Veterans Affairs Committee on April 20th, 2010

[Rob Oliphant, Liberal, Don Valley West, ON]

Thank you.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann.

Now on to Monsieur André pour sept minutes.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Good morning and welcome to our committee.

First off, Ms. Baker, I have a few questions on your study. How many families did you meet? What type of research did you do? Did you meet with the children, for instance? How did you organize your research? Can you tell us about the various methods you used for your research?

You also referred to a significant rate of spousal separation for people with post-traumatic stress syndrome. Do you have any statistics on that? You also mentioned that, quite often, a different man would return home after the type of trauma he may have experienced during a difficult military mission, for instance. Women have to adapt to this new reality, to these new men who return home from war or difficult humanitarian missions. What characteristics do these men display? Are they more angry, more violent? I would imagine they are more isolated.

In the same vein, I would also like to ask a question of Mr. Zimmermann. We often hear that the new Veterans Charter provides for a number of services but that people are unaware of them. There is a lack of communication. We need to raise awareness of the services that are offered to those in need, more specifically in rural settings, as you mentioned in your statement. I have spoken about this on a number of occasions, because services are more easily accessible in large cities than in rural settings where the distances are greater, and this causes problems. I always say that there is a way to build partnerships between psychosocial services, occupational therapists and physiotherapists, and regional health care facilities, to develop expertise, groups, and so on.

I'd like to hear your comments on the points I have just raised.

[Sandra Pickrell Baker]

First I'll address the study I did as a thesis for my master's degree in family studies and gerontology. It's a rigorous master's degree, an applied master's degree. I used the qualitative framework. I interviewed eight families, eight female partners of military veterans who had experienced operational stress injuries or were diagnosed with post-traumatic stress. There had to have been a period of time elapsed between when they had left the military and when I interviewed them. I was not ethically allowed to interview any family that was in crisis, although I would argue they were still in crisis even though they weren't diagnostically still in crisis.

[Guy André, Bloc, Berthier—Maskinongé, QC]

How many families were you referring to, eight?

[Sandra Pickrell Baker]

The two models I used in looking at the interviews I did of these women were Hill's ABCX model, A being the event--it's an old model of family systems therapy--and the other one was the circumplex model, again a model of family therapy, family functioning.

I interviewed the women for an hour and a half to two hours. The interviews were recorded, then transcribed, and then I coded all the data I received in different categories of ambiguous loss, which I spoke about--family in crisis, any instances of adapting or having to adjust their behaviour or the family's behaviour around the veteran. So I was able to write up all of that. I defended it at the university, and it's now published on Theses Canada as part of the research.

The next piece you had was about the statistics of marriages breaking up. I've spoken to nurses who work in support of the women. The research says it's 60%. The nurses I spoke to said realistically it's 80%. They would argue that in the ones that don't get reported, the marriage breaks up; it just doesn't get documented because they don't formally divorce. Closer to 80% of the marriages do not survive, so eight out of 10 marriages do not survive.

A wonderful author by the name of Dr. Pauline Boss speaks about ambiguous loss as frozen grief because it's difficult to grieve someone who's standing in front of you but isn't the person you married. I heard over and over again that violence was certainly an issue. I heard a story of a woman who had been married and had two children. She was waking up at night with her husband having her pinned to the floor and his hands around her neck. He was having a flashback. So she had to leave the marriage because she wasn't safe.

Inappropriate anger--they lose their guard. We all think things sometimes but we don't say them. In a lot of cases the men said things that were hurtful without thinking about what they were saying, or used violent language that was mentally abusive.

An inability to maintain an intimate relationship on any level, whether that was conversing or even further on the spectrum of being intimate; they just were not able to function in that way. They retreated into their own world of imagination, and desolation in a lot of cases.

I'm trying to remember your fourth question--the rural areas. I'm not sure how it can be managed. I know it was difficult for the families in really rural areas because it's a small town; she talked about forming a support group for women who were like her because it wasn't an area where a lot of military families commuted from, but then everybody in the small town would know what they were doing because word would get out if they had a meeting at the library: “Oh, you're the group whose partners have....”

So there was the stigma of mental illness. This is the same woman who said if her partner had come back with a physical challenge, it would have been fine.

[Guy André, Bloc, Berthier—Maskinongé, QC]

I would have liked to continue our discussion, but briefly, once you have completed your study, can you make it available to the committee so we may consult it?

[The Chair, Conservative, David Sweet]

Monsieur André, we're already at eight minutes. I'm sorry, you're way over.

I need to time the member. I know he did ask a question and he asked for Mr. Zimmermann's input too, and we don't put a time restraint on witnesses.

Mr. Zimmermann, regarding the other questions that were asked of Madam Baker, if you want to make a comment before I move on to the next member, it's fine.

[Wolfgang Zimmermann]

I'd be happy to do that.

In terms of the communication of services and what's out there, I think that's a straightforward internal function of Veterans Affairs and what happens there. But I do want to point to a very specific example, because the question of rural services is absolutely critical, and the point the honourable member made with respect to partnerships.

One of the things that's currently happening is that DND has established a very strong partnership with various acute care rehabilitation facilities across the country, in all of the provinces. For example, GF Strong is our major provincial rehabilitation centre in British Columbia.

From what I gather, it's working really well. It's trying to address the issue of bringing services for veterans as close to home as possible. Rather than having one major trauma rehab centre in Ottawa, you structure these various arrangements with different rehab centres, whether it's Sunnybrook in Toronto or GF on the west coast, the ones across the board.

In my view, there's absolutely no reason--particularly with services in rural areas--why there would not be an opportunity to do exactly the same in the context of holistic rehabilitation with various workers' compensation boards. I'll just use our province as an example. The fact is we have somewhere between 1,500 and 2,500 permanently disabled individuals every year. Most of them come from rural communities. So the infrastructure and development is set up, and that is supported through regional offices. I don't see why one could not look at a creative partnership, understanding that there are issues around the military family.

The problem, frankly, with the case management system that's driven out of Veteran Affairs is that there is a massive caseload; you have relatively few resources that you can allocate, and you've got a vast dispersion. So why would you not tap into an existing system that is designed to serve those needs? Veterans Affairs is really, as I mentioned in my earlier comments, the occupational injury carrier for disabled veterans in the same way that a workers' compensation board is responsible for occupational injuries.

So I think there are some excellent opportunities to achieve much better outcomes for the disabled veteran--that we are certainly not getting today--through some creativity. I would encourage you to perhaps look at starting this with a pilot project with one of the provinces. I would suspect that our board might be quite interested in supporting this type of endeavour from an evaluation point of view to see if we could get better outcomes at the end of the day. I'm sure we could.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann.

Now on to Mr. Stoffer for five minutes.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, Mr. Chairman, and thank you to both of you for coming today.

Sandra, you had indicated that the families were unaware of the programs that are out there for them. It's not just a failure of DVA or the government; it's a failure of all members of Parliament. We send our stuff out to people. We ask them to read it and if they need any help to give us a call. But obviously they're either not reading it or they're using it like junk mail and throwing it away, which is most unfortunate. But it just shows you that all of us have to do a better job of reaching out to them to say, if you ever need help in anything, give us a call.

I don't know what more we can do as MPs. We have the Internet. We mail out. We do this, we do that. But it's not just the government's fault. It's our fault as well. It's something we're going to have to get out there.

I wanted to focus more on the children and the aspect of the children. If you could elaborate a bit more on what the children are going through and what services they may be receiving, or what additional services you think as a government we should be doing....

Mr. Zimmermann, my brother actually worked for Mac Bloedel at the Canadian White Pine mill for 41 years. He was the number one guy on the IWA seniority list. He was quite proud of that.

You must have known a gentleman, before he passed away, by the name of Sean McCormick. He was from the east coast, very similar to yourself. He did this type of work on the east coast. He always found that when people were disabled and they went into another job that they were accommodated for, they always referred to it as their Plan B or Plan C job. What they really wanted was to be able to go back to what they were doing before. They had to deal with that sort of psychological concern that....

For example, veterans are no longer in the military. They've been 3(b)-ed out. I'm following two guys in Nova Scotia. One is very well-adjusted. He's got a new job, he's happy, life is great. But the other one is still thinking that he wants to go back into the military. That's what he knows, that's what he loves. He's got a job, but he's not there yet. He is sick a lot; he calls in sick. The employer is kind of wondering why they have this guy. They're doing their best. So it's a challenge.

I was wondering if you could assist us in how we can assist them in accepting the fact that unfortunately they can't go back into the military, but this other career job is a good thing for them to be doing in that regard.

Sandra, if you could elaborate on the children, that would be most helpful.

Thank you both for coming.

[Sandra Pickrell Baker]

Thank you.

One of the things the research indicates about children is that in military families children are stressed more so than in any other kind of family. That's because of the postings and the deployments. They deal with the parent coming and going at a rate different from most other professions. So that already puts a stress on the family. Although there are things, like the military family resource centre now...but you have to live close to one in order to access the supports.

What the people I interviewed about their children talked about was, again, the loss of the father who was. Because I interviewed the female partners, I'm only talking about dads: “Daddy can no longer go out to dinner with us because he can't be in a restaurant.” Family events had to be planned. A graduation has to be planned. They take two cars so that if dad has to leave, he can leave. The seating has to be planned. You can no longer go to a movie because dad can't sit in a theatre.

In terms of the one who was talking about the graduation, they went the day before to plan out exactly where they were going to sit. They had a contingency plan so that if he couldn't stay for the whole graduation, at least the mother would be able to stay. There would have been somebody who could make sure the dad would be able to get out and get to a place where he was going to feel safe.

So everything becomes complicated. All of life becomes complicated for these kids. They're no longer able to be free. They also become hyper-vigilant about, “Did I do something wrong? Am I watching something on TV that's going to cause Daddy to have a flashback?” The whole family becomes infected.

The author, Sandra Bloom, speaks about trauma being like a virus. It's insidious and it spreads through the family. So these kids, themselves, become predisposed to things like depression or traumatic injuries. They learn to be hyper-vigilant. They learn to be hyper-vigilant in taking care of the parent, by creating that environment, by trying to control the environment so that the parent is not going to have a reaction, not going to have an outburst, so that he is going to feel safe. So the role gets reversed. They become the parent and the parent becomes the child. So when they do become adults now they are predisposed themselves to suffering a lifetime of mental illness because of that hyper-vigilance and its range, and the brain chemistry and all of the neuroscience that goes around that....

It's not just. It's not fair to these children to be put through this. They have no control. They had no choice to be brought into this situation. And the support they need is to be able to be children and to be free and understand that they didn't do anything wrong and that there's nothing they can do to fix their parent, which is what they all want to do. They all want to make their parent better. They want things to go back to the way they were before, which is not going to happen.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you.

[Wolfgang Zimmermann]

I appreciate your comment because it was a flashback to my own experience in many ways. I had initially graduated in civil and forest engineering and was working out in the bush. But then I ended up actually retraining as an accountant. Nothing against accountants, but I hated every minute of it. It was simply a job that I was doing that provided an opportunity for going forward. Ultimately, I ended up in HR. So I was fortunate.

Very specifically, I think what could be done in your case or in the government's case is this. I see a huge opportunity for alignment, in the sense that you wouldn't want to take somebody who's been in the field and all of a sudden put him into an office job here in Ottawa or Vancouver or Toronto, wherever. That doesn't make any sense. In terms of warehousing, when we introduced our program, you would think that in a company in Canada--we had almost 12,000 employees--you'd have a significant number of opportunities. It was difficult, simply because of a whole bunch of rules and regulations and being spread across the country.

But in this case you have a tremendous workforce. If you look at what I think would be areas that are fairly close to a front-line service, if you look at Fisheries and Oceans, if you look at Parks Canada, if you look at labour inspectors at part of Labour Canada, if you look at folks who work at Industry Canada, if you look at the coast guard, the list is essentially quite endless.

While it may not be possible for somebody to go back into the military, if you went with something else that was along the same lines, that was fairly closely aligned with the interests of the individual, then I think you'd have a much higher success rate. But that requires some bureaucratic flexibility. That requires folks saying, “Look, we're not going to drive a square peg into a round hole. We're going to look at what actually makes sense.”

If I didn't have the option of doing what I'm doing today, if I continued being, if you will, a bean counter, then that would have been very challenging, because it just doesn't fit my background and personality and so on. So I think in this case the key is looking at creative solutions, and the government has those.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, sir.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann.

Now over to Mr. Kerr for seven minutes.

[Greg Kerr, Conservative, West Nova, NS]

Thank you both very much for coming. It's actually quite enlightening to hear your views on an issue that all of us, as committee members, take very seriously.

I'm not going refer to areas that you raised, although I may come back to them, as much as to ask questions. A lot of changes continue to be made and people do endeavour to make improvements as things come up, and a lot of things have gone on. As the direction continues to change, I'm trying to find out what your sense is on where we are making progress and where we have to work harder and so on.

Specifically, one of the challenges for many of us who are rural members, as we hear the issues that you raise, is that it's a very elusive thing to try to find both the resources and the links that can take place in a rural area. As a matter of fact, many of us can attest that it's going in quite the opposite direction in rural Canada in many areas, and it's a very challenging issue for us to face that.

I will go to you first, Ms. Baker. In your experience, in a research capacity, you ran into some real examples. Did you see evidence of where progress had been made or other attempts have been made where we should focus on making more use of that, or do you think it's simply lacking?

The reason I ask is that we've heard a lot of witnesses over time, and in some cases they are saying, “If there were more of this” or “If there were more focus on that”, because many initiatives between DND and Veterans Affairs have tried to move in the direction of capturing the people while they're in active service and identifying in peer support groups, recognition groups, and family support centres and what have you, and again, less so in the rural areas.... Are there examples of where you see evidence of some improvement or recognition taking place that we should be thinking more of how to support, or are you talking about basically starting afresh?

[Sandra Pickrell Baker]

In one of the families that did seek support, he was diagnosed before he was discharged from the military. He was on the submarine that caught on fire, so he was part of that. They figured part of the reason his diagnosis happened so quickly was because he took part in a very publicized event.

He was involved in peer support, which he found very helpful, and because he was involved in peer support, she had access to support for herself through the Halifax trauma treatment centre. They were local, so they lived right in Halifax and it was easy for them to access support. She took part in a program run by two of the social workers at the Halifax trauma treatment for the wives of military men and veterans diagnosed with PTSD, and she really felt that this was her saving grace. It was the place that was her touchstone, where she was able to go and ask “Is this me, or is this him? Am I being unreasonable, or is this unreasonable behaviour on his part?” It was a six-week program that she went through, and she found it immensely helpful. They also left the door open when she finished the program so that if at any time she felt she needed to come back to gain support again she was welcome to do that. I think that would need to be replicated where those rural women are, and to be more widely known.

One of my frustrations was the only way she could access that support was because her husband was actively engaged in seeking support. She had to get a referral from his therapist in order to take part in that group. Because her husband was open enough to seek support, she was able to get support. But if he hadn't been open, that door would have been closed to her.

[Greg Kerr, Conservative, West Nova, NS]

I agree with that fully in the sense that one of the difficulties found in receiving services and so on is the early recognition and early treatment recommendations that come from that. You're saying that if the intervention is there, the opportunity is better for the family, and that it's a geographic pressure because of the availability. It's part of getting it done before they're out of the military that's really important.

[Sandra Pickrell Baker]

There is that, and also it cannot be tied to the veteran seeking support. If she had wanted to seek out support and he hadn't, she wouldn't have been allowed. I asked if other women in the study could take part. They said the husband had to have been diagnosed, had to have been seeking support. They needed a referral from his psychologist in order for her to gain support through the military trauma treatment centre. This was very frustrating because these women could have really used that peer support, a place to debrief and have a barometer of whether they were being unreasonable with their expectations--which we all can be--or whether it was really the husband's behaviour that was unreasonable. And if it is the husband's behaviour, how do they deal with that, how do they work with that as family units rather than being isolated?

[Greg Kerr, Conservative, West Nova, NS]

I guess it makes the point that the type of service necessary could be or is available when the linkages are there at the beginning. I think it's one thing we would probably all agree on.

Mr. Zimmermann, I like your overall point. We've all talked to veterans who have gone through it. The frustration is often that they're the wrong peg in the wrong hole or they've been overlooked for whatever reason.

You talked about partnerships. I know we don't have time today to delve into it. Within the present system, part of it is the attitude of the government, the bureaucrat, and so on, but do you see any indications of examples that could be pursued?

I guess the same question for a different reason is this. Is there any evidence where it's been recognized that it could be duplicated or expanded within the government service? Have you run into anything that works in that way?

[Wolfgang Zimmermann]

Yes. There was a point in terms of the relationship that DND has whereby they created partnerships with all of the regional acute care rehabilitation facilities in order for veterans to be closer to their families and closer to their home bases, rather than having everything centralized in Ottawa.

On a much smaller scale, during my tenure at the workers' compensation board, there was a major rehab facility that ultimately ended up being literally torn down. Workers would come from rural parts of our province, whether it was Prince George or Prince Rupert or wherever, and would have to spend two or three weeks at a time in Vancouver and away from their families. The strategy was to bring those services closer to the worker, as opposed to the other way around, so that there was no sense of isolation and despair or all the other issues these individuals had.

I think this model would lend itself very well to that. You have something in place. In my view, DND has done a great job in establishing partnerships with all of the major provincial rehabilitation centres. The treatment is closer to home and they're closer to their families. They can get as much support as they need without being very remote.

[Greg Kerr, Conservative, West Nova, NS]

Thank you very much.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Kerr.

This concludes our first round of seven minutes. We have consumed a lot of time, partly because we started late and partly because of the high quality and robust answers from the witnesses.

We'll move on to our five-minute round.

Madam Sgro.

[Judy Sgro, Liberal, York West, ON]

Thank you very much, Mr. Chair.

I concur with everything the chair has said. The presentations from both of you have been extremely interesting. I thank you for being such great Canadians and taking the time to come here to try to make a difference in the work we're trying to do.

Ms. Baker, could we have a copy of the paper you wrote?