Evidence of meeting #12 for National Defence in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was medical.
A recording is available from Parliament.
Col David Weger
That question has more to do with health services. The chain of command in the theatre of operations and clinicians who specifically treat the injured work together.
LCol Gerry Blais
Perhaps I could clarify the issue a little from an administrative standpoint. Currently there is a program in place to help injured members reintegrate into the workplace. We make every effort to reintegrate them into the workplace as quickly as possible, whether it be in their particular field or in some other area.
We first want to ensure that the work gives them a sense of purpose. That is very important because we do not want to relegate them to minor tasks. For example, a double amputee from Edmonton is current providing support services to injured members. These are the types of things that we do.
Universality is an enduring principle when it comes to Canadian forces services. Ultimately the issue is whether these members have a future in the forces and whether they can conform to the premise of service universality. Every possible effort is made to reintegrate them into the workplace. If that is not possible, then we do everything we can to help them find a good civilian job.
Bloc
Claude Bachand Bloc Saint-Jean, QC
What about the options available to some soldiers, especially those who are suffering from post-traumatic stress disorder or who are seriously depressed. Do you consider medicating them and sending them back into combat zones?
Speaking of drugs, I would imagine drug costs are covered by the Canadian Forces. Could a soldier who is very depressed and who is sent back to Canada possibly rejoin his originating unit in a theatre of operations, while under medication, for the purpose of seeing whether if he is fit for duty?
Col David Weger
If the member is suffering from a permanent, or chronic problem, steps can always be taken to improve his condition. However, as the Brigadier General stated when he last appeared before the committee, it is not possible to heal every person suffering from post-traumatic stress disorder or from other mental health problems.
Our clinical section personnel may be in a better position to answer questions about cases of this nature.
Claude Bachand Bloc Saint-Jean, QC
Eventually, we will need to hear from the people working on the clinical side of things.
Public services come into play when dealing with members with special conditions or in need of medical care. I understood you to say that the public sector in each province was responsible for providing this care. How does this work? Does each province bill the government for the cost of the care provided to CF members? Is that how it works?
Col David Weger
We do a combination of things. Uniformed mental health services providers are stationed on most of our bases. I believe virtually all of the psychiatrists work out of the clinics on military bases. We provide a range of services to members. Perhaps the person responsible for health service delivery could better answer that question. He could explain the balance we try to strike.
Bloc
Bloc
Claude Bachand Bloc Saint-Jean, QC
Some trauma centres are located on military bases. The Canadian Forces ombudsman has already talked about the possibility of opening trauma centres off base, since victims of post-traumatic stress disorder are stigmatized to some extent.
Would you be in favour of an initiative like this?
Col David Weger
I am not a clinician. I am an administrator. Therefore, I am not in a position to say how to best go about treating persons, regardless of their mental or physical condition. That question would be better put to the Director, Health Services Delivery, or to our health services officials.
Conservative
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
Thank you, Mr. Chair.
Thank you to both of you for coming to the committee today.
I've been meeting with some families of military personnel who've served overseas and have come back with various traumas. A couple of the families I've met with have felt that there have been many obstacles in the way of getting a diagnosis, that it was a very lengthy process even though they were incredibly concerned about the person who'd come back from the mission. I'm sure that's something that all of the Canadian Forces is looking at and attempting to improve the services for.
But I want to ask particularly about the issue for reservists, because we know in the next rotation there's a large number of reservists going over—in fact, quite a few from my own community, New Westminster, the Royal Westminster Regiment.
One of the concerns I've had, and I know it was raised at the meeting last week—I wasn't here, but it wasn't addressed; there was no answer given in the testimony—is how will it work now for reservists? We know when the regular forces come back they'll be stationed at a base, they'll be part of the military community, for want of a better word, and yet reservists will go back perhaps to a community in the north or a community not near a base. How will the follow-up be done for post-traumatic stress disorder or acquired brain injuries, or any other kinds of injuries that reservists may find once they've gone back to their home communities?
LCol Gerry Blais
From an administrative point of view, there are now, in 11 areas of the country, detachments of my organization, the centre. They are there to look after regular forces and reservists. We are working right now at expanding the detachments to have more staff, and they are going to look after all the injured in any particular area.
So the first thing that's very positive is that any reservist who returns from theatre with an injury is serviced on class C reserve service, which means he or she has all the same benefits as a regular forces member. That will be extended until such time as the person has recovered and the commanding officer and the doctor certify that the person can go back to work.
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
I guess my question is a little bit more specific. I know they've said that in six months they will have an examination of returning soldiers on the base. How will that follow-up take place if someone is in Pouce Coupe or northern Alberta and not near one of the 11 centres you talked about?
LCol Gerry Blais
The detachments are very mobile, and they have a region, not just a small area of responsibility. They will ensure that they maintain contact with these individuals. Through that contact, they will also be in contact with the member's case manager and ensure that the person has the information, whether the medical service is going to be provided in the person's own community or at the base. Either way, the persons travel—
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
So they would do some travelling to seek these people out?
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
I have another question, and it flows from the testimony last week but also from personal interest. I don't know if you're the appropriate person to ask, but I'll throw the question out, and you can let me know.
I'm interested in the screening that's done for recruits, the psychological screening. They said in the testimony last week that it's not done, basically. They don't do much in the way of psychological screening for recruits. I know they do it in police forces across Canada, so I wonder why the Canadian Forces doesn't do that.
Also, in talking to military families, I've been told by some that the first reaction in some cases, when they've raised the possibility of post-traumatic stress disorder or of some kind of occupational stress injury, is that they've been told sometimes that it's probably a pre-existing condition, which they've argued against. I'm just thinking that if you had an effective and proper screening process, you would know if there were pre-existing conditions that would result in this kind of behaviour or illness.
There was an article in, I think, one of the Vancouver papers, where I live, about a really horrible example of the lack of screening. A fellow who'd actually been an associate of the Hells Angels, who had been, I think, charged with murder in British Columbia, was able to get through whatever screening process there was. He was in training in Quebec, and it was his fellow service people who were alarmed by his behaviour and went to the authorities above, and he was eventually discharged. I can't help but think that if there were a proper and thorough screening process, this kind of situation wouldn't arise. You wouldn't have someone like that who gets through the process and becomes enlisted and then has to be discharged. Also, it would certainly lessen the number, perhaps, of people who show mental health problems later in service.
So I'm wondering about the whole issue of psychological screening.
Col David Weger
Certainly neither of us is the ideal one to ask the question to, but perhaps I can point you in the right direction.
With respect to the efficacy of psychological testing to pick up things of the nature you've identified, likely the best people to talk to are the directors of health policy. The medical recruiting office falls under their responsibility and could very likely provide you with some information, or could at least point you in the right direction with respect to that specific area.
In a wider sense, on the actual recruiting process and the screening associated with that, the director general of recruiting and military careers or the commander of the Canadian Forces recruiting group would be the most likely sources for answering those questions more effectively.
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
What sort of educational training do soldiers get about post-traumatic stress disorder? Are sessions given so they can self-identify and understand what might be going on if they're starting to show signs or feel within themselves signs of a problem? What kind of education do you provide to help them self-identify--or their families, for that matter?
LCol Gerry Blais
As a component of the operational stress injury social support program there is a speakers bureau. These are folks who have lived through either post-traumatic stress or a form of operational stress injury, and they now speak at all leadership courses to ensure that people are aware. That starts at the lowest level, at the master corporal level, and they go all the way up. We're currently trying to widen that mandate so we get it into as many training modules as we can to ensure that people are aware of the signs and how this actually occurs, and to reduce the stigma.
Conservative
