Bill C-211 (Historical)

Federal Framework on Post-Traumatic Stress Disorder Act

An Act respecting a federal framework on post-traumatic stress disorder

This enactment requires the Minister of Health to convene a conference with the Minister of National Defence, the Minister of Veterans Affairs, the Minister of Public Safety and Emergency Preparedness, provincial and territorial government representatives responsible for health and representatives of the medical community and patients’ groups for the purpose of developing a comprehensive federal framework to address the challenges of recognizing the symptoms and providing timely diagnosis and treatment of post-traumatic stress disorder.

Federal Framework on Post-Traumatic Stress Disorder Act

[Joël Lightbound, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I rise today to speak to private member's bill, Bill C-211, an act respecting a federal framework on post-traumatic stress disorder.

Mental health is a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Improving the mental health of all people living in Canada is a priority for the federal government, which is one of the reasons why this government will be supporting Bill C-211 with amendments and we will work to address those at committee stage.

The Minister of Health continues to engage provincial and territorial governments to deliver on important investments in health, with mental health as a priority area of focus.

On December 19, 2016, the Government of Canada offered to give the provinces and territories approximately $11 billion over 10 years for mental health care and home care in addition to $544 million over five years for federal and pan-Canadian organizations to support initiatives on prescription drug and health innovation. Many provinces have decided to work with the Government of Canada by using the funds to improve mental health services for Canadians.

In addition, the Government of Canada is promoting people's mental health and well-being by supporting programs that build resilience in individuals and communities to help them overcome adversity. This involves all levels of government, national indigenous organizations, non-governmental organizations, and the private sector.

The Public Health Agency of Canada is the lead federal organization for mental health promotion and mental illness prevention. The agency supports federal coordination in these areas across the health portfolio and other departments to provide a coherent approach to promote, protect, and improve the mental health and well-being of all Canadians.

The health portfolio, in collaboration with other federal departments, supports policy development and community-based programming across various life stages. Key areas related to post-traumatic stress disorder, otherwise known as PTSD in Canada, include family violence prevention, suicide prevention, targeted indigenous mental health promotion initiatives, and helping victims cope after emergencies.

Being a victim of violence is a significant risk factor for developing post-traumatic stress disorder, which is more commonly known in Canada by its acronym, PTSD. Domestic violence, including intimate partner violence and child abuse, is a serious public health issue and a significant risk factor for developing PTSD. Some 32% of adult Canadians reported that they have been the victim of some form of violence before the age of 16.

Research shows that women who have experienced intimate partner violence have heightened rates of PTSD, injury, chronic pain, sleep disorders, substance use problems, and other mental health issues such as depression and anxiety.

Children who have been abused or exposed to abuse in the family also have a higher risk of developing mental health issues, including PTSD. Those who were maltreated as children are twice as likely to have poor mental health and are over three times more likely to report suicidal thoughts. Boys who have been victimized or raised in violent homes are at an increased risk of becoming perpetrators of violence as adults, and girls exposed to violence in the home are at an increased risk of being victimized as adults, thus continuing the cycle of violence.

Our government is supporting community projects aimed at improving the physical and mental health of individuals who have been the victims of child abuse or intimate partner violence, thereby helping them to rebuild their lives. Our government is also investing in projects to better equip health professionals to work safely and effectively with survivors of domestic violence using strategies specifically tailored to the trauma experienced by each individual.

The Public Health Agency of Canada coordinates the family violence initiative, which brings together 15 federal departments to prevent and address family violence from multiple perspectives. Partner departments meet regularly to share new research and findings, provide advice on design and project ideas, contribute to policy initiatives, connect to stakeholder networks, and ensure that new knowledge is applied across all sectors.

As part of this initiative, information is also shared through the Stop Family Violence web pages on behalf of all the family violence initiative partners. This is a one-stop source of information and resources for professionals and for the public.

At the heart of what we are talking about today is the fact that people who have PTSD are more likely to self-harm or commit suicide. Sadly, more than 4,000 Canadians commit suicide every year.

In accordance with An Act respecting a Federal Framework for Suicide Prevention, the Public Health Agency of Canada coordinated the development of a federal framework for suicide prevention. The main goals are to raise public awareness, reduce the stigma surrounding suicide, disseminate information about suicide and its prevention, and promote the use of research and evidence-based practices for suicide prevention.

Tools and resources are also being developed to help reduce the stigma and raise public awareness about suicide, informed by research evidence on safe messaging for Canadians. In addition, a guide of standard terminology and practices for federal departments to avoid stigmatizing and inappropriate language in communication products is under development.

An online suicide prevention resource has been launched, including information on where to get help, resources for professionals, and links to additional resources and information. Funding has also been provided to support the Canadian distress line network to develop a 24/7 national suicide prevention service. Once fully implemented, this line will ensure that individuals in crisis, regardless of where they live in Canada, have access to free and confidential support on a 24/7 basis, in a way that works best for them, by chat, text, or phone.

The Public Health Agency of Canada co-leads the National Collaborative on Suicide Prevention together with the Canadian Association for Suicide Prevention and the Mental Health Commission of Canada. Their members include various health and community service organizations that work to promote mental health and prevent mental illness and suicide across the country, including the Assembly of First Nations and the Inuit Tapiriit Kanatami organization.

Federally, the Canadian Institutes of Health Research, Health Canada, and the Canadian Centre for Substance Abuse, which are federally funded, are also partners under this umbrella. The mission of this Canada-wide collective is to enhance the capacity for suicide prevention in an effective manner by connecting people, concepts, and resources across the country.

Indigenous populations may be at increased risk for PTSD because of historical and intergenerational trauma. First nations, Inuit, and Métis experience some of the most significant health inequities in Canada. The proportion of indigenous individuals experiencing mental illness during their lifetime is 55% versus 33% of the non-indigenous population. Evidence shows that health is adversely affected by culture loss; racism and stigmatization; loss of language and connection to the land; environmental deprivation; and feeling spiritually, emotionally, and mentally disconnected from one's identity.

The federal government also supports indigenous populations through programs that are culturally adapted to the communities they serve. For example, the aboriginal head start program offered in urban and northern communities promotes the healthy development of indigenous children from birth to age five and helps them achieve their full potential in adulthood.

The community action program for children and the Canada prenatal nutrition program also support the healthy development of vulnerable children aged zero to six years and their families. Special emphasis is placed on the inclusion of indigenous pregnant women, children, and families. The Nobody's Perfect parenting program is a strengths-based, educational health promotion program for parents of children aged zero to five years living in socio-economic conditions of risk. The program is offered in indigenous communities across Canada.

These targeted programs help Canadians develop protective factors that will help them build their mental resilience and lower the risk of PTSD, because they are based on the knowledge that a significant number of mental problems stem from childhood.

People who have been exposed to natural disasters and extreme events are at risk of developing mental illness, including PTSD. Extreme weather events as a result of climate change are expected to increase in numbers and severity. Many climate scientists agree that the Canadian wildfire activity of the past few years is well above average and is connected to the warming climate.

I see that I only have one minute. I thought I had 20 minutes, so I will conclude at this stage.

The federal government's efforts on PTSD so far include following through on some of these recommendations and taking advantage of existing federally run activities that target the needs of specific populations. Many of these programs and activities could also be used to support other communities in Canada.

Through these concerted efforts, and the ongoing commitment to sound, evidence-based approaches, our government continues to work to improve the lives of Canadians and those affected by PTSD.

The House resumed from February 9 consideration of the motion that Bill C-211, An Act respecting a federal framework on post-traumatic stress disorder, be read the second time and referred to a committee.

Health

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, since introducing my private member's bill, Bill C-211, I have heard from hundreds, if not thousands, of individuals who are in the fight of their lives. There is no standard diagnosis or care for PTSD that is consistent from the east coast to the west coast. Our first responders, our veterans, and our firefighters, who have sacrificed so much for our country, are not receiving the proper care and support needed to deal with PTSD.

Lives are at stake. My simple question is this. Can we count on the Prime Minister and his Liberal caucus to support Bill C-211 when it is voted on at second reading, yes or no?

Federal Framework on Post-Traumatic Stress Disorder Act

[Sean Fraser, Liberal, Central Nova, NS]

Mr. Speaker, I am thankful for the opportunity today to debate the creation of a federal framework on PTSD through Bill C-211. I would like to thank the hon. member for Cariboo—Prince George for shining light on this important issue, and for his very thoughtful remarks today. It is hard to do justice to an issue of this magnitude in a little less than 10 minutes, but certainly I will do my best.

Over the course of the next few minutes, I hope to highlight the importance of the issue of post-traumatic stress disorder, nationally and in my own community; the impact it has not just on the members of our military but on emergency service workers as well, as so many have alluded to; and the impact the bill could potentially have in collaboration with some other initiatives going on in communities across Canada and within the federal government today.

Beginning with the issue of post-traumatic stress disorder in our military, I have to commend anyone who has had the opportunity to serve. So many who go do so knowing that they may not return safely, or may not return at all. Far too many of those who do serve overseas and who are lucky enough to come home do so with physical or emotional scars that run so deep they may never be cured.

In my view, the cost of engaging our military in a mission that puts the lives of Canadians in danger includes the cost that it takes to ensure they are well. If we can afford to send our citizens to war, we can afford to take care of them when they come home, full stop.

The Canadian Forces are in a mental health crisis. The Afghanistan mission serves as a perfect example. Every member in the House knows well the turmoil that those who have served face today. Since the end of the mission, at least 71 members of the Canadian Forces have taken their own lives. By comparison, I believe the total who lost their lives in combat during the course of that mission was 138, and every one is a tragedy. The fact that we are now over the 50% loss of lives in the mission through veterans who have taken their lives by suicide is a statistic that should shock the conscience of every Canadian. We need to do something about this, and we have the capacity to do something.

This is a difficult issue for the region I represent because of some recent events that took place earlier in January in the community of Upper Big Tracadie. Just minutes away from the town that I was born in, an infantryman took his own life. When we hear members of his family speak about it, they speak about the inner demons he faced and was unable to overcome. What made the tragedy that much worse was that it was not just his life that was taken, but the lives of his family as well. His mother Brenda was killed. His wife Shanna, who recently graduated from St. Francis Xavier University, where I studied, and who worked in the hospital I was born in, as well as his 10-year old daughter, Aaliyah, were killed as a result of this horrific incident.

This bill may not have done something for that specific incident, and it may take a long time to make a difference. The initiatives we are trying to launch at the federal level may take a very long time to make a difference, but my father always told me the best day to plant a tree is today, so we may as well take the chance while we have it.

It is not just our military. So many others are impacted by post-traumatic stress disorder. Our emergency service workers go through turmoil, which I am so lucky to not have witnessed myself. Every member of the House who has not worked as an emergency service worker can probably not understand. I have been taking meetings with police officers, firefighters, and paramedics who have explained the unimaginable horrors they live through in the course of an ordinary day. As other members alluded to, they hear the sounds they have heard, the smells they have smelled, and relive the events time and time again. It keeps them up at night and interferes with their ability to enjoy life in their full capacity as a human being. That is not right. We need to offer them the services they so desperately need to be full and well.

This issue is not without hope, although I may have painted a bit of a desperate picture. There are things we can do. I commend the effort in Bill C-211 to bring together different ministries, like the Minister of Health, the Minister of Veterans Affairs, and the Minister of Defence, along with medical service providers, and, importantly, patient organizations.

We know the answer is not simply to put money into a program, but to make sure that any investments are made wisely to see the outcomes that are actually going to improve the quality of life for people living in our communities.

When I look at initiatives that are going on with all parties, I look at the report of the Standing Committee on Public Safety and National Security. I look at the multi-party committee on veterans affairs which has undertaken a study on mental health and the suicide crisis among veterans in Canada. I think this is a very positive thing.

Within a week of his being sworn in, I saw an article in The Globe and Mail saying that the Minister of National Defence had instructed the highest ranking members of the forces to make the suicide crisis a priority. I see investments with provincial governments like my own in Nova Scotia where dollars have been earmarked for mental health.

We can see in Canadian communities that this is a priority as well. We see organizations like TEMA that try to draw attention to the issue of post-traumatic stress disorder, but also help individuals who are trying to become well.

To those who defend our interests overseas, who keep us safe in our communities, and who respond when we are in need of emergency services, I would like to communicate that whatever I can do to ensure they have the mental health care they need to be whole and to do their jobs so my family and I can sleep safely at night, I will do what I can.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Mr. Speaker, I want to thank my hon. colleague from Victoria for stating his unequivocal support for this private member's bill, and my hon. colleague from Guelph who made a speech although we have yet to hear whether his party, the government, will be supporting this legislation.

First responders, firefighters, military personnel, corrections officers, police officers, front-line health care workers, like our dedicated nurses, and countless others face traumatic situations in their day-to-day work, the work they do to serve their fellow citizens and to protect our great country. While the work that these men and women do is well known, what is less known is the mental demands that these occupations require.

In these professions, men and women are regularly exposed to graphic scenes and images that anyone would find difficult and sometimes even heartbreaking to see, making them exceedingly susceptible to PTSD. As the official opposition critic for Veterans Affairs and having spent over three decades as a firefighter, I am all too familiar with the devastating effects of PTSD, and how it plays on those who wear the uniform and the negative impacts on their families.

PTSD is a condition that is characterized by persistent emotional distress occurring as a result of physical injury or severe psychological shock. It typically involves disturbances of sleep, and constant, vivid recall of the traumatic experience with dulled responses to others and to the outside world.

Post-traumatic stress disorder is characterized by the onset of psychiatric symptoms after exposure to one or more of these traumatic events. The characteristics of PTSD develop in four domains: intrusion, avoidance, alterations in cognition and mood, alterations in arousal and reactivity. People can react in many different ways. They might feel nervous, have a hard time sleeping, or go over the details of the situation in their minds. Others have more serious symptoms and their lives can be seriously disrupted.

Our society requires that these people continue to do their job, so it is the government's job to ensure that they have the ability to seek the help, should they require it.

Bill C-211 will help ensure that men and women who are suffering from PTSD are able to get the help they so desperately need. We need to develop and implement a federal framework on PTSD that provides for best practices, research, education, awareness, and treatment.

We really need people to help. Military personnel, veterans, and police officers are expected to lend a hand when the need arises. The bill calls for a federal framework “to address the challenges of recognizing the symptoms and providing timely diagnosis and treatment of post-traumatic stress disorder”.

Bill C-211 is a private member's bill sponsored by the member for Cariboo—Prince George. I want to highlight and acknowledge all his hard work on this bill. Ever since we were elected to this Parliament, I have had the pleasure and the honour of working with the member on this, and I know how extremely invested he is to ensure that our first responders, our military personnel, and our front-line health care workers are looked after.

These brave men and women do so much for our society and give back in ways that cannot be expressed in words. They give their lives to serve our country. Bill C-211 would require the Minister of Health, the Minister of National Defence, and the Minister of Veterans Affairs to consult with the provinces and territories, as well as stakeholders from the medical community and patient groups, in order to develop a comprehensive federal framework to address the challenges of identifying the symptoms and providing a timely diagnosis for the treatment of these men and women who are suffering from PTSD.

There are some statistics that I would like to share in order to highlight the high PTSD rates among Canadian first responders: 24% to 26% of corrections officers suffer from PTSD, 22% to 24% of paramedics suffer from PTSD, 16% of firefighters suffer from PTSD, 10% to 12% of police officers suffer from PTSD, and 5.3% of military personnel suffer from PTSD.

We cannot forget those who serve on the front lines of the medical field, including doctors and our hard-working nurses. These statistics clearly highlight that large percentages of workers in these essential professions are suffering.

I want to share the story of Natalie Harris, a paramedic from my riding, who was on the front line and the first on the scene of a brutal double homicide. Natalie, who has become a friend and an inspiration to me throughout this process of supporting the member for Cariboo—Prince George, experienced unimaginable traumatic events while working a shift as a Simcoe County paramedic.

Rather than focus on the event and the effects it had on Natalie, I want to focus on her advocacy to help others who suffer from PTSD. Natalie began her road to recovery by simply telling her story. She told her story to a lot of people. In fact, it was at an event in Barrie that we first meet. That night, I told Natalie that I would help her raise the awareness of the issue at a national level, and here we are.

Shortly after the election, the member for Cariboo—Prince George and I talked about the work that he had done to that point and his plans to introduce this bill.

For Natalie, the work continued in spite of some lapses and triggers. She continued, and continues, to speak out, continues to support others suffering from PTSD through social media and a support group she calls Wings of Change. Recently, Natalie wrote a book, to reach even more people with her story. What an inspiration.

Mental health is important to talk about. Those who suffer from PTSD need better resources.

Bill Rusk of Badge of Life Canada stated:

...there’s more of a chance of [police officers] following through [with suicide] because they have the means readily available to them, as opposed to a member of the public, who might have the same feelings, but not the means readily available.

We have a problem here, and it needs government's attention.

Mental illness, like PTSD, can strike at any time, to anyone, regardless of one's age, race, gender, occupation, or income level. It does not discriminate, and it is non-partisan.

Vince Savoia of Tema shared the sad news from his research on PTSD that roughly 60% of first responders who committed suicide in 2015 were diagnosed with PTSD. These are great tragedies.

We need to give our servicemen and servicewomen the help they need and allow them to live their lives to the fullest, rather than be burdened by their illness. People who are in these professions wake up every single day and know that, when they go to work to support our country and their fellow Canadians, their life is at risk. They perform brave tasks day in and day out and are left with the haunting images, sounds, and smells for their lifetime. Bearing witness to the tragedies and suffering that they see often becomes difficult to cope with.

Through the work of this bill, meetings with stakeholders, and the development of this framework, it is my hope that the men and women who do so much for us are able to have the services they require and know that they are not alone in this fight. We owe it to these servicemen and servicewomen, who serve us relentlessly day in and day out, to address PTSD, as it can severely impact their lives and the lives of their families.

In a larger context, mental illness indirectly affects all Canadians, whether through a family member, a friend, or a colleague, and 20% of Canadians will personally experience a mental illness in their lifetime.

Our first responders, veterans, and front-line medical personnel are sick, not weak, and they need this country's help. Therefore, I ask all members in this House to support the bill that was brought forward by my friend and colleague, the member for Cariboo—Prince George.

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, I am very pleased to rise in support of Bill C-211. I thank the member for Cariboo—Prince George for bringing the bill forward. I also thank my colleague from Guelph for his thoughtful remarks.

This bill would create a federal framework for post-traumatic stress disorder, or PTSD. That is a mental condition that can devastate an individual, impacting the individual's family, his or her ability to work, and even his or her ability to perform simple tasks.

As is the case with other mental health conditions, public awareness has often grown in the wake of extreme events, such as wars or natural disasters. Sadly, this has been our experience in Canada as we have seen men and women in the Canadian Forces returning from Afghanistan and struggling for years with the burdens of their experiences there. However, we should not think that this is simply limited to those kinds of extreme events. A soldier returning from a distant combat zone may be the first image in our minds when we talk about PTSD, but more and more, we are learning that stress, trauma, and our body's complex responses to it are issues throughout society, far from battlefields or police precincts or emergency wards.

We see it on university campuses, where students are helping expand access to mental health services and offer more support for survivors of abuse, including sexual abuse.

We see it in workplaces, where employers and workers are finding ways to reduce the stigma of mental illness and encouraging those who once suffered in silence to find the help that they need.

Nearly a decade ago, one academic study pegged the lifetime incidence of post-traumatic stress disorder across the Canadian population at nearly one in 10. In most cases, this could be linked to a single event, such as the unexpected death of a loved one, sexual assault, or witnessing a violent death or injury.

While any Canadian can experience PTSD, certain Canadians are disproportionately likely to shoulder the burden. In particular, I am referring to front-line workers who volunteer for duties that expose them to extraordinary stress. They are police officers and firefighters. They are paramedics and prison guards. They are military personnel and others whose public service can take a great personal toll. Studies have found that members of these professions can experience PTSD at rates at least double that of the general population.

A number of provinces have moved forward on legislation to remove the barriers that Canadians in these professions may face. For instance, in my province of British Columbia, first responders who experience PTSD must prove that it is work-related in order to receive support and compensation.

Last year, in my home province, the NDP labour critic tried to amend a bill in the provincial legislature to fix that problem and make it easier for those first responders, police, firefighters, and others to get the help they need and deserve. It is absolutely shameful that the current Government of British Columbia declined to fix that problem.

Let me share just one story to illustrate why this is so important.

Lisa Jennings was a paramedic in Victoria. In the summer of 2014, Lisa suffered an assault while responding to a call. In the wake of the attack, she suffered flashbacks and suicidal thoughts. After consulting with a psychologist, she filed a claim for workers' compensation. Her claim was denied not once, not twice, but three times, because the board was able to argue that her condition was not the result of the trauma that she had experienced in that assault. In fact, because she had visited a psychologist after her parents and her brother had died in quick succession, she was labelled as having “a well-documented psychiatric history” and her claim was denied. Shameful.

Lisa fought back. With no financial support other than a small disability pension, she appealed the ruling. She even lived in her car while doing so. As Lisa said, “This is for all the first responders in B.C.”

I am happy to report that three weeks ago, Lisa Jennings won her battle. An appeal tribunal reversed the earlier decisions, clearing a path for other first responders to access the support they need after suffering trauma in the line of duty.

A story like that should shock all Canadians and should move us in this place to act. Luckily, we have before us a proposal that would take one step forward, providing the much-needed federal leadership in this context.

What would the bill do? It would instruct the Minister of Health to convene a conference with her colleagues in National Defence and Veterans Affairs, provincial and territorial governments, and stakeholders in the medical community to develop a comprehensive federal strategy framework on post traumatic stress disorder.

This framework would help illuminate the prevalence of PTSD across Canada, as well as its social and economic costs to Canadians, by facilitating better national tracking and data collection by the Public Health Agency of Canada. It would also seek to improve treatment by making it easier to share best practices and by establishing guidelines for diagnosis, treatment, and management of PTSD.

Last, it would broaden awareness of this condition by setting down guidelines for the creation and distribution of educational materials for public health providers across the country.

I want to raise one final issue.

Several months ago, I was contacted by Mark Farrant, a Toronto man who served as a jury foreman on a first degree murder trial. In the course of that trial, he and other jurors were exposed to graphic and disturbing visual evidence and testimony surrounding the brutal murder of a young woman. Jurors are sworn to secrecy, and the moment after the verdict is delivered, released back into their daily lives. In the wake of that experience, Mark began to experience symptoms that would later be diagnosed at PTSD. It would come to disrupt his personal life, his young family, and his successful business career.

Yet, as Mark discovered, jurors in Canada are uniquely unsupported by our justice system. There are supports for judges, court staff, and many others who are exposed to the same graphic evidence and stressful situations, but not for ordinary Canadians who are required to do their civic duty as jurors. It is time that changed. Canadians, no matter where they live, who do their civic duty and serve on a jury, ought to have the proper support services available.

To that end, I raised this issue with my colleagues on the justice committee last year and have written repeatedly to the Minister of Justice, asking that her department assess what steps it can take to address this gap. It is my hope that the justice committee will soon become the first parliamentary committee to study this problem during its upcoming review of the Criminal Code.

While, sadly, we are still waiting for any federal response, I am happy to report that as a result of Mark Farrant's tireless advocacy, and at great personal cost, his home province of Ontario just weeks ago launched a program to provide free counselling to jurors who needed it. Therefore, if Bill C-211 is referred to committee, I will be seeking to develop an amendment to ensure that the issue of juror support is considered in any federal framework on PTSD.

The bill before us today gives us a chance to stand beside Canadians like Mark Farrant in Toronto and Lisa Jennings in Victoria, who swam against the tide at personal cost to do us all a public service. In that spirit, I ask all members to support the bill.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

moved that Bill C-211, an act respecting a federal framework on post-traumatic stress disorder, be read the second time and referred to a committee.

Mr. Speaker, I rise today to speak to Bill C-211. However, before I get into my speech, I want to first acknowledge and thank the first responders, the veterans, and the active military members who have emailed, called, and with whom I have met in person. Many of them are on the Hill with us today. I want to acknowledge their courage in coming forward, and their fight to break the stigma and the silence. These are brave men and women who have been ridiculed, shamed, told to “suck it up and move on”, told that they are making it up, that they are faking it, and, worse yet, that they are weak. I want to thank them for trusting me enough to share their stories with me.

I also want to thank the family and friends of those who could no longer fight for their strength, and their commitment to ensure their loved ones are remembered and that their fight was not in vain.

Moreover, I want to apologize to all for it taking so long to get to this point. I have had this speech prepared for a while now, and as I wrote it, I took time to reflect on the hundreds of individuals whom I had the privilege of meeting with over the last year, those who helped get this bill off the ground, and the thousands more who continue to live in silence.

Mr. Speaker, today is not about you or I, or our colleagues. This is not a Conservative, a Liberal or an NDP issue. Today is about the brave men and women who serve our communities and our country without hesitation and without fail.

I would like to read an email that I received about two weeks ago. It states:

“Our paramedics and other first responders in Canada are amazing. We demand they show up for anything, at any house [at any time] in any weather. They fix our injuries, treat our sickness, restart our hearts. Then they wash their hands, head for home, and rise again to answer the call of duty. They do this job...without thanks, because they want to heal and ease pain. They do this job without fanfare or pursual of fame, and then feel like they get tossed to the curb when the stress builds up too much. Our first responders across Canada need to be treated like the heros and humans they are. This Bill needs to pass.”

There is no rescue for the rescuers. This is just one email, one story, but there are thousands more like it across our country.

One week after being elected, on October 19, 2015, I arrived in Ottawa as a newly-elected MP for the riding of Cariboo—Prince George. I had with me two documents and a head filled with big ideas. The first document was an analysis of challenges and opportunities that existed in my riding. The second was the background for Bill C-211.

Over the course of the two years I spent campaigning, both to win the Conservative nomination and the general election, I met with people from all walks of life. I heard deeply personal and intimate stories of hardship and pain. Many of these individuals were struggling with PTSD themselves, or they knew a colleague, a friend, or a family member who had contemplated suicide or had taken his or her life. They experienced the pain and suffering that was a result of post-traumatic stress disorder.

Bill C-211 was born out of these stories, because it was through these stories that I realized there was no standard of diagnosis, care, treatment, or even terminology for PTSD that was consistent from one end of our nation to another.

The outpouring of letters and phone calls that my office has received since the bill was first introduced last year has been overwhelming. The stories are overwhelming. I have worked hard to meet with individuals and organizations across the country. They are only asking for proper care to be made accessible to our front-line warriors, those who have dealt with the sights, sounds, and smells that average Canadians would find horrifying and heartbreaking.

Our brave men and women put their uniforms on every day, knowing full well that they may have to take the life of another person during the course of their service to our communities and our country, or that in their service and their dedication to our country, they may indeed make the ultimate sacrifice themselves.

Bill C-211 seeks to establish a cohesive and coherent national framework to ensure our military, first responders, paramedics, police personnel, firefighters, emergency dispatchers, veterans, and correctional officers get timely access to the resources they need to deal with PTSD.

The bill sends a message to our silent sentinels that this is not a battle they have to fight themselves, that someone is fighting for them. It is up to all of us, federal, provincial, and territorial legislators, to come up with a plan to ensure that no one is left behind; that our terminology and laws are consistent across the country, from the east coast to the west coast, so an RCMP member serving in Nova Scotia has consistent care with his or her colleagues across our nation; so a firefighter who is not well has the courage to come forward and say “I am not well”; that our veterans or current military know that just as they stood tall for our families, someone is fighting for them, that they know they are not alone, that they can get the care and attention they need when they need it, wherever they need it.

Bill C-211 is about being human. It is about taking a stand. It is not about assigning blame, not passing the buck, not turning a blind eye and saying that it is not our problem. Bill C-211 is about breaking the stigma of mental health injuries. It is about helping them build the courage to come forward and tell their story and seek help.

I have been told over the course of the last year that PTSD is a provincial matter, that this is an issue for the industry to solve. I have also been told that people should know what they are getting themselves into when they sign their job contracts and go into service. I want to reiterate that it is up to all of us to come up with solutions, because lives are being lost.

We are inundated in the media of stories of another veteran or another first responder who have taken their lives and lost the fight due to PTSD. This is unacceptable. Since I tabled my bill over a year ago, countless lives have been lost. This is shameful. We must do better. This begins with education and a willingness to listen without judgment, because less known to the general public are the mental demands that these occupations face. This includes working in a profession that regularly exposes them to graphic scenes and images that anyone would find disturbing and difficult to see.

My bill focuses on first responders, veterans, and military. Even in these three groups, we have differing terms, references, and sector inclusion. Recently, I had the opportunity to speak with a gentleman by the name of Mark Farrant. He shared with me that jurors, who in accepting their civic duty swear an oath to the crown, in fulfilling their duty to the crown were subject to the horrific crimes committed. They bear witness to graphic details and images over the course of their duty, whether it is nine days, nine months, or 19 months. Then, just as they are sworn to secrecy, they are turned out in anonymity to somehow reconnect in our communities, void of the experience and human tragedy that they have witnessed. They are tossed aside.

While not part of this legislation, it is my hope that bringing this forward and speaking to it tonight, the Minister of Justice can perhaps review this issue, and it can be part of our national discussion regarding mental health. We can talk about those who are impacted by this.

The reality is that experiencing human tragedy affects us all differently. Just as one story is not the same, there is not a one-size-fits-all treatment. These incidents and experiences cannot be erased from our memory. One cannot just hit reset. Instead, the images, sights, sounds, and smells keep playing on a continual loop. Simple things can trigger anxiety attacks or severe depression.

Staff Sergeant Kent MacNeill of the Prince George RCMP told me recently that for over 16 years he has served as an RCMP in his community. Over eight of those years he has led serious crime investigations. Just in his daily commute, he passes by two sites of horrific crimes. A simple action of dropping his daughter off at school can trigger his PTSD.

Triggers can come at any time and any place, without warning. A noise, a sight, a sound, or a smell can trigger the debilitating effects of PTSD. Most of us can never imagine what our warriors go through on a daily basis. I know there are practical questions that members across the way may be asking. Will there be a cost for implementing a national framework for PTSD? The simple answer to this is yes, it will cost money, but I counter with this. What is the alternative? What is the cost of inaction? How many more lives are we willing to lose before the government, before we, step up to the plate?

If members on all sides choose to vote down Bill C-211, what then are we proposing as a substitute? What is the message we are sending to those who we trust to be there when we are in need, those who without hesitation answer when the world calls? The question we need to ask ourselves today is what value do we place on these brave men and women?

Right now, we have a piecemeal system of scattered provincial legislation. Ontario, Manitoba, Saskatchewan, Alberta, Nova Scotia, and New Brunswick have all taken steps to rightfully adopt legislation to deal with PTSD. While we are making progress on this front and we have come a long way in recognizing PTSD, leadership is needed at the federal level. The standard of care varies from one province to the next, and we have people falling through the cracks. Individuals suffering from PTSD have an 80% higher risk of suffering from depression, anxiety, alcoholism, drug abuse, and suicidal thoughts. As a society and as legislators, we have failed to come up with solutions to help our heroes, our warriors, the families, and the survivors, because a hero in the east should be treated the same as a hero in the west. Let us get this bill to committee so that we can discuss it, and amend it if necessary. Even with this, we have studied this enough to recognize that much more needs to be done and action is required.

Last October, the Standing Committee on Public Safety and National Security tabled the report, “Healthy Minds, Safe Communities: Supporting our Public Safety Officers through a National Strategy for Operational Stress Injuries”. Bill C-211 was tabled before this committee, and I had the opportunity to participate in that study also. The report echoes much of what I am saying today, and indeed the minister's own response to the committee report said:

...the Government acknowledges the needs articulated by Canada's public safety officers and agrees that, in recognition of the daily challenges that are unique to public safety officers in the community, national leadership and alignment are necessary in order to effectively address this multidisciplinary issue.

Bill C-211 is a perfect place to start and is in line with the government's own commitments. Therefore, it is my hope that we can move swiftly, because we will save lives. Every minute wasted, every hour wasted, and every day wasted, we are losing lives. Action is needed. We are at a crisis level.

As I near the end of what I know is a very long speech, I would like to acknowledge that I am the first one to admit when I stand up in this House that it is usually to act as a voice of opposition to the issue of the day, but Bill C-211 transcends party lines and partisan squabbles. It is an opportunity for all parliamentarians to stand together and acknowledge the very real impact that PTSD has had on the lives of our warriors. If members would bear with me, I just want to read an excerpt from another website:

I get up all hours of the night and check the house over and over. I don't even know what I am looking for. I was asleep about a month ago, and I just knew that someone had fired a gun in my living room. I hear people pound on my door in the middle of the night, when in fact there was never anyone there to my knowledge. One night I got up out of the bed.... I don't know what I was looking for, but on my way through the house, I cocked my weapon. On the way through the house, the .357 discharged and shot a hole through my floor.... I need help, but I have dealt with it for the past two years. It is getting harder to deal with.

By nature, our first responders are part of a culture that frowns upon weakness. The job comes first, and feelings, wellness, and family come second. When lives are affected by PTSD, families are left behind to pick up the pieces on their own. Families are forgotten. Only through bipartisan support and co-operation can we hope to achieve effective and viable strategies, terminology, and education to help deal with PTSD.

Through Bill C-211, we have the opportunity to recognize the sacrifices that our brave men and women have made so we can be here today. Our warriors are our silent sentinels protecting our Canadian values and our way of life. They ensure our maple leaf stands tall, that Canada remains the true north strong and free.

As parliamentarians, let us stand in solidarity in support for those who are willing to give their lives to protect ours. I am asking for the assistance of members today so that we can begin to work on a national framework, and I ask that all members in this House help in achieving this goal by voting for Bill C-211 at second reading, because lives are at stake.

Holidays Act

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, it is an honour to rise today to speak to Bill C-311, an act to amend the Holidays Act, regarding Remembrance Day.

I will start off by saying that I am one of the people, and I think we all are here, who believe our veterans should be celebrated every day for their supreme sacrifices, as well as those who continue to put the uniform on so that our maple leaf is still standing tall and that we remain the true North, strong and free.

I want to celebrate and acknowledge our colleague from West Nova for putting the bill forward. I think the intent of the bill is the right thing to do. However, as has been mentioned by not only the member himself but a number of other colleagues, the bill is flawed and does require some work. The intent of the bill is to ensure that all Canadians from coast to coast to coast have the ability to pay their respects to our soldiers and veterans and to make sure that November 11 continues to be a sacred day for Canadians. It is an opportunity for us to show our fallen, our veterans, our forces members, and their friends, families, and loved ones, that they are honoured and respected both in life and death. We will never forget.

There are thousands of distractions that compete for our time on a daily basis, be it the work email that needs to be answered, the TV in the background, or that phone call that needs to be returned. However, Remembrance Day is the one day where on the 11th hour of the 11th day of the 11th month Canadians pause to remember. It is an opportunity for us to take time to be thankful for the sacrifices of others, whether protecting our country, working with our allies and partner countries, providing humanitarian assistance, aiding countries by helping to restore the peace, or fighting for our freedom. The sacrifices of our brave men and women have allowed us to continue to live in a free and democratic country where we are tolerant and we respect freedom of speech, religion, thought, belief, and expression.

We live in the best country in the world. I know that I do not need to tell the hon. members in this chamber that. We all have the privilege each and every day to walk into this chamber and raise the issues that are important to our constituents.

I want to hearken back to when I was a sea cadet. For a long time, I proudly wore the uniform and I proudly marched in Remembrance Day ceremonies. I had what I consider to be the distinct honour of being an honour guard at a number of those ceremonies. I want to come back to one of the most proud days that I had, which was the day right after being elected last year. Remembrance Day had taken place and I was going to be sworn in the very next day, but I had that opportunity to lay the wreath that said “Canada” on our local cenotaph. I am getting goosebumps right now just thinking about that because there is no greater honour than paying respect to those who have given the supreme sacrifice. There is no greater honour than when we look through the windows and we see the flag.

As I am looking over your shoulder right now, Mr. Speaker, I cannot help but look at that flag and think of the blood that was spilled fighting for our country, the blood that was spilled ensuring that you, I, all of the members in the House, and our friends and our families can sleep silently and know confidently that we are protected.

We all have the privilege each and every day to walk into this chamber and raise the issues that are important to our constituents because of democracy, because of the sacrifices that these soldiers, these brave men and women, have made for our country. Remembrance Day is a time for everyone to come together and pay their respects for the loss of youth, for the blood of their comrades who may or may not rest in foreign fields, and for the sheer anguish of having fought in war.

We are now just understanding what the term PTSD means. It is one of the reasons why one of the very first things that I did in coming to the House was to table Bill C-211, calling upon the government to develop a national framework recognizing the challenging demands that our first responders, our military, and indeed our veterans have faced dealing with PTSD, as we are just now beginning to understand.

November 11 is not the only day to remember that. As I said earlier, we should always be remembering that supreme sacrifice.

There is much debate about the flaws in the bill and whether it is a provincial or federal regulation. The important part is that the bill is going to hopefully go to a committee. The bill as it stands today will be completely different when it comes out the back end, but my hope is that perhaps we can engage veterans from coast to coast. Perhaps we can engage the Legion. We need to have that conversation. We need to always be mindful of those sacrifices and celebrate them.

This day was created to honour our history and remember that the freedom we have in Canada comes at a cost. We are thankful to those who were there and to those who are today always willing to fight for us to have the privilege of waking up each and every morning knowing that we live in peace. As I said earlier, they are our silent sentinels. While most would run away from danger, they run toward it. When they wake up each day, they live with the knowledge that when they put their boots on in the morning, they may have to put their lives at risk to support and protect Canadians and our country.

It should never be forgotten that this freedom comes at the most significant cost of all, the supreme sacrifice. It comes at the cost of bloodshed, injuries, post-traumatic stress disorder, and death. Even when our soldiers are able to return home, it will never be the same for them, because they will never forget. They will continue to be haunted by the horrific sights and smells of war. The nightmares and the mental demands do not end. These are graphic scenes and images that anyone would find difficult to see.

It is so important that we educate our next generation, our future generations, about this history, the importance of our forces, and the price that was ultimately paid by the youth of another generation in preserving our freedom. This responsibility falls on all of us as citizens, as educators, and as families across Canada.

We cannot have this debate without bringing in the fact that the Royal Canadian Legions are our guardians of remembrance. There are more than 1,400 branches across Canada. More than 300,000 members give about 1.5 million volunteer hours a day. They give back to the communities about $6.5 million helping our soldiers and veterans come back and have some form of peace. They give back to their communities, and we can never forget that.

It is my hope that by getting the bill to the next level, Dominion Command will be invited to Ottawa to speak before the committee and that veterans will have the opportunity to be heard.

This is about the over 1.7 million Canadians who have served our country, whether in the First World War, the Second World War, the Korean War, the conflicts we have had in recent years, or the ones we are facing today. It is about all of those who have honoured us by serving and some who made the supreme sacrifice.

In closing, it is a true honour and a privilege today to rise and speak about our troops and our veterans. I will be voting to send Bill C-311 to the committee stage. On a personal note, I hope that all Canadians will make an effort to participate in Remembrance Day ceremonies in their communities on November 11. If that is not possible, I hope they will take two minutes of silence at 11 a.m. to remember those who made such a huge sacrifice for all of us. To those who are listening to this debate today, they have served beyond.

Situation in Indigenous Communities

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, I will join my hon. colleague in imploring the government to invest more immediately.

One of the reasons I tabled my Bill C-211 is to look at a national framework to deal with PTSD for first responders and veterans, because mental health issues affect all Canadians. We need to have a national strategy. In putting forth that bill I hope to not only help those who run toward danger when others run away from it, but to have this discussion so that we can serve all Canadians and build a national framework so that we can stop this incredibly horrendous epidemic.

Public Service Labour Relations Act

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, it is a great pleasure today to rise in the House to debate Bill C-7.

I will start by thanking the RCMP members in my riding of Cariboo—Prince George, and I thank as well my hon. colleague from Yellowhead for his 35 years of service.

I would like it to be on the record that I was an RCMP brat. My stepfather served in the RCMP, which meant that I saw many of the small communities from the tip to the tail of British Columbia.

Our RCMP members are moms, dads, sisters, and brothers. They are volunteers in their communities. They coach minor sports, work with charities, and contribute to the health and wellness of our communities, and not just when they have the uniform on, but every day.

The men and women of the force put their uniforms on and go to work every day knowing full well that they will experience human tragedy. They know full well that their lives may be placed in danger just so that we and our families can sleep well at night. They are our silent sentinels.

The legend of the Mountie is well known: always getting their man, Dudley Do-Right, and my favourite superhero, Captain Canuck, who by day is a mild-mannered RCMP officer and by night fights evildoers.

The red serge and the campaign hat are representatives of our proud country. Core values of integrity, honesty, professionalism, respect, and accountability were exemplified by the first 150 recruits to our force back in 1873 and are now carried by the 28,461 current members of the force.

As I said earlier, my stepfather was in the RCMP. He told me long ago that it was not because of the great wage at the time but because of the pride and respect associated with the force.

The musical ride is internationally recognized. I have travelled with Mounties from coast to coast and overseas in representing Canada, and I can say that the lineups to get photos with the Mounties were always the longest at every event.

However, today our forces, all 28,461, are at capacity. There is a 30% disparity with their unionized counterparts. They are facing increasingly challenging times.

An average citizen may expect or experience one to two traumatic events in a lifetime, whereas a police officer may experience 600 to 900 traumatic events over the course of his or her career. A recent study shows that over the course of a 20-year career, a member of our police forces will face over 900 traumatic incidents.

Over 30% of our police officers suffer from PTSD. We need to break the stigma. We need to give our men and women the confidence that they can come forward and report issues, whether it be harassment or PTSD. We need to give them the confidence that they can ask for help. As well, we need to give the organization, management, and families the resources for training so that we do not unnecessarily lose another life.

We are here to talk about Bill C-7 and about a secret ballot. We are here to talk about allowing those who put their lives in danger every day the democratic right to a secret ballot without fear of intimidation or reprisal. Regardless of what labour policy reads, as my hon. colleague from across the way has said, fear and intimidation happen. Whether it is in our RCMP force, police forces, firefighters, or regular everyday workforces, fear and intimidation of some sort does happen. Harassment and intimidation take place.

Our Conservative stance is that we support the Supreme Court decision and stand with our men and women on the front line. However, we believe those who risk their lives every day deserve the democratic right to vote free of intimidation and reprisal.

Over the last couple of days, I have been accused of being against unions and our front-line members. This could not be further from the truth. Over my time, I have belonged to five unions. I believe they have a right to exist in today's work environment. I also believe that my bill, Bill C-211, calling for a national framework to deal with PTSD for our first responders, RCMP members, veterans, corrections officers, and firefighters, speaks for itself and to my belief and stance in support of those who put their lives in danger every day.

Communities in my riding are facing increased policing costs. They are struggling to be able to fund our police forces appropriately. Whether it is overtime due to illness, injury, or lack of resources, meaning members, we are struggling.

Just in my community of Williams Lake, to the south of Prince George, we have an ongoing issue with gang violence. Just last night, I was meeting with Minister of Public Safety on this issue. Just one tactic to combat this issue that we face, asking for three additional officers, would mean a tax hike of 2% on an economy that is already stressed, on a mayor, on a council, and a town facing challenging times already, and gripped with fear of the increasingly violent activities of these gangs.

We need to give appropriate resources for our police forces, for our front-line members, for our management. We need to be able to give them the opportunity to vote free of fear of reprisal. Amending Bill C-7 to allow for the democratic right to a vote is the right thing to do. The responsible thing to do is to consult with the municipalities that ultimately bear the costs of policing, so that the resources necessary to fulfill the agreements that are there, either for unionized forces or under negotiation, are in place. Giving the resources for our communities, giving the resources for our management and our police force, is the right thing to do.

However, we face challenging times. We have a government that does not believe that giving a democratic vote or voice to those who put their lives in danger is the right thing to do.

I will not be supporting this bill, but I do hope that it can get to committee so the government can do the right thing.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Stamatakis, I just want to say thank you to our guests as well.

In developing my bill, Bill C-211, I am deeply familiar with some of the concerns that are being experienced, but one of the things that I failed to do adequately, and the question has been raised.... How would you define the term “first responder”?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Thank you, Mr. Chair.

I want to thank our guests, as well as my colleagues across the floor.

As my colleague Mr. O'Toole has mentioned, I'm deeply passionate about this. This is something I'm very familiar with and I have spent a long time working with those who have been inflicted with PTSD. I have had a lot of colleagues, over the years, who have been dealing with this.

I'm going to direct a few questions, but I'm going to do a shameless self-promotion, if I can, because my passion and my belief in this area and why it's so critical—and I applaud this government for taking this on—is that this discussion is long overdue. That is why I tabled Bill C-211 calling for a national strategy and the development of a national framework dealing with PTSD in first responders and veterans.

Specifically for the areas of concern that we've been talking about here and some of the intricacies in dealing with what our guests are talking about, there has to be a national strategy that deals with and then can build on the standards and consistencies among all of the levels of first responders or the classification. This means the terminology, the best practices, ultimately the care and education, looking at pre- and post-vulnerability, dealing with the very real stigma attached to PTSD, so that our first responders or veterans have the ability to come forward and have a voice, and that we've armed their colleagues and families with the tools to be able to deal with and recognize the concerns and the challenges as we move forward, and the warning signs, so that we don't lose another person.

I do have a question for Dr. Sareen.

In your testimony before the Senate Subcommittee on Veterans Affairs, you referred to a concept called “the rule of thirds” and you indicated that a third of OSI patients can be expected to have a full recovery, a third will have a moderate recovery that leaves some remaining symptoms but it enables a patient to function well, and another third will continue to struggle over a long period of time

I have to challenge you on this. I'm not quite sure we can erase the traumatic incident from people, which they've experienced. I agree on recovery. I think we can provide resources and the ability to cope and to lead a productive life, but I'm not quite sure that we can fully recover, as with any other mental health issue.

Dr. Sareen, can you provide a little bit more insight as to how you came to that recommendation that there can be full recovery on that? I'm interested in your comments.

Federal Framework on Post-Traumatic Stress Disorder Act

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

moved for leave to introduce Bill C-211, An Act respecting a federal framework on post-traumatic stress disorder.

Mr. Speaker, I would like to introduce my private member's bill, seconded by the member for Barrie—Innisfil, who served as a firefighter for 33 years. This private member's bill would put in place a national framework on post-traumatic stress disorder for first responders, firefighters, military personnel, corrections officers, and members of police forces such as the RCMP. These are individuals who wake up every single day with the knowledge that when they go to work they may have to put their lives at risk to support and protect Canadians and their country.

It is my sincere hope that with this private member's bill, the men and women who are our silent sentinels know that they are not alone in this and just as they fight to protect our nation there is someone fighting for them. Heroes are human too.

(Motions deemed adopted, bill read the first time and printed)