National Defence Committee on Nov. 21st, 2013

[Mike Allen, Conservative, Tobique—Mactaquac, NB]

Mr. Ferdinand, do you see that fitting well?

[Mark Ferdinand]

Very briefly, yes.

We have psychiatrists who work with us, and psychologists and social workers who work in CMHA's.... The goal is not to think about it from a provider perspective; the idea is to think about it from a person-centred perspective.

[Mike Allen, Conservative, Tobique—Mactaquac, NB]

Okay, I appreciate your saying that, because I think that is exactly where we need to be.

Thank you.

[The Chair, Conservative, Peter Kent]

Thank you.

Go ahead, Monsieur Larose.

[Jean-François Larose, NDP, Repentigny, QC]

Thank you, Mr. Chair.

Thank you to the witnesses for being here today.

Mr. Ferdinand, in your presentation, you mentioned the problem of underfunding. Could you give us some more details of the impact of the inadequate funding? If funding was not inadequate, which priorities would need to be addressed?

[Mark Ferdinand]

That is a very good question.

Our health system is definitely organized around urgent care. A good report published by Health Canada 40 years ago now said that we have to make a greater investment into prevention and health promotion. Some provinces have done that. At times, the federal government has done it as well. The Mental Health Strategy that the Canadian Forces have just published is a timely step in that direction.

In terms of family support, other witnesses have said that families help veterans to get back on their feet, but they do not have the same access to services as a soldier or a veteran. So we must make sure that families and close friends have access to some services. I do not have statistics on the way programs and services can be organized so that soldiers or veterans can get back on their feet with the help of their close friends and family. At the moment, this is a shortcoming that your study might identify. I could quantify it in due course, but, at the moment, we do not have the necessary statistics.

[Jean-François Larose, NDP, Repentigny, QC]

You may not have statistics on the impact of the lack of family support, but is it something you have heard?

[Mark Ferdinand]

In mental health, unfortunately, economic analysis arrived on the scene very late. In the last three decades, there has been some economic analysis in other areas of health, but our area is lagging behind, both in Canada and around the world. At the start of this year, the Mental Health Commission of Canada published a report on the effect greater investment might have in some areas of promotion, but that focuses on the workplace. The committee might find it interesting to look at that report from the commission.

As for soldiers and veterans, I do not know whether there are any studies that provide figures on the economic aspect and the personal impact.

[Jean-François Larose, NDP, Repentigny, QC]

As I understand it, the Canadian Forces strategy mentions family support, but there is no associated funding. Is that correct?

[Mark Ferdinand]

I do not know whether there is funding or not. I just know that the strategy talks about family support and the importance of family in a soldier's rehabilitation. It also says that appropriate services for family members have to be found in the community. That is all. At that point, the strategy should be identifying the encouraging relationships to promote and the lines of communication that need to be established between the Canadian Forces and the community. That is in the knowledge that community resources will not be able to support the families in the hoped-for way. At the moment, the words sound good, but we have to continue our work together so that we can find out if we can achieve our goals in this phase that, at the moment, unfortunately ends with nothing more than a fond hope.

[The Chair, Conservative, Peter Kent]

Thank you, Mr. Larose.

Mr. Williamson, go ahead, please.

[John Williamson, Conservative, New Brunswick Southwest, NB]

Thank you, Chair.

Thank you to all the witnesses for being here today.

I'm going to begin with Ms. Steggles. Could you perhaps elaborate? You were kind of cut off, because of the time, on a question that Mr. Ted Opitz asked you with respect to your recommendation. It was regarding the number of officials you would have at each of the facilities across the country, if you want to follow up.

I'm a new member of the committee. Have you talked about how many facilities there are across the country in that recommendation, and what would it mean, please?

[Elizabeth Steggles]

Yes, certainly.

As I am quite sure you know, there are rehabilitation facilities within National Defence across the country. We would like to see, ideally, two occupational therapists at each, so that we have physical and mental health expertise. It's not that they would do all the work. It's that they recognize the issues and can direct the occupational therapy treatment for those individuals. What they would also do is recognize if other occupational therapy services are needed, and some of those are currently contracted by civilian occupational therapists.

One of the things we would like to recommend, as I mentioned earlier, is that we realize that civilian occupational therapists don't necessarily recognize the culture of the needs of people who are in the military, so as an association we would like to help build capacity for those individuals. We already provide a number of educational resources on a number of topics. To give you an example, I've been in communication recently with the Canadian Pain Coalition. And we have a networking group of occupational therapists. Some of them work already with people who are in the military, although the OTs are not employed by the military.

What we would like to do is provide some webinar services, lunch and learn services, which we already do, that help focus more on the specific needs of people within the military. As I said, that's the kind of service we supply already, but we would like to focus in on the needs of people who are in the military who need our services, so that the occupational therapists are better able to provide those services.

[John Williamson, Conservative, New Brunswick Southwest, NB]

Would you envision these occupational therapists working directly with—if that's the right term—or interacting directly with soldiers who have been injured, hurt or—

[Elizabeth Steggles]

Absolutely.

[John Williamson, Conservative, New Brunswick Southwest, NB]

I wasn't sure if it was coordination or.... Okay, good.

I'm sorry, how many facilities are there across the country?

[Elizabeth Steggles]

It's six or eight. I'm sorry, I've forgotten.

[John Williamson, Conservative, New Brunswick Southwest, NB]

That's fine. Thank you very much.

My next question is for the Canadian Association for Disabled Skiing. I thought your presentation was interesting, and again Mr. Opitz talked about the importance and the uniqueness of the program, but I got the sense you're a bit at your wits' end or frustrated by the inability to kind of punch through and have your program perhaps a little better known by soldiers themselves.

What could be done to improve that, versus your advertising in a newspaper to get to soldiers to offer them your program?

[Clay Dawdy]

In dealing with the Soldier On organization for the first two years, what happened is they just indicated to us that they had a human resource problem in handling everything they do. Consequently, we were kind of left on our own out here.

First of all, we need somehow to take a look at that organization within the military and see how it can disseminate our information packages. For example, at the army run this year we thought it would be an excellent opportunity to advertise for new applications for soldiers and veterans. We weren't able to secure a display space after about three or four months. That could be due to our own incompetence, but I would think that at the same time it is due in part to the bureaucracy that we were trying to get through there to get a display space at that run.

Consequently, it would be of great assistance to somehow allow us to have the Soldier On organization distribute that information for us, with the applications coming directly to us.

The other key here was the ability for the military to recognize our winter sports clinics as an approved event. That enables the soldiers to get leave to attend our event and get paid, to be considered on duty.

[The Chair, Conservative, Peter Kent]

Mr. Brahmi, the floor is yours.

[Tarik Brahmi, NDP, Saint-Jean, QC]

Thank you, Mr. Chair.

My question goes to the Canadian Association of Occupational Therapists.

You said that, in Canada at the moment, only two occupational therapists are working directly with the Canadian Forces and that, of those two, only one, the one in Valcartier, is a permanent employee. At least, that is what I understood.

Do you have an idea of the number of soldiers or veterans who might benefit from occupational therapy services?

[Elizabeth Steggles]

No, I'm sorry; I don't have that statistic at hand.

[Tarik Brahmi, NDP, Saint-Jean, QC]

You recommended that it would be a good idea for the Canadian Forces to have six permanent, full-time occupational therapists across the country.

Could you give me an idea of the number of people that might cover? Would it be hundreds or thousands? Do you know the figure?

[Elizabeth Steggles]

I'd like to clarify. We would like six to look at mental health and six for physical health.

[Tarik Brahmi, NDP, Saint-Jean, QC]

So we are talking about 12 occupational therapists for the Canadian Forces as a whole.