National Defence committee  It's a good question, and we realize that the Canadian population is not a perfect match for us to use, for some of the reasons you mentioned, such as the mental health screening that we do or the medical screening we do before they enter. However, we feel that it's important to make a comparison, so we do try to do the best we can to make sure that the comparison we conduct is as close as possible, as close as can be made.

National Defence committee  At the present time, we are not making comparisons with other militaries. There is such a difference across the various militaries that it would be, we think, a worse comparison than comparing us to the population from which we actually recruit. When you look at the different experiences on operations and at the baseline rates of suicide in the various countries that they recruit from, there are considerable differences.

National Defence committee  It's very difficult to measure programs that are trying to prevent things. Measuring what you have prevented is a challenge across any health jurisdiction. We have seen an uptick particularly in the army. In the air force and navy, there was a bit of a decline in the suicide rate, and then it came back up and stabilized.

National Defence committee  Yes, any suicide, including RMC cadets, will be included in these numbers.

National Defence committee  Thank you very much, Mr. Chairman. Mr. Chairman and members of the Standing Committee on National Defence, thank you for the opportunity to present the results of the “2016 Report on Suicide and Mortality in the Canadian Armed Forces”. Every suicide is a tragic premature loss of life which we all mourn; it has far-reaching negative repercussions on the lives of family, friends, the military community, and health care providers.

Veterans Affairs committee  I believe that when we refer them to those civilian in-patient facilities it's because there's a need for that kind of intense substance-use-disorder care. That is a valuable resource available to us to provide the care to our service members.

Veterans Affairs committee  We did have in-house services in the past, and I think we closed them down in the nineties. It's important to remember that they go away for a period of time when they're in-patients to get that intense care, and then they come back to us. There's a next phase of care where they're at home and they're working with our health care providers.

Veterans Affairs committee  Since General Auger presented, we did create a medical regulatory affairs group within the Directorate of Health Services Operations. For unlicensed medications, they do track anybody who has been provided those unlicensed medications—this is since they've been put in place—and whether or not there were any reported adverse events as a result of the use of those medications.

Veterans Affairs committee  Mefloquine is not an unlicensed medication in Canada. It became licensed in 1993, I believe.

Veterans Affairs committee  To my knowledge, there was no study looking at the use of the unlicensed drug.

Veterans Affairs committee  In chloroquine-resistant areas, we would usually offer three medications. The first one is Malarone; the second one is doxycycline; and the third one is mefloquine.

Veterans Affairs committee  We could find that for you. Malarone is our most-used medication at this point in time, and I believe it's the most expensive. For doxycycline, I'm sorry, I'll have to get you the data.

Veterans Affairs committee  Addiction or substance-use disorders are a concern of mine, certainly. One of the things we do see is that mental illness combined with substance-use disorder makes it very complicated to treat patients. We have in-house treatment available. We have addictions counsellors available and all of our mental-health providers can deal with addictions.

Veterans Affairs committee  Yes. Typically one could continue to serve even with some minor medical employment limitations. The general result is that we're looking for people who can deploy.

Veterans Affairs committee  The administrative review process could result in significant consequences, yes.