Thank you for the question.
There are two parts to that. First of all, the wait times, and then the difference I've seen in how people suffer from the days when I first started working in this field until now.
I gave the example from the Royal Ottawa hospital, of the difference, at times, being 12 weeks in our system to 12 months in the provincial health care system. One of the problems for a lot of the organizations that you're talking about is that they fall under medicare. They fall under the provincial health care system, and they don't have their own internal health care and mental care like we do in the military, so it becomes much more difficult.
We've instituted programs where, for example, we will see the RCMP members who have deployed with us. We will prioritize them and see them for assessment. We will then give back recommendations to their physicians so that they can start getting treatment. It's because it was taking so long for them to get services in the civilian world, and of course, they had deployed with us and had put themselves in harm's way, the same as CF members had.
In terms of the difference, that's a really good question. One of the things that I remember from when I first started working in the OTSSC, was that when members came in and I took their history, it wasn't uncommon for them to tell me that they had not slept through a single night in 10 years since returning from Rwanda or from Somalia, and that they had nightmares for almost all of those nights.
I have to tell you, as a civilian psychiatrist first starting to see people, I was taken aback. It was a bit hard for me to believe. But, of course, I had so many people who came in over and over again telling me that same story that I realized it was, in fact, true. These people had suffered in silence for years and years, had continued to work, and were stoic. I often needed to get their spouses in to get the real story of how much they were suffering because they didn't want to say very much.
Now it's much more the case that people come in six months to a year after returning from tour if they find that they are still having nightmares or still having an exaggerated startle response. I think they are much more willing to come in. There seems to be less stigma associated with this. I think part of it is that often their partners are much better educated now. They won't let them stay in the basement and drink for 10 years anymore. They say, "Hey, you're going to go and get some help.”