Public Safety Committee on Sept. 26th, 2017

[Liane Vail]

Absolutely.

[The Chair, Liberal, John McKay]

Monsieur Picard.

[Michel Picard, Liberal, Montarville, QC]

In my opinion, the importance of the presentation is obvious. At least I speak on behalf of my colleagues and me; you will be able to share your needs.

Ms. Vail, it is essential to understand your methodology and approach. You can summarize how this is normally done. Committee members want to know what you are doing and understand what is going on. However, it seems to me inappropriate for a public committee meeting to become a public laboratory for the exercise you are proposing. For the benefit of this committee, I invite you to introduce the mechanics you use in training and summarize what happens in training.

[Liane Vail]

Yes, certainly.

Eight scenarios are provided in the kit for managers. There are four in the basic kit. We provide questions related to the scenarios.

Here, we are not yet comfortable enough to do that, and that is understandable. Often, this is done at the end of the training and it works better, because we have already given participants an opportunity during the day to talk about mental health.

Destigmatizing the stigma around talking about it works well.

The next part of the program is about returning to work. It's not only about returning to work for the person who has struggled with the mental illness; it's also for his peers. Oftentimes, when somebody comes in from maternity or paternity leave, there's cake, balloons, and a welcome back. People want to see the baby pictures and everything. But does the person who comes back with a mental illness get the same sort of welcome? Not necessarily. It's no fault of those employees, because what's happening is that they don't know how. Having this education in the program gives you the opportunity to debunk the myths of this video.

[Video presentation]

It's the fear of not knowing what they're going to say.

Regarding the evaluation results, based on quantitative results of the pre-workshop survey, the commission has looked at R2MR and the working mind, which is the civilian version. They've done post-workshop surveys, and reassessed at three and six months. The evidence shows quantitatively that there has been a decrease in stigmatizing attitudes in managers, a decrees in employees pre and post, and the majority of the gains are retained for up to three months at follow up. There is a significant increase in resiliency skills, as well as overall resiliency, mental health and well-being.

With the qualitative results, you're looking at what people have said about the program: “I liked the program.” The workshop “dispelled myths and common misconceptions”. It was an “eye-opening experience”. It “was very interactive, well presented” and “excellent videos”. They are lived experiences, so people are really open to it and it resonates with them.

Who are we reaching? Well, with the R2MR we've reached over 59,000 people. There are 1,238 trainers. The number of people trained in the working mind to date is about 14,000, of which 330 are trainers.

In terms of partnerships, R2MR has been partnered with several police organizations and more than 250 first responder groups. I was part of the implementation of the R2MR in the RCMP. I went to the senior executive committee in front of our commissioner, Bob Paulson at the time. He actually made this program mandatory across the country.

The importance of this is vital. It's not the be-all and end-all, but it opens the door to a wave effect that can produce a significant increase in self-management and a significant decrease in the number of dollars that we put into mental health at the moment. It will make a difference.

We have a four-hour delivery format in an eight-hour day. There's one week to train the trainer, where we'll go in and teach how to teach the program by using the managerial program. Normally speaking, the number of participants is 12 to 36, the reason being that we don't want it to be too big. There's some intimacy in the fact that we can talk about mental health and debunk the stigmas. Yes, it is an uncomfortable conversation. It is the elephant in the room at the beginning, but when we get into this, throughout the day you will notice that people are more open to having that discussion.

The primary package is four hours. It targets the same modules as the leadership package. The difference is that the leadership package does the shield, sense, and support, for which the group is divided into three.

One group will look at “shield”. How do we promote positive mental health in employees? The commission is not there to give them the answers. They are there to guide them to find their own answers that will be appropriate for their own environment.

One group is on a sense of early recognition. What do you do, and how do you do that?

When it's in the red, you have support, but what kind of support? Where can we get the support? What treatment would be required, based on the situation?

Oftentimes, especially in policing, they've struggled with a trauma. Whether or not they go to the appropriate health treatment...is a big indication of whether or not they're going to get the appropriate treatment to get back into the green.

Then, there are the practical skills and application, which we showed you in the scenario.

That's it for my presentation. Thank you very much for listening and participating. I've been working with the commission and the R2MR program for many years. It has championed a lot of follow-up in looking at the wellness of our employees, specifically on the mental health side of things.

[The Chair, Liberal, John McKay]

Thank you, Madam Vail. I appreciate the presentation. It's certainly very interesting.

We're going to go to formal/informal questioning.

Monsieur Picard.

[Michel Picard, Liberal, Montarville, QC]

Thank you very much for your presentation and, most of all, congratulations on your work. I know there is still a lot of work to be done; it's work that has no end. On behalf of those who benefit from your services, I thank you very much for your dedication.

According to your slide comparing treatments for a physical health problem with those for a mental health problem, it's quicker to diagnose a physical health problem than a mental health one. However, depending on the break-down you make, after diagnosis, the treatment of a physical health problem lasts about as long as the treatment of a mental health problem.

I'm surprised. In the case of depression, people are treated for more than three months. In the case of a physical health problem that is not too serious but that requires care, or even a heart attack, the person will recover within a few weeks or months. I would have thought that some mental health problems, without being extreme, required care over a period of years. So I was somewhat surprised that your assessment of treatments for mental health problems was virtually the same as for physical health problems.

Could you tell me more about that?

[Liane Vail]

In other words, you're surprised at how long it takes to recover from a mental illness, compared to the time it takes to recover from other illnesses, is that correct?

[Michel Picard, Liberal, Montarville, QC]

The slide in question has four lines—

[Liane Vail]

Right.

[Michel Picard, Liberal, Montarville, QC]

After diagnosis, the duration of treatment seems to be almost the same, within a few millimetres. I'm surprised. I would have thought that the treatment for mental health illnesses would be much longer, since some of them require much more care.

[Liane Vail]

Right, I understand.

Actually, it depends. In the case of depression, it's important to know whether it is something recurring or an isolated incident.

Let's take the example where, after the death of a spouse, a person shows symptoms of depression. The signs and symptoms may last a very long time if the person does not recognize them as symptoms of depression.

The data here is collected from the moment the treatment begins, and I stress the fact that the right treatment needs to be given. If the person is referred to a professional who specializes in treating children, do you think they will get the right treatment? No. It is important to refer people with signs and symptoms to the appropriate professional. For me, it was the clinic specializing in operational stress injuries.

According to research, eight to ten sessions can normally cure an incident of depression or anxiety.

The difference with police officers is that they may have had not one, but several incidents of depression since the beginning of their careers. When I started in Neguac, there were many cases of suicide and all sorts of other things. I stayed on. Then there was more and more trauma; it was an accumulation of problems.

To answer your question on that slide, I would say it's related to an incident.

[Michel Picard, Liberal, Montarville, QC]

I have one last question.

You mentioned the reality of police officers and soldiers. When police officers get in their cars, their stress levels are higher than those of the average person.

[Liane Vail]

Absolutely.

[Michel Picard, Liberal, Montarville, QC]

In the same way, as soon as soldiers put on their uniforms and go into the field, their stress levels are necessarily higher. The context is completely different.

So, the percentage of 8% to 10% is somewhat surprising, since the base is not the same as for a shift in other trades.

Does your intervention begin when a mental health problem is diagnosed, or are you asked or would it be justifiable to ask that you intervene in cases where people are in a grey area?

Everyone knows people who are not doing well at one time or another. The latter do not necessarily suffer from a mental health problem. There is no standard. It is impossible to determine precisely from what point an individual is considered to be suffering from a mental health problem and not merely a little crazy in the good sense of the word. However, for a mental health issue, it is often advisable to consult a professional, simply for follow-up. It is not necessarily that things are going so badly, but we don't want to get to the point of no return.

Do your interventions cover these grey areas? Do you intervene during yellow or orange periods, or only when they turn red?

[Liane Vail]

Do you want to answer that?

[Michel Rodrigue]

At the commission we don't intervene on the ground. That is really not part of our mandate. However, we are doing prevention. Many of our programs are focused on prevention.

We all know about the first aid program, which allows us to intervene when a person gets injured and to stabilize the situation until help arrives. For our part, we offer the first aid in mental health program, which allows us to do the equivalent. We are able to determine whether or not someone is in a crisis or about to be, whether to intervene, to determine where they should be directed, or to decide whether to take them there straightaway or to call for help. That is one of the programs we offer. We really work in the area of prevention.

We believe that by offering promotion and prevention programs, we can have the greatest impact. With this in mind, we offer the mind to work program. This is the version received by those who do not work in the military or police fields. Having attended this training with senior officials, I can confirm that this finally gives people the tools to better deal with staff who are receiving treatment or experiencing difficulty. I believe this initiative is relevant. It allows for prevention. However, when people are experiencing difficult times, support programs are needed.

[Michel Picard, Liberal, Montarville, QC]

Thank you.

[The Chair, Liberal, John McKay]

Thank you.

I appreciate that I'm running a formal/informal clock here. I see that your presentation has stimulated a lot of questions.

Mr. Dubé, you have the floor.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

Thank you for your indulgence, Mr. Chair. I will be brief.

First of all, I would like to thank you for being with us and for your presentation.

Mr. Rodrigue, you just spoke about prevention. I know that operational training issues, meaning specifically what happens on the ground, are outside of your mandate. However, with regard to the events in Moncton, which have been mentioned several times, it has been pointed out that training and available equipment could perhaps have prevented this incident and post-traumatic stress in some members affected by this tragedy. This has even been the subject of a lawsuit. It's obviously a more controversial issue.

To what extent are you involved in more practical matters, such as ensuring that working conditions prevent you from having to intervene afterwards for cases of mental illness?

[Michel Rodrigue]

I will respond briefly and then turn to an expert in the field.

We have developed the National Standard of Canada on Psychological Health and Safety in the Workplace. It is the first of its kind in the world. This standard has been adopted by thousands of workplaces. It creates healthy environments. Last year we were pleased to hear from the Clerk of the Privy Council announcing that all workplaces in the federal public service would adopt this standard. Large companies have done that. This includes a number of measures that create a healthy workplace free from harassment and psychological stress.

[Liane Vail]

If I could answer in English, essentially we talk about Moncton—I brought that up—and yes there are other factors. There are investigations and so forth. But the fact is that this R2MR was provided to them the year before that incident. I would hate to think of what would have happened with their mental health if they didn't have those tools already in place.

This program is essentially because I had people coming to me or to that drop-in centre saying, “I'm in the red. I'm not doing well.” If we didn't have something like this in place where we've identified what's important in prevention and self-management, we may have had a bigger crisis on our hands.

Does that answer the question?

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

Sure.

I don't want to go into it too deeply, because we're being mindful of time. I think it's also just understanding sort of where the mental health issues join with what's actually—

[Liane Vail]

In place.

[Matthew Dubé, NDP, Beloeil—Chambly, QC]

Yes, making sure that officers are properly trained, not just on dealing with mental health issues but in terms of the physical intervention, equipment, things like that.

In other words, if we have a construction worker who is up on the scaffolding and the scaffolding is rickety, obviously you can deal with the aftermath of the injury, but you want to make sure that the scaffolding is not rickety to begin with.

[Liane Vail]

Absolutely.