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Results: 106 - 120 of 1662
Rebecca Shields
View Rebecca Shields Profile
Rebecca Shields
2021-04-23 13:31
Uncertainty is a trigger for all of us. Uncertainty leads to higher stress. We're dealing with people who are in acute stages of stress and chronic stress. What that means is that they're at a higher risk of trauma, which means they're at a higher risk of depression. Trauma and depression may lead to suicide. We're really trying to build out trauma-informed and trauma-specific services for our communities.
View Tony Van Bynen Profile
Lib. (ON)
Thank you, Mr. Chair.
Thank you to all of our witnesses for joining us today and sharing their experiences with and concerns about the pandemic.
It's a great honour to be able to welcome a constituent to the committee and have their voice reflected in the work we do here, so I will be directing my questions to Rebecca Shields from CMHA York Region and South Simcoe and acknowledge that she serves a population of over 1.2 million people across more than 10 different municipalities.
Firstly, Rebecca, I want to thank you for the many projects that you have undertaken in conjunction with community partners like York Regional Police or Southlake Regional Health Centre. You have put together teams to respond to situations that are urgent and often call for a police presence, but also will have the presence of your team so that you can respond effectively to these.
Last fall I moved a motion in this committee to study the impacts of COVID-19 on mental health and the well-being of Canadians. That was well more than four to five months ago. I referred to mental health as being the third pandemic, and it has become the fourth pandemic now, and I very much understand what your concerns are.
You supported the call for the study and said that to achieve full economic and social recovery, we must understand the true impacts of the pandemic on the mental health of Canadians. I completely agree with you, and I thank you for that support.
I know it's critical to invest in comprehensive community-based research to understand the impact and to identify the most promising strategies. You made some references to hot spots. While the scope and the scale of this committee is more broadly countrywide, how would you suggest we go about trying to identify the community-based strategies?
Rebecca Shields
View Rebecca Shields Profile
Rebecca Shields
2021-04-23 13:34
It is really true that each province and territory addresses health care differently. Mental health affects us all, but we do have unique community needs. This is what we're seeing.
At the very basic level, we understand that COVID, which is a health care issue, has impacted different communities differently in disease with completely different impacts and outcomes. What we're learning from the research on COVID is that we have to translate that into local neighbourhood-based research. We can pull data from our hospitals around, and we do, and share that information, but what does it mean to have population-based research?
There are many components of that, and there are some great leading practices coming out of, for example, the Slaight Family Centre for Youth in Transition at CAMH, where they are looking at youth-specific research. One of the things they are sharing in co-design and co-participatory research is how COVID is impacting youth differently. Not all cohorts of youth are the same. Some might be thriving at home, and, as my colleague, Mr. Mitchell, said, some are not, and how do we understand and address that so we can be designing and delivering services that are effective so that we can take a health equity approach.
In community-based research what we want to have is the lens of health equity across that research, and then to be able to co-design and deliver services that are effective for those communities.
The research must be embedded in community, it must be co-designed, it must take into account a population ethnocultural lens so we can have a health equity approach, as well as addressing other cultural-specific groups like my colleague, Mr. Leslie, said: those with developmental disabilities, the 2SLGTBQ, and our indigenous communities and our Black communities.
All those communities have their own needs, so as we design and break down research, we need to not just stay at a global level, but to really take the investment to dig a little bit deeper because we know that responses must be designed to meet specific needs. The pandemic has shown us this. If we do not take in the specific populations, they get left behind, and without that health equity lens, they are disproportionately impacted.
We can do better, and that's what I would like to see us do.
Thank you again for your question. I hope I responded.
View Tony Van Bynen Profile
Lib. (ON)
Thank you.
The access to mental health resources and supports has been key during this pandemic for many Canadians. Our government has stepped up with the Wellness Together Canada and the Kids Help Phone. I know that CMHA had its own telephone-based supportive counselling.
Was this service in place pre-pandemic? If so, can you elaborate on the changes, or the differences between before and during the pandemic, that your staff have noticed?
Rebecca Shields
View Rebecca Shields Profile
Rebecca Shields
2021-04-23 13:38
First and foremost, obviously as did all mental health agencies, we switched to, as much as possible, virtual care. That allowed access to people. I mentioned that we need to ensure equity of access. We offered specific counselling for frontline health care workers and we offered a variety of walk-ins. We really tried to take away any sort of wait-list, so we offered a lot of walk-in or call-in services in order to address immediate needs. We expanded the access to the BounceBack program through an investment so that we would not have anybody waiting for that over-the-phone cognitive behavioural therapy that addresses—it's an evidence-based form—worry, low mood, stress and anxiety.
Those are the types of investments that we made to quickly address population health, and then we did deeper dives into specific vulnerable populations like our homeless population.
I see the red card, so thank you very much.
View Sonia Sidhu Profile
Lib. (ON)
What type of training, including in the cadet curriculum, especially on the mental health perspective or any other training...?
Christine Whitecross
View Christine Whitecross Profile
Christine Whitecross
2021-04-22 20:11
I'm sorry, Madam Chair; I am not up to date on that. I'm sure Major-General Whelan could get that information for you.
I can say that in the last couple of years, there have actually been mental health experts who are physically positioned right at the military college, to my understanding, so that they can provide an immediate resource to any of the officer cadets or the staff who may be having any issues.
Glynne Hines
View Glynne Hines Profile
Glynne Hines
2021-04-21 15:38
Thank you, Mr. Chair.
Mr. Chair, members of this committee, and fellow panel members, good afternoon. I'd like to thank you for the invitation to appear today.
Before I get into the substance of deliberations, I'll give a brief background of myself. I am a veteran of 41 years' service of the Canadian Armed Forces, in the regular and the reserve forces, having served in the army, the navy and the air force. When I retired in 2012, I remained in Brussels, where I was the civilian director of NATO's intelligence-sharing enterprise.
None of this has anything to do with veteran mental health care. However, since that time I've been involved with supporting and advocating on behalf of veterans and their families in a variety of capacities, with my emphasis being on veteran and family mental wellness.
I understand the focus of your committee right now in this session is on the supports and services to veterans' caregivers and families, and that today you wish to focus on three elements: the impact of the caregiver recognition allowance since its introduction; the relevance and possible means of enabling family members to get VAC services on their own behalf; and to reflect more generally on the support offered by VAC to family members, particularly when it comes to veteran health that requires ongoing care.
Starting with the caregiver recognition benefit, I just want to correct a statement that was made in my invitation, which referred to something called a “caregiver recognition allowance”. It's actually the caregiver recognition benefit, and this nuance is important. It's not an allowance per se, but it's a $1,000-per-month benefit to recognize, and not compensate, the contribution of a family caregiver to the care and recovery of our most severely disabled veterans based on their disability, not necessarily based on the impact on the family. It does not replace income or earnings lost by these family caregivers; it merely recognizes that they have a role to play in caring for the veteran.
As I indicated previously, in my advocacy role my emphasis is on veteran mental health. I'm particularly interested in the caregiver recognition benefit as it applies to veterans with a diagnosed mental health condition.
Since raising this issue of equitability—that is, the equitability between a veteran with a mental health condition and a veteran with a physical disability—I have focused on some data from VAC. It indicates that approximately 70% of the applicants for the caregiver recognition benefit are in receipt of disability benefits for a mental health condition, and that 81% of those eligible for that benefit actually have an approved disability entitlement for mental health conditions. So, in fact, it does appear that the award of the caregiver recognition benefit is equitable for veterans struggling with mental health conditions as it is for those with physical disabilities.
When we talk about enabling families to obtain VAC services on their own behalf, I think we could take a lesson from our allies in Australia. In Canada, there are very few supports and services provided to family members, and there are no supports and services provided to family members on their own right from VAC. Family members will only get support from VAC if it is directly related to the veteran's condition and recovery. This means that the family's need for support must be directly related to the member's condition and treatment. Thus, if a veteran himself or herself does not have an awarded condition, a family member who may be suffering as a result of the member's service is not able to access VAC support for themselves, and this is especially important when we're dealing with family mental health. The veteran may choose not to apply for a disability award or to seek help, for whatever their own personal reason is, but that doesn't mean that his or her dependants aren't adversely impacted by the veteran's service, or that they don't need help.
Consider for a moment the teenager who has moved with their parents every few years while growing up. A parent is deployed every few years, school has been disrupted, the teen starts struggling with their own mental health. They don't have access to mental health care, because they're always moving, and they go on a rather lengthy provincial waiting list to get care. They don't have access to VAC services because their veteran parent doesn't have an awarded condition, so they suffer without help, even though their condition may well be attributed to the veteran's service.
We used to say that members joined the Canadian Armed Forces, but their families were drafted. I chose to join. My wife and my kids didn't choose to join, but they have been subject to all the career implications and the lifestyle implications as a result of my service. Unfortunately, in retirement or after release, this continues, whereby the dependants are struggling sometimes with conditions that their veteran parent has, but they don't have access to services and support.
The care and support needed are often in the area of mental health, and it's a discipline that is stigmatized, making access even more difficult for spouses and children. Veterans and their families face a unique experience during a military career and transitioning to civilian life, and it is very difficult for them to get the care they need while they're on lengthy provincial waiting lists, especially for mental health conditions.
Military life can involve significant challenges, not the least of which is exposure to life-and-death situations. For many veterans, military service and operational deployments can lead to a strong sense of identity and belonging. For clinicians working with veterans, demonstrating an understanding of the military experience enhances the therapeutic alliance so they can get effective treatment.
View John Brassard Profile
CPC (ON)
Oftentimes when a veteran is dealing with mental or physical injuries, occupational stress injuries or mental health, they just can't take it anymore, can they? If you're exhausted, I can't imagine how exhausted veterans and their families are in going through this process time and time again, as is the case with Max. Finally you just throw your hands up, and he told us that this week in a separate message system. He said, “I don't know what to do anymore.” Is that the kind of thing you hear often?
Greg Passey
View Greg Passey Profile
Greg Passey
2021-04-21 16:16
Yes. I deal almost exclusively with post-traumatic stress disorder, and about 49% of people with PTSD think about suicide; 19% actually act on it.
I've been very fortunate. I think it's partly the therapeutic relationship and the bond I have as a fellow veteran. In all my years—in June I'll have been a doctor for 41 years—I've never lost a patient to suicide, but the example I gave you would have been my first, and I didn't know about it. That's telling me that not only are they getting worn down, but they're now starting to not reach out, because had he reached out, I could have done something about that.
It's a really dire scenario. We're not tracking the suicides when our veterans leave the military. To be honest, every one of my veterans—and I mean every one—develops anxiety when they get a letter or an email from VAC, because the vast majority have had negative interactions.
There's a reason why there's bulletproof glass in the VAC offices now, and that shouldn't be there; it should be a supportive environment.
View Rachel Blaney Profile
NDP (BC)
Thank you, Dr. Passey.
I'm going to come back to you again, and I want to thank you for acknowledging the great workers who are in VAC. I agree with you; there are amazing workers. I think one of the biggest challenges is that they're being put into a box where it is like these outputs are more important than the human connection, and that does concern me.
My next question to you is really.... First of all, I just want to acknowledge that the vast majority of caregivers are women, and women's work continues to be undervalued again and again in our system. I think that when we look at $1,000 a month for women who often have given up big chunks of their careers because they believe in the service that their partner provided, we need to acknowledge that and understand how we're valuing that.
My bigger concern on this issue is that caregivers, families and loved ones are being asked to treat and manage PTSD with no training and no support. I think about listening to them talk about modifying all this behaviour and trying to create a safe space in a world that is often very triggering.
I'm just wondering what the impact on the family is. You talked about how many partnerships are ending because of this. What is the impact on the family, and how does the lack of knowledge affect that? What are the tools that would be more supportive to caregivers?
Greg Passey
View Greg Passey Profile
Greg Passey
2021-04-21 16:37
You can actually develop what's called vicarious PTSD as a result of being exposed over long periods of time to individuals who have untreated PTSD and are very symptomatic. Family members, that can be the kids, that can be the caregivers, etc., can actually develop their own mental health issues. There's no way around that.
I know when I was still working at the B.C. Operational Stress Injury Clinic, we had a group program that attempted to address this. We had the spouses come in, and we tried to give them some tools and stuff, but it's difficult to understand and treat this disorder when you're a professional. As a layperson watching a loved one go through this, it can be quite devastating, because you personalize what's occurring and you think that it's your fault that your partner is blowing up or whatever, and it typically has nothing to do with you. It's because they've been triggered. We need better education. We need better resources available for family members and, particularly, the caregivers.
In caregiving at this level, professionals have difficulty with it, and we're expecting amateurs, lay people, to do this. I think the caregiver allowance.... If it's $4,000 a month for someone to be in a long-term care facility and we're only paying a caregiver $1,000, I think that's crazy. They need better support financially, emotionally and professionally to do this type of support.
Glynne Hines
View Glynne Hines Profile
Glynne Hines
2021-04-21 17:02
I will make three quick points. One thing that's in the budget is mental health treatment while awaiting care. To me, that is an admission of failure. If we cannot get people access to mental health care in a timely fashion, what more processes are we going to put in place to get somebody access through this system? We already have wait times that are unacceptable. Now we're talking about putting more money into something and having to develop another process to get it.
As far as I'm concerned, money for mental health care, absolutely, but money for interim mental health care means you've failed somewhere else. Our biggest failure is the wait times.
View Darrell Samson Profile
Lib. (NS)
I hope you're not trying to make me speak in both languages at the same time, Mr. May.
Mr. Gauthier, as Mr. Desilets said earlier, Veterans Affairs Canada reportedly confirmed several times in the past that the number of francophone employees was much lower than it should have been. In our most recent interview with employees, we were told that, of the 350 new employees, up to 33% were francophone or bilingual.
We've seen progress in the past six months. One thing that was pointed out and that I'm very pleased about is the fact that some francophone employees are processing files in English. There must be a way to structure this better so that these files can move forward.
Ms. Bart, you as well had good and very precise information about the role of a caregiver and the responsibilities and the challenges around the caregiver. It is very important information.
I'd like to speak about awareness. I think awareness is extremely important.
On mental health, Dr. Passey, you made reference to it, but I want to go back to that benefit. I know that Mr. Hines's comments may be different from yours on this point, but on the investment in the new budget to support people's mental health while they're waiting for their claim to be processed, the objective here is to try to help them from day one. How do you think this will help the many people you work with?
As you indicated in your testimony, it's taking so much time for them to get the results, and then they're not getting the results they need. I'd like to have your comments around this funding. Government doesn't dream about how it's going to do this. It's based on the testimony we've been getting. People are waiting too long, and they're not getting the treatment they need. How do you see this supporting your clients, Dr. Passey?
Greg Passey
View Greg Passey Profile
Greg Passey
2021-04-21 17:07
I think it's important, because there is certainly a significant wait-list to even be engaged with a mental health professional who can provide appropriate assessment, treatment and support. That part is important.
I'll tell you, though, I'd like to see a good chunk of that money.... Rather than have it going to mental health while they're waiting for their claim, how about you redistribute it so that the claims are processed quicker? Because that is partly treatment for their mental health issues, for the stress of waiting and the sense that they may be denied. That's easily treated if you can speed up the process.
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