National Defence Committee on Feb. 14th, 2008

[Joe McGuire, Liberal, Egmont, PE]

Most MPs deal with veterans mustered out after the Korean War or the Second World War, who just wanted to get home, so they just said, “There's nothing wrong with me; get me the hell out of here.” Then years later they started suffering from injuries that occurred while they were on duty. So they have to go back and prove all this stuff.

I would imagine that a lot of these people, too, are pretty anxious to get home and pretty anxious to get away from medical examinations and just get clear of it for a while. You're saying that they're not dropped there when they muster out, that they're followed up on, six weeks later, and there are safeguards.

[Cdr R.P. Briggs]

Three to six months.... There's not a lot of hard, fast proof of the ideal time, but it's some time after the initial honeymoon phase of redeployment back with the family, as well as post-deployment leave, which lasts anywhere from four to eight weeks typically. That's why three to six months is generally what you aim for, because that's before the regiments get into their regular training routines, etc.

That seems to have worked reasonably well, but we rely on the chain of command to ensure that the members actually do go through the enhanced post-deployment screening. Part of the reason the third location decompression is effective is because you have a captive population. They're not going to simply go home as opposed to sitting through some of the educational sessions, for example.

[Joe McGuire, Liberal, Egmont, PE]

We were told when we went up to Petawawa that a lot of divorces occur after soldiers come home, because they just can't fit in with life as it was.

[The Chair, Conservative, Rick Casson]

Joe, we'll have to come back to that one. I apologize.

Finishing this round will be Mr. Hawn, and then we'll get into the cleanup round, starting with Mr. Coderre.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you, Mr. Chair.

I want to address a couple of different things. We talked about the ratio of 1 to 145 by the time we get to 447 mental health professionals in the military. Obviously, we face a lot of trauma in society generally, more and more every day, but nothing nearly as concentrated as what happens in places like Afghanistan.

But if we apply the same ratio of 1 to 145, we would have to have 221,000 mental health professionals in Canada. I don't know what the number is and you probably don't either, but I'm suspecting it's quite a bit less than that.

There are two points I'd like comment on. First, is the CF very different from society in general in terms of exposure to trauma given the concentration in that? And at the level of 1 to 145, I would suggest we are obviously treating what is necessary to be treated, but treating it in a very aggressive, proactive way. Is that a fair statement?

[Col A.G. Darch]

Yes. The study that was done in 2002 showed that the Canadian Forces at that time had an incidence of post-traumatic stress disorder that was equivalent to the civilian population.

With the deployments in Afghanistan, it has gone up a little bit. I don't have the exact numbers, but it makes intuitive sense in terms of the things the soldiers have been exposed to there.

I'm sorry, sir, what was the second part of your question?

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Just that with the ratio we have of 1 to 145 we are giving much more access to care than the general population gets.

[Col A.G. Darch]

Yes, sir. Our intention is that none of the soldiers will suffer from a mental health disorder, an operational stress disorder, any longer than possible, and that they're picked up as soon as possible, given appropriate treatment, and returned to normal duty.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

From what you just said with respect to the Douglas study that was done in 2002, which has changed somewhat, obviously, with Afghanistan, is the CF substantially different from society in general? I realize this calls for a somewhat subjective answer.

[Col A.G. Darch]

We're just really getting the numbers coming in on that. It would seem to me, given that our soldiers are thoroughly prepared for the deployment, they're given realistic training before the deployment, they have social supports, they're educated on stress-related injuries, and there's the unit cohesion of the military family, all that makes a big difference as well.

The numbers I've seen so far would indicate that perhaps we're seeing approximately twice the rate of PTSD following deployment to Afghanistan.

[Cdr R.P. Briggs]

Sir, I don't know if this will help at all, but I've gotten some numbers from Halifax and they inform me that in terms of being assessed at the OTSSC, the Operational Trauma and Stress Support Centre there, it takes anywhere from one to eight weeks until somebody gets in and is fully assessed, which includes a battery of psychometric testing that is standardized across the CF.

The average waiting list in Ontario to see a specialist is 15 weeks, I'm told, which is actually the best in Canada. That's generic specialists. That's anything from cancer to orthopedic surgery, so it may not be as helpful. In Saskatchewan it's 27 weeks.

So even with our current resources that aren't end-state, I still think we're doing pretty well in the CF in terms of getting folks to specialists.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Okay.

I wanted to explore something briefly that came up with Mr. Nadeau's questions, and it related to the continuity of service between somebody in the military and somebody out and how that transition works, because as a veteran I have access to services that are provided under my pension plan, but it doesn't mean I go back to a military clinic.

Can you describe how things are transitioned from DND or the CF to Veterans Affairs? Can somebody do that?

[Capt(N) M.E.C. Courchesne]

I'll take that on.

As I was trying to explain to Mr. Nadeau, when people leave the military they no longer have access. It's outside of our mandate to look after them. This is for any member who takes a release from the military.

If they are injured, they will be transitioned to VAC and VAC will take over. We are working in close collaboration. The Chief of Military Personnel organization is especially working very closely with VAC to improve the transition and make it much smoother. I can say for our part that if there were any concern that people would not have their care taken over immediately by a civilian practitioner, we would continue looking after them until such time as we could hand them over to the civilian sector and they were well connected with Veterans Affairs to ensure their needs would be looked after.

[Cdr R.P. Briggs]

Occasionally we'll even extend termination leave just so we can get the person stable.

My point earlier was that if somebody believes he has PTSD attributable to service, then as a veteran, in that particular instance, he can come back and be assessed. That was the caveat there. Perhaps I didn't explain it well enough.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

So that person can come back, within the military system, to be assessed--

[Cdr R.P. Briggs]

Exactly. It will be in the OTSS Centre.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

--and then treated outside the system.

[Cdr R.P. Briggs]

That's an MOU between us and VAC.

[The Chair, Conservative, Rick Casson]

Good. That clarifies that.

That ends the second round.

To start the final round, we'll have the official opposition, the government, and the Bloc for the first three slots.

Mr. Coderre.

[Denis Coderre, Liberal, Bourassa, QC]

Thank you, Ms. Courchesne.

Indeed, your last point was important in terms of our ability to comprehend the current situation.

My first question is clear and specific: in cases where a person under medication is sent back to theatre, what medications would he be receiving to treat his anxiety or mental health issue?

[Capt(N) M.E.C. Courchesne]

Well, that depends on the diagnosis.

[Denis Coderre, Liberal, Bourassa, QC]

Give me two examples. I know we are not talking about Sudafed.

[Capt(N) M.E.C. Courchesne]

Are you specifically referring to mental health issues?

[Denis Coderre, Liberal, Bourassa, QC]

Yes. For example, if an individual thinks that he is fairly well, he is given a specific medication and sent back to theatre. What medication would he be given?

[Capt(N) M.E.C. Courchesne]

I cannot give you specific examples. I have no immediate knowledge of that, but if it were a mental health problem, he would be treated by a mental health expert. The medication would likely be an anti-depressant or anti-anxiety type of drug.

Having said that, as we stated earlier, if that is the case, it is under very specific conditions and, if it has been recommended by the mental health professional, once that individual is in theatre, he will have immediate support.