Evidence of meeting #38 for Veterans Affairs in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was case.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

  • Anne-Marie Pellerin  Director, Case Management, Rehabilitation and Mental Health, Department of Veterans Affairs
  • Lina Carrese  Scientific Director, Department of Veterans Affairs
  • Jean-Robert Bernier  Deputy Surgeon General, Department of National Defence
  • Gerry Blais  Director, Casualty Support Management, Department of National Defence

4:50 p.m.

Col Jean-Robert Bernier

And substance abuse.

Back in the 1990s, things were not good. We've improved dramatically since then. We spend almost $40 million a year now just on mental health—$38 million and something a year—and we have spent over $100 million since 2006 in the increased health system budget.

We do a lot of screening and a lot of education and peer support. There are screenings for mental health conditions at enrollment, regular periodic health assessments pre-deployment and post-deployment, detailed assessments post-deployment at three to six months, third-location decompression, at which there are mental health professionals and education ongoing at that time as well, enhanced post-deployment screenings at the time of release, and ongoing research all the time at a global level to try to identify the problem.

For education, there are the Strengthening the Forces health promotion programs that cover all of the impacts and basically all of the issues that are symptomatic of or causative or that contribute to mental health conditions. In particular, there are programs on addiction awareness to help people identify not just the individuals themselves but supervisors and peers where people are having difficulties. We have in-patient treatment programs and we have a series of civilian programs to which we send folks.

There's a very detailed program called Road to Mental Readiness. That's an international model looked at around the world. It provides detailed education and enhances resilience as well as recognition—self-recognition and peer and supervisor recognition—of mental health issues. That begins right at the time of basic training and has components throughout all career courses now, and peri-deployment—pre-, during, and post-deployment.

Finally, we also have a very robust peer support network of people who personally have suffered mental health conditions in the past, to help individuals who may have an issue but are reluctant to present it, or who don't recognize that they have a problem, and to get them into care, which is the best thing we can do to resolve their mental health condition and prevent things like suicide.

4:50 p.m.

Conservative

The Chair Greg Kerr

Thank you very much for that, Colonel.

Ms. Mathyssen, for five minutes.

4:50 p.m.

NDP

Irene Mathyssen London—Fanshawe, ON

Thank you very much, Mr. Chair.

Thank you very much for your information.

I want to go back to some of the things Madam Pellerin said, just for clarification.

You indicated that there are approximately 250 VAC case managers across the country and that the goal or standard is 40 clients per case manager. Could you explain why that is important? What's the necessity of achieving that or of perhaps, as you indicated, being well within that target?

4:50 p.m.

Director, Case Management, Rehabilitation and Mental Health, Department of Veterans Affairs

Anne-Marie Pellerin

Thank you for the question.

The case management function is a very critical and important function within Veterans Affairs, and we want to ensure that our case managers have a caseload that is reasonable within a standard of practice, so that they can dedicate the time required to individual veterans and ensure that they are able to provide the case planning, the monitoring, and the work with the family. We are endeavouring to ensure that the ratio of caseload to case manager is no more than 40 cases. In fact, at the present time we're exceeding that number. We're at an average of about 30 cases.

If I could at this juncture get back to the question Mr. Stoffer asked earlier, I'll note that we have just over 15,000 Veterans Affairs clients or veterans who are accessing benefits of the department for a mental health condition. That could be for a disability, a benefit, or accessing a rehabilitation program. But not all of those 15,000-plus veterans are being case-managed, nor do they require case management services, because the majority of those who have a mental health issue are in fact able to function well in society and in fact are doing that. So it's those who have the most complex mental health issues—and we're running at about 25% of that cohort—who are actually receiving case management services.

June 5th, 2012 / 4:55 p.m.

NDP

Irene Mathyssen London—Fanshawe, ON

I understand how important it is to have that positive ratio in terms of managers to clients.

You also said that the modern-day veteran population numbers are on the rise, and that many of these modern-day veterans are being released from service with more complex health and re-establishment needs.

Last week the veterans' ombudsman was here. He gave us some statistics, and I want to run these by you.

The department's own life-after-service studies show that two-thirds of Canadian Forces former regular force personnel released between 1998 and 2007 are not receiving benefits. However, 54% of those report at least one physical health condition; 13% report at least one mental health condition; and many report chronic health conditions [following on] three decades of high operational tempo.

So potentially a lot of people are going to need services. You've indicated that it's important to keep the ratios down and to make sure those services are truly effective.

The ombudsman worried that needs would not be met.

4:55 p.m.

Conservative

The Chair Greg Kerr

Could you get to your question, please?

4:55 p.m.

NDP

Irene Mathyssen London—Fanshawe, ON

But, Mr. Chair, you have to set the scene.

4:55 p.m.

Conservative

The Chair Greg Kerr

You're doing it very well.

4:55 p.m.

NDP

Irene Mathyssen London—Fanshawe, ON

Do you have those same concerns? How will you approach those unmet needs? What plans are in place? Obviously we can't allow those folks to go without the services they have earned and deserve.

4:55 p.m.

Director, Case Management, Rehabilitation and Mental Health, Department of Veterans Affairs

Anne-Marie Pellerin

Thank you very much for the question.

Certainly our outreach strategy, in terms of Veterans Affairs, is very much in response to the studies that have been done that would indicate a veteran population not currently accessing services of the department.

Through that outreach strategy, the department is endeavouring to educate people, to encourage people to approach the department if they have a need they think may be related to service, and then in that way to determine eligibility, and if that eligibility is established, to provide the services.

We're continually pursuing that outreach, and so far that has meant a slight increase in terms of people approaching the department for service.

The other avenue we're monitoring very carefully with our colleagues at National Defence is the potential releases. Colonel Blais mentioned there is a period of up to two or three years during which members are retained in the military before release. That period enables the Department of Veterans Affairs to plan and be proactive in getting ready to serve that population that is going to be releasing from the military.

We feel that we're relatively well positioned to be able to absorb more cases, based on our exceeding the standard at the moment, and to put services in place through our existing case manager complement and through our health professionals and contracted services as well.

4:55 p.m.

Conservative

The Chair Greg Kerr

Thank you very much, Ms. Pellerin.

Now we go to Mr. Storseth for five minutes, please.

4:55 p.m.

Conservative

Brian Storseth Westlock—St. Paul, AB

Thank you very much, Mr. Chairman.

Thank you very much to the witnesses for coming today.

Colonel Bernier and Colonel Blais, it's good to see you again.

I have a couple of questions. I'd like to dive right into them.

If there are Canadian Forces members looking to medically retire, then I assume, from the conversation we just had and your presentation, that an integrated transition plan would have been done for every one of them in the last six months.

5 p.m.

Col Gerry Blais

Yes, it would have been done in the last six months. Especially as we begin the process, we are focusing on those who have complex needs. The plan is that by the end of the year everybody releasing for medical reasons will have an integrated transition plan.

5 p.m.

Conservative

Brian Storseth Westlock—St. Paul, AB

Who would be included in who they would be sitting down with?

5 p.m.

Col Gerry Blais

I'm sorry?