Thank you very much for inviting me to speak with you today. I'm a registered doctoral clinical psychologist and professor at the University of Regina. I have expertise in anxiety, trauma, and pain, having worked with traumatic responses for the past 15 years.
My research is supported by the Canadian Institutes of Health Research and the Saskatchewan Health Research Foundation, among others. I maintain a small private practice, primarily treating RCMP officers and other public safety personnel who have PTSD and other operational stress injuries.
Canadians have recognized the need for ongoing dedicated efforts to support our military; our public safety personnel, which include a wide array of personnel, such as police, firefighters, and paramedics; and also corrections officers, 911 dispatch operators, veterans, and their families. As you heard from my colleague, Dr. Sareen, we've come a particularly long way in supporting military mental health, but we have a similarly long way to go in supporting the mental health of our public safety communities.
Our public safety personnel have unique workplace environments, where trauma exposure is the rule rather than the exception. That exposure is different for public safety personnel than for military personnel, not better, not worse, but different. Our public safety personnel are deployed at home in an environment of ongoing uncertainty, often for decades. They have complex roles, such as providing protection, law enforcement, and community development. Accordingly, they require dedicated and specialized resources to ensure their mental health.
I have seen, recently and consistently, exceptional mental health leadership from our first responder communities. Indeed, we are seeing increasing demands from all public safety personnel to provide ready access to evidence-based solutions, interventions, and preventive strategies for improving mental health. The rationale is clear: they are reaching a tipping point. The dramatic increase in reported operational stress injuries is starting to overwhelm the stigma that has silenced so many of these citizens for so long. However, these same citizens have also underscored the need for evidence-based solutions informed by expert research.
Our government has set a mandate to develop a coordinated national action plan on PTSD and other operational stress injuries for our public safety personnel. That mandate was followed by the January 29 national round table on PTSD hosted by our Minister of Public Safety at the University of Regina.
The round table brought together leading researchers with leaders from government and public safety, all of whom supported the urgent development of a coordinated national action plan with a heavy focus on research.
Canadians have an established national mechanism for supporting, coordinating, and communicating health research. The Canadian Institute for Military and Veteran Health Research, CIMVHR, represents a 40-university network and facilitates the development of new research, capacity, and effective knowledge translation.
For the past 18 months, the University of Regina, a founding member of CIMVHR, has been working closely with research leaders from other member universities, international academic leaders, and our public safety leaders to develop a dedicated Canadian institute for public safety research and treatment, to support evidence-based policies, practices, and programming for public safety mental health.
The rapidly developing institute includes a host of academically diverse leaders from universities across Canada. The institute's leadership also includes key representatives from the Mental Health Commission of Canada, CIMVHR, the RCMP, the RCMP Veterans' Association, the Canadian Association of Chiefs of Police, the Canadian Police Association, the Paramedic Chiefs of Canada, the Paramedic Association of Canada, the Canadian Association of Fire Chiefs, and the International Association of Firefighters, to name only a few.
Institute members are already assessing the impact of implementing the road to mental readiness program with Regina Police Service and others, researching formally integrated mental health into policies, education, practices, and support, concluding the first of several program evaluation reports after assessing the evidence base for and the deployment of crisis intervention and peer support programs for Canadian first responders.
Right now the institute is poised to, first, conduct a coordinated national mental health prevalence survey to refine the widely varying estimates associated with public safety personnel.
Second is to conduct a Statistics Canada feasibility study supporting a gold standard epidemiology survey for public safety mental health.
Third is to conduct a pilot study exploring high-fidelity simulated traumas and training scenarios, so that we can empirically and experimentally better understand risk and resiliency variables for operational stress injuries, therein informing traumatic stress procedures.
Fourth is to implement a comprehensive and ongoing biopsychosocial assessment of RCMP cadets and officers using state-of-the-art technologies to evaluate the impact of integrating evidence-based interventions throughout their initial training, during their service, and as part of lifelong learning. The research will be globally and historically unprecedented, providing crucial information about risk and resiliency variables to inform mental health physicians for the RCMP, other public safety personnel, all of their families, and eventually all Canadians.
The institute can also build solutions to help address new challenges in meeting demands for mental health services, such as those recently underscored by the military ombudsman. The solution requires that we do three things: first, ensure patients can and do access appropriate specialists who are correctly using evidence-based treatments; second, support the training and accreditation of more specialists; and third, support research that improves evidence-based care and innovates models for care delivery.
To that end, the institute is also poised to extend work done at the University of Regina on Internet-delivered cognitive behavioural therapy, ICBT, which can increase our access to highly effective, private, popular, and broadly deployable evidence-based treatment as part of a national stepped care system for all public safety personnel. Pending resources, pilot testing for that system in Saskatchewan and Quebec can begin as early as 2017 with pan-Canadian access for our public safety personnel as early as 2018.
The institute can also help to emphasize evidence-based practice. Indeed many public safety personnel appear to be receiving care that is not empirically supported and that is not good enough. Accordingly, members of the institute have worked with the Alberta Paramedic Association to develop new standards for mental health provision for their members. We have also seen efforts to improve mental health care quality and access through the Canadian Association of Cognitive and Behavioural Therapies, which is working to certify practitioners and ensure access to evidence-based care. These are only a couple of examples of people working hard to ensure that our evidence-based practices are made available to those who need them most.
Solutions for public safety personnel inform solutions for all of us. Moreover, they are our community leaders and role models who can facilitate transformations in attitudes and actions towards mental health at a grassroots level in communities across Canada. We have leaders, including all of you, who want to build on the initiatives I've highlighted today.
I suggest that a full and proper response to the Prime Minister's mandate requires that we do the following: First, invest in the Canadian institute for public safety research and treatment; second, ensure the institute remains at arm's length while engaging federal and provincial governments, academics, policy-makers, and key stakeholders; and third, support ICBT treatments and stepped care clinics that are funded through partnerships between federal and provincial agencies with workers' compensation boards.
The institute can then do four things: first, use evidence to guide a national action plan for research and treatment dedicated to public safety personnel that incorporates leadership from our public safety personnel; second, facilitate cross-sectional and longitudinal interdisciplinary research projects so we can speak with authority about variables associated with risk, resiliency, and recovery; third, develop nationally recognized online evidence-based resources for operational stress injuries to support our clients, their families, and their providers; and fourth, work collaboratively to facilitate pan-Canadian access for public safety personnel to minimum standards of evidence-based prevention, early interventions, and programs for treatment.
We can do better and we must do better. These solutions are no longer aspirational; they are achievable. Working with our public safety personnel as role models in all of our communities, we can develop and proliferate better assessments and better interventions, and engage in preventative strategies that reduce risks, increase resiliency, and improve mental health, first for these critical members of our communities and then for all Canadians.
We look forward to your support. Thank you.