Evidence of meeting #49 for National Defence in the 41st Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was researchers.
A recording is available from Parliament.
Director, Canadian Institute for Military and Veteran Health Research
It's certainly mental health, physical health and force protection, and family health. Those would be the top three.
Conservative
The Chair Conservative James Bezan
Perfect. Thank you very much.
We're going to move along.
Mr. Norlock, it's your turn.
Conservative
Rick Norlock Conservative Northumberland—Quinte West, ON
Thank you very much for appearing today. I'm very interested in all you have to say, quite frankly.
I have a couple of questions.
The first one has some ancillary questions after a statement. As you are an innovative organization that engages existing academic research sources and facilitates the development of new research, research capacity, and effective knowledge exchange, I believe it would be beneficial to the committee if you would explain how you conduct your research, number one. And I have some ancillary questions. Do you speak with veterans and serving CF members directly? How do you assemble and analyze your findings? Can you inform us as to the types of research methods you use, as there is such a broad scope of maladies that can affect CF members?
Director, Canadian Institute for Military and Veteran Health Research
Yes, certainly.
In the research being done, the actual methodology for the research is really nothing new. It's the type of research where there are epidemiological studies, there are clinical studies, and there are case histories. There's everything that you would normally use in research. So standard research protocols are followed.
I think what we've done is we've just brought the idea to the research community that military and veterans and their families have unique health needs, so they're studied as a different population or included as a marker. As you're doing a large survey you would ask questions: Did you serve in the military? Were you a first responder?
You would ask those questions to be able to distinguish out the crowd.
Standard science is what is used typically, and it depends on the type of research that's being done. We have engaged, as I've said, a very broad spectrum of researchers, so there is a broad spectrum of methodology being done.
Conservative
Rick Norlock Conservative Northumberland—Quinte West, ON
Do you speak directly with veterans and CF members, or do you use the interviews from other studies?
Director, Canadian Institute for Military and Veteran Health Research
Both are done. Typically we try to give researchers access to the populations directly if that's the type of research they're doing. Some of the database research is done using existing Stats Canada databases and stuff. But no, as much as possible, we try to link the researchers with the relevant populations.
For example, one of the top PTSD researchers in the country, Dr. Jitender Sareen from the University of Manitoba, has assembled a national team together to look at conducting the Canadian community health survey again for veterans. Going back to Mr. Harris' question, it was done in 2007, and there are some old data, but they want to redo it and get new data, again with a particular focus on military and veterans. He's going across the country doing town halls with veterans.
Conservative
Rick Norlock Conservative Northumberland—Quinte West, ON
I think you've maybe answered a lot of my second question, but I'm going to ask it just so you can fill in some of the gaps, time permitting.
Some of the institute's key outcomes in the research division fall under the heading of knowledge exchange, where listed activities are research forums, workshops, peer review publications, and extensive use—and this to me is the important one—of social media. Can you explain further how your organization liaises with educational facilities and other institutions—and again I highlighted this one—and what you've achieved thus far using these methods?
Director, Canadian Institute for Military and Veteran Health Research
Well, I think our biggest accomplishment is having engaged the 25 universities, and people recognizing that we do focus on a special population.
On the use of knowledge exchange, we've been able to bring new research teams together. I'll give you a really concrete example. There's a huge movement afoot in the country on sport concussion research. It's in the papers every day, and the NHL is very involved. I guess they have to have something to do.
That's been a very big issue. We were able to bring the sport concussion research community and their tremendous researchers into the military realm of traumatic brain injury, because it's very similar. The head is getting jostled around and the brain is getting bruised. We were able to link the sport concussion community with the military community, and now they're talking. So some of the top research and best practices are coming to the clinicians who deal directly with those soldiers.
Was that a good example?
Conservative
Rick Norlock Conservative Northumberland—Quinte West, ON
Yes, it is actually very good.
How much time do I have?
Conservative
Rick Norlock Conservative Northumberland—Quinte West, ON
Going back to workshops, peer review publications, extensive use of social media, can you give us some examples of the latter?
Director, Canadian Institute for Military and Veteran Health Research
Some of what we're doing now, along with our website and what not—Facebook and Twitter for the younger generation—is looking at apps to help people, so apps for smartphones. We're working with several different research groups around the country to look at bringing apps to serving people that can help with their health care specifically. If somebody has a mental health issue and they're going into a situation that will be stressful, they can be fed information: “This is a stressful time; here are some things you may want to do to help with your health. You're in such and such a location now. If you need emergency services, this is where you can go. If you want to contact your clinician, drop them an e-mail or text them. They are there for you.”
We're really looking at that, especially for younger soldiers and sailors and airmen. That's how they function, right? They live on their smartphones.
Conservative
Rick Norlock Conservative Northumberland—Quinte West, ON
Thank you very much for answering my questions.
Conservative
Liberal
John McKay Liberal Scarborough—Guildwood, ON
Thank you, Chair.
Thank you, Dr. Aiken. I suppose I should add a second thank you because I didn't know I should thank you for the influence or contribution made to the Scarborough shootings, which happened in my riding. Two people were killed, 43 people injured, and apparently nobody saw anything—but that's another issue.
I do remember talking to the chief afterwards and talking about how effectively the whole thing was triaged, and the various people, based on their state of injury, being farmed out to the various hospitals as they were available. So thank you for that. I didn't know it was you to whom I should direct my thanks.
Director, Canadian Institute for Military and Veteran Health Research
Well, it's Colonel Tien. I can take no credit.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
The issue of concussive injuries, following on Mr. Norlock's question, is pretty vexing. It has both a civilian and a military application. I would be interested in your thoughts with respect to, if you will, the latest area of research in that field. Where do you think the research might be going? And what is its relationship to PTSD and other mental expressions of what is a physical injury?
Director, Canadian Institute for Military and Veteran Health Research
That's a great and very timely question. A lot of the research being done now is really trying to distinguish between mild traumatic brain injury and post-traumatic stress disorder, because the symptoms people display are often very similar. Some of the higher-technology research going on and the really cutting-edge stuff is around brain mapping, which is looking at the physical changes in the brain, to see if you can distinguish between post-traumatic stress disorder and mild traumatic brain injury. But it's also brain biomarkers, so actually measuring the chemicals in the brain to see if there are different chemical changes, because there are changes in the brain with both. It's being able to distinguish them.
As I'm sure you can appreciate when it comes to a clinical level, if you make the incorrect diagnosis and you are treating for post-traumatic stress disorder and the person has a mild traumatic brain injury, they are never going to get better. So it's really critical.
I think those are the really cutting-edge things being done. We have some sensational researchers in Canada doing work, looking at eye movement, which is very closely related, obviously, to brain function—all our movements are, but the eye is in particular—and seeing if they can distinguish between different eye movements to determine it, so it's not as invasive as doing brain biomarkers and brain mapping.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
I know the forces are very keen on this research, particularly Brigadier-General Bernier. Describe for the committee the interaction between the forces and your collection of researchers and how that's working and what each brings to the party.
Director, Canadian Institute for Military and Veteran Health Research
With respect to the brain biomarkers, one of the mental health leads from the Canadian Forces, one of the uniformed psychiatrists, is working directly with the research team. He's a co-investigator with the research team. And they were able to bring some money to that team through Defence Research and Development Canada—a small contract through them. They were able to facilitate this research, with a lab that contains the world's experts in measuring brain biomarkers. They are very engaged in that particular research.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
I'm given to understand that there is something in the order of 1,300 members or past members of the forces—I may have got my figures wrong—who have exhibited PTSD or may even have been diagnosed. I'm not absolutely certain about this. I understood at the meeting on Tuesday that this number will double. What advice would you be giving to the forces that would be unique with respect to members returning from combat and facing re-assignment or possibly leaving the military, voluntarily or otherwise? What would your research tell the military as to how to do discharges differently?
Director, Canadian Institute for Military and Veteran Health Research
If you can make an accurate diagnosis and implement the appropriate treatment, then you have a greater chance of curing someone and allowing them to stay in. With PTSD that has been properly diagnosed, a third will be treated and get better and be fine, a third require ongoing treatment but can still serve, and about a third are not responsive to treatment. It may be that some of those have traumatic brain injury. For the military, what they want to look at is how to protect against this. They want to know what they can do to protect against mild traumatic brain injury or post traumatic stress disorder. Mild traumatic brain injury could be an equipment issue. Post-traumatic stress disorder is not.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
I have one final question that is not on the previous lines. It was given to me by a veteran and it is related to your research. Injured veterans might not receive the care that they need under the new Veterans Charter as compared with the Pension Act. In the face of this, what would you recommend as treatment of ill and injured prior to medical release for not meeting the universality of service?
I can't say that I actually understand that question, but it does seem to me a very important one.
Director, Canadian Institute for Military and Veteran Health Research
That was some research that I conducted three or four years ago in which we compared the Pension Act with the new Veterans Charter in terms of financial compensation for seriously disabled veterans. That's 1% of the veteran population, the people who are deemed to have greater than 78% disability. What we found in three case studies was that the Pension Act paid more money.
What we didn't take into account was all the other programs, the focus on rehabilitation and reintegration, that the new Veterans Charter has. The Pension Act would just pay you and you wouldn't have to work. So philosophically, for 99% of the veterans, the new Veterans Charter is probably better. Unfortunately, we were misquoted a lot. But the people at Veterans Affairs know me, so they didn't get too upset. It was controversial, but they were great. In fact, it was taken into account before they made the most recent changes to the Veterans Charter.
Conservative
The Chair Conservative James Bezan
Thank you. Time has expired.
We're going to go to five minutes now, and I'm going to be very judicious because we only have half an hour left with Professor Aiken.
Mr. Chisu, you have the floor.