Public Accounts Committee on Feb. 25th, 2015

[Dawn Campbell]

—so that they can then get into....

[Malcolm Allen, NDP, Welland, ON]

And then they can go and get service.

[Dawn Campbell]

Right. So that's, I think—

[Malcolm Allen, NDP, Welland, ON]

So there could be additional wait time beyond that to actually get service.

[Dawn Campbell]

Right. Correct.

[Malcolm Allen, NDP, Welland, ON]

This just simply gets them a card, I believe, or at least a process that says they can go ahead and get service now, but then they might wait somewhere else.

[Dawn Campbell]

Yes.

[Malcolm Allen, NDP, Welland, ON]

But we're trying not to make it look as bad as it might be. We're trying to help you.

Brigadier-General, thank you very much for your report. It was quite interesting. On page 1, down near the bottom, you have 94% of your 445 authorized mental health positions filled. I guess the question from me to you, sir, would be this. Is 445 what you need or is 445 what your budget allows?

[BGen Jean-Robert Bernier]

So far our assessment is that at steady state that will be what we need. That was based on a 2002 study. We're reviewing it all based on the Canadian Armed Forces mental health survey of 2013, where we're still doing lots of analyses with regard to it. But there will always be surges, ups and downs, depending on demand. So the more successful our stigma reduction measures are to bring people in for care, that's when we'll increase wait times, where we'll overwhelm elements of the system. We're working on a number of measures I've mentioned to try to deal with these surges, but we will always have a gap. We'll never achieve the full 445—

[Malcolm Allen, NDP, Welland, ON]

I just need, sir, to jump in between that because the chair will cut me off at the time limit.

I want to actually be clear here. It's 445 authorized spaces based on a 2002 survey. Is that what you're telling me?

[BGen Jean-Robert Bernier]

That's right.

[Malcolm Allen, NDP, Welland, ON]

You have a new one that's done, but you haven't actually decided what those authorized positions would be based on the new piece. Is that correct?

[BGen Jean-Robert Bernier]

Right. There have been incremental increases over time as a result of various other studies conducted during the operations in Afghanistan, and subsequent to that over the last couple of years based on tweaking the numbers that we deem required to address the demand.

[Malcolm Allen, NDP, Welland, ON]

But have you ascertained the number of positions you actually need based on that new study? Has that been determined?

[BGen Jean-Robert Bernier]

No, the analysis is still going on. There are about 50 subanalyses going on in that study.

[Malcolm Allen, NDP, Welland, ON]

Sir, I recognize this is a tough business. I mean, it is. I can sympathize with you. But clearly we're trying to figure out what the numbers are. It's not easy; you get surges.

The other piece that was interesting here around the numbers issue was that when you had long-term absences, whether that be parental, maternal, long-term sick, you didn't seem to have the buffer to cover that. Is that what you told me here?

[BGen Jean-Robert Bernier]

No. We have a network of anywhere from 4,000 to 6,000 external mental health providers. When a psychiatrist or a psychologist is not available, nobody is not getting mental health care. Everybody from day one, if it's an urgent requirement, sees a psychiatrist or psychologist the same day. But they are all under primary care, and up to 85% of all mental health care in Canada is provided by primary care physicians. So they're all seeing and having access to addiction counsellors, mental health nurses, primary care physicians, in addition to sometimes general mental health psychiatrists and psychologists.

So the fact that there's some delay before getting a detailed assessment by a subspecialized operational and trauma stress support centre doesn't mean that they're not getting good mental health care. In many cases, the OTSSC specialists simply confirm the treatment plan that's already been put in place by the primary care people. All of those patients are constantly being triaged and reassessed, so if at any time their condition changes and requires more urgent, subspecialized assessment, then they get it, the same day if necessary.

The other thing is that those numbers, the 445, is double what we had before. We were ready even before Afghanistan began, and we've modified those numbers over time. It's the highest per capita ratio in NATO and close to double the per capita in any jurisdiction in Canada. Just a few years ago, we were spending roughly about six times per capita more on the mental health care of our troops than any other jurisdiction.

[The Chair, NDP, David Christopherson]

Thank you, time has well expired.

Over now to Mr. Woodworth, you have the floor, sir.

[Stephen Woodworth, Conservative, Kitchener Centre, ON]

Thank you very much, Mr. Chair.

Good afternoon. I would like to welcome our witnesses and thank them for being with us today.

I hope that you will be able to tell from the number of Conservative members present here today how much interest there is on our side of the House on this particular issue and how much concern for veterans.

I'll begin with the fact that I have some worry that members of the public have been left with the impression over the last number of months that a lot of veterans who apply for mental health disability benefits have to wait many months before they receive mental health support from any source. That's not really what your report said, is it, Mr. Berthelette?

[Jerome Berthelette]

No, sir, it isn't.

[Stephen Woodworth, Conservative, Kitchener Centre, ON]

In fact your report, particularly at paragraph 3.19, found that veterans who apply for mental health disability benefits have access to mental health support on a timely basis from quite a few other programs. Isn't that correct?

[Jerome Berthelette]

Mr. Chair, as we've noted in paragraph 3.19 and to be fair to Veterans Affairs Canada, Veterans Affairs Canada has put in many supports, the ones we've noted here in particular, for veterans in need of health support. That's right.

[Stephen Woodworth, Conservative, Kitchener Centre, ON]

Even, for example, Veterans Affairs Canada assists veterans in accessing mental health support from provincial health programs, isn't that correct?

[Dawn Campbell]

Sorry, can you repeat the question?

[Stephen Woodworth, Conservative, Kitchener Centre, ON]

Veterans Affairs Canada will assist veterans in accessing mental health support through provincial health care programs, is that not correct?