National Defence Committee on Dec. 3rd, 2013

[Dr. Marc Fortin]

Again, we'd be happy to provide that information to the committee. I don't have a count of the number of projects.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

When that's provided, can we get a detailed accounting of the projects and what they're doing?

[Dr. Marc Fortin]

It will be our pleasure.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Can you tell me if DRDC is exploring the links between, say, MTBI, PTSD, and dementia?

[Dr. Marc Fortin]

In fact, to put the last couple of questions in context, MTBI and PTSD are some of the elements of a much broader set of mental health issues in the military. They're not negligible, but they're a small set of a broader range of mental health issues. We make a fairly large investment. We can measure our investment more broadly in the health sector in the military personnel research and analysis sector. Again, we'd be happy to provide that information.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Okay, so you'll table that with the committee then.

One of the other things Colonel Tien indicated was that the focus of the Canadian Forces Health Services Group was acute trauma. Now that Canada's combat role has come to an end, he expected that this focus would shift to dealing with the aftermath of war, largely around mental health issues. Is this shift being reflected at DRDC?

[Dr. Marc Fortin]

Absolutely. I mentioned earlier that on an annual basis, we review our program of work. We review that program of work with all level one commanders, the surgeon general, the chief of military personnel, and of course the environments, army, air force, navy, CJOC, and so on and so forth.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

So that's happening. Can I pick up on that?

[Dr. Marc Fortin]

That is on an ongoing basis.

In the post-combat mission, as the issues on what we call the client side, which is the military side of the house as well as DND, have shifted, we've shifted our research program accordingly.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Can I pick up on that?

Can you actually demonstrate what that shift was? What was being funded in terms of personnel and finance when it was trauma, and now what is the focus? Can you demonstrate that?

[Dr. Marc Fortin]

We can certainly demonstrate the evolution of the research program, the plan of work for DRDC again adjusted on an annual basis. We have to understand we're dealing with research. Research, despite all best efforts, all best expertise, sometimes will take us in a direction where perhaps the answer doesn't lie, we realize, and we have to retreat and refocus.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

That's how research works.

[Dr. Marc Fortin]

That's the nature of research and development work.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Could you table with the committee what was personnel and finance under acute trauma and is now personnel and finance regarding in the aftermath of the war?

[Dr. Marc Fortin]

We'd be happy to provide the information.

[The Chair, Conservative, Peter Kent]

Time has expired. Thank you very much, Ms. Duncan.

Mr. Williamson, go ahead please.

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

Thank you, Chair.

I'm going to split my time with Mr. Opitz and allow him to begin this session. The questioning will come back to me.

[Ted Opitz, Conservative, Etobicoke Centre, ON]

Thanks, Mr. Williamson.

Thank you, Mr. Fortin. I'm delighted you're here today. That was a great overview of what DRDC does.

I'm interested in some of the specific research you do on PTSD, in particular in the Toronto area. Some of that research has to do with quantifying salivary hormones; it has to do with melatonin devices. It's developing a device that is able to monitor the hormones and the endocrines in soldiers and identify those who, because of hormonal imbalances, would be most susceptible to PTSD prior to going into combat. It would be able to determine those sorts of balances between—and I'm not a scientist—the hypothalamic-pituitary-adrenal axis in the brain that is able to regulate the production of that hormone, which would then mitigate the effects of PTSD. Then we would be able to treat these soldiers before they developed these acute symptoms.

As well, there's also research going on in melatonin rhythms, including with sleep issues, on which we're going to hear from Dr. Moldofsky later.

Are you, or maybe Dr. Tremblay, able to comment on any of that?

[Dr. Marc Fortin]

I'll start, and I'll be happy to bring my colleagues into that discussion.

No one around the world has found the magic solution for PTSD. It remains a challenging problem that is faced by the surgeons general of various countries. There are many lines of investigation around the world, some more specifically pursued by Canada, others pursued by other countries, and others in collaboration.

As I mentioned earlier, we're looking at any kind of indicator that will allow us to identify predisposition to trauma through stress leading to trauma. We're looking for any kind of indicators that will allow us to better diagnose and treat. The studies you are referring to are one line of investigation. That is not completed; it's still a line of investigation.

[Ted Opitz, Conservative, Etobicoke Centre, ON]

I have to stop you there, sir, because I don't want to take all of Mr. Williamson's time. Thank you for that. That is an important line that is being developed now, and definitely, I'd like to hear from some of your personnel in the near future on the specifics of that research.

[The Chair, Conservative, Peter Kent]

You have two and a half minutes.

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

Thank you very much.

It seems to me that, as we exit Afghanistan, there's going to be more and more focus on PTSD and the impact on families, but on our readiness as well. What are we doing in terms of amplifying that? Perhaps this is something that is, I don't want to say it's catching us off guard, but it seems to be in the news more and more. Is this something we can examine in a way that's going to help families? That's a bit of a simplistic way of putting it. What is being done here in conjunction with our allies, the Americans in particular, who might have more experience in this area, to ensure that resources are being adequately deployed to deal with this issue?

[Dr. Marc Fortin]

I'll ask Dr. Dursun to expand on this.

[Dr. Sanela Dursun]

Thank you, sir, for the question.

As you can appreciate, it certainly is a complex issue, mental health issues, including PTSD. It is a relatively new disease and the comorbidity rates are really high, which means that lots of people who are diagnosed with PTSD are all suffering from other mental health illnesses.

In DRDC, this also speaks to how our priorities have shifted since the changes in the priorities of the government and the organization in terms of understanding the impact of the operations for the ill and injured, what kind of research we do for the ill and injured.

We established recently a research program to understand the programs. We cannot talk about the services that we provide to the ill and injured, but we are doing the research to assess those programs and how well those programs are working in helping the ill and injured to recover and rehabilitate.

One example of that is we recently completed an assessment of the return to work program. It is one of those programs under the joint personnel support unit. It is not only limited to mental health issues, but most people there do suffer from mental health issues, including PTSD. We interviewed over 100 Canadian Forces personnel in that program from across the country, including the coordinators in that program, and absolutely, the findings that we fed back to the program providers were very valuable.

[The Chair, Conservative, Peter Kent]

Thank you, Dr. Dursun.

Monsieur Brahmi.