Veterans Affairs Committee on April 3rd, 2008

[Stéphane Beaulieu]

There are two questions. First, how appealing the profession is, and then, how appealing veterans as a client group would be to those entering the profession. It is not difficult to attract doctoral candidates in the area of psychology. That is not the problem. As we mentioned in our presentation, we are currently increasing the number of positions within our doctoral programs.

As stated by the Vice-President of the Ordre des psychologues, Ms. Lemieux, we do not know why it would be difficult to attract psychologists to offer services specifically to veterans. Unfortunately, we have no information on that.

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

That leads me to another thing I wanted to clarify with you. How would you characterize your relationship with Veterans Affairs Canada? Do you have a direct relationship with it? Or is it just specifically that some of your members are contractors with it, and that's the limit to the relationship?

[Édith Lorquet]

At this point, there is no direct relationship with the department. So, as far as I know, at the Ordre des psychologues du Québec, we do not know what the situation is like in Quebec specifically. Is there an access problem? You are telling us that there is, but we have no details to that effect. Are some regions more poorly serviced than others? We do not know which ones. Is there a quality related problem? If there were, we would have received complaints, and there would be a process that would be followed. I do not believe there is a quality related problem, but that remains to be seen. What about numbers? Once again, we would have to see with the department what the situation is like specifically in Quebec, because I would imagine the problem differs from province to province. We have no objections to sitting down with departmental representatives. However, with respect to commercial relationships, which I would refer to as a contract, a mandate, that is something that is discussed between the member and the Minister of Veterans Affairs. We do not negotiate fees nor contract terms and conditions between our members and third-party payers, nor to we negotiate service contracts.

We certainly would be prepared to hold discussions with departmental representatives to try to see with them whether or not we can settle these accessibility problems.

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

But you are open right now to...?

Mr. Beaulieu, I believe you said that for people to get specialty training in PTSD, they had to go outside of the province. Did I capture that correctly? Is that not correct?

[Stéphane Beaulieu]

No, I didn't say that--or I don't remember.

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

No, that's okay. I thought you had mentioned it.

It was mentioned as well that there are basically two professionals training others. If psychologists in Quebec wanted access to PTSD training, particularly for veterans, there are two professionals at Sainte-Anne-de-Bellevue working with your order. Is that correct?

[Marie-Josée Lemieux]

I think there was a misunderstanding. When we referred to M. Guay et Ms. Brillon, we were referring to people who came to testify before your committee, who have had contact with your committee. We know that Mr. Guay has done research with Ste. Anne's Hospital. Mr. Guay and Ms. Brillon are specialists in the area of PTSD. They are not the only two trainers in this area. Currently, they are two people who happened to stand out from a popularity and research productions standpoint, etc., but they are not the only two trainers in this area.

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

The last witness we had here was an occupational therapist. She actually spends all of her time working with aged veterans from the Korean War and World War II, whom we sometimes call traditional veterans. She was saying that one of the most important aspects of getting occupational therapists up to speed in working with veterans adequately, with dignity and compassion, is to have those professionals understand the culture of the military, which is unique in and of itself.

I'm wondering if you have plans for your order, in terms of the additional training that you have for your psychologists in PTSD, to call on the services of, possibly, Veterans Affairs Canada to give that cultural indoctrination, so to speak, on how they can best relate to that specific and unique environment a veteran comes from, which is totally different from what the average person in Quebec or the rest of Canada would ever experience.

[Marie-Josée Lemieux]

If I understood your question correctly, we want to know whether the Ordre des psychologues du Québec can provide specific training for psychologists who would want the added value of understanding military culture? Is that correct?

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

Oui. It would be part of it, or a component. You can teach all of the specialties around PTSD, how to diagnose it and how to be able to help them, but the cultural aspect is just as important when it comes to a veteran.

[Marie-Josée Lemieux]

Our system is distinctive. The Ordre des psychologues du Québec must ensure that psychologists have adequate training, that they develop the necessary skills through continuing professional development. The Ordre is a regulator and ensures that. It does not offer services, we do not prepare courses on PTSD, for instance. We oversee training, various training programs that are offered, so that they may meet the minimum competency standards of the Ordre.

We have noted that programs are being developed which are a reflection of societal evolution, markets and needs. So, universities need to be kept abreast of these needs.

Having personally work on a few occasions with military personal as a clinical psychologist, I have a good understanding of the component, or a very specific culture which must be considered. But the Ordre cannot provide this type of training.

I think it would indeed be in the interest of the Department of Veterans Affairs to create partnerships with universities so that a type of specialty, if you will, can be developed in this area.

Our role is to ensure that psychologists who work for you have the necessary skills. It is not our job to develop these skills, rather it is the job of the universities.

[The Chair, Conservative, Rob Anders]

Thank you very much.

And there you go, seven minutes turned into nine minutes and 41 seconds. Very impressive.

We're on to the second round. Now there are no more seven-minute questions; they're all five now.

We're back over to the Liberal Party of Canada, and Mr. Valley, for five minutes.

[Roger Valley, Liberal, Kenora, ON]

Thank you, Mr. Chair.

Thank you for coming in today.

You mentioned a couple of times the things that are working in Quebec and some things that are working in the rest of Canada. Our job is to find something that will work all across Canada. So thank you for that. After your time here today, if you want to send something in writing to us about things that you think should be in place across Canada to help veterans, we'd appreciate that. It would help our researcher if you have any thoughts on that afterwards. So you can think about that.

You're the regulatory body in the province of Quebec. Is there a federal body? Are the other provinces similar to yours? And at any point during the year, do all of you get together to talk about what we can do?

[Stéphane Beaulieu]

We do.

There is a Canada-wide organization for all professional psychological bodies which does hold meetings twice a year. That could be an interesting contact for the Department of Veterans Affairs.

[Roger Valley, Liberal, Kenora, ON]

I hope this can fit into one our recommendations: that they should be meeting and this should be a place for them to start. I say this because we want to look at the successes, whether they're in Quebec or Alberta or anywhere, and try to get them into place across Canada.

I'm just wondering how many psychologists in your organization would have served in the military. My guess is that it is a very low number, if any.

[Stéphane Beaulieu]

It is probable, but we have no information on that.

[Marie-Josée Lemieux]

We have no statistics on that. As Ms. Lorquet mentioned earlier, that is not one of the institutions we have indicators on when we register our members. We know which members work for the Department of Health and Social Services, we know which ones are in private practice, which ones are in private practice for the CSST or the SAAQ, but we have no statistical information on those who work for Veterans Affairs.

[Stéphane Beaulieu]

How many served in the military? Is that what you said?

[Roger Valley, Liberal, Kenora, ON]

Yes, I'm just wondering who would have military service.

[Stéphane Beaulieu]

We don't know, sir.

[Roger Valley, Liberal, Kenora, ON]

I would suggest that it may be an interesting figure for you to find out. You should do so from the organizations right across Canada, because no one is going to better understand the problems that veterans and serving military people have than someone who has actually been through them. So it would be an interesting exercise to find that out, not from the national organization but from your national twice-a-year meet and greet session, or whatever you call it.

[Stéphane Beaulieu]

The cultural aspect is very important.

I'll continue in French, if you don't mind.

Once psychologists start providing services, they are confronted with this cultural reality. That is when training occurs. The issue is how to draw psychologists in this service network. Initial training, internship... People can do one-year internship. For instance, they can spend a year at Sainte-Anne Hospital or in any of the OSI clinics in Canada. There are five of them at the moment, and there will soon be ten. It certainly is the way of the future, because young psychologists are trained on-site, they understand the culture, they are interested in this clientele. They are more likely to remain.

There's also the issue of ongoing training for psychologists already practising. Almost 2,000 psychologists in Quebec offer post-traumatic stress disorder treatment. Almost 2,000 psychologists offer this type of service in Quebec. It is probable that very few of them are trained to work directly with these clients, because they do not know them. That does not mean they cannot work with them, but they do not have a good understanding of the culture. I think ongoing training could certainly be of interest.

Ongoing training is not mandatory in Quebec. It may become so under a new bill, Bill 50. Through mandatory ongoing training, the Ordre will have oversight on the type of training offered to its members. If there were a need in Quebec to specialize and to provide specific training to our psychologists for them to work with veterans, we would certainly be open to doing so. We would be prepared to assess the content of this training, evaluate supervisors who provide the training, if there is such a need, of course. Sometimes, you create a need. You must start by discussing it and creating an interest. I think that is certainly one approach to consider.

[Roger Valley, Liberal, Kenora, ON]

I don't mean to shorten your answer. I would never do that. But are you aware of any psychologists who are actually serving in uniform at this point?

[Stéphane Beaulieu]

I'm aware that there are some in Quebec City, at Valcartier, but I can't tell you the exact names.

[Roger Valley, Liberal, Kenora, ON]

Then I'll lead to my last question, because he is quite mean, the chairman.

You know the level of service you have in Quebec. You've explained some of the successes. We know that there's a twice-yearly gathering. Where does Quebec stand in services for veterans in your field, in the body you're regulators for, across Canada? Are you ahead of the curve? Is there another province that should be emulated? Is Quebec leading? I'm just wondering, if you have 8,000 serving and you have some serving in different areas, as you've mentioned, if there is something we should be following--because Quebec has a lot of services we should be following. I'm just trying to figure out where we fit and how we lead.

The chairman's cutting his throat. I'm not going to look that way.

Help me understand where we sit in Canada on services. If Quebec is doing quite well, where do the rest of us sit?