National Defence Committee on April 1st, 2014

[The Chair, Conservative, Peter Kent]

Thank you, colleagues. As we continue our study of the care of ill and injured Canadian Armed Forces members today, we welcome again to committee Colonel Gerry Blais, the director of the casualty support management and joint personnel support unit, Department of National Defence, to address questions and issues around operational stress injury and social support.

Colonel Blais, you have a ten-minute opening statement, sir.

[Colonel Gerry Blais, Director, Casualty Support Management and Joint Personnel Support Unit, Department of National Defence]

Thank you, Mr. Chairman.

Mr. Chairman and members of the committee, it's a pleasure to appear before you once again to discuss the operational stress injury social support program, or OSISS as it's commonly known.

OSISS, which is now a mature 13-year-old program, is a partnership between the Department of National Defence and Veterans Affairs Canada. The aim of OSISS is to ensure that military personnel, veterans and family members entering the program reap the benefits of programs and benefits that can assist them in their recovery. Breaking down the barriers of stigma and providing social support has led many of the target group to seek the help they need. OSISS Is a critical non-clinical component of the mental health services of both departments.

Peer support coordinators and family peer support coordinators are typically former members of the Canadian Armed Forces or family members of veterans and serving personnel who know first-hand the difficulties of living with an operational stress injury and the possible impacts. More specifically the peer support coordinators provide the following services:

Provide peer support to those making the first steps in re-establishing a social connection in both one-on-one and group formats. They perform outreach activities to reach out to peers in need and to community support organizations that provide support to OSISS peers. They work with peers to identify and implement actions that will lead to improved social relationships. They actively work with peers to encourage positive self-care; actively support peers in efforts to better manage and adapt to life events and transitions; manage unusual or difficult situations when delivering peer support in the community with at-risk populations; participate in developing and delivering awareness and information activities; work to break down the barriers of stigma and provide social support; and provide ongoing mentorship and guidance to peer volunteers.

Peer support involves hours of conversation, working to balance listening with sharing, and helping peers connect with others. The staff of OSISS, along with their 127 trained volunteers, is an extremely dedicated and passionate group who serve more than 2,000 people in need in both individual and group settings. The majority of OSISS peers are housed in the joint personnel support unit's integrated personnel support centres, and a few are located in VAC offices.

The highly successful OSISS program, complemented by the helping others by providing empathy, HOPE, program that provides peer support to bereaved family members, are outstanding gateways to clinical mental health programs. This helps the Canadian Armed Forces attain the objective of providing mental health care to all its members who require the services.

I will be pleased to answer any questions the committee may have.

[The Chair, Conservative, Peter Kent]

Thank you, Colonel Blais.

We will begin our opening round of questions with seven-minute segments.

Ms. Gallant.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Thank you, Mr. Chairman, and through you to Colonel Blais.

With operational stress injuries, often not just the serving member is impacted, but the entire family. They become so involved in the day-to-day care and they're impacted as a consequence of how the member of the forces treats them because of what they're going through.

Could you tell me what sort of support, if any, OSISS provides to the family members?

[Col Gerry Blais]

The staff of OSISS is comprised of peer support coordinators on an almost 50-50 basis. They provide support to the individual suffering from the OSI. The other half are family peer support coordinators who provide support to family members. We have members of families who have lived through the experience of living with someone with an OSI who are now able to talk the family through what they're going through and also direct them to the resources that are best able to provide them help.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

When I was first introduced to OSISS—I would say it was over a decade ago—the criticism was that “these are just peers and they don't have any training”. They were accused of just being drinking buddies and working through the problems in a very unprofessional fashion. Is that the way it is today? Is there any training for the volunteers or the peer support individuals?

[Col Gerry Blais]

Absolutely. When the program began, as with any program, of course, there was a learning curve. The program actually began in a waiting room where two individuals who were seeking treatment began speaking to each other and realized how therapeutic that could be. Since that time, we have a partnership with Veterans Affairs, and some of the staff at St. Anne's Hospital, who are experts in the field, train all of our peers. All of our volunteers receive the exact same training as the peers in how to deal with this.

The important thing for them is to respect boundaries. They are not clinical staff so they don't have the ability to treat clinically. What they are there to do is to listen and refer. They will take the problem under advisement. They'll encourage the person to seek medical help and take their medication if they are receiving treatment, guide them down the proper path, and also lead them to the resources that can best help them.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

When OSISS first stood up, there was a turf war, I would say, between the medical professionals, who felt they should be the sole providers for the personnel, and the OSISS. How has that relationship evolved over time?

[Col Gerry Blais]

Very positively, I'm happy to say. As the officer responsible overall for the OSISS program, it's one of the components of casualty support, and I speak very, very frequently with the director of mental health in health services. Any conflict that there used to be in that relationship is no longer there.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

At one point in time, we had our special forces who were having challenges in obtaining the Veterans Affairs benefits as a consequence of the specifics of their operations having to be kept separate from those of any other department. OSISS filled a role in bridging that gap. Do the members of the special forces have access to OSISS?

[Col Gerry Blais]

They absolutely do. Any member of the armed forces, or any veteran for that matter, has access to OSISS, as do their families.

For those special service forces members who have participated in operations that have a high security classification, if there's any issue with benefits for Veterans Affairs, I personally review their file and provide Veterans Affairs with a letter that provides a level of detail that they need to be certain that things are as the member states, but that also respects the security classification of the documents, and the member obtains his benefits that way.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

When a member returns from abroad, they sometimes come back with not the same demeanour they had when they left, and this has a huge impact on children. How does OSISS help the children of the affected member?

[Col Gerry Blais]

That is probably the one area into which OSISS has not really spread yet, because it would be.... Obviously, for peer support, if you need the training, etc., it is more difficult, depending on the age of the children, to train them. The family peers are there to deal with the family as a whole, although I would say that they are probably more successful with spouses. The dynamic of the children...I would suggest that our best opening is to take them to the family support centre. Either they will have social workers on staff who can help, or they can get them into the proper resources in the community.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Okay.

When we first became involved as a country in the Afghanistan conflict at the invitation of the president of Afghanistan, the OSISS coordinators really were living on a shoestring. They depended on the charity of a base commander for even a location on base. Has anything changed over this campaign in terms of providing funding to OSISS?

[Col Gerry Blais]

Yes, not just throughout the campaign, but over time, as with any other program. In its initial stages, it was a program that was on a pilot basis and, of course, the robust funding was not there. The program is now fully funded for both the staff and for their operational needs. As far as housing is concerned, they are located with the joint personnel support unit, and in locations where there's not quite enough room, we have them set up in the Veterans Affairs offices.

[The Chair, Conservative, Peter Kent]

Thank you, Colonel Blais. Time is expired.

Mr. Harris, please. Seven minutes.

[Jack Harris, NDP, St. John's East, NL]

Thank you, Chair.

Colonel, you talked about how the whole program here was designed to assist in the recovery of people who have both physical and mental needs. I'm at a real loss here to understand how it is that discharging someone who has been in service for nine and a half years, has been diagnosed with PTSD, and has been unable to work as a result, assists in their recovery, for someone who's looking forward to not having a pension, being out in a few months, and really feeling hopeless. I really can't understand why you can't figure out a way to include someone in the service until that 10 years is reached, so they'd at least have some security afterwards.

Can you comment on that, please? I'm really at a loss here.

[Col Gerry Blais]

What I would say is that there is a misunderstanding on the pension issue. When somebody is released for medical reasons, when they do reach the 10-year point, the annuity about which you're speaking is their Canadian Forces superannuation. For a member with 10 years' service, that is 2% per year, so we're talking about 20% of their salary. For the most part, these are very junior members who would be released. So, if we use $50,000 as a baseline salary, and you're talking 20% of that, no one is going to be able to live on that. Very often the individual is better to come under the care of Veterans Affairs at an earlier point because the benefits are more generous than if they were to remain in military service.

[Jack Harris, NDP, St. John's East, NL]

They don't always qualify for veterans services. In fact, the case I'm talking about is one where it doesn't.

[Col Gerry Blais]

If I may, if they were released for post-traumatic stress, which is definitely related to military service, they would absolutely be eligible for Veterans Affairs benefits.

[Jack Harris, NDP, St. John's East, NL]

Well, that may be an issue in this particular case.

I think that people who have 20% of their salary feel better off than people who have nothing. So I disagree with you on that, sir, with respect.

I'd like to ask a question about the issue of suicides. We've heard evidence before this committee on a number of occasions suggesting that the issue with respect to the Canadian Forces was in keeping with the general population. That's debatable, and it has been debated as to how it's calculated. Also, there is information made available by the Library of Parliament that with respect to veterans, and currently serving members, the rate is 45% higher than the general population. What I want to know is, how can we make sure that veterans who obviously have this issue in front of them...?We're hearing about it now...because someone was out for a year, someone who has been serving hasn't been able to cope.... How do we ensure that as people leave the service, they get tracked, they get help, they get it out? It's been mentioned before. I don't know what system is in place. You're in a position to tell us what should be done. How is it being dealt with now? And what needs to be done to improve it?

[Col Gerry Blais]

Well, I can speak about it on two fronts.

The first is with the program that we're discussing today, the operational stress injury social support program, it is a joint program between Veterans Affairs and DND. If someone is receiving peer support from OSISS when they leave the armed forces, that support continues and is seamless because it's the same peer who delivers the support.

Also, for anyone who's posted to the joint personnel support unit—and the vast majority of people leaving for mental health issues would be posted to the unit—there is a transition plan put in place in which Veterans Affairs participates. They're at the table with the individual and the DND service providers, and for the last six months of their service, the case managers do a complete transition and hand over the file to ensure that this person doesn't fall through the cracks.

[Jack Harris, NDP, St. John's East, NL]

So in your view there is no issue with respect to ultimately tracking individuals after their release from service?

[Col Gerry Blais]

Well, there could be, because the one important factor in this is that the individual has to want help. So if the individual moves or changes location and doesn't seek assistance in the new location or doesn't inform anyone, then at that point, there could be a problem.

[Jack Harris, NDP, St. John's East, NL]

One of the concerns raised by the ombudsman Pierre Daigle last fall was the understaffing of JPSUs and the difficulty that experienced people had guiding physically and emotionally battered troops—his words—through a career transition. We've heard on a personal visit or a committee visit to Petawawa, for example, that an individual was turned down twice for career counselling support. It would have been off the base.

How could that be the case for someone who is going to be transitioned out of the forces, who needs to know what's available in the job market, needs to know what may be out there and what qualifications or aptitudes they might have? How could they be turned down? Is that something that's done on an individual case-by-case basis or is there a general availability of career counselling?