Veterans Affairs Committee on March 1st, 2007

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Yes.

[The Vice-Chair, Liberal, Brent St. Denis]

We'll go to Peter, and then I have nobody else on the list. Is there anybody else who wants to go on after Peter? David?

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I just have one quick point.

[The Vice-Chair, Liberal, Brent St. Denis]

Okay, then it's to Peter, and then to David.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, Mr. Chairman.

I apologize to the witness for being late this morning.

Sir, Pascale Brillon was here as a witness at our last meeting, and she indicated that there is evidence that PTSD can be transferred from the person who has it to a spouse or quite possibly their children. I assume it would be the same for the RCMP. Would that be correct?

[Dr. Robert Belzile]

Yes. Funnily enough, I haven't heard it stated like that, but as you know, the successful way to reduce the risk when you come home is through family support. But when you come back from a mission, either as a police officer or a member of the military, you don't speak to anybody; you stay in your room, and it gets harder. The poor people who don't have the background education make the situation worse, so that's why they need to be trained.

Can they be upset when you come back and you don't speak and you're crying all the time and you start drinking? Of course. It can be a major stress. As for it being PTSD for the family, the psychologist is better than I am in terms of coming to that conclusion.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

I'm not sure if you had a chance to read it, but in The Globe and Mail today, they had a front page story about some children of some military personnel in Petawawa who are going through some pretty serious concerns. I won't get into the argument of who should pay for that, but there is no question that the family support is critical to assist.

Obviously when anyone is coming back from a tour of duty, from what Madame Brillon talked about, they've seen some pretty serious things, and some things we couldn't even imagine. I know we're short of psychologists throughout the country for this type of analysis, but should not the federal government or the department, in your view, try to do more to assist not just the veteran but the family members themselves?

[Dr. Robert Belzile]

Definitely, and as you know, we do it. If you're working for External Affairs, they'll book your family. When I went to France thirty years ago with my father, I had a medical. They do that. When we send families to the north, we assess all the children, because they're going to Iqaluit for the next three years.

The support definitely has to be done beforehand. We start that with the RCMP before you arrive, as I said. Sometimes we have problems with human rights, though. For example, you don't want us to see your wife to see how the situation will be when Peter comes back. But most of the time it's done on a voluntary basis, and about 90% participate.

It would be very interesting to inform the kids. As an occupational physician, I believe you cannot have too much information, if it's well done. You have to be transparent and advise them of what the risk is: your father's going to Afghanistan, and yes, there are some terrible casualties, but there's also the other side. It's a risk assessment.

These poor families are alone. They probably get their cheque, and if they go to see a psychologist, they have to fight, etc. I'm concerned about that. We need to help the member's family, because that's part of their life--more so if there was a death, and more so if the guy is sick and is not feeling well.

That's why there's the transition. That's why we have an aggressive employee assistance program that contacts the members once they're back. In fact, we see them a month after and three months after they get back, and we all have data on how they are. He won't call us, but we call him and say he needs to do a debriefing. The debriefing is not official, and I know there's a lot of controversy about that. It just asks him how he's doing, and we even speak to the family, because sometimes he doesn't know he's all upset. It's not evident.

So that's why we do the family assessments both before deployment and after deployment. Particularly in critical missions like Afghanistan, they should be assessed.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, Mr. Chair.

Merci.

[The Vice-Chair, Liberal, Brent St. Denis]

I will go to others on my list. I have short questions from David and Gilles. Then we have a little bit of business after that, colleagues, so please stick around for a few minutes.

David.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Doctor, after hearing the aggregate of your testimony--you were talking about surveillance as well as this pre-deployment assessment and then, of course, the repatriation interview, debriefing--I think much of this workload could be handled by general practitioners like you who have an occupational speciality.

[Dr. Robert Belzile]

Background, yes.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Just to use some numbers, 80% of that workload would be in those areas, and the real specialists--psychotherapists, psychologists on PTSD--would be there overseeing, validating the instruments that you're using, those kinds of things.

[Dr. Robert Belzile]

Definitely. That's what we do here in Ottawa. We have our outside consultants, who are specialized and follow the rules of confidentiality, etc. It's not done in-house. There's greater credibility, more communication. If I talk to the guy who's in charge of giving my profile where I'm going to be working when I come back.... We don't want that to be a problem. It has to be a solution.

So yes, and this could be feasible all over Canada.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Now that you've answered in that fashion, that leads me to this. I asked a question of the last witness regarding training for medics and other personnel. Really, on the briefing and the training on this, as far as a lower-level camaraderie issue to help people.... From what I'm hearing, everybody has a reaction to stress; it's just how they recover from it.

[Dr. Robert Belzile]

That's it.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

There could be a significant amount of training happen for the rank and file and for those in supervisory positions, to be able to not only recognize but also help after a fire fight in order for all the comrades to decompress, etc.

[Dr. Robert Belzile]

After a critical incident we do a post-mortem, and sometimes a doctor is there just to have a debriefing and discuss it. It's not individual.

Definitely the co-workers are the key, because they know you are reacting differently from usual. And we train people. You don't want them to say to Gilles, “Hey, you're a little crazy.” They have to be polite. So they say, “Gilles, you're reacting differently and I feel you should see someone.” That's the type of rapport we're trying to get with co-workers. They're helping, because if they put a gun in his hands and he doesn't feel well, there could be a critical incident.

Sometimes you're scared when people act differently. You need to train people. It's not a problem to say, “Gilles, you should take a few days off--I see you're nervous; you don't see it--but you should.” That's the type of rapport we need to build up. We do that with police officers where we have a detachment of two police officers. We have no choice, because the other guy is saving a life. So if he's sick, you have to do something.

The military is the same thing. You work as group. So if you know you're working with George and he's not 100% and you're in a tank with him, if you have a problem, you know you have a problem. This is the type of rapport.

How much is built up? I haven't seen it yesterday, but I know this is the type of build-up we're trying to create between colleagues.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Thank you.

[The Vice-Chair, Liberal, Brent St. Denis]

Thank you, David.

Gilles, for the last question.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

Can I make another comment, Robert?

I don't want to sound defeatist, but it seems to me we have a long way to go before we can take better care of these people. Even for the older veterans, we need to do a lot of training: training among the commanders—along the same lines as what David Sweet was saying—training for senior military people who are working on the ground and who can try to see what's going on.

It's not that they're doing it wrong, but they don't have any training when it comes to human behaviour. They may wonder why someone is behaving a certain way. Maybe it's because that person slept on the wrong side of the pillow or had something to drink the night before. Even I would be unable to determine whether someone has symptoms and if we should be asking ourselves certain questions. People need to be trained and made aware of this problem.

At the present time, the military doesn't recognize the existence of PTSD. During training on military bases, when young people experience stress, they are told they are suffering from serious nervous depression, with all the symptoms of post-traumatic stress disorder.

Robert, I want to thank you for this, because I believe you've helped us to see the direction we need to take. It rounds off the discussion we had with Dr. Brillon on Tuesday. I am taking the liberty of thanking you, because I am the one who suggested you be invited.

[Dr. Robert Belzile]

I want to thank the Committee for inviting me.

[The Vice-Chair, Liberal, Brent St. Denis]

Merci beaucoup, Dr. Belzile.

Thank you to Gilles too for his initiative, and the support of all colleagues, on the PTSD.

We thank our witness.

Colleagues, we have a bit of work to do. so we'll just take a two-minute break to allow our witness to go.

There's a request that we go in camera for this discussion.

[Proceedings continue in camera]