Thank you.

Good evening. My name is Dr. Margaret McKinnon. I'm a licensed clinical psychologist who serves as a full professor and associate chair of research in the department of psychiatry and behavioural neurosciences at McMaster University. I have secured funding for my work in the field of post-traumatic stress from the Public Health Agency of Canada, National Defence, Veterans Affairs Canada and the Canadian Institutes of Health Research. I'm invited nationally and internationally to serve as an expert surrounding post-traumatic stress injuries.

However, I am not only an expert in the field of mental health and well-being. I am also a person with lived experience and a long-term history of depression, post-traumatic stress disorder and suicidality. As such, I am here this evening as a person with lived experience, and would ask the committee to be respectful of that status in their questioning. This is very difficult testimony to give.

Finally, I am testifying tonight as an individual. I do not represent any organizations in the remarks I will provide.

I would like to emphasize here that while individual experiences are not generalizable, they are in fact illustrative and point to the potential consequences of a decision to adopt MAID for mental health. I have tremendous sympathy for individuals wishing to access MAID and great empathy for those who are suffering. I'm here tonight, however, to represent Canadians who may feel much less safe and who feel at risk with the possibility of this legislation being enacted. This is a perspective that is rarely considered.

My own history with depressive symptoms and a subsequent diagnosis of major depressive disorder now spans nearly 40 years, since I was 12 years of age. I have received continuous treatment for depression since I was 24 years of age, including gold standard therapeutic approaches. In 2001, during my honeymoon, I was aboard an Air Transat plane that ran out of fuel midway over the Atlantic, during which we were prepared for the ditching of the aircraft into the ocean over a 25-minute period. Having survived this incident, I also developed PTSD.

I am very fortunate to be part of the system, and over the years have received access to both standard and leading-edge mental health treatments. Despite this access and the ongoing support of family and very close friends, I suffered a years-long period where I wished to die, had a fully fledged suicide plan and access to means, and lived with a hopelessness that meant I saw my life as not worth living. Critically, I would have been an ideal candidate for MAID for mental health at the time, with a long-term history of mental health difficulties that I saw as both irremediable and associated with grievous suffering, despite continuous treatment.

In fact, if the proposed legislation allowing MAID for mental health conditions had existed at the time, I believe I would not be here to testify tonight. Instead, I believe I would have availed myself of this option at a time when I was also a much-loved family member and friend and functioning at the level of an accomplished faculty member and clinician at a major Canadian university and hospital. I would have chosen this option to die and would not be here. Instead, I am now in a period of primarily sustained recovery, despite my previous persistent wish to die.

In the intervening years, I have experienced periods of both relapse and recovery, with treatment ongoing. A year ago, I found many of these thoughts of suicide and the desire to die returning. Despite being a mental health professional, it was shocking to me how quickly these thoughts returned, how strongly I believed I wanted to access MAID and how irrevocable these feelings felt. While I recognize that I may have needed to wait for MAID access under these conditions, the future I envisioned for myself at that time was one that clearly included MAID.

In sharing this experience, I hope I'm illustrating to the committee the lack of safety that some Canadians feel in light of this legislation. To me, this feels like an option that, should I become ill for a long enough period of time or my life circumstances change substantially enough, I believe I may attempt to access, despite clearly recognizing when well that there is hope for recovery, as I'm experiencing now.

I am very fortunate to be a person with good access to mental health care, financial means and extensive social support, yet I feel at great risk in this situation. Moreover, as has been illustrated repeatedly in this committee’s deliberations, it is a fallacy to believe that all Canadians have equal access to treatment for mental health conditions. In the case of PTSD and depression, national and international guidelines recommend what are essentially first-, second- and third-line treatments. As incidents like Tumbler Ridge and its aftermath illustrate, access to first-line mental health care for rural community members, for example, is less available than in other regions of the country, let alone for second- and third-line treatments.

I therefore appeal to the committee on two fronts. The first is to consider Canadians who, like me, will feel at risk and unsafe should this legislation be enacted. The second is to acknowledge that not all Canadians will have equal access to all recommended gold standard treatments prior to undergoing MAID in a country marked by economic, geographic and cultural inequities that continue to persist despite marked efforts to address such wrongs.

Thank you.

Meeting #5