Evidence of meeting #26 for Veterans Affairs in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was soldiers.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Carl A. Castro  Director, Military Operational Medicine Research Program, Headquarters, U.S. Army Medical Research and Materiel Command
Michel Rossignol  Committee Researcher

3:35 p.m.

NDP

The Vice-Chair NDP Peter Stoffer

Good afternoon, everyone.

We have a very special guest with us today, Carl Castro, the director of the military operational medicine research program headquarters.

Sir, we're honoured and delighted that you've taken the time out of your busy schedule to be with us today.

I should let you know, sir, basically who we are. We're the Standing Committee on Veterans Affairs for the Parliament of Canada, and we're represented by the four political parties in the House of Commons. We have members of the Conservative Party, the governing party; the official opposition, the Liberal Party; the third party in the House of Commons, the Bloc Québécois; and ourselves, the NDP. Our chair, I'm sure, will be here at any moment. I'm Peter Stoffer, the vice-chair.

Normally, sir, the way we proceed is to allow our guests to make a 10- or 15-minute submission, and then we open it up to a round of questions. Again, sir, we thank you very much.

We are doing a health services study and a review of issues such as post-traumatic stress disorder and other issues that face soldiers, the men and women of our militaries, when they come back and become veterans, and how we can better advise the government on procedures and policies in the future.

Sir, please go right ahead.

3:35 p.m.

Colonel Carl A. Castro Director, Military Operational Medicine Research Program, Headquarters, U.S. Army Medical Research and Materiel Command

Vice-chair and members of the committee, thank you for having me. It's my pleasure to be here.

I was asked to say just a couple of brief words about the battlemind training system. Is that correct? Is that what the focus of this--

3:35 p.m.

NDP

The Vice-Chair NDP Peter Stoffer

That is correct, sir.

3:35 p.m.

Col Carl A. Castro

Okay.

I want to highlight maybe just three key things if I can. One of them is that the U.S. Army has officially adopted the battlemind training system as a mental health training program, and I really should emphasize that the battlemind training system is a mental health training program. It was adopted by Secretary Geren about a year ago. This year it became mandated, and it consists of a variety of training modules that soldiers go through pre-deployment, during deployment, and post-deployment. I just want to highlight that aspect.

And the third aspect I want to highlight, which is probably the most important for your purposes, is that it's the only mental health training program in the world that I am aware of--certainly in all of the NATO countries--that actually has randomized group trial validation studies supporting its use. And I highlight that, because it really is evidence-based. What we've shown conclusively now in three randomized group trials is that soldiers who go through the post-deployment battlemind training system up to nine months after having received the training report fewer post-traumatic stress disorder symptoms, fewer depression symptoms, and overall better transition at home.

I guess those are the things I would like to highlight, and I would just open up the rest of the time for questions from the panel.

3:35 p.m.

NDP

The Vice-Chair NDP Peter Stoffer

That's fine, sir. Go right ahead, sir.

Sorry, Mr. Castro. Just for the record, what is your current rank, sir?

3:40 p.m.

Col Carl A. Castro

I'm a colonel.

3:40 p.m.

NDP

The Vice-Chair NDP Peter Stoffer

Thank you very much, sir.

We'll start with ten minutes of questions, sir, by my colleague, Mr. Todd Russell, who comes from the province of Newfoundland and Labrador, representing the area of Labrador in eastern Canada.

3:40 p.m.

Liberal

Todd Russell Liberal Labrador, NL

Good afternoon, Colonel. I'm so happy you could be with us.

As our vice-chair has already said, we're doing this with a view to providing advice to our government on training programs that will hopefully help our soldiers. Certainly this has been highlighted because of the Afghanistan war and the conflict we're now in, but it's seemingly not a new condition, so to speak. Some of our people used to call it shell shock.

3:40 p.m.

Col Carl A. Castro

Yes, sir.

3:40 p.m.

Liberal

Todd Russell Liberal Labrador, NL

So I guess it's not a new phenomenon, but we're dealing with it now in new ways.

Could you give us a bit more detail on how many of these seminars or these training sessions your soldiers go through, and for what length of time, and maybe just give us a little detail on some of the components that you present to the soldiers?

How receptive are soldiers to this? Because it comes with a presumption sometimes that you're going to have some kind of a mental disorder--maybe that's not the right word, but there's a presumption there that--

3:40 p.m.

Col Carl A. Castro

No, that is the right word. That is the right word, sir.

3:40 p.m.

Liberal

Todd Russell Liberal Labrador, NL

I'll just start there and ask you those particular questions.

3:40 p.m.

Col Carl A. Castro

Okay. At the end of my answers to your questions, if I actually skip one, please remind me.

Let me first say that we started looking at changing the way we do mental health training because the way it went in 2001 and 2002, when the war in Afghanistan started, was that the U.S. military had no standardized mental health training program at all--neither the army nor the air force nor the marine corps nor the navy. So one of the things we thought would be useful was to standardize the training and at the same time to answer a fundamental question: is mental health training effective or useful?

So we took a step back and asked, what is it that soldiers need to know, and when do they need to know it? So if a soldier is getting ready to deploy to combat for six months or a year or longer, what should you tell them? What does a soldier, a marine, an airman, or a sailor need to know? And when they're in the combat environment, what do we need to tell them and how do we support them to sustain them for the period of the combat deployment? Then when they come home, what do we tell them? What are the things we should tell them?

In the U.S. Army, when soldiers come back they're basically in garrison for two weeks, and then they're kicked loose for a month of leave. So what do you tell a soldier who you're not going to see for a month about mental health?

One of the things we decided right up front is that we needed to take a strength-based approach. That is, we did not want to go in assuming that a soldier or a service member was going to have problems. In fact, what we tell them is that being in military service, they have lots of strengths, and what we want them to do is to use those skills, to use those strengths, to facilitate their transition home and to prepare themselves to go into combat and to sustain themselves there. So it focuses on skills and strengths, not on weaknesses and disorders.

As part of our ongoing assessment, what we always do is that we ask our soldiers, what did you think of the training? Was the training useful? Did you learn something? Was the instructor good?

So we go through a training evaluation, if you will. And across the board, anywhere from the high eighties to middle nineties, in terms of percentage, of soldiers rated the training as either good or excellent. If you can get junior enlisted soldiers to say mental health training is good to excellent at those rates, you've really hit a home run.

I should say also, and I'm sure you're aware of this, that the Canadian Forces actually employs the post-deployment battlemind training in their third location decompression site, and they're getting equally positive responses from those service members who attend that training.

Now, the training itself is unique in a couple of ways. One is that in the U.S. military before the introduction of battlemind training, we would bring soldiers in a battalion at a time. So there would be 700 to 800 soldiers in a noisy auditorium, and a mental health person would come in and talk for ten minutes and then leave. What we've done with this training is that it's designed to be done in small, platoon-sized groups of 25 to 30 service members per group. There is an instructor, a facilitator, but the facilitation is also interactive. While it's didactic in the sense that soldiers get a powerpoint presentation, they're also encouraged to interact and share their experiences.

So the veterans who deployed before can share their experiences of what they went through, how they transitioned and how they adjusted. And that serves to normalize the symptoms and reactions that other soldiers may have, because one of the things we really focus on, for example, in post-deployment is three elements. We focus on normalizing symptoms and reactions; we focus on safety, that is, soldier safety and the safety of families, because we don't want service members coming back and getting into trouble, through violence and stuff; and then we focus on taking care of each other.

So you may be fine, but look at your buddy; take care of your buddy. As a leader, look after your subordinates. So there's a self-aid component to it, and there's what we call in the military your “buddy aide”, or your “mate”, which I think is the word used in Canada. Then we also have the leadership, that junior leader responsibility of looking out for their subordinates as well.

We try to have all of those elements at every one of the training modules, to tell them things to focus on differently, whether it's pre-deployment, during deployment, or post-deployment.

I'm giving it to you in a nutshell, but that's sort of what the program consists of.

Did I answer all your questions? If not, I apologize for that.

3:45 p.m.

Liberal

Todd Russell Liberal Labrador, NL

Yes, you did.

How much time do I have left, Mr. Chair?

May 15th, 2008 / 3:45 p.m.

Conservative

The Chair Conservative Rob Anders

You're right at seven minutes, but the clerk has just mentioned something about ten minutes.

3:45 p.m.

Liberal

Todd Russell Liberal Labrador, NL

I have a follow-up.

Let's not waste time talking about it. They gave me ten minutes.

3:45 p.m.

Conservative

The Chair Conservative Rob Anders

I just want to revisit this.

Mr. Stoffer, what were you up to?

3:45 p.m.

NDP

Peter Stoffer NDP Sackville—Eastern Shore, NS

I made an error. I said ten minutes.

3:45 p.m.

Liberal

Todd Russell Liberal Labrador, NL

I'll just ask a very quick question.

3:45 p.m.

Conservative

The Chair Conservative Rob Anders

Sir, according to the predetermined times for all the parties, you are at your seven minutes. I'm sorry.

By the way, I just want to extend a deep thank you to Mr. Stoffer for having begun the chairing of the committee. I mistakenly went to the usual committee room, even though I announced last week that it was indeed going to be here. I'm the one who got messed up by it more than anybody.

Now it is over to Monsieur Perron with the Bloc, for seven minutes.

3:45 p.m.

Bloc

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

Good afternoon, Colonel. It is wonderful to hear that you provide a new form of training to help your young soldiers better understand what I call psychological wounds rather than operational stress. I consider these wounds to be the same as wounds to arms or legs, for example. If I use the words psychological wounds, I am sure that you will know what I mean.

Since this committee started its work, I have been fighting—my colleagues here can confirm that—for the Canadian army to prepare our young people as they depart for Afghanistan or some other theatre of operations. The system has only been in operation for a year and I know that that is not long enough for the statistics to be really meaningful. But I would like you to give me a rough idea.

For example, if 10% or 15% of the soldiers coming back had psychological wounds before your program was established, the program surely produced an improvement, as you said earlier. Could you give me a rough estimate, please?

3:50 p.m.

Col Carl A. Castro

Let me give you some data that we collected about six months ago looking at our pre-deployment training.

By the time the program came out a year ago, obviously a lot of soldiers had deployed to Iraq and didn't get the battlemind pre-deployment training, and some soldiers did get the pre-deployment training before they deployed to Iraq. While the soldiers were deployed--this was during the deployment--we did a survey and evaluation of the mental health status of the deployed force in Iraq. Of those soldiers who did not receive the battlemind training, about 20% to 22% screened positive for post-traumatic stress disorder. For those who did receive the battlemind training, only about 12% screened positive for post-traumatic stress disorder.

The number is still not zero, so it's not the silver bullet. It's not that you do this training and you are not going to have any mental health problems, but it does significantly reduce the symptoms for post-traumatic stress disorder.

Sir, I would just like to say that I completely agree with you that post-traumatic stress disorder is an injury, and it should be viewed as an injury. I don't know if you're following it at all, but within the U.S. military there's a very big debate going on concerning whether or not the Purple Heart should be awarded for psychological injuries just as it is for physical injuries. As you can imagine, those veterans who were physically wounded are not terribly supportive of that proposition, but it is being discussed.

3:50 p.m.

Bloc

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

What is your relationship with the Department of Veterans Affairs in the United States? Is there a link between what you are doing and what those who are no longer with us went through?

3:50 p.m.

Col Carl A. Castro

That's a very good question. I probably should have started with this, given that your committee is focused on the veterans affairs.

We have been working very, very closely with the Department of Veterans Affairs. They have actually taken the battlemind training system, which we developed for active duty, and modified it for use for veterans who come to the Department of Veterans Affairs for psychological help. They have not done any systematic studies or evaluations, but they say that the soldiers....

They've used it for all the services. We developed it specifically for the army, because the army was my focus, but they have used it for marines, airmen, sailors, and of course soldiers. They all like it. It gets very high evaluations in terms of being relevant and hitting on the key issues.

One of the things we did not anticipate when we put together the battlemind training system is that it gave our service members a vocabulary to talk about mental health issues, which they were lacking. It didn't really occur to me that our soldiers didn't know how to talk about mental health issues because they lacked the proper vocabulary. So that was very, very important.

3:50 p.m.

Bloc

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

I took part in a forum on post-traumatic stress attended by American experts. Everyone agreed that, in an operational theatre, a soldier undergoing severe emotional trauma must receive care as quickly as possible in order for him to get back on his feet. We are talking 24 to 48 hours.

In operational theatres, does the American army have psychologists and psychiatrists who can look after and listen to young people suffering from psychological wounds?