Veterans Affairs Committee on April 24th, 2007

[Roger Valley, Liberal, Kenora, ON]

Thank you.

Can you tell me, when someone comes out of the theatre, how important is the immediate debriefing? Maybe all three of you could give opinions. How important are the first 24 hours, 36 hours, one week, or two weeks? Can you give us an assessment on how important that is?

[Maj Chantal Descôteaux]

We believe that the time they spend in Cyprus is extremely important. This decompression period takes place in an area outside the combat zone. Often, military personnel see this as something they would rather not go through so that they can immediately return home, however, ultimately, they are very happy for this period. This is the first decompression period, and I think it is essential.

[Marc-André Dufour]

Another interesting aspect of the decompression period is that they are still all together. They have experienced the same things and they are not being sent off home, alone. Yes, they will go back to their families, however, they have experienced something unique that is difficult to talk about and share with people within their circle. Being with the very individuals with whom they experienced those events is another element that can act as a protection factor.

[Maj Chantal Descôteaux]

Earlier, you talked about reservists returning from in-theatre, who have their decompression period, return to Canada and remain with the group with which they were deployed for a period of time before going back to their communities. Sometimes, symptoms don't appear until this last period. If we could ensure that these reservists had another class C contract—we're talking about money—at the same base for a one-year period, we could keep these people working near us, which would allow us to treat them and to screen for any problems. If they had another one-year contract upon their return from their mission, they would be near us, which would probably improve the care they would receive.

[Marc-André Dufour]

All CF members must also undergo a post-deployment interview, meaning after their deployment. Usually, this interview lasts about an hour and 15 minutes or an hour and 20 minutes, during which we go over the events that occurred during their mission. CF members must complete a very detailed questionnaire, including questions on post-traumatic stress and alcohol consumption. This is what we call improved screening, which allows us to identify to some extent CF members who may present various problems.

[Roger Valley, Liberal, Kenora, ON]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you very much, Mr. Valley and our witnesses.

Monsieur Perron with the Bloc is next, for seven minutes.

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

Good morning, ladies and gentlemen.

Chantal and Marc-André: I want to speak mostly to you. I apologize for calling you by your first names, but being 66 years of age, I feel that I may do so.

I was sickened, some weeks ago, when Ms. LeBeau, whom you no doubt know and who works for OSISS, the Canadian Forces Operational Stress Injury Social Support Program, came here to testify. She told me more than once that before CF members are deployed, they get approximately three and a half hours of training during which they are told a little bit about the problems that may occur in relation to PTSD. I cannot comprehend this.

[Maj Chantal Descôteaux]

Do you mean that it's not enough?

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

It is absolutely not enough. We are spending millions of dollars sending them to the southern United States. I have no objection to them getting field training, but we are spending almost nothing on training them between their two ears. We are physically training them, but within the Canadian Forces, we are doing very little to train them mentally.

[Marc-André Dufour]

Field training includes mental training, which is very important. The realistic nature of the training—

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

That is not what I'm talking about.

You know Pascale Brillon. She goes to your base, Valcartier, and I think we can recognize that she knows a great deal about this subject. She is recognized not only in Quebec, but also nationally and internationally. So, I take what Pascale says as gospel. I don't know whether your soldiers have red Pascale Brillon's guide for sufferers. Pascale told us that we need to treat PTSD as soon as possible.

How many psychologists are there in Afghanistan, for example? How many psychologists will follow the Royal 22^nd on site? They must be treated within the 24 or 48 hours following or as soon as possible after experiencing a stressful event.

[Maj Chantal Descôteaux]

There are many parts to your question.

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

This is a discussion; let's go over my suggestions.

[Maj Chantal Descôteaux]

First, within the eastern area, particularly at Valcartier, we are extremely innovative and we are trying to implement many things. Currently, we have a program called the Resiliency Training Program, which was used for the first time this year, prior to the summer deployment of our troops.

Resiliency training is the kind of psychological training you're talking about. It is a psychological frag vest.

I would ask Marc-André to explain a little bit more about this program.

[Marc-André Dufour]

In fact, Dr. Christiane Routhier, a psychologist, was freed from all her other duties in order to be able to work full-time on the Resiliency Training Program, or RTP. This program is much more extensive than a mere three hours on PTSD. Obviously, it deals with operational stress. It also addresses terrorist tactics. What's extremely interesting about this program is that in order to get the soldiers to take it more seriously, we present stress as a combat weapon. This is an extremely interesting concept that was developed by Dr. Routhier so that soldiers would see that this is a weapon used against them, that it can cause damage and that it is very subtle. Symptoms of their injury may occur several months after their return here. Nevertheless, it is a weapon and it is the cornerstone of terrorism. Furthermore, it is a war of fear. They will scare you and you will be afraid: this is basically what we tell them. We tell them what fear is, what psychological stress is but also what physiological stress is. We give them the tools to minimize their anxiety and to learn to breathe better and even techniques to slow down their heart rate.

We normalize stress, which is also extremely important. We do not tell them that they won't be afraid, that everything is going to be fine, that they're trained and that everything will be great. We could tell them that but we also tell them that it's normal to experience stress, that they will experience stress. After we name it, we tell them how to deal with this stress. That's what we teach them.

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

Pardon me, I wish to say something.

Earlier, you said that this was the first time. Have there been any studies or statistics that show how many there are when they return, compared to those who returned from Bosnia, for example?

[Marc-André Dufour]

Indeed, the project is going to be validated. Soldiers who underwent the tests before being deployed are also going to take the tests upon returning from their mission. It is a matter of assessing the efficiency of the measures, which are meant to be preventive.

We are talking about stress, but as has been raised by chaplains, there's also a component regarding the combatant and death. We talk about death, and the link between armed combat and death, which is a possibility. We lead the soldier into thinking about the meaning attached to the mission. He will be making more money, of course, and that's nice, but given the context in which he is being deployed, he must be asking himself questions that go above and beyond that fact.

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

Chantal, I want to come back on what you said about the psychological profiles drawn up before hiring a soldier. I am fully aware of what this is about, because since I was elected in 1997, post-traumatic stress disorder among young people has become an issue of particular concern to me.

I know that the RCMP has a program that allows for the psychological profiles of members to be drawn up. I also know that the value of these profiles has not led to a consensus among psychologists and researchers. I understand your situation. Another issue you confront, as does the RCMP, various police forces and firefighters, is access to information. If a soldier or a police officer wishes to forego a test, you cannot force him to undergo it: he is protected by the Canadian Constitution. Breaching this right may even lead to lawsuits.

When I think about all of these problems, an image pops up in my mind. I met a young soldier at the Valcartier base. He talked to me about the stairway of shame, referring to the stairway that leads to the second-floor offices of psychologists. One must not forget that these young people are macho—pardon the term—young men who see themselves as strong and for whom the concept of death is unfathomable. We were the same when we were their age.

I wish to congratulate you, because at least you are working in the right direction. However, you still have not told me how many psychologists are actually on site.

[Maj Chantal Descôteaux]

You asked several questions.

[Marc-André Dufour]

The issue is being clarified, but currently, there are no psychologists on the ground. That position does not exist within the armed forces.

[Maj Chantal Descôteaux]

Within the uniformed military, there are social workers and mental health nurses. The American forces have military psychologists. I believe that it would be very worthwhile to consider something similar. You must understand that we would never send a psychologist to the theatre of operations to carry out a long psychotherapy session to talk about childhood trauma and things that happened with his matter when the soldier was two years old. Concrete measures must be taken on the ground, encouraging measures.

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

Or send them back home.

[Maj Chantal Descôteaux]

Absolutely. True psychotherapy happens at home, at the garrison. With respect to psychological assistance provided within the theatre of operations, we could certainly entertain the possibility of having uniformed psychologists. The concept does not exist within our armed forces.

[Marc-André Dufour]

I trust the social workers and chaplains who work within the theatre of operations. In Afghanistan, there is also a psychiatrist.