Public Safety Committee on Sept. 26th, 2017

[Michel Rodrigue]

I hope I can communicate this next message properly.

We are all susceptible to mental health problems. It is not a moment of weakness and there is no predisposition. Of course, some people can be predisposed to problems of that kind. If we add a medication or an illicit substance, marijuana for example, to that predisposition, it can act as a trigger. But that aside, we are all at risk, just as we are all at risk of having an accident and breaking an arm.

The best thing to do is to put institutional mechanisms in place to support people and to make sure that they can be rehabilitated as quickly as possible and return to work.

[The Chair, Liberal, John McKay]

Mr. Motz.

[Glen Motz, Conservative, Medicine Hat—Cardston—Warner, AB]

I'm thankful for the world of first responders in my world of policing. When Dave, Michel, and I started policing many decades ago, we did not have the training on mental illness that we do today. For that, we are heading in the right direction.

Due to the experience we've had, we screen people before we recruit them and that has been very helpful. We train them in mental readiness as part of our recruits' training. The key is to add resilience. You want to build resilience over time and you do that early on in someone's career.

This program works well. We rolled it out a few years before I left policing. It is having a positive impact in that it allows police officers to speak with each other about the trauma they are seeing or the opportunities where trauma can exist. That in itself is great.

I remember early on we took the PTSD training, the debriefings and defusing and the peer-to-peer counselling work that's been done in the U.S., and we were certified in that. This, to me, is more of a hands-on, everybody can do it, makes a difference program, and I applaud the commission for doing that. I think it's a step in the right direction.

I think it's important to recognize that some studies are to be done. A paper was released last year entitled the “Blue Paper” by a doctor out of Regina. His paper is a review of our police wellness programs in our country. He indicates there needs to be more research. There has to be continuity between services. Sometimes I think that's the current breakdown. We are going in the right direction. It's just a matter of allowing agencies to make sure we all participate in some way.

I think two of you have commented on this. This is not a single event, one training opportunity that fixes the problem. This is an ongoing, annual part of professional development days. We incorporate some mental health training every year, and it's important that we do that.

Matthew, you asked if the scaffolding can be fixed before it's broken. Sometimes you can and sometimes you can't.

We are on the right track. We're going in the right direction. We do need more work. This isn't a fix for everything. It's a first step. You're to be applauded for the initiative.

I don't have a specific question, Mr. Chair.

[The Chair, Liberal, John McKay]

Mr. Fragiskatos.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Thank you for the work that you're doing.

I have a question about family members of first responders and where they fit into the R2MR approach.

A second question relates to challenges of implementation. I was reading an article, which was published just a few days ago, that looked at a situation in Manitoba where paramedics are implementing this very approach. There's a bit of a challenge, it would seem, when it comes to implementing the strategy in rural areas as compared to urban areas. I wonder if you could touch on that as well.

[Nicole Boisvert]

Certainly, I can talk to that.

With regard to families, the commission actually just developed a family package that is specifically for families of first responders because we understand that they don't leave this at work. This flows into their family life and whatnot. We are currently piloting that package across a couple of first responder groups that we've worked with in the past. That package is geared towards any type of family member, spouse, partner, parent, sibling, child, as long as they're an adult. The package is not yet designed for youth. The package is being piloted over the next several months and, hopefully, will be rolled out sometime in 2018 across the board.

[Peter Fragiskatos, Liberal, London North Centre, ON]

My question was provoked by the video with the OPP officer who talked about his family.

[Nicole Boisvert]

Yes, exactly.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Obviously, he was going through challenges. He's the primary focus, but the family goes along with him.

[Nicole Boisvert]

It's a pared-down version of the program—

[Peter Fragiskatos, Liberal, London North Centre, ON]

The family suffers with him, I should say.

[Nicole Boisvert]

—that focuses a lot on the continuum and on recognizing signs and indicators that family members might see in their spouses or whoever, whatever the relationship is with the first responder. It takes away some of the return to work and those kinds of things, and it focuses a lot on recognizing the signs and indicators in their family members.

Your second question....

[Peter Fragiskatos, Liberal, London North Centre, ON]

It was on the challenges of implementation: urban areas compared to rural areas.

[Nicole Boisvert]

It is definitely a reality that a lot of the groups we've worked with have been in major cities. The first reason is funding. Those in smaller, remote communities often have a lack of funding to pay for a program like this. For some of them, especially firefighters, a lot of them are volunteers, so there is no funding at all. The other issue is just accessibility. For example, when somebody attends training like this, they have to, obviously, not be on shift and active at that point. Taking those people off shift to attend training like this is sometimes hard with scheduling when there aren't a lot of people. We're saying that a class has 12 people in it. To take 12 people out of rotation for a half day, or a day if they are managers, is often difficult in smaller communities.

It's something that we're addressing in a number of different ways. For example, we're hosting. Typically, the sessions are run within an organization by the organization. The commission has started delivering sessions that are hosted by the commission. Those 12 to 24 people who attend are individuals from various organizations, so an organization can send maybe two or three people at a time instead of having to host a full class of 12. One, it reduces the cost because they don't have to host it themselves, and they don't have to pay for space and all that stuff. Two, they can send just a couple of people at a time instead of having to have a whole class.

We're also doing it with larger organizations, in a sense, lending their trainers to smaller organizations. They're volunteering their time to go into those remote and rural places. We're also looking at changing some of our business model to allow for partners that specialize in delivering training to first responder organizations. We've licensed a couple of those types of organizations that specialize in training to then go off into these remote and rural areas. They might go and deliver multiple types of training, not just ours, but ours would be a piece of it. That way they have easier access to those places because they have people in those areas.

There are different ways of addressing it, but it really does come down to funding.

[Peter Fragiskatos, Liberal, London North Centre, ON]

I have one final question. The commission, I would assume, is not the only body involved in implementing a training strategy across the country. I'm going to assume there are others involved. Is there collaboration between the commission and other organizations? I ask the question because one worry I would have, or one concern that may exist, is perhaps a fracturing of efforts, so that training and the content of that training might not be consistent across the board. Obviously, it's going to be different, but you wouldn't want it to be different to the point that you're having completely different approaches implemented and what that means in terms of results. Could you touch on that?

[Michel Rodrigue]

I'd be happy to. As an organization we're very proud that whenever we deliver training it is informed by evidence. We are quite pleased to be able to share that knowledge as we develop programs. Perhaps I could give you a short summary of how we deliver the programming.

When we first thought of rolling this out, we asked ourselves how we could have the biggest reach right from the start. That's how we decided to work. With large organizations, we train the trainers. That way they can roll it out on a consistent basis internally. We also work with incredible people like Liane, who deliver the programming on our behalf. For this program we have well over 1,200 trainers. We're always looking to expand through partnerships. As an example, for mental health first aid we're working with a number of partners to expand our reach and they are delivering the program. But we are maintaining the consistency. I think fidelity to the program is critical for one simple reason: some people may have some wonderful ideas, but they can do a lot of harm if the approaches aren't validated, tested, and ensured. We're quite pleased to partner, because our aim is to broaden the field.

I hope that answers your question.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Thank you very much.

[The Chair, Liberal, John McKay]

I want to thank each of you for your presentation.

That's all the questions the committee members have, but unfortunately, this committee is afflicted with a chair who likes to ask questions. First, do you have, or would you like to have, or is there now a longitudinal study of the people you are presenting this program to? It seems to me it's almost a tailor-made population for a longitudinal study. Second, is there a criterion for success? When will you know if you have success or failure? The third question is on the mix of terminology. What is a diagnosable mental illness? I hear all kinds of things. Is PTSD a diagnosable mental illness?

Hopefully with the indulgence of my colleagues, you can answer those questions briefly; otherwise, they will rebel against the chair.

[Voices]

Oh, oh!

[An hon. member]

Again.

[The Chair, Liberal, John McKay]

Again, yes.

[Nicole Boisvert]

I will try to be brief in my answers.

As to the first question, we did conduct evaluations for the programs, as Liane said, pre-, post-, three-month and six-month follow-up. There are follow-ups being done with the organizations that have ongoing training. They're still being done after six months. As Liane mentioned, we just launched the booster sessions. We were seeing that after six months some of the results were starting to drop off, and so we launched the booster sessions in July. We are now working with some of the organizations that had previously rolled out the initial program and that are now starting to roll out the booster sessions to make sure they're meeting the goal.

[The Chair, Liberal, John McKay]

That's not a longitudinal study within the concept of a longitudinal study. A longitudinal study goes 5, 10, 15, 20 years.

[Nicole Boisvert]

No, we don't have one.

[The Chair, Liberal, John McKay]

You don't have one. Really. That's interesting.