Commissioner for Children and Youth in Canada Bill
Second Reading--Debate Continued
November 19, 2020
Honourable senators, today I wish to speak to Bill S-210, An Act to establish the Office of the Commissioner for Children and Youth in Canada. I thank our colleague Senator Moodie for bringing this important piece of legislation forward.
I am in support of a national commissioner, as it could be a positive step forward in improving the lives of young people in this country.
It is important that this office have a mandate that will allow it to effectively address the needs of all of Canada’s young people, and that its work be informed and evaluated by robust data that is properly analyzed with minimal interpretation bias. Its work must be built on science, meaningful data and critical reasoning. Without that, the office may become a house built on sand. It may look good, but when the rains fall and the floods come and the winds beat against its walls, it will fall down.
There are two things that I would like us to consider as this bill moves forward: first, data, and second, mandate.
Let’s begin with data. Canada has a long way to go until we have robust, valid and reliable national data that can be used to understand the complex components of health and well-being of all of our children and adolescents. For example, the Canadian Statistics Advisory Council report of October 2020 noted:
There is presently no standard or coordinated way to assess priority data requirements within the federal government. There needs to be a fundamental shift in how statistical data needs in Canada are assessed.
The office of commissioner for children and youth must be founded on and use best available, scientifically valid and meaningful data. The data needs to be nationally available, independently collected and analyzed on a regular basis. It must be able to tell us where and for whom the needs are greatest, and what has been achieved or not. It can then be used to guide policy and other interventions.
The office cannot rely on advocacy organizations to provide it with the data it will use for critical decision-making. This includes advocacy organizations both in and from outside Canada.
There is actually no use in collecting less than top-of-the-line data. Poor data is worse than no data at all.
Let me illustrate what I mean. I will focus on mental health data related to young people because this is an area that I have some knowledge of. Professor Scott Patten and I recently wrote a piece in Policy Options related to mental health data being collected in numerous surveys and polls in Canada during this pandemic. Overall, we found that this data is of poor quality, based on problematic study designs, uses inappropriate measures and demonstrates frequent bias in interpretation. This often results in sensationalized reporting in the media that distorts the realities of the existing situation. Sadly, this has even contributed to some of the psychological malaise and non-adherence to following public health guidelines that we are witnessing now.
Unfortunately, it has also taken away our attention from where the substantial needs are: young people who are the most in need, the most marginalized, those that are suffering the most. This is exactly the populations of young people that the office of the commissioner for children and youth must ensure it addresses.
This work requires robust and meaningful data. It is easy for enthusiasm for a cause to colour what “evidence” researchers gather and promote. We all know that it is quite possible to find so-called evidence to support what we want to believe to be true. Indeed, our brains are programmed to do so. The psychological mechanisms of brain shortcuts, confirmation bias and choice of focus based on social conformity are well known, and occur commonly in all forms of advocacy and debate. These are amplified when strong emotions are at play, and these psychological mechanisms — if we as policy-makers are not aware of them — may have a pernicious impact on our decision-making. A conscious effort to avoid these pitfalls is essential as this office is developed.
Honourable senators, that is part of what sober second thought is all about; using best-in-class data and trying to make sure we apply constructive and critical cognitive appraisal to the issues at hand.
Let me illustrate what I mean through a dive into some statistics that have recently been quoted in well-meaning advocacy for children. Don’t worry, this will not be a boring recantation of a college statistics class, I hope.
The UNICEF Worlds of Influence 2020 report is the source of this data. Although the report addresses many domains related to health and well-being, I will only focus on one, for illustrative purposes. I’m not extrapolating this analysis to all of the report and also have not relied on my own interpretations, but have enlisted the opinions of a number of Canadian experts: Doctors Patten (University of Calgary), Kurdyak (University of Toronto) and Black (University of British Columbia).
In the report there’s a measure called “mental well-being,” and on that measure Canada ranks 31 out of 38 nations. Taken at face value this is a highly concerning exposition. A closer look reveals a different reality. That measure is a composite, made up of two components: self-perceived life satisfaction and suicide rates per 100,000 (between ages 15 and 19), averaged over a period of three years.
Self-perception is highly vulnerable to multiple factors that call into question its validity as being meaningful; for example, unrealistic expectations. There is an entire field in the study of psychology called relative deprivation theory which shows that if we have unrealistic expectations or have been made unfulfilled promises, we will experience a host of negative feelings — such as unhappiness, dissatisfaction, disgruntlement and so on — which could be tagged as low life satisfaction. This, however, would not be the same as an objective, meaningful measure of what we are experiencing.
Yet, Canada does not gather that measure. You may wonder: How can Canada be ranked and compared if we don’t even use that measure; inadequate and potentially misleading as it is? The report noted that since one half of this composite measure was not applicable, it would not apply it in the calculations, but nonetheless it would compare Canada to countries that were rated on both components of the metrics.
Honourable senators, this simply is not a valid way to measure anything. We can’t accept the statistical sleight of hand as a basis to inform child and youth policy in Canada.
Let’s take a closer look at the second part of this composite; suicide rates. Here we have another substantive problem. Suicide rates from any specific location may reflect social problems, rates of mental illness and substance abuse, access to or quality of mental health care or a host of other factors, but they are not a valid measure of mental health or mental well-being. And comparing suicide rates in Italy, France or any other country to Canada is comparing apples and oranges, because of so many different factors that influence suicide rates at play in different populations.
Unfortunately, unreliable use of suicide data can have negative and unintended consequences.
Let me demonstrate with some data from Statistics Canada. In 2015, the number of young people ages 15 to 19 that died by suicide across all of Canada was 203. In 2016, it was 185. In 2017, it was 223.
Clearly, if you choose 2015 as your base rate, or 2016 as the base rate for intervention, you get a very different outcome. If we had implemented an intervention in 2015, we could have wrongly concluded that the intervention had worked, because the 2016 number was lower. Or if we had implemented that intervention in 2016, we could have wrongly concluded that because the number in 2017 was much higher, the intervention had made things much worse. Neither would be true.
This data also hides the fact that youth suicide rates are not distributed equally or randomly across Canada. Rates are much higher in First Nations and Inuit populations. Rates in males are much higher than in females because males use more lethal means of taking their lives, such as guns. It also misses the subtle but real and gradually rising rates of self-harm and suicide in younger teenage girls over the last decade.
Looking only at the general numbers in a narrow age group, we miss the fact that we need to invest in developing and implementing effective suicide prevention programs in those areas where the need is greatest.
I raise these issues regarding robust, meaningful and independent data that is properly interpreted and effectively communicated to illustrate what is needed for the office of the commissioner for children and youth to improve outcomes. We need solid data on all aspects of health and well-being of young people.
I thank Dr. John LeBlanc from Dalhousie University, who has sketched out the criteria for such data. It must be transparent, pertinent, representative, periodically collected, of high quality and well translated for policy-makers and the public. Some of that type of data, such as the Early Developmental Instrument, is already being collected by the Canadian Institute for Health Information, but it is not enough. This measurement is not collected everywhere in Canada, so it is difficult to use it to guide interventions and evaluate impact. There is much more to do, and it must be done.
Now I will briefly address terms of reference and mandate. The period from 2000 to 2011 saw the creation of over 25 child commissioner-type offices worldwide. It is now 2020 and Canada can learn from their experiences, from their mistakes, as well as from their successes. In most cases, these offices were designed in conformity with the Paris Principles of 1991, which noted that the key elements of the composition of a national institute are its independence and its pluralism.
As Canada moves ahead, it is essential that the office be truly independent, not only from all government entities but also from all other advocacy groups. And it must reflect the pluralistic reality of this country. It must be structured in such a way that ensures the diverse populations within Canada can effectively and appropriately participate in development, governance activities and evaluation.
There exists international criteria and certification standards that can be used to help guide the structure and mandate of such an office. For example, those set by the European Network of Ombudspersons for Children. Looking forward, perhaps the committee tasked with studying this bill could explore this in greater detail.
Furthermore, it is essential that this office be constructively, meaningfully and critically evaluated. Frankly, it’s of little or no value to create an office of a commissioner for children and youth if it cannot be determined what impact this office has had on improving the lives of children in this country. It must be able to demonstrate that it is the lives of those who have traditionally been left behind, those young people who live in poverty, who experience racism, who are from First Nations, Inuit and Métis origin, who are refugees, and all those whose ability to share in the overall bounty of this land has been and continues to be limited by structural and other inequalities have been most improved.
We must also be able to determine if the return on investment is appropriate or not. In order to do so, this office must undergo rigorous, robust and independent evaluation. If that is not built in from its inception, it is not likely that it will be added later on.
Honourable senators, as I wrap up, I would like to reiterate my support for the establishment of an office of a commissioner for children and youth in Canada that is independent and pluralistic; an office that has a clear mandate to ensure that the health and well-being of all of Canada’s children are improved; an office that uses best available, robust and meaningful data to determine need and impact; an office that is independently evaluated, not on its activity but on its outcomes; and an office that makes sure its primary focus is addressing the full range of requirements of young people who have the greatest need for life betterment. Thank you.