National Defence Committee on Feb. 7th, 2008

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Thank you, Mr. Chair. I would like to welcome our witnesses, whom we have seen a lot of on Parliament Hill lately, including at the Standing Committee on Public Accounts and the Standing Committee on Official Languages, where I saw Mr. Semianiw.

You are here today to help us determine whether, as far as the mission in Afghanistan is concerned, Canadian Forces are appropriately prepared when they return from their deployment back to their families, and whether they are receiving adequate health services, and more particularly treatment for mental health disorders.

General Jaeger, you talked about extreme shocks. Can you please explain to me what that is all about?

I don't mind if it is in English.

[BGen Hilary Jaeger]

Perhaps it's better to explain it in English--Une choc extrême, an extreme shock--I think it's intuitively obvious that if you were riding in the back of a LAV III and it blew up and killed the guy next to you, if you survived, then you have lived through a certain shock. If you were involved in a firefight and one of your best friends was killed, that's a shock. If you're a woman walking through Central Park in New York and you are gang-raped, that's also a physical and an emotional shock.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Would you say that those extreme shocks could be an initiator of the post-traumatic stress symptoms?

[BGen Hilary Jaeger]

Those are the classic examples of the kinds of things that, down the road, may lead to post-traumatic stress disorder.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

You mentioned that when we are on the battlefield and we have a near-death experience, we come very close to death, our hormones go up, our heartbeat goes up. It's kind of normal. I guess everybody's on a battlefield. You say this is a case where we'd be diagnosed with the syndrome.

How does it develop?

[BGen Hilary Jaeger]

I'm not a neuropsychiatrist. I'm not even a psychiatrist; I'm a general practitioner. But I'll give the dumbed-down version, as I understand it.

In the presence of that kind of hormonal flood, the brain actually processes memories differently. The memory of the last time you went to Disney World is in your brain, right, but it's there in a very mundane and normal way. The memory of the situation you were in when you almost died is processed in a different way. It sits in a different part of your brain, where it's more hard-wired into that whole hormonal mix that leads to the fight or flight thing. It makes you anxious.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

My question is more on how it ends up that for some it's like a normal reaction and for others it develops into post-traumatic syndrome. Does it depend on the individual?

[BGen Hilary Jaeger]

There's a great individual variability.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Okay.

You have some statistics. Did you provide us with statistics regarding PTSD?

[BGen Hilary Jaeger]

No.

[MGen Walter Semianiw]

As I said last week,

we're still gathering those for here.

Again, I would caution that the statistics are only generalities. Getting into the details.... There's a danger with PTSD. But we're looking at and gathering those.

These are the generalities, in a sense.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Post-deployment, how long does it take before the syndrome appears? I believe you said it can take up to two years.

[BGen Hilary Jaeger]

It can take a long time. We never know exactly when the symptoms will appear, or whether members have experienced the symptoms but have ignored them or repressed them for a while.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Another question seems important to me. Some troops unfortunately die in combat. What kind of support do the families, spouses and survivors of the fallen troops receive? What is out there for the survivors, the widows and widowers of military members who die on deployment? Are there programs available to them, are they monitored? After all, they have lost someone very dear to them and there may be psychological consequences.

[BGen Hilary Jaeger]

In the last six months, we have lost four medical technicians, including two from Quebec, from within our health services. We also have bereaved families and widows. In English, the most important point of contact is called

the assisting officer.

I'll go on in English. It's much easier and faster.

It's somebody who is appointed right at the time we find out the member is deceased to guide the family through the process and to support them.

Personally, I have a bias in this. I think it's very important not to medicalize grief, so we don't turn around and automatically truck out and refer them to physicians and things right away. Grieving is a normal process. The vast majority of people have it. It feels awful. They are not having a good time; you don't want to be in their shoes. But they come through it.

[Steven Blaney, Conservative, Lévis—Bellechasse, QC]

Merci.

[The Chair, Conservative, Rick Casson]

Thanks, Mr. Blaney.

Just before we get into the final round, I have just one quick question, if you don't mind.

What percentage of deployed troops actually develop PTSD? Do you have a number for that, quickly?

[BGen Hilary Jaeger]

We have an imperfect number, as far as we know, and this is based largely on the first rotation that went into Kandahar, the guys who did the first full rotation. From the post-deployment screening figures, the best number we have for PTSD is between 5% and 6% of those.

[The Chair, Conservative, Rick Casson]

Okay, thank you. I appreciate that.

For the final round, to clean up on the questions, we start with the official opposition, and then we'll go back to the government.

Go ahead.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

Okay. I'll be sharing my time with Mr. McGuire.

This question has been skirted around, and I'm not sure exactly how to ask it. I'll just preface it by saying you mentioned that 20,000 troops to date have gone to Afghanistan, 739 have been injured, 298 have been wounded in action, and 350 have had non-battle injuries.

Where does OSI or PTSD fall in there, or does it fall into those numbers at all?

[MGen Walter Semianiw]

Let me first clarify that what I said was “into the theatre of operations”. Remember, this is not just people in Afghanistan; it also includes those who may be on a ship in the gulf and who are injured. It includes those who are in a theatre of operations, not just focused on Afghanistan, to be clear. The theatre of operations also includes the gulf—the air force, the army, and the navy.

[BGen Hilary Jaeger]

I believe that where we have been able to establish a clear link for mental health issues, or OSIs, the numbers are in there. Remember, we are still expecting to get, six or twelve months down the road.... Those numbers will be underreported for mental health issues, because it's something that comes up later. The people who track stats as people come back in airplanes from Landstuhl don't have those figures.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

So they're not placed in either the wounded in action or non-battle injury category. They're not placed in there?

[BGen Hilary Jaeger]

I have no confidence that all of them are in there.

[MGen Walter Semianiw]

What it says here is that wounded in action includes injuries from IEDs, personal injury—to get to what you're looking for—acute psychological trauma directly attributable to combat action that required medical intervention. Those are the wounded in action—