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View Wayne Easter Profile
Lib. (PE)
Thank you, witnesses, for your presentations.
I can tell you that these statistics—80% more women die from lung cancer than from breast cancer and 200% more men die from lung cancer than from prostate cancer—were shocking to me. Those are shocking facts based on the publicity out there on breast and prostate cancers.
With regard to one of the key causes of lung cancer, smoking, how are we doing in Canada? I'm from Prince Edward Island and I see more young people smoking than I did a few years ago. I have no statistics or anything. I don't know. How are we actually doing especially in terms of young people smoking? One of the things I hear is that flavoured tobacco products are in fact potentially enticing youth to smoke. What's your view on that?
Rob Cunningham
View Rob Cunningham Profile
Rob Cunningham
2015-06-16 16:14
We are making progress at reducing youth smoking but a lot of work remains to be done. Every month more teenagers begin smoking. It's not just cigarette smoking. It's also these flavoured products. There are also cigarillos, water-pipe tobacco smoking, and smokeless tobacco. I know that in P.E.I. a bill has just been introduced to ban flavoured tobacco. Six provinces have done that. You know, we would support a ban on all flavoured tobacco including menthol across Canada. We have a lot more work to do. There are still 37,000 Canadians dying each year because of smoking and 5.7 million Canadians who smoke. There's a whole range of measures that can be taken. Australia has plain packaging as do Great Britain and France. Ireland will have it next May. Funding to Health Canada for its efforts to reduce smoking among youth can be increased. There are cessation programs and enforcement. It's a comprehensive approach. We're making progress, but a lot more remains to be done.
View Patricia Davidson Profile
CPC (ON)
Thank you, Mr. Chair.
Thank you, gentlemen, for appearing before us today.
Part of the mandate of this committee, when the study was approved, was to study participation in recreational fishing. During your opening remarks, if I understood you correctly, I think you commented that salmon fishing is seen as a public right in Quebec; that you do have an aging population of fishermen; and that you're seeing a decline in activity. Could you confirm that I understood you correctly?
If so, could you talk a bit about who is participating and where you see the decline? Are the young people not participating? Is that the issue? Or is the issue the aging of existing fishermen? And what could be done to turn that around?
Jean Boudreault
View Jean Boudreault Profile
Jean Boudreault
2015-06-04 11:53
That is a very good question. It is a major issue. Are we seeing a decline? I think so. In fact, this decline is partly related to the catch and release system imposed in other rivers. Not all people are educated to catch and release. So people stop doing it.
In terms of the new generation, the average age of Quebec anglers is about 55. However, since we are talking about the average, many of our anglers are aged 55 or 70 and over. This baby boomer generation will be out of the picture around 2018 or 2020. We expect to see them leave our rivers then. Right now, the biggest concern of all wildlife stakeholders in Quebec is to focus on the next generation.
Why is there no next generation? We can answer this question in a number of ways, but I would say that the FQSA is making a great deal of effort in that sense. Every year, we develop mentorship programs across Quebec so that young people can participate. There is a lot of training right now in Quebec.
Will we be able to make up for the shortfall? It is very difficult to say. Earlier, in my comments, I said that it would help if the government supported us through funding, promotion and fishing development programs. That is very important because it would help us. We could then make sure that we maintain an economic activity that often comes from urban centres and whose economic benefits are good for the regions in Quebec where the need is greater.
Marc Plourde
View Marc Plourde Profile
Marc Plourde
2015-06-04 12:05
Good afternoon. Thank you for inviting me to appear before your committee today.
My name is Marc Plourde. I am the CEO of Quebec Outfitters Federation, which has been in existence since 1948. The federation represents a group of 350 outfitters and 12 regional associations. Its mission is to represent and promote the collective interests of its members from a sustainable development perspective.
Quebec has a legal definition of what an outfitter is. An outfitter is a company that provides, for a fee, accommodation or services, equipment for the recreational practice of hunting, fishing and trapping activities. There are just over 600 active outfitters in Quebec. Our network welcomes over 425,000 people annually who come for hunting, fishing, trapping and outdoors recreational activities. The Quebec Outfitters Federation is the largest network of accommodation in nature. In Quebec, this means 5,000 shelter units and over 32,000 beds.
There are two types of outfitters in Quebec. In both cases, they provide accommodation since that's part of the legal definition. We have outfitters with non-exclusive rights, whose mandate is economic development. They are mostly located on public lands. There are also outfitters with exclusive rights. In addition to having a mandate for economic development, they have to protect the land.
The term “outfitter with exclusive rights” does not mean that they have exclusive access to lands, but that the exclusivity applies to the practice of hunting and fishing activities.
There are around 180 outfitters with exclusive rights in Quebec. In Quebec, lands where outfitters have exclusive rights range from 2 km2 to 400 km2, for a total of almost 25,000 km2.
There are almost 420 companies with non-exclusive rights that are, as I said, mainly located on public lands. However, some of them are on private lands. A number of those companies are also located around salmon rivers.
Let's talk about the management of fish by outfitters. First of all, outfitters are required to produce an annual activity report. All outfitters therefore provide the government with a registry of the clients and a registry of catch. They also list the wildlife development sites and the stocks on their land. The outfitters with exclusive rights have a management plan that is revised every three years and submitted to the department. The management plan is based on inventories and on the knowledge available on the ecology and the biology of the bodies of water on the land. Each outfitter has management objectives that are set according to the knowledge and operational monitoring carried out every year. All our member outfitters provide fishing opportunities. Over 256,000 fishers go to our outfitters. The estimated revenues are over $75 million.
Among the most sought-after species, the most popular in our outfitters in Quebec is the brook trout, commonly known as speckled trout. There is also walleye and pike, the predatory fish that are extremely popular, as well as lake trout. In northern Quebec, you find the Arctic char. Clearly, as I was saying, about 30 outfitters provide salmon fishing opportunities.
Let me turn to the profile of our outfitters' clients. Our most recent numbers are from 2011. The visitors to the outfitters contributed to almost 1,200,000 days of activity. Almost 80% of those activities are performed by Quebec residents, and almost 5% by people from the rest of Canada, 10% from the U.S. and 6% by people from abroad. We see that just over 20% of clients who come to the outfitters are from outside Quebec.
Clearly, outfitter fishing is the most popular activity, generating over 65% of all the days of activity with outfitters.
In terms of fishing management, the QOF is one of the founding members of the Quebec round table on freshwater aquaculture. Almost all the fish stocked in our water comes from private fish farms.
Outfitters represent about 60% of the stocked fish market in Quebec, so about 425 tonnes a year. There are 125 outfitters that stock some of their waters, primarily with brook trout. In those outfitters, the most popular technique is the put-and-take. We work with our people to increase the recapture rate by sport fishing, so that there is maximum return on the stocking. The economic benefits of outfitter stocking are estimated at over $40 million a year.
I will now talk about the issues in our sector.
In Quebec, there is an issue with the protection of indigenous sources. We are particularly vigilant when it comes to maintaining the indigenous populations and strains. We make sure that we don't use more bodies of water for stocking than necessary. There is a particular issue with allopatric brook trout pools. Those are pure brook trout populations, meaning that they don't live with other species. We are talking about the Croissant Vermeil and the Monts-Valin in the regions of Saguenay—Lac-Saint-Jean and the North Shore. That is characteristic of Quebec and we hope to protect it.
Invasive species are a different issue. This includes the diseases that those species can bring because of the use of bait fish, among others. In Quebec, there are discussions about the need to be cautious about that. The importing of bait fish has been banned recently in Quebec. Once again, we need to preserve the indigenous species.
People are afraid for the river system. The Asian carp seems to have reached the Great Lakes. For us, that is a very clear threat.
In terms of the issues that we are starting to think about, I would add the impact of new technology on the success of fishing. The sonar is increasingly sophisticated, which significantly increases the success of fishing. Clearly, we need to err on the side of caution in that respect.
Let me turn to the major outfitter trends. Fly fishing has regained popularity. It used to be associated with catching salmon, but it is increasingly developed for other species. Young people are particularly drawn to this type of fishing. As I said earlier, there is an issue with the next generation of clients. The baby boomers are getting old and they represent a major part of the clientele. So there is a concern about renewing the clientele.
Fly fishing is growing. It is appealing to us because it attracts young people in particular. Fly fishing is often associated with the practice of non-retention or catch and release. This practice could reduce the pressure on fish populations in our bodies of water.
Fishing is increasingly being practised in a context of multiple activities. Young people between 25 and 44 are still interested in fishing, but much more in a context where they can do other outdoor activities.
That is bringing about a change in our clients' traditional practices. Usually, they came on three-, four- and five-day trips to fish, pure and simple. Today, outfitters have to have a range of products, providing the opportunity to discover nature and observe wildlife, as well as the more sporting activities. Finally, we are seeing—
View Lawrence MacAulay Profile
Lib. (PE)
Thank you very much.
So, you do not believe this activity takes place, or it's very limited in Newfoundland.
In your quite interesting presentation, you also indicated a lot of young people were not interested in the fishery. They have a lack of knowledge and do not know anything about the fishery. What needs to be done in order to bring back the interest of the young people?
Also, when you're answering me, on the boat charters that go out, you're talking about the season not being long enough. Does that season also need to be extended?
Barry Fordham
View Barry Fordham Profile
Barry Fordham
2015-06-02 11:52
Mr. Chair, in response to the member's question about the young people, in my statement I was talking about the inshore fishery, which was a commercial fishery itself, where the skills and knowledge are not being passed down to the sons who would normally strike out on their own.
Sir, with respect to the recreational food fishery, we believe by extending and combining the seasons it would give the youth more opportunity to learn all there is they need to know, all we feel they should know, and all we feel they are missing out on. By educating the young, and especially adopting this gulf recreational fishery for Newfoundland and Labrador, it would allow our youth to fish off the wharves and the rocks, within safe locations, of course. That would teach them all these skills. Then we get them back on track with our history and our culture.
Thank you.
Walter Regan
View Walter Regan Profile
Walter Regan
2015-06-02 12:21
Mr. Chair, the Sackville Rivers Association is a not-for-profit, volunteer-based, community group concerned with the health of the Sackville River watershed. The SRA's mandate is to protect and where necessary restore the river and environment of the Sackville River watershed. The Sackville River flows for over 40 kilometres before discharging into Halifax harbour. The 150-square-kilometre watershed contains 13 lakes, many wetlands, ponds, streams, and feeder brooks. The population on the watershed is currently over 60,000 and increasing daily.
The Sackville River is a historic Atlantic salmon river. In the mid-1800s, a salmon hatchery was established at the mouth of the river and was closed in the early 1960s due to deteriorating water quality and diminishing salmon returns caused by development in the watershed.
The SRA, in partnership with the Department of Fisheries and Oceans, participated in a stocking program to restore the Atlantic salmon to the Sackville and Little Sackville rivers, which was stopped in 2013 due to budget cuts. SRA has continually counted Atlantic salmon since 1989. In 1996 we counted over 750 adult Atlantic salmon in the Sackville River.
The SRA uses the wild Atlantic salmon as a biological indicator of water quality, a canary in the mine. If we can keep the salmon in the watershed, all species of fish can live in the river. The Sackville River is used extensively by recreational fishermen, and by commercial and aboriginal fishers.
If the youth of today are our future, we need to educate and encourage them to go fishing. We need to promote recreational fishing in Canada much better than we are doing. Our youth know how to shop in a mall and play electronic games, but they do not know how to catch a fish. We must get our youth into a more active lifestyle that includes the outdoors and fishing.
Urban rivers must be highlighted, enhanced, and protected, so that the increased population now living in nearby cities can have access to recreational fishing. It is our youth who are the ones we want to have out fishing, and by doing so increase the future of the recreational fishery, and not have them hanging around their rooms and in malls playing electronic games. We need those urban rivers protected.
Due to a lack of access to wild Atlantic salmon eggs for our educational fishery program in schools for grades 4, 5 and 6—teaching about 500 children a year—we had to start using speckled trout eggs. This limits the effectiveness of the program. DFO has to change its policy and provide salmon eggs for this valuable education program.
We are desperate for a marine recreational fishing licence. This licence would cover shellfish, groundfish, striped bass, shad, grass prawns, and smelts. It is estimated that over 8,000 people alone spend over $5 million a year on marine recreational fishing, just for striped bass in the Bay of Fundy.
How do you manage a fishery with no catch data, no fishing network information? The licence would provide funding information for studies, habitat restoration, species management, and science. This would also be consistent across Canada, as British Columbia now has a tidal waters fishing licence.
Set DFO free to go to sea. Coastal and marine ecosystem changes must be studied and DFO must be given the resources to focus studies that would determine why salt water mortality for wild Atlantic salmon is happening, what ecosystem changes are occurring, and recovery actions needed to be implemented to stop this mortality. DFO must be allowed to do at-sea research to find and stop the black hole.
It's clear, so it must be clean. Wild fish need good water quality. Acid rain may be the single largest reason for the decline of wild Atlantic salmon in the 73 Southern Upland rivers in Nova Scotia. Due to the lowering of the pH and raising aluminum levels in the rivers, to overcome the negative effects of acid rain, Environment Canada and DFO should partner to lime the rivers that are affected in the Southern Upland on an ongoing basis.
At least 13 rivers of the Southern Upland are totally unsuitable for spawning or rearing based on the acidity and aluminum levels. This affects over 10 million square metres of wild Atlantic salmon habitat. Liming must be started and carried out to return these rivers to full production. The liming project at West River, Sheet Harbour initiated and maintained by the Nova Scotia Salmon Association for the past 10 years on a shoestring budget must be taken over and operated by both Environment Canada and DFO.
For example, in Norway and Sweden, over $20 million a year is spent on liming rivers with a five-year payback from increased tourism. We live next door to 400 million tourists or fishermen. Many would come here if we had fish and promoted fishing correctly.
Another problem is, who looks after acid rain? Is it DFO or is it Environment Canada? This must be straightened out and resources provided to correct the problem, not just studies.
In 2007 there was an escape of aquaculture fish, farmed fish, rainbow trout. Several of these fish showed up in the Sackville River, hundreds of kilometres away. Rainbow trout is an invasive fish species here in Nova Scotia. What are DFO and the province doing allowing invasive fish to be raised in open net sewer pens where escape is possible?
DFO is a promoter of the aquaculture industry and the regulator at the same time. This is a conflict of interest.
DFO is mandated to protect endangered wild Atlantic salmon, but they do not use the precautionary approach when there isn't science to prove an activity is safe. Recently the Nova Scotia government gave the aquaculture industry $25 million. DFO should give NGOs in Nova Scotia a similar amount to save the wild Atlantic salmon.
The volunteer is doing what he can where he can. Of the more than 550 watersheds in Nova Scotia, with 73 rivers known to have salmon, containing over 78 million square metres of Atlantic salmon habitat alone, this habitat is not just for salmon but for all fish species and must be protected and restored where possible. In-stream work required to address habitat issues is part of what will be required to reverse the declining population trends. This work is now being done by volunteer groups. In Nova Scotia there are about 25 groups actively doing in-river restoration. We need more groups and resources for those groups.
Thanks to the Province of Nova Scotia, the recreational fishing licence habitat stamp program, which funds a NSSA Adopt a Stream program every year, great work is being done to restore the fish habitat in Nova Scotia rivers. This program must be supported by DFO by funding an equivalent $1 million a year, or by matching dollar-for-dollar from the province's habitat stamp.
Perhaps the time is right for a new green fund. Perhaps a habitat fund could be created where offsetting funds for all fish habitat losses could be placed to help the volunteer groups restore our rivers. This fund would be overseen by the present NSSA Adopt a Stream program, which is already up and running. Population viability analysis indicates that relatively small increases in either freshwater productivity or at-sea survival are expected to decrease extinction possibilities for Atlantic salmon, especially in the Southern Upland rivers of Nova Scotia.
While a freshwater productivity increase of 50% decreases the probability of extinction within 50 years to near zero, larger changes in at-sea survival are required to restore populations to a level above their conservation requirements. Acidification and barriers to fish passage in rivers are thought to have reduced the amount of freshwater habitat by over 40%.
What happened to the wild Atlantic salmon when it reached the culvert? It got hung up. With an estimated 100,000 culverts or more in Nova Scotia watersheds and the fish passage failure rate of 50% to 80%, many millions of square metres of salmon habitat are inaccessible to wild Atlantic salmon. More inspections of culverts are required by more DFO inspectors and actions taken to correct issues, not just to inventory the losses.
This is and will be an ongoing problem until all culverts are installed correctly. Contractors should have to pay a fee or offsetting levy for the habitat destroyed to be used for stocking, liming, and for restoration of Atlantic salmon and other fish stock habitats. Small-diameter culverts authorized under guidelines now do not have to fund offsetting work. This must be changed.
We need a Nova Scotia habitat credit bank fund, possibly funded by installation of culverts, that would allow developers to put money into the fund so they can get on with their projects and not unnecessarily be held up, delaying economic development. Those moneys collected could then be used to restore lost habitat and to lime rivers.
In addition, like a carbon credit, NGOs could sell their restored square metres to the developers at $40 per square metre, and then use this money to further restore Nova Scotia rivers and damaged habitat to increase recreational fishing in Nova Scotia. Currently, DFO does not allow this habitat banking approach.
The present DFO RFCPP is a very good program and should be expanded and increased. Well done, DFO.
Henry Milner
View Henry Milner Profile
Henry Milner
2015-06-02 12:13
Thank you, Madam Chair. I am happy to be here.
I will make my presentation in English, but I can answer questions in both languages.
I'm actually just coming from a session of meetings of the Canadian Political Science Association, which is part of the Congress of the Humanities and Social Sciences taking place at the University of Ottawa right now. In fact, at this session I was just giving a paper on declining youth political participation, which is an area I've been working on and have written books about, and we have some pretty scary new data. This is comparative. It's not only Canadian; it's all advanced democracies, and Canada is certainly one of the more acute examples of that. It means that it's not simply that young people vote less when they're young and more when they're older, but there are generational phenomena that show that the current generations are voting less when they are young and are likely to vote less when they're older.
It's part of a wider phenomenon, which is the sense of duty to vote. The sense of duty to pay attention to politics isn't what it used to be under previous generations. This has something to do with means of communication, the arrival of the Internet, and so on. But most democratic countries, as far as I can tell, are making efforts, therefore, to make the vote more accessible under these circumstances, rather than less. It's hard to get real detailed information on very specific aspects, like the aspects that are in this particular law, but in general the tendency has been for countries to figure out what the impediments are to voting and to try to remove them as much as possible.
I'm not going to repeat the arguments made by the former and current heads of Elections Canada and the arguments you've heard today. It's very hard, in the context of what's happening in general, to understand the need to tighten this particular law or other laws. Focusing on these laws, I cannot see why we have to require, for example, registration after the writs have been issued. Especially now that we have fixed election dates, the idea that we have to wait until the writs are issued before somebody can apply to vote from outside of Canada, strikes me as quite.... I'd love to know the reasoning behind that.
I couldn't find other countries that are so restrictive in terms of when people can get on the lists. What we do know is that of the countries to which we can compare Canada, almost none are really as restrictive as we are. For example, as you may know, Americans can vote forever outside of the country. We are restricted to five years. In the United Kingdom it's 15 years. I have more data about other countries, but very few.... Only Australia's sort of close to us. They allow six years, but they allow you to renew if you actually apply. This five-year limit—it's five years and you're out—is something that is hard to understand.
Of course, the problems with producing the kind of information needed in order to actually have access to the vote...I think the critiques you've heard are quite compelling.
You may know there are countries that really do make it easier to vote from abroad in different ways. For example, some countries actually have electoral districts simply to represent their expats. The French do that. Some of you may know that expats from several countries, Portugal, France, and so on, actually have direct representation in the Parliament and they vote directly for their own representatives. Quite a few countries make it possible to vote in different ways.
There is postal voting, which is the way we do it, but there is also voting at embassies and voting sometimes by proxy. That's something I'm not too keen on but there are some countries that do it. Now, countries like Estonia, which have introduced electronic voting, are also working on introducing electronic voting for people outside the country.
In general what we're seeing are more efforts being made to facilitate the ability of people to vote in the country but also outside the country, to vote and to participate in the political process.
You've heard the reasons put much more eloquently than I could in terms of why it's important to have that electoral connection, but I must say I have some difficulty understanding why, in Canada, we feel the need to tighten these restrictions.
I'll leave it there. Thank you.
Karen R. Cohen
View Karen R. Cohen Profile
Karen R. Cohen
2015-05-28 15:56
Thank you.
Good afternoon, Mr. Chair and committee members. My name is Dr. Karen Cohen. I'm the chief executive officer of the Canadian Psychological Association or CPA.
CPA is the national association of Canada's scientists and practitioners of psychology. Approximately 18,000 psychologists are registered to practise in Canada. This makes psychologists the largest regulated, specialized mental health care providers in the country.
Psychologists are employed by publicly funded institutions inclusive of hospitals, family health teams, and primary care practices, schools, universities, and correctional facilities. However, with cuts to human resources in the public sector, psychologists increasingly work in private practice.
Their scope of practice includes the assessment and diagnosis of mental disorders and cognitive functioning, the development and evaluation of treatment protocols and programs, the delivery and supervision of treatment, and research.
We are pleased that in the 2015 federal budget the Government of Canada indicated its intention to renew the Mental Health Commission's mandate for 10 years. CPA has a long history of involvement with the commission from providing support for its creation, sitting on advisory committees, and providing input on past and current projects. This new investment will hopefully give the commission a mandate to implement the recommendations of the mental health strategy. The strategy scoped out the changes that Canada needs to make to enhance the mental health and well-being of its citizens. It's now time to make change happen.
The strategy called for increased access to evidence-based psychotherapies by service providers qualified to deliver them. We hope that the commission will work with governments and other stakeholders to move this important recommendation forward.
Research has demonstrated that psychological treatments are effective for a wide range of mental health disorders such as depression, anxiety, eating disorders, and substance abuse. They are less expensive than, and at least as effective as, medication for a number of common mental health conditions. They work better than medication for some kinds of anxiety. They lead to less relapse of depression when compared to treatment with medication alone. They lead to patients who better follow through on treatment, feel less burdened by their illness, and have lower suicide rates when used with medication for bipolar disorder. They help to prevent relapse when included in the services and supports for persons living with schizophrenia. And, finally, they reduce depression and anxiety in people with heart disease, which when combined with medical treatment, leads to lower rates of heart-related deaths.
Despite this evidence, there are significant gaps in service and care when it comes to mental health. Canada has no parity in its public funding of mental and physical health care. Canada's mental health strategy tells us that spending on mental health in Canada has been measured at only 7% of total health spending. Psychological services are not covered by our public health insurance plans. Canadians either pay out of pocket or rely on the private health insurance plans provided by employers. Coverage through private plans is almost always too little for a clinically meaningful amount of service.
Erin Anderssen from The Globe and Mail hit the nail on the head this week when she wrote about this health crisis. She stated, “We have the evidence...Why aren't we providing evidence-based care?”
Access to treatment should not depend on your employment benefits or your income level. Those who cannot afford to pay for treatment end up on long wait lists, they have to depend on prescription medications, or they simply do not get help at all. If we want a health care system that will deliver cost and clinically effective care, then we must re-vision policies, programs, and funding structures through which health care is provided.
CPA commissioned a report by a group of health economists that proposed several models of delivering enhanced access to psychological services for Canadians. The report provides a business case for improved access to psychological services based on demonstrating positive return on investment and proposed service that yields desired outcomes. It looked at countries like the United Kingdom, Australia, the Netherlands, and Finland that have programs that make psychological services accessible through public health systems.
A 2012 report on the U.K.'s improving access to psychological therapies program says it has treated over 1.1 million people, with a recovery rate in excess of 45%. Some 45,000 people have moved off sick pay and benefits. Savings from the program in 2015 are estimated at £272 million for the National Health Service and £700 million for the entire public sector. By the end of 2016-17, the net financial benefit of the program is pegged at £4.6 billion and judged attributable to prevention, early intervention, and a reduction in absenteeism.
Mental disorders that are addressed promptly and effectively will yield a cost offset from their treatments. That can include fewer medical visits and interventions, and decreases in short- or long-term disability. On the other hand, untreated or undertreated disorders cost the workplace tens of billions of dollars annually.
Accessing needed psychological care affects people across their lifespan.
The May 2015 report from the Canadian Institute for Health Information showed that emergency room visits and hospitalization rates for children and youth with mental disorders have increased since 2006, particularly for those between the ages of 10 and 17 with mood and anxiety disorders. Use of psychotropic medications has increased as well. A 2011 report from the Canadian Policy Network and CIHI shows that the strongest evidence for return on investment in mental health involves services and supports that are geared to children and youth and that reduce conduct disorders and depression, deliver parenting skills, provide anti-bullying and anti-stigma education, promote health in schools, and provide screening in primary health care settings for depression and alcohol misuse.
Canada's population is aging and seniors will also face barriers to accessing necessary psychological care. While many of us will age in relatively good health, others will face a wide range of cognitive, emotional, and physical challenges that include dementia, depression, anxiety, chronic disease management, and end-of-life care. As many as 20% of seniors are living with a mental illness. Depression occurs in about 40% of patients who have had a stroke. Up to 44% of residents in long-term care homes have been diagnosed with depression and 80% to 90% have a mental illness or cognitive impairment.
Canada has taken some very important steps to improve the mental health of Canadians. Campaigns and public conversations deliver the message that Canadians can and should seek help for their mental health problems. Collectively, we are reducing the stigma of mental health and substance use disorders. However, only about one-third of Canadians seek and receive such help. While stigma may be one barrier, access to care is another.
It is time Canada walked the talk and made needed treatments and supports available. We need a health care system that is nimble enough to respond to the health needs of our citizens, deliver evidence-based care, and hold us accountable for care delivered. To accomplish these goals, innovation is needed.
The federal government has an important role to play in Canada's mental health. This role includes delivering care in jurisdictions under its authority, increasing or targeting mental health transfers to provinces and territories, and collaborating with provinces and territories in delivering effective innovations in health promotion, illness prevention, and health care delivery.
To ensure that innovations in mental health care delivery happen, the federal government can set up an innovation fund to assist provinces and territories in developing sustainable mental health infrastructure across Canada that will bring psychological care to Canadians who need it. The fund could, for example, be used by the provinces and territories to adapt the United Kingdom's improved access to psychological therapy programs here in Canada and to expand the role of primary health care in meeting mental health needs.
Finally, investment in research and training for students is also critical to the success of Canada's health system, the success of which will depend on its ability to effectively respond to the changing health needs of Canadians. While research into the biomedical causes and treatments of mental disorders is important, research into the psychosocial determinants and treatments is equally important. Like many more long-standing health conditions, mental disorders involve a complex interplay of biological, social, and psychological determinants and depend on a team of providers, services, and factors for their treatment and management.
Canada is poised to do better by the mental health of Canadians. The Canadian Psychological Association is very pleased to participate in this work.
Thank you for the opportunity to present to this committee
Christian Leuprecht
View Christian Leuprecht Profile
Christian Leuprecht
2015-05-28 8:59
Thank you, Mr. Chair.
Distinguished committee members, thank you for having me. I will be pleased to answer questions in both official languages, but if I may, I will speak in English.
My presentation will have three parts.
The first is laying out why I think this particular issue we're dealing with today will continue to persist for years to come; why I sympathize with the measure; and why I think there are good ways of rationalizing this particular measure, both within the Canadian context and the comparative context.
Here's why this is going to be a persistent problem. I think there have been two fundamental changes that have brought this whole phenomenon much closer to home. Those are two revolutions.
One is the communications revolution, which has made it so much easier for people to get their twisted messages out. Everybody has a mobile phone. Aside from the ability to spread one's message in a way that would have been much more difficult a couple of decades ago, we also have what sociologists call the “filter bubble”. This phenomenon says that even though we have a very pluralistic social media universe, individuals are increasingly reading only the types of information that reinforces the biases and stereotypes they already hold. As people start to buy into this type of extremist narrative type of messaging—which that might cause them to engage in violence and travel abroad for either the purpose of committing violence, or joining an organization that the Government of Canada has decided is an organization we'd rather not have them join—I think that media communication is a major part of it.
The other is transportation. It's so much easier and cheaper today to get anywhere. For a couple of thousand bucks, you get on a plane in Edmonton and you fly to Istanbul and find your way to the border. If you think about a hundred years ago, if somebody immigrated to Canada they left everything behind. They maybe sent a letter or so back, but they wouldn't be thinking about going back. Staying in touch would be very difficult. I think these two fundamental revolutions have very much changed the game.
There's another element that I think is going to be a challenge for years to come with this phenomenon of extremist travellers, or “foreign terrorist fighters” as the UN calls them. It is the immense structural imbalances that afflict the countries that span from North Africa through to Pakistan, this arc of countries. It is the very high fertility rates that lead to severe demographic imbalances and very large youth bulges. If you look at a country such as Pakistan, you're going to have a 50% increase in their population over the next 40 years. These are recurring or replicable phenomena in most of the countries throughout the region, and yet we have social structures, economic structures, and political structures that are ill-adapted to this demographic growth.
In part, for instance, if you're smart and an ambitious young person, even if you try, it's very difficult for you to get a job because many of the economic structures and the state structures are so ossified you can't get a job unless you have all sorts of connections with senior elites, and whatnot. It's no wonder we have a large bulk of individuals in the region who are frustrated and who buy into extreme solutions and narratives not necessarily because they might be entirely convinced by the ideology being peddled, but because they're the one organization that gives them some hope of changing the circumstances in which they live.
What we've seen over the last 30 or so years, as a result, is what you might call the phenomenon of the globalization of terrorism. Previously we had domestic terrorism and we had international terrorism, both state terrorism and state-sponsored terrorism. What we've seen is this proliferation of this phenomenon of transnational terrorism and the narratives that go along with it, and now also the opportunity of ISIS, which has essentially turned the al Qaeda strategy on its head and deliberately tries to hold and control urban centres and lines of communication among these urban centres. If you wanted to join al Qaeda it was really hard. You had to get to Pakistan, and you had to find your way over to Waziristan. That was a dangerous trip and many people didn't make it. Now it's so easy to join these organizations.
While I think we can manage the ISIS phenomenon, it becomes a bit of a whack-a-mole game. As a result of these imbalances that I've laid out for you, I think instability and extremist-type narratives in these types of organizations are going to be a persistent problem for years and decades to come.
The challenge we have with people travelling abroad is going to be a persistent challenge. Sure, it dates back to the Spanish revolution and, as some of you might know, we still have the Foreign Enlistment Act on the books that was implemented at the time to dissuade individuals from going. We had this problem with German Canadians and Japanese Canadians during the Second World War. We had this challenge with some members of the Sikh community joining Babbar Khalsa, and with some members of the Tamil community joining the LTTE. As a result of these revolutions that I've laid out, this is a whole new world. It's no longer limited to particular ethnic or religious communities, because these narratives can speak to just about anybody.
As a result, what do we need? We need a much more nuanced tool kit for our security services. We've done a good job of focusing on what you might call “criminal pre-emption”, but we need to have a more nuanced tool kit in what my colleague Craig Forcese calls “administrative pre-emption”. Passport revocation is a very important component with regard to precision kinetic counterterrorist intervention, not for some mass community radicalization, whatever, talk, but rather targeting that small portion of individuals looking to travel abroad to engage with these organizations.
I might remind the committee that, of course, it's not just about adults travelling abroad. It's also about youth travelling abroad. I think the state has an obligation toward minors, toward people under 18, to intervene in ways that it might not with adults.
We also need to remember that these people will return. We know that about one-third of foreign fighters have returned. We know nine out of ten of them return deeply disillusioned and with serious mental health issues. And we know that about one out of ten—from is Thomas Hegghammer's study out of Norway, based on a sample of over 1,000—returns as a hardened ideologue.
One way or another, there are significant implications for Canadian society and for the Canadian taxpayer, if we don't engage in more effective administrative pre-emption.
Why do we need to do this? In itself, this will have a deterrent effect, if people understand that their passport may end up being revoked or they may not have one issued.
I think we also need to protect the integrity of the Canadian passport. As a result of incidents in central Asia and in north Africa, the Canadian passport in these regions is not treated now with the recognition and respect it had previously. So I think we need to be at the forefront of making sure we protect the Canadian passport as one of the most respected travel documents in the world.
I would like to finish on the premise that a passport is not an entitlement but more like a driver's licence. If you engage in conduct that clearly contravenes the collective interest, as Canadian society has outlined it, then you simply don't have the right to that particular document.
However, I might perhaps have one suggestion in closing that the committee might want to entertain. When we take people's drivers' licences, we don't take them forever, in most cases. We take them for a limited period of time. I wonder if the committee might want to consider some sort of a sunset clause built into the provisions here, whereby there is some obligation on the government to renew the provision of either not issuing a passport or renewing the revocation of that particular passport. Moreover, if we do have a permanent revocation of somebody's document, we need to make sure that we have an administrative procedure that independently confirms the assessment by the minister and by our law enforcement and security agencies that this individual's actions are so severe that they need to have that document essentially revoked for a lifetime. That would be the caveat that I might introduce.
Thank you for your time.
Thank you for your attention.
View Wayne Easter Profile
Lib. (PE)
Dr. Leuprecht, do you have anything to add?
Then moving to your larger tool kit, I think, Dr. Leuprecht, in your remarks—and maybe you didn't intend it this way—but I wondered whether you had confidence in deradicalization programs.
I ask because I think Mr. Quiggin is right. I think this is one measure that's needed among many. Young people of 18 are wanting to leave—some of them are wanting to leave for just pure adventure I expect—and they are having their passports revoked. But I hope that there are ways and means for them to get their passport back, as things change over time and your life experiences change.
Should deradicalization programs or other programs be necessary to accommodate that? You spoke about that a little earlier.
George Weber
View George Weber Profile
George Weber
2015-05-26 16:52
Thank you very much, Mr. Chairman.
Ladies and gentlemen, good afternoon. Bonjour.
I am pleased to appear before you, as the chair has noted, as the president and CEO of the Royal Ottawa Health Care Group, to share our views on the mental health strategy for Canada.
Thank you for inviting me to take part in this important forum.
I also applaud your efforts focusing on a critical issue in health care today, the mental health care of our families and communities. For us at the Royal Ottawa, you can't talk about health unless you support mental health. Understanding the link between mental and physical health is paramount to understanding the complexities of the brain.
Along with my senior management team, I'm responsible for leading and managing the operations of an academic health science centre specializing in the treatment of mental health and mental illness and addictions. We serve a large spectrum of clients receiving services through more than 15 specialized programs at the Royal. Our mandate is to treat patients as young as 16 years of age with complex mental health needs to geriatric patients with age-related issues, including dementia, behavioural problems, and chronic medical issues. We run a 222-bed treatment centre in Ottawa, which has served more than 1,600 in-patients and 14,000 out-patients in the past year.
We also hold over 1,000 telehealth consultations every year.
We have also used technology, through the creation of apps for mental health awareness, early identification of mental health problems, and a self-management tool. In Brockville, we operate a 630-bed forensic treatment facility, including two beds for the Correctional Service of Canada.
This year, we also started looking after female prison inmates, who increasingly need mental health services.
We also provide mental health treatment and clinical services to 100 male offenders serving provincial sentences at the St. Lawrence Valley Correctional and Treatment Centre for the Government of Ontario.
We are very proud of the work we do in our operational stress injury clinic, as the only academic health science centre in the network of OSI clinics for Veterans Affairs Canada. We offer specialized mental health care treatment and research to veterans, soldiers, and RCMP officers. These are men and women who perform a great service for our nation and for the peace and security of the world. Whether they were deployed in combat duty, on peacekeeping missions, or domestic operations many of our veterans and Canadian Forces members are experiencing psychological consequences as a result of their courageous service. The number of soldiers seeking help is on the rise. Last year we saw a 238% increase in referrals compared to five years ago. We are doing our best to provide the necessary treatment and help them to regain a quality of life.
Today, I would like to comment on three critical barriers to mental health and where a national strategy, advocacy, and funding could change the lives of people and their clinical outcomes.
The first is access to care. It's not a new word, not a new concept, but something we just can’t guarantee in our current mental health system. There is no question that our anti-stigma campaigns are reaching Canadians, breaking down social barriers, and encouraging people to seek help. The problem is that awareness campaigns are not tied to treatment options. Realizing that you need help is the first step. Trying to get the right treatment at the right time is the real challenge. With no increase in our global operating budgets in the last six years, we have streamlined operations to make them more efficient in order to get more people into our care; however, a growing number of people are trying to get in. We know, according to the latest statistics from the Public Health Agency of Canada, that one in three Canadian will be affected by a mental illness during their lifetime. We had always thought that the figure was one in five. Those are the latest statistics. The numbers of those seeking treatment are rising, not decreasing.
Every day, I look at the schedule of our wait lists and the number of people looking for treatment. Funding is available to help people navigate a fragmented mental health system in Ontario, but not for specialized treatment that will give people their lives back.
We are doing our communities an injustice when we focus on working around holes in the system rather than building the services that will bring about recovery. How we approach access to care has an impact far beyond the individual patient. Mental illness touches the entire family in every way possible. It also impacts friends, colleagues, and employers.
Mental health affects all of us. It is a social problem that demands our attention.
I talked to a mother last week who urged me to have her 20-year-old son Andy admitted to the Royal, as he continues to harm himself. I had to tell her that the first available appointment in our concurrent disorders, an addiction program, is in three months' time. What will Andy do during that time? Will he be able to stay with his parents? He has already threatened them several times, and police have been called. Ending up in jail is a real possibility for him. What is the chance that he will be able to wait at home, holding on to some hope about getting help? It's more likely that, without the benefit of a specialized team who know how to treat his complex disorders, he will grow anxious and frustrated trying to manage his disorders and addictions.
There is a long list of people like Andy. As a matter of fact, as of yesterday we had 1,858 patients in the greater Ottawa area on our waiting list, with 500 still to be triaged, and this story isn't unique to our organization. In talking to some of my colleagues across our country, the situation is basically the same from one province to another and in the territories.
The Government of Canada succeeded in the past with their wait-list national policy for certain medical procedures, which was introduced in 2004. Many Canadian lives benefited from this much-needed government action. The reports from the Canadian Institute for Health Information clearly showed how a $1 billion investment significantly reduced wait times across the country and enhanced quality care. Can we not do the same for mental health?
As reported by the Mental Health Commission of Canada, Canada spends about 7% of every public health dollar on mental health. Countries like New Zealand and the U.K. have devoted up to 10% or 11% of public health spending to mental health in order to bring in addressing the needs of their citizens.
We support the commission’s recommendation to increase mental health-related expenditures to 9% over a 10-year period.
The question we need to ask ourselves today is what is preventing us from reaching this realistic objective?
We know that more than 75% of mental illnesses will manifest during adolescence. Can we not show our youth that they really do matter, and that services and treatments are available for them in real time should they develop a mental illness? Those who suffer from mental illness need a national voice and funding for specialized treatments in addition to much-needed awareness campaigns.
We must make the mental health of Canadians a priority.
Morally and socially, increasing support for mental health care is the right thing to do, but it also makes economic sense. A 2011 report prepared for the Mental Health Commission of Canada reported that mental health problems and illnesses cost the Canadian economy, in both direct and indirect costs, over $48.5 billion every year. This means that the right thing to do is also the smart thing to do.
Another significant issue is our aging population, as you've heard many times before. It is a factor driving significant demographic change. As we know, the proportion of seniors with dementia will more than double by 2031 in Canada; by 2028 more than 310,000 seniors in Ontario alone will have dementia.
We are seeing a significant increase in the age groups between 65 and 90. We need to go in a new direction with this issue.
We know that we can change the outlook with a targeted course of action. Research in the last decade in Canada, the United States, and Europe has clearly shown that late onset of depression is a prodrome, an early symptom for dementia. If we are concerned about the lives of our seniors and the futures of our younger generations, we need to invest in earlier treatments that will address the significant risk factor for dementia and reduce those alarming statistics. We have the opportunity to stem the tide before it turns into a tsunami.
You heard from Dr. Merali last week about the important depression research being conducted at the Royal's research institute and his perspective on the need for national collaboration, as co-founder of the Canadian depression research and intervention network. We need to invest more in mental health research to improve the clinical outcomes for depression. Let’s get more people treated better and faster.
My third and final point is about the minimal amount of research funding in mental health and, in particular, suicide prevention research. Understanding the brain is the last frontier of discovery that will enable personalized treatments for mental illness. Suicide prevention research funding and national coordination are needed to advance best practices across the country.
As co-chair of the Community Suicide Prevention Network in Ottawa for the last four years, I know too well what suicide does to families. We have made the Ottawa region a suicide-safer community and have brought together the key community agencies, hospitals, police, government agencies, United Way, schools, colleges, universities, clients, advocates, and youth to help us identify the gaps, break down the silos, and better coordinate our efforts in order to save lives.
We have been inspired by the Nuremberg community model of reducing suicides in Germany and have learned from their experience. In Ottawa, we have set an objective of reducing suicides by 20% by 2020. We have championed new initiatives that train and empower our youth to reach out and help each other. We’ve also generated awareness among youth about who they can turn to for support and have created community gatekeepers in order to build a climate of trust and safety for all our youth.
The Royal, with the support of DIFD, a youth-led initiative, and the Mach-Gaenslenn Foundation, has established a Canadian chair in suicide prevention research. There are many initiatives across the country on suicide prevention, but do we really know what is evidence-based or more effective in reducing suicides? We want to find the answers and we hope we can lead a collaborative and supportive effort across the country. We owe it to our clients—
View Colin Mayes Profile
CPC (BC)
Thank you to the witnesses for being here today.
The issues around social services are quite broad, so I want to focus some of my thoughts, because I don't know if social finance fits all of the services that are provided.
One case, for instance, is the fact that the Government of Canada transfers moneys for youth skills training. That was not working well. The outcomes were not good and so, of course, we came out with our Canada skills funding and partnered with business, partnered with the provinces, and partnered, of course, with the federal government so we could have those outcomes.
I think one of the challenges we have in Canada is that we're such a large country. The regions are all different and the needs are different. It makes it difficult to really have a program that fits every province or every region. In saying all of this, I really agree with what Dean Mulvale said about making sure that we do have the outcomes, that the goals are met, and are met in a timely fashion.
Then there was an interesting thought from Lars that was a value-for-money lens, and I just thought right away, whose lens are you looking through? That's the challenge: what lens do we look through to evaluate value for money? Are we having successes in the programs that we are moving forward on? I'd like to ask how you see that framework and how we could provide a good way of evaluating the programs. As I say, there are some programs you just cannot include. They're ongoing. But I think taxpayers definitely need to see value for money and see outcomes.
Maybe I could turn that over to Madam Guy to give us some thoughts about that.
View Patricia Davidson Profile
CPC (ON)
Thank you very much for that answer. I'm glad to hear that recreational fishing is on the rise and that families are involved. I think it's a great family activity, and one that my family has been involved in for many years.
We certainly are wanting to promote it for younger children as well. Does your organization do anything in particular for young folk to get them interested? For example, this weekend I'm taking my grandson to our local hatchery where they have a fish pond that is stocked. The kids learn how to cast. They are able to catch a fish, and do catch and release. They promote events like this a couple of times a year.
Do you do anything like that?
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