Veterans Affairs Committee on Nov. 29th, 2011

[Charlotte Stewart]

Certainly for those who've served in the military, the military culture and the military family have different characteristics from what you would have in civilian life. Those who have moved in civilian life have had different opportunities, moving between different employers and making career choices fairly independently of their employers. Within the military, your career is very much overseen and directed within the military culture and military personnel management system. The pride and affinity of serving members to their regiment is very profound. As young people enter the military, that becomes their home. They're given a lot of guidance and direction within the military. Those outside the military, as I said, would make more independent decisions, no doubt, over time.

I think what we have found is that over time, the military culture has a very large impact on individuals, and it's extremely important to them.

Yes, those who have worked outside the military culture obviously have had different life experiences. Obviously they've also had work opportunities that were extremely important to them. But I don't think you can underestimate the impact of the military culture. What we find is that as releasing members begin to prepare to move out of the military, there's a sense of wondering, “What's out there for me?” Within the military, it was fairly clear to them, throughout their whole career, what their progress might be, who was in charge, etc. Outside, there's a far greater requirement for them to take the steps needed to make independent decisions.

That's the cultural issue that we, in Veterans Affairs Canada, want to assist the member with. In Veterans Affairs Canada, for instance, all employees are working on taking cultural awareness and Canadian Forces awareness training. We're also working on ways we can reach out in a way that is culturally attuned to the military. We recognize that special element of serving in the military, which I do believe, from our findings, and certainly from speaking to the military members, is unique to that experience.

[The Chair, Conservative, Greg Kerr]

Thank you very much, Ms. Stewart.

That ends the first round of questioning. As we start the second round, we have a fair amount of time. We're trying to be fairly expansive, I guess you could say, in allowing time.

We have two people on the list for the second round, so we'll start with them. If there are any others, perhaps they indicate so.

We'll start with Ms. Papillon, for four minutes.

[Annick Papillon, NDP, Québec, QC]

First of all, thank you for being here today.

I have a few questions concerning the New Veterans Charter. I know that you meet with the Royal Canadian Legion approximately once a year and as often as necessary, and that is a good thing. You have perhaps been made aware of the fact that, with the New Charter, there have been cases of mismanagement of the lump sum by new veterans. I have heard about a situation that, I am told, occurs quite frequently, much too frequently in fact. When returning from combat or from a mission, some veterans buy a house, get married and, unfortunately, because they are veterans and face numerous problems, their wife leaves them perhaps a year later and gets half the value of the house. I hear about this.

Sometimes, this lump sum seems to create certain problems. Has this issue been brought to your attention? Will you be taking steps to ensure that the lump sum doesn’t disappear too rapidly, as apparently, it does?

[Bernard Butler]

Thank you for your question.

Thank you. The issue of the lump sum being mismanaged in certain circumstances has been a concern for the department. About 18 months ago, the department looked at that question very seriously. We conducted a survey of veterans who were receiving the benefit to try to determine how it was being spent.

For the most part, it would appear that the money was being spent wisely. There were a few cases, particularly cases in which individuals may have been suffering from serious mental health issues perhaps or had other issues in their lives, where that might have put the individuals at risk.

The decision at the time, and what has led us to make enhancements to the lump-sum payment award, was basically predicated on the assumption and principle that veterans have the right to choose. It's a fundamental principle that veterans should be able to choose how they spend their money, unless they are not competent legally. If they are competent legally, they should fundamentally have the right to choose. That's one principle.

In that process, we determined that that some individuals would profit greatly from having financial counselling about managing the money. The department provides up to $500 for any individual receiving the lump-sum benefit to receive counselling on how it is spent.

Another consideration is that these large awards are only paid at the point in time that the individual's health conditions supporting the award are stable. There are checks and balances in play to try to ensure that the money is used appropriately and that we don't find ourselves in the situation you described, which would be most regrettable and unfortunate.

[Annick Papillon, NDP, Québec, QC]

How do you make sure that this competency exists? How can you be certain that the veteran is competent to make that choice?

[Bernard Butler]

It would depend, I would submit to you—and my colleague Charlotte may have an additional comment on the service delivery side—on the nature of the disability. If an individual is pensioned for a condition that would give rise to a question of their competence from a legal point of view, then we would have to inquire into that. But for the most part, it's simply a question of personal choice. What you might choose to do with your lump sum might be quite different from what another individual might do with their lump sum, without necessarily meaning that one is a wrong choice. It might not be the choice that you would make, but that doesn't make it the wrong choice for the veteran.

[Annick Papillon, NDP, Québec, QC]

So, you take this competency for granted—

[The Chair, Conservative, Greg Kerr]

Thank you, Ms. Papillon.

We now go over to Ms. Adams.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Thanks very much.

Since the implementation of the new Veterans Charter, we have talked about that charter as being a living document. Of course, there were enhancements made to the new Veterans Charter, but we keep hearing from veterans who say that they're dissatisfied with the VAC's service or that VAC isn't meeting the needs of veterans.

Does VAC have the capacity to meet the changing needs of the veteran population?

[Charlotte Stewart]

Yes. It is our mission to meet the needs of our veteran population. That is what we're all about. We take any concerns that are heard very seriously, and that is in fact the reason for our embarking on a very ambitious transformation agenda.

To bring it into real terms, when we ask veterans about their concerns, we find that they need to know they're going to be able to work with someone in Veterans Affairs Canada one on one. They need to know that they can have access to people in Veterans Affairs Canada who can provide them with professional counselling, case management services, etc.

We have taken steps to ensure that this access is in place. We have more than 300 case managers who provide this front-line service to those veterans who need the new Veterans Charter. They are well trained. They're located where they're needed, in areas of high demand. We put more on the bases, and we've taken steps to reduce their workload so they have the time to deal with complex issues and cases. We manage their workloads very carefully. The whole point of this, of course, is to make sure that when someone with a need comes to Veterans Affairs and is eligible for services under the new Veterans Charter, we have taken steps to ensure they will have access to the people who can help them get those benefits and services.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Thank you.

Now, when a veteran does get ill, the family steps in and is a critical help to the veteran. What is VAC doing to support families?

[Charlotte Stewart]

That's one of the cornerstones of the new Veterans Charter and one of the characteristics that makes it such a powerful program, because veterans can be part of the process. For instance, as I mentioned, when veterans are injured and need case management services, they'll meet with the case manager and get an individualized case plan. The spouse or common-law partner is encouraged to participate in that as well. Typically, the interviews, the discussions, and even the development of the plan would incorporate a family member.

Family members, depending on the needs of the veteran, can also receive direct support. If part of the veteran's need is to get psychological counselling to strengthen some element of their family life, the spouse or common-law partner can also participate in that if it's directly linked to the veteran's need. Beyond that, family members have access to operational stress injury clinics. They have access to our OSSIS network, which is more of a peer support and family support network across the country. That's where they can meet with people who are facing similar issues to their loved one's. We have a 24-hour help line. Family members can call at any time and voice a concern or raise an issue. Obviously, our protocols around privacy are clear in that regard.

There are a lot of supports for the family.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

What type of response time can the family expect if they call that 24-hour help line? How quickly are they hearing back?

[Charlotte Stewart]

The purpose of that is to get the help very quickly. Once the call is made, if there's an issue for the client, it is directed to the district office that is closest at hand, and the individual would expect to receive a call back the next day.

[The Chair, Conservative, Greg Kerr]

Thank you very much, Ms. Stewart.

Now, Mr. Genest, for five minutes.

[Réjean Genest, NDP, Shefford, QC]

Good day.

As you know, veterans are facing a whole new problem. In fact, today, our armed forces not only protect, they are also involved in wars, in particular, in Afghanistan. The war in Afghanistan has been very hard on our soldiers. I know it because this situation has had an impact on certain members of my own family. One sees a physical wound, but it is hard to have a sense of the distress caused by post-traumatic stress. A soldier that has been two or three times in Afghanistan can have had enough and decide to give it all up. Usually, a military career lasts 10, 15 or 20 years, but a soldier can decide to put a stop to it because of the very difficult situations he has had to face. Very often, soldiers feel they don’t have the right to demonstrate any kind of weakness, particularly on a psychological level. The army frowns upon any kind of psychological problem.

Do you have a service that allows you to determine if a soldier has a problem, particularly some form of distress related to post-traumatic stress? What kinds of services are available? Sometimes, soldiers in distress make bad choices when it comes to benefits. They don’t know if they should choose a lump sum or a series of payments.

Provincial psychiatric hospitals aren’t able to identify the problem. You are getting rid of military hospitals, but military psychologists are the ones who really have a handle on this problem.

Given all of these facts, how do you think you will be able to really help veterans, how will you ensure that they are able to overcome the problem and adapt to civilian life that is so different from military life?

[Charlotte Stewart]

Your question speaks to a very important issue facing those who are leaving the military today. The important element here is that mental health, including PTSD, is an issue that is very complex and the response to it and the way that we work with it is multi-faceted.

When someone is about to leave the military, even if it's a career that they've loved and enjoyed, as they begin to transition out, especially if they have a post-traumatic stress disorder or any other disorder, they typically would have been case managed within DND before they leave the department. As they are transitioning, the case manager, who is a nursing officer within DND, would have been working with them to give them the support they needed. For most of those individuals, that begins when they are in DND; it doesn't start when they come to Veterans Affairs Canada.

In the military they've made a lot of progress in opening up discussion around issues like this, as has society in general. Mental health is beginning to be treated more openly as an illness like any other. So in the military it will be recognized and they will begin to get case management services. When they transition, the partnership with VAC means that we will find out more about that person before they leave. We'll know a bit about their history and some of the issues they're facing. They likely will have been receiving treatment within the military. When they transition to Veterans Affairs Canada, we work with them in a transition interview to make sure that we bridge the services to the extent possible, so that they come to us in such a way that we're supporting them at the point when they leave. So, as soon as they leave, we're able to support them from that step forward.

Our case managers are trained to understand mental health issues and post-traumatic stress. If an injured individual doesn't want to share that, our case managers are trained to use certain cues and certain questions to try to elevate the issue or tease it out and find out more. It's becoming very much a part of the day-to-day work of our case managers.

Once they have identified that the individual is looking for help, the person will have access to a full range of treatment, be it from a psychologist, psychiatrist, clinical care managers, or people in the community who provide very customized service for post-traumatic stress. Beyond that, we can put them in touch with the peer support network I spoke about a moment ago. It consists of about 26 individuals across the country who have gone through the same thing, who have had a military career, left it, and suffer from an operational stress injury—an umbrella term that includes PTSD and other anxiety issues, etc. They can have peers give them counselling and support.

At the end of the day, there's a rehabilitation program designed to help that individual become stabilized with their PTSD, to understand it, to get the support they need, and to engage their family fully in it because that's going to be key. Our goal is early intervention. The sooner we get access and conversation going with the individual, the greater the chance of success.

We have about 14,000 clients of Veterans Affairs who have mental health issues, and upwards of 10,000 of them have post-traumatic stress disorder. It's becoming very much front and centre in our world. With our research colleagues in Bernard's area, we're finding out more and learning from other countries about what they're doing. So this is all coming together to provide the kind of support that these individuals would need.

When they are in treatment for this in Veterans Affairs' rehab program, there's no time limit on that. It's not like they come into a rehab program and they have six months to get better. It's not like that at all. They take the time they need, and that's a cornerstone of the new Veterans Charter. That's a policy that exists now that was not available to us before this charter was put in place.

[The Chair, Conservative, Greg Kerr]

Thank you very much Ms. Stewart. We let it go on a little long, because it's a very thorough answer. We appreciate that.

That ends the second round. We did say we had the witnesses until 10:15. If it's the will of the committee, we could go around and take a quick question from everybody before we go into committee business. I'm just going to go by a show of hands, and then I can sort the time out.

I see five people. We don't have time to have questions from them all unless it's a 30-second question.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Okay. Who is on for the first round ?

[The Chair, Conservative, Greg Kerr]

It depends how long.... We can go with one short question.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Do you want to do four, two, and one, then?

[The Chair, Conservative, Greg Kerr]

We'll do the same as in the first round, but we'll shorten the time so that we get out of here at 10:15. So you really have about a minute for a question and an answer, or a little bit more.

Is that agreed?

[Some hon. members]

Agreed.

[The Chair, Conservative, Greg Kerr]

First is Ms. Mathyssen, and as I said, just one question, please.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you very much, Mr. Chair.

Basically this is a request. A lot numbers are swirling around concerning pensions, benefits, and lump-sum payments. If possible, I would like to have a chart, please, outlining the monetary benefits and the criteria used to determine those benefits, so I can see the various categories and what is available by way of financial support and pension benefits.

If that's possible, I'd appreciate it.