Thank you, Mr. Chair. Thank you to the Standing Committee on Justice and Human Rights for the opportunity to discuss mental health supports for jurors.
I'm a clinical psychologist who has worked with many individuals who have experienced trauma in their line of work, including first responders and military members. What many of them have in common is not only mental health injuries as a result of exposure to trauma but also the confusion and stigma that they're suffering as a result of something that's considered a normal part of their duties. Therefore they often do not recognize or seek help until much later, when their difficulties have impacted many aspects of their work and personal lives.
Why is this important to the Canadian government? In addition to the amount of suffering of individuals and loved ones, the Mental Health Commission of Canada has estimated the cost of mental health difficulties to employers in Canada to be $6 billion in lost productivity per year. As well, 30% of short-term and long-term disability claims can be attributed to mental health difficulties.
Imagine if we could make a dent in that economic cost and that incredible amount of suffering. We can certainly do so by improving awareness and increasing early access to effective treatments to reduce this ripple effect on our economy. The World Health Organization estimates that every $1 invested in treatment for depression and anxiety results in a return of approximately $4 in better health and our ability to work.
Returning to the impact of trauma on mental health, I'd like to highlight the impact of cumulative trauma or the repeated exposure to traumatic material and human suffering. For example, criminal investigators may have to view extremely disturbing and graphic images and videos over and over. They may bear witness to extreme suffering and work with victims and their families. The impact of exposure to such material can induce feelings of horror and helplessness, and these were included in the revised criteria for PTSD a few years ago.
Repetitive exposure to traumatic, gruesome details, as well as witnessing the emotional impact on victims, their loved ones, and witnesses, can certainly impact those in the courtroom as well. Members of a jury have no choice as to whether they serve on a jury or as to the type of trial. As does the work of investigators, jury duty may involve exposure to horrific images, videos, and details of unspeakable horrors and immense suffering, yet currently jurors do not receive any education on the potential impact on their own health.
As do first responders and others exposed to trauma in their work, jurors may try to “suck it up” and fulfill their civic duties. They may not recognize that they're suffering until they have finished and have returned to their regular routines. There, they may begin to see the impact on their emotional and physical functioning.
PTSD symptoms may include but are not limited to repeated disturbing memories and images; nightmares; feeling jumpy; trouble sleeping and concentrating; and feeling numb, guilty, sad, or scared. They may try to cope by drowning out these problems with alcohol or drugs. Imagine experiencing these types of problems day after day, night after night, seeing horrible images when you look at your computer screen or—worse—in the faces of your loved ones.
I worked with an individual who was severely impacted by his service as a jury member. He was repeatedly exposed to horrific images and details of the victim's suffering throughout the trial. He performed his civic duty well; however, he developed PTSD. Of course, he had no idea what was happening because he knew nothing about PTSD except that it was something that happened to soldiers and victims of terrible crimes. He never imagined that his difficulties may have been the result of a regular societal role of serving on a jury.
His home life deteriorated, and his work suffered. When he tried to reach out to the justice system for help, he received few answers. By the time my client realized something was wrong and that it was connected to his jury duty, and by the time he eventually made his way into my office, at least a couple of years had gone by, and his PTSD symptoms were by then well-entrenched and impacted every single aspect of his life.
There were then many other stressors to deal with on top of his PTSD. Treatment was also a major financial burden for him, resulting in fewer and irregular sessions. If he had had knowledge of how trauma could impact jurors, guidance in accessing services sooner, and financial help in paying for evidence-based treatment, he could have started to feel better much sooner, and many of these ripple effects may have been avoided.
This brings me to evidence-based treatment for PTSD. This term “evidence-based” is important.
There are many counsellors and therapists out there who offer therapy for trauma. Their effectiveness varies widely. Some may be ineffective or may even worsen one's PTSD. It is crucial that evidence-based treatment be available for both the client's access to effective care that can help him or her and for reducing long-term costs for the payer of that treatment.
The American Psychological Association recently updated its guidelines for best practices in PTSD treatment based on strong research support. These include treatments such as cognitive behavioural therapy, prolonged exposure, and cognitive processing therapy. These treatments have also been studied and recommended by the National Center for PTSD run by Veterans Affairs in the U.S.
In summary, there is a similarity between jurors serving their civic duty on trials and criminal investigators bearing witness to traumatic scenes over and over. Recommendations for this standing committee include the following practices.
One, provide jurors with education about the potential impact of traumatic material as well as resources for healthy coping skills before and throughout the trial. This can also help to reduce stigma.
Two, provide psychological information and check-ins after each trial so that individuals can recognize if they do begin to experience trauma-related difficulties. Such a process would let individuals know that experiencing intrusive symptoms such as memories and nightmares for the first few weeks is normal. This process would not ask individuals to go into detail about the trauma, as doing so can be harmful too soon after the experience.
Three, because many individuals may not notice problems until they have transitioned back into their regular lives, it will be important to provide contact information for a specific organization or individual should the individual need guidance in accessing services.
Four, having funding available for evidence-based treatment can make an incredible difference in both the short term and the long term.
Thank you, members of the committee, for allowing me the opportunity to speak today about the impact of trauma on jury members. Having a federal framework in place to support members of our society performing such an important civic duty will be remembered as a crucial step forward in promoting mental health for Canadians as a whole.