National Defence Committee on Dec. 3rd, 2013

[Dr. Harvey Moldofsky]

Yes, I think it's helpful.

She wrote a seminal article earlier this year in the American Journal of Psychiatry, and I quoted from her that sleep disturbances are the hallmark of PTSD.

There are very few of us who are looking at it. She is and I've been looking at it, but knowing the people in Pittsburgh, she's focusing on specific and traditional brainwave patterns. I've gone beyond that.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Okay. Thank you.

You mentioned your findings, etc. Having dealt with a different thing from a quasi-political perspective, when we have people who may not fit the norm, in other words, may not be going down the.... One of the hallmarks of acceptability for people's—I won't say “thesis”—but people's findings is that it is peer reviewed and backed up.

With regard to your assertions that you're giving us today, have some of your findings been peer reviewed, and are they complementary to your findings?

[Dr. Harvey Moldofsky]

I've published many papers, all in peer-reviewed journals. When these data became evident to me just recently, I thought I had to bring it to the attention of my colleagues in DRDC, who in turn spoke to Mr. Opitz and came here. Obviously a lot of the work is self-funded and we get stuttering funds through the goodwill and help of my colleagues.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you.

I take it by your answer that it is somewhat peer-reviewed.

[Dr. Harvey Moldofsky]

It's peer-reviewed by my colleagues, but it has not been submitted for publication. The aim in the next phase is to complete what I'm saying, verify what I'm saying, and present it. It's been presented at meetings.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you.

One of the questions I or someone asked Dr. Germaine was whether we can research through the hiring process, whether it's psychological, and whether there would be a set of questions so we could find out if a person is predisposed to PTSD. In other words, is there a percentage of people who are more prone to PTSD, and is there a way of ferreting that out before you actually hire them? Has there been any work done on that?

[Dr. Harvey Moldofsky]

There's been lots of work through the American military. They've been looking at personal and family history of predisposition to mental illness as one of the factors. There's an effort under way at looking at the genetic profiles of these people. This is an ongoing area. We don't have the actual predictor for PTSD at this time.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you.

You talked about early detection. I gather you're not referring to pre-hiring. You're talking about being able to see PTSD affecting people before they go into obvious behaviour. I know that the previous minister of defence and the chief of the defence staff, along with people.... We're talking about operational stress injuries, OSIs. The mental health folks actually gave them a citation for their work in that your peers would be able to recognize in the individual serving member some behaviours that they would suggest to you and then work with you to identify the need for treatment. Would you say this is a step in the right direction?

[Dr. Harvey Moldofsky]

Thank you. Precisely.

[The Chair, Conservative, Peter Kent]

Thank you.

Ms. Duncan, go ahead please. You have seven minutes.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Mr. Chair.

Thank you, Dr. Moldofsky. I'm sorry you're feeling so unwell.

Witnesses today spoke about funding of university partners. What is your view on resources available for studies?

[Dr. Harvey Moldofsky]

Resources depend upon interest. Until we can stimulate interest within the university to go in and tackle this as a significant Canadian problem, you're not going to have too many people applying. When I say people, I mean people at a senior level who are skilled in carrying out research and can be identified.

I remember that one day a gentleman knocked on my door. He turned out to be the director of the Canadian Space Agency. He came to visit me in my lab and introduced himself. He'd heard about my work and said, “Would you put a grant application in?”

[Kirsty Duncan, Liberal, Etobicoke North, ON]

What recommendation, Dr. Moldofsky, would you like to make to this committee regarding funding of university research?

[Dr. Harvey Moldofsky]

Put out requests for applications targeting the topics I'm talking about, and you'll get an answer.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

To all my colleagues, I want to express my heartfelt condolences and I know we all do, to the families of the people we lost last week. My prayers and thoughts are with them.

Like all of you, I've had the privilege of working with service people and veterans across our country. I've heard their stories: a veteran living for 10 years in the bush; receiving a suicide note from a veteran on Sunday afternoon and having to find help; having to find a veteran lost in a snowstorm because no psychiatrist appointment was coming for three months despite a diagnosis of PTSD for years and years; not hearing from a veteran for weeks and waiting for him to re-emerge from the darkness of his basement; receiving a note from a veteran distraught because a young friend was found dead on the roadside and another dead in the basement, both of whom had simply stopped living, had given up eating and taking their medication. I will share these comments and again, my condolences to the families.

This is what I hear from our country's extraordinary heroes in their desperation: “We are all suffering and we need help. It's not only guys we lose overseas, it's the guys we lose here to suicide. They may as well have died overseas. We have all contemplated it, the thoughts are relentless. When I contemplate suicide, it is a relief. It means stopping the pain, no more fights with that. The question we ask ourselves is how can we leave and leave our family in a better position. Everyone else is better without us.” This is from a physician who veterans call the “Guardian Angel”, “They are hurting, their families are hurting. Many wives have contacted me. They are afraid to stay with them. They are afraid of them and for them.”

I'm wondering if you can share in a broad sense, the symptoms that the people you treat are suffering from. What does their life look like and what should we be doing?

[Dr. Harvey Moldofsky]

I'm deeply grateful to you for those comments. I've heard these stories. I've seen them.

Do you know what it takes for someone to see a psychiatrist in the province of Ontario? They have to wait.

I don't understand that. I've been a teacher and received awards for many years.

Let the stats speak for themselves. The average psychiatrist in Ontario sees two new people a week. There will never be enough at that rate. We need to have identified clinics where these people can be rapidly identified and assessed.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

That's a recommendation, rapidly identified and assessed.

How were patients referred to you?

[Dr. Harvey Moldofsky]

I'm what's called—I don't even know if I'm tertiary; I'm way down the line. They've seen many physicians. They've even been seen at other centres across the country. I'm grateful to Don Richardson for identifying these people and trying to get them in, but do you know what it takes to get them in? I would see them the next day. “I'm busy”: it's not just physicians not being available; patients need to be strongly encouraged that they have to be seen.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

What level of care did they receive before coming to see you?

[Dr. Harvey Moldofsky]

I don't understand it. I ask them who they have seen, and what they have done. They tell me, “Oh, I saw somebody, a psychiatrist, and they said I'm nervous and they gave me a tranquilizer.” They didn't even think they had PTSD. So they took the pills, got hooked, got into drugs or alcohol, and got into trouble. Then they get identified.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I had U.S. military doctors up here last spring to talk about brain injury, to talk about PTSD. They were very concerned about suicide. I mean, some numbers, Veterans Affairs reports—

[The Chair, Conservative, Peter Kent]

Very briefly, Ms. Duncan. I'm sorry, but your time is almost up.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Can you talk, very briefly, about the rising number of suicides in the U.S. and what this might mean here?

[Dr. Harvey Moldofsky]

I think the best-kept secret is that this will have a phenomenal financial impact on our health care system. The U.S. government isn't telling, and I don't know where that information is. I certainly haven't read anything.

[The Chair, Conservative, Peter Kent]

Thank you, Dr. Moldofsky.

We have time for two final five-minute segments: first Mr. Williamson, and then Mr. Boulerice.