You have been given a printed version of our brief. It's multi-coloured and it's in PowerPoint format, but it's very easy to read through. We will be referring to that as we go through our brief presentation at the beginning and then of course during the Q and A.
I'll not be reading all of the slides, obviously, but rather we'll just touch on a few of the high points and focus on what's new in the operational stress injuries social support program, the key determinants of its success, and the major challenges that face the organization.
I am sure most of you are familiar with the term “operational stress injury”. At the risk of digressing for a moment, that term in fact is a Canadian invention by the OSISS team, and it's been inherited internationally, which we'll get into when we talk about international activities.
As you know, OSI is not a diagnostic term, but rather a term developed by the OSI social support organization to put focus on the injury and to work towards destigmatizing the condition. The term is now in wide use by clinicians and non-clinicians as a way to encompass all operational-related mental health injuries—and, as I mentioned, nationally and internationally. I'm sure if the question comes up during the question period, these two officers with me here can attest to their participation on international forums in NATO, in Europe, and of course a lot of time in the United States, working with their colleagues who have served in the Iraq war.
The presentation package includes a background of the OSI advisory committee. This group was formed in 2002 and brings together a group of interested people from Veterans Affairs, Defence, veterans organizations, the RCMP, the ombudsman's office at DND, and various mental health professionals three times a year to provide advice to OSISS and feedback to senior management in both sponsoring departments.
The terms of reference are included in your package, but very briefly, it's to provide advice and guidance to the OSISS management team to improve delivery; to help identify systemic gaps or shortcomings in the peer support program; to assist the OSISS management team in coordinating the program; to deliver aspects of the peer support network with respect to agencies and departments; and to actively take part, where and when possible, in raising awareness of the OSISS program. As chair, I emphasize this to all of the committee members, recognizing that we don't have any executive authority, but they're encouraged, as they put it, to spread the gospel in regard to the outstanding success of the peer support program. The composition is 24 members, and they're listed in one of your handouts.
OSISS itself—you'll notice I switch from “committee” to “OSISS”—came into being within DND in the spring of 2001 in response to input from SCONDVA, the Croatia board of inquiry, and the DND ombudsman's office. Shortly thereafter, recognizing the shared responsibility for the welfare of Canadian Forces members and veterans, a partnership was formed with Veterans Affairs Canada.
OSISS was clearly the result of the vision and drive of one officer, Lieutenant-Colonel Stéphane Grenier. He is not here today because he has finished his tenure. He's a PTSD sufferer.
He served in Rwanda with General Dallaire for 10 months. He returned home, recognized he had a problem, but he lived with it. In fact, he was deployed to Cambodia, to Haiti, to Lebanon, and so forth, fighting that problem. Needless to say, at a certain point he did talk to sympathetic superiors, not the least of whom was the then General Dallaire, who was followed by General Couture—may he rest in peace—who became a champion of the OSISS program. By the way, although he's still a PTSD sufferer undergoing treatment, Colonel Stéphane Grenier is serving in Afghanistan as a public affairs officer. He says it's time to get back on the horse, and to his credit that's exactly what he's done. He has been decorated by the Governor General with the Meritorious Service Cross for his drive and initiative in establishing this program.
He's moved on, but he's been ably replaced by Major Mariane Le Beau, who, as I indicated, is an extremely hard-working officer and very dedicated, having spent many years—and has served in Afghanistan. The co-manager, of course, supported Stéphane Grenier from the start. Kathy Darte is one of the originals, as we call her, and works very closely with her colleague in DND.
The mission of OSISS is twofold: to develop social support programs for members, veterans, and their families who have been affected by operational stress, and to provide the education and training that will eventually change the culture toward psychological injuries in the CF. I emphasize “families” because families always have been important to those who have worn a uniform. Having served on 14 separate missions and having had to leave my family behind, for the most part, I can be very sympathetic with the emphasis on family as brought out with the recent passage of the new veterans charter.
The key to effective peer support, which is the heart of the OSISS program, is the initial selection of the right kind of people, the peer support coordinators and, recently, but gathering momentum, and rightfully so, as their peers, the family peer support coordinators. The numbers I will leave to the questions and answers, and they will be answered by my colleagues.
Aside from the basic two-week training course the peer support coordinators and family peer support coordinators always see, the OSISS program runs a far-reaching continuous education phase as well for both those groups, recognizing that they also have a need for self-care, which I'll leave to my colleagues in the Q and A.
In the end, it all comes down to developing trust with the members, veterans, and families who come forward to talk to a peer support coordinator, wherever they may be and wherever they are referred from, technically through DND and VAC. They may meet in an office, or, if they don't like that, maybe they'll meet in Tim Hortons, so they can talk the issues through and make the informal assessment and refer them accordingly, developing trust with members and veterans who come forward, allowing them to proceed at their own pace, and providing a supportive shoulder to lean on. If you wish, we can get into some personal experiences in the Q and A.
It's essential that the peer support workers understand the role they play, understand when to pull back, and be willing to refer the peer to a professional resource, a clinical resource. The danger of the peer support coordinator is burnout, compassion stress, trauma, depression, and physical illness. What is absolutely amazing and a testament to both the quality of the people involved and the level of care provided by both departments in this program is that there have been very few such problems in the five years this program has been running.
There are several new initiatives to talk about in OSISS, which you are welcome to pursue in the question period. The new bereavement peer support initiative delivers support to the immediate families of those who have lost a loved one in military service, again to be delivered by those who have been through a similar event. Notice the emphasis on the word “peer”.
There is considerable international interest in the success of this program, and, as I mentioned, both of the co-managers can talk on these approaches at some length.
The third location “decompression” operation in Cypress provides members rotating out of Afghanistan with an opportunity to spend a few days transiting from a theatre of war to their living rooms, all as part of a significantly enhanced redeployment program. Having personal experience with it, I can assure you that the program is successful. We have dragged in several people who were under my command who had been involved at the massacre sites and so forth. We were not going to send Captain X back to his wife 24 hours later. He had to be decompressed, which meant going away for three or four days and possibly being able to talk the issue through while receiving some peer support and a shoulder to lean on, as I indicated.
We have learned that there are several key determinants to success in a program like this. First, and perhaps most importantly, is the need to involve peers right from the beginning of the program development and policy. An excellent interdepartmental partnership is essential to success, as is the use of a multidisciplinary management team. The emphasis on self-care and realistic boundaries has been another key area.
As I mentioned in the beginning, the recruiting and screening of the right people is essential, and perhaps the area where this program has excelled, in my opinion. To help provide relief for that key group of peer support personnel, recruiting, training, and retaining a network of volunteers is vital.
This is all a fallout of this interdepartmental cooperation from ten years ago, when they were at both ends of the table. I guess they would talk, but since the new veterans charter, or starting with the Canadian Forces Advisory Council and the workups—and I'm getting off the subject here—a number of us in this room have been intimately involved in this process. It's very heartwarming to see that the two departments have come together. In other words, as recommended by the council, it's a seamless approach. That's where we are now, and these two officers here are examples.
In terms of challenges, there are certainly many out there. For example, there are still a number of systemic barriers in place. Some clinicians are still suspicious of non mental health professionals meddling in their business. I don't know if I'm allowed to say this, but having read some of the transcripts from previous witnesses here, I think you can understand that there is some hesitation by the professionals in regard to the peer support business. On the other hand, others who have experienced the value of working with a peer support coordinator literally sing their praises in both departments.
Just the physical size of the territory covered by this very small group of peer and family support coordinators is amazing when you recognize that there are currently only five OSI clinics from Veterans Affairs in place and a number of OTSSCs from DND. Especially for reservists who may live far from a major base, getting to where we have a peer support coordinator can be a real challenge.
Growing the volunteer network that I referred to is another challenge that our PSCs face each day—and I might add that it is their responsibility, in part. Once the investment has been made to find and train these folks, retaining them becomes another challenge. The peer support groups that are such an important part of this program also take a lot of effort and significant resources because many peers are reluctant to meet at on-base facilities. As I indicated earlier, even finding a place to meet can be a problem. That's why I indicated that sometimes they meet at McDonald's or Tim Hortons.
I'll just back up to that point because there are a lot of soldiers who will not admit they have a problem. They do not want to be seen going into a “mental health facility” or some facility like that on the base. They'll be identified, and in their mind, that's not good or it's not macho—if you want to use that term—since they have to stand up and brush it off. So there are avenues for them to approach.
The last challenge on the list is certainly not the least. Let there be no doubt that the culture of the Canadian Forces, in dealing with mental health issues, has changed significantly in the last six years or so. However, there's still a long haul ahead, and to my mind it will never completely go away. We have to continually fight the fact that there shouldn't be a stigma associated with an operational stress injury, including PTSD and the other subtitles.
Education and training are the key to cultural change, and as is often the case, the long-term investments are frequently overtaken by the shorter-term demands. To even sustain the gains made in the last few years, great effort is required, and this is, and will remain, a constant challenge.
Ladies and gentlemen, just before I finish, this very successful program is funded by both departments, of course, and 75% of those who are serviced are in fact veterans, and 25% are serving members, plus or minus a few percentage points, and I'll be corrected by these officers if I'm wrong on those figures. But it doesn't make much difference, because, Mr. Chairman, it's understandable that those percentages would be there because the uniqueness of this program is that a lot of the veterans, be they Korean War vets, be they Beirut war vets, be they vets of Yugoslavia or the former Yugoslavia and so forth, are coming forward: “I've got a problem”; “I was bombing out of Aviona and I've got a problem”; “I was part of the Swiss Air cleanup and I've got a problem”; “I was on that aircraft that crashed short of Alert and I've got a problem”; “I'm a SAR tech and I've got a problem”. These people are coming out of the woodwork, and they may be retired. So this program, in my mind, is literally an outstanding success.
Thank you for your attention. With that, I'd like to invite your questions. If you would address to them to myself, as required, I'll direct them to the appropriate officers, sir.
