Veterans Affairs Committee on April 20th, 2010

[Sandra Pickrell Baker]

My thesis is available at Theses Canada. I have a copy I could leave, if you'd like, but it is published on the Theses Canada website. As I said, it was part of my master's degree, and it's a published document.

[The Chair, Conservative, David Sweet]

That would be best. We'll then have it translated. The clerk will obtain it from the Internet and distribute it to the members.

[Judy Sgro, Liberal, York West, ON]

It must have been a very emotionally difficult program to do.

We've talked about all of these different things. We're doing everything we can to make sure the messages get out there. But as Mr. Stoffer pointed out, in spite of everybody putting out all the information they can, people often don't know about it. We hear about debriefings and all that happens, and it amazes me that there are so many people who are somehow unaware that the service is there.

I've always been of the mind that we should look at all of our men and women coming home as automatically suffering PTSD in one form or another. There's no way you can go through some of these experiences and then come back and tell me you're the same person you were when you left. It's probably a huge step to ask anyone to take, but it would seem to me that we would be smart to assume these individuals no doubt have this and to start offering support to individuals and their families right off the bat.

[Sandra Pickrell Baker]

Then you could determine whether that needed to be extended or whether the debriefing was enough. But again, some of the people I read in my literature review said that even witnessing 9/11 on the television changed everybody, because trauma changes who we are. It changes whether we feel safe in the world and whether we feel our families are safe. So being over in Afghanistan or Bosnia, or any of those places where there is trauma, does change who we are and our perception of our world here.

Whether that's going to become an operational stress injury or not, we don't know. It might happen 18 months after they're home, but at least if they were screened or had the opportunity to explore the fact that it's normal to have this traumatic experience change how you feel about who you are in the world and how safe you and your family are, then it would also open the door to the possibility of seeking help in the future. It's just about giving them the opportunity to be self-reflective and to do an assessment of how their life has changed, and then I think they probably would be more likely to seek support if they needed it—and certainly the family would.

One of the things I heard from the families was that the pieces of information might be coming through the door, but they're not making their way to the partner, whether because the information gets recycled in the trash or because of denial on the veteran's part, who says, “Oh, that doesn't apply to me.” Who knows what it is? It's unfortunate. Again, it was frustrating, because I knew the people at OSISS were willing to offer support. I was frustrated with the trauma treatment centre, because of the need to get a referral, but OSISS was there, and these veterans didn't even know what OSISS was, let alone that they could access support.

[Judy Sgro, Liberal, York West, ON]

That's amazing.

Mr. Zimmermann, I was fascinated to listen to you and all of what you've been through in your lifetime and how you responded to your own injury initially.

I'm not sure that it's mindset simply because we're dealing with the military. Nonetheless, it would seem logical that once you have been in the military, you are an employee of our country forever, and that doesn't end the day you're discharged or the day you end up getting your disability rectified, but somehow you continue to be the responsibility of the Government of Canada to some degree or another.

But you've managed to talk about the core principles that should guide what we're trying to do today, optimizing all of the opportunities and looking at partnership. Again, I don't know if it's a consequence of all the military ideas in our heads, but it would seem to me that any logical organization would be partnering with other organizations. All of it would not have to be all self-contained within the military, that just because you're in the military everything has to be done through the military.

Why weren't we already working on partnerships, like what has been going on in B.C., with all the work you have done?

[Wolfgang Zimmermann]

That's an interesting comment. I think in part you've hit the nub of it, which is really the whole notion of the military family and that individuals want to stay within that military family. At the same time, I know enough veterans and enough processes, and there's the example I mentioned earlier, where DND has successfully created a partnership with rehabilitation facilities, so you're not starting from scratch. I think that opportunity exists and I think this is also well understood.

I don't know that there is really a need, because when I look at individuals who have been discharged, are outside of the system, and all of a sudden have to deal with a case management organization, such as the one that's being employed here that was hired from the U.K.—from what I understand, they didn't even have a base in Canada before they started—there's really no difference to that. I think there's a great opportunity to be far more structured in that regard, and you have some good models to follow.

The other part is that the government absolutely has a responsibility as the employer, in my view, and has the opportunities. It's not like we are asking a small retailer around the corner to have a responsibility. We're talking about a huge agency that employs 220,000 individuals in a whole cross-section of jobs. For those of us who are in the business, if you will, or work in the area of accommodation and trying to optimize opportunities for individuals.... Essentially we all define and identify ourselves with the work that we do. It's unfortunate, but the reality is that who we are and what we do is a large part of our sense of self-identity. It's our sense of being able to contribute and to be able to continue supporting our families. If we can't do that, obviously the corollary is, and continues to be, all of the social and psychological issues that Sandra talked about and the impact on the families.

The government is the employer. In my view, it has an unequivocal responsibility, much like how we as employers in the private sector have an obligation. We have the duty to accommodate, as do so many other organizations that recognize they have a responsibility and that it is in their best interests, it is in our society's best interests, to maintain the productive and human capital of every individual, and not focus on what may be, in some cases, a minor disability and ignore the fact that we all have abilities regardless of who we are and what we do.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann, and thank you, Madam Sgro.

We're now on to Mr. Lobb for five minutes.

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

Thank you, Mr. Chair, and I thank the witnesses for appearing here today.

Mr. Zimmermann, with your extensive experience, what do you see as perhaps the top three suggestions you would have for this committee to take back to improve or enhance the new Veterans Charter as it is today?

[Wolfgang Zimmermann]

I would look at improving the holistic outcomes in terms of rehabilitation. I would suggest you consider, at the very least on a pilot basis, entering into a relationship with one of the workers' compensation boards. The level of service, the caseload that individual case managers in the current system have, is absolutely unsustainable, and in my view having caseloads in the hundreds, if not higher, does very little for the individual. So I would look at that as one strategy.

The other thing is that I would absolutely revisit the whole question of being able to accommodate disabled veterans within the federal government, within some of those departments of the federal government.

The other challenge you have as well--and this is a third opportunity--involves those individuals who have been out of the workforce for a long period of time and have in fact moved to the margins of society. You have to look at what type of rehabilitation strategy you might be able to apply. One of the challenges you have is that the longer you are out of the workforce, the less likely it is you will ever get back into the workforce. The evidence is overwhelming.

We also know that if somebody's been out of the workforce for two years, there is a 10% or less chance that he'll ever go back to work. There is some significant global evidence and some individual case studies that unfortunately support that. Nevertheless, that does not apply universally.

We have been able to get individuals back to work when they have been off work for 10 or 12 years or longer, because their circumstances have changed and the opportunities that exist have changed. The trouble we have is that when you have somebody who goes off on long-term disability, they're out of sight and out of mind. They're forgotten. You're out there, somewhere in the system, and it's really the individual and the individual's family who have to deal with that.

If I may make one further suggestion, I would seriously look at something like the Canadian Council of Chief Executives as a way...because they represent, by and large, large organizations that have the capacity to hire individuals with disabilities, as a way to promote these individuals as a whole new pool that might go there.

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

There are two other spots I want to look at, but I don't know if I'll have enough time. One is the on-the-job placement part. I think I read somewhere or you mentioned something about the university degree being a barrier to entry.

[Wolfgang Zimmermann]

That's right.

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

Certainly, many of us around the table have post-secondary degrees of some sort or another. One thing that does is teach you how to memorize things and write them back down on pieces of paper, which certainly doesn't mean you're going to be a great employee. Many people who don't have post-secondary degrees are what I call the can-do people. They're the ones who certainly know how to get the job done.

What are your thoughts on that? Obviously, it's not really feasible for everybody to go back to university just to qualify to get a job. What do you see, or what have you seen in your past experiences, as being a good avenue to go down or to explore this so that our veterans, who obviously have a great set of experiences and knowledge, wouldn't have to necessarily do this?

[Wolfgang Zimmermann]

You see this with a number of universities that are in the process of developing different types of prior learning assessments to establish some level of equivalency in terms of what that means.

I look at Ryerson and their disabilities studies program. They have created a process of recognizing prior learning and prior experience as a contributor towards admission to a degree. Royal Roads University in Victoria has done exactly the same so that individuals who don't actually have an undergraduate degree are able to get into the graduate program. So there are a number of ways to be able to do this.

It's a function of somebody saying, how can we come up with an effective prior learning assessment to recognize this, and then what is necessary for this individual to be able to fit into those positions?

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann. Thank you, Mr. Lobb.

Now we move on to Mr. Vincent for cinq minutes, monsieur.

[Robert Vincent, Bloc, Shefford, QC]

Thank you, Mr. Chair.

I would like to continue with the theme of rehabilitation. You mentioned health and safety at work and talked about the CSST. We do rehabilitation to a degree. An individual is accepted according to his level of education. If he has already been to university, he can continue his studies in some other field of interest. On the other hand, someone who has only finished the second year of high school, enlists in the Armed Forces and becomes disabled, cannot be accepted. That depends on the degree of disability. Clearly, 5% disability is completely different from 90% disability. At that level, some training can be given.

Could you tell me what is being done now, and what you would recommend? You have both identified the problems, you have put your finger on the problems that we are facing now. What do you recommend? We must not let the Canadian Armed Forces do your thinking for you. I am not sure that it would go very far, as far as thinking goes. You have to live with these problems; what would be your recommendations on the matter?

I have seen that 75% of the people were in rehabilitation. The program lasts from 18 to 24 months. You said that you did some training with companies. Have you thought of paying a certain amount of money, of paying the person's salary while they are learning?

We know that self-esteem is really important, whether it be for someone who has had an accident or an injury. Leaving people alone, even with 75% of their salary, will not create self-esteem or encourage them to find a job. They have to be told that they are capable of finding a job. At some stage, we must let people fend for themselves. At the moment, we want to look after people and do their thinking for them. We tell them that we will find them a job and that if they do not have the skills, we will train them. At that point, there is no self-esteem any more. There is no self-esteem when we find the jobs for them.

In your opinion, what should we do to change the Veterans Charter and to give veterans the self-esteem that will let them go out and find a proper job?

[Wolfgang Zimmermann]

One of the things I would do as a first step is also what a number of large organizations--for example, Ford Motor Company--have done, which is to take an inventory of current existing jobs. In other words, what are the bona fide occupational requirements for the jobs we're looking at? If you're looking at disabled veterans, there are a range of positions that would be suitable for them and that they could basically get into.

Then at least you have a baseline of knowledge. As you probably sense, I'm a very strong advocate of maintaining that immediate attachment to the workforce so that the individual doesn't “break service”. The first step has to be to look at the bona fide occupational requirements.

To give you a sense, if I can digress for two seconds here, we did this in one of our pulp mills. We looked at every single position and the bona fide occupational requirements and the physical requirements for the individual to be able to get back into a job; then we looked at the skill sets, experiences, and capabilities of the individual to see which job that individual might fit into.

When you're dealing with physical injuries, you simply look at the position, you look at the current capability, and you look at what is out there in terms of current assistive technology. Our technology has come so far today that there are very few jobs that couldn't be done. Obviously, as Sandra pointed out, if you're dealing with a mental health issue, different intervention strategies are necessary.

[Robert Vincent, Bloc, Shefford, QC]

In the Armed Forces, if an employer needs a workstation to be changed, to adapt the workstation to the veteran's disability, is that possible? Can that be done?

[Wolfgang Zimmermann]

I honestly can't answer your question about what happens within DND. I do know that the biggest challenge currently is the interface between the Department of National Defence and Veterans Affairs, that individuals stay too long within DND even though they are not being permanently accommodated. In many cases we have lost the window of opportunity for them to be reintegrated, because there is a significant drop in long-term return to work rates once one is beyond six months of work. And that is a significant challenge.

About what is happening inside DND, I'm sorry I don't have any knowledge of that.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann and Monsieur Vincent.

We will now move on to Mr. McColeman for five minutes.

[Phil McColeman, Conservative, Brant, ON]

I, too, want to add my thanks to you for being here today, certainly in terms of the extensive knowledge you both have in your fields. It's very impressive and you've given us a lot of food for thought.

Ms. Baker, in your research, which has obviously been very specialized, have you looked at parallel situations? What I'm thinking about specifically is whether you have looked at how similar this is to families who face disabilities outside of the military, who perhaps have a child who is born with multiple disabilities. Is there any of your research that has taken a look at those parallel communities?

[Sandra Pickrell Baker]

There certainly is a parallel, again, to families who have a child born with a special need. There is again the ambiguous loss, because the dreams you had for that child--and in my experience with my daughter with her injury--and the reality are very different. It's not that you don't love your child, but the system again has to adjust and adapt around that, and we need resources to manage that.

[Phil McColeman, Conservative, Brant, ON]

Going a step further, in most communities there are resources that are established by both health care systems and community support groups. Are they meeting the need, in your opinion, or not meeting the need?

[Sandra Pickrell Baker]

In theory, there are resources in all communities for support. In reality, that's not the case. I can't speak to any other province, but in Nova Scotia for sure there are areas that are referred to as black holes of service. There is just nothing available. It is underfunded, underresourced, and the resources that are there are so stretched beyond capacity, it's appalling.

[Phil McColeman, Conservative, Brant, ON]

I want to get the overall picture, because some of the witnesses we've heard and what we might take from their information, incorporating that into the review of the Veterans Charter, is that certainly there is a role for Veterans Affairs to play. We know that; that's why we have it. But there is also a role for communities to play, “communities“ meaning other support groups, other levels of government, both municipal and provincial levels of government.

I'm trying to get an understanding of being in that situation and having that dynamic happening. In the case of your rural example of obtaining access, if a family member is aware of it and they make a health professional aware of it, my experience has been that one would get referrals of some sort to some resources somewhere. Is that not happening in parts of this country?

[Sandra Pickrell Baker]

You might get a referral and you might be lucky enough to see somebody. In Nova Scotia it will typically take you two years to see a psychiatrist. That's outside of the military. A crisis might get you in a little sooner, but ongoing care is very difficult to manage. It seems to be that what's getting managed are absolute crises, because that's all there is time for. Anybody who isn't in an absolute crisis right now gets pushed to the side. Unfortunately, that is due to the lack of funding, both municipally and provincially. There simply aren't the funds or the resources.

You can go to mental health. The community has mental health outreach centres. Again, you're going to wait to see somebody, and the person you're going to see may not have what you need or the understanding of the special dynamics of a military family. The demands that are placed on those families are different from any other family. It's not that the person you see has to have an absolute understanding of military dynamics, but certainly they should have some appreciation that these families are stretched beyond capacity even in normal functioning, with deployment and posting, let alone adding a traumatic injury to that.