Veterans Affairs Committee on April 29th, 2009

[Doug Clorey]

I will start. There are many questions here.

In terms of preventing operational stress injuries, your first question, one of the findings in research is that the best way to prevent, if you can prevent, is to build resilience so you have an opportunity to be more prepared for what you are going to deal with. Very often where we find ourselves in Veterans Affairs is very much downstream, where the opportunity to prevent the operational stress injury is not there because it has already occurred. I cannot speak for the Department of National Defence, but I know they are working very hard at trying to build resilience in the members of the military so they are better prepared to deal with what they have to deal with and hence to avoid some of the operational stress injuries that occur, we hope.

The other area of prevention is education. Here we are doing quite a lot in terms of building awareness, as are the Canadian Forces, to reduce stigma, to get across the idea that a mental health injury is an injury, just like a physical injury, and it needs to be approached in a very similar way in terms of approaching various agencies for services, treatment, and whatever benefits are required.

The second question, on success in terms of rehabilitation, Brenda may wish to speak to. The approach we take in Veterans Affairs is that recovery is possible and that recovery should be the norm. So we approach the delivery of services as if there will be a recovery at the end.

Our statistics are really not that sound at this point, in terms of lifetime projections. How successful have we been over the lifetime of an individual? That's really hard to tell. But the approach we use is that the individual will be able to recover, and we work toward that end.

In terms of other mental health problems, yes, what we see in veterans is reflective of the general Canadian population. We will see all kinds of mental health problems, some of which are related to operations and some of which are not. So it's not unusual for us to see that.

In terms of collaborating with local agencies, as in the province of Quebec, we very much try to do that, primarily with our district offices. We also work very closely with our operational stress injury clinics to reach out to these agencies to provide education awareness training. In fact, there are four functions of the operational stress injury clinics that may be of interest. The first is to provide a comprehensive assessment to individuals; the second is to treat, where it's appropriate; the third is to reach out to providers in the local communities, like the ones you've mentioned; and the fourth is to conduct research.

It's very important for us to reach out to service providers in the community, because these operational stress injury clinics provide only a temporary service. Eventually the individuals will return home, return to the local community, and will need to rely on local service providers in the community. So part of the job is to reach out to them so they are able to provide the kinds of services that are required.

Have I addressed most of your questions?

[Guy André, Bloc, Berthier—Maskinongé, QC]

I have a question as well. You talked about resilience as a way to somewhat prevent operational stress.

I know that, when people are in the armed forces, they undergo physical examinations to determine whether they are able to take part in military missions. Is any vigilance exercised with regard to the psychological side?

As you know, some people are more prone to develop operational stress than others. Is any screening work really being done?

[Doug Clorey]

Again, this question would be better directed to the Department of National Defence, but I do know they screen in their recruitment phase, both physically and psychologically, and they screen before and after deployments. But you would need to ask the Canadian Forces themselves the details of that. Part of the role is to be able to build that resilience so individuals are able to deal with what they're going to encounter in missions.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Clorey.

Thank you, Mr. André. That's seven and a half minutes as well.

Go ahead, Mr. Stoffer, for five minutes.

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

Thank you very much, Mr. Chairman.

Thank you all for coming today.

Your presentation says your traditional veteran clients are diminishing by about 5,000 each year, but that's your client base. Correct me if I'm wrong: the reality is that we lose a lot more who are not your client base. Is that correct? Thank you.

As you know, the government made a promise in September of last year regarding the allied veterans promise. I wonder if you could tell us approximately when we may be able to see that promise completed in terms of any direction you may have been given.

Also, I assume most of the decisions you've outlined on page 19 are VRAB decisions. Am I correct?

[Darragh Mogan]

Actually, most of them would be primary decisions. Some would go to appeal, but it would be a relatively small number.

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

Okay.

Would you have a figure on how many people have applied and been turned down a first time? Of course on the letter it says you always have an appeal, but they may not appeal, because they're of the generation that understands that if the government says no the first time, they figure there's no hope. Do you have a figure for how many of those people wouldn't have appealed in that process?

Also, the Royal Canadian Legion has written all of us and has indicated concerns on the living charter in terms of the lump sum payment. That possibly could be looked at. Some veterans are asking for a lifelong pension instead. I wonder if you could address that issue.

Also, I have two people in my riding--in Dartmouth, actually--who went through psychiatric treatment. They were both determined to be cleared, but their children were denied further assistance because the parents were no longer receiving psychiatric help. Since the parents were no longer receiving psychiatric help, that help was cut off for their children. We've heard in testimony that PTSD and symptoms of that nature could be transferrable, but unfortunately their children were denied further assistance in that regard.

The other concern I'm getting in fair numbers relates to asbestos on ships. I have about a dozen cases on my desk from across the country of people who were denied asbestosis claims. We know now that there was asbestos on the ships in the 1940s and 1950s.

There is also the matter of hearing loss. As you know, after the court case a few years ago, DVA was forced to go back and contact all those people who had claimed hearing loss and were denied. I wonder if you can tell us how that process is going and whether it is almost finished.

Last but not least are the hospitals. As you know, the hospitals under DVA--which are now provincially run, except for Ste. Anne's--are for World War II and Korean veterans. What are the plans for those hospitals when the vast majority of those individuals have passed on? Do you plan to open them up for more modern-day veterans, or what would be the proposed plan in that regard?

Thank you very much. I have more, but I'll be cut off very soon. Thank you.

[Darragh Mogan]

I'll attempt to answer some of those, Mr. Chair, if I can.

With regard to the question you raised about allied veterans, your question of course requires a political answer, as you know--what, when, and under what circumstances--but it's fair to say, I think, that everybody is interested in helping these individuals as soon as possible, so there is a certain heightened awareness there.

With regard to the percentage of appeals that are required and successful, we'll submit that information to you, Mr. Chair. I don't want to speculate on that.

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

I understand.

[Darragh Mogan]

That's understood? All right.

With regard to the lump sum versus the annuity or the return of the pension, to an extent it depends on who is asking, because some people want the lump sum paid out as an annuity, which is a possibility if it's invested properly, but you've got to be careful when you're investing these days, as we all know.

Whether we would return to paying out pensions, which by their very nature grow if you can demonstrate a greater illness, apart from a policy point of view, that can and does, I think, run counter to the wellness approach. So I'm not optimistic that there is going to be revision back to the old pension days, but I am quite convinced that there is a ministerial commitment that improvements in the charter are going to be considered as soon as possible.

Mr. Chair, Mr. Stoffer asked about the children of veterans who were receiving psychiatric help, and the veterans recovered and the children didn't. We'd have to look at those cases. I think we have the authority to continue to help those children, so maybe I could get names at the break. We'll have a look at that.

With regard to asbestosis on ships, we're aware of that concern and we're looking into it. I can't give a progress update now, but I can submit one if you wish.

With regard to hearing loss, we certainly are trying to revise our policy in line with the Federal Court of Appeal decision. We are looking back to provide disability benefit decisions in line with the court decision. That policy should be released quite soon.

[The Chair, Conservative, David Sweet]

Mr. Stoffer, I have to say that I was already getting some concerns from this end of the table about the long list of questions you delivered, and we're over the five minutes now, so....

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

Five?

[The Chair, Conservative, David Sweet]

Yes, that's the rotation.

All right, it's now Ms. O'Neill-Gordon, for seven minutes.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Thank you, Mr. Chairman.

And I want to thank the presenters for being with us this afternoon.

My first question is probably just one that I was thinking about. As we know, as we went through all that information, there's certainly a lot of information to be dealt with and to be digested, and I was just wondering this. Is there a means by which the veterans are given a way to understand all they have coming to them and what they deserve to have and what is out there for them and their families?

[Brenda MacCormack]

Yes, there is, certainly.

We have a comprehensive outreach strategy we've implemented, which includes taking advantage of every opportunity we have to provide briefings to members while they are still in service and veterans groups while they are out. At SCAN seminars and any general kinds of meetings, we take that opportunity.

We also have a speakers network formed of VAC employees across the country who take opportunities to visit bases and provide information at any opportunity. We have a VAC presence on 17 bases and wings across the country, and we continue to augment that presence as we go forward. That provides an opportunity on a one-on-one basis to impart that kind of information.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

That is good to know, because there is so much to comprehend, and some of these veterans and their families could overlook some of the things that are available.

Yes?

[Brenda MacCormack]

I was just going to indicate, as well, that we also provide a transition interview to all releasing members, as they transition out. So again, that's another checkpoint for us to provide the information. We also have the opportunity to publish in a lot of CF publications, which again affords us the occasion to convey the information about the programs.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Good.

Can you provide us with the advantages and a comparison of the disability award versus a monthly disability pension?

[Brenda MacCormack]

The new Veterans Charter, as I've mentioned, is really about a very comprehensive approach to meeting the needs of veterans and their families. To make a comparison between a disability pension and the disability award, per se, is probably not a fair comparison. What we really ought to compare is the disability pension and then the entire suite of programs that now is there, which offers security and opportunity and really is targeted at wellness, investing money in terms of achieving wellness types of outcomes, and offering people security and opportunity—the security, really, of knowing those programs are there if something does occur.

So it's much more comprehensive in terms of its approach, and it's based on principles that are very consistent with a modern approach to management of disability.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Okay.

How long has this charter been in place?

[Brenda MacCormack]

The charter was implemented in April 2006, so we're really just three years in. That's new, in terms of our government programming, so I think we still have a lot to learn in terms of what kinds of outcomes we're going to achieve with what's here. It's an excellent package that we have, in terms of moving forward, and as Darragh mentioned, there's been a government commitment that it's a living charter. So we'll continue to evaluate outcomes, evaluate the programs, and consider options in terms of responding to emerging needs as they occur.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Yes. Well, I'm happy to see our government has put this in place and it's working so well, because certainly everyone loves our veterans, that's for sure.

Thank you.

[The Chair, Conservative, David Sweet]

There are three more minutes remaining, if someone else has a question.

[Phil McColeman, Conservative, Brant, ON]

I will, Mr. Chair.

I want to extend my appreciation for your time here today in meeting with us.

Is PTSD more common among traditional veterans or newer veterans?

[Doug Clorey]

If you had asked me that several years ago, I would have probably told you that it's much more prevalent in CF veterans. I'm not so sure that's the case any more. It's interesting to see, as war service veterans reach a certain point in their lives, that they start to reflect back on their lives, as we probably all will do at some point, and it seems that as they do that, they start bringing up some of the traumas that occurred when they were younger and that have been repressed for up to 60-plus years.

In fact, there was a study in Australia on Korean veterans. It was really quite astonishing how many Korean veterans, 60 years after the fact, who had apparently lived very successful lives, what one would call very stable lives, and had families, reached a point in their lives where they started to reflect back, and suddenly all these symptoms started to show up and they became clinically diagnosed with PTSD.

So I'm not sure, to answer your question, but I do think what is happening is that there is greater data now, which shows that PTSD, within the military, can show up at any time, either very early on or 60-plus years later.