Veterans Affairs Committee on April 19th, 2007

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

Thank you, Mr. Chair, and thank you, gentlemen, for appearing before us today.

In slide 4 you talk about PTSD as a psychological response to an intense traumatic event. Sometimes I worry that if the Liberals or Conservatives ever form a majority government, I would have political traumatic stress disorder.

The reason I say that is I've talked to doctors in Halifax who say PTSD can also be a string of minor events that are accumulated over a long period of time, not necessarily an intense—like fire or death or something, but little things that accumulate and because they were never dealt with in a proper manner or discussed and given proper treatment or advice or peer advice, for lack of a better term, they build up. All of a sudden, these little things all become one big one and blow up. So I'd like your comment on that.

In The Hill Times you probably saw the story of Louise Richard, and I'd like to read into the record what she said. This is about the fact that the modern-day veterans, she's claiming, do not have access to federal government health care facilities. Here's what she says:

“PTSD and other disorders that are related to military service require a suite of expertise in order to deal with those ailments,” says Sean Bruyea, a former Canadian Air Force intelligence officer who is also suffering from a service-related disability. “So pawning us off on a civilian institution that may not necessarily have any expertise whatsoever in caring for military-related injuries sounds like a complete abandonment of their responsibility for the care, treatment and rehabilitation of all disabled veterans.”

The article goes on to say that DVA believes that sometimes community hospitals or facilities closer to the home of the veteran are probably just as suitable for them in that regard.

I'm wondering how you would respond to the first comment and what you would respond to Louise Richard and Sean Bruyea in terms of their concerns about not having access to Perley, Ste. Anne's, etc.

[Bryson Guptill]

I'm not a clinician in this field, but I can tell you from what I've read and from what clinicians have told me that PTSD can certainly result from a number of different types of events. I don't think our definition or our medical advice around people with PTSD conditions would constrain any very broad acceptance of a series of events as leading potentially to PTSD. I think you can see from the numbers we presented that the number of people who are diagnosed with the condition have increased rapidly in the department.

But I want to emphasize that under the new Veterans Charter we are now able to deal with these people and treat them as a result of a very quick examination by people on the front line in our 32 offices across the country. Area counsellors in our offices now are able to assess the need for rehabilitation and start people in the treatment program without the requirement to put people through a very complex, quasi-judicial adjudicative process.

I also think that what Louise Richard was being quoted as saying is quite true, that there is a lack of capacity across the country in the diagnosis and treatment of PTSD and other occupational stress injuries, and that's why we've tried to establish this network of clinics where there is a critical mass of expertise.

I'd like to deal specifically with Mr. Bruyea's allegation that we don't have the right kind of response in place. I don't accept that, and I don't accept it for a number of important reasons. If you look at where people have wanted to receive the treatment—and this comes back in part to Mr. Perron's point—it's unlikely that people who are suffering from PTSD or other occupational stress injuries or other illnesses related to recent deployments are going to want to be treated in a geriatric hospital that Veterans Affairs Canada might have operated after World War II. That's what these contract facilities are all about, these nursing homes where we provide contract beds.

What we've been doing with the younger veterans, and I think this is the appropriate thing, is giving them a lot more choices about where they're treated in communities, and we are able to draw on the expertise that has developed across the country where there is capacity to deal with the specific types of illnesses these people are suffering from.

I should point out that there's been about an 80% increase in the occupation of what we call community beds across the country in the last couple of years, and yet the people who are in what we call our contract beds...the use of those contract beds over time has been diminishing quite dramatically.

So I think if you look at the choices younger veterans are making, if they have to go into a nursing home kind of setting or a setting where they are getting treatment, they'll often want to get the treatment closer to where they live rather than in the departmental facilities we occupy in very limited places across the country.

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

Very briefly, Peter, if you're following up....

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

I'll wait until the next time.

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

Thank you, Peter.

Mrs. Hinton, please, for seven minutes.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you.

I'm going to share my time with Mr. Shipley, but I guess that will depend on the length of the answers.

I think you would agree that it's pretty obvious to any Canadian that there has been a lack of health care providers, whether that's doctors, nurses, or psychiatrists—anyone to do with post-traumatic stress disorder. There has been a lack of these health care workers for over a decade. I was actually quite impressed; I think I heard you say 32 working clinicians. That's very impressive.

It is also interesting that we've had this problem for so many years. You were referring to “shell shock” from the Second World War, and “combat stress reaction” is what you were saying it was called in the United States. I think we've come quite a long way in helping people.

But one of the things I noticed in your chart was the number of RCMP officers. I'm assuming that's the third column.

[Bryson Guptill]

Yes.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

That's a pretty dramatic jump from 2005 to 2007. I'm not doing the math properly, but it's almost a 50% increase. I wonder if you could discuss the RCMP portion a bit. Obviously these are all stress-related injuries.

The other question is that you've given us charts on clients with a favourable decision for the condition of PTSD, but could you provide some background on the number of clients who have not received favourable decisions? I'll let you answer that first.

[Bryson Guptill]

In terms of the favourable versus unfavourable, we thought you'd be interested in seeing the number of cases that we have approved. I can't tell you right now what the numbers would be in terms of unfavourable. In general, the favourable rate for these kinds of conditions is around 50%. It has been like that for many years. But we could provide more specific information on that.

I've forgotten your first question.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

My first question was my surprise at the number of RCMP and the more than 50% increase in cases. These RCMP officers are serving in Canadian cities, I am assuming, and not in war zones, so I was really quite shocked to see that kind of a dramatic increase.

[Bryson Guptill]

I think the percentage increase in RCMP members is very similar to the increase for younger CF members. As you would know, the RCMP is eligible to receive the same kinds of interventions from the department, for the same sorts of conditions, in terms of disability awards or disability pensions.

There has been deployment of RCMP members to some of these war zones, and a number of RCMP members are serving in areas of conflict. I'm thinking about Haiti, for example, as a recent one. The response by RCMP members has been much the same. We've been encouraging the RCMP to take advantage of some of the wellness programs that are available under the new Veterans Charter.

The committee may not be aware that although they avail themselves of disability awards and pensions under Veterans Affairs programming, the RCMP don't actually have eligibility for those programs under Veterans Affairs legislation. They get it by virtue of RCMP legislation and regulations. They haven't yet modified their legislation to take advantage of the full benefits available under the Veterans Charter. We think they could probably benefit significantly if they were to do that. The wellness programs that are now available to National Defence members, Canadian Forces members, are not yet available to members of the RCMP, but this is by choice. The RCMP hasn't taken that step yet.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

One final question was regarding the issue that was raised with mental health issues in children of families. We obviously have bases in Ontario, but we have bases in other parts of the country as well, where there has been the same type of loss. Has there been any other provincial government that has been reluctant to do their part, as a provincial government, or is this unique to Ontario?

[Bryson Guptill]

I haven't heard of other provinces being reluctant. We've been talking, for example, about recent deployments, and some of the recent fatalities in Afghanistan were from Atlantic Canada. We've been briefed very thoroughly by our colleagues in National Defence about missionary work that they are undertaking with provincial health officials to help them get ready for people returning from deployments, especially in Halifax, at the VG, and from Gagetown, for example.

The reports our DND colleagues are giving us are that they've been getting very enthusiastic endorsement from the provincial government to welcome these folks back if they have treatment needs. So I'd be surprised to hear of similar situations, but it certainly could happen.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

I'm not sure how much time I have.

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

Well, you're at six minutes now.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Well, then, I'll make a closing remark.

I just want to tell both of you how grateful I am, as a Canadian citizen, that you do the job that you do. I recognize that you're doing it under very difficult circumstances, with a shortage of personnel, and that things seem to be moving along as well as could be expected under the circumstances. But I just thank you very much for the job that we do for our veterans, and I appreciate your showing up today at this hearing.

Thank you.

[Bryson Guptill]

I appreciate it.

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

Okay, thank you.

Now, Bev, are you going to wait for your—

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

I'll wait.

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

Yes, because your full turn will come up here shortly.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

He doesn't want 30 seconds?

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

Well, we'll add it.

Thanks, Betty.

Roger Valley, please.

[Roger Valley, Liberal, Kenora, ON]

Thank you.

Thank you for the information.

I have a quick question for Mr. Lalonde. You mentioned that the beds at Ste. Anne's are for PTSD. You mentioned five other clinics across the country. I missed them when you listed them.

Could you tell us what areas these are going to go into?

[Raymond Lalonde]

I'm sorry, I missed your question.

[Roger Valley, Liberal, Kenora, ON]

The beds in Ste. Anne's are slated for PTSD, a lot of them. You've mentioned five other clinics across the country that are going to have beds for—