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June 3rd 2020 - Study on the government’s response to the COVID-19 pandemic

Senator Poirier: My question is for the CPA. A term we have often heard is “echo pandemic” to describe the potential surge of people struggling with mental health issues. In your opinion, is this a real possibility? If so, has the federal government put in place the services and funding needed to answer a potential echo pandemic at this time?

Dr. Zahirney: Thank you for the question. We have some preliminary data that has come out of previous disasters but the evidence base for actual epidemics such as this is somewhat less.

Rather than calling it an epidemic, we are concerned with the increased mental health needs post-pandemic or in the recovery and reintegration phase to some sense of normal life.

I think we have to distinguish between increased levels of distress and depressive or anxiety symptoms, whereas we know the majority of the population will not be presenting with more depression or anxiety disorders.

We need to monitor some of our mental health care workers or those exposed to some of the worst traumatic events of the pandemic in Canada, for PTSD may be foreseen. The greatest concern right now is there certainly can be increased rates of substance use disorders. It is well documented. Increasing rates of intimate partner violence and, potentially, child abuse are also well documented and have been seen in previous countries.

Our concern is balancing the needs of those who have acute distress — which is a normal reaction to very abnormal circumstances — and distinguishing the most vulnerable populations who are most at risk of having relapsed or significant exacerbation of their ongoing mental health challenges.

Senator Poirier: Thank you. My second question is for the Centre for Addiction and Mental Health. In your recent survey you state that nearly one quarter of the respondents reported engaging in binge drinking at least once in the past week, while those who are very worried about the impact of COVID-19 on their personal finances were especially likely to engage in binge drinking.

What has the government done to reduce substance abuse and binge drinking during the pandemic and especially after the pandemic?

Dr. Stergiopoulos: I’m not aware of any specific responses to the issues of increased substance use during the pandemic. The Government of Ontario has developed hubs of mental health supports both for the general public as well as those at high risk, which includes front-line workers, people affected by COVID and providers not just in hospitals but also in long-term facilities that may be most at risk.

I’m not aware of specific addictions-related responses in any of our provinces.

Senator Poirier: This is my first question for the CPA. I know you explained what needed to be done. Has the federal government put in place during the pandemic the services and funding needed to respond to the echo pandemic?

Dr. Zahirney: Certainly we welcome some of the recent and early announcements in terms of income support, because loss of income can be a risk factor for the development of depressive or anxiety symptoms. More recently, the increased investments for our Indigenous population in terms of helping as well with the concerns over intimate partner violence are the [Technical difficulties] so far that I am aware of.

I have also seen a great mobilization from many of the NGOs, such as the Mental Health Commission of Canada, who are providing those kinds of resources to help decrease mental distress and give people increased coping mechanisms to deal with this because everyone is dealing with the stress of the new times. Those investments are interesting but, again, different from the ongoing chronic issues of unmet service needs in the Canadian health care system. Those still need to be addressed.

Senator Poirier: Thank you.

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Senator Poirier: My first question is for Kids Help Phone. The Government of Canada announced a support of $7.5 million to support Kids Help Phone, and in your presentation, you said it was over 21 months during increased capacity. Have you started to receive the funding promised by the government? And why is it spread over 21 months?

Ms. Hay: Thank you for the question, senator. Kids Help Phone is most appreciative of the support from the government. We have started to receive the funding. We’re working with the Public Health Agency of Canada on that.

For us, we understand that the impact of COVID-19 is not going to be over when school begins in September or even this time next year. In our discussion with the Public Health Agency, we asked: How do we take this funding and make sure it keeps us sustainable while we are grappling with the increased volumes? We don’t anticipate our volumes will drop, actually. We pulled it out over a period of time to make us more sustainable.

Senator Poirier: Thank you. How exactly have these funds that you have started receiving helped you during the pandemic?

Ms. Hay: Thank you for this question, senator. Like all charities in Canada, our funding model is a combination of mostly philanthropic support, Canadian corporate support, mass fundraising in various communities across the country and government support. At Kids Help Phone, a maximum of about 40% of our total budget is government support, and mostly provincial support, actually.

The reality is that when the pandemic hit and impacted the economy in Canada, our revenue lines were going to be down. That was a piece of the discussion that we had with the Prime Minister’s office and the Public Health Agency of Canada. Things like our national Walk so Kids Can Talk is a $4 million annual budget line for us to support our service. So there is a drop in revenue that we recognized, and there was also the increased demand for service that we knew was coming our way.

We support our regular service and our professional counselors. We have about 120 of them in Canada. We moved them remotely, and then we were able to hire some more. As well as that, we need to expand our texting program. What is extraordinary about that is our crisis responders are trained volunteers who are already on a dynamic technology, so it is scalable. We were able, with this funding, to expand the scalability of it, make sure we had the right professional counselors who oversee this service, the right number of coaches and trainers training more Canadians to be crisis responders and a focus, with this increased capacity, on underserved populations in particular.

Senator Poirier: Thank you. Ms. Hay, in a recent interview on a CBC broadcast, it was reported that Kids Help Phone had expanded its support to adults, which speaks loudly to the lack of access and services for mental health, especially during this time.

You have expanded your service by text for adults and front-line workers. In your opinion, has the federal government invested in the direct help for mental health services for adults and front-line workers, which in turn allows you to fully focus on youth and kids during COVID-19?

Ms. Hay: Thank you for this question, senator. It’s a very important one.

First, I would like to share with the committee that about, pre-COVID, 10% to 15% of our Crisis Text Line texting platform, powered by Kids Help Phone, was adults 30, 40 and 50 years old, because at 2 a.m. in Canada there is not another national service that is there for crisis response. Kids Help Phone is it. On our professional counselling service, we will often get adults who reach out to us and say, “I know this is a service for kids” — and I’m going to be overly dramatic — but they will say something along the lines of, “I feel like my life is worthless and I’m walking toward means for suicide,” and at the end of the day, we would help them.

That’s just a lay of the land pre-COVID-19. We have the technology in Crisis Text Line, our texting platform, to be able to spread and scale that. Our training is not youth-specific, though we do have modules specific to Indigenous youth. We have the technology, we have the infrastructure and we knew that we could scale this. At this time, it was the appropriate time to do so.

As it relates to funding from the government, we actually expanded Crisis Text Line All Ages through Wellness Together Canada, which is a new portal for mental health and substance abuse funded by the federal government as a result of COVID-19. We are one of the partners and one of the e-mental health solutions within that portal, and the funding came to Kids Help Phone through that to launch Crisis Text Line All Ages, so it did not take funding from Kids Help Phone proper to launch Crisis Text Line All Ages.

I would like to make one point in support of my colleague, Dr. Emily Gruenwoldt. Virtual care is an important addition to mental health services. When Kids Help Phone launched Crisis Text Line, in 2019 we handled more than 200,000 texting conversations in every province and territory, with wait times of less than five minutes. It has a neural network and AI machine learning, so if a person is in crisis they are served within 40 seconds. It’s not first-come, first-served; it’s based on acuity. We ran that entire service in Canada for about $3.5 million. That is incredible return on investment for Canada.

Senator Poirier: Thank you very much.

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