National Defence Committee on Nov. 1st, 2012

[The Chair, Conservative, James Bezan]

Thank you.

We now have Mr. McKay for the Liberals.

[John McKay, Liberal, Scarborough—Guildwood, ON]

Thank you, Chair.

As Mr. Harris said, it has been an interesting and fascinating discussion, and I thank you for it.

I've been reflecting on your conversation, Colonel McLeod, about the distinction between illness and injury, and it's kind of hard to tell, at times, what is what. I just wonder whether this is language that makes it more acceptable to a soldier, which in turn will encourage him or her to seek therapy.

For instance, I think there is good literature to support the notion that if males at a certain age smoke marijuana, that will precipitate a psychotic break for a certain percentage of them and they will have a mental illness. I'm assuming—but I don't know—that soldiers who experience certain trauma will have a psychotic break, and that psychotic break will lead to a diagnosis of a mental illness.

So here's the question I have. It's a little vague, and I apologize for that. Is this distinction between illness and injury an appearance of a distinction or is it a reality? Also, is it a bit of a fiction so that you effectively can encourage everyone to get more involved in their therapeutic needs?

[Col Scott McLeod]

Well, it's a good question. How do you define an injury, and how do you define an illness? Post-traumatic stress disorder is an illness. It occurs as a result of a trauma that somebody has been exposed to. If you were exposed to a trauma and you broke your leg, we would call that an injury; they were exposed to a trauma and they have a mental health injury related to that as well.

Whether you define it as an illness or an injury, I don't think makes that much difference, but if it allows people to accept it, come in for therapy, and get their treatment early, then it's useful. If changing the terminology helps us get somebody in early and get them treated, then I am all in support of changing that.

[John McKay, Liberal, Scarborough—Guildwood, ON]

I see a lot of head-nodding here. I'm fine with that; I was just thinking that you can't really tell sometimes.

My second question has to do with the immense pressure that the military is under for financial savings. It's just a reality that the budgets are going to be wound down quite substantially.

This puts you in a very awkward position, I should think. A soldier has to be deployable and has to meet certain standards, and his unit has to have a certain number of available bodies. I would think that one of the ways of rationalizing has to do with injured soldiers: “let's shove them off to some other unit or get them out of the military”. Do the unique pressures that the military is under at this point create any pressures for you?

[Col Scott McLeod]

We have not seen any of those unique pressures in any way. We've had tremendous support in looking after anybody who is suffering with any form of injury or illness.

Having the IPSCs available on the bases allows somebody to be posted to a unit while they undergo therapy. That unit can backfill with somebody else to continue doing their day-to-day job, but it allows that person the option of recovering and then returning to the unit.

When we put people in protective medical categories to limit their activities in the job, to help them recover, doing so may pull them out of their job, but we do want to get them back in. We've trained these folks, we've invested a lot of money in them, and we want to keep them. We want to do everything we can to get them back into that job. That's the most cost-effective and efficient way to deal with these cases, so that's what we try to do. We have not been under any pressure to do anything different from that.

[The Chair, Conservative, James Bezan]

Thank you.

We're going to have to move on.

Mr. Chisu, you have the last question for the Conservatives.

[Corneliu Chisu, Conservative, Pickering—Scarborough East, ON]

Colonel McLeod, what mechanisms do you have in place to monitor and evaluate your policies and programs for their rate of success? How are you evaluating that your programs and your policies are successful...? What is the measure of that?

[Col Scott McLeod]

That's a great question. We have just completed the Rx 2000 rollout of what we consider to be our mental health program, and we're just initiating a validation of that model to look at a variety of different outcome measures.

The other thing we're looking at doing is instituting an outcome measures tool to look at how our patients are responding to different levels of treatment. If patients aren't responding well, we can look back at the case, we can find out what more we can do to help them, and we can reinvest treatments in that person. Or if somebody is doing better than expected and they don't need as much therapy, we can redirect those resources to people who may need a little bit more. We are absolutely looking at many different ways to validate what we do and make sure that it's appropriate.

[The Chair, Conservative, James Bezan]

Thank you.

Colonel McLeod, you have some homework that I'm going to have to send out with you. You have a few questions that would be good information to get back to the committee with. Mr. Harris asked you for the breakdown on mental health services out of the 378 full-time employees who are in the mental health services section. Also, Madam Moore asked about access to those services for reservists who are in more isolated communities across Canada. Mr. Brahmi asked for the percentage breakdown of civilian versus military mental health care providers within your department.

On behalf of the committee, I want to thank all three of you witnesses for participating in our study. This is a very important and timely issue and is one that all of us are taking quite seriously. I want to thank you for your commitment to help with the recovery of our men and women who have bravely served this country and who are dealing with all the stresses of the injuries that they've incurred while serving our nation.

I'm particularly thankful to both Ms. Hull and Ms. Vandergragt for being here today and talking about the use of animals, especially that great beast, the horse, in helping our men and women recover, to be more functional with their families and to be able to get over the stresses they've incurred.

Colonel McLeod, I'm sure we're going to see you again, and maybe even next week, I understand.

With that, I'll entertain a motion to adjourn.

[An hon. member]

So moved.

[The Chair, Conservative, James Bezan]

We're out of here.