Thank you.
I'm Dr. Dadson. I'm the adjunct professor at the University of British Columbia on the advisory committee for the centre of group therapy and trauma. I'm also the clinical director and the national director of the veterans transition program. As well, I'm a board member of the International Society for the Study of Trauma and Dissociation. I'm an ordained chaplain and I operate a trauma treatment centre and training centre here in Langley, British Columbia, that services about 200 folks a week.
I'm here to speak to the committee primarily as a clinician and through my experience in the veterans transition program. The veterans transition program is a group-based experiential program that's been operating for 18 years. It was researched and developed through the University of British Columbia. In our experience, we have seen the struggles for veterans and first responders in accessing mental health treatment. We see that there are several barriers that prevent them from accessing treatment. We actually would take the view that there are a lot of effective, empirically based, research supported treatments available but that many first responders are unable to access these treatments because the job that they do requires them to operate at such a high level of competency and high pressure that if they begin to crack, show weakness, or ask for help, they're perceived as failing or being weak and unable to continue in their work. Seeking help may pose a risk to their careers. We've seen this regularly with veterans where, even though they are suffering clear occupational stress injuries or even post-traumatic stress, they'll continue to work in their field and they will resist seeking treatments early because they believe that it could threaten their career, where early treatment may actually prolong their career.
They deal with situations that are far outside the norm. They are not only experiencing a single incident or event but they are exposed to multiple traumatic or high-impact stress situations. They often express that, even in speaking to therapists, they fear that they will damage their counsellors because of the horrors that they've seen. The way that these traumatic experiences, or these occupational stress injuries, intersect with the masculine gender role or the masculine expectations of their position, because they're very highly.... The expectations are that they are to behave in accordance with masculine norms, which is that they are strong, hard-chargers, capable, independent, and don't seek help. They're not the lambs, they're the ones who go and actually provide the help. When they need help it's very difficult for them to actually seek help because that contradicts the very culture in which they are working.
The way that the veterans transition program has addressed this is, first, it was developed in accordance with first responders. We met with first responders, we worked with first responders, and we asked them what would help them to be able to address these concerns. We offer a multidisciplinary program that focuses on a strength-based and peer-helping approach. We work in groups and we don't just help or provide therapy for individuals, we show them some very basic techniques and very basic communication skills that can help them support each other. This, in itself, normalizes the experience, which is really important for those first responders because it helps them to recognize that they can still be the warriors that they see themselves to be but they can incorporate the possibility that they also may need help.
They also find it easy to communicate to one another the experiences, the horrors that they've seen, because they know that they've each seen them. They're not saying anything new when they speak in a group to one another. That normalizes their experiences and it makes them available to receive help. We buffer them from the experiences by providing a very caring and supportive environment, which actually reduces the anxiety and the avoidance so they are able to go deeply into their experiences with one another in a shared way. This actually helps them normalize the experience and then do the work that they need to do.
In effect, they challenge one another to do the work because they see that as part of their new battle, or their new career or their new job.
We use de-stigmatizing language. Instead of using language such as “seeking therapy”, we use language such as “trying to drop the baggage” or “just trying to move through a situation”. Instead of talking about emotional experiences, we'll talk about sensory experiences. We'll begin with the body and their physical reactions, and normalize those reactions.
We believe that one of the reasons our program is so successful is that 50% of the folks who are recommended to our program are actually recommended by other veterans or first responders. That means they come in already expecting that they're going to receive some help that's a bit different from what they've seen in the past. In other words, they won't experience the barriers they've experienced.
Here's an example of a barrier for a veteran. For veterans to apply to be treated for PTSD, they need to demonstrate that they have PTSD, which means they need to retell the story several times, again and again, to a variety of folks who have a pretty clinical mindset. They're not there to actually do therapy; they're there to assess whether the people actually qualify, whether they meet the standard for PTSD. Telling the story in this context again and again actually is unhelpful. It creates avoidance, and they actually avoid even applying for help.
We see many veterans who aren't even a part of VAC services, because they can't go through the process. Their injury is a barrier to their going through the process. That means they don't get treatment.
So 50% of our participants have not accessed services from Veterans Affairs Canada. We have a 90% retention rate, which means that, of the people who have gone through our program, very few have dropped out. When they do, it's usually because of family or because of medical concerns. I'm aware of only one person who's dropped out of the program because they decided not to continue on; it wasn't right for them.
We screen participants, so we don't take everyone. If someone is highly suicidal or psychotic, then we're not going to see them in our program. They need to first get some of those things in check. But our program has a high success rate. Not one participant, of over 600 participants who have gone through our program, has committed suicide.
Our concern primarily is that, at this moment, for us, in our program, we have waiting lists across Canada that can mean some veterans can wait a year and two years, depending on their region, to go through our program. Yet if they go through our program, we're confident that the possibility of suicide will be significantly reduced, to the extent that now we.... Our research demonstrates depression has dropped and their suicidality is minimized.
My concern is that, as these folks wait to get through our program, if any commit suicide while waiting to get into our program.... It troubles me to know we could have helped them significantly, and they're waiting to access our services.
We're kind of boots on the ground. We're here to communicate to the committee some of the challenges we see veterans facing as we're working with them therapeutically.
I think that's where I'll conclude.