Evidence of meeting #5 for National Defence in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was therapists.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Clay Dawdy  Director, Calabogie Adaptive Snowsports, National Capital Division, Canadian Association for Disabled Skiing
Mark Ferdinand  National Director, Public Policy, Canadian Mental Health Association
Elizabeth Steggles  Professional Affairs Executive, Canadian Association of Occupational Therapists
Bob Gilmour  Operations Director, Calabogie Adaptive Snowsports, National Capital Division, Canadian Association for Disabled Skiing

9:50 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

What I would ideally like to see is that we have one occupational therapist representing physical health and one in mental health to teach at the rehabilitation facilities across the country.

9:50 a.m.

Conservative

Ted Opitz Conservative Etobicoke Centre, ON

I don't mean to cut you off, but I think I'm down to 45 seconds here.

You guys are talking my language when you're talking about skiing. I wish I could spend half the year doing it, if I could, but that's clearly not going to be possible.

What you're doing for the soldiers—I'm just going to comment—is excellent. It's great physical therapy. I like what you had to say about the couples skiing together because it is a very family, collaborative sort of thing, where the entire family can go to Calabogie, where you have your pool and gym and everything else. A soldier wants to stay fit, and it takes more than skiing to develop the muscles to be able to do that. The program that you have going right now is a very good one and something that's very productive and showing positive results.

Thank you.

9:50 a.m.

Conservative

The Chair Conservative Peter Kent

Thank you very much, Mr. Opitz.

And now, Ms. Michaud.

Ms. Michaud, the floor is yours.

9:50 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

Thank you all for your presentations. They were really enlightening.

My first question is for Ms. Steggles.

I represent the constituency of Portneuf—Jacques-Cartier, in which the Valcartier military base is located. Could you tell me a little more about the role of the occupational therapist at Valcartier, what she does and how she works with soldiers and veterans?

9:50 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

Yes, certainly. I've only met her briefly, but I know she started off working with people with mental health issues and then was actually transferred to working with people with physical conditions, which is quite a shift and I think highlights the need for expertise in both areas, and thankfully we are trained in both areas. My understanding is that the majority of her work now is on return to work, driver rehabilitation, vehicle modifications, and home modifications.

9:50 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

When you say return to work, do you mean moving to life as a civilian or returning to work in the Canadian Forces?

9:50 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

Both. It depends on what's most applicable. If possible, it's to return people to their former employment or former role, and if that's not possible, then perhaps an adapted role that's still within the military. If that's not possible, then it would be for a return to employment within civilian life. It's a process that looks at individual skills and abilities and what's going to be the most appropriate and what can be accommodated if necessary.

9:50 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

Thank you.

Could you briefly comment on your organization's position on the new policy in the Department of National Defence and the Canadian Forces, whereby military personnel who are ill or injured are retained in the forces for a maximum of three years following an injury?

9:50 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

We don't have a specific position, but off the top of my head, I would say that if we had occupational therapists working closely with those people, it would be much more likely that they would be able to meet that qualification and stay in the role for a period of three years.

9:50 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

Thank you very much.

My next question goes to Mr. Ferdinand.

What are the main challenges you face when you have to deal with ill or injured soldiers?

9:50 a.m.

National Director, Public Policy, Canadian Mental Health Association

Mark Ferdinand

We have no statistics for soldiers, but I can say that they are able to access our services in the community. When people identify themselves as soldiers, reservists or veterans, we can help them find the appropriate social or mental health services. We have no statistics on that per se. So I cannot answer your question about particular challenges.

9:55 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

In previous meetings of this committee, witnesses have told us about cases where military members with mental health issues have been improperly diagnosed by Canadian Forces health care providers. Can you talk to us a little about the difficulties in diagnosing mental illness, particularly with respect to post-traumatic stress disorder?

9:55 a.m.

National Director, Public Policy, Canadian Mental Health Association

Mark Ferdinand

First of all, I must tell you that I am not a health care professional. My association is not aware of problems with diagnosis, and neither am I. That said, diagnosing some mental illnesses is still not an exact science. My suggestion to you is to put that question to psychiatrists, social workers, psychologists and doctors in order to get a specific answer.

9:55 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

Thank you very much.

Do I have any time left, Mr. Chair?

9:55 a.m.

Conservative

The Chair Conservative Peter Kent

You have 30 seconds.

9:55 a.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

Mr. Dawdy, do you receive support from health care professionals such as psychologists and psychiatrists when soldiers who come to your clinics share their experiences on the stress they are going through or their injuries?

9:55 a.m.

Director, Calabogie Adaptive Snowsports, National Capital Division, Canadian Association for Disabled Skiing

Clay Dawdy

We have included therapists upon occasion at our winter sports clinics, but we do not have a fixed defined role at this time. It's kind of on an ad hoc basis.

9:55 a.m.

Conservative

The Chair Conservative Peter Kent

Thank you, Mr. Dawdy

Merci, Madame Michaud.

Mr. Allen, please.

November 21st, 2013 / 9:55 a.m.

Conservative

Mike Allen Conservative Tobique—Mactaquac, NB

Thank you very much, Mr. Chair, and through you to the witnesses, I appreciate the testimony you've given here today.

As a new member to the committee, it brings a couple things to my mind. Number one is the multidimensional challenge of providing the support to our veterans and injured soldiers when they come back, but also the challenge of making sure we have minimal overlap and at the same time we don't have any gaps in the services. That's the thing I see as a challenge.

Ms. Steggles, I'd like to start with you. You talked a little bit in your answers to Mr. Harris about Valcartier, and you pointed to a situation where she was able to achieve a double return-to-work rate. What specifically was that attributed to?

I ask that question because when you look at our joint personnel support units and those types of things, the idea is to bring together all the people, the social workers, the occupational therapists, and the whole thing.

What can you attribute that return-to-work rate to specifically? And how does that differ and vary from other locations? I assume in each case these people have case managers. Is that processed differently?

9:55 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

I think the difference between Valcartier and other areas is that there's an occupational therapist doing return to work and there isn't at any of the other facilities.

In answer to your question about what the occupational therapist would do that is different from anybody else, we look at what people actually need to do for their job. We don't only look at a specific symptom or a specific life circumstance; we look at the individual's abilities around a particular job, or any job. We look at those skills and abilities, we look at the environment in which they work, and, if necessary, we can modify the environment to make it fit better with the person. So we're really focusing in on the activity.

I guess the best way is to suggest thinking about your own specific job and then something else gets in the way. It's no good to say to you that now you have a mental health illness it's going to be tricky. Rather, it's what are the specifics of the mental health illness that would make it difficult for you to perform the duties that you need to do every day. We would then identify how we can work on those specific skills, or if we know that those skills are not available to that person anymore, then how we can adapt the job itself.

It's a very much more focused, practical approach to what an individual needs to do.

9:55 a.m.

Conservative

Mike Allen Conservative Tobique—Mactaquac, NB

I'll ask the next question to both you and Mr. Ferdinand.

I know you can give a comment about how closely the occupational therapists work with the other specialists. Quite frankly, do you see a conflict situation between the providers as to who should take the lead on these files? That's the thing that strikes me as a potential issue here.

10 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

We'll fight it out, right?

10 a.m.

Voices

Oh, oh!

10 a.m.

Conservative

Mike Allen Conservative Tobique—Mactaquac, NB

I was hoping you would, but I didn't mean it on purpose.

10 a.m.

Professional Affairs Executive, Canadian Association of Occupational Therapists

Elizabeth Steggles

I actually don't see a conflict.

I mean, everybody has their own specific skill and ability. Ours happens to focus on occupation. Practitioners have their own individual skills and abilities, too.

If we take the example I used in my introduction around a physiotherapist versus an occupational therapist...if we have the same patient with, say, an upper limb injury, the physiotherapist will work on the upper limb. That's important. We need to get the muscles working in a range of motion. But what the occupational therapist will do is work with the physiotherapist to say the reason we need to get that arm working again is because this person needs to do X, Y,and Z. So the occupational therapist will gear things toward the actual activity or occupation.

That's an example of how we all need to work together with our different skills, but again, toward a common goal.