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Results: 2581 - 2595 of 2664
View Massimo Pacetti Profile
Lib. (QC)
Thank you, Mr. Chair.
Hopefully it will only be a couple. It's a very interesting topic. I'm used to being on the finance committee, and this is a change of pace. I think we're getting into a subject that normally we touch upon very briefly at the finance committee. Groups come before the committee asking for money, but we're not so sure that we understand the problems in-depth.
My question is the same question you have been asked, but I guess it's from a different perspective. In terms of services, are services ultimately getting to people who need them? We see a lot of groups coming before the finance committee representing different things and providing different services. I'm not so sure they provide services--because isn't the ultimate service provider the health side at the provincial level? Are the groups just there? They seem to be asking for programs, but there are a lot of administrative things involved. Is there money clogged up and not being used for the ultimate beneficiary?
Michael Kirby
View Michael Kirby Profile
Hon. Michael Kirby
2009-04-30 12:34
Yes, and I have two comments.
Is the system inefficient? It's colossally inefficient. It's inefficient because there are so many service providers operating in any given municipality that the same number of services are provided by a large number of service providers.
Do I think you could ultimately redesign the system so it would be a lot more efficient, and with the administrative numbers more money would fall to the bottom line? Absolutely. That's what the mental health strategy will do.
Let me be clear. For an average person with a mental illness, less than one-third of the public money that is spent on them is spent by health departments. The rest is spent by housing, by training, by social services, and so on. If someone has a heart attack, it is all spent by the health department. You not only have the fragmentation at the service delivery level, you have the fragmentation at the provincial level and at the federal level.
There is no minister in the federal government responsible for people with a mental illness. The funds the feds spend come out of a lot of different pockets. The same thing is true provincially, and the same thing is true on the ground. Clearly, you're right. There's a huge element of duplication.
View Massimo Pacetti Profile
Lib. (QC)
I don't mean to interrupt; it's just that our time is short.
We have constituency offices, and a lot of people who come to see us are going through hard times—and some have permanent hard times. It depends on what they're there for. We try to channel them in the right direction, but in fact it's not necessarily towards the traditional health institutions. The local Quebec MPs--we have CLSCs—will refer them to a CLSC, and sometimes there is a follow-up, but there just don't seem to be enough resources. Sometimes we'll get good success, but there doesn't seem to be the 100% hit rate. I'm not even sure what the hit rate is.
The other part of the question is about funding. I think you spoke about it in terms of proper programs from the government point of view. What I've been seeing is that businesses have been taking responsibility for certain items. When we were in Victoria last year with the finance committee, the chamber of commerce from Victoria got together with the homeless, and there seemed to be an initiative so that they were going to work on it together. When we got to Halifax, it was still the social workers versus the chamber of commerce. There wasn't that linkage. I'm wondering what your perspective is. Is there some collaborative work being done? Mental health is an issue in the workplace. And let's face it--a lot of times employers, rather than dealing with the issue, will try to find a way to get rid of this guy or this woman so that they don't have to deal with the person.
Michael Kirby
View Michael Kirby Profile
Hon. Michael Kirby
2009-04-30 12:36
That certainly happens. The reality is that there's growing recognition now among at least the major employers in the country that there's a real need for them to begin to deal with it. We have a workforce advisory committee that is working with a number of companies now on pilot projects to figure out--I'm going to use the same word as we use for people with disabilities--what workplace accommodation is required for them to be able to employ people.
We're making progress on that, and it is hugely economically beneficial to the company. When someone goes off on short-term disability, they continue to pay the salary during the short-term disability. So to the extent that you don't have to send that person off, or they're off for a much shorter period of time, the money that would otherwise be spent is now going to fall directly into the profit line.
So there's a huge economic incentive. The more progressive employers in the country are starting to recognize that. I'm going to ask Jane to comment specifically.
We're hoping to really make some progress on that. I will tell you, interestingly enough, that governments and government agencies are not anywhere near among the best people to deal with this issue.
View Ron Cannan Profile
Thank you, Mr. Chair. Thank you to our witnesses.
Thank you, Dr. Kirby, for your outstanding work. In working closely with the Canadian Mental Association in my riding, as Glenn has alluded to, and the great work they're doing across the country and in the business community...the model after the Calgary strategy, which our own community is embarking on. It takes all levels of government, the community, the taxpayers--and the business community is a big component of that--to have a successful plan moving forward.
I just want to comment on an aspect of progress and change. In my own personal experience, my oldest daughter is going to be 24 this year and she has gone through a borderline personality disorder and had a breakdown after two years of university. I have had the opportunity to work with professionals. There are many out there in the community, and I appreciate their dedication.
My question to you is this. As far as your commission is concerned, what do you see as the definition for mental health illness, and what percentage of Canadians are affected by that?
Jayne Barker
View Jayne Barker Profile
Jayne Barker
2009-04-30 12:40
Well, there isn't one universal definition, but definitions of mental health usually encompass the idea that people can have successful relations with other people, that they can make contributions to society by holding down a job. How they think and how they feel allows them to function fully and engage in everyday life.
When you start talking about mental illness, then you're really talking about having how you think, how you feel, how you respond, and how you behave affected by your illness. So the symptoms are manifested through, as I say, how you think, how you feel, or how you behave.
Howard Chodos
View Howard Chodos Profile
Howard Chodos
2009-04-30 12:41
Just to add to that, the working definition of mental health, at any rate, that we've used in the context of developing the mental health strategy comes from the World Health Organization. It says that mental health is:
...a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
That is a definition of mental health.
What we've tried to do is distinguish between mental health and mental illness, and to recognize that people who are living with the symptoms of mental illness can also experience a great deal of mental health, in the sense of having a positive outlook on life and having the resilience to cope with the symptoms of their illness.
So when we talk about mental health and mental illness, it is in fact two different things. Having positive mental health can contribute in ways, independently, of having the symptoms of mental illness. We would want to encourage the greatest degree of positive mental health for all Canadians, at the same time as we find ways to encourage people and to enable them to cope with the symptoms of mental illness when they experience them.
View Ron Cannan Profile
I think that's an excellent fact that we have to communicate to Canadians. You alluded to where we are with mental health in comparison to breast cancer 30 years ago. That is an excellent analogy. I believe individuals with mental illness deserve the services, support, and access to them.
The federal government is trying to provide those funds to the provinces and territories. I spent nine years in local government working at that level and getting the funds down, but the challenge we have jurisdictionally is ensuring that the provinces deliver the dollars where we'd like them to go. As you said, supportive housing is something we've heard from other witnesses who have come to the committee, and we'll continue to get that message to the provinces. Once again, each province and territory is unique.
I have a follow-up question about facilities for the individuals you mentioned. The police force has indicated that approximately 50% of 911 calls are due to mental health. How are you addressing networking with our judicial system and the Criminal Code? Are there recommendations coming forth from the task force?
Michael Kirby
View Michael Kirby Profile
Hon. Michael Kirby
2009-04-30 12:43
Absolutely. The reality is that when we de-institutionalized in this country.... We closed the old asylums, as they were called when I was a kid, the mental hospitals. In theory, we were putting people out into community-based facilities, except that we didn't build the community-based facilities very fast. The result is that the streets and the prisons have really become the asylums of the 21st century, which is outrageous, frankly.
We are working not only with the Canadian correctional services—in fact, we're running a conference with them on this specific issue in about two months—but I think all of the people concerned with the justice system, beginning with the judiciary and the lawyers, recognize that we need to do two things. We have to start providing mental health services to people we incarcerate, which we don't do now. The result is that they're worse off when they get out than when they went in. More importantly, we have to start focusing on the broad question of how we stop them from going to jail in the first place. Having mental health courts is one way of doing it, but we think there may be other ways.
Our mental health and the law advisory committee is chaired by an Ontario judge, Ted Ormston, who created the first mental health court in the western world, in Ontario. He has some very creative ideas that we're talking to the provinces and the people who run the jail and penitentiary systems about.
View Glenn Thibeault Profile
View Glenn Thibeault Profile
2009-04-30 12:45
Thank you, Mr. Chair. I appreciate the question and I will try to keep it brief.
You mentioned the repatriation. I'm sure we could talk for an hour and a half about the repatriation and the term they use when they've taken individuals from institutions with no preplanning and put them into the community. Many of the issues we're talking about now could have been resolved if there had been a lot of preplanning.
We've talked a lot about “housing first”, and one of the things that I think is very clear that I would like to hear you explain is.... It's great when you get a roof over your head. That's an important piece in reducing homelessness and addressing mental illness. But as soon as they get a roof over their head, you can't wash your hands of the individual. There are so many responsibilities in becoming a tenant, and with mental health, all of a sudden you have to worry about paying all of your bills. The “housing first” strategy can't just be putting a roof over their heads. There have to be so many other support services in place. Is that correct?
Jayne Barker
View Jayne Barker Profile
Jayne Barker
2009-04-30 12:46
That's absolutely correct.
One of the supports that is part of the program we're testing is the interface with the landlord. So when landlords feel frustrated, or when something happens, they have somebody they can call who will go and address the issues.
It's also about teaching people who have lived on the streets, who maybe don't have the skills to deal with landlords and have never had that opportunity to learn how to talk to a landlord. It's teaching them the kinds of things that are expected in keeping an apartment or a place to live. You're absolutely right, supports that help in dealing with a landlord as well as supports for dealing with health and mental health problems are crucial.
View Candice Hoeppner Profile
Thank you very much for the opportunity. I'm going to try to make this brief as well.
My question has to do with treatment. I know there are a lot of drugs that have been prescribed. Many times that contributes to or doesn't help the problem. I'm wondering if you have looked at faith-based communities and programs to help the mentally ill, more of a holistic approach.
Michael Kirby
View Michael Kirby Profile
Hon. Michael Kirby
2009-04-30 12:47
Your question was, have we? We are so early getting going. The answer is, we have not, but we will. The answer is yes.
Let me tell you where my bias is on this issue. I had a sister who suffered for many years from severe depression, including a suicide attempt. She subsequently died of cancer. She would say to me that she felt she got more help from her spiritual adviser than she did from her psychiatrist. While that is anecdotal, it gives a little bit of bias on the question.
The reality is that the aboriginal Canadians have understood for centuries that you have to treat the whole person, and the whole person is not just the head and not just the physical body. It is the combination, and it has a spiritual element to it. I use spiritual rather than faith-based, which connotes a somewhat purely religious point of view. Spiritual need not be religious in the normal sense of the word.
Yesterday at a meeting Jayne Barker and I were at with CIHR, we discussed the question of how we get some evidence to establish empirically what appears to be anecdotally very true, which is that the spiritual element of treatment is a very important element.
Doug Clorey
View Doug Clorey Profile
Doug Clorey
2009-04-29 15:55
Good afternoon, everyone.
Although this presentation is on the new Veterans Charter, we felt it was important that you have an understanding of the mental health context in which the new Veterans Charter is provided. As I understand, Mr. Chair, there will be a separate briefing on the full mental health strategy of the department within the next few weeks. Hopefully we'll get into a lot more detail there.
Slide 20 speaks about mental health generally within the Canadian context. Essentially, one out of five Canadians lives with a mental health condition during their lifetime.
The second bullet is interesting as well, because in the Canadian context of those who have need of mental health services, only one-third actually access them, so two-thirds don't. That seems to have some effect also in terms of the specific population we serve. The economic impacts are listed there as well. It's a significant cost to the Canadian economy.
In terms of the extent of need for mental health services, you would be familiar with this, I believe. The increased CF participation in military operations, the combat style of missions, and the more frequent deployment of members of the military with less time to recover and recuperate between deployments have all contributed to increased mental health conditions within the military.
The last bullet on slide 21 speaks to the results of the 2002 Canadian community health survey, on CF members in particular, which identified the four major categories of mental health condition within the military. In order of prevalence, they are depression, alcohol dependency, social phobia, and PTSD. The interesting thing there is that this is the order in which they occur. PTSD, which is obviously very much in the media these days, is actually fourth in the list of the mental health conditions that are experienced.
In terms of clients within the Department of Veterans Affairs who receive disability benefits as a result of a mental health condition, as of the end of March we had 11,888 who have received a favourable decision for disability benefits associated with a psychiatric condition. That breaks down into roughly 63% CF veterans, of whom 12% continue to serve in the military; 24% war service veterans; and 14% RCMP members, of whom 5% are still serving. It is important to note that our strategy on mental health in the department is not just for the CF veterans; it's also for the older veterans. It scans the whole spectrum of mental health conditions, from those related to service at a younger age to those dealing with dementia, Alzheimer's, and all of those related conditions. We've seen an increase in clients of about 8,000 since March 2003. That represents about 1,500 to 1,600 new clients every year with a psychiatric condition who enter our books.
Of all of these clients, 68% have PTSD. Again, I would recall the previous slide, which showed that two-thirds of all of our clients who come forward do so with PTSD. One of the implications there, and we may wish to speak to it at some point in time, is that PTSD seems to be a condition that members of the military and veterans are more open to coming forward with, as opposed to, say, depression.
The third bullet shows the connection with the new Veterans Charter rehabilitation program. We see that 60% of clients coming into rehabilitation--which is a conservative estimate at this point, and it's probably quite a bit more than that--are coming in with a mental health condition as well. That creates a dynamic and a complexity around rehabilitation that is quite significant.
Slide 23 has the breakdown of the numbers more specifically. Of the 2,591 rehabilitation clients within Veterans Affairs, about 1,600 or so have mental health conditions. So it's a significant percentage of clients with mental health conditions that we are trying to rehabilitate into society.
Slide 24 is a very brief summary of our mental health strategy, which is essentially providing access to or in some cases providing within the department a suite of mental health services and benefits that will assist veterans and their families to regain functioning. It's focused on early intervention. The earlier you are able to intervene with these individuals, the more chances of success of recovering and maintaining and retaining full functionality within one's life.
We're also trying to focus on all aspects of life that support mental health and well-being, which we think is unique within the Veterans Affairs mental health programming. It isn't only about health services through psychiatrists and psychologists and other health professionals, but it's also about providing social support, economic support, physical support in the home, and also dealing with individuals on a one-to-one basis based on the World Health Organization's whole-of-person, whole-of-life perspective. We're also building capacity, exercising leadership in the field of mental health, and doing this in partnership with many others.
I won't go into slide 25 in detail, but it's a sampling of some of the services we provide to assist veterans and their families in regaining their mental health and well-being.
View Judy A. Sgro Profile
Lib. (ON)
With respect to the issue of mental health, we were talking a lot about PTSD and the new clinics and services that are being made available. At one point, many of those services would have been referred to as mental health services. What is the difference between mental health services and PTSD? Are they not similar?
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