Veterans Affairs Committee on Sept. 29th, 2016

[Irene Mathyssen, NDP, London—Fanshawe, ON]

If families were treated together, would the veteran heal better, faster, or would the families be able to heal better than currently is the case? I throw that out to both of you.

[Oliver Thorne]

I think I would defer to Doug on that a little bit, as I tend to do in this situation, but I do know that one thing we hear a lot of feedback on in our program—it's the reason the program is structured the way it is—is that very often the experiences that veterans or service members may have had in the military are so profoundly traumatic and so difficult to speak about that they won't talk about them with their family or in front of their family. The term they often use is that they don't want to put it on them.

When we put them in a group of their peers, they can air these things. They can talk about them. They know they're not going to hurt the person in the group across from them because they've had similar experiences. I think there's absolutely a place for veterans to work with their families to heal and to improve the family relationship, but I think there also needs to be a place for the veterans to do their work separately. There are some things they simply won't want to put on their families.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Bratina is next.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Thank you.

First, thank you for your service to our country.

You were an infantryman. Are there any quartermasters and chefs, the people who.... It's easy for us to understand someone who's been in the heat of battle, but are there also pressures that relate to illness from the non-combatants in the forces?

Mr. Allen can go first.

[Doug Allen]

Absolutely, yes. There's no script for trauma. Trauma is something that happens in the body, and there's no unit of measure that you can use. It doesn't matter if you're a combat soldier or a cook or a clerk. It doesn't matter. Trauma occurs.

With the veterans transition program, I've worked with more non-combat military members in the Atlantic because they're predominately navy and air force. However, you're also dealing with things like the Swissair crash, which has had a profound effect on non-combat military members, but nobody seems to think that, because they say, “Well, you're not in combat, so what's wrong?” There are so many things that our men and women in the military have done that people don't necessarily see, but it has a traumatic effect on them.

Yes, I do see them coming in, and they have a need, and the program works really well. It also works really well with different experiences. You can have a combat veteran and you can have somebody who's never been in combat come together because of trauma, and the shared experience is the fact they have gone through trauma and they can help each other through.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Madame Dussault, would you comment on this question of non-combat—

[Nancy Dussault]

We have had military medics who were not directly involved in combat, but who had to look after their comrades. They had been diagnosed with post-traumatic stress disorder after providing that care to their comrades.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Thank you.

You stated in your information that you have seen an increase in psychological distress among veterans over the past three years or so. Do you have any thoughts about why this increase is occurring?

[Nancy Dussault]

The main reason why veterans come to the Maison La Vigile is that they are suffering from post-traumatic stress disorder. Fifty per cent of those diagnosed with post-traumatic stress disorder develop dependency problems. A lot of members of the military and veterans with that diagnosis have problems of dependency on alcohol or drugs.

Abusive consumption of alcohol and drugs leads to family problems, and the entire family suffers the consequences. The symptoms of post-traumatic stress disorder can also become aggravated. Very often, they are hypervigilant, they have nightmares, they are easily startled, they experience avoidance. They withdraw; that leads to all kinds of consequences for the family and the distress increases. That is what we see with veterans.

[Jacques Denis Simard]

If there is a marriage breakdown, the pressure increases even more and it can lead to a suicidal distress situation.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

To compare the two organizations, Mr. Thorne and Mr. Allen are using therapeutic enactment role-playing; I believe in the case of La Vigile there are other therapies that are basically trying to get at repressed behaviours from the past.

Tell us a little about the kind of therapy that goes on at La Vigile for these same problems.

[Nancy Dussault]

Actually, the goal of the Maison La Vigile is not to provide psychotherapy or to work directly on the trauma. You have to understand that, when a person is living through an experience, it triggers thoughts and interpretations of the event, which lead to the particular behaviours. It’s often those initial interpretations that are false.

At the Maison La Vigile, we use the cognitive behaviour approach. We are interested in the interpretation of the thoughts, whether it is realistic, whether it can be countered, in order to lead the person to change their behaviours when they realize that the thoughts are not accurate. Our involvement is based on the cognitive behaviour approach that is widely used by psychologists.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

When measuring success—and Mr. Allen, you're a measurer of the success, I suppose—do you do continual feedback? Do you come back a year later? Tell me about how you measure your success.

[Oliver Thorne]

The program has been fairly well researched since 1997, which is when the first group was run by Dr. Westwood and Dr. David Kehl. In 2012, we brought on a researcher from the U.S., who's now based at the University of British Columbia, Dr. Dan Cox. He's now conducting the outcome research, essentially, on our program. We deliver questionnaires pre-program and afterward, at three, 12, and 18 months after the program.

We're using a suite of different diagnostic measures. In 2012, we switched to using the OQ-45—outcome questionnaire 45—which is in line with what Veterans Affairs is using, but we're also measuring depression through Beck's depression inventory—a PTSD checklist, essentially—and other measures of quality of life.

We've just recently performed the analysis on our 18-month data because we run small groups, so it takes a while to get to a significant sample size. We've seen significant reductions in post-traumatic stress and depression symptoms and the frequency and severity of suicidal thoughts, and we see an increase in quality of life.

[The Chair, Liberal, Neil Ellis]

Go ahead, Mr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you, Mr. Chair.

Thank you all for coming today. My first question is for the Veterans Transition Network.

We discussed at length many of the difficulties that veterans face and how your program has helped with them. Can you touch on how these difficulties can be addressed, say, before someone is released from the Department of National Defence, while they're still in active military service? Is there something that can be done at that end that could help to prevent some of this?

[Oliver Thorne]

Essentially we'd like to have services like ours available to those who are preparing to transition out or are in the process of transitioning out. We have found that for those who transition out, initially perhaps the experience was good, but then they begin to find that they're having difficulties with family or they're having difficulties with career, or whatever it may be. If they don't have services available at that point, in the early stages, they can very easily slip into negative coping strategies, such as isolation, alcohol or drug abuse, or self-medication.

In terms of preventing that and having to get them when they're far down the road and do reparative work, we believe that if services—not just ours, but like ours—were available to those who are releasing or preparing to release, we could prevent them from falling into those negative coping strategies. To that end, we've recently submitted an application to the Department of National Defence asking to be considered as a service provider.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

For Maison La Vigile, would you agree, or do you have anything more to add to that statement?

[Nancy Dussault]

Unfortunately, we are not really familiar with that transition period.

[Jacques Denis Simard]

I have heard veterans say that the transition period was an obstacle for them because they were no longer in the military. They were forced to leave the armed forces because they were psychologically or physically wounded. The result was a sense of failure. It was difficult for them to except their status as a veteran.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

Now, for Maison La Vigile, for veterans within Quebec, would you say that the process is different for transition in the rest of Canada? Is there a marked difference for the Quebec veterans?

[Nancy Dussault]

Unfortunately, we are not aware of that process at La Vigile.

[Jacques Denis Simard]

For the people referred to us, the transition process is already done, is already under way. Case managers refer them to us and we take care of them at La Vigile. However, we are not aware of the differences between Quebec and the other provinces in terms of the transition.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

To the Veterans Transition Network, I'm impressed by the high level of satisfaction you have with the people who go through.

Are there any recommendations you have for the individuals who come through and don't see the positive changes they were looking for? Is there another avenue that you tend to recommend to them?

[Oliver Thorne]

Absolutely, and I'm sure Doug can speak to this, too.

One of the things we've always tried to stay rather open about is that we know we're not a silver bullet and we know that we're not the ideal program for everyone. We're one of the many available programs that are out there. We believe that we fill a particular niche, and we do that quite well, but we recognize that not everybody is going to get as much benefit from our program as someone else might.

It's sometimes the case that we find somebody who is not engaging well with our program and chooses not to return, for whatever reason, or perhaps drugs or alcohol are a bigger factor, and we have to ask that person not to return, which, fortunately, rarely happens. We have about a 95% completion rate. When that does happen, we work with the psychologists on the program to get them linked to other services.

For those who come to us who are not with Veterans Affairs, we're often trying to refer them back and get them other services because we're aware that it's not going to work for everyone.

Does that answer the question sufficiently?