National Defence Committee on March 25th, 2013

[Chungsen Leung, Conservative, Willowdale, ON]

Thank you, Mr. Chair.

I have not had the privilege of serving with people in uniform, but I did serve as a military adviser in UNCTAD. My area was in the provision of emergency water, emergency power, and shelter. I must admit that having been in areas of non-combat, I also feel the effects of how the operational stress injuries could happen because it does happen to those of us who are not in uniform. Because we serve with a broad contingent of people in these UN missions, is there a difference between an actual engagement in the combat situation versus in the non-combat situation? Sometimes these different types of operational stress injuries will manifest themselves much later in life.

I'll share my personal experience. I was asked to do some water purification work and I came across a mass grave. I must say that was something that still affects me today. From time to time I often ask myself whether I should seek some psychiatric care, even though I feel very strongly that I can handle the psychological impact of that and I'm still functional, but again, a lot of these things can manifest much later in life.

Perhaps you could share with us how we should look at the combat situations versus the non-combat and peacetime situations where we are put in a situation of operational stress.

[Stéphane Grenier]

I think what your question alludes to is the core of the definition of the four causes of operational stress injury, the four causes that we developed in cooperation with the U.S. Marine Corps in the 2007-08 era.

Very clearly one is trauma. I believe it's very fair for me to say that if you are in a combat situation, you are experiencing high-intensity trauma. That's the trauma perspective, or the trauma lens, that allows, unfortunately, some people to develop mental health conditions from traumatic events.

The three other causes of operational stress injury are those causes that are under-endorsed, misunderstood, and often ignored. This goes back to an earlier question. These are the three other causes which, by the way, remain to this date, despite years of fighting in Afghanistan, I believe, the top causes of why soldiers decompensate. They are fatigue, the cumulative wear and tear on the soul.... I'm not talking about being tired and wanting to sleep. I'm talking about the fatigue of really having a hard time continuing to do what you're doing because there have been too many mass graves.

There's grief. Grief is that sense of loss. When you look at grief as a cause of stress injury, you don't need to know your friend or you don't need to know the person who died. It's a sense of loss. It's a corporate sense of loss. Mr. Alexander was in Afghanistan. There were a lot of ramp ceremonies, weren't there? The entire contingent grieves. I lost only two soldiers on my tour of duty. I knew them very well. I grieved at a different level. But every time a coffin came back to Canada, there was institutional grieving, and there's a cost to that.

Finally, there's the moral conflict. Moral conflict is probably the most important cause of stress injuries, and I think it's what you're alluding to. You went overseas thinking you would do x, y, and z, and all of a sudden you're confronted with situations that don't quite fit. You're not too sure what to make of all of this. It causes moral conflict, questioning, and it opens a Pandora's box.

Whether you need treatment, sir, I couldn't say, but the fact that you're talking is a good thing, and it just shows your humanity. For that, I applaud you.

[Chungsen Leung, Conservative, Willowdale, ON]

I've always been very open about my experiences, but I am just thinking of it from an institutional point of view. What this committee needs to bring to the attention of Parliament is whether our role, our international role as peacekeepers in the future, because we're not always in a combat situation, should be included in this entire framework of support services for operational stress.

[Stéphane Grenier]

Absolutely, which is why I said now that we're not in a combat role, we cannot let these programs erode, because we will be one day. Peacekeeping erodes people as much as combat does. I'm convinced of it. I hope that one day Parliament will calculate the human cost of all these operations, not fuel, boots, tanks, and planes, but the human cost.

[The Chair, Conservative, James Bezan]

Thank you. The time has expired.

Before I skip to the third round, I want to get in a couple of questions myself.

I'm listening to your testimony, Colonel, and you're talking about the delivery and some of the gaps between different levels, for example, between Veterans Affairs and National Defence, and provincial services versus the quality available within the Canadian Forces.

I don't know if you're familiar with the ombudsman's report to the minister, “Fortitude Under Fatigue”. The sixth recommendation is that the CF's strategic leadership consider the viability of a more modern application of the principle of universality of service.

Is that what you've been trying to get at in your testimony today, that we need better universality?

[Stéphane Grenier]

Well, I will be very candid, Mr. Bezan, and say that I think there is no such thing as universality of service. I'll be very candid again. I'm not in uniform anymore, but I think it is a figment of the Canadian Forces' imagination to think that every soldier, sailor, airman, airwoman is put up against the same standard in order to validate their physical and mental ability to serve their country. I know for a fact that if you are a corporal at 2 RCR in Petawawa, in order to demonstrate your ability to serve against universality of service standards, it is significantly different from if you are, let's say, an air frame tech serving in Trenton, which is why this paradigm of ours has to change. If you are an infantryman and can no longer demonstrate universality of service in Petawawa, where the standards are much higher than in Trenton, let's stop kidding ourselves. Give that person a chance. Let the person go to Trenton, and I bet you that person will meet the universality of service. It is the biggest misnomer, in my estimation, that we have to wrap our minds around, and the ombudsman is completely correct.

[The Chair, Conservative, James Bezan]

Would a recommendation of how we go about achieving that be changes in the philosophy within the leadership?

[Stéphane Grenier]

I would have to think about that. I did not come prepared to answer the question of how, but I do know that it does start at the leadership level. I do understand that hopefully there will one day be a chief of military personnel or a chief of the defence staff who will accept that this universality of service thing is a figment of their imagination. It's a bit like an alcoholic finally realizing that they have a drinking problem.

Some of our leaders unfortunately have not realized that it's a joke, quite frankly. Until that happens, nothing is going to change.

[The Chair, Conservative, James Bezan]

I applaud you for all the work you've done in reducing the stigma and putting together the organizations to provide the support to our members of the Canadian armed forces.

One of the witnesses we had here last week was from the True Patriot Love Foundation. Bronwen Evans actually made the comment that the women who serve us in the Canadian armed forces are least likely to come forward and say that they are suffering from PTSD or they have some other OSI.

In your experience in the work you've done in and outside the Canadian armed forces, do you see that as well, that women aren't stepping up to say they have a problem and they need help?

[Stéphane Grenier]

I don't have decades of experience in my civilian work now, but I have to say that every meeting I go to, every corporation I work with, the majority of people who are stepping up are in fact women. So if True Patriot Love is reporting that women aren't coming forth in the military, I would say that is not consistent with what I've experienced. I find that I work with a lot more women out there who wish to engage in these programs than I do men. However, I don't know what that's attributed to.

I have to say that—

[The Chair, Conservative, James Bezan]

To quote her, she actually said that women are concerned that they are going to be perceived as not being able to cut it.

[Stéphane Grenier]

I don't know what it's like to be a woman in the military; I have no idea, but I can imagine that in order to make your place in a man's world, you're going to have to work perhaps as hard or harder. Therefore, when you've achieved that, the demise could be that much more rapid if you expose these potential vulnerabilities or perceived vulnerabilities. I can imagine that it is most likely true; however, in my experience in the military, I did see a lot of women come forward. Actually I had outstanding peer supporters who were women who were doing an outstanding job.

I think the women who engage in our program were representative of the demographics of the military, but I'm not saying this to dispute your former testimony.

[The Chair, Conservative, James Bezan]

Thank you.

We're going to go to our third and final round so that everybody has another chance to ask some questions.

Madame Moore.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Thank you, Mr. Chair.

I'd like to come back to the peer support issue.

As far as programs go, it's clear that people have a very hard time overcoming the stigma and admitting they have a mental health problem that is affecting their life. Alcohol or substance abuse problems are prevalent. In terms of alcoholism, Alcoholics Anonymous is one example of a peer support program that works well.

The situation is different when it comes to drugs, however. Unlike in the civilian world, where drug use doesn't have a stigma, in the armed forces, it does. So on top of the initial stigma of having a mental illness, people face a secondary problem. If someone talks about their drug use, they risk ending their military career.

How can we handle drug or substance addiction by members of the armed forces more effectively? Could peers play a role in that regard? I would appreciate hearing your view on that problem.

[Stéphane Grenier]

You're no doubt ware that DND introduced blind testing policies to screen for those who could be taking drugs. As parliamentarians who study these matters, you also know, however, that soldiers are resourceful people. Our soldiers are extremely resourceful.

Something unexpected and unintentional happened. Under a policy that was put in place, testing was done to check whether anyone had used drugs on the weekend, for example. And soldiers in some places began replacing cannabis with harder drugs such as cocaine. Why, you ask? Because cocaine is eliminated from the body in 24 or 48 hours, whereas cannabis stays in the blood stream or urine for months.

From a strategic perspective, then, it's important to first consider the unintended consequences that our drug testing policies could have. When a soldier uses drugs or alcohol to cope with a mental illness, that addiction is what we call the presenting problem, but it's not the underlying problem. Unless we're talking about a criminal thug who slipped through the cracks at the recruitment centre, generally speaking, substance abuse is a way to cope with the illness.

What is imperative is to treat the illness, ensure it is recognized. Through a strategic lens, I believe we need to maintain our peer support programs to encourage people to seek help as early as possible. It's extremely important that we not let austerity measures in difficult years chip away at mental health programs for Canadian Forces members. The worst thing the government could do would be to allow the army to cut what is sometimes perceived as fat. We've finally got some good programs. It would be a sin if the army lost them.

To answer your question, I would say that, first of all, the current screening system could be having devastating consequences on some individuals because they are so resourceful. Second, I would say that we really need to continue focusing on mental health. That is my view.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

As things stand now, do members of the Canadian Forces talk about their drug use or do they keep quiet about it until they are caught? Do people ever seek out help before they are found out?

[Stéphane Grenier]

Again, this is my opinion and I can't prove it. But my intuition tells me that among younger members, say those with less than 10 years of service, 4 or 5 years in, for example, a certain culture has developed in some units. It is seen as cool. Certainly, like anywhere else, people don't shout it from the rooftops, but it is known within their group, and they party hard on the weekend.

As I said, members of the military try to get around the screening policies. Cannabis is cheaper but riskier when it comes to testing. Cocaine is more expensive but less risky in terms of testing. The drug problems today are a bit more complex than they were when people stuck to cannabis.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Basically, then, people get help only when they're caught and backed into a corner, in other words, if they are forced to do something.

Very well. Thank you.

Do you know the percentage of program participants who are active members, meaning, those still serving in the Canadian Forces, versus the percentage of veterans who are in the program?

[Stéphane Grenier]

Unfortunately, I don't have any numbers with me. I've been away from the program for three years now. But those numbers are easy to get. There shouldn't be any trouble obtaining that information.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Were many women available as peer helpers?

[Stéphane Grenier]

You mean women acting as peer helpers?

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Yes.

Can a female member ask to speak with another female, or is she simply assigned someone without the option of specifying the helper's gender? In terms of post-traumatic stress syndrome, say, a woman may have an easier time talking to another woman.

Was that a possibility?

[Stéphane Grenier]

You bring up an important consideration when it comes to the peer helper. When I put programs in place in private industry or large companies, we do the same thing. There isn't an official way to access peer support. In other words, the person who needs help seeks out a person of their choosing. If you look at the OSISS website, you will see a map of Canada with all the names of those who are available. If you're in Petawawa and you'd like to speak with Janet in Winnipeg, you can call long distance. The cost of the call is covered by taxpayers, but that's okay. People are talking.

That's a fundamental difference from the medical system, which is very much planned and extremely dogmatic. The medical system relies on reference material and prescriptions. The peer support system conflicts with that philosophy. It's a complementary system. Philosophically, it's a huge departure, but it's not a problem. The peer support system doesn't work like that.

My answer is affirmative. The individual chooses the person she feels comfortable with.

[The Chair, Conservative, James Bezan]

Merci. We're well over our time.

Mr. McKay.

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

Your testimony has been a fascinating two hours. I appreciate the effort you've made to be here.

I have a couple of issues.

The observation you made about soft drugs and hard drugs is one I've heard about. Soldiers are very clever about getting around whatever tests they need to get around.

I want to go back to the beginning, in terms of when you decided the military needed to run peer support programs. My observation, from testimony here, is that the walk and the talk don't actually match up all the time. Soldiers say, “We really need this kind of therapy”, and the brass are saying, “We don't have any empirical evidence that this actually works”, and there are arguments to be made on both sides.

I'd be interested in your experience with respect to the genesis of the proposal for the peer support program and what your observations were with respect to getting it off the ground, as well as what resistance, if any, you received, and how you measure success.