Veterans Affairs Committee on March 2nd, 2011

[Dr. Marvin Westwood]

So far, we've focused primarily on support coming from the other soldiers who've been to the program. The community groups have shown interest and want to support this, but it's mostly in terms of contributing money. I haven't done an outreach program in the community like that, except through community awareness. I'm often speaking in the local community or being invited to speak about this, but not in a formal way.

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

We've been dealing with the transition from active duty with the Canadian Forces to Veterans Affairs in regard to how they fit into the department and all the different programs they have to support the veterans. Would you say you're focusing more on that transition from active duty to civilian life and how they fit into society?

[Dr. Marvin Westwood]

Yes, I think you're right. There are folks in the transition program...it does include symptom reduction, but there's a need for assistance in transition to get them connected with their families and headed toward being re-employed or getting a new job and so on.

But we do process the trauma first. I need to say that. Our program has a little broader spectrum than just symptom treatment. Let me try to explain it this way. When people have psychological injuries from trauma, they cannot do anything until that's repaired. They come to our group and have symptoms such as flashbacks, intrusive thoughts, depressive reactions, inattention, and so on. Their families are fed up with them and they are going to get fired from their jobs, so we have to say, “Okay, let's get this symptoms management reduced first”. They call it dropping the baggage, and that often means telling stories of what happened to them, of what they witnessed, what they saw, and of what they have to let go.

Then they have relief from the intensity of the symptoms and they can concentrate on getting their families back. They can say: “I want a life. I don't want to live out in the bush country in a cabin by myself with an ammunition store. I want to come back into the community”.

That's what I really want to convey to the people today: that the psychological injury from war-related traumas is so serious around disorganizing people's ability to function. They can't do anything, so it's not helpful to offer courses or training until they drop the baggage and engage in trauma repair. Then they can move on. I know that's a long answer to your question, but that's exactly how the transition program works over the three months.

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

There was one comment we had from our witness from the forces in Australia who deals with PTSD, and especially suicide amongst veterans. The statement was made that a lot of the stress...or that of those who committed suicide, only one-third of them actually saw active combat duty, and that a lot of the issues around suicidal tendencies were more about things like marriage breakdown, financial issues, and tragedies in their lives that sort of manifested themselves in their lives. They weren't necessarily connected to their combat duties.

[Dr. Marvin Westwood]

No.

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

Do you find that at all?

[Dr. Marvin Westwood]

Yes, we absolutely do. Drug addiction is one of the symptoms of people who are traumatized. It's a cascading or domino effect. They cope by trying to self-medicate; that's one thing. But if depression sets in and they're not treated.... They may not have seen active duty; they could have been traumatized by what's called “vicarious traumatization”, or secondary traumatization, by what they witnessed. That's a whole group that we don't really understand, but if you serve overseas...if you're in Afghanistan as a soldier, you may not be involved in direct face-to-face combat, but you can also pick up a certain amount of trauma just by the exposure of what you experience.

When they come back to Canada, I think you're absolutely right that we take very seriously that they...we look for acute depression that leads to isolation and that leads to giving up. People commit suicide in a number of ways, it has been my experience. They may commit suicide in an aggressive and active way, but some people just get really sick. I'm speaking now as a psychologist. They just give up, they get illnesses, and they die--and they die because of that.

I think that it's quite complicated, too. When you talk about suicide, I'm more concerned about all of the stresses our soldiers have before we have suicide ideation. I'm concerned about the risk of addiction, acute depression, isolation, becoming unproductive, and losing all the supports around them.

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

Would there be any possibility--

[The Chair, Conservative, Gary Schellenberger]

Excuse me, Mr. Mayes. your time is up.

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

Okay. Thank you.

Thank you very much.

[The Chair, Conservative, Gary Schellenberger]

We should have a little time later.

Ms. Coady, please.

[Siobhan Coady, Liberal, St. John's South—Mount Pearl, NL]

Thank you very much.

You had a good line of questioning from my honourable colleagues. One of the things that I thought was interesting, which the previous speaker talked about, was lifelong care for the veterans and how that's what we're trying to achieve. We're trying to get to that point.

Mr. Westwood, this has been a very interesting topic this afternoon. You're bringing up the idea of this lifelong care and the fact that we have to do some trauma repair. I want to tell you about a case from St. John's, Newfoundland that I was dealing with. His name was Joe Hawco. He was a peacekeeper and, during his tour of duty, he had a number of peacekeepers die in his arms. He was in a fight and, unfortunately, there was loss of life.

The man went through his life. He had some issues, but he did make it through his life. When he turned about 70, the family started to notice a change. It was noticed that he was having more dementia, if I can say that, and eventually they thought it was Alzheimer's. So because modern-day veterans do not have access to pavilions, he ended up in a mental hospital in St. John's. He couldn't be held in an Alzheimer's unit because he regressed to when he was in the military serving as a peacekeeper, and he could actually pick the locks of the Alzheimer's unit.

I have two questions here. First of all, could you could talk about some of this trauma? When you've been tracking the success over the 14 years, are you finding that those later in life are not having as many challenges? Would it have any effect on the possible later onset of dementia? Two, could you answer that question of whether you're seeing any relationship?

The second question is about the veterans pavilions. Right now, we're housing modern-day veterans who are now growing older. As I said, Mr. Hawco was in his seventies when he passed. He died in the mental hospital, actually. I wonder if you could address where you think the best care is. Do you think there is some other mechanism or means to treat people in later stages of life who don't have access to the veterans pavilions? I'm concerned about that, because they are regressing to when they were soldiers.

I'll leave you with those two questions, if you could answer them, please.

[Dr. Marvin Westwood]

Okay. You've said something that we have observed, which is that if you don't get trauma treated when you're younger, you will have symptoms later in life, and it increases near the end of your life. They are troubled by that. They start getting flashbacks. As you've said, it can be confused with dementia, and so on. I think it's the evidence of untreated trauma. That's why we want to—on the advice of our World War II veterans—offer a chance for them to drop this baggage when they're younger.

So how do I see going forward with this? I would say one of the best treatments for older vets is to be in the company of other veterans who have some paraprofessional training. Where do veterans feel most at home? They feel most at home among those they have served with. Going forward, what I'd like to see is the government agencies working with community agencies or public programs like ours in the community to support these people. It isn't a one-shot treatment.

Your suggestion has interested me in coming back to that as a focus that we might consider out here: how do you ensure the support of older veterans who've had trauma? My answer? Keep them connected with other soldiers. That's what they appreciate. Whether it's pavilions, or if VAC does that, or colleges and universities set out to help create these groups, I think that's one of our best bets. Because that's where they feel at home.

[Siobhan Coady, Liberal, St. John's South—Mount Pearl, NL]

Well, thank you for that, because I think you're absolutely right. What ended up happening with this particular soldier.... As I said, it was very traumatizing for him and very traumatizing for his family. He was in a place where he could not relate to those around him. When soldiers would go to visit him, he could absolutely relate.

So I would suggest that even those who have passed the 65-year mark, let's say, still may need to have that trauma addressed.

[Dr. Marvin Westwood]

Absolutely.

[Siobhan Coady, Liberal, St. John's South—Mount Pearl, NL]

Now, on one of the things you talked about, is it possible to roll out a program like yours across the country?

[Dr. Marvin Westwood]

Let me just say that we've been quite careful in doing our program, studying it, and evaluating it over the last 10 years, and we're now in a position where we have received money to develop increased capacity by training more people to deliver this program. My answer is, yes, it could be, but it has to be the kind of program where people would be trained. I think that personally I would feel some responsibility in training them, supervising them, and being very careful that they are the right people.

Then they could go to Nova Scotia in teams--we've had requests from Nova Scotia and from Ontario--and they would be funded to go, because this requires high expertise. This program can never be “manualized”. Some programs and treatment can be: there's a manual and you can give it to workers in another city to do it. This requires a lot of sensitivity to the existing symptoms of trauma. We are trained in that and I train my people to do that.

So the answer is yes. We could send teams out to the various regions of Canada, and then link to the locals to join in at that time, and they would carry on with the support following the delivery of the program. That would be one of my goals. I'd like to see that happen so I really appreciate the suggestion.

One of the things I wanted to say is that I think people were critical of our program at first, and I think...[Technical Difficulty--Editor]...guys would say, “This is great, it's been three months, I'm okay now”. Then they would disappear. No, we don't do that any longer. They need to be followed up. I think it can be delivered, but we have to be responsible for training the workers in this profession. Running groups of traumatized men and women--and in our case, it's mostly men--is very complex work. You need to have a lot of skills and I'd feel more confident knowing they were well supervised.

[The Chair, Conservative, Gary Schellenberger]

Thank you.

Mr. Storseth, please.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

Thank you very much, Mr. Chair.

Thank you, Mr. Westwood, for your presentation, and thank you for the dedication you have to our men and women in the Canadian Forces, our veterans, and our police officers that you help out.

You hit a whole bunch of things that I think were very good. One thing I would like to follow up on is the culture our military has. Have you noticed a change? Obviously, Veterans Affairs and DND have tried to change to address this culture a little and make mental health awareness something that's more top of mind and more accessible. Have you noticed a change in the culture?

[Dr. Marvin Westwood]

I've noticed that there have been attempts within VAC, and I think the Canadian Forces and a number of people have attempted to change the culture by bringing up these issues earlier. I find soldiers resist listening to that because, when they come back, one of the characteristics of trauma is denial: that doesn't apply to them, or they don't need that, or that belongs to somebody else, or someone else has that weakness.

But here's what I have noticed. You may know Stéphane Grenier. I've met with him a couple of times. He's a former service person and is working I believe in VAC. He's having some success in introducing to the younger soldiers the information and psycho-education: If you go overseas and serve, you could take and sustain an injury called an occupational stress injury. So they are e attempting to do that, but what I find with the young guys is that don't take it up because soldiers in the military strongly believe “I'm all right, mate”. They believe they're invincible, they're strong, and they don't need that. There's a psychological resistance there.

Well, as I said before, the people they will listen to will be other soldiers who come back who meet them and spend some time with them. These are sometimes what I call “alpha soldiers”. Alpha soldiers are soldiers who have been through our program and who are highly respected in the community because they had an honourable firefight in Bosnia or they were heroic in Afghanistan. Their status is very high in the regiments. But some of them are a part of our program and soldiers will listen to them. That's what I see. There is some movement, but not as much as I would like.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

I represent a rural riding with a couple of military bases in it. One of the concerns in my area is access to treatment. Sometimes your treatment meetings can be 15 to 20 minutes long, but it's a three-hour drive to a place to access them. Is this a concern you share as well?

[Dr. Marvin Westwood]

I absolutely do, and I would never actually offer that kind of service, because notice that I said that ours are 10 days or residential; you really can't effect much change at all in such a brief meeting. People need support. One of the healthiest kinds of support we have is groups. Groups are the best place to get support from other people such as your peers. When soldiers are with other soldiers, and the soldiers have been somewhat trained, they respect and trust them totally. They go to them for support more than they go to us. I think that there are possibilities for developing groups that are sustained and ongoing that soldiers could go to.

At the beginning today, one of the people said that it's kind of like AA. AA is well known in our society. Who helps people with alcohol addictions? AA has been a very strong force. I'm not proposing that model. I'm proposing a model that joins the best expertise we see in VAC, the universities, and the medical clinics with the soldiers who are being trained so that they can offer something outside.

Why? Because if they don't get treatment, they avoid getting the services they're entitled to, and they won't even go near the VAC offices when they feel that way.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

Thank you.

I have just one more quick question for you. There has been a tremendous number of changes to programs. The government is trying to address some of the issues we've been talking about. In your mind, how knowledgeable are the soldiers you're talking to about the changes that have been made to programs or about additional programs that are available?

[Dr. Marvin Westwood]

Well, I'll tell you, I don't think they're really very aware, because so many of them report having not positive experiences with VAC, unfortunately. Even if they are, I think they're a bit suspicious. But OSISS workers--volunteer counsellors who are former serving soldiers--I think are making a good attempt to reach out to the soldiers and explain. I notice that some of the soldiers we work with will trust an OSISS worker if they know that he has served before in the military. I think that's progress.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

Thank you.