- Member of Parliament
- Member of Parliament
- NDP
- Courtenay—Alberni
- British Columbia
- Voting Attendance: 67%
- Expenses Last Quarter: $148,159.67
- Government Page
Mr. Speaker, it is an honour to rise today on the unceded lands of Tseshaht and Hupacasath on Vancouver Island in Nuu-chah-nulth territory to speak to Bill C-62, which is calling for the extension of the temporary exclusion of eligibility for medical assistance in dying for persons suffering solely from a mental illness by three years, until March 17, 2027.
Clearly, without an intervention by Parliament, this expansion would come into effect on March 17, 2024, in just one month. New Democrats agree with the majority decision made by the Special Joint Committee on Medical Assistance in Dying, also known as the AMAD committee, which I will refer to it as in my speech. It reported that Canada is not adequately prepared to deliver medical assistance in dying to individuals whose sole underlying medical condition is a mental disorder.
The bill would allow more time to implement the necessary safeguards and address the capacity concerns that are expected to be the result of the expansion of medical assistance in dying for those with the sole underlying medical condition of a mental disorder. It would give medical practitioners more time to become familiar with available training and supports, while providing time for the public to become more aware of the robust safeguards and processes in place. I know this is a very sensitive and very personal matter to so many people around this country. Especially in my riding of Courtenay—Alberni, I have heard from many people about this.
We also need to ensure that we have the understanding and compassion to respect the right of an individual's choice of dignity when they have deep, prolonged and ongoing suffering. I will speak to that. Suffering from mental illness is extremely serious, and it is just as real as suffering from a physical illness. In our health care system, we clearly do not have parity when it comes to mental and physical health, and I will speak to that as well.
We must also affirm and protect the most vulnerable when we do any sort of decision-making on such a serious piece of legislation as expanding medical assistance in dying. This additional delay is necessary and needed right now to ensure that we have a health care system in place that can safely provide medical assistance in dying for those whose sole underlying medical condition is a mental disorder.
We know how we got here. The Liberal government made an ill-advised decision and did a complete 180° by accepting the Senate's amendment to Bill C-7 in the 43rd Parliament. That is what got us here. The government changed the law before any kind of comprehensive review had been conducted, and we have been trying to play catch-up ever since. I am going to speak about the important work that needs to be done, and I want us to be thoughtful in our approach to expanding medical assistance in dying.
As New Democrats, we take people's concerns and feedback very seriously. We are committed to helping find the best possible solution for Canadians in the policy of medical assistance in dying to ensure that it does what it was always intended to do. One of the biggest concerns New Democrats have with the expansion of medical assistance in dying is with the barriers that many Canadians face when they reach out for mental health treatment. Because of the Liberals, and the Conservatives before them, the chronic underfunding of our health care system has become even more apparent. It is now more than ever, as we see the disparity between mental and physical health and how people are taken care of.
We heard the Prime Minister promise to implement a new mental health transfer of $4.5 billion over five years, but he has still not done that. Even with the bilateral agreements, the Liberals are falling far short, and that would not even be enough. Everyone should be able to access mental health supports when they need it, but under the Liberal government, and that of the Conservatives before it, this has not been the reality. It is the same with all provinces and territories.
New Democrats wholeheartedly support the delay in expanding medical assistance in dying for those who have a mental disorder as the sole underlying condition, but the Liberal government needs to ensure that proper consultation happens between now and the expansion date, or it would need to be extended again. It needs to ensure that people will be protected while respecting their individual choice.
The Liberals cannot just delay the expansion either. They need to fund adequate supports and treatment options for people dealing with mental illness. Members have heard me say this repeatedly, but we need a pathway, a road map, to how we are going to achieve parity for mental and physical health and ensure people get the timely help they need when they need it.
Seven of the provinces and all three territories have said that they are not ready and have signed a joint letter to that effect, including my home province of British Columbia. That was signed by the ministers of health in those provinces and territories. They are calling for an indefinite pause on the expansion for individuals whose sole underlying medical condition is a mental disorder. That is what those ministers identified.
As New Democrats, we want to see a MAID regime where guardrails are in place to protect vulnerable populations while still allowing for personal bodily autonomy and end-of-life choices. We must make sure that people do not request medical assistance in dying because they do not have access to treatments, supports and services. This has to be absolute. The Liberals need to make sure everybody can access mental health supports. However, after nine years of carrying forward with the Conservative cuts to health care, this is where we are at right now right across the country. Help is out of reach for many people. This needs to change before medical assistance in dying can be expanded.
We know that the housing, toxic drug and mental health crises that are happening are not being addressed. I see that I do not have a lot of time left, but I want to ensure I outline that the AMAD committee heard from plenty of witnesses who cautioned the committee on expanding MAID in cases of persons suffering solely from a mental illness. I want to share what a couple of those experts had to say.
Professor Brian Mishara, who is with the Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices at Université du Québec à Montréal, said, “The expert panel report on MAID and mental illness states that there are no specific criteria for knowing that a mental illness is irremediable”, and that there is absolutely no “evidence that anyone can reliably determine if an individual suffering from a mental illness will not improve.” He warned us that “any attempt at identifying who should have access to MAID will make large numbers of mistakes, and people who would have experienced improvements in their symptoms and no longer wish to die will die by [medical assistance in dying].”
We heard from many experts. The CAMH raised similar concerns.
Because I see that I only have a couple of minutes left here, I want to talk a bit about the system and the lack of access. We are talking about a crisis going on from coast to coast to coast, according to a poll done just a year ago. The Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction released a report talking about postpandemic findings. It cited that 35% of respondents reported moderate to severe mental health concerns.
This is alarming. It should also be alarming to all parliamentarians that it found that fewer than one in three people with current mental health concerns accessed services. The report identified key barriers to accessing services as financial constraints and help not being readily available. We know that right now we are in a financial crisis, and I am sure those numbers have only gone up. It identified that one of the top stressors was between income and unemployment with mental health concerns.
We need to create a system of parity with mental and physical health. The government has not delivered when it comes to a plan, a road map, on how we achieve parity with physical and mental health. I hope in this budget, it is going to release funding on top of the bilateral agreements directly to community-based organizations as a COVID emergency recovery response because, post-COVID, we know some people are struggling financially, but the biggest concern right now and the biggest epidemic post-COVID is in mental health. I hope the government is hearing that.
I see that I have run out of time. I have a lot to say on this matter. I look forward to taking questions from my colleagues.
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Mr. Speaker, I want to thank my colleague for talking about some opportunities and she also cited broken promises when it came to palliative care. As members know, I was here last Monday and the Monday before and would have been here tonight on Adjournment Proceedings, to drag the government here to talk about mental health, but it was disrupted so I am back.
I asked the minister about mental health just last week. She cited:
Through the proposed bilateral agreements on the shared health priorities, we are working with the provinces and territories to integrate mental health and substance use as a full and equal part of our universal health care system.
However, when it comes to the reality on the ground, the Liberals have still not delivered on their promised mental health transfer of $4.5 billion. Even the agreements that they signed with the provinces today do not assure that.
Does my colleague agree that we need, enshrined in the legislation, parity between mental and physical health to have a proper conversation in this House about expanding medical assistance in dying for those whose sole identified underlying medical condition is a mental illness?
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- Oct/20/22 7:21:12 p.m.
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Madam Chair, we know the mental health crisis has been referred to as the parallel pandemic. This House has not had a debate on how to respond to this. Earlier this month, I rose and sought an emergency debate on Canada’s mental health crisis, but unfortunately it was denied.
I want to thank the minister, as she acknowledged tonight we have never had this conversation about mental health until tonight and we have never had a proper debate. I want to thank the Conservatives and the Bloc and their House leaders for agreeing to have this important conversation, because it took all parties to agree to do this take-note debate.
Over the last two and a half years, the mental health of Canadians has been negatively impacted by the loss, social isolation and financial strain the pandemic has brought. We all have constituents struggling with their mental health, and many of us have loved ones who are as well. My good friend from Vancouver Kingsway always says that there is not a family not touched by the mental health or substance use crisis in this country.
I really want to thank my colleague from Cariboo—Prince George for sharing his personal story about his brother Kevin and his brother-in-law. We hear those personal stories from our constituents every day as parliamentarians, and it is painful to hear.
We know we are going into a period where we are seeing a lot of impacts right now on people's health. The cost of living is rapidly rising and likely we are going to see a recession. The stress Canadians are facing has not abated. Just yesterday, the Minister of Finance warned Canadians of difficult days ahead and suggested the federal government might not be there to help.
Now more than ever we must recognize that mental health is health, and we need to take steps to ensure Canadians have equitable access to the services they need. This month, the Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction released a joint report on the continuing impacts of the COVID-19 pandemic on the mental health of Canadians, which detailed some alarming findings.
According to polling conducted for the report, 35% of respondents reported moderate to severe mental health concerns. We see that as parliamentarians. It also found that fewer than one in three people with current mental health concerns accessed services. That is alarming. The report identified key barriers to accessing services as “financial constraints, not having readily available help, not knowing how and where to get help, and long wait-lists.”
The report identified financial concerns as a top stressor during the pandemic and discussed the links between income and unemployment with mental health concerns. Given the current economic forecast, there is a real risk the mental health and substance use crisis will worsen in the months ahead. That is scary. As my colleagues have identified, 10 Canadians die a day from suicide and 21 from a toxic overdose.
We also know health care workers and first responders have been raising the alarm that our health care system is under tremendous pressure. Unfortunately, too many people struggling with mental health issues are left with nowhere to turn but crowded emergency rooms. A worsening mental health and substance use crisis will only push our health care system closer to collapse.
It is clear we need to make sure people can get help in their communities before they are in crisis. While there are many great organizations working hard to support Canadians struggling with mental health issues, we know they are running on fumes. The demand for mental health services has increased since the onset of the pandemic, but that demand cannot be met under the current system when frontline organizations are having to worry about keeping the lights on. They need help and they need help now.
We need system change that will finally bring mental health care fully into our universal public health care system once and for all. We need sustainable funding to ensure all Canadians have access to services when they need them.
In the last election, the Liberals made a promise to Canadians that they would take steps to improve access to mental health care in Canada. A cornerstone of the Liberals’ promises on mental health was to establish a new permanent transfer to the provinces and territories to expand publicly funded mental health care and address backlogs. Canadians were told an initial investment of $4.5 billion over five years would be made in the Canada mental health transfer.
Now, $250 million of that funding was supposed to be delivered in 2021-22, with an additional $625 million in 2022-23. To date, of that money, no funding has been delivered. There has been no transparency from the government on when the money would get out the door.
Last week the Canadian Alliance on Mental Illness and Mental Health, with the support of 65 organizations from health and allied sectors, wrote an open letter to the minister expressing concern about the delay in establishing the mental health transfer and calling on the government to take immediate steps to fulfill this important and critical campaign commitment.
The minister has taken the position that national performance standards must be developed prior to the creation of the Canada mental health transfer. However, the open letter I referred to demonstrated there is a clear consensus from the mental health community that the development of these standards should not delay the Canada mental health transfer. There is an urgent need for increased mental health services in communities right across the country. Wait times for publicly funded mental health services are unacceptably long.
In Ontario, where we are right now, there are more than 28,000 children on wait-lists for community-based mental health services. The wait could range from 67 days to more than 2.5 years, depending on the service, exceeding clinically appropriate wait times. For children and youth, delays in accessing care could have lifelong impacts for them, their family and society. Tragically, it could also be a matter of life and death.
According to Stats Canada, suicide is the leading cause of death among youth and young adults aged 15 to 34. This has touched my life and those of many people here in this chamber, as we have discussed tonight. UNICEF has reported that Canada has one of the highest rates of youth suicide in the world. We heard my colleague from Nunavut just two days ago share that tragic story of someone who could not find housing. This is unacceptable in a wealthy country like Canada. It is preventable.
For those struggling with substance use disorders, waiting could also be a matter of life and death. Across Canada the average wait time for adult residential treatment for substance use is 100 days. Every day that someone must wait for access to treatment or harm reduction services, they are put at risk because of the toxic drug supply.
The Canada mental health transfer would provide an infusion of money for services that could save lives now. It is urgently needed, but there is other critical work that must be done to transform mental health here in Canada. Beyond the mental health transfer, mental health advocates have been long calling for legislation to enshrine law parity between mental and physical health.
Last month I tabled private member's Motion No. 67, and I hope my colleagues will second it, calling on the government to finally develop that legislation and urgently fulfill its promise to establish the Canada mental health transfer. I hope all members of the House will recognize the crisis we are in and support these urgently needed calls to action.
Untreated or inadequately treated mental health carries significant social and economic costs. The Mental Health Commission of Canada estimates that mental health issues and illnesses cost Canada at least $50 billion a year, not including the more than $6 billion in lost productivity.
Relative to the disease burden caused by mental health and compared to our G7 and OECD peers, Canada is underspending on mental health. France spends 15% of its health care budget on mental health, whereas the U.K. spends 13%. Canada, depending on the province or territory, spends between 5% and 7%. We are falling way short.
For the well-being of Canadians, for our economy and our communities, mental health cannot wait. It is time to invest in the care Canadians deserve, and to truly treat mental health like health. We need to listen to the experts. We need to listen to the expert task force on substance use. We need to listen to the 67 organizations. I hope that together we can do that.
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- Oct/3/22 2:46:58 p.m.
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Mr. Speaker, Canadians are suffering and even dying, because getting help for their mental health is not affordable and wait lists are months or even years long.
This week is Mental Illness Awareness Week, and mental health organizations are once again calling for the government to recognize that there is no health without mental health. During the last election, the Liberals promised to spend $4.5 billion over five years to expand mental health services and address backlogs. They still have not delivered.
When will the Liberals follow through on their funding promises to improve mental health services for struggling Canadians?
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