Veterans Affairs Committee on Nov. 24th, 2009

[Ronald Griffis]

A lot of the work is done on a volunteer basis. But on the same token, a volunteer can give only so many hours before it becomes cumbersome. I'm not suggesting a salary, but I am suggesting that arrangements be made where a veteran could be available to speak with other veterans at particular functions--perhaps on a Wednesday afternoon between two and four or between one and five, something of that nature--where a veteran could come in and ask a question, bearing in mind that there are no silly questions. We'd be able to assist them one way or another, give them information and share information with them. But on the same token, as I've indicated, you can volunteer only so much.

[Ben Lobb, Conservative, Huron—Bruce, ON]

Okay.

We did hear testimony in our last study on a lot of different aspects. The one thing that came out of it was that Canada is in a sense on the leading edge in some of our mental health detection and prevention. We can always do more, no doubt.

One announcement that came out yesterday was Dr. Kirby's study on mental health, and the housing aspect of it. I wondered if Ms Taylor or Ms von Zweck could make a comment on some of the observations they made in the field regarding post-traumatic syndrome, regarding mental health, and any of the other.... You said going back to work is often one of the solutions. I wonder if you've observed if housing or any of the other things that Dr. Kirby is going to be looking at tie in there.

[Dr. Elizabeth Taylor]

There are a couple of things I'd certainly like to address. One of them is proactivity. Particularly as military personnel are moving from active duty to VAC, there is a need at the beginning to look proactively at the roles they play in their lives to make sure those roles are changing and shifting and to be sure that people are working with them so that if they're not going to be soldiers any more, they can actively take a role to become productive. What are they actively able to do and call themselves? We all identify with the occupations we have and the things we do, and we need to help our soldiers do that.

With regard to Michael Kirby's report, housing certainly is a key. If you're dealing with people who have post-traumatic stress and are not using the services that they should be using, to re-engage them you often have to begin in the community with a safe housing project. It just happens to be something I do on the side. I hate to say this, but I run a little project called House Next Door in Edmonton. We have five houses where we re-engage people in the community and hopefully move them back into the resources and services they need.

If people have a mental health issue and they're not accessing services, they need safe housing that has health professionals who help them re-engage into the community. There's no question of that. You help people transition back into getting services. That's the key.

What we see and what I see on the street when I'm working out there are people who are disengaged from the services they so rightfully should be using, and they are good services. We want to make that really clear. We offer our veterans excellent services, but sometimes when you're dealing with depression, dealing with post-traumatic stress, dealing with OSI injuries, you don't understand what's happening to you and you use addictive behaviour, for example. You believe what is familiar.

What I do in the Edmonton community is chair a board that has housing that re-engages people so that we can move them back into the resources and services they should be utilizing. That's part of the role we play.

[The Chair, Conservative, David Sweet]

With great thanks for his service earlier, I go to Mr. Oliphant. You have five minutes.

[Rob Oliphant, Liberal, Don Valley West, ON]

Thank you again to the witnesses. It's nice to be on this side so that I can ask you questions.

First of all, I will say that someone once said there were no silly questions; today you may have seen that's not always the case in a parliamentary committee.

Having said that, I'm trying to sort out some of the roles that OTs could play in this system and the role of the OT in the Canadian Forces health services. Then there's a role with veterans, and it seems to me that the transition or transfer from medical care in the Canadian Forces--which has its issues--to medical care as a veteran may be a particular place that OTs and their individual case management style could be helpful. I wanted to check that out and see if you have any thoughts on it.

[Dr. Elizabeth Taylor]

Do you want to go on that one, or should I?

[Dr. Claudia von Zweck]

I would tend to agree with you. When people are making the transition from being active soldiers, they've created an identity for themselves as soldiers. It's what they've been trained to do, so to think about what happens next and to look at what's going to happen in their work lives and family lives, they need to have a number of supports in place.

The military offers them an entire lifestyle. It offers housing for their spouses and it offers income security, so there needs to be a very holistic approach taken in terms of helping someone make that transition. I think an occupational therapist can work with the individual. Our role is really to help individuals look at the activities and occupations they engage in and to help them to continue to do those in the most effective way. It may be what they are doing within paid employment--how they are going to make that transition from being an active soldier and how they can re-use their skills, their strengths, and their abilities in a civilian lifestyle--but it can also be how they can make that transition into family life. We've heard very strong stories today about how important it is that we consider an individual within the family context as well. We need to look at all aspects.

I think one of the frustrations we were expressing earlier was that we tend to look at things in a very fragmented way. We may be looking at one particular aspect of an individual's function, but we need to see that the person functions within an entire context. They need that support and they need to look at it very proactively so that they understand that they are making this transition, that there are issues they are going to face, and that these services are available to them. They need to understand that it's okay to access those services, that this is a normal process of transition, and that this is how we can support them in that transition.

[Rob Oliphant, Liberal, Don Valley West, ON]

Could I just ask this? In the Canadian Forces medical teams—and I understand there are problems there about getting OTs on the primary care teams—there are sort of three return-to-work programs. One would be to return to combat, one would be to return to non-combatant work within the military, and the third would be to turn to civilian life. So there would be some preparation in the Canadian Forces to get people, for our sakes, into Veterans Affairs in a way of increased health and wellness. That would be one concern, which is a literal gap; it's like a leap. I'm just wondering, in your understanding, if the Canadian Forces are doing the best they can do, with your help, to get into that next phase.

[Dr. Elizabeth Taylor]

I think there has been a real expanded role for occupational therapy within the forces and they are working very hard to expand the numbers. We were very privileged to meet with the Surgeon General, Commodore Jung, and he was talking about putting an occupational therapist in his policy group now to make sure the services within the military are very smooth. In fact, there will be occupational therapy representation right across the country. They are actually expanding the role for the profession because they've seen the results and they see the fact that it helps not only with return to active duty but with the transition, where it occurs.

[Rob Oliphant, Liberal, Don Valley West, ON]

Has that conversation gone on with the Department of Veterans Affairs too, a similar conversation?

[Dr. Elizabeth Taylor]

We're just beginning that conversation.

[Rob Oliphant, Liberal, Don Valley West, ON]

That's why you're here today.

[Dr. Elizabeth Taylor]

Yes.

[Rob Oliphant, Liberal, Don Valley West, ON]

All right, thanks.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Oliphant.

That concludes two full rounds.

We're on to the third round now, to the Conservative Party, with Mr. Kerr.

[Greg Kerr, Conservative, West Nova, NS]

I know, Mr. Chair, we've got some business to do, so I've got just one quick question and our side will be finished.

I do want to assure Mr. Stoffer that I am nice and calm now. He was concerned about me a while ago. He hasn't seen me get worked up here, so it's unusual, I guess.

The whole business of the disability as against the pension itself, or against the income, is one of the few areas that I think Mr. Stoffer and I have found some reasonable agreement on, getting away from all the other issues of what goes on with pension and income. Do you see that as something that really deserves specific attention? In other words, it comes up over and over again that we're treating a disability as though it's an income. I can't put it any clearer than that. Do you think that in itself is the wrong interpretation? That again is a general question.

[Lorne McCartney]

I don't understand the question, to be honest with you.

[Greg Kerr, Conservative, West Nova, NS]

That's why we always have a problem with it.

When we get into our discussions, and it comes up several times, oftentimes we hear—and you've alluded to it today—the fact that when somebody receives a disability, or core payout or whatever, for the pain and suffering part of it, that it should not be considered as an income. Forget the taxing part of it, it should not be considered as an income. I'm just looking for your thoughts. I can't really hear my question now, and that's part of what my problem is today. I would say to you that is a repeated point that's raised in several quarters. I'm just wondering what your thought is on the treatment of disability as an income.

[Lorne McCartney]

First of all, I don't believe it is taxable. Having said that, it's not supposed to be income, it's supposed to be—I don't know—something for the people who have gone through pain and suffering because of the injury they have, and this is some money for that pain and suffering, which ultimately they can do with whatever they want.

Our only question really from that, and we've been thinking about it more recently, is that although it was geared to be paid out right at the beginning, there's some question as to whether it should be a protracted payout so that perhaps it won't be wasted by a young soldier, sailor, or airman at the beginning.

[Greg Kerr, Conservative, West Nova, NS]

Fair enough.

[Ronald Griffis]

Some time back, they changed that to be designated an award as opposed to anything else. I think that could be the interpretation. We have no idea why it was changed to an award. Bearing in mind the maximum $260,000, we don't know why it was changed from pension to an award, but they chose to do that and that's....

[Greg Kerr, Conservative, West Nova, NS]

That's your problem with it then. Okay.

[Dr. Elizabeth Taylor]

I think one of the things we've been debating a lot is the very young age of many of the veterans and the costs associated with them and that the cost of the lump sum should not be mistaken for rehabilitation. They need to have rehabilitation programs above and beyond. There are many costs associated with putting somebody on a disability pension for life that could be averted, given that they have rehabilitation that gives them back a productive role. I think we have to separate out those issues and be very clear that everyone should be entitled to rehabilitation, so they are able to do the roles they need to do to have a productive, well life despite the circumstances they may have been left with.

[Greg Kerr, Conservative, West Nova, NS]

Thank you very much.

[The Chair, Conservative, David Sweet]

Thank you.

Now we go to the New Democratic Party. Mr. Stoffer apparently has a brief question.