Veterans Affairs Committee on Nov. 16th, 2010

[Janice Burke]

Yes, I certainly read the article, and I also read the article today that reported the story wasn't quite factual. We did talk with National Defence, because, as you know, we work very closely with National Defence to ensure that through our network of clinics across the country and our network of service providers there are no gaps in service and that people who need treatment and need to get into counselling get that required treatment.

From a VAC perspective, we have service providers in the Pembroke-Petawawa area. We have our clinic in Ottawa. We're very confident that for any veterans—and there may only have been a few—who may have received counselling from there, it's not going to create a problem. And in terms of National Defence, they did announce today that they are establishing an OTSSC, I believe, in Petawawa. So that is great news for the still-serving members and their families.

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

Excellent. Thank you.

[The Chair, Conservative, Gary Schellenberger]

Mr. Kerr, please.

[Greg Kerr, Conservative, West Nova, NS]

Thank you, Mr. Chair.

Welcome. We're very pleased to have you here today.

You're obviously aware of the review we're trying to do in a very brief period of time and all the issues that face us. I know the importance of the study coming in next year. Can you talk about that a bit, and what you hope to gain from that? Because it focuses on some of the very things we're going to be talking about as well.

[Janice Burke]

I could certainly start, and Raymond could add in.

We have a number of studies that will be coming out. For example, our research folks are partnering with other organizations to do the life-after-service study. Those results, again, will be out in early 2011. And that's looking at the physical health, the mental health, the social health, and the economic health of our veteran population since they have been released from the service. That is working with Statistics Canada.

Also, they are looking at the mortality and cancer study, and that's on data that we've had since, I believe, 1972. So all released members and veterans since 1972 are in that database. That will provide us, again in early 2011, with much more data around the mortality of our veterans and also cancer data.

Those are the two main studies.

Raymond, are there others?

[Raymond Lalonde]

Of course in the area of research around PTSD and operational stress injuries, much research has been done across the world in this area, a lot around PTSD from rape, from accidents, and car accidents. There has been a lot of PTSD research done in the States around the U.S. veterans and military.

In Canada the research is growing, but it's starting. For example, there is research being done right now on the use of certain drugs to limit the impact of the traumatic memories around PTSD. There is research being done around the efficacy of some treatment modalities in conjunction with one another—for example, using drugs and exposure therapy, or cognitive behavioural therapy for conjoints.

So there is a lot of research to better understand how these treatment modalities can be effective for our population of veterans. And the culture in Canada is different, the military environment is different, and the types of operations that we have undertaken in the past are different, so we need some of our research. For example, in one of our clinics we're also doing a research study on the emotional and behavioural impact on children having a parent who has PTSD, which is going to bring us a better understanding of what the issues are so we can direct our treatment efforts in the right direction.

[Janice Burke]

I may not have covered the question quite the way I should have, if you are referring to the suicide prevention report or strategy that we have developed. As I said, we're not waiting to do work in that area, for Statistics Canada to give us data, because that will just give us data. What's important are the reports and review we've done to date and the recommendations we're going to be putting in place this year. If you require more information on that, Tina certainly would be able to give you a summary.

[Greg Kerr, Conservative, West Nova, NS]

There are a dozen areas I'd like to go to. I realize that, and I think that's why this year's particularly pivotal in making the changes and adjustments. I think it's very important to get on record what you see as the timing of and the unveiling of, if you like, the start point and the measurements that go with it.

I was at the conference Raymond Lalonde was at in Montreal just a couple of weeks ago. I did want to raise a point, because it seems to come through all this. Of course, that's the International Society for Traumatic Stress Studies. For the first time Veterans Affairs Canada was a partner there.

One of the things that was said there, in the brief time I was there, and it seems to be an extremely important thing for us to consider, was about the stigma and the public education or understanding. You hear it over and over again that if only the public--the public being all of us--would treat this as easily as it treats physical injuries, we'd be making a lot of progress in terms of moving forward.

I guess the stigma question is what I wanted to raise specifically in light of that conference. Do you see progress being made such that people, particularly these veterans who are in this circumstance, are more prepared to come forward because the public is more accepting?

[Janice Burke]

I could certainly start, and Raymond and Tina can respond.

The post-deployment study, for an example, that the Canadian Forces did to identify any physical and mental health problems following deployments indicated that 13% of the 8,000-and-some they had surveyed indicated they had problems in five or six mental health areas. Because of that, they are being referred and they are being put in counselling.

Anecdotally, what I'm hearing within National Defence is that there are a lot more younger veterans coming forward to the mental health clinics on the bases and to the OTSSC centres, and they are talking more. They are talking about what their issues are. So they're seeing progress in that area.

Even when you look at it from a Canadian perspective, stigma is still a major issue. The Mental Health Commission of Canada, as you know, is embarking on a nine-year or ten-year anti-stigma campaign. We are working closely with the Mental Health Commission on some of these areas to ensure that veterans and their families are considered in all of the work they're doing, including the anti-stigma campaign.

[Greg Kerr, Conservative, West Nova, NS]

Okay, thank you.

[The Chair, Conservative, Gary Schellenberger]

Five minutes, Ms. Sgro, please.

[Judy Sgro, Liberal, York West, ON]

Thank you very much for coming today.

Mr. Lalonde, it's nice to see you again.

I look at the deck--beautifully done. It's full of information that's valuable and all of that, and the health and wellness framework.... If you listen to the folks I have heard for the last two or three years coming before our committee and when we visit, everything should be just fine, because there's so much work being done, so much outreach being done. Clinics are set up here, there, and everywhere.

We shouldn't have all these other issues that we're hearing so much about in these last six or eight months if we were to believe everything that's in here and everything that we've seen and heard. The best intentions in the world, I have no doubt about that...but there are lots of issues out there that none of this is covering.

The fact is we have veterans who are having to go to food banks in western Canada, who are in a homeless shelter in downtown Toronto. There are all these other issues where people are coming forward and saying they couldn't get heard, they couldn't get help, whatever the case may be.

In spite of all of this, there are some serious issues out there. We're missing the boat somewhere.

[Janice Burke]

Yes.

I'll respond, and then certainly you can add to it.

When you look at the system that we have today between Veterans Affairs and National Defence, and what has been built over the years, I feel it's a pretty good system in terms of our having all of the major areas covered.

Are we satisfied? No, we're never satisfied with the status quo. We need to continue to work on it.

What I am seeing over the years is that we're talking about veterans who had been released following the Gulf War, for an example, and their involvement in Croatia. They had been released without the benefit of this early intervention and without the benefit of some of the programs that exist today, without the benefit of the transitioning programs that exist. I feel that because of that lost opportunity, really, it is very challenging for some veterans. They may not even be aware of our programs. That, again, is--

[Judy Sgro, Liberal, York West, ON]

Why are we not able to track them? They all get disability pensions of some sort. Where we send the cheque is where we should send the letter saying “By the way, we're doing all these wonderful services for you. If you need them or you need help, you don't have to go to an emergency ward at the Ottawa hospital where everybody else goes.”

We keep putting in place all kinds of things that are there to help the people we care about. All of us as Canadians want to see that veterans have a special place in society. They don't have to go to the emergency ward where I have to go. They can go where they will get that special care. What is wrong with them is probably a result of what they went through in whatever war or whatever period of time.

Why can't we communicate more directly with them so they know that Veterans Affairs Canada cares and is there?

[Janice Burke]

That is certainly the role of our district offices. If they are clients, they are in contact with them. We have a proactive screening unit that does proactive kinds of contacts.

I'm not sure whether the group you may be referring to is in our program itself. But there's also a group out there that may not even be aware of our programs. We recognize that we need to do more outreach and get more knowledge and information to these veterans and their families. If they are clients of the department and in these situations, they should be case-managed.

[Judy Sgro, Liberal, York West, ON]

If they are getting a pension cheque from Veterans Affairs Canada, does that automatically make them a client, or is it only when they reach out for a particular service?

[Janice Burke]

If they are in receipt of any benefits from Veterans Affairs they are considered a VAC client, and they therefore would be entitled to case management, rehabilitation--

[Judy Sgro, Liberal, York West, ON]

So why don't they know that? Why do they seem to be unable to access this bureaucratic system that we have out there? They're turned off from accessing it, and would rather live in a shelter with next to nothing than go to VAC and have you help them. They think it's a big, crazy, bureaucratic nightmare of a place, and they don't want to be bothered, I guess. I don't know.

[Janice Burke]

Are you referring to our veterans who are in homeless situations?

[Judy Sgro, Liberal, York West, ON]

Yes. I'm referring to veterans not going to you and saying “This is my situation. I don't have a place to live.”

[The Chair, Conservative, Gary Schellenberger]

We have come to the end of the five minutes. Can you respond, please?

[Janice Burke]

You're referring to veterans in homeless situations. When you look at how they got there, had there been early intervention programs they wouldn't be there. Now that they are there, quite a bit of work is happening through the department in Vancouver, Montreal, and Toronto. We're also working with the Mental Health Commission. There are five or six pilot sites across the country where there are veteran identifiers, and they're being referred to our district office.

We are helping those veterans, but as you indicated, some veterans are saying they would prefer not to get support. We are getting the majority of them into our programs and it is making a difference. Continuing with the outreach and working with the veterans will take time. When a veteran reaches the point where they are either homeless or have a severe mental health condition, it takes time to establish a relationship and trust in the system.

[Judy Sgro, Liberal, York West, ON]

Thank you.

[The Chair, Conservative, Gary Schellenberger]

Mr. McColeman is next, and then Mr. André.

[Phil McColeman, Conservative, Brant, ON]

Thank you, Mr. Chair.

Thank you for being here to delve into this study we're embarking on.

Can you discuss the treatments for us? What things would a veteran experience if they walked into one of the OSI clinics? Can you walk us through that?