Evidence of meeting #29 for Veterans Affairs in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was soldiers.
A recording is available from Parliament.
Conservative
Ben Lobb Conservative Huron—Bruce, ON
I don't mean in his statements today, but in his book or any of his speeches or interviews during that time. Did your studies look at any of his work?
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
We specifically looked at the impact of peacekeeping on the mental health of soldiers. I'm sorry, but I don't remember what he specifically recommended in his book around suicide prevention.
Conservative
Ben Lobb Conservative Huron—Bruce, ON
Certainly he felt that on-base peer support groups were a tremendous help in providing a reduction in suicidal tenancies.
On page 3 of your handout in the last paragraph, it says: Other risk factors that have been noted are factors that are specific to military populations, including being an active duty regular force member rather than a reservist....
I wonder if you can elaborate on that and what that sentence means.
Research Assistant, Mood and Anxiety Disorders Research Group, Department of Psychiatry, University of Manitoba
Basically it's saying that the rates are higher in active-duty members than in reservists. I'll come back to a previous comment that we often lack data on reservists, so it's hard to say that's truly the case. But it has been noted in the literature to date that active duty has a higher risk.
Conservative
Research Assistant, Mood and Anxiety Disorders Research Group, Department of Psychiatry, University of Manitoba
Absolutely.
Conservative
Ben Lobb Conservative Huron—Bruce, ON
I was at Wainwright last summer when the reservists were performing Maple Defender. I talked to some guys who had performed in three and four tours in Afghanistan and then went back into their communities. I realize that a great many of them are tracked. I'm not sure for how long, but I guess that's a question I have.
In your third recommendation on the last page, it says that “increased attention should be directed towards increasing collaboration”. For our analysts and to have a little more detail, I wonder if you can elaborate on that. It is pretty vague. With whom and where would collaboration be increased?
Research Assistant, Mood and Anxiety Disorders Research Group, Department of Psychiatry, University of Manitoba
When I was looking at my speaking notes today, I noticed that sentence had been cut short. I was referring to greater coordination among the different kinds of health services available to veterans.
I mentioned a little earlier in the report there is a need for collaboration between alcohol services and mental health services--getting those people talking to each other. Alcohol use disorders can be a large risk factor, especially among this kind of group. Impulsive people are more likely to die by suicide. So we're talking about getting those two groups contacted, connected, and talking about the health of the soldier.
Conservative
Conservative
Ben Lobb Conservative Huron—Bruce, ON
Thanks.
I'm a little surprised that in any of the work or any of the questions you wouldn't have asked either active-duty or veterans if they'd participated in any peer support work with the OSISS program on base. That's about the first question I would ask.
Was that because no data or no reports were available? Why was that omitted?
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
Just to be clear, these data were collected by Statistics Canada. We didn't collect the data. Statistics Canada did a mental health survey of all Canadians in 2002. As part of that, the Canadian Forces then commissioned Statistics Canada to do a representative sample. So we weren't involved in the data collection. We were involved in the data analysis.
You've mentioned a very good point, but we weren't involved in that part. I think it is a miss, but it's not something that we were trying to look at.
Conservative
November 18th, 2010 / 5:10 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you, Mr. Chair.
Thank you to the witnesses. Thank you for your research and your time and effort today.
I think you've raised two important issues. We know coming home we're going to have a lot of operational stress injuries, whether it's anxiety, depression, PTSD, or traumatic brain injury. You've talked about the lack of tracking. I'm going to speak specifically related to VAC.
If people leave the service, I am looking for very specific recommendations. How do we ensure they are tracked? How do we ensure they have the support they need? We know that data collection is a problem. We've talked about gatekeeping. Should everyone who leaves have an interview with a psychiatrist, a psychologist, a mental health worker?
Should there be a survey? If they are identified as at risk, should they be assigned a case manager--which, we believe, they are being assigned--but specifically a peer support worker? How often should they be checked? Is it often enough to do a survey six months later?
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
A post-deployment screening has been developed and is being collected. Mark Zamorski has been doing this.
The challenge is more awareness for the family, as well as for the soldier, and as you were saying, the peer support. As the person leaves the military it is a challenge, and this is the difficulty. How do you get care for people? Raising awareness is probably the most important method. The primary care physician is also a person who can be helpful.
As we mentioned in the report, if the person has made a suicide attempt they probably are at the highest risk. And if they have post-traumatic stress disorder--
Conservative
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you, Mr. Chair.
I've heard from a number of families. They didn't recognize the symptoms. They didn't know that was a risk factor. The family member went into the basement--in three different cases--and they had lost their son.
We have to do more. There has to be more to awareness and education. The child--the young man--lived in the basement for six months.
There is more to this than awareness and education.
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
Yes. I mean, this is the real difficulty. One of the challenges, if someone is extremely depressed and a family member is concerned, is whether he should be hospitalized against his will. That becomes an issue in such cases.
The challenge is that not all suicides are preventable. The hundred suicides that were reviewed in New Brunswick, the cases Ms. Belik was talking about, were studied very carefully. That's where the recommendation of coordination of mental health and addictions services came from. Also, they noted that 30 out of the hundred suicides were not preventable, even if anything and everything could have been done. It's important to try to raise awareness among people in contact with the person, and to provide family-member peer support. If a person is depressed and feeling hopeless, and wanting to die, that person is not going to seek services.
You have a comment?
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Yes, thank you.
Not everybody has a family member. That's really important: then what happens?
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
Right. As you're saying, it is a challenging issue, how you track and support these people.
The U.K. study showed that for young soldiers leaving the military, that was the time of highest risk. Probably the first year after is the highest risk of all, but it can happen at any time. So trying to figure out ways to provide outreach and support is essential.
Conservative
Dave MacKenzie Conservative Oxford, ON
My thanks to the panellists.
I have a reasonable amount of experience in dealing with suicides. We should not lose sight of the fact that suicides occur in all walks of life, not just in the military. Doctors, lawyers, police officers, factory workers—all commit suicide. I recognize that, and I appreciate your comment that not all suicides are preventable.
My sense...and you didn't hear General Dallaire, but I saw the same thing where I came from. Frequently we ended up with the wrong people, a round peg in a square hole or vice versa. He talked about three-hour sessions in which they sat down with people who had experienced these things. In one group, four young men decided that the military was not for them, or at least that part of it.
If we're looking strictly at the military, and that's what this committee is trying to deal with, how would we avoid putting people who are not psychologically suited to dealing with heavy stress into situations that could cause them to become mentally ill? Based on the studies you have done, do you know a way of heading off the problem before it's a problem?
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
This was addressed in a study by Rona in the British Medical Journal, using U.K. data. They looked at screening for mental health problems prior to entrance into the military and whether that would predict future problems. If someone had a history of mental illness, depression, or anxiety, would that person have a higher likelihood of post-deployment mental health problems? Their conclusion was no. According to the study, this information didn't help predict who was going to experience problems.
This is the biggest challenge with mental illness in general. As with diabetes or heart disease, there are genetic risks. Childhood adversity, physical abuse, sexual abuse, family difficulties, exposure to alcoholism in childhood—these factors put people at higher risk when they have a traumatic event. At least that is what's thought. But at this point, the short answer is that we don't have a good understanding of who is going to develop mental health problems after severe trauma. This is the huge question. We tried to do a study on it, but we didn't have the necessary support.
Conservative
Dave MacKenzie Conservative Oxford, ON
That deals with post-traumatic stress types of individuals, but we have a lot of suicides, as you well recognize, that have nothing to do with post-traumatic stress disorder. Lots of times it's young people, but it's all age groups.
In this case, what this committee is wrestling with, in dealing with the military, is whether there is any pre-screening for occupational deployment, if you will. We do it in other industries. Some people are better suited to being salespeople and some people are better suited to being whatever.
Are there any kinds of things we can do to help the people in the military prior to being deployed into these situations?
Professor, Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba
Do you want to answer?
