Veterans Affairs Committee on Feb. 9th, 2011

[Tim Wall]

In terms of resiliency.... I may be misunderstanding the question a little bit. There are all sorts of programs for building mental health resiliency, increasing capacity for people to be more flourishing in terms of their mental health. There are lots of programs that have been developed that are separate from the issue of suicide bereavement.

When there has been a loss related to suicide, we need to help people walk through their grief. And sometimes that's just not there, giving people an opportunity to understand how they've been impacted by what's happened to them, and to give them room to tell their stories and to recover from that trauma.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I guess that's what I'm asking.

[The Chair, Conservative, Gary Schellenberger]

We have come to our time.

Mr. Lobb, please.

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

Thank you, Mr. Chairman.

[The Chair, Conservative, Gary Schellenberger]

I just want to remind people that we'll be going until about 4:35.

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

Mr. Wall, thank you.

In your statement you talked about a national strategy on suicide prevention with DND and Veterans Affairs Canada underneath that strategy, or involved in that strategy. Is that correct?

[Tim Wall]

They are involved, yes.

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

You are partnering with that strategy.

The veterans ombudsman testified at our last meeting, and we've heard this before, that Veterans Affairs and DND are, on the world stage, really leading the way on PTSD and operational stress injuries. From your objective eye, do you believe that statement to be true? Do you believe that we are on the right track and are leading?

[Tim Wall]

I don't know if we're leading compared to other countries, because I don't know what's happening in other countries in terms of their military or their departments of veterans affairs.

I think there is certainly growing attention being paid to the issue of trauma within the military. I think the military is looking at some really progressive ways of addressing the issue of trauma. From what I've seen so far, I've been generally impressed with the direction they're taking. I don't know that they're there yet, but I think they're on the right path.

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

Another question I've asked a couple of witnesses is whether they feel that there's adequate training for the mental health professionals who are providing support to members of the Canadian Forces and our veterans. Their answer, both times I've asked the question, was that they felt that the psychologists or psychiatrists, or whoever is treating those individuals, do receive the proper training because of the experience they get when they're doing their practical training, whether it's at Parkwood in London or at Ste. Anne's in Montreal or wherever they are learning their craft. Is that something you subscribe to?

[Tim Wall]

I'm aware of some programs that deal with the issue of operational stress that are very progressive and very much on top of the issue of trauma. I'm making some assumptions based on my experience with mental health programming outside of the military. I'm making an assumption that there are probably not huge differences between those two groups. There is still a bit of work to be done in becoming more trauma-informed. The whole area of trauma and trauma recovery has grown in leaps and bounds. Even in the last year we've had new information. I think that some of the training being offered hasn't kept up.

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

Senator Kirby and his Mental Health Commission I think have received some high grades for the work they have done. Are there pieces within that commission, within the work he has done, this committee should look at and further investigate? It may not be on trauma or PTSD, but there may be some pieces on the mental health side of it that we should look at and should try to add to this report.

What are your thoughts on that?

[Tim Wall]

I think in terms of mental health overall and mental health promotion, what the Mental Health Commission has come up with is fairly comprehensive. There isn't too much I could see that would be missing, with the exception of suicide prevention and trauma. I think there are seven pillars to the strategy they came up with. I would love to have seen nine, one of which looked at the issue of trauma, which is something that connects most of the other pillars. Trauma is often the undercurrent of all those other issues. And of course there is suicide prevention. I think those are the two things that are....

[The Chair, Conservative, Gary Schellenberger]

Thank you.

We'll go to Mr. Vincent, please, for five minutes.

[Robert Vincent, Bloc, Shefford, QC]

Good afternoon, Mr. Wall.

You said earlier that the armed forces have a coordinated approach for its suicide prevention strategy and you congratulated them on their efforts. Have you been in the field, to any military base, to evaluate the Canadian Forces' current prevention efforts and the services offered to veterans?

I understand that veterans fall under one of your national areas of authority. Did you really go into the field to evaluate the Canadian Forces' strategy?

[Tim Wall]

In terms of going to bases, no, I haven't. I wish I had the resources to do that.

[Robert Vincent, Bloc, Shefford, QC]

I'm sorry for you because you spoke previously about $700,000. Right now there is a freeze on budget envelopes. So to go further with your $700,000, I think you're going to have to come back in a few years.

You said that you have a report containing 50 points, and you talked about its benefits. But you know that there's a big difference between what is really happening in the field and what is being written. I'm having difficulty following your strategy. You say that, yes, it's good, it's perfect and you're moving in the right direction, except that no one will check what's going on in the field. There isn't any monitoring. What do you think about that?

[Tim Wall]

I can't tell you things are going fine. I can just tell you that it's my belief that the Canadian Forces are working on a plan, on a strategy, to do that.

I think your point is well taken that whatever we do needs to be evaluated in some way to see if it is having the desired effect, if it's making a difference. I think the evaluation piece is often missing. So I agree with you.

[Robert Vincent, Bloc, Shefford, QC]

It's clear that the strategy's principle is to save lives, but what happens if we can't do that? Especially since Canada has not signed a national suicide prevention strategy agreement. How can we have a suitable strategy for the Canadian Forces when we don't even have a national one? This leaves a really big gap for all these people and there is no strategy. We don't where we're going, we don't know what we're doing, the left hand doesn't know what the right hand is doing. We hope, we think that it's being done well, but there is no one outside the Canadian Forces who can go into the field to evaluate what is currently being done and make recommendations. Do you believe that this would be one of your recommendations, that people outside the Canadian Forces be able to go and evaluate the training that is given to these young people who go into theatres of operations? I don't know too much about what training that would require because we have no idea what the training strategy or the plan is. It's easier for my conservative friends to understand the word "strategy" than the word "plan". There is no plan. We don't know what their plan is to ensure that our young people be able to return in an intellectual state similar to the one they had when they left for a theatre of operations. I would like to know your opinion on that.

[Tim Wall]

I agree with you that because suicide prevention is so fragmented, as you said, the right hand doesn't always know what the left hand is doing. I think the work that's being done by the Canadian Forces, as with other groups that are involved in suicide prevention, would be better served if it fell under a larger umbrella, that of a national strategy, and was informed by that so that there was some continuity and some consistency in our approaches and what was being done.

I think that any kind of evaluation and looking at what the outcomes are of a strategy or any kind of program needs to be done objectively and needs to involve input and some oversight by a group that is diverse in its representation. So that includes outside experts, and it's not an evaluation process that's insulated and only involves those who are directly involved. I think you always benefit from bringing other people in.

[Robert Vincent, Bloc, Shefford, QC]

I have one last question.

You agree with me that if there was a national strategy and we had the money required, we could possibly save the lives of our veterans who have left the Canadian Forces. These individuals are often left on their own and end up in the streets, in groups like AA or groups like that. If there was a national strategy, do you think that we would be able to save these lives?

[Tim Wall]

Yes, I do.

[The Chair, Conservative, Gary Schellenberger]

Mr. Kerr, please.

[Greg Kerr, Conservative, West Nova, NS]

Thank you.

I'll be very brief. I'm not going to ask you a question because I think it's been well covered today and we're a little short of time. But I really want to say thank you. I know the work that you're doing. The fact that you've left the study, which has the recommendations in it, certainly helps our effort as a committee, because it's very difficult to get a consistent pattern of where the issues are coming from, and what are the recommendations. And I think you underscore the fact that this is an extremely difficult issue we're dealing with and it may never be totally resolved, but there's an opportunity for better coordination. So I just want to say thank you for the work you do and for having the study. We're certainly going to review it very carefully, because I think there's some good work in it.

[The Chair, Conservative, Gary Schellenberger]

As chair, I have one small question I'd like to ask. This bothers me quite a bit. If a person has a mental health problem, suicidal tendencies, and does not accept help or treatment, can that person be forced into treatment or care? Whether a veteran, a Canadian Forces person, or a civilian, can that person be forced into care?