Evidence of meeting #19 for National Defence in the 41st Parliament, 2nd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was care.
A recording is available from Parliament.
Director General, Civilian Human Resources Management Operations, Assistant Deputy Minister, Human Resources - Civilian, Department of National Defence
I wouldn't say there are any barriers, but we do have the Public Service Employment Act so we just have to follow that. They have to go through the process just as any other folks do. So that's not necessarily a barrier; it's just how we maintain fairness in our employment on the civilian side.
NDP
The Vice-Chair NDP Jack Harris
Thank you, Mr. Bezan.
We now have time for a third round. Each party has one questioner for five minutes starting with Madam Michaud.
NDP
Élaine Michaud NDP Portneuf—Jacques-Cartier, QC
Thank you very much, Mr. Chair.
When Colonel Gerry Blais last appeared before this committee, on April 1, he told us about a full review of the joint personnel support unit network and the integrated personnel support centres. The results of this review contain recommendations about future staffing needs.
Could you give us a little more information about future staffing needs? What are the current initiatives to meet needs? What other recommendations have been made and what are the resulting initiatives?
BGen Jean-Robert Bernier
Thank you for your questions. However, I cannot answer them because those are two separate units. I am responsible for the health system and not the medical support system, which is Colonel Blais' responsibility.
NDP
Élaine Michaud NDP Portneuf—Jacques-Cartier, QC
Nevertheless do they have some work elements in common?
BGen Jean-Robert Bernier
Yes. Case managers are part of this team. There is constant communication between the medical service and Colonel Blais' organization.
NDP
Élaine Michaud NDP Portneuf—Jacques-Cartier, QC
Your responsibility is to inform them of the state of the situation and certain needs that you identify. Then, everything to do with staffing is done on his side of the organization. That is what I make of it.
BGen Jean-Robert Bernier
I look after staffing for health services. That involves the clinical services required to provide health care, education, training for mental health awareness and so forth. Colonel Blais is responsible for his unit, which looks after all the other elements that provide support.
NDP
Élaine Michaud NDP Portneuf—Jacques-Cartier, QC
I want to get back to health-related topics.
On June 3, 2013, the committee heard from Heather Allison, who is the mother of a ill and injured soldier. Then, on June 5, 2013, we heard from Corporal Glen Kirkland. He told the committee that he was very worried about the fact that doctors seemed to be prescribing too many medications to soldiers who are ill or injured.
Have you heard similar concerns?
BGen Jean-Robert Bernier
That's always a concern. In medical school, they teach you to avoid medication as much as possible and to find other ways to treat a patient.
Everything we do is based on the best scientific data. We are always trying to determine the best ways to treat patients, based on new research. We always push doctors to consult all that information. We hold training sessions. All of our doctors take a minimum amount of training on news and updates in clinical science.
I can't speak to individual cases. However, we can always conduct clinical audits through the chief medical officers on the bases. We can also conduct central or national assessments. The director of mental health and his staff will conduct assessments of specific cases.
Our strategy is to ultimately create a clinical management and assessment system for each individual case that raises an alarm, for example, if something is not going well or does not correspond to scientific best practices.
NDP
Élaine Michaud NDP Portneuf—Jacques-Cartier, QC
Could you give me an example of these best practices, without giving any details on individual cases? I understand those restrictions.
How does an assessment work if someone suspects an individual is abusing prescription drugs? What steps could be taken quickly to help a solder? Would it first go through the soldier's doctor? Would the doctor be the first person to note the problem? Are other staff members who are trained to intervene or detect potential problems able to note the problem as well?
BGen Jean-Robert Bernier
Our awareness program includes families, people in leadership roles, as well as the soldiers' peer support system. We are trying to rely not only on health care services, but also the entire community around the individual to speak up if their behaviour changes or there is something else that indicates a problem.
NDP
Élaine Michaud NDP Portneuf—Jacques-Cartier, QC
If someone is prescribed psychotropic drugs, antidepressants or anything else to help them through a mental health issue, will they automatically receive mental health services from a psychologist, social worker or psychiatrist? Taking medications alone, without any consultation with a clinician is often ineffective. It is also a factor that can lead to prescription drug abuse.
NDP
BGen Jean-Robert Bernier
That depends on the individual's specific condition. In Canada, in most cases, people will be treated only with medications prescribed by their family doctor, but in some cases they will need more than that.
Our group has an entire team. It is not only a doctor working independently. The entire mental health team and primary care team work together.
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
Thank you, Mr. Chairman.
To the surgeon general, you referenced the self-delay in seeking treatment...soldiers don't think they need help. What's been explained to me is that in some circumstances the individual doesn't recognize treatment is needed until they're ready to blow. They're a volcano about to erupt. That may not occur during the hours of operation of the mental health unit. Consequently, military police may be called in, but the option at that point is for the soldier who in crisis to go willingly into a psychiatric hospital.
For a soldier, willingly going and submitting for psychiatric help in a hospital is akin to surrendering. I'm sure you're with that military ethos. So the only way they can go in their minds is against their will. That action often has even greater consequences on the soldier's future in the military, and even civilian life. Civilian police can obtain a form from a physician ordering or allowing the police to take the individual to a hospital for psychiatric care. I understand a similar situation does not exist for the military police. So is it possible to get a similar measure in place so that the military police can force a soldier to a hospital for psychiatric treatment so that a crime does not have to be first committed before they're apprehended?
BGen Jean-Robert Bernier
Yes ma'am. All of our physicians have licenses that permit them to issue that form. Which arm of the police service, whether it be the civilian police or the military police, that exercises the requirement for a mandatory psychiatric assessment.... The civilian police could equally do it if the military police....
I can't comment on what the military police authority is, but we have had situations in various provinces where our military physicians issued a form and the civilian police collected the individual and took them to the nearest facility that had the competencies and capability necessary to conduct the psychiatric assessment for self-harm or harm to others.
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
So then it's a provincial matter because—
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
—the military police in Ontario tell me they cannot do what a civilian police officer can, and consequentially the soldier in crisis has to commit a crime before they can forceably take them. So this isn't something that can be solved through the military. Does it have to be through the province?
BGen Jean-Robert Bernier
It's not necessary. If a family member, if any physician for any reason...whether the report of a military police officer.... The family member sees enough to be convinced that there's a need, that there's a sufficient risk of self-harm or harm to others, that requires a psychiatric evaluation.... Any physician can have whatever legislative authority in that province by completing a form—and it's a different form in each province—to mandatorily apprehending, and having that person be mandatorily assessed for psychiatric risk of self-harm.
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
Does it have to be done in a very short length of time, or do there have to be symptoms that somebody observes in advance for that to occur?
BGen Jean-Robert Bernier
It can happen just based on symptoms. It doesn't necessarily mean it has to be an acute crisis with a criminal offence taking place.