Veterans Affairs Committee on Nov. 18th, 2010

[The Chair, Conservative, Gary Schellenberger]

I'm going to call the meeting to order.

The first part of our meeting is only going to run until 4:25, because we do have to get ready for the video conference we're going to do right after that.

I welcome everyone here to meeting number 29 of the Standing Committee on Veterans Affairs. Pursuant to Standing Order 108(2), we are conducting a study of combat stress and its consequences on the mental health of veterans and their family.

Our first witness is Senator Roméo Dallaire.

Welcome, sir. I'm very pleased you could come to our meeting today. If you would like to open with a few words, you're on.

[Senator Roméo Dallaire, Québec]

Thank you, Mr. Chairman.

To speak of a topic as weighty as operational stress injuries in a brief ten-minute span is not an easy thing, especially for a former general who has now become a fledgling politician.

I'm going to do a quick overview in order to leave the time needed for questions, when the topics of particular interest to you can be broached in greater detail.

I know that prior to this, other committees of the House and of the Senate have studied post-traumatic stess. However, it is a fact that studies require revisiting and updating. And so I congratulate your committee for having undertaken this study of injuries sustained in combat or conflict. These are not diseases, but truly operational injuries, and they should be treated with the same urgency and empathy as physical injuries, that are often easier to detect.

The stigma of having an operational stress injury within a very Darwinian organization like the forces has taken a fair amount of time to make its way into the acceptability, in the culture of the forces, that someone who is injured between the ears--not overtly visible--has the same requirements of urgency and need of care and return opportunities to either full employment or partial employment, or the support from Veterans Affairs, as someone who has any other physical injury. It took us years to simply identify this as an injury. From the minute we mentioned mental health, everyone went running. No one wanted to live with that stigma, which exists still today in the civilian world.

I'll provide a very short history before we can go to questions. Prior to 1997 we had one small clinic at National Defence headquarters that was at about 40% capacity. I was then chief of staff of the assistant deputy minister of personnel and was responsible for all of the medical staff and that clinic, which fell under my authority. It became evident that we were missing the boat in regard to this injury, with an increasing number of family breakups; of early retirements due to pressures from family; of increased substance abuse, including alcohol; and of increased discipline problems, even to the extent of a number of excellent soldiers all of a sudden seeming to turn bad and ending up in front of judges and prosecutors, who couldn't figure out why such circumstances had arisen.

In 1997 I was to present a report to the media that essentially said that although we had a raft of suicides.... Remember, ladies and gentlemen, we really started this new era with the Gulf War, and so we are talking about 1990-91. By 1997 we had troops in Bosnia, Rwanda, and Somalia. So we already had a fair amount of visible casualties, but certainly a lot more non-visible casualties, by 1997, and we had adjusted nothing by that time. However, the report that I was supposed to present said specifically that the 11 suicides over the past were not directly related to operational stress. There were said to be a whole variety of other reasons that all of a sudden simply got exacerbated by the fact that the member of the forces was deployed and was predisposed ultimately to maybe taking their own life.

I refused to recognize that as a reality and started a campaign after becoming assistant deputy minister of personnel of looking, with Veterans Affairs Canada, at the whole arena of operational stress and “PTSD”, as we finally had it coined, recognizing the fact that PTSD could be a terminal injury. In so doing, the care, the therapy, the institutions, and the recognition by the chain of command and the forces of this injury had to make a massive leap forward, or we were simply going to continue to lose a lot of very good soldiers, sailors, and air persons not only because they were injured but also because the impacts on the families were simply not sustainable. We were going to lose our shirts with regard to our enormous investments in very qualified people who, after one or two missions, could not continue to serve or who had become administrative discipline problems, ending up in jail, or worse, with some of them killing themselves.

We have been at it for 13 years now, and over that time there have been numerous initiatives at both National Defence and Veterans Affairs. In early 1998 I was able to have a brigadier general transferred to Veterans Affairs as liaison instead of a lieutenant colonel. His name was Pierre Boutet and he'd been the judge advocate general.

For five years he and an assistant deputy minister called Dennis Wallace worked on a massive reform inside Veterans Affairs for the recognition of this injury, but also the recognition that they were in a new era where they were going to pick up casualties, versus the era of anticipating simply losing clientele due to the previous wars.

Larry Murray, an ex-admiral of the forces, became deputy minister of Veterans Affairs after 2000. He continued this significant review that ended in 2004 with the Neary report, which I participated in tabling with him. It recommended that we have not only a new Veterans Charter, but a new way of looking at the casualties and their care.

We've now created clinics. Both Veterans Affairs and National Defence have clinics. We've created joint offices to exchange information, although the computers still don't talk to each other, so there's still a major problem in medical documentation. We have moved into the arena of prevention before deployment.

My son was on a ten-week course for recruits in Saint-Jean. They had a three-hour session with a new-generation veteran who suffered from PTSD, but who was part of the peer support structure. My son said it was the most riveting three hours of the course. The next day four guys quit because they felt it was too much. This whole preparatory exercise has matured, and still needs to be worked on.

There's the in-theatre recognition of casualties, and actually deploying therapists into the field. In 1992, when I commanded my five brigades and had troops in Bosnia, I mentioned that we should have some of that sort of scientific knowledge there to pick up the casualty data. It was said to be unnecessary. We have rectified that.

I think the strength right now is in the coming home and recognition of those who are casualties. The system that is now in place is pretty sophisticated in identifying those who might be at risk. The question, however, is what do we do beyond that recognition? In particular, what are we doing about the reservist who has gone back to Matane, is 500 kilometres from the nearest base, 200 kilometres from the nearest hospital with any real psychiatric capability, and is isolated out there after serving maybe up to 18 months in a high-intensity operation, and maybe more than that due to multiple deployments?

The risk arises when the soldier returns home. Preparation in the theatre of operations can always be improved, but the risk arises when the armed forces member returns home. We have to see what can be done to minimize the consequences of this injury for the individual, to convince him to seek therapy and take medication. It is important that he or she receive support from peers. Families must be helped to understand the individual who comes back injured, and care must be taken to prevent substance abuse, and to prevent the individual from committing criminal acts and winding up in jail. And ultimately, the person must be prevented from committing acts that could lead to suicide.

I will give you a short anecdote, if I may, to indicate that if you're studying operational stress injuries and the impact thereof on the forces, it is essential that you study the families also. When I returned from Rwanda, my mother-in-law said that she would never have survived World War II if she'd had to go through what my family went through. My father-in-law commanded a regiment in World War II. The whole nation was at war, so everybody had something to do with it. There was very little information that was let out, and even the technology of that time was quite limited.

In this era, however, the families live the missions with the troops. They are continuously zapping every communications means they have in order to find out if we've been killed, injured, captured, if the mission has gone sour, about any frictions there might be. So when you return from missions, you're not returning to a household that “held the fort”, as it historically used to be called, but in fact you're returning to a family that has already gone through significant stresses of seeing what's going on but not necessarily being able to influence it. I must say, though, that the availability of the Internet and those communications have alleviated somewhat the distance between the troops in the field and the families.

So we are now at the stage of looking into the future. Last week I was at a symposium in Montreal, an international symposium on operational stress, that was led by Veterans Affairs and an international body now garnering more and more data and building the capacity in regard to research on this injury, the sources of it, and the means of attenuating it.

I also was two days ago at a forum in Kingston called the Canadian Military and Veteran Health Research Forum--led by Queen's and RMC--that was meeting one criteria that I was most fearful of maybe falling through the cracks. Afghanistan was supposed to end in 2011. We will end the combat element, but we will still have troops in the field and potentially in harm's way, so we will continue to have need of support. But it was feared that as we tone down that mission, we would also start to tone down the needs of the casualties, and Veterans Affairs Canada and DND would not recognize that the girls and boys who have done three or four tours are now going to come down from that adrenalin high. The impacts of those missions are going to start to hit them as they come back to a certain level of normalcy, and that's when operational stress comes in spades. So you're going to have a significant increase of those and their families who have now so far been able to sustain it.

The other thing is that we started with nothing in 1997. I went to the United States veterans affairs clinic in White River Junction, Vermont, to meet the head of that. His name is Dr. Matthew Friedman. I asked him to help us build ours, because they'd had Vietnam and we'd had nothing of real significance except a bit of Congo, a bit of Cyprus, since Korea. There was no depth in our capabilities.

They readily helped us. They gave us a statistic that was interesting, and I'll end with that, before we go to questions. They told us they didn't want us to go through what they had gone through in the Vietnam War. On that black wall in Washington, there are 58,300 names of those who were killed in theatre in Vietnam. However, by 1997, 22 years later, they had on the books, for those they were able to record, just under 102,000 suicides directly related to the Vietnam experience.

So how many real casualties did Vietnam cost them? Was it 58,000, or was it maybe closer to 160,000?

I ask you the same question: how many real casualties have we taken? Is it 152, or maybe 170 or 175? I can tell you about my mission in Rwanda; I had casualties in the field, and two years ago, 14 years after the mission, one of the officers committed suicide.

Ladies and gentlemen, you're into a subject of enormous import to those who are serving and to their families. I would contend it's also of enormous import to the operational sustainability of the Canadian Forces in order to keep the experienced troops healthy and able to sustain such injuries.

Thank you.

[The Chair, Conservative, Gary Schellenberger]

Thank you.

We'll try to keep our questions to five minutes so that we can get as many questions in as possible.

Ms. Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Mr. Chair.

Thank you, Senator. Your testimony is overwhelming, and it's hard to know where to start. Thank you for your courage and your leadership in this area.

I'm going to pick up on what you said about the return being where the risk occurs. We know there's an exit interview in which people must self-identify. But I hear repeatedly that people go home, the families don't recognize them, and there may be alcohol or drugs. They may lose their partner. They're waiting for payment. They lose their house and they end up homeless. That's one scenario.

I'm wondering how we track people as they come out. How do we check in with them to make sure they're getting the support they need? Are we doing enough in terms of medical checks, in terms of counselling? As one man said to me, “I wait a month for my appointment. But it doesn't matter, I've got a shotgun fully loaded.”

How do we do that follow-up to keep them healthy and safe?

[Senator Roméo Dallaire]

I'll respond with a couple of points.

For those who remain in the forces and go through a process of follow-up at three months and six months--my son came back six months after a tour of duty in Sierra Leone and went through the process--although they may be identified with PTSD at a different level, which is essential to identify early, the availability of care is not necessarily immediately there. So with the follow-up, the care, there's a deficiency, both on civilian street but also with the military, although both DND and VAC have increased the contractual arrangements to get more therapists available.

One of the downsides is that we're not putting enough emphasis on psychologists versus psychiatrists. I like to use the analysis that if a person puts their hand on a burning stove the psychiatrist will give you the pills and so on to attenuate the pain and to try to watch it heal. The psychologist is going to ask why you put your hand there in the first place.

The deficiency is not in giving them that initial stabilizing, and in some cases creating zombies; that stabilizing effect by therapists is more and more available, and it comes out. It is in fact the therapeutic side of bringing them back to a level at which they can sustain a reasonably normal life--i.e., build their prosthesis to live with--because that's what you have to do. So it's professional therapy, medication, and accepting that.

Then the third one is peer support. That is to have someone there between those sessions who's willing not to ask any stupid question but to listen for hours, to let you talk. Rarely is it the family, because they're too close. My family hasn't even read my book. It can be uncles, peers, and so on. In building of the peer support, recently Veterans Affairs opened up their peer support for families, which is interesting, and for children it would be needed.

There are processes in motion for those in the regular force. Those in the units are staying within a cohesive group, like in a regiment. But there are a lot of individual augmentees, who end up all over the forces, who are not necessarily followed up on because nobody else in that unit has gone there. There's not the same concern by the chain of command on the follow-up of the individual, or the leadership won't even understand what the problem is. In so doing, they can fall through the cracks.

However, the greatest deficiency is with the reserves. For the reservist who ends up in all kinds of villages across the country and decides to quit, there is very little follow-up on how they're being taken care of. That's why you're ending up with more soldiers in front of the courts. You'll see a lot of reservists there because they've been nearly abandoned.

That is a great deficiency for the reservists. We are counting more and more on them to be operationally capable, which is a whole world of difference from what we were doing in the seventies and the eighties, when we thought them to be the mobilization base during the Cold War.

[The Chair, Conservative, Gary Schellenberger]

We have to move on.

[Senator Roméo Dallaire]

I'll try to shorten my answers.

[The Chair, Conservative, Gary Schellenberger]

Mr. Vincent, please.

[Robert Vincent, Bloc, Shefford, QC]

Thank you, Mr. Chairman.

Thank you, Mr. Dallaire, for having accepted the committee's invitation.

I took a few notes during your statement. You talk about acceptance within the culture of the forces, and full employment following post-traumatic stress. But in the field one hears a different take: the culture of the forces still leads people to say that this does not exist. People have told me that they had to wait two or three months before being able to see a psychologist. At a certain point, one person was unable to return to her battalion. She was unable to leave her house for two, three, four or five days. When she returned to the base she was told that if she was unable to do the job, if she was too stressed and didn't like it, she could just leave and she would be demobilized.

This is how these people who experience post-traumatic stress are treated. They can't rejoin the ranks and so they are demobilized. They have trouble accepting this because very often they have been there for years and they have given a lot of their time. One person was telling me that in a theatre of operations, you never leave anyone behind; when you leave it after having experienced certain things there, however, they do leave you behind, and there is no follow-up.

I would like to hear your comments on this.

[Senator Roméo Dallaire]

You have put your finger on the difference. In a theatre of operations, there is constant follow-up for people. There is a whole structure in place to ensure that they are ready to conduct operations, and they are monitored. In spite of that, there were two suicides on the base, but both were quite particular cases. Basically, the follow-up is continual.

When they go back to their military base, for instance to Valcartier or Petawawa, they resume their normal personal lives. Evenings, weekends and holidays, the follow-up is not as close, even if they are put to work for a month or two, which is one option. This is particularly true for reservists. Rather than just letting them leave, since they have been with the regiment for 18 months, they are kept for a few additional months to see what will happen.

In the regiment that I commanded a year and a half ago, one soldier came back from two tours of duty in Bosnia and three tours of duty in Afghanistan. When he returned he seemed in reasonably good shape. Nine days later, he hung himself. After that everyone tried to figure out why. It is because there was no follow-up.

You talked about isolation. Some men are isolated because they are stressed and at the end of their rope. We need people to carry out operational tasks. The units are small and we have to go and get people elsewhere. The universality of the service does not allow for much leeway. And so they are removed from the structure that is familiar to them. This is being remedied so as to keep them longer within the unit and give them little tasks to do. However, in several other cases things are centralized, and then we lose them. That problem has not been resolved as we speak.

[Robert Vincent, Bloc, Shefford, QC]

When a person is demobilized in a theatre of operations overseas and is to be sent home, he or she is put on a plane to Canada. Once that person is here, there is no one to meet and support him. These people have experienced major post-traumatic stress but are left to their own devices. They have to find a psychologist to treat them on their own. The forces are not there for them.

[Senator Roméo Dallaire]

I live in Quebec and I have seen men come back alone from Afghanistan, but they weren't alone. A chaplain or family members were waiting for them as they got off the plane, and the regiment took care of them.

However, it is different for those who are not members of a regiment, for instance.

the individual augmentees.

They are plumbers or technicians who come from elsewhere when we need them. Sometimes there are reservists who arrive at the last minute. Those people don't have the same follow-up. We need resources in the reserve units, for instance, so that we can follow these people.

It is not systematic; not everyone is followed in the same way. It depends on the structure they come from. The program has to be developed.

[The Chair, Conservative, Gary Schellenberger]

Next is Mr. Stoffer, please.

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

Thank you very much.

Mr. Dallaire, thank you for coming today, and thank you for your recent book on the child soldier. It's going to open up a great debate in this world that we have.

You had mentioned that Dr. Friedman had talked to you about the 102,000 who had passed away as well, and that's an extremely valid point. We know there are certain individuals who have committed suicide after their return from Bosnia or Afghanistan, yet we don't seem to mention them. We mention the 152. I think you make a valid point for them, and I thank you very much for that.

As you know, military life is a culture. Once you get in there and you do it for many years, it gets into your DNA. It's your way of life. You and your family are all part of it. And then, for whatever reason, you are medically released, even though you don't wish to be released, and then you say, “Now what do I do?” Even though they can offer retraining and everything else, you've lost the camaraderie and the spirit. In some cases I've heard someone say, “I've lost being a man. My children don't look up to me anymore.” There's nothing wrong with being a commissionaire, but it's not the same as the military and that kind of thing. So they feel kind of left out. Not that it detracts from them—I don't mean that--but basically, they feel not as worthy.

I just wonder what you can recommend to us to encourage these individuals. What can we do not only to improve their psychological way of living but also to acknowledge the fact that they may no longer be in the military but they still have a role and a purpose?

[Senator Roméo Dallaire]

In 1971 they had a plan called “Restore”. That was when we massively cut, hugely cut, the forces. We offered people a golden handshake, even people who had been Korean vets, and we let them go, like that.

Within three years, we were getting reports that a lot of them had died. It was not suicide; they had simply died of broken hearts, because they entered a world they didn't understand, and they were abandoned.

One of the areas looked at, and which we were seeing as a deficiency, was that being released from the forces and handing in your ID card and your uniform doesn't mean that the forces are out of you. When you instill loyalty, it stays ad vitam aeternam. What you need is a bridge to the next entity, in a sort of paternalistic way, to continue that loyalty you've committed to, particularly if you are a veteran, particularly if you've been in combat, have actually been injured, and have seen people killed. And there was no bridge. They were dropped off the forces, and they had to climb their way back into the veterans system, and then the veterans system took them as they could within the old system.

That process of rehabilitation and reintegration was introduced with the new Veterans Charter, but not many have taken them up on it. One of the interesting reasons is that not many of them have actually been released yet. A lot of them, particularly those from the Afghan war, are still in the forces. When they start to be released after their accommodation period of three years or sometimes four years, we're going to see whether that rehabilitation and reintegration program Veterans Affairs has built to pick them up before they leave--in fact, they're looking at six months beforehand--and help them through that transition to civilian life is going to work.

It's interesting; there was an article today about an interview I did yesterday. With the universality of service, the forces can't keep them, because there are too few to do the job to start with. But you might want to create a sort of subservice, where people who are injured can remain in uniform, maybe under different conditions. They can continue to serve in different jobs, because they have skills and experience, and not necessarily be released out. In so doing, you'd minimize, in fact, that trauma of moving to civilian life. Some don't want to see a uniform anymore and are happy to get out, but others simply want to stay on.

The forces would have to get an extra sort of manpower level, or person-power level, to absorb them, because what will the number be? Post-Afghanistan, there may be 1,500 to 2,000 who are significantly injured, not including all the post-traumatic stress. And we must remember that from 1991, with the Gulf War vets, whom we have treated rottenly, right through to 2006, when we started to bring in the new Veterans Charter, we have taken a lot of casualties. More than 10 were killed and more than 100 were significantly injured, and a couple of thousand were psychologically injured, everywhere from Somalia to Rwanda to Bosnia, and so on. That gang is sort of feeling a bit left out. Yet only with the changes we've seen today, with this coming legislation, are they going to start to be able to benefit from the new Veterans Charter, if that rehabilitation and reintegration starts.

Yes, Veterans Affairs Canada has a program. It's yet to be tested to know if it really works. But maybe DND should be given the option of trying to keep them.

I end that with the following. In 1998, when I was the ADM, I was brought on the carpet, for the forces, in front of our Human Rights Commission. The fourth pillar of it--that is to say, the hiring of disabled people--we were not meeting. The civilian side of DND was doing not too badly, but on the military side, no, because they all had to be universally deployable.

We could actually answer more appropriately the Human Rights Commission the right of employing injured veterans...but within the context that it does not affect the operational effectiveness of the forces--that is to say, those who are committed to deployment.

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

Thank you.

[The Chair, Conservative, Gary Schellenberger]

Mr. Kerr.

[Greg Kerr, Conservative, West Nova, NS]

Thank you, Mr. Chair.

Senator, good to see you again. I wish we had a lot more time because there are obviously a lot of topics to continue.

I appreciate not only your years of service but also the years of activity in terms of bringing about some of these changes in the last few years and the fact they are continuing. Although there is a lot of work to be done, I think that's important.

What I would like to do is go right to the symposium that we were both at. What strikes me, in the time I'm spending around Veterans Affairs and veterans, is, one, the stigma question that of course stays there; it's a bit of the culture. The other is this growing recognition that as a society we recognize a physically wounded soldier but we don't tend to want to recognize somebody who has a mental problem or a psychological disability, and so on. That's why I was enthused by the conference in the sense that the civilian and the veterans side, if you like, were coming together and recognizing that we collectively have a great responsibility to educate the public, inform the public, and so on.

I was wondering if you would care to comment further on that approach or that partnership.

[Senator Roméo Dallaire]

The serving member--they can be serving and a veteran also, as you know--although not necessarily overtly conscious of it, is expecting that the social contract of the unlimited liability clause between the individual and the people of this country is forever. It is not a short-term contract, such as an insurance policy. For that person--and the family--having committed to a place where he could have been killed, as some are, or injured for life, the Government of Canada will forever be that backdrop to which they can turn as part of that social responsibility, that social contract.

That is not articulated well yet, and is not felt well. There is this feeling that they are dropping off the radar when they are identified as an injured veteran and then become a veteran.

I remember when I was serving it was honourable to have a physical injury. In fact it was called an “honourable injury”. I remember at happy hour a guy showing me where he had been shot in the buttocks. He never bought a beer for weeks after that. But there were also guys sitting in the corner who always seemed to have a lip on, who were sort of hiding between the paint and the wall. Nobody talked to them, and they talked to no one. They were often mad and difficult to handle. They were those who were affected psychologically. It was nearly considered not an honourable injury: you couldn't hack it.

The Darwinian nature of the forces and the absolute dependency of every member on the other in operations create an incredible intolerance. That intolerance is essential in the field. However, when you come back to garrison and you lick your wounds, there has to be a way of transitioning that into a level of respect.

I would contend that it is culture change, and there is a process going on in the forces. The CDS last year launched a very significant culture change exercise. We are getting less of the intolerance than we used to have. I think one of the greatest advantages we have now is that we have a forces of veterans. It's sort of like the fifties. You have a bunch of veterans and you have non-veterans. Usually the intolerance comes from the non-veterans, even at different ranks. But now we have enough of a volume of veterans at all ranks, including general officers, who are going to attenuate that sort of perspective of you weren't there, you don't know how it was, and that is an injury; that is coming more and more to the fore.

I think it will be interesting to see the leadership of the forces managing the veterans part of the forces with the non-veterans and ensuring that synergy between the two.

[The Chair, Conservative, Gary Schellenberger]

Our next round is only going to be three minutes. Please try to....

Ms. Zarac.

[Lise Zarac, Liberal, LaSalle—Émard, QC]

Thank you.

Thank you, Senator Dallaire, for being here with us today.

You talked about prevention, and we have just talked about synergy between the armed forces and the veterans. That is where there seems to be a disconnect; we have to ensure that there is monitoring of people who are contemplating suicide.

You talked about prevention, that seems effective. Some people have decided not to go that far. Potentially, these people would not have survived.

You talked about a three-hour training. Did I understand you correctly? Is that sufficient?

You mentioned that it is difficult to convince them to seek the therapy they need; I would like to know if the families are also trained in prevention.

[Senator Roméo Dallaire]

You've managed to insert 15 questions in one. I congratulate you, that is clever.

First of all, what I had recommended in 1998, and this was done, was that the individual seek therapy voluntarily. Without therapy, those who are affected by operational stress will not be able to recover. That is the first principle. If your arm has been ripped apart and you don't go and see a doctor, you will die. It's the same thing with this kind of stress.

So I tried to convince the therapists not to wait in their offices for the people to come to them, but to go to them and try to promote their services. First, the role of the therapists is not explained sufficiently, people don't know what they can do and how they are integrated into the organization, particularly the civilian therapists who are assigned to the Department of Veterans Affairs or even to National Defence, without any experience in the armed forces. They would have to be taken to the field and given some experience so that they get to know the culture.

So, the first step is for the therapists to promote their services.

Woody Allen said it was “in” to have a psychiatrist. Remember his movies? And so it is: it's in to have a psychiatrist. I have been 13 years under therapy, psychiatrists and psychologists, and with medication.

The other aspect is how to bring these people around and not let them fall into a state of depression that can lead to suicide.

Suicide can happen in two minutes, any time. An odour, a noise, anything can trigger this catastrophe. In my case, it took four years before I suddenly became completely dysfunctional. I was dismissed from the Canadian armed forces because of this injury. Following that I became suicidal because there was no system aside from therapy and so on. There was no peer follow-up.

The peer support structure for the individuals and the families has to be the most innovative, cost-effective, and progressive—all the superlatives you can find—of the tools we have in prevention. A couple of years ago, the OSISS gang, the peer support gang, said they were preventing a suicide a day; these are just members.

What I have found disappointing, however, until now, was that the 400 involved in operational stress--who do a lot of volunteer work, who spend a lot of time in Tim Hortons with people, listening and so on, very low-budget—are getting a certain recognition, but there are nearly no officers. I've seen a warrant officer go into a jail cell to get a colonel out, and be that colonel's reference, for over a year.

In my opinion, operational stress is the element that should be the topic of in-depth study.

Senator Kirby, in his work that he's doing now on mental health across the country, has the founder of the operational stress program working with him, Colonel Stéphane Grenier, and he would be an excellent witness. He created it. I remember I was still serving, and we didn't believe it. The professionals really pooh-poohed it, yet it has proven to be outstanding to the extent that Senator Kirby is now looking at creating this capability within society at large.

[The Chair, Conservative, Gary Schellenberger]

Thank you.

Mr. Mayes.

[Colin Mayes, Conservative, Okanagan—Shuswap, BC]

Thank you, Mr. Chair.

Thank you as well to our witness. Senator Dallaire, I know that we have a nation grateful for the way you have served in your role in the Canadian Forces, and we respect that.

One of the issues you identified is that prior to 2006 there was recognition of having to do more than just pension a veteran off and say, “Okay, go take care of yourself. Here's the money.” There needed to be a charter to follow the veteran's life and to be that support.

I was here in 2006 with Mr. Stoffer. That was an exciting part of the Veterans Charter, and we're moving through that. I would expect that you support the charter and the initiative. The goals of the charter were to make sure that we followed the veterans and supported them, and PTSD is part of that.

I find this interesting. We had a report last week by the department, which said that the rate of suicide within the general population was the same as it is among Canadian Forces members and veterans. There is going to be a witness after you who is going to say the same thing, that particularly those under the age of 24 did appear at increased risk when compared with civilian males of the same age.

So do you think it's not just the type of theatre we're seeing on the battlefield but also society itself and the value of life and some of the things that bring a hopelessness to those people who are seeing these horrific things happen to their fellow man?

[Senator Roméo Dallaire]

I won't talk about the charter, because I'm the chair of the veterans subcommittee. We've been studying it for the last eight months, and we hope to continue to study it and get into the nuts and bolts of not only the charter but how it's being applied and interpreted in the regulations. I am also the one who, in 2005, passed it through the Senate, so I'm committed to it.

It is resultant of the studies. The question is how effective it is. Well, we're learning how effective it is, and that's how we'll continue to improve it, of course.

In regard to the state of mind and the impact thereof, what is creating a lot of the injuries is not only the sights and the smells and the sounds. Often you're in the midst of it, you're busy doing things and you're trying to save other people and so on, so there's a kind of a film in front of it. It's when you come home and you're sitting at home having a beer that all of a sudden--boom--it starts to come clear. Or it's at night, or on a bad day like today and stuff like that.

If you don't build that prosthesis of knowing places to avoid.... For instance, I don't go to grocery stores because of the opulence of the fruits and vegetables and the smell and the odours literally paralyze me. I can't move, because it brings me back into the food distribution points and where people were trampled to death and so on. So there's a building of the prosthesis that takes time and must be nurtured by therapy and peer support.

Where we really we see the casualty levels, or that difficulty of living with life around, is in the moral and ethical, and sometimes legal--depending on the mandate--dilemmas of actually.... Contrary to World War II, where the rules of engagement were that you knew what uniform they were wearing--bingo. It was very linear, a very set piece, and so on. Today they are in all directions. Today the other side, the extremists, the terrorists, play by no rules. It could be a 14-year-old pregnant girl who is a suicide bomber, just as it could simply be a 14-year-old pregnant girl who is looking for protection.

It is those dilemmas and how we respond to them that are really burning up the cells. PTSD is a physical effect on the brain; it's not simply psychological.

When it comes to the numbers, I keep hearing all those numbers, that there's no more than on civvy street and so on. But let's think about it. I mean, these people are selected, these people are trained, these people are sort of weeded out, those who will not be able to meet the requirements. They are prepared for the operations. They're under a whole system of control and command and so on. They entered a way of life, a culture that instills pride and all that kind of stuff.

So you have all that positive baggage, and yet we say that our figures are no more than on civvy street? Well, if they're the same as on civvy street, we have one hell of a problem. Surely, even though they see these traumatic experiences, they should have, because of the selectivity of it, less than equal, let alone more.

A year ago I was lecturing at the U.S. Marine Corps where they were having a symposium. The Americans were having massive problems of suicides that all of a sudden appeared because of the stressors of coming back to a normal life that simply was not there any more: I'm not who I was when I left and my family is not who they were when I left.

So bringing that back together is where some of those stressors really create the traumas.