Regarding your first question, I think that, if you have not yet invited Dr. Marc Zamorski, you should ask him to appear before your committee. He could provide you with a very comprehensive answer to the question of how Canada stacks up against its allies. I want to point out very candidly that he shared with me in 2009 certain studies indicating that, compared with the United States, England, New Zealand and Australia, Canada was a leader in “destigmatization”.
Dr. Zamorski congratulated me and pointed out that we have invested a great deal of effort in the peer support program. He did not give the program I launched all the credit for Canada's position among other countries, but he said that it has certainly had an impact. He also mentioned the fact that the Canadian culture was not comparable to the culture of other countries. So this is a complex issue, but I suggest that you invite him because, as an epidemiologist, he is very open. He could provide you with much more information on this topic.
Based on my experience and on what I have noticed by working primarily with Americans, I think that we are indeed ahead of the pack. As for the term “operational stress injury”, I developed it somewhat strategically by moving away from the notion of combat. When the United States began to use that term—which was first adopted by the U.S. Marine Corps—they reverted to the use of the word “combat”. They talk about “combat stress injury”.
I think that is a tactical error because it gives the impression that people need to participate in combat to experience the consequences of an overseas deployment. In short, I think this is both a step forward and a step backward.
To answer your second question regarding the two types of injuries, my answer would be no. Unfortunately, I have not seen any programs that are as rigorous as the Canadian one in terms of non-clinical care. Some countries have made a lot of progress on a clinical level. The idea, especially in the United States, is to deal with physical injuries through a psychological approach from the outset. Here, in Canada, I think we are a little bit behind in terms of that. Unfortunately, other countries don't have any significant non-clinical programs. So I have not seen any examples we could follow.