Notes for an Address
June 13, 2011
Ongwanada’s Board of Governors’ Dinner
Ongwanada’s 60 year history serving Kingston, first as a tuberculosis hospital, then a chronic care facility and now a facility for those with developmental disabilities offering support for clients and families is a jewel in the Kingston crown. The dedication to supporting these clients and their families, responding to their needs, advocating for their rights, and increasing their opportunities to have choices and make decisions for themselves is what this community is all about. There is not a person alive who doesn’t long for social inclusion, acceptance and the wish for a productive life.
I have for two years now, been among those supporting the nomination of Jean Vanier for a Nobel Peace Prize for his work at L’ Arche homes around the world,which he started,for the developmentally challenged. His basic premise was that overarching values such as love and community cannot exclude those who, through no fault of their own,face developmental challenges and have a right to be loved and accepted for who they are – just like rest of us.
That same principle must also extend to social and healthcare priorities. To the extent that public funds are involved, discrimination between straightforward physiological symptoms or diseases of the body and organs, and developmental or psychiatric challenges is simply unacceptable. The fact that diagnosis of the latter category may be more challenging or complex is interesting but not exculpatory and is certainly not justifying of less effort or engagement on all our parts.
There is not a jot of evidence that those with developmental or mental challenges suffer less, or are less able to contribute to society when doing so is made possible, than others who engage our health care infrastructure. Yet, we have been slow in Canada to step up to the challenge of fairness and equal engagement across the full spectrum of physical and mental illness or disability. Ogwanada has always been a pioneer.
In 2006, The Standing Senate Committee on Social Affairs, Science and Technology, chaired by the Honourable Michael Kirby, tabled its final report on mental health and addiction in Canada. OUT OF THE SHADOWS AT LAST: Transforming Mental Health, Mental Illness and Addiction Services in Canada. This report was 3 years in the making, covered every area of our country and heard from more than 400 witnesses. It was and continues to be the foremost research into and compilation of testimony ever in the history of Canada relating to successes and failures of our mental health system, first-hand accounts from those who have suffered and attempted to navigate the system and ideas and possible solutions presented by experts in all areas of the field.
After former Senator Kirby’s groundbreaking report, he retired from the Senate and was appointed,at a dollar a year,as the chair of the newly minted Mental Health Commission of Canada by Prime Minister Harper in 2007. Under his leadership, the Commission has taken on the largest ever research project into homelessness and mental illness in Canadian history. At Home / Chez Soi has assisted more than 1300 people to receive housing and recovery-oriented support and intervention services that best meet their individual needs. Using the “Housing First” model, the hypothesis is that once a person is given a place to live, he/she can then better concentrate on other personal issues and with support can achieve housing stability and recovery from mental health challenges, addictions and other issues. This project has a national scope and compares different Housing First approaches and “care as usual” and is being studied in all project sites. In addition, each site has specific population targets and various sub-studies. It has projects running in:
Moncton: one of Canada’s fastest growing cities, with a shortage of services for Anglophones and Francophones.
Montreal: where mental health services are provided to homeless people in Quebec.
Toronto: services for the ethno-cultural diversity including new immigrants who are non-English speaking.
Vancouver: people who struggle with substance abuse and addictions.
Winnipeg: assisting the urban Aboriginal population.
The Commission is a small organization with a large mandate – to help change our society in ways that lead to improved mental health for Canadians and has attracted an impressive array of experts and advisors to partner with it in various ways. Perhaps its greatest accomplishment will be bringing such a diverse group of people and organizations together to help transform the system.
Poverty and mental illness are often fellow travellers on a road to despair. The Kirby report and this Commission are doing yeoman’s work in bringing the problem into the open, working with partners to alleviate it and stripping away the stigma that is so often attached to mental illness.
The Commission has a number of other important projects underway that include the release of Canada’s first National Mental Health Strategy, providing a guide and leadership for all those interested in mental health; Mental Health First Aid, delivering practical training to thousands of Canadians each year, doing for mental health what traditional first aid does for physical health – to recognize the signs and symptoms of a mental health issue, to provide initial help, and guide people towards more appropriate assistance; creating a Knowledge Exchange Centre that will ensure that information is shared and available to the broadest possible audience; and the Commission’s eight Advisory Committees are involved in research projects specific to their mandates, from children to seniors and from First Nations to the science of mental health.
The homeless are not MORE mentally ill than other segments of society. But they are challenged by their circumstances to deal with mental health issues. Over five years, and with the assistance of countless researchers and partner organizations,the commission's At Home programme will create evidence of what works best to help address the mental health and housing needs of homeless Canadians.
These research projects will end in 2013 and will collectively develop a body of evidence to help Canada become a world leader in providing services to homeless people living with a mental illness.
A few years after the Kirby Senate Report, in 2009, the Cities sub-Committee of the Senate Social Affairs Committee, released its report, In from the Margins: A Call to Action on Poverty, Housing and Homelessness. This report, released after more than 2 years of study, focused on our cities and the trap that is poverty – and the Committee’s unfortunate conclusion was that the system that is supposed to help lift people out of poverty is substantially broken, entraps people in poverty and needs a complete overhaul. As you in this room know so well, a significant portion of people with developmental disabilities rely on social assistance. During our hearings, the Committee learned that while provincial and territorial governments provide higher benefit levels for people with disabilities who are not expected to work than for employable recipients, the benefit levels had actually declined in real dollars in the period from 1997 to 2005, by percentages ranging from 1.5% in New Brunswick to 19.2% in Prince Edward Island. In seven of 10 provinces, assistance rates in 2005 for persons with disabilities were the lowest they had been since at least 1986.
The late Senator David Croll released his report on poverty in 1971 – 40 years ago. The introduction read: “The poor do not choose poverty. It is at once their affliction and our national shame. …Unless we act now… five million Canadians will continue to find life a bleak, bitter and never-ending struggle for survival. The 2009 Committee learned that people with disabilities are one of the groups whose poverty has persisted, both in depth and duration, since the time of the Croll Report. In from the Margins recognized the serious lack of coherent policy especially relating to the barriers facing persons with disabilities in terms of education, training, employment and housing and any policy has been intermittent at best, and usually short-lived.
While the committee hearings focused on poverty in all its forms, relating to all age groups, races, First Nations people or immigration status in Canada with a focus on our cities, we also paid particular attention to the disabled - many of whom were ready and prepared to become participating members in our labour force but faced walls in terms of training and support. As well, we heard from those who work with the more severely disabled to assist them in navigating a social support system that is often unmanageable. Your clients here and Ongwanada, their case workers and certainly their supportive family members will understand the complexities of a bureaucracy that imposes rules and regulations in order to “tighten up the system” when in actual fact, the myriad of rules erect barriers for those least able to navigate the system. As a result, In from the Margins dedicated several of its recommendations to the disabled in order to ease the burden for those able to find employment as well as those who are unable to work. Several of the recommendations are worth repeating this evening.
The Committee recognizes the importance of support services for persons with disabilities entering jobs, and that these supports are often lost when employment earnings begin. Therefore, the Committee recommends that provincial and territorial governments extend these supports for up to 12 months following employment to persons with disabilities leaving social assistance and that these governments negotiate with employers to provide these supports indefinitely for those earning low incomes.
One constant problem with the income support system, mentioned over and over again in our hearings, is that income support is a network of rules-based, yet sometimes subjective, decisions that does not respond to the reality of life for those living on social assistance. What qualifies an individual for one program may exclude the same person from another. For those living with a disability, attempting to break out of the system can be sometimes impossible. The trap is not tied to the amount of money a client may receive each month but rather the benefits attached to eligibility. An individual may be qualified, willing and wanting desperately to take on an entry-level position but how are you supposed to make that leap when needed drugs, eye care or dental care are no longer accessible? This does not make sense.
The Committee recommends that the Government make the Disability Tax Credit refundable.
The Disability Tax Credit recognizes the costs of some disability-related items on an individual’s ability to remit tax but is payable only to those people who having sufficient income to pay income tax. This is a catch22. If a physically, emotionally or developmentally disabled person has little income and is therefore not taxable, the credit is useless. It is not refundable to those who do not earn enough and therefore never reaches those with the lowest incomes. Disability organizations have called for making this credit refundable as an important first step to redressing the poverty of many with disabilities.
As well, recommendations for broad reform are based on a refundable Disabled Tax Credit as an important building block that could be expanded and targeted to significantly reduce poverty in this group.
The Committee recommends that the federal government develop and implement a basic income guarantee at or above LICO for people with severe disabilities.
For Canadians with severe disabilities, there is absolutely no valid reason for them to be forced through the maze that is “income assistance”. And even if that maze is navigated successfully, this would be reason enough for the federal government to ensure a quality and standard of living which guarantees no disabled Canadian will live in poverty. While the Low-Income-Cut-Off is not a direct poverty measure, as we are so often warned by those studying the issue, it is currently the only measurement we have that provides accurate Statistics Canada numbers relating to this country’s neediest citizens. Such a move would not only provide some measure of support and dignity for the disabled, it would be an economically sound decision that would free up the costly bureaucracy that must deal with applications, reviews and evaluations. And furthermore, for those family members who are charged with caring for and supporting a disabled individual – and we all recognize the financial load of such a responsibility – this one measure would ease the burden substantially. I was the vice chair of this subcommittee and, regardless of partisan divisions, stand by them. While some progress on lower income seniors has been made and transfers to provinces and individuals have been ringfenced by this government of Canada in its various expense reduction plans, there is still more to be done.
The Kirby report on mental health and addiction and the Social Affairs report on poverty and homelessness in our cities both highlighted the need for bureaucratic common sense. Canada is not a nation that deserts those who need assistance, or housing, or medical care, or support, or family backing – it’s not who we are. So why is it that every band aid solution to each immediate problem seems to adversely affect those who are supposed to be helped? First and foremost, for the purposes of your work and your clients, we must tear down any and all bureaucratic walls that put up barriers for those who want some measure of the independence and autonomy you and I enjoy. Rules and regulations should not be an impediment to anyone who is willing and able to work – especially if those rules actually put an individual farther behind. For others who may require constant care or supervision, a basic income guarantee, to ensure a standard of living that includes a quality of life we would want for any of our own loved ones, is the best and most financially advantageous answer.
Common sense needs to prevail with our legislators and policy designers. We need to build a new road where roadblocks are replaced with bridges and where dead ends become boulevards of opportunity and fairness.
The Senate is not the Cabinet and, while advice and consent can be offered in our chamber, decisions that matter are made elsewhere. As long as I am in the Senate, this battle for fairness and humanity and a more effecient and humane approach to genuine equality of opportunity will remain my central and most pressing social policy priority.
I thank you for the work you do. I thank you for the respect you show your fellow human beings and the passion you bring to their cause, rights and prospects. And I am genuinely humbled and honoured for the chance to be with you all this evening.