National Defence Committee on May 9th, 2023

[Christine Normandin, Bloc, Saint-Jean, QC]

Can you describe how you cooperate with the military base clinic, in terms of sharing information when a recruit or service member is in a crisis situation, for example?

[Myriam Lafond]

We have open lines of communication. We keep personal information confidential, but we waive that when someone's life is at stake. Sometimes it's a matter of life and death at our centre, and when we waive confidentiality, the lines of communication are open. We have a wonderful partnership with the medical clinic, because we give them the information they need while also informing the recruit or service member of what information we're giving out.

[Christine Normandin, Bloc, Saint-Jean, QC]

I'd like your comments on the system used to fund your services. What kind of partnership do you have with the military base?

[Myriam Lafond]

We are a community organization funded by the provincial government. The Canadian Armed Forces have insurance through Blue Cross, I believe. Blue Cross pays us the same amount they pay when a service member is hospitalized in Quebec. Our accommodation services are billed on a per-night basis, and the insurance company pays for the bed for the person in crisis. That certainly provides a financial contribution to our organization.

[Christine Normandin, Bloc, Saint-Jean, QC]

For the same price, then, I understand that the Canadian Forces have access to much more specialized services to manage military mental health issues.

Is that right?

[Myriam Lafond]

Yes, that's exactly it.

In Saint‑Jean‑sur‑Richelieu, we're in a francophone environment, and service members and recruits are generally anglophones. We offer completely bilingual services, whereas according to recruits and service members, often no one speaks English at the hospital. This makes it hard for them to receive proper care and services. They are isolated. They get good physical care, but the psychological care isn't as good.

The crisis centre is therefore a safer and healthier environment for recruits and service members in crisis.

[Christine Normandin, Bloc, Saint-Jean, QC]

Thank you.

[The Chair, Liberal, John McKay]

Thank you, Madame Normandin.

Colleagues, Ms. Mathyssen's time will expire about halfway through the time we've agreed to, so if you don't mind, we can either not start, or we could do her six minutes.

[James Bezan, Conservative, Selkirk—Interlake—Eastman, MB]

I want to head over to the chamber.

[The Chair, Liberal, John McKay]

Do we agree to that?

[Some hon. members]

Agreed.

[The Chair, Liberal, John McKay]

We'll suspend until we return.

[The Chair, Liberal, John McKay]

I see quorum. We'll resume our meeting.

Ms. Mathyssen has six minutes. Then, colleagues, once her six minutes are done, we have about 25 minutes left. I'll probably have to shrink the second round to get within the timeline.

Ms. Mathyssen, you have six minutes, please.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Thank you, Mr. Chair, and thank you to the witnesses for their patience through all of this today.

I want to start with Ms. Tam-Seto.

You've done a lot of research, as I understand it, on the impacts of operational stress injuries and PTSD on women serving in the CAF. I'm wondering if you could talk about the differences that you see in terms of that research: how women are impacted by it, the service gaps that exist for women veterans in receiving the supports, and the trends that you see around OSI and PTSD.

[Dr. Linna Tam-Seto]

The majority of the work that I've been doing that would be classified as an operational stress injury acquired through work is related to military sexual trauma. Outside of that is less...has been outside of my scope. To be completely transparent, that's where the bulk of my research has been: around the impacts of military sexual trauma.

Broadly speaking, around the mental health challenges experienced by servicewomen, we don't have an understanding of how that impacts goals and how it impacts their identity, particularly around transitioning. I know that a lot of individuals who identify as women have difficulty accepting an identity as a veteran because of what society stereotypically sees veterans as. That's part of some of the stressors that women experience as they transition.

I know that doesn't specifically answer your question, but my work hasn't been specifically on operational stress injuries in women.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Okay.

In terms of PTSD, that has a huge impact. Could you get into a bit more around what you mean when you say that they find it hard to see themselves as veterans? Are there supports or programs? Is this seen more and more, and have the CAF, the DND and VAC dealt with this in any way? Has it been identified other than by some of your research?

[Dr. Linna Tam-Seto]

I examine a lot around identity and the change in roles and identities as people go through transition, so my work is around stages of change. As people are releasing from the military, they're changing from being from a military member to becoming a veteran and, essentially, a civilian. For a lot of women, that shift is different, because there is this social perception of what a veteran looks like, and that quite often doesn't match with how women appear in the world. There isn't, also, that acceptability. Quite often, I hear stories about women veterans with the veteran plates, and people will approach them and ask, “Oh, did your husband serve? Did your dad serve?” This is then compounded by the experience of military sexual trauma, where there is institutional betrayal. There is that difficulty for women to identify with the institution that has betrayed them, whether it be military sexual trauma or any other type of injury or illness that they may have acquired over the course of their career.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

In the incredible work that I've seen done on the streets in my hometown of London, Ontario, with veterans who are facing homelessness, there was a lot of that conversation about veterans overall. These were mainly men, interestingly, but it was that identity and what they had in terms of their service, the institution that provided them with the structure of that service. Then, once they left service, it was what they weren't left with in terms of the identity that they had but also the structure that they had.

Is that the same for women, as well, in that role?

[Dr. Linna Tam-Seto]

It's essentially moving from one culture to another. I know that in London, in particular, they have an incredible operational stress injury clinic. I have colleagues who are there, and we are working on how to support health care providers to realize and to recognize these identity shifts that veterans are going through, particularly those who are coming into the clinic with work-acquired trauma and illnesses, and what that means to them. We are starting to develop those structures. My particular area is around military cultural competency and what that means for health care providers, particularly with regard to my colleagues at the OSI clinic.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

We have also had previous CAF officials at this committee, and there's a bit of confusion, because they were talking about trying to get into the operational stress injury social support systems that are provided with the OSISS, but that is not covered. They don't work at all in terms of sexual misconduct and that trauma. Is that correct?

[Dr. Linna Tam-Seto]

People are going to OSISS clinics because of military sexual trauma. It is a subsection of a type of trauma that is unique, so that experience is unique, and we're just beginning to understand how it's different from other work-acquired PTSD from service.

There needs to be a concerted effort, and there has been. Again, I've been in communication with the OSI clinic in London, where they've identified that there is a subsection of people who are coming with trauma, but it's specific to military sexual trauma and about what supports and education we can give to these service providers in order to help them. It's very important for service providers to understand the nuanced contexts of what it means to have acquired military sexual trauma, which is very different from civilian trauma.

[The Chair, Liberal, John McKay]

We're going to have to leave the answer there, thank you.

Colleagues, if I do a second round and cut a minute off everyone, there's a good chance we'll be able to do it by six o'clock.

With that, Mr. Kelly, you have four minutes.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

I think Mrs. Gallant is going to go.

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

Colonel Pucci, you referred to some technologies that were not being funded. To which technologies were you referring?

[Col (Ret'd) Richard Pucci]

I was speaking to treatment modalities that are currently out there. As I stated earlier, I'm not a clinician, and I feel very uncomfortable talking about treatment modalities, because they are outside the scope of my area of expertise; however, many companies have approached Veterans Affairs with new technologies and new modalities of treatment. They're currently being reviewed, but the process is extremely slow.