Veterans Affairs Committee on Nov. 25th, 2010

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

Good afternoon, Dr. Richardson. You said that the biggest problem was access to services. You feel that a soldier has to realize that he has a problem and to know where to go. I would like to pursue that a little more and I would like to know your opinion.

When I think of a soldier, I imagine someone tough and strong. In most war films, after all, soldiers are shown as tough guys who are not afraid of anything. I feel that is how soldiers see themselves. It cannot be easy for them to admit that they have a problem, especially a psychological problem. I would like to hear your comments on that.

Let's talk about access to services. There is always a little shame attached to saying that you have a psychological problem, even in 2010. In the private sector, there is a service called EAP, the employee assistance program. Everything is handled discreetly. You call a number and you get an appointment with a psychologist or someone to help with your needs. It's all done without anyone else knowing. If you work in a company, you won't meet anyone else when you are there. It is done very discreetly. The service is not just available for the employee, but for the employee's family as well.

Is there a service like that in the armed forces? If not, don't you think that one should be started?

[Dr. Don Richardson]

The first part I think you're touching on is the issue of the stigma of mental illness. The observation, especially in the military culture, which is a macho culture, adds another variable to the difficulty in seeking treatment. Part of the culture of the military is to be strong and to help others. To then admit you have a problem and that somebody has to help you is obviously a very big issue.

I think that is part of the challenge. On the civilian side it is very difficult for people to admit they have depression; for the military, which is predominantly male, it's more difficult. I think you're bringing up a good point there.

With respect to the issue of the employee assistance program, which I think you brought up, most of them have that.

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

When you say most of them, who wouldn't have it?

[Dr. Don Richardson]

Pardon me?

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

You said most of them would have it, so who wouldn't have it?

[Dr. Don Richardson]

A lot of the companies have it, especially people working for the federal government.

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

Okay, but I'm talking about the forces. Do they have it in the forces?

[Dr. Don Richardson]

That's a good question. The veterans have a 1-800 number they can call, and I think it's the same number for—

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

What's the service behind that?

[Dr. Don Richardson]

They will see a therapist. It's for short-term therapy for identifying issues and problems. If it turns out the person will need longer-term treatment, then part of it is to refer them.

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

Is it strictly confidential, though?

[Dr. Don Richardson]

Is it strictly confidential in what way?

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

Can he go and get the service without any of his colleagues--other soldiers--knowing?

[Dr. Don Richardson]

That's a good question. You'd probably need to ask somebody from Veterans Affairs specifically, a person who administers that program. I would assume it's confidential in the sense that there is usually confidentiality when you see a clinician.

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

But you don't know exactly. Would you think this would help to identify more cases?

[Dr. Don Richardson]

I think it may help; however, if they see their family doctor, that would be confidential too. It would be confidential in the same way.

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

Would you admit that a family doctor...? We had witnesses come here and say that a family doctor doesn't have the knowledge because he doesn't understand the problem this soldier is going through. We've been told it takes from two years to four years of training to understand and to be able to help a veteran in this situation, so I don't think a regular family doctor would be able to help a veteran. What do you think?

[Dr. Don Richardson]

I don't know about two to four years. I think it is helpful if you have somebody who is caring and understanding. They may not understand the entire culture of the military, but they are able to screen and know what resources are available. That one person will not necessarily be able to help everybody, but that person would be somebody you're working with who would know what resources are available to you to get treatment.

[The Chair, Conservative, Gary Schellenberger]

Okay. Thank you for that. We have to move on.

The next questioner is Mr. Mayes, and then we will go over to Mr. André.

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

Thank you, Mr. Chair.

One of the things we're studying is the occurrence of veterans' suicide. Specifically, I think we know the stress issue is out there, but stress doesn't necessarily lead to suicide. We're trying to determine if there's a higher risk of suicide to Canadian Forces personnel or veterans who have come out of the Canadian Forces. We've had Canadian Forces witnesses who have said they have found no indication that there's a higher risk of suicide for those who have been engaged in combat than for any other veteran who's serving in the forces. I think out of the 10 that they indicated last year, or 2008-2009, there wasn't one that was related to combat.

Stress is a very difficult thing to identify and track. It's difficult to know what the outcomes of stress are going to be. I was just wondering about a statistic out of the U.K. that suggests that if a person is discharged from the forces under the age of 25, there's a higher risk of suffering suicidal tendencies than for those who maybe go longer in their career in the forces. Could you comment? Do you think that statistic is a true tendency?

[Dr. Don Richardson]

I'd have to review the exact study you're talking about. I probably have heard the same stats from the Canadian Forces, because they presented recently at the symposium in Kingston. The data they have indicate that the rate of suicide in currently serving members has not changed, meaning that it hasn't gone up with recent deployments, in contrast to what has been presented in the U.S., where the rates of post-deployment suicide were higher.

Considering that we're all probably genetically similar, it's hard to read what the statistics or the research is showing. There are significant studies and research demonstrating that people who have depression have higher rates of suicidal ideation, or thoughts of suicide, and have increased risk of suicide, meaning completed suicides or suicide attempts. Then there was a study done in the U.S. indicating that just having PTSD symptoms increases your risk of suicidal ideation, so that for each additional symptom, you have more suicidal thoughts.

The challenge for us is that those who have more severe symptoms of PTSD or depression may have been released and are now civilian veterans. They would not be recorded in the data captured by National Defence, because they're no longer serving. What we don't have in Canada yet are stats specifically on that veteran population, meaning those who are released and are now considered civilians. Having those data, I think, would be very helpful.

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

How much work has been completed in profiling high-risk individuals in terms of their personal characteristics or tendencies, their family background, their status as either married or divorced, and different issues like that? Has there been a lot of work done on that, and are there any conclusions that can be drawn from those who are potentially at higher risk than others because of their personal profiles?

[Dr. Don Richardson]

I think there's been sufficient research done on that, and I can probably get you or the committee some comprehensive studies that specifically examine the area of the risk factors for suicide. I'm not aware of specific risk factors for suicide in veterans. They are a distinct group, and I'll probably have to look at that specifically.

[The Chair, Conservative, Gary Schellenberger]

Okay, we have to move on.

Go ahead, Monsieur André.

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

Good afternoon, Dr. Richardson, I am glad that you are here with us.

I have a very specific question. How long is it between the time a soldier or a veteran contacts you—asks for your specialist help—and the appointment with you? Of course, he has to have a medical referral. On average, how long does he have to wait?