of course, today is Thursday. Next week we have the 11th and the 13th. I anticipate that because there are not a lot of members here today, we might have to review some of the things we did today. After all, this is only an information session today. Based on some members being unable to be here, we'll review what transpired here today. Then perhaps we could invite Health Canada to at least join us for part of that meeting to give us a base in terms of what they're doing to date in this area.

Ms. Miller Chenier.

Ms. Nancy Miller Chenier: I think it might be a good idea to think of Health Canada over a couple of meetings, partly because if you bring the five branches here to talk to you there may be a fair bit of information. It might be a bit more than you could collect in an hour. It's just a suggestion.

The Chair: It's a good one too.

Let's tentatively schedule Health Canada, conditional upon the agreement of all members who would make up quorum. If the decision is to cancel, that's fine; I respect that. On the 11th, next Tuesday, at 3:30 in the afternoon in 371 West Block, we'll begin by reviewing what took place at this meeting, because after all there are no votes or decisions being taken; we're simply gathering information. So we'll review that. Then we'll go into a review from Health Canada vis-à-vis mental illness and mental health. Then we'll reserve the 13th for Health Canada to come back to complete their overview.

Then of course we have the two-week break. Then we have to deal with Mr. Elley and Ms. Wasylycia-Leis. I think between the two of them, Ms. Wasylycia-Leis led on this—the issue of the Auditor General coming. So based on his availability and/or his people, we'll work that in and we'll post you accordingly as to when that is.

• 0930

Following that, I think we should start to think about other government departments. Maybe we'll have the researchers give some thought to that and come back with who they think appropriate and what dates, because there is always a juggling back and forth as to who's available and who's not.

Then, of course, that moves on to agenda item number three, the potential witness. Of course, I'm going to state now what I always state, and that is that we want to ask all members, if they have potential witnesses who they think are appropriate to appear, to submit that to our clerk as soon as possible.

I think, Ms. Fisher, you should also be sending out correspondence to all members inviting them to do so. I think we need to have that list as soon as possible because we want to schedule them accordingly.

I don't think we'll take a lot of time now talking about witnesses. Suffice it to say, as Ms. Miller Chenier and Mr. Williams indicated in their paper, there are a number of national groups, there are some local groups, and there are others who we want to invite in. Maybe we can do as we did with CIHR and have panels and groupings. I think from a logistical point of view that's always worthy to do because it simply scopes people into sessions in a more productive fashion.

Suffice it to say, number one, we will have witnesses; number two, we'll have members recommend witnesses; and number three, we'll try to cover as many people as we can. I think as the parliamentary secretary said the other day, this is a very important issue and we want to make sure that everyone who wants to be heard is heard. At least, that's my position. Unless I hear anything contrary, I think we should go on that basis.

The direction to researchers is item number four. I think I have already given some direction, and I think any other direction will come in the normal course of how we would conduct a study. As I told Mr. Richard Paré not so long ago—Mr. Paré of course is the chief librarian, as these two well know—we were well served not only by Mr. Williams and Ms. Miller Chenier, but these are seasoned people. So we'll defer a little bit to their good judgment.

In terms of direction to researchers, I think the researchers will assist, and rightfully so, and we'll carry on accordingly.

Are there any other items we should talk about? Mr. Parliamentary Secretary, do you have anything to add? Again, this is really by way of background information. We'll bring all members of the committee up to speed and we'll make sure they get all the transcripts of what happened here today. We'll make sure they get the documents. We'll make sure they get the agenda. We'll make sure they're corresponded with vis-à-vis witnesses and their input. We'll make sure we have time at the next meeting to discuss more fully when everyone is here, hopefully....

We heard the other day, for example, that people decried the fact that we hadn't had a meeting for a while; therefore, let's have a meeting and get down to work. Well, here we are getting down to work, but we don't have quite enough people. I guess these things happen. I take all these matters with a grain of salt.

Mr. Parliamentary Secretary, any words of wisdom?

Mr. Yvon Charbonneau (Anjou—Rivière-des-Prairies, Lib.): How can we add wisdom to your words?

[Translation]

I think the work plan drawn up by our research officers is eminently suitable. It is fairly broad in scope and will afford us the opportunity to hear all viewpoints. We will start with the department, and gradually familiarize ourselves with the issues. As for the timetable, I don't think we can do any better than this.

[English]

The Chair: Thank you very much. Anything to add, Monsieur Proulx?

[Translation]

Thank you very much.

[English]

That being said, this meeting stands adjourned.