National Defence Committee on Feb. 23rd, 2017

[BGen Hugh MacKay]

When I last looked at the data for vacancies in positions, they're fairly evenly distributed across the country.

Is there an issue in Quebec City sometimes, perhaps?

[Col Andrew Downes]

Quebec City hasn't been a particular issue, although at every clinic from time to time we might run into a difficulty in finding individuals.

For example, at CFB Shilo we went a couple of years without having a psychiatrist on base. It was not for lack of trying, just for lack of availability, but we've since been successful in filling that position.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

I'm getting the signal that I'm getting close to the end here, so I have one final question.

For those who may have been receiving treatment or were being monitored for mental illness and who then left the services, are we making sure that this information somehow gets passed along so they get the services they need as a veteran?

[BGen Hugh MacKay]

Everybody who leaves the service now gets a copy of their medical record so that they have that available to carry with them to their next health care provider. We do work very closely with Veterans Affairs now, so if they're going to be a Veterans Affairs client, that information will have been transferred through to Veterans Affairs as well.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thanks very much.

[The Chair, Liberal, Stephen Fuhr]

Thank you.

Mr. Robillard, you have the floor.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

Thank you, Mr. Chair.

Welcome, Mr. MacKay, and thank you for your testimony.

I will ask my questions in French.

In recent months and years, a most pressing question has been about the difficulty that former members of the Canadian Armed Forces experience in making a smooth and effective transition from military life to civilian life. But it now also seems, in the light of the recent cases of suicide among new members of the armed forces, that the transition from civilian life to military life also presents our young recruits with significant challenges.

Can you tell me if any thought has been given to people making the transition from civilian life to military life? If so, can you tell me the precise aspects that you are currently exploring? In your view, what possible solutions could we look at to better prevent cases of suicide among our recruits?

[BGen Hugh MacKay]

Thank you for those questions. It is easier for me to answer them in English. My apologies.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

No problem.

[BGen Hugh MacKay]

It's a good question. It is quite a transition that one undertakes, going from civilian to military life.

One of the things we have introduced into the recruit training—I believe it happens in week two—is that they undertake a program called road to mental readiness. In addition to their learning about the culture as they go through their basic training, we also address with them knowledge about mental illness and strategies to deal with stress.

I believe we are starting to see some success with the introduction of this program at the recruit schools, in that we seem to be seeing a bit of an increase in the success of recruits going through the school. We sensitize them to their own reactions to things and help them understand where that might place them on what we call the continuum of mental health. We have it colour-coded, so as they reach different stages, they can realize that perhaps it's time for them to go and seek some assistance to deal with the stresses they may be facing or the symptoms they're experiencing.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

We know that funeral expenses for former CAF members are fully reimbursed, albeit with certain conditions, by the Last Post Fund. We also know that the military is looking to rectify omissions in awarding medals and other delays in cases of death by suicide.

What happens with suicides of members of the forces who have not been deployed? Without going into specific cases, what happens with new recruits to the forces?

[BGen Hugh MacKay]

The issue of funerals, honours, and awards is not a situation that I deal with as the surgeon general. I know that they are looking at reviewing those who have passed on by suicide. What we face is a very difficult issue. Because of the multifactorial causation of suicide, it is not easy to say, when somebody takes their own life, just what it is that has actually contributed to that decision. Sadly, there is much that we need to learn about suicide in order to understand what brings people to that decision.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

As mentioned in the mandate letter for the Minister of Veterans Affairs, our government has promised to re-establish lifetime pensions as an option for our wounded veterans. The promise was repeated by the Prime Minister during his cross-Canada tour in January.

Where does the implementation of that policy stand today? Are you facing any obstacles with it?

[BGen Hugh MacKay]

Again, this is a question on a Veterans Affairs issue, so I am not in a position to comment on that. I am not involved in trying to create the policy.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

Here is my last question.

What do you think about the first recommendations in the ombudsman's investigation into the cadets, which reads as follows:

…that, in the event of an illness or injury arising out of an approved cadet activity, the Department of National Defence and the Canadian Armed Forces ensure that cadets are compensated and supported in a manner that is commensurate with the compensation and support available to members of the Canadian Armed Forces.

[BGen Hugh MacKay]

Again, my mandate is to provide health care for those who are ill and injured. We do provide health care for cadets who become ill or are injured while they are attending cadet camps. We also sustain that health care until the other programs are in place. This is an insurance program that is available to them to continue on with health care for their illness or injury. We provide the care and ensure that the transition to their civilian health care providers is smooth.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

Thank you.

[The Chair, Liberal, Stephen Fuhr]

Thank you.

We're going to go to five-minute questions.

Mr. Spengemann, you have the floor.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

Thank you, Mr. Chair.

Thank you very much, General MacKay and Colonel Downes. Thank you for your service. Thank you for being here and for your important work.

I want to touch upon an issue that you addressed briefly in the written submissions, and that's our reserves.

This committee has received evidence from other witnesses on the state of our reserves. Mr. Robillard just made a comment in terms of the difficulties for people transitioning from civilian to military life. For reservists it can be even more challenging to do this repeatedly, especially for reservists who are employed in overseas combat operations. A significant percentage of folks who fought in Afghanistan were, I'm told, reservists.

Are there special considerations, special factors, for reservists with respect to mental health? What is the suicide risk? Is the transition to civilian life on an ongoing basis, on a repeated basis, a positive factor, or does it represent an additional challenge that has its own complexities?

[Col Andrew Downes]

Would you like me to answer that?

[BGen Hugh MacKay]

Sure, go ahead.

[Col Andrew Downes]

It's interesting to consider the situation of reservists. In many ways, reservists actually have an easier time because they're returning to communities where they have established support networks, where they have health care already set up, where their families are already well integrated. Regular force members may return from a deployment and be moved to another location, and so they face the upheaval of a move.

We know from our mental health survey that in many ways reservists have mental health concerns that are very similar to those of members of the regular force. We will offer programs and services to reservists for illness and injuries related to military service. If they are injured physically or mentally, we will provide care where we can, keeping in mind that some reservists live in communities where we don't have a base or a clinic.

Reservists also are entitled.... Because they have health cards, their primary health care needs are met through the civilian provincial health care systems. In a way, they have more choice and opportunity open to them. We certainly will provide and top up any care that they need that they aren't otherwise able to get through their normal system.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

That's very helpful. Thank you, Colonel.

I'll delegate the rest of my time to Ms. Romanado, Mr. Chair.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Thank you.

Thank you both for your service. It's a delight to be back at this table.

I'd like to talk a little bit about the mental first aid training that is provided, often through the military family service centres. Often serving members who are struggling are a little fearful about coming forward, especially with respect to mental illness out of a fear of stigma, universality of service issues, and so on and so forth.

What are you doing to work closely with the families who are seeing their loved ones struggling at home, self-medicating in the basement, and so on? What is it that you're doing to make sure that the families are equipped to be able to recognize, help treat, and get the help that our members need?

[BGen Hugh MacKay]

Most of that work is not the work that we do, but we do work with the military family resource centres to help them to understand the military member's life and what they might expect to be able to see.

The other thing that we do is try to have patients allow us to engage with their family members in their care because we view that as important. Unfortunately, as there are privacy regulations, should members not agree to have family members as part of their care, then it's difficult for us to engage directly with the family members. We're certainly always open if family members want to come forward and tell us what they're seeing so we can use that in our decisions about the clinical care of their loved ones.