Public Accounts Committee on Jan. 31st, 2008

[Borys Wrzesnewskyj, Liberal, Etobicoke Centre, ON]

Thank you.

[BGen Hilary Jaeger]

In a week or ten days, we'll get you the active number of mental health patients across the country. That will not necessarily tell you which ones are related to service in Afghanistan or which ones just have mental health issues.

[Borys Wrzesnewskyj, Liberal, Etobicoke Centre, ON]

Thank you.

I have a tremendous sense of unease. In fact I'm somewhat disturbed that we have over a quarter of our soldiers returning from the mission in Kandahar, and they're identified as having mental health issues. We have no idea how many of those soldiers are receiving the type of care they require. These people could be in very dark places. We also know that a significant number of them have been flagged for substance abuse or potential substance abuse with addictive substances. Suicide was mentioned, and we know that they have access to weaponry.

What's most disturbing about this isn't just not having the figures, but that the armed forces have known, since 2002, the last time they checked on this.... Six years have passed, and for the last six years they've known that 75% did not feel that they were getting the type of mental health care they required.

The initial answer was, well, we'll get those numbers in two years. It's taken this committee to request to get at some of those numbers, and the numbers could have been accessible. The armed forces, if they truly were concerned about this issue, would have had those numbers.

I have a question to the brigadier-general. Back in October, when this report came out, Mr. Day was quite concerned, and rightfully so. He said that by 2009, meaning by the end of 2008, $100 million would be poured--he said this in October, in the same timeframe that the mini-budget was being presented--into issues of mental health, and 200 mental health care professionals would be hired by the end of this year.

How many millions have poured into your department, Brigadier General, since that statement three months ago? And how many of those 200 have been hired or are in process--the actual numbers?

[MGen Walter Semianiw]

If I can kick off here before General Jaeger comes back, on the first comment you made, first, if you had the information but you didn't have the programs, what would that achieve? I would come back and tell you--which I think is the tougher question--what has this department and the Canadian Forces put into place to ensure that its soldiers, sailors, airmen, airwomen who have mental health challenges actually are getting the support they need?

If you want to—I don't have time—I could sit this afternoon for a couple of hours and tell you what's been done since 2002 to make sure they get the support they need. I would submit to you that's the issue at hand. Rolling up information from bases and wings, I'll give that to you any day you want. My issue is, are they getting the support they need?

We have put clinics in across the country. We have put policies in place. We are hiring more individuals- General Jaeger will answer that question in a minute. A lot has been done in the last six years, not just in mental health but in OSI, in PTSD, establishing peer support networks. To be fair, a lot has been done by the Canadian Forces because it knows this is a challenge, it knows it needs to do this to do the right thing.

So I would come back and say a lot has been done. I'd be more than happy to lay it all out for you. We'll get you the figures. The lack of figures has not stopped us from doing the right thing to get them the support they need. There always will be cases; you can bring them from your constituency, one or two here who need different and better support. Part of the challenge is in the number of mental health practitioners and finding people to bring them into the organization. Getting them to want to go to Petawawa to live there is also a challenge.

Again, I come back, we've done a hell of a lot to do this and get this better. We've got a hell of a way to go, but we're on the way to getting it right.

[Borys Wrzesnewskyj, Liberal, Etobicoke Centre, ON]

Major General, as a senior army officer you must realize that you have to have accurate information when facing an enemy out in the field. This is an enemy within that can cause lives to be lost among our armed forces. I'm stunned to hear that it's not critical to gather the information, to have proper assessment of how to go after that particular enemy that could be taking the lives of our soldiers.

I guess we still we haven't had the answer about the commitment of the $100 million—

[MGen Walter Semianiw]

If I may, I come back to the comment and the point that was made here that we have the information, but it's at what level? Right now, at our bases and wings, our medical teams know what the challenges are. When they need additional staff, they get hold of her. We ensure that they get hired. For me to tell you that I can't, at the tip of my fingers, give you that information is one part. The critical information that we need to have is at the right place, decentralized, to be able to get the resources that we need to support them.

[The Chair, Liberal, Shawn Murphy]

Thank you very much, Mr. Wrzesnewskyj.

[Borys Wrzesnewskyj, Liberal, Etobicoke Centre, ON]

On a point of order, the second part of my question was not answered.

In October the Minister of National Defence had said $100 million would be poured into mental health issues, and 200 professionals would be hired. Has the department seen any of that $100 million, and have any people been hired?

[The Chair, Liberal, Shawn Murphy]

Very briefly, Major General, if you want to respond to that specific question.

[BGen Hilary Jaeger]

The $100-million figure does not ring any bells with me. I don't recall the statement first-hand, so it puts me at a bit of a disadvantage.

[Borys Wrzesnewskyj, Liberal, Etobicoke Centre, ON]

It was made in the House of Commons on October 30, 2007.

[BGen Hilary Jaeger]

The mental health program under Rx2000 represents $90 million of incremental resources over baseline from its inception in 2005-06 to its completion next year, in 2009. That does involve the 200 additional mental health providers. We are about halfway done that hiring process.

[The Chair, Liberal, Shawn Murphy]

Thank you very much.

Mr. Lake, you have five minutes.

Mr. Lake is the last questioner, and I have a few myself.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

Thank you, Mr. Chair.

I'm almost inclined to have a discussion, of course, about the impact on physical and mental health of the proposed opposition policy of sending our soldiers into Kandahar for reconstruction and training without allowing them to defend themselves when attacked by the Taliban. But we won't have that discussion, obviously, in this short timeframe.

Actually, there are a few things you talked about today that raise some questions about the numbers. You talked a little bit about the suicide rate. I think you said it has been the same for some time, 10 to 13 per year. That's over how many years?

[BGen Hilary Jaeger]

I would have to double check if you want the exact answer, but that is dating back to at least 1999. That includes the mission since it's been in operation in Afghanistan.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

So there hasn't been a marked increase in that time period.

[BGen Hilary Jaeger]

No. It has stayed reasonably consistent, recognizing that suicide rates are difficult to track because they represent rare events. You have to track them over large populations to get reliable data.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

It's concerning, nonetheless. Ten to 13 suicides per year is still—

[BGen Hilary Jaeger]

Any suicide is concerning, but if you look at comparators to an age- and sex-matched Canadian population, our suicide rate is actually slightly lower—

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

That's what I was going to ask, actually.

[BGen Hilary Jaeger]

—which is particularly remarkable, because our rate of depression, which is the most recognized risk factor for suicide, is actually 80% higher. So we have more depression but less suicide.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

I do want to quickly move on, if I could, because I was interested in hearing you talk about this director of family services office. I sense that you might want to talk about it a little bit more.

I had the opportunity this past weekend to go to the War Museum. They have a slide show there on the men and women who have lost their lives in Afghanistan, and it honours them. There are pictures of them and their families. I was struck by how many of them have young families, with three and four kids in them.

As a parent myself, I'm really concerned not only for whether the families are being taken care of here, not just the families who have lost a parent but the families whose parent is off for six months at a time, but also for the peace of mind. It's tough enough for us to leave for four days, let alone going halfway around the world to face what they're facing there. That peace of mind would be so important for all the things we're talking about right now, the mental stability and things like that.

I think you said it's due to be in place in three months. Can you talk a little bit more about this office and what its role will be?

[MGen Walter Semianiw]

To give it some historical perspective, the Canadian Forces, as stated, established these military family resource centres across the country. They do sterling work in assisting families who have loved ones overseas on any operation. I know the discussion gets focused on Afghanistan, but it is anywhere we send our men and women in uniform. They support that.

Our view, as mentioned here, is that we think we can strengthen this, and it needs to be strengthened. We have a number of policies we are going to put in place very shortly. I talked about the structural piece, but that was to have an individual within our headquarters who would be responsible and accountable--I think there is an issue of responsibility and accountability--to whom we could turn and who would put the policies in place for a strategic framework across the country, to ensure there is a consistent application across the country for our families.

We see an increase in the resources we will put in that area, no ands, ifs, or buts. I can't give you the figures in three days, a week, or two months. Intuitively, I can tell you it is going to cost more. We have the money set aside to be able to do what we need to do, to build on the military family resource centre success and to make it stronger and connect it nationally across the country, to ensure that we probably do more.

What do I mean by that? Here are some of the things we're looking at. It already happens in theatre that families do talk to loved ones by telephone; they get so many minutes a week. Perhaps we can move to video teleconferencing. Other militaries do that. Could we put that in place? Some of that is already actually being done on a case-by-case basis. Back home there are a lot of activities, as all of you see in your constituencies, that the MFRCs do in their work with the families, such as activities on the weekend, to keep the families together.

Again, the challenge has come back to the issue of what role we have to play in supporting the family, especially with mental health. It has been raised here. It is the issue we are going to speak to the department about, of what we can do to make this better on the mental health side. A mental health solution for a soldier is a family solution; it is not just about the soldier. We're putting the director in place--there will be an announcement--and a lot more, to bring it all together to strengthen that piece for our soldiers, sailors, airmen, and airwomen.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

I just want to follow up on Borys' line of questioning there.

I thought you made a good point. The treatment and help for people is the most important piece, and we can't forget that. But, for myself, I want to have some confidence that steps are being taken to address these deficiencies in terms of the information that you're gathering, so that you can do an even better job of delivering that treatment in the future.

So I will close with that. Please give us some reassurance that you are taking steps in that.

[MGen Walter Semianiw]

We are taking steps. We could sit here for hours and lay everything out that we're doing. It's not the aim of this committee, but I'd be more than happy for you to come and receive a briefing on what we're doing. I think you'd be very pleased to see this, as we're moving it ahead. Some of it has been done intuitively, because we know we need to do it to get the right thing done. Again, what the Auditor General raised will only help make it stronger. I would agree with you.