Evidence of meeting #15 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 paramedics.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Randy Mellow  President, Paramedic Chiefs of Canada
Pierre Poirier  Executive Director, Paramedic Association of Canada
Daniel Dubeau  Deputy Commissioner, Chief Human Resources Officer, Royal Canadian Mounted Police
Don Head  Commissioner, Correctional Service of Canada
Paul J. Charbonneau  Past President, Paramedic Chiefs of Canada

12:15 p.m.

Liberal

The Chair Liberal Rob Oliphant

Mr. Poirier is smiling at that.

Mr. O'Toole.

12:15 p.m.

Conservative

Erin O'Toole Conservative Durham, ON

Thank you to all of you, and through you to your members, for the important work you do for the public, and for taking the time to be here today to represent your members on the issues impacting them.

Chief Mellow, I was struck by the number you quoted: 1,700 members of the 40,000 that Mr. Poirier referred to, who right now are dealing with operational stress injuries. How did you ascertain that number and how many of those 1,700 would be off work versus working and persevering with an injury?

12:15 p.m.

President, Paramedic Chiefs of Canada

Randy Mellow

Mr. Chair, I could answer that question, but first I'd like to clarify that I referenced roughly 8,000 paramedics in the province of Ontario and the rate of 22% coming from just one of these studies, and there are many of them in different, I suppose, silos. One study we saw predicted 22%. That's how I came up with that 1,760 here in the province of Ontario alone. That doesn't include our communications officers in the ambulance world and then, of course, the other first responders in the community.

Mr. Poirier quoted 40,000 paramedics across Canada, and I agree with that number. If you take 22% of that, it's a much larger problem. I wish I could answer the question as to how many are off work. I wish I could tell you what the financial burden is that's associated with that. I wish I could tell you how many medical errors or risky behaviours we see in our communities.

Those are all types of research projects we've been embarking on and we would like to give you further information on, but again, as I stated earlier, we need broader collaboration to bring those research projects together so we could answer that question more clearly for you.

12:20 p.m.

Conservative

Erin O'Toole Conservative Durham, ON

We've heard from some fire services, and I spoke to their national convention not long ago. York, for instance, is rolling out resiliency training through the Road to Mental Readiness document, which originally was a DND document that has been adapted for first responders.

Have any of your forces engaged in resiliency training using that document or another road map, and have you had any success from that?

12:20 p.m.

President, Paramedic Chiefs of Canada

Randy Mellow

If I could pass that to Mr. Charbonneau, I'd appreciate it.

12:20 p.m.

Past President, Paramedic Chiefs of Canada

Paul J. Charbonneau

Thank you, and through you, Mr. Chair, the Road to Mental Readiness program has actually just been adopted for the paramedic world. Tomorrow, in Toronto, the Ontario Association of Paramedic Chiefs is holding a whole day of meetings around mental wellness, and this will be brought to us by the Mental Health Commission of Canada.

It is being looked at very favourably, as it has been for fire services and police, and indeed, for our military personnel. We're keenly interested in it, because we hear great results about how it has been used, particularly with the RCMP, which was the first police force to use it in Canada. We're very excited about it, and I think it will be one of the very good programs for our staff, just as it is for firefighters and police officers and corrections officers.

May 10th, 2016 / 12:20 p.m.

Conservative

Erin O'Toole Conservative Durham, ON

A number of you commented on the suicide challenge that we've seen in a number of uniformed services in recent years, along with mental wellness and stress generally.

One thing I think it's important to note— and we heard this from some witnesses who were here at our last meeting—is that you can actually demonstrate through MRIs people who may be predisposed to operational stress injuries. Among your members, do you find there are cases of depression and a range of mental illnesses that may not be related to operational stress but may occur with the same sort of incidence found in the general population?

In some cases, are you able to distinguish which it is? Obviously, for somebody who develops a mental illness that is not related to operational stress, resiliency training and a range of other things won't actually help them. How detailed is the mental health discussion? I found this with Veterans Affairs as well. The military, the RCMP, or any force will have people with personality issues and a whole range of mental illnesses unrelated to stress, and if they're just given resiliency training, it's not going to help them.

12:20 p.m.

Executive Director, Paramedic Association of Canada

Pierre Poirier

I have probably a couple of comments.

One was that we did take a look at the incidence of suicide among paramedics and compared it to that for the general population. I'm not sure I'm answering your question directly, but the rate of paramedic suicide was over and above that of the general population.

What I think you're alluding to is that there may be people who become paramedics who are already predisposed to that. That is a possibility, but recognizing that there's a differential between the general population and paramedics because of what's happened to paramedics, our belief and our assertion are that the job and all those activities related to the work we do are related to that differential in mental health issues.

12:20 p.m.

Conservative

Erin O'Toole Conservative Durham, ON

I agree.

The issue is more about treatment. If somebody develops an operational stress injury or something that's diagnosed clinically, like PTSD, the treatment regimen for that injury and that disorder is quite different than someone who would have a general anxiety disorder.

What I worry about is that the stressful environment that does lead to higher OSIs, in your service and in the RCMP and others, leads to this resiliency approach. However, that's not going to help everyone, because some people will be suffering a general mental illness and may need accommodation outside of training.

We're at such an early stage with discussions on OSI and PTSD and these sorts of issues, I'm wondering whether we are able to distill and tailor treatment regimes or accommodation for people on a range of issues.

12:20 p.m.

Executive Director, Paramedic Association of Canada

Pierre Poirier

I work with the City of Ottawa, and that's been an interesting recognition or kind of alarm bell that's gone off internally within the city. I think it's true across the country that EAPs, employee assistance programs, are really set up for—and please don't take it the wrong way—the run-of-the-mill depression or other kinds of mental illness. They are not necessarily able to focus on what we describe as mental health issues related to the job.

Over the last couple of years, that's been recognized within the City of Ottawa. They've had to revise the EAPs to be specific to first responders. That work is ongoing, not just with the paramedic community, but within the fire community within the city. That's taking place across the country. Until recently, EAPs did not understand the mental health issues related to first responder work.

12:25 p.m.

Liberal

The Chair Liberal Rob Oliphant

Mr. Dubé.

12:25 p.m.

NDP

Matthew Dubé NDP Beloeil—Chambly, QC

Thank you, Mr. Chair.

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

A lot is said about tackling the issue of post-traumatic stress, and it is very important that this be done, but I think that in some cases, we also have to tackle the incidents and events that can cause it.

My question is for you, Mr. Head, and it relates to prisons.

I remember reading an article—I think it was in 2014–that talked about an increase of around 60% in workplace accidents in prisons. We know that some of these accidents are related to violence. Situations like double-bunking can create dangers for correctional officers and additional violence.

Is there something that can be done about this? We want to offer them mental health help, but should we also, first, be looking at reducing the number of events that can cause post-traumatic stress?

12:25 p.m.

Commissioner, Correctional Service of Canada

Don Head

I think there are definitely things that can be done in relation to the specific items you mentioned. We've reduced levels of double bunking, which relieves some pressures in the institution—those kinds of things.

One of the things that's important to remember in this discussion is that what we're calling “occupational stress injuries” can come as a result of many things, some of them more physical in nature, such as assaults and seeing others assaulted, to situations where.... I'll give you an example. In our admission units across the country, we have clerical staff who read the police reports, the criminal profiles of individuals, each and every day. Some of the crimes committed by people who come into our system are horrific. Those reports are very graphic, very detailed. Until now, we would never have thought that doing this kind of work could result in a mental health issue or an occupational stress injury.

We need to be careful that we don't pigeonhole things into these easy categories. What people physically experience is one category, but there are a whole range of issues, particularly within our environment. Our psychologists having to deal with some of the most difficult mental health cases in this country, day in and day out, can take its toll on people. There are the parole officers, who have to weigh all kinds of information in relation to an individual's crime, his or her progress, and make recommendations about whether this individual can be released. All those things come into play.

Within the correctional world, it's more than just the physical altercation piece. There are all kinds of other factors that come into play.

12:25 p.m.

NDP

Matthew Dubé NDP Beloeil—Chambly, QC

Thank you.

You talked about people who have been killed. There was a person in the community. Was that at work or was it someone who went looking for the person and knew where they lived? What were the circumstances in that situation?

12:25 p.m.

Commissioner, Correctional Service of Canada

Don Head

The situation in the community was the murder of Louise Pargeter in Yellowknife. She was doing what we call a home visit, following up with an offender who was in the community and who had been released by the parole board. He was serving a life sentence already. During that home visit, he went off to make a cup of tea, came back, murdered her with a hammer, and then sexually assaulted her body afterwards.

12:25 p.m.

NDP

Matthew Dubé NDP Beloeil—Chambly, QC

In other words, it's so important not to forget parole officers when you hear a story like that.

12:25 p.m.

Commissioner, Correctional Service of Canada

Don Head

Exactly.

12:25 p.m.

NDP

Matthew Dubé NDP Beloeil—Chambly, QC

Fantastic.

With regard to paramedics, Monsieur Poirier, you talked about how you're essentially the third-largest health care provider. What does that element of being part of health care, basically, but also working alongside first responders who deal with very different situations as well...? You mentioned it a bit, but could you get into some of the specifics around the challenges that those two realities can present and the kind of work we need to do to make sure that you have better structure around the help you need?

12:30 p.m.

Executive Director, Paramedic Association of Canada

Pierre Poirier

First off, I appreciate the question, because going back to 1981 and the Canada Health Act, paramedics were not envisioned within health care from a national perspective. That's always been one of our long-term visions, I guess, that when you look at health care it will include the paramedic component, as in, right after that 911 phone call, when you start to touch the people who can provide the care, it should be considered within health care. But I know that's another tangent.

I think the uniqueness oftentimes is that paramedics do develop relationships with their patients. That has an emotional context, too, which oftentimes isn't seen with the fire community, for example—although that may not be in the same.... That's what I refer to as us having a unique relationship. Oftentimes there's an emotional attachment—or maybe detachment, however we want to work it.

We are engaged emotionally with our patients in their treatment. We see the ups and downs in terms of our interventions. I think that really does add to the level of complexity, or to what makes so unique the work we do. It's not that we're better than; it's just that it's different.

12:30 p.m.

NDP

Matthew Dubé NDP Beloeil—Chambly, QC

Thank you for that answer.

My last question concerns the data and is for all the witnesses. I would like you to answer as briefly as possible because I have very little time left.

The question of data is something that comes up very often. This is an easy recommendation that the committee could make. We have to have more data to identify workplace incidents, mental health problems, and incidents that result in post-traumatic stress. I would like to hear all the witnesses as quickly as possible in the thirty seconds I have left.

12:30 p.m.

Deputy Commissioner, Chief Human Resources Officer, Royal Canadian Mounted Police

D/Commr Daniel Dubeau

I will talk about it as it relates to the RCMP.

We have data about incidents that happen in the workplace. There is also the Veterans Affairs Canada data that gives us an idea of the number of people who apply for a pension. There is also data from our insurance companies. We have a lot of data, but what we do not have is internal data. We do not have data about our members who are ill. That is really the data we are missing. We are in the process of buying a computer program to collect that data, a

case management tool for health care.

When it is in place, it will give us more data and information about this.

12:30 p.m.

NDP

Matthew Dubé NDP Beloeil—Chambly, QC

What is the situation for ambulance attendants?

12:30 p.m.

President, Paramedic Chiefs of Canada

Randy Mellow

Just very quickly, to give you the paramedic perspective, as you're all aware, we are very much a provincially based organization. That causes some fracturing in our data. We have data, as our friends in the RCMP do, in each of our provinces, but we need a better way to come together nationally to collaborate on the sharing of that data and then, more broadly, to use it across the entire first responder community so that we can support one another.

12:30 p.m.

Liberal

The Chair Liberal Rob Oliphant

Mr. Mendicino.

12:30 p.m.

Liberal

Marco Mendicino Liberal Eglinton—Lawrence, ON

I'd like to thank the rather large group of witnesses we have in the panel. I would echo and contribute to some of the statements made by my colleagues. We're very grateful to all of you for the service you provide.

I want to explore some of the statistics we heard earlier around the very difficult issue of suicide. I just want to make sure I have the numbers right.

Mr. Head, I understand that 27 of your CSC staff either attempted to or did commit suicide in 2015.