THE STANDING SENATE COMMITTEE ON SOCIAL AFFAIRS, SCIENCE AND TECHNOLOGY
EVIDENCE
OTTAWA, Thursday, October 6, 2022
The Standing Senate Committee on Social Affairs, Science and Technology met with videoconference this day at 11:32 a.m. [ET] to study on the Federal Framework for Suicide Prevention; and Examine and report on such issues as may arise from time to time relating to social affairs, science and technology generally.
Senator Ratna Omidvar (Chair) in the chair.
[English]
The Chair: Let me call this meeting to order again. I’m going to have to take it from the top so the witnesses hear the framing and the context setting.
Before welcoming our witnesses, I would like to provide a content warning. For our first panel, our committee continues its study on the Federal Framework for Suicide Prevention. We will be discussing topics related to suicide and mental health. This may be a trigger to both people in the room with us as well as those watching and listening to us.
Phone numbers for crisis lines will be broadcast during this meeting. Senators and parliamentary employees are also reminded that the Senate’s Employee and Family Assistance Program is available to them and offers short-term counselling for both personal and work-related concerns, as well as crisis counselling.
For our first panel, joining us by video conference, we welcome Dr. Sidney Kennedy, Professor, Department of Psychiatry, University of Toronto; Dr. J. John Mann, Director, Conte Center for Suicide Prevention, Columbia University; and Dr. Gustavo Turecki, Professor and Chair, Department of Psychiatry, McGill University. Thank you very much for joining us today. We look forward to your comments. I wish to remind everyone that the focus of the study is on the evaluation of the Federal Framework for Suicide Prevention, published in 2012, as opposed to insights and wisdom on suicide prevention per se.
I’d like to ask both the witnesses and our committee members to keep that framing in mind. I now invite each of you to provide opening remarks. Please keep these to five minutes. This will be followed by questions.
Dr. Kennedy, the floor is yours.
Dr. Sidney Kennedy, Professor, Department of Psychiatry, University of Toronto, as an individual: Thank you very much for the invitation to speak to the Standing Senate Committee on the Federal Framework for Suicide Prevention.
Death by suicide remains in the top ten causes of death in all ages and is the second leading cause of death in 15- to 24‑year‑olds in Canada. There are many risk factors, multi‑factorial, some protective factors. Suicide is not a medical condition but is associated with numerous mental disorders, including depression and substance use disorders and bipolar disorder.
Significant risk factors may transition, and the concept of acquiring capability is relevant, as an individual may have ideation, translating to action as an attempt or ultimately death by suicide.
The framework does not provide adequate information on the acute management of suicidal crises. It does an excellent job in many ways in highlighting the longer-term goals in the public health domain, reducing stigma, promoting awareness, connecting Canadians and providing information and resources and accelerating research.
The area of acute medical treatment in the community or emergency room or elsewhere deserves more attention. I will not speak for Dr. Mann, but he certainly has highlighted in recent communications many aspects of medical treatments that can reduce the risk of an acute suicidal act, which can often be a lifesaver and is not adequately addressed.
There are many more biological areas of research in terms of some of the brain imaging work that can be done to appreciate different responses in what we would consider to be functional brain imaging.
Finally, best practices are important, but they may not be the most evidence-based treatments. And I think there is a risk of endorsing treatments based on their accessibility rather than necessarily proven efficacy and, indeed, safety.
My final example would be the Canadian Drug and Health Technology Agency, or CADTH, review of clinical effectiveness of suicide-specific psychotherapies versus non-specific therapies delivered to individuals during a suicide crisis. Five trials were identified. Three were randomized control trials. There were essentially no differences between general psychotherapies and more specific therapies, yet we continue to follow what seems to be common sense rather than evidence-based approaches.
These are my brief impressions of the living document that has emerged over recent years. Thank you.
The Chair: Thank you very much, Dr. Kennedy.
Dr. J. John Mann, Director, Conte Center for Suicide Prevention, Columbia University, as an individual: Thank you. I’m honoured to be invited to contribute to your deliberations.
I need to state from the outset that I haven’t read any of these documents or plans, so I have no idea what you’re envisioning at the moment. What I can do is summarize a comprehensive paper that my colleagues and I wrote very recently in The American Journal of Psychiatry. That paper attempted to evaluate the data supporting the efficacy of different suicide prevention strategies and then classifying each of those strategies into whether they can be scaled up so they can be applied to a city, state or nation level.
Essentially, the main findings of that paper are that probably the single most effective measure shown in studies — 10 out of 12 studies — is to train primary care physicians to better recognize and diagnose major depression and then treat it more effectively. You will notice that the word “suicide” does not appear in that objective. Nevertheless, we do know from studies that about half of all suicides are a complication of a major depressive episode. If you can train the nation’s primary care physicians to do a better job of recognizing and treating depression, you’re going to save a lot of lives.
The other thing that’s important to know is that people who die by suicide in the next 30 days will see primary care physicians, internists or OB/GYN physicians at double the rate they will see psychiatrists or mental health professionals. You want to focus your effort on where these patients are going. About 40% of these patients will see somebody like that in the first 30 days before they die, and about 80% will see them within a year of dying. So this group of physicians are uniquely placed to save a lot of lives.
One can expand this program by extending it to people in internal medicine, emergency room physicians, OB/GYN, et cetera, and possibly get a multiplicative effect on this.
The next area that demonstrates strong evidence this approach works is outreach and follow-up. When a patient presents in a suicide crisis either to an in-patient unit or an emergency department or any health care professional — when they present in that acute suicidal crisis or ideation that they’re not sure they can control, if you then organize active follow-up — which means if they don’t show up for an appointment, somebody reaches out to them — and send an occasional email and ask them how they’re doing over a period of months or a year, that is the highest-risk period for that group of patients to die. If you can prevent that from happening by diligent follow-up, you may halve the suicide attempt rate in that population.
The third area that really works is means restriction. For example, as you know, south of the border in the U.S., we have a terrible problem because the country is awash with firearms, so people are killing themselves. Half of the suicides in the United States are as a result of self-inflicted firearm wounds. The problem with firearms is that the fatality rate per attempt is extremely high, and it’s very hard to rescue people. If you can stop people having access to the most lethal methods, then they’re forced to use less lethal methods or they are just discouraged from making any attempt. Remember that a person who survives a suicide attempt only has a 20% chance of dying by suicide for the rest of their lives; so it is really important to try and make it as difficult as possible for people to get access to the most lethal methods.
The fourth area where there is some evidence that you can improve suicide risk is the media. If the media are properly educated to not sensationalize suicide but to focus on the fact that there are treatments to prevent it and help people — for that I don’t just mean print media and electronic media, I also mean social media settings. That is an extremely important battlefront for trying to prevent at least a small segment of suicides, particularly in young people.
The Chair: Thank you, Dr. Mann.
[Translation]
Dr. Gustavo Turecki, Professor and Chair, Department of Psychiatry, McGill University, as an individual: Honourable senators, hello. Thank you for inviting me to testify and thank you especially for your interest in the issue of suicide in Canada.
[English]
The Federal Framework for Suicide Prevention has good intentions and overall objectives but lacks specifics and more importantly lacks budget items attached particularly to the six elements for action. I would also like to say that the framework lacks specific goals and deliverables and, importantly, methods to quantify the success of the six elements that were put for action.
For instance, I’m going to focus my points on element number 6, which calls for increased research and evidence-based practice for suicide prevention.
Over the last five years, I chaired the Canadian committee to define a national research agenda on suicide and its prevention. This committee was coordinated by the Public Health Agency of Canada in collaboration with the Mental Health Commission of Canada.
The committee did excellent work in terms of developing an agenda that is broad and incorporates elements of evidence to guide physicians, but it was also politically influenced, and most importantly, again, there were no budget lines attached to the recommendations.
Important omissions of this exercise were that the main research funders in Canada were just bystanders. How can we expect an adoption of a research agenda such as this one when the Canadian Institutes of Health Research, or CIHR, and other tri-council agencies and other agencies that directly support research in Canada were not central to this exercise? Further, how can this be a success when there are no budget envelopes associated with this work? There are no new budget envelopes in Canada to support an agenda to develop a national suicide research plan.
To complement that, we heard from the two previous witnesses that suicide is strongly associated with mental illness, particularly depression and related depressive states. However, most of the individuals who are depressed and manifest suicidal ideation will not die by suicide and have low risk of acting on suicidal thoughts.
It is essential to invest in research. Though we know much about suicide prevention, as was discussed previously, the exercise of risk identification and screening of individuals at risk, for instance, in emergency settings, is approximate at best. We need to invest heavily in the development of new knowledge to better identify, in a more precise manner, individuals at risk and then determine how to better respond. Thank you very much.
The Chair: Thank you very much, Dr. Turecki.
I just want to alert you that Dr. Turecki is only with us for another five minutes, I understand. Senators should either direct their questions to him now or ask the clerk to get a response from Dr. Turecki.
Senator Bovey: I’d like to thank all three of you. With this information, I will start with you, Dr. Turecki, if I may. I’m really intrigued by your comments about research and the lack of funding provisions in the framework that we’re in the throes of recommending be updated.
Two simple questions, if I may. You talked about the research funders, and I certainly understand that. How much research is currently going on in universities now or in the scientific field now that may be coming up with some of the gaps that the current framework is missing?
Dr. Turecki: I don’t have the exact numbers to answer you, but I would say that certainly not enough. There has not been a clear policy in Canada to promote research on suicide. There is certainly research on suicide, but there’s no action plan in that sense.
The exercise that we did that was connected with priority number 6 of the framework was primarily to define an agenda to identify priorities for funding. As I pointed out, there are no specific new budget envelopes assigned to that. It is unclear to me, after having worked on this agenda for five years, how that would be achieved.
Senator Bovey: Dr. Kennedy said that there’s not enough in the current framework regarding the management of suicide crises, and Dr. Mann mentioned the need to include diagnostic needs and increase the role of primary care and obviously outreach and follow-up. Those are big issues to add to a framework.
Should all those issues, for the three of you, be articulated or embedded in research that will come up with the quantitative measures that we need to be able to move forward? Do we know how many Canadian research chairs we have in universities dealing with this issue now?
Dr. Kennedy: I can say fewer than five.
Senator Bovey: That’s what I feared. Putting the testimony of the three of you together, research dealing with the management of suicide crises, diagnostic needs, primary care and follow-up, would you say those are the key issues that need to be included in the next iteration of a Canadian suicide prevention framework?
Dr. Mann: I presented you with basic tools that we have available now. You can save Canadian lives by using tools that you have already. Those tools are imperfect. They can be improved. To improve those tools, there has to be an investment in the research that’s required to improve those tools.
So to follow one course without the other leaves you falling behind with what might be the future of suicide prevention. If you look at the testimony of the three of us, you will see that we’ve touched on elements of each of these two pathways, but I think all of us would agree that you should pursue both pathways at the same time, save Canadian lives with the tools you have now and develop better tools for the coming years.
The Chair: Thank you very much.
Senator Kutcher: Thank you to the witnesses for being with us and sharing your experience and wisdom with this committee. We can really benefit from it.
Our new Minister of Mental Health and Addictions said at this committee:
Suicide is too serious an issue to be funding ideas at the expense of evidence-based programs which actually save lives.
She has committed to an action plan based on the best available evidence.
Dr. Mann, you gave us pieces of really good advice about what should be in the framework that’s evidence-based. I would ask that Dr. Mann’s paper in The American Journal of Psychiatry, in 2021 be made available to the committee as well as Dr. Turecki’s.
The thing that the minister was talking about was twofold. Making sure that the evidence-based components that we have already are in the framework to help guide us, just as Dr. Mann said, but also making sure things that are in the framework that we don’t know are evidence-based shouldn’t be taking up a lot of the budget items and direction.
Dr. Mann, you talked in your work about things that do work or are helpful.
There are a couple of things I would like your opinion on as to how helpful they are and whether they have met the threshold for evidence of effectiveness. The three are general population-based gatekeeper training, specific programs to promote awareness of suicide and interventions that promote overall mental health, wellness and well-being. For each of those three areas, would you share with this committee your take on the robustness of evidence that each of those prevents suicide?
Dr. Mann: Thank you very much. Gatekeeper training has not been shown to work. If you screen populations for depression, that is as effective as any approach. In adults, there are no control trials of gatekeeper training. It cannot really be regarded as evidence-based.
In terms of youth, gatekeeper training has been shown not to be effective, actually. In studies in high schools, educating teachers, social workers, parents, et cetera, in mental health, in suicide and so on and so forth, has not been shown to be effective. Actually educating high school students has been shown to be effective. That’s not the same as gatekeeper training. In general, I would put gatekeeper training to one side as an available evidence-based tool.
Second, as I pointed out, education overlaps with gatekeeper training, but it appears that if you focus education on at least high school students, that does seem to have a beneficial effective in lowering suicidal behaviour and suicide attempts in high school students. That does seem to be a worthwhile approach. Talking about suicide and depression and explaining it to students does not place students at risk. Those students who are in need of help are more likely to get it, or seek it.
Finally, the least effective approach is wellness training for the general population. The idea that one can make all parents better parents, make all partners better partners, make people more resilient, that has never been shown to work. That is the most expensive and least targeted approach, and, in my opinion, it’s a waste of time and effort.
Senator Kutcher: Thank you very much for that.
The Chair: Thank you very much for that observation.
Senator Brazeau: Thank you, and good morning to you, doctors, for participating in this study. We are studying the Federal Framework for Suicide Prevention, but at the same time, it’s being suggested that we don’t talk about suicide prevention.
Before the framework entered, we had 0.07 per 100,000 deaths per year. After the imposition of the framework, numbers are essentially similar or the same. However, when we talk about Indigenous over-representation in terms of suicides, with males, we see that they have 2 times more chances, and females have 4.2 times more chances. Inuit males have 7 times more chances of committing suicide, and between the ages of 15 to 24, it’s 24 times.
If we still have this over-representation and we have this framework to work with in terms of a directive to deal with this issue, what can we include or what do you have to recommend so that going forward, we actually deal with the statistics where we have problems? If there is over-representation in terms of suicide within Indigenous populations, what can we include in that framework to deal specifically with those populations?
Dr. Mann: Your question is a very simple one. If you have an outbreak of a highly infectious disease in a locale, you send in experts to study what has gone wrong. Even those of us not in Canada know that there is a big problem in the Inuit and First Nations. They deserve to be treated the same way as everybody else. There is no room for extrapolation and speculation by looking at the urban population in Toronto and trying to figure out what’s going on. What should happen is that you should begin at the ground level, which is a psychological autopsy investigation. For the next 100 individuals or the next 50 individuals who died by suicide in those populations and areas, their families should be interviewed in great detail to get the facts. Why did they die? We have had experience doing this in a variety of settings, different countries and different populations. That’s how we figured out who is at risk and what the real factors are. Remove all of the speculation and mythology.
Dr. Turecki: The study that Dr. Mann is suggesting has been done. In a seven-year study done in Nunavut looking particularly at Inuit death by suicide, which as you pointed out, senator, is one of the most at-risk groups. The study concluded that many of the risk factors that we see in urban regions also apply to the Inuit reality, as well as a number of other factors that are specific to that community.
I understand that there are a lot of difficulties implementing and following on the recommendations of these studies — this particular study as well as other studies that have been conducted. To answer your question, the first thing is that the evidence that these studies generated needs to be taken into account in the development of action plans associated with the framework. To my knowledge, that has not been done.
Second, as I pointed out initially, there have to be specific measures as to what it is that the framework needs to achieve and in what particular time frame, which has not happened either with the framework. So it’s very difficult to answer your specific question because we don’t know what specifically from the framework has actually been put in place and what the results have been.
[Translation]
Senator Mégie: My question is for Dr. Mann. In your article, “Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review,” you spoke of the advantages of training primary care providers so that they can detect the signs and symptoms of depression and treat it.
Currently, primary care is not one of the main components of the federal framework. How do you think this type of training for primary care providers could fit into a new federal action plan?
[English]
Dr. Mann: Thank you. Sorry for wasting the committee’s time to have it repeated, but I understand the question now.
The answer is that this is one of the very best tools that we have, so it is clear from these kinds of medical education interventions that you have to have an ongoing education program with refresher courses; otherwise, after two years, everything that has been taught fades away. You can produce a very substantial decrease in the number of deaths due to suicide by doing this.
It would seem to me that what one should invest in is educational programming targeting the groups of physicians that I mentioned, starting with GPs, extending it to internists, OB/GYNs, and emergency room physicians. These are the obvious major physician targets, and that should lead to some measurable saving of lives.
There has to be a budget for this. When we had a big opioid crisis — we still have an opioid crisis in the United States — somehow money was found to send out a required online training course for every physician in the U.S. on how to manage pain and use opioids. Now, we need the same kind of attitude and investment of resources for suicide prevention but focusing it on depression recognition and treatment.
As Dr. Turecki points out, that will treat a lot of depressed people who are not going to die by suicide. Those depressed people will have better quality of life. They will go back to their jobs more quickly. They will come off unemployment rolls. There will be many benefits to society, which will repay that investment many times over.
[Translation]
Senator Mégie: I have a follow-up question. I understood your answer and I thank you. Do you think it would be necessary to offer guidelines, either online or in person, so that patients who have been treated in a hospital, who have left the hospital or who during their period of hospitalization only presented suicidal behaviour can receive follow-up care? Do you think that these guidelines could ensure follow-up care after the patient has been discharged from hospital? Do you think that would be useful?
[English]
Dr. Mann: Yes. I think one can create a standardized outreach and follow-up protocol that can be routinely used by all clinics and hospitals. There are countries, like in Denmark, for example, where they are scaling up this approach substantially in order to reduce suicidal behaviour. In fact, suicide attempts, looking at the literature, are approximately halved in these individuals in the year or so after discharge when you employ such strategies.
[Translation]
Dr. Turecki: I have something to add on the subject. It is extremely important to set up a follow-up program after people go to the ER or access emergency services. Often, there is no follow-up. People go to hospital and then there is no support. This is a well-documented problem in Quebec. You may have heard of the case of Amélie Champagne last week, which was the subject of much discussion in the media. I think that is precisely the type of service that needs to be offered.
[English]
Senator Moodie: I’m wondering about what sounds like a really sound plan of caring here beyond the acute event in a follow-up methodology. Who should be doing this? Are the countries that you are talking about that scale up these sorts of plans that carry on care through hospitals or clinics or whatever, are they also experiencing acute shortages in psychiatry services, trained psychiatrists? How are they getting around an absolute finite resource of psychiatrists that may be smaller than it needs to be?
That’s one of the problems that we have. I’m a physician. I see patients, primary care pediatrician. I see patients, and often if there is an acute episode, we have nowhere to go in that follow‑up round. Are we asking primary care trained-up individuals to carry on care? And how do we escalate up to the necessary appropriate care? What’s the plan around that follow-up that you would recommend?
Dr. Kennedy: If I could start. I think it’s a very good question.
In terms of screening, we know that it’s not cost-effective to screen an entire population. I think starting there, we need to identify the at-risk groups better, and just as we would do with cancer, for example, somebody with a Stage 4 cancer would be seen more frequently or would have an extra level of treatment.
I think we haven’t identified in our mental health services who needs intense treatment, where the specialists don’t do, sort of, almost primary interventions. They do tertiary interventions.
We do need more resources, but we also need to be doing more screening, as it were, within our own profession, I think.
Senator Moodie: Dr. Mann, could you comment? When you talk about these strategies around follow-up and scaling up, is that follow-up through a population?
Dr. Mann: There is no question that more resources have to be deployed, and it costs money.
There are studies from the U.K. and Denmark that demonstrate that when there is an investment in infrastructure in terms of more staffing, training more people, more clinic appointments, continuity of care, that this is proportional to the degree of improvement in terms of dropping suicide rates and suicide attempt rates. You get what you invest in, provided you invest in the best places, and what you are suggesting or implying, this follow-up approach automatically selects the highest-risk patients, because they are the ones who are presenting in their crisis. You are not giving this to every patient. You are focusing on what you can detect quickly as the highest-risk patient.
We do know that their greatest period of risk is in the first year after their crisis, and if they can survive that 12-month period, their risk of suicide drops very meaningfully. We need to get them through that crisis period of their lives.
Senator Moodie: A follow-up question to you, Dr. Turecki.
You made mention of the fact that there was little consultation around the building of this framework for key agencies like the Canadian Institutes of Health Research and so on. There is an action plan currently being developed. Have you and others, these agencies, been consulted?
Dr. Turecki: Thank you for the question, senator. I’m not sure of what action plan you are referring to. If that action plan is linked to the framework that’s the one I mentioned. Yes, it’s this national Canadian agenda on suicide research.
Senator Moodie: I’m talking about the one that Minister Bennett informed us of when she was a witness here. They are in the process of developing a suicide prevention action plan.
Dr. Turecki: That’s not a recent action plan.
The Chair: I’m afraid we have to stop it there. We have very little time left.
Senator Cordy: Thank you to the witnesses for your presentations. I would like to go back to Senator Brazeau’s question, because I wasn’t quite sure if I understood the answer or not. We have all heard about the over-representation of suicide within the Indigenous population and within Indigenous youth. You referenced a seven-year study that has been done in Nunavut. Aside from the northern regions, we also know that the suicide rate for Indigenous peoples within urban areas is also very high. You have all spoken about the investments of resources and investing in the best places. That is sort of what we would like to come to when we finish our study.
Do we not have enough information yet in order to plan a strategy and a path forward? The suicide rate within the Indigenous community is not something new. We have known this for a very long time. Yet, we seem to be doing more studies. Studies are great, but when we do we move forward with a framework specifically for Indigenous people, keeping in mind the things that you said about investing in the right places and not investing in places that are not going to make a difference.
Dr. Turecki: I think we do have significant information to develop a strategy for intervention in Indigenous communities, keeping in mind that not all Indigenous communities are the same. There is great variability. The risk factors that apply in Nunavut, let’s say, would not apply necessarily in a community in B.C. or somewhere else. We have sufficient knowledge to intervene and to develop strategies to support them. That said, suicide is a complex issue and by no means do we know all. The realities within the various communities are both different and complex. There are cultural and political factors that come into play as well that need to be taken into consideration. That said, I think we are ready and should be acting — yesterday, actually.
I want to thank you again for the invitation and apologize, but I have to leave. I have to give a talk at a conference in five minutes.
The Chair: Thank you for joining us.
Senator Cordy: Dr. Mann, you said we have to invest in the best places for investing. Do you know what the best places would be in terms of the Indigenous community, where the numbers are so high?
Dr. Mann: Did you address this question to somebody in particular?
Senator Cordy: Yes, Dr. Mann.
Dr. Kennedy: As the other Canadian, I can say I don’t know. However, it is worth picking up on the comment about whether research is almost in competition with clinical delivery of care because the evaluation of clinical care is part of the research. We have certain methodologies, including adaptive trials. When two or three treatments are being compared and we see along the way that one is not working as well as the others, we can adapt and avoid expensive, ongoing treatment with something that’s not as effective as one or two of the others. It’s important to think of the research as being embedded into the clinical programs.
The Chair: Thank you, Dr. Kennedy.
Senator Patterson: Thank you to our panellists. We have heard in this committee that access to lethal means is one of the four factors present in suicides and maybe preventing suicide. Dr. Mann, you talked about the prevalence of firearms in the U.S. and their presence in half the suicides. We have the same challenge in the Inuit communities where I live. The traditional hunting economy is very active, and there are firearms in every household.
One of our oldest rules in firearms control in Canada, in addition to the requirement for possession and acquisition licences, requires the safe storage of guns, including trigger locks, and the separate storage of ammunition, which is not widely enforced, I can tell you. Having regard to the challenges in the U.S. with firearms and suicide, do you have any comment on whether safer storage of firearms, namely, having them in locked cabinets with trigger locks and ammunition stored separately, could have an impact on reducing the high rates of suicide among the Inuit population with firearms in almost every household?
Dr. Mann: Based on a great deal of research done around the world, I would predict that the more gun safety measures that are in place, the less the risk of firearm deaths by suicide. That definitely works. You either have no guns or fewer guns. For anybody who has a gun because it’s required, gun storage becomes critical. That is, separate storage for the gun and separate storage for the ammunition. We have advocated for smart guns, which would only recognize the trigger of the owner. We find that screening people for impulsive purchase of weapons is probably okay, but most people kill themselves with a gun that’s been in the house for years.
What you describe is exactly what should be done, and it should be strictly enforced to create a culture of safety.
The Chair: I’m sorry, but we cannot go to a second round. In fact, I don’t have the time to ask my own question, but that’s okay.
Thank you very much to our witnesses for providing us with your insight and wisdom. This is really important for us, so I want to thank you once again for taking the time.
Colleagues, this brings us to the end of this panel. I will now ask our witnesses for our next panel to turn on their cameras.
The Chair: For our next panel, we have Yolande Bouka, Assistant Professor, Department of Political Studies, Queen’s University; Paulette Senior, President and Chief Executive Officer of the Canadian Women’s Foundation; and Jane Stinson, Research Associate from the Canadian Research Institute for the Advancement of Women.
I’d like to invite you each to provide opening remarks. You will have five minutes, followed by questions from the senators. Professor Bouka, we will start with you.
Yolande Bouka, Assistant Professor, Department of Political Studies, Queen’s University, as an individual: Good afternoon, and thank you very much for having me today. I am delighted to have been invited to this session, all protocols observed.
My name is Yolande Bouka, Assistant Professor, Department of Political Studies at Queen’s University. My research and teaching focus on gender, African politics, security, political violence and field research ethics in conflict-affected societies. Some of my current research at the moment focuses on women’s participation in non-state armed groups, and with two colleagues at Queen’s University, I’m conducting a comparative study on women, peace and security implementation across three regional organizations: NATO, the African Union and Asia. I’m one of the co-directors of the Research Network on Women, Peace and Security funded by DND. I’m also a member of the GBA Plus team of the Defence and Security Foresight Group, DSF, funded by the DND as well. This particular program is headed by Dr. Bessma Momani at the University of Waterloo, and the GBA Plus team is headed by Dr. Maya Eichler at Mount Vincent University.
I’m going to focus specifically on the work I’ve been doing with DSF under the DSF group umbrella. We work with scholars and policy-makers to help them apply the GBA Plus tool to their policy papers focused on risk assessment and conflict analysis. In collaboration with Dr. Nadège Compaoré at the University of Toronto, I focus on research in Africa, and we meet with scholars and policy analysts ahead of the drafting of their document, if possible; if not, after the completion of the initial draft of the manuscript, to see how to apply the GBA Plus Toolkit that we developed. This toolkit is available online, and I can share that with you.
We ensure that authors and analysts understand GBA Plus, gender and diversity approaches, the difference between sex and gender and the intersectionality analysis framework.
We then encourage them to respond to a series of questions that are focused on agenda setting, research, development and findings and recommendations. Some of the agenda-setting questions are regarding who takes the lead in deciding the priorities of the research and who develops and who is participating in shaping the research questions, what type of data is going to be used and what kinds of concepts are being used in the research.
Some of the research development questions are identifying biases in the frameworks that we are using: who collects the data that informs the research and who are the key actors that are going to be related or engaged within the analysis. Some of my reflection, after doing this for a few years, from a professional standpoint, I find it very interesting to see how GBA Plus is conceptualized and applied in a variety security settings. Some scholars and analysts have properly reflected on issues that would never be addressed otherwise.
However, it’s difficult to apply the tool after the fact. Often we meet with researchers and scholars after they’ve conducted their research and they’re trying to shape their policy responses ex post facto the research. Therefore, some of the questions that we address in our toolkit cannot be used or applied properly.
While some of the participants are willing to engage in the process, we still encounter quite a bit of resistance among academics and policy advisers alike.
The last point I want to make before I close my remarks is that the illustration often used to understand intersectionality is kind of this flower illustration where you have gender, sex. We are all familiar with this. One of the challenges with this, however, is that there are three components that are often omitted from that framework, and that is time, place and space. These analyses vary based on time, and often you want to have some kind of longitudinal study. They change based on the space in which the individuals, group or groups of individuals are located but also their places in societies, geographies and the international system, depending on who is doing the analysis. I can answer questions if you want me to elaborate on this.
There needs to be a better assessment on the GBA Plus theory of change in each of the contexts, which means that once we assess the initial situation for policy development, what is the theory of change within a specific context that will lead to the optimal outcome? There is sometimes the assumption that if you apply the toolkit, the ideal outcome will follow, without really discussing the theory of change.
The last thing is that GBA Plus analysis of stakeholders is required as well beyond the targeted group. Thank you very much.
The Chair: Thank you very much.
Paulette Senior, President and Chief Executive Officer, Canadian Women’s Foundation: Thank you, senator.
Similarly, protocols observed. I’ll just jump right in, as time is limited. I’m happy to join you today.
The federal government made a very welcome, broad commitment to GBA Plus across the whole of government, some years ago. We’ve seen it in federal budgets, but it needs full implementation across government. So far, we know it’s been applied somewhat unevenly across departments. As the Auditor General’s report of May 2022 pointed out, federal departments and agencies need more support to fully integrate GBA Plus into the design of policies, programs and initiatives. Monitoring and reporting on outcomes for diverse groups of women and gender‑diverse people also need improvement.
So what can GBA Plus tell us? Not only how an economic trend or policy decision will impact based on gender, but also how it intersects for populations experiencing the impacts of systemic discrimination based on race, indigeneity, ability, age, socio-economic status, sexuality, et cetera. We advocate for centring populations of women and gender-diverse people marginalized by multiple layers of discrimination at all government policies and programs. We know this can’t be achieved without an understanding of who those populations are, how they are differently impacted and what the underlying causes of their marginalization are.
You see we begin to unpack this when you apply GBA Plus to policy-making. For example, as pandemic lockdowns began in 2020, there were record job losses. Gender analysis showed massive job losses led by women in March, with a sharp increase in men’s unemployment in April — [Technical difficulties] — than women, as construction and non-essential manufacturing halted.
An intersectional GBA Plus analysis revealed that job losses were highly concentrated among the lowest earners in the highly racialized population of mainly women earning $16 an hour or less, where 50% of that group lost their jobs. The top 10% of earners making $48 or more per hour experienced 1% job loss, and women lost all of those 1% job losses. Women in the bottom 20% experienced job loss at 50 times the rate of top earners.
So where we see progress in the implementation of GBA Plus, the government made some promising changes in response to the 2015 report of the Auditor General on the implementation of GBA Plus, including it being mandatory in all federal budget proposals, Treasury Board submissions, memoranda to cabinet and made investments in disaggregated data and research.
Our colleagues working on gender issues globally report that Global Affairs Canada, which adopted a feminist foreign policy, has done an effective GBA Plus across departments. An example working with GAC is that free trade templates include GBA Plus language so it is there from the outset of the process. GAC also maintains an advisory of civil society gender equality organizations that are working globally.
At this stage, we know more work needs to be done. Public Safety Canada and Emergency Preparedness, we have seen systemic misogyny embedded in military and police forces in Canada, as seen in numerous sexual assault and misconduct cases coming to light in recent years, and in Louise Arbour’s report and recommendations on the military. At this point, it’s directly to the urgent need to embed GBA Plus in the work of Public Safety Canada.
There are some practical examples I’d be happy to share later if time permits.
What we also need is an action plan in the economy, so for women in the economy. The Canadian Woman’s Foundation welcomed the announcement of possibly opening the door to sustained economic planning, with GBA Plus and policy design integration of gender equality, employment equity and ending systemic discrimination into core economic policy.
While we’ve seen substantial movement on childcare major policy initiative in line with GBA Plus, we still see a missed opportunity there that we can align further. We encourage the government to create a long-term, whole-of-government action plan for women in the economy with a GBA Plus lens and supported intersectional gendered economic planning.
Finally, in terms of climate change, to date the federal plan to address climate change is lacking. We’ve heard that Women and Gender Equality Canada, or WAGE, has been tasked with developing this lens, and we look forward to seeing that and contributing however we can.
That said, the work towards GBA Plus needs to be integrated in every department so that the analysis occurs at the earliest stage of policy development and is integrated into the choices made from the outset. Climate action plans should have GBA Plus at the design stage. Those are my comments for now. Thank you.
The Chair: Thank you very much, Ms. Senior.
Jane Stinson, Research Associate, Canadian Research Institute for the Advancement of Women: Thank you, Madam Chair. I’d like to start by acknowledging that I live on the unceded territory of the Algonquin Anishinaabeg peoples. The work I do on intersectionality and GBA Plus is geared towards recognizing and addressing discrimination and marginalization of Indigenous peoples, as well as others.
CRIAW, the Canadian Research Institute for the Advancement of Women, really welcomes the opportunity to share our thinking with this committee about what should be done to advance gender-based analysis plus in the federal government. I personally have been working on a number of CRIAW’s recent GBA Plus projects in the federal government over the past four years or so.
CRIAW has a much longer history with gender-based analysis, going back to the 1990s as part of the group of feminists who were pushing it at the United Nations, which is what led to Canada adopting its commitments to implement gender-based analysis.
Over the past four years in particular, CRIAW has been working to apply a gender-based analysis plus in certain federal government departments and agencies. Unfortunately, federal progress in adopting gender-based analysis plus has been slow, and it’s unclear whether the GBA Plus actions are actually achieving better gender equality, diversity and inclusion outcomes. This was according to the most recent federal Auditor General report.
In September 2022, the Auditor General recommended to this committee that the key federal agencies driving GBA Plus — the Privy Council Office, the Treasury Board Secretariat and Women and Gender Equality Canada, or WAGE — should be collaborating more to ensure GBA Plus is producing the full integrated to produce the real results for Canadians. CRIAW supports that recommendation.
We further recommend that WAGE be mandated to develop a clearer plan for training on gender-based analysis plus across the federal government. Also that it be involved in conducting a more extensive audit and evaluation of GBA Plus in the federal government. Specifically, we think three areas need particular attention. They are training, the application of GBA Plus and the outcomes generated by applying gender-based analysis plus.
For example, we recommend the following questions be asked. On training, for example, how many federal departments and agencies have required all of their staff to take the online WAGE GBA Plus training course? And we need to recognize that is only an introduction to gender-based analysis. So the next question is even more important. How many departments and agencies have developed gender-based analysis plus customized to their work in their department or agency?
Related to that is the application. How many federal departments and agencies have applied GBA Plus to their work? It’s really important to get these examples, both to identify where it’s not occurring but also to identify where it is and to build on the positive case examples. CRIAW knows of a few that we’ve been involved in. For example, over the past four years, I think it is, we’ve been working on different projects with the federal Impact Assessment Agency to develop materials to help with the application of GBA Plus and intersectionality in the impact assessment processes, as it is required now by the legislation.
So right now we’re working with others to develop a methodology and tools for an intersectional approach to health impact assessments. As well, we worked on customized training to apply GBA Plus to the work of Health Canada’s Chemicals Management Plan. That project was a minister’s signature initiative project, which meant it had elevated importance in the department and made sure others knew it was being done. Those were important signals to be sending.
Third, questions need to be asked about outcomes. Departments and federal agencies should be asked to provide examples of how applying GBA Plus to their work has led to different outcomes. How has it substantively or structurally changed programs or practices? Because that’s what it should lead to.
CRIAW would really welcome an opportunity to work with WAGE to develop such a plan, to conduct the more extensive audit and evaluation. The work that the Auditor General does is extremely important, but I think this is the more proactive approach to identify what the areas of need are. What are successful examples to help then inform the development of a plan for training materials that focus on the application of GBA Plus, which needs to be somewhat customized.
CRIAW has relevant experience, as do the women whom you heard from earlier before me. We have an extensive network of gender-based analysis plus experts that we can draw on, and we would like to contribute to strengthening the application of GBA Plus in the federal government so we can achieve the outcomes that it promises. Thank you very much. I welcome your comments.
The Chair: Thank you very much.
Senator Bovey: Thank you. I’d like to thank our witnesses. I certainly share the goal to reach the goal of outcomes. I share your concern about intersectionality and on the lack of consistency of implementation across government.
My question is really simple. You’ve addressed it a little bit, Ms. Stinson, with the need for methodology and training so that we can increase the application. I’d like your comments on what needs to be done to break down that resistance that I think, Professor Bouka, mentioned, and what needs to be done to encourage GBA Plus work and the intersectionality?
My question is: What tools do we need that aren’t there now? How do we erase the resistance so that the application is no longer a problem? I ask that question to all the witnesses.
Ms. Stinson: Great question. I think requirements are extremely important.
Part of the reason this is happening around impact assessments is because there’s now a legislative requirement that intersectional analysis occur within impact assessments. Maybe it’s a combination of carrot-and-stick legislation being the requirement. I mean the stick in that sense; breaking down the resistance.
There will always be resistance, it seems. Whenever we do training, maybe a third of the participants aren’t really interested and resist, but it has to be done. There will always be resistance, but it just needs to be done. Making it a requirement is extremely important.
Ms. Bouka: One of the challenges is how early or how late the concept of GBA Plus is introduced to the general population, the same way equity, diversity and inclusion started to be introduced in high school or primary school discussions. I’m talking here long term as opposed to short term. How early people are familiar with the concept and normalize it. For some people, it’s not once you arrive in government that these types of issues and conversations are going to change the mind of those who already have deep-rooted opinions about whether or not these things are relevant.
The normalization of these types of conversations in public discourse would help implementation in policy and in government.
Ms. Senior: I can only assume that when we introduce policies, we would like to see them succeed. It makes no sense that we would introduce this as a framework that is legislated but the impact is not there. That’s one of the reasons why it needs to be taken seriously, despite the resistance.
The other point in terms of encouragement is the way that Canada is lauded. I happen to sit on the Gender Equality Advisory Council, or GEAC committee, in Germany. It’s one of the things that other countries are looking to, as an example as to how we actually make this happen in Canada. The fact that it’s something that is legislated and tied to the Treasury Board is really seen as a huge improvement, but now it’s about implementation.
Canada can be a leader in this, if we actually take it seriously and look towards how we can implement it much more effectively.
Senator Bovey: Thank you.
Senator Patterson: I’m thinking about the recommendations that this committee should make to the Government of Canada as a result of this study, and I’m trying to make notes about what I’m hearing.
Dr. Senior, I thought that after the statistics you gave us about turmoil in the workplace affecting minorities and women, you might recommend the creation of a long-term, whole-of-government strategy on women in the economy as a priority for us.
Dr. Bouka, you’re working with DND, and Dr. Senior talked about challenges in that department. What would your top recommendation be for our committee to put to the federal government in our report on this study?
I could start with Dr. Senior. Is it the long-term, whole-of-government, women-in-the-economy strategy?
Ms. Senior: Certainly. What’s needed at this point is investment to achieve full implementation at the design stage, which I mentioned earlier, across the whole of government and in producing the disaggregated data, which is the evidence required to support full implementation. That’s what I would say.
The economy is an aspect. Climate change is an aspect. Gender-based violence is an aspect. What we really need is a whole-of-government approach at this stage and the required investments.
Ms. Stinson: I’d certainly support those recommendations. I guess I’d return to the one I was emphasizing, which is greater collaboration on the part of WAGE with those others outside of government who work in this area and have expertise on gender-based analysis plus, in order to particularly focus on the training and the application.
I certainly agree with the points that have been made about the importance of doing things early. It has to be at the beginning of processes.
Ms. Bouka: I concur with my colleagues. From the inception, development and also expecting specific outcomes and evaluating them.
I would also add to this combo, the importance of remembering that success with policy is also dependent on the citizenry’s expectations of applications. Voters are also involved in the process of expecting or not caring about these particular issues.
There needs to be not only a whole-of-government approach, but also one in which citizens are empowered and encouraged to participate in these conversations at the local, provincial and federal levels in order to set an expectation.
Canadians have expectations about the environment, for instance. Do they also have an expectation about GBA Plus analysis and GBA Plus implementation in local governments, on school boards, in provincial government and federal government policies as well? There is integration that is also needed within the population.
Senator Patterson: Dr. Bouka, there’s a lot of attention focused on DND. I know you are perhaps beholden to them. You are working with and maybe for them. Are good things happening there? Are they making progress?
Ms. Bouka: There are good conversations and exchanges across academic policy-makers, DND and the Government of Canada overall, but like my colleagues would say, there is definitely a need for a change of culture in DND overall and that takes time. The conversations are happening, the extent to which all the stakeholders are committed to some of these changes remains to be seen.
I don’t want to speak on behalf of DND, but as an observer, what I can see is that at least from the work we are doing, there are conversations happening.
Senator Patterson: Thank you very much.
The Chair: Professor Bouka, if I may intervene with a question of my own.
You noted that the conversation around GBA Plus needs to be brought to the citizens, needs to be localized and actualized. Whilst I agree with you, I find it hard to have a conversation about GBA Plus with ordinary people. They say, “What is that?” It’s a concept that’s uniquely inside government and inside the machinery of government.
Would you like to see a recommendation around branding of the words “GBA Plus”?
Ms. Bouka: That’s a very interesting question. My first response would be another question: What is our priority, whether it’s the GBA Plus name or whether it’s the level of comfort of the population with regard to issues of gender and sexual equality in our country?
I teach gender and politics at Queen’s University, and most of my students are not familiar with GBA Plus, but they are being introduced to broader discussions about politics, gender and intersectionality in our courses.
The branding is not necessarily an issue, but the thematics and objectives need to become part of public conversation and discourse. With that, then will come the recognition of GBA Plus as a policy priority. But prior to that, we need to have a certain level of public policy or public relations discourse about issues of gender beyond this discussion of equality or descriptive equality. What does it really mean to be substantive? That requires public relations work with the federal government across jurisdictions and with the population.
The Chair: Thank you.
Senator Moodie: Thank you to our guests today. Ms. Stinson, I thank you for the clear road map you’ve provided for an evaluative framework. You’ve told us how to approach evaluation and you’ve given us the questions and measures. I think that will be very helpful.
I wanted to pose two questions to you. Can you go a step further in saying who you think needs to be ultimately responsible for ensuring that GBA Plus is conducted in our government and in our agencies? Should we be centralizing that responsibility to a specific department, for example, WAGE?
The second question I have is around reporting and other accountability. In your opinion, what products should be reported to Parliament or published for public consideration as part of the accountability of government agencies collecting, understanding and using data to form policy?
Ms. Stinson: Thank you for those questions. The first one, who should be responsible, we feel that WAGE plays an important role. My only hesitation there is to ensure they have the authority to ensure that things are being done.
I appreciate the other point that’s been made about whole-of-government approach. I think WAGE has expertise, should be developing even greater expertise, and should be in a position to do much of this, but it would need to have authority recognized in government as well. I certainly think that budget requirements and other requirements are important.
In terms of what should be reported and published, we have provided the beginnings of a list. Some of the other witnesses have suggested other things that might be included too.
Personally, I think it shouldn’t just be the Auditor General who is rapping knuckles about this. It should be more of an ongoing process and responsibility, maybe with annual publications about what are the strategic goals and where we are in achieving them in advancing gender-based analysis plus.
Senator Kutcher: Thank you so much to the witnesses. I very much appreciate your being here and sharing with us.
My question is slightly different from the discussions so far. We have touched on this with various other panels, but I don’t yet have a good feel for it, so hopefully you can help me out.
People have to learn how to conduct a proper gender-based analysis plus; right? Okay. So they have to be trained to do that, then; right? So I’m okay so far.
The question is this: How effective is the training? You have mentioned that you can measure — this doesn’t go into policy, but at the individual level, when training programs are provided to bureaucrats who are supposed to do this analysis, how effective are those training programs? Do those who take the training programs improve? How much? How many? What percentage?
Are they then able to conduct gender-based analysis plus? What’s the data on that? Do they have a threshold that they are supposed to reach, like in your classes at Queen’s, you have to pass, or is there no threshold of what’s acceptable?
In terms of any improvements that have been shown, do they decay over time? All our knowledge decays over time. Is there analysis of the impact of these training programs in terms of decay over time? Should there be refresher programs?
All these training programs that I hear about, are they all equal in these results? Is there a way we can say that these programs have met certain criteria and have these kinds of results, and these programs haven’t met those criteria, and what programs we should be using? That’s where I’m lost on this topic. Thank you.
Ms. Bouka: Thank you very much for the question. I can only answer the question within the context in which I operate. I’m hoping that Ms. Stinson and Dr. Senior will be able to provide information because they work more in that field.
In terms of the work I do with academic and policy analysts, we provide a toolkit and training, multiple iterations of conversations. However, we don’t have a baseline assessment. Our program doesn’t require any baseline assessment, meaning what do you already know and what do we hope the learning outcomes will be, which is what often happens in the classroom, for instance.
What we do assess is the quality of the policy report. The policy documents go to DND and other government stakeholders. We try to see an improvement in the quality of the responses to the toolkit and the questions. That’s within a very limited framework.
Generally, the baseline will be the initial paper. Then we go back to multiple iterations of conversations and hope they address the issues.
Within our context, there is no pass/fail. There is not necessarily a demand that they answer all the questions. The Defence and Security Foresight Group requires that every single publication to go through our process. It’s part of a checklist. If I’m not mistaken — and I would like my colleagues to weigh in — it’s often a checklist. The quality, intensity and sustainability of the implementation of these policies are usually not necessarily evaluated.
I’ll defer to my colleagues, who have more experience in working with government on these issues. Thank you.
Ms. Stinson: You have put the hammer on the nail in terms of a big gap and more things that could be added to the evaluation. I don’t think there is any system for evaluating the training that’s going on right now, certainly not across government. The WAGE online GBA Plus course is good, but it’s an introduction. When we have been contacted, it’s usually after staff have taken the course and are wondering, okay, what does this mean for our work? That’s why I emphasize the application. The training is often most effective, and sticks best, when people understand what this means in the context of their work.
One example that was quite successful is the Chemicals Management Plan at Health Canada, where we worked with staff to look at the work process. They each developed their own work flow and then we worked with them in terms of where in that work flow is it important to be asking questions related to GBA Plus.
As Professor Bouka has mentioned, it’s often about asking questions and being reflective or reflexive about the implications of policies for different equity-seeking groups.
I would emphasize the importance of ongoing training and conversations, as Professor Bouka mentioned, and the iterative nature of it. I have been working on this for a long time, and it takes a lot of thinking to figure out what this really means and how we apply it in a concrete way to this work. It’s not one training and it’s done. It’s an ongoing process of understanding and deepening that understanding.
Ms. Senior: My colleagues have covered the gamut of your question quite well. What I can add is that GBA Plus is not an easy concept to grasp, similar to intersectionality. Five or six years ago, in the sector in which Ms. Stinson and I work, just trying to get our peers on-board with the importance of this concept has involved ongoing education, advocacy and learning in order to get it right, and that still goes on.
It’s a new concept that needs to be concretized. That’s the effort we’re making right now. In terms of the outcome, the statistics are telling us that there is a better way to do this work. GBA Plus is an attempt to get at what that can look like so that everyone benefits and so that we can actually make a difference on the ground for those who are impacted, based on the statistics that we all shared earlier. This needs to be done. It’s ongoing work. We’re kind of at the beginning of it. But the pieces around accountability, training and education, like any new concept that’s introduced — such as gender equality was decades ago — needs to be understood and workshopped in order for it to take root. I think that’s where we are now.
The Chair: Thank you. My question is for Ms. Senior. The Canadian Women’s Foundation is not a government, but it’s a national institution. It gives millions of dollars in grants to organizations, movements and charities across Canada. I am pretty sure you apply robust GBA Plus analysis not just to your grant making, but also to understanding the impact of your work, which is obviously what this is all about.
Can you describe to us if there are any practices that you have experience with at CWF that you would like to recommend to the government?
Ms. Senior: Thank you for the question, senator. We are a national body that is funding organizations that focus on various aspects of gender equality work, from GBV to women’s economic development, to women’s leadership, to girls’ empowerment, to folks being able to live in a healthy society in a prosperous way and to be safe. What we know from the stats that inform our work, as well as the organizations from which we receive evaluations — and we make sure that we’re doing an evaluation of all our granting areas so that we can utilize that information for continuous improvement of our granting programs. What we know from the data is that those who experience multiple barriers — and that may be based on issues around disability, racism, socio-economic status, indigeneity, et cetera — they are the ones pushed to the margins in terms of being able to access services, economic prosperity and being able to live in safe environments. We then utilize the powers we have in terms of investment tools to be able to focus on organizations that are serving those populations in particular.
For example, years ago, we had an issue, with not being able to direct funds to Canada’s North or to remote communities. When we looked at our practices, we saw that we were the barrier in terms of what folks needed to do to apply. We had to create a different kind of strategy and approach through our Northern Strategy. We went to organizations to ask what it is that they needed in order to be able to access the funds to address the issues that are pertinent to you, to put in place the programs that are important for women in the North, for example. That’s what we have been able to do quite successfully over the past three to four years, to be able to direct those funds specifically to those communities.
We also make sure that within the breadth of organizations that we fund, that we’re funding organizations that are Indigenous-led, that are led by folks within racialized communities, that are focused on women with disabilities — the folks who are experts in their own communities, so that we can have the kind of impacts that we are seeking to have within those areas. Hopefully, that addresses your question, senator.
The Chair: It does. I think I hear you say it’s more than a checklist.
Ms. Senior: It’s beyond a checklist.
The Chair: It’s a circular, iterative approach.
Perhaps my next question can be answered by everyone who wants to provide some perspective. We have heard from witnesses previously that the “plus” in the GBA Plus is an afterthought. It is perceived and received as an afterthought, and that it inherently disadvantages an already multiply disadvantaged community. Some thoughts were put on the table that it is better to separate it out, to give it prominence, but there are also perspectives that say, no, splintering it out would actually be a step back. I would like all of you to give me your thoughts on that.
Ms. Stinson: It’s difficult to do it all; to do gender and all of the “plus” considerations, and that is what intersectionality speaks to. I think it’s important to keep it together and to struggle with how we do GBA Plus, or what I would prefer to call an intersectional analysis. How do we try to recognize the multiple systems of oppression, exploitation, discrimination, or whatever language you want to use that negatively affects groups of people? Your experience is not just, say, as a woman or as a person of colour, it is the combination of our experience. That’s not just our identities, but the systems that we find ourselves within. It’s hard, and I think we do need to continue to struggle with it.
Ms. Bouka: I don’t know how you do GBA without the “plus.” The analytical framework itself is rooted or has its foundation in an intersectional approach. When you are talking about gender, sexuality, immigration status, race and so forth, which women are we talking about? Which group within the gender spectrum are we talking about? Are we only speaking about women? Are we talking about men and masculinity and the obstacles that some of those conversations bring to implementing gender and equality? Or are we talking about gender nonconforming individuals? Do we want them to be part of the analysis?
Within those groups, as Ms. Stinson mentioned, there are various layers within the country and on the international global scene. It’s difficult for me to conceptualize it. The way I teach and apply in my policy work, from the moment you have — and maybe people don’t like this term — a feminist lens to understanding issues of security, stability and climate change, it requires you to use an intersectional approach if you want to have a broader reach to the people you are trying to impact. Otherwise, without the plus implied, it assumes you are speaking about a particular standard of gender analysis or a particular group. And who is the standard? In Canada, it could be, for example, a white anglophone woman of a particular class. That excludes a very large group of people.
I don’t know how you do GBA without the plus. I wasn’t part of the conversations of the labelling of this particular term, but I understand the importance of including intersectionality. Whether we drop the plus or not is a question we need to pose ourselves in terms of the extent that intersectionality should be part of the GBA to begin with. You cannot do GBA without the plus, particularly in a country like Canada if, in fact, we want to implement a type of feminist foreign policy or a foreign policy or domestic policy that has a broad definition of gender and inclusion involved.
It is a marketing question, but it is also a foundational understanding of what these lenses are about, their history and what their objectives are.
The Chair: That was a superb answer. Thank you very much. Unfortunately, I believe that the government of Canada lacks the focus on the plus, and we have seen that in various reports.
I will ask Ms. Senior for her perspective.
Ms. Senior: I don’t understand how we can continue to enact a policy and practice that has been based on exclusion. GBA without the “Plus” is about exclusion. If we want to be the inclusive society that we desire, then we mustn’t just add the “Plus”; we must name the “Plus.” We must identify what the “Plus” is about.
Like my fellow witnesses, I believe we have to spell that out. Who are the folks who are within this “Plus”? What fails us with GBA Plus, as it is now, is the limitation of the language. I’m on a path to find a language that will capture what it is that we’re trying to do, and then I want to be able to enact that in a way that makes it easier for folks to be able to apply that.
The best we can do and the best we have done is intersectionality. That’s the best we have done. When you consider what that means conceptually, it’s looking at people within their existence and the various intersections through which their lives are impacted.
If we consider it that way, then perhaps we’ll actually get at a better framework, eventually, of being able to capture that in the language that makes sense to everyone. Until then, what we have is GBA Plus and intersectionality.
The Chair: When you come to that language — hopefully in the next three or four weeks — you can send it to us.
[Translation]
Senator Mégie: I would like to thank the witnesses here with us today. My question concerns gender-based analysis plus, also called GBA Plus, and intersectionality. When you look at gathering desegregated data, how should that data be reported, published and used, especially when we know that the data is coming from the provinces? Do all the provinces have the same standards in terms of data gathering?
[English]
The Chair: Professor Bouka, why is it that I think that question is in your bailiwick?
Ms. Bouka: It is actually not in my sphere of expertise. If we look at public health, for instance, we know that during COVID, there were a lot of conversations about segregated race. In an article that my sister and I published recently, we talked about immigration status as one of the criteria that should be entered into the collection of data.
How do you then use that data? There has been a lot of debate in academic circles and academic links to policy about the risks associated with how the publication of this data is done and for what purpose. It can be a double-edged sword. But I will leave it to my colleague to give more insights.
Ms. Stinson: Data is important, for sure. The role of Statistics Canada is extremely important in collecting data. They have established a centre for gender, diversity and inclusion statistics that is trying to go back over old data and I think build in some GBA Plus indicators. Certainly, though, going forward they are doing so to make sure we’re gathering data that helps with an intersectional analysis.
Rather than relying on the provinces, I would much rather see a strong role for Statistics Canada in doing this to make sure that we have consistent data across the country.
They have started, and I think they probably need more help in doing so and in publishing their data. But I think they have started a little dashboard and they are trying to get things out there.
The Chair: Thank you very much.
Ms. Senior: I agree with what the previous speakers have said. We are one of the organizations that has been meeting with Statistics Canada, Imagine Canada and others in terms of what it is that they are measuring and what we need in the sector to be much more precise, particularly for those who are foundations, in terms of the investments that we are making in communities.
Desegregated data is extraordinary informative and helpful. Having Statistics Canada take this formal approach is an important direction that we’re going in now.
I was going to make another point. It has since left my brain, but maybe it will come back at some point.
The Chair: Yes, let us know if it occurs to you.
Colleagues, I think we are done with our examination with our very qualified and excellent witnesses. Witnesses, I want to thank you all for sharing your wisdom and perspectives with us, especially given that you were informed at relatively short notice. Thank you very much.
Honourable senators, our next meeting will be Wednesday, October 19 at 4 p.m., when we will continue our study on the Federal Framework for Suicide Prevention.
(The committee adjourned.)