National Defence Committee on Feb. 14th, 2008

[Cdr R.P. Briggs]

Very good.

[Dawn Black, NDP, New Westminster—Coquitlam, BC]

I just wanted to get that in.

Apart from things that we in the general community would understand, like seasickness--which I did get, by the way--

[Cdr R.P. Briggs]

You're not the only one, ma'am.

[Dawn Black, NDP, New Westminster—Coquitlam, BC]

--there's also isolation at sea when people are on deployment. What special psychological challenges does your command have to deal with because of long deployments at sea? I know people are in the gulf now.

[Cdr R.P. Briggs]

The navy has a history of being away from home a lot without it actually being called a deployment. In the old days of the 1960s, 1970s, and 1980s, it was common to be away from home for six to eight months of the year, and that was just business as usual. Typically you'd come ashore, and then you'd be on a career course, usually in Halifax, away from your home port. So it was a very tough life for families in the navy.

There have been more and more so-called operational deployments with the navy. In Operation Apollo, from 2001 to 2003, folks were literally going on deployment a year after they had come back. They had a very heavy load, because of course the navy is much smaller than either the air force or the army, at just less than 10,000 sailors. It was a heavy load on those folks, especially when they started getting ill or burned out. People who were supposed to be in shore billets suddenly did a pier-head jump back to sea.

From a health services perspective, right now our greatest challenge is that our physician assistants are being hired in droves by the civilian world, primarily Manitoba, Alberta, and Ontario.

[Dawn Black, NDP, New Westminster—Coquitlam, BC]

I understand that's pretty much true of a lot of trades.

[Cdr R.P. Briggs]

Absolutely. We've made inroads, as Colonel Darch mentioned, on the general duty medical officers. We're critically low on pharmacists and PAs. We're low on medical technicians and a variety of other specialized trades like lab technicians, x-ray technicians, and biomedical engineering technicians.

[Dawn Black, NDP, New Westminster—Coquitlam, BC]

Is there anything specific to the navy, in terms of psychological stresses, that is different from the other two forces?

[Cdr R.P. Briggs]

When we talk about psychological stresses, I would say the trigger is obviously different. It could be a flipped-over rigid hull inflatable boat that you happen to be in, or a line that breaks and hits your friend next to you during replenishment at sea, or some other type of trauma, such as body recovery for clearance divers. So I would say the incident that triggers the operational stress injury may be different, but the symptoms are otherwise undifferentiated.

We have folks on army deployments, our explosive ordnance disposal experts, and of course our so-called purple trades—our medical folks, our cooks, and our other support trades, who deploy with the army and then come back into the navy formations, and then dwell with us.

So it's really a hodgepodge of issues. We're talking about the same issues, but obviously we don't have the numbers the army does.

[The Chair, Conservative, Rick Casson]

Thank you.

Mr. Hawn.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you, Mr. Chair.

With respect to avoidance of medical care and so on, I can tell you that as pilots we generally tended to avoid flight surgeons too, but I think Captain Courchesne knows that.

I want to talk about the study that was brought up. It was actually called the Douglas study. It was just released, but it was actually done in 2002. Of the 81,000 regular and reserve force members at the time, 8,000 were surveyed. Of that number, 1,220 had symptoms of one or more mental disorders, and of that number, four out of six had not sought help. So the real number is about 800 out of 8,000 who were surveyed. For a lot of those folks, obviously it's not Afghanistan-related; it's probably related more to experiences in Bosnia and Somalia, and in other branches.

With all the things that have gone on to ramp up the availability of services and education, to remove the stigma, to bring knowledge and awareness, and all those things that we know the CF has worked very hard on, Captain Courchesne, in what direction do you think that reluctance to seek assistance is going? Are people becoming more reluctant or less reluctant?

[Capt(N) M.E.C. Courchesne]

I'm speaking outside of my realm here, because I don't advise the Surgeon General on mental health issues, but through collaboration with our colleagues and all the initiatives that we have put into increasing access to mental health, I would hope that we are breaking the stigmas. We're making it more available. We're pushing it out front. As my colleague, Colonel Darch, has indicated, we have mental health professionals deployed with the troops so that they have ready access. We're doing this to improve access for CF members.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Maybe I'll ask Colonel Darch a similar question, because obviously the army is probably the most beset at the moment with this situation.

One of the things the report said is that this is probably applicable to all militaries for all the obvious reasons. Have we done any work with particularly the U.S. military or the Brits with respect to the same issues and the experience they're seeing?

[Col A.G. Darch]

We do collaborate with them quite a bit. I don't know what specifically mental health may have done with them.

You asked Captain Courchesne about the stigma and what we are doing about that, sir. Some of the things we have found to be very helpful in terms of reducing the stigma are to educate people when they come back from deployment, and educate the non-commissioned officers and the officers taking career courses regarding operational stress injuries and mental health in general. Those have been very helpful.

We have found that the education they've had with both the third-location decompression and with the post-deployment screening has really done a lot to break down those barriers, because people have talked to mental health care professionals, and they find it much easier then to come back to talk to them if they need to.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Okay. I just want to talk about the medication aspect again. When people hear the words “soldiers on medication”, that conjures up all kinds of things that are not reality. Is it safe to say that any time any soldier, sailor, airman or airwoman is under medication, it's done under very close supervision, and, as Commander Briggs said, any potential impact on their operational effectiveness or safety would render them unemployable for that period?

[Col A.G. Darch]

Yes, sir, absolutely. We would never deploy somebody who we knew was suffering from an untreated psychiatric or physical disability.

However, we do deploy people who have successfully been treated for those things, and I know that if a person is given medication in theatre, it's under very carefully controlled conditions and they are watched very carefully. We do have a mental health team in theatre, and if there is any concern that the person was not fit for that type of work, they would be removed from it.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Concerning resources, obviously all three branches have mental and medical professionals. Do you have the ability within the three branches to do some shifting of resources to the army if the need is greater there, and so on? What capability do you have to shift the personnel resources back and forth? Commander Briggs, I'll ask you.

[Cdr R.P. Briggs]

Sir, since we've had the centralization of the Canadian Forces health services into one group, in effect, it's really allowed us to use all our assets; whether they're headquarters assets, training establishment assets, or army, navy, or air force assets really doesn't matter.

In any given deployment--and currently I think we have 160 folks in Afghanistan or in that area of operation--people are taken from any of the 30 clinics all over Canada. In fact that's what happens.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Okay, good.

With respect to the whole ball of wax of health care and mental health care particularly, obviously with the tempo of operations we've had in the last few years and in Afghanistan in particular, is it safe to say this is going to be a continuously evolving aspect of the service that part of the military provides? Are we always going to be a little bit behind whatever is happening?

[Col A.G. Darch]

The nature is that we're a learning organization, and one of the things that's very important to the whole process is what we call “lessons learned”. After an event or an operation, we assess and analyze the operation to look for things that we could do to improve the service we provide. We put that into effect for the next operation or event.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

With respect to those lessons learned, I know that on the combat side, lessons learned in the field get back to Wainwright within a matter of 24 to 48 hours and are implemented as the training is going on.

How quickly do the lessons learned--medical and psychiatric--get back into the system?

[Col A.G. Darch]

That's a good question, sir. I'm afraid I don't know specifically how long it would be.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

I know there's probably not a specific answer, but what's the process?

[Cdr R.P. Briggs]

There's a lessons learned process that we've developed through our operations folks, so I would say that on the operational piece, sir, we do much better than other aspects. Nobody does it better than the army, I'll be quite honest with you. They've had this process in effect for a long time.

We, the CFHS, send things up through the army as well as through our own operations cell, and it's certainly a priority of our group to develop a robust lessons learned capability beyond just operations. I would say, for example, when you talk about the TO and E, the table of organization and equipment, which is basically who goes on the deployment from a medical perspective, we're constantly tweaking that, whether it's critical care nurses, social workers, physiotherapists, or bioscience officers for force protection. That goes on and on. I would say it's pretty quick. We're pretty quick to make changes.

As well, I know Colonel Bernier, our director of health services operations, is in contact with the task force surgeon overseas on a daily basis.

[The Chair, Conservative, Rick Casson]

Thank you very much. You'll have to catch him next time.

That ends the first round. We'll go to a five-minute round. We'll start with the official opposition and Mr. Cannis. Then we'll go back to the government and then to the Bloc.

Go ahead, Mr. Cannis.