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91ƵDeeper conversation91Ƶ needed on assisted dying, mental health: Holland

91ƵPaths out of darkness91Ƶ need to be fully tapped before assisted dying an option for mentally ill
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Minister of Health Mark Holland listens to a question from a reporter during a news conference, Tuesday, Dec. 12, 2023, in Ottawa. THE CANADIAN PRESS/Adrian Wyld

Thirteen years ago, in the throes of a major political loss and personal crisis, Mark Holland experienced the darkest period of his life.

Since his return to federal politics, he91Ƶs been candid about his suicide attempt, and the mental-health struggle that took him 91Ƶto the doorstep of my own oblivion.91Ƶ

Now, as the federal health minister, he is asking Parliament to slow down on his government91Ƶs plan to expand access to medically assisted death for people whose sole underlying condition is mental illness.

Holland asserts that the ordeal he survived is different from the suffering of people who he said would qualify under the program.

More time is needed to get medical systems and the public ready to tell the difference, he told The Canadian Press.

91ƵI want to make sure, with every inch of me, that everybody is afforded the same path out of darkness that I was able to find,91Ƶ Holland said in an interview about his own mental-health experience.

91ƵWhere we91Ƶre having really difficult conversations is: What do we do when there are circumstances that we can91Ƶt figure out? Where people are in nightmarish pain?91Ƶ

Under existing legislation, people in mental anguish will qualify for medical assistance in dying starting in mid-March.

Last week, Holland tabled legislation to delay expanding the eligibility for three years.

Provinces told him they either weren91Ƶt ready or weren91Ƶt willing to move forward, he said, and putting it off is meant to allow for more time to prepare.

The pause would also give Canadians more bandwidth to confront their discomfort with the policy, he said.

91ƵBecause it91Ƶs uncomfortable, it91Ƶs easy to pretend there are simple solutions and to not dig into it,91Ƶ Holland said. 91ƵI think part of the idea of this pause is to allow an opportunity for a deeper conversation.91Ƶ

Holland was a career politician until he lost his seat in the 2011 federal election. After that loss, he said he fell into despair.

91ƵThere91Ƶs a feeling of complete hopelessness and isolation and abandonment and feeling that 91Ƶ there isn91Ƶt any way out of the pain that you91Ƶre in,91Ƶ he said.

What separates his experience from that of those with mental illness who could eventually have access to assisted death is that he sought help and it worked, he said.

91ƵWhen you91Ƶre in that circumstance and you go and you seek help, the vast, vast majority of people will, with clinical support, support and love of friends and family, are going to be able to get lifted out of that circumstance and see that it was a moment in time,91Ƶ he said.

Many people who suffer from poor mental health struggle to get help, the minister acknowledged.

But medical assistance in death is intended for people who have 91Ƶtried everything91Ƶ and are 91Ƶunable to escape their mental hell,91Ƶ he said.

91ƵThat91Ƶs a big difference.91Ƶ

Public sentiment on the policy is difficult to gauge.

A September Angus Reid poll commissioned by Cardus found that while there was broad support across Canada for existing assisted death policies, half of respondents surveyed were opposed to expanding eligibility to people who only suffer from mental illness.

Meanwhile, an Ipsos poll conducted on behalf of Dying With Dignity Canada last summer suggested 80 per cent of those surveyed thought an adult should be able to get assessed and, if eligible, receive assisted dying for severe, treatment-resistant mental disorders if they are experiencing intolerable suffering.

While some people conflate suicidal thoughts and long-term, indomitable suffering out of good-faith concern, Holland said he believes fears are sometimes expressed to 91Ƶplay games and politics.91Ƶ

If Parliament grants the extension, it will mainly be up to provinces to get staff ready to separate people in crisis from the very few who should qualify, he said.

91ƵMy job, when I91Ƶm talking to my provincial and territorial counterparts every day, is to make sure that they91Ƶre working toward that, and asking them how we can support them in it,91Ƶ he said.

The pause would put the expansion off until well after the next election. The Liberals91Ƶ Conservative opponents have said they would scrap the expansion if elected.

The scale of the mental-health problems in Canada is enormous, Holland said, and the government is moving to improve access as part of a series of bilateral deals with provinces and territories.

91ƵI didn91Ƶt understand that what I was going through was so common to other people91Ƶs experience, that so many of us hit that moment where we don91Ƶt think we can handle (it) anymore, and we feel like we91Ƶre alone,91Ƶ he said.

But that isn91Ƶt an argument against assisted death, he said.

91ƵThe challenges that we have in mental health and how we91Ƶre going to address that as a society are separate and apart and totally different from the conversations about the extremely limited circumstances where you have an intractable mental illness.91Ƶ

If you or someone you know is thinking about suicide, support is available 24/7 by calling or texting 988, the national suicide prevention helpline.

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