Evidence of meeting #13 for Public Safety and National Security in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was treatment.
A recording is available from Parliament.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
I'm honoured to be here. This is a very important subject.
I'd like to thank all three presenters for stepping forward and providing us with this information.
I'm interested in the overall budget applied to PTSD. I note with interest that the ministerial round table talks about Public Safety working with Health Canada, the Department of National Defence, and Veterans Affairs Canada to develop options. There's a budget to develop a national action plan. I'm assuming there is also an ability to pull together the resources currently applied to providing support for people with PTSD.
Could you give us a sense of what the overall resources are now and the number of people who are clients, either first responders or those in the Department of National Defence or Veterans Affairs, who are currently undergoing treatment? Would you have those figures?
Assistant Deputy Minister, Emergency Management and Programs Branch, Department of Public Safety and Emergency Preparedness
Thank you for your question. I'll give a couple of answers to that.
First, budgetary pieces are spread across different departments. Within Public Safety, my particular area, I have some resources that are working towards that. Within the portfolio itself, the RCMP would have some resources associated with that, as would Corrections, as an example, or CBSA. I don't have those numbers in front of me, but that's something we could get for you.
More broadly, the health portfolio through the CIHR, the Canadian Institutes of Health Research, has money associated with that as well.
Different pots of money are spread across a number of different spectrums. Sometimes though it's divided up for mental health as opposed to specifically being dedicated to post-traumatic stress disorder. We'll get you some more detailed information on that particular piece.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
The first part of the question was on the overall budget allotted to pulling together this national strategy.
Assistant Deputy Minister, Emergency Management and Programs Branch, Department of Public Safety and Emergency Preparedness
Right now we're working with a small budget within Public Safety, and most of the engagement we're doing involves consultations through things like the round table. We have just stood up an assistant deputy minister's steering committee. We'll do the next round table sometime in summer and then come up with a plan after that. We are also engaged in a number of different forums that we have in place with our provincial and territorial counterparts.
We have a small budget using a number of different mechanism that are already in place to leverage the work we need to do.
Assistant Deputy Minister, Emergency Management and Programs Branch, Department of Public Safety and Emergency Preparedness
That's part of what we'll get back to you with.
Peter Julian NDP New Westminster—Burnaby, BC
I think that would be helpful for the committee.
Has there been any estimate of the number of people requiring support through the Department of Veterans Affairs or National Defence as well as first responders?
Assistant Deputy Minister, Emergency Management and Programs Branch, Department of Public Safety and Emergency Preparedness
I can speak specifically to the global number of first responders, and I'll give you some percentages. I don't have that data for Veterans Affairs and Defence with me today, but I'll speak to Public Safety.
Approximately 250,000 people would fall into the category of public safety officer: approximately 69,000 police officers; 110,000 firefighters, of which about 80,000 are volunteers; about 20,000 paramedics; and about 18,000 volunteer search and rescue workers. Then in the broader public safety portfolio, you would have the RCMP with around 16,000 members, correctional officers at around 8,200, and then CBSA workers.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
I'm specifically thinking of the number of cases of PTSD among them. I imagine you wouldn't have those numbers at hand, but could you provide those to the committee?
Assistant Deputy Minister, Emergency Management and Programs Branch, Department of Public Safety and Emergency Preparedness
We have a few. As an example, we know from some surveys we've done that about 36% of male correctional officers have identified as having post-traumatic stress disorder. At the lower end we have about 7% of police officers, but numbers vary, depending on the study or the survey that's been done.
We would identify this area as a gap, because we don't have good data collection. People don't always identify because of the stigma associated with it. People know it's personal, private information and they don't want it known.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
Thank you very much.
Dr. Lanius, I'd like to move to you. You talked about the fact that we've made a lot of progress in terms of treatment options and treatment targets. You also said treatment is different depending on how people respond to those traumatic events, whether it's with a heightened sense of reaction or whether it's with a numbing.
Could you run us through what a treatment plan that is very effective would require, such as the number of months, or weeks, or years of treatment, and with what regularity? I understand there are different cases, and they require different treatments. If we were to provide a top level of support for those who are suffering from PTSD, what would that look like in terms of resources?
Professor of Psychiatry, University of Western Ontario, As an Individual
We have several evidence-based treatments right now, and usually people recommend about 12 sessions of treatment. If we look at the reality of, for example, the veterans who start these treatments, over half of these veterans don't finish these treatments. I think there's a big individualized response to different treatments. I think the next step in improving treatment outcome is to develop individualized treatments for different people given what symptoms they present with and what difficulties they have. Generally speaking, right now, 12 sessions is generally recommended.
NDP
Professor of Psychiatry, University of Western Ontario, As an Individual
Those would be weekly sessions.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
Okay. When you say half the veterans don't complete the treatment, is that because they don't feel they need it anymore, or because the veterans and the professionals feel they've run the full course of treatment, or is it because the treatment isn't working? What are the reasons for that?
Professor of Psychiatry, University of Western Ontario, As an Individual
There are a number of reasons. Some feel the treatment is not working, and some have difficulty engaging in the treatment. There seems to be a problem with some of the standard treatments, and with people completing them, and being able to engage in them. There's some important literature coming out on that.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
Thanks to all of you for coming out today.
Dr. Lanius, I'm going to start with you. We know first responders and corrections officers are more at risk for developing PTSD and operational stress injuries. Do you think there's enough data and that enough research has been done on that, and if not, do you see a role for the federal government in helping to improve the data we do have?
Professor of Psychiatry, University of Western Ontario, As an Individual
Absolutely. I think there's very little research on this topic, and we could certainly really benefit from learning more.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
From your research, and from what you've discovered in terms of the way individuals react differently to stress, how do you see the federal government playing a role in sharing best practices? For example, you have lots of great programs going on across the country right now, but there doesn't seem to be a coordinated effort to share those. I'm wondering if you see a role we can play as a federal government to facilitate the sharing of best practices.
Professor of Psychiatry, University of Western Ontario, As an Individual
I think setting up a committee that comes up with best practice guidelines that are flexible and that promote an individualized medicine approach would be very useful. Then the whole country could refer to those in the treatment of these disorders.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
I know the Road to Mental Readiness is something that's being adapted from Defence for various first responders and fire departments. What are your thoughts on that program?
Professor of Psychiatry, University of Western Ontario, As an Individual
I think it's an excellent program, and I think it's had a lot of success in the military. I think all areas of occupational stress really benefit from that. I'm happy to see that it's been individualized to the different professions.
