National Defence Committee on May 9th, 2023

[The Chair, Liberal, John McKay]

I was going to run it for another 15 minutes anyway, and then we'll suspend to vote and do it that way. Is that agreed?

[Some hon. members]

Agreed.

[The Chair, Liberal, John McKay]

That's very impressive.

You have about 15 seconds left.

[Shelby Kramp-Neuman, Conservative, Hastings—Lennox and Addington, ON]

I'll ask quickly, is there a crisis response available for CAF members after hours on the hotline?

[Myriam Lafond]

Our services are available 24‑7. No matter when, they are always available.

[The Chair, Liberal, John McKay]

Madame Lambropoulos, you have six minutes, please.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

Thank you, Chair.

I'd like to begin by thanking our witnesses for being here with us today.

I'm going to start with Mrs. Tam-Seto. You mentioned that there is no consistent way for files to be transferred to the civilian system once the military signs off and a member retires.

Based on what you've observed in your time observing and being in that system, what are specific things you would change in order to put in place a better system for transition? How would you make it flow better and make sure there are no gaps, so that everyone receives the same transition?

[Dr. Linna Tam-Seto]

I don't think we have enough time today for that.

I have a couple of things off the top of my head. The responsibility currently lies at the doorstep of the member, which I don't think is fair. A lot of folks I've spoken to will take it upon themselves to do the groundwork before.

In the SCAN seminars that people attend, there needs to be much more emphasis on strategies, so that people can move forward and it helps with their transition. I think physicians right across Canada, but particularly those who are in military-connected communities should look at how they are prioritizing their wait-lists, which I know is a big ask.

Before people retire and before they attend SCAN seminars, they need to be given the heads-up that this is the process of transitioning out.

The federal government needs to be talking to the provincial governments to find a system to make accessing health care at the provincial level a lot easier for them, extending health services well beyond someone's date of release until they can find someone within the provincial government.

Like I said, these are just a couple of the strategies that I have off the top of my head.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

Would you be able to put them down on paper and send them to our committee, so that we have access to them?

[Dr. Linna Tam-Seto]

Yes, I will do that.

Thank you.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

Thank you.

Mr. Pucci, I appreciate your being here as well, and speaking about your own experience.

You mentioned that when you were released, you got certain services for a couple of years and you were seeing a clinical psychologist, but not everybody has access to this.

I am wondering, first off, what factors played a role in your receiving these services. Secondly, why don't all members have the same?

[Col (Ret'd) Richard Pucci]

I think all members have access. When they go out the back door, everybody is set up and they know exactly what their medical release data is. It's a 3B release, whether it's for a mental health disorder or a physical disorder.

It's been exactly seven years to the day since I retired, but at the end of the day there is an opportunity when the attending physician provides you with what you need to do when you release from the Canadian Armed Forces. It's up to the member and then the veteran to seek that care.

The problem is—and this is what my argument has been—that it's hard to get from that back door to the front door of a new clinic, because there are just not a lot of primary care providers out there. If somebody needs mental health care thereafter, they still need to have a primary care provider; hence my argument about setting up this primary care hub for our veterans.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

I heard your recommendation loud and clear, and we're definitely going to be able to look at that and see if we can include it in the recommendations we submit.

If there were a health services task force, in your opinion and based on your own experience, what would be the main thing that it would recommend?

[Col (Ret'd) Richard Pucci]

I think the recommendation would be to look at a cross-Canada governance system to see how we can facilitate the smooth transition from being in the military to being a civilian. The veterans task force would look at each provincial health care system from coast to coast to see how we could better facilitate that move as well, so I think it would be setting up a governance structure to meet the needs of veterans and newly released members, but also at the same time to deal with provincial health care authorities to make sure they're aware of what we are doing.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

Thank you.

I guess the last question is a bit broader.

Dr. Tam-Seto, I want to know if you can let us know what trends you've been seeing in mental health in the general Canadian population and how they compare to those you've seen in the military population.

[Dr. Linna Tam-Seto]

Unfortunately, I won't be able to speak to that. My research has been predominantly with military populations.

From what I understand, the rates are comparable; however, what is striking is that the rates in mental health are usually connected to military service, whereas, for most Canadians, it is not directly related to their career choice.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

Have you noticed that things have gotten worse of late? What have the trends been in the time that you've been there?

[Dr. Linna Tam-Seto]

I think, generally speaking and speaking broadly around mental health reporting, it has increased over the years, just because of awareness and decreased stigma. I'll just leave it at that.

[The Chair, Liberal, John McKay]

Ms. Normandin, you have the floor for six minutes.

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

Thank you very much.

I'd like to thank all the witnesses for being with us today.

Mrs. Lafond, I'd like you to tell us about crisis management before the Canadian Forces called on your centre. To your knowledge, how well did the military base handle the situation when a member or a recruit was in a crisis situation?

[Myriam Lafond]

Thank you for the question.

Prior to our agreement with the Canadian Armed Forces, the military at the base managed crisis situations with the green office. The green office is sort of the administrative centre for the St‑Jean‑sur‑Richelieu base, which we actually toured. Someone was on duty 24 hours a day in the green office. Someone in a crisis situation would be set up there on a cot, and they were monitored at all times.

This is how crises were managed. They wanted to avoid sending them to the hospital if it wasn't an emergency. They preferred to wait until the 41 Health Services Centre would open. The centre is open weekdays from 7:30 a.m. to 4:30 p.m. Outside of those hours, the green office handled crisis situations.

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

Thank you very much.

In the early days of your partnership, how were people in crisis referred to you? Did it go through the green office or the clinic?

[Myriam Lafond]

In the beginning, people were sent to us directly from the green office. It was really the military referring them to the centre; they avoided going through the clinic. Unfortunately, a suicide occurred. After staying with us, the member wanted to return to the base. However, we recommended that he be sent to the hospital and seen by a physician. It was a Saturday and there was no physician on the base. The suicide occurred at that time.

Based on the agreement we made as a result of that incident, all recruits and military personnel who stay at our centre must have been seen by a base physician, or alternatively by a hospital physician, prior to coming to the centre. Before coming to stay at our centre, they must be seen by either the base clinic or our city hospital. This process was put in place following the unfortunate suicide that occurred.

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

What I understand is that now, as part of your partnership, military personnel receive better medical guidance in crisis situations.

Is that right?

[Myriam Lafond]

Yes, that's right. They automatically receive medical follow‑up in these situations. So that results in better management and continuity of care after the crisis is over.