Veterans Affairs Committee on June 12th, 2012

[Dr. David Pedlar]

Carlos, do you want to speak to that?

[Carlos Lourenso, Director, Treatment Benefits and Veterans Independence Programs, Department of Veterans Affairs]

First of all, Mr. Chair, the department is continuing to ensure that its focus is on veterans being able to choose the channels of service that fit them the best. Things are changing. We know technology is changing and we know we're able to serve people in a variety of different ways. Veterans today are very different from veterans of years before. They expect to be able to be served in a variety of modalities, which means they expect to be able to go online, through the telephone, in person, and so on. Veterans Affairs is committed to ensuring we have all of those channels available to veterans.

In terms of being able to access a service face to face with the department, that service will continue in all areas where veterans need that service. In years gone by, veterans were scattered all across the country, in various points where there weren't service offices or district offices—they could have been in northern Ontario or in northern Quebec somewhere—and that would mean we would have people who would go visit them. That will still be the case in the future. We will always have points of contact where veterans can walk in and receive the services, and we will have points of contact where we will go out and we will meet with veterans, but we're making changes to ensure, as well, that we're cutting red tape, making things easier for them, and ensuring that all of those different service channels are available to them, regardless of the way they present to us.

[Annick Papillon, NDP, Québec, QC]

That, of course, is the point of view of Veterans Affairs Canada. It is cutting the number of public servants and thinks that every veteran is able to transition easily into civilian life in less than six months. Unfortunately, that isn't the case. When you listen, when you ask veterans in Quebec City, in Quebec, for their opinion, that isn't what I am hearing, and I am sure that veterans in Quebec City are no different from veterans in the rest of Canada. They are not getting services. They have told me that they never complained about services; they are only asking that there be more people to respond to their needs. They have never complained about the work of public servants, and salute their work, but they think that there aren't enough of them. So, imagine how it will be with the cuts that are under way in this area. It really isn't the right direction to take.

That is the message that needs to be put across on behalf of all veterans. They want to know that this committee and the department will take their needs into account. They are asking for more direct services, to speak to a person and not stay on hold after dialing a 1-800-something-Canada number. They want to speak to people and do not want to go from one case manager to another, and tell their story again and again to each one. They want to feel that they can trust the individuals who will remain in place and who will be able to provide them with services. That is the first important thing.

I'm wondering if you have a game plan for long-term health care, which continues to be a problem. Given the closure of the Sainte-Anne hospital, this will be abandoned. Have you thought about providing veterans with long-term health care?

[The Chair, Conservative, Greg Kerr]

Unfortunately, we're quite a bit over time. That was a very articulate presentation. I think it's on record. If any of you want to respond in writing to the questions, certainly we encourage that to take place.

Now we go to the very quiet and subtle Mr. Storseth for five minutes.

[Voices]

Oh, oh!

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

Thank you, my valued Chair.

I'm going to go back to the transformation initiatives.

Colonel Bernier, you've been here before, and I always appreciate your testimony. You talked about the stigma, though, and I think this is critical. I can tell you that Mr. Chisu is right—the stigma of the men and women who served in Bosnia and other places.... Certainly I've sat with them. It has taken them years, and they've suffered for many years before coming forward. We must strive to never have that happen in our country again.

There have been some great changes in the leadership of the Canadian Forces. Generals Natynczyk and Hillier have both taken on strong roles and are making sure they try to change that stigma. I take it from your testimony you feel as though the stigma has changed as well.

Do we have any indicators or measurements that show this is working, that the stigma is actually changing?

[Col Jean-Robert Bernier]

Yes, sir. In addition to the general cultural mindset that's palpable in the armed forces, where it is countercultural to not be supportive as a result of all of the education that has occurred to sensitize leaders, peers, subordinates, and individual members and family members to the signs, the symptoms, and the ways to obtain care, we have about five objective measures that demonstrate....

One is a study we did just two or three years ago, in which we found that only about 7% of Canadian Forces respondents would think less of another individual soldier who had a mental health problem or who presented with a mental health problem. That's quite significant, even compared to the civilian population.

The Royal Society of Medicine in the United Kingdom published a study comparing the stigma levels in five Anglo-Saxon and Canadian major allies—New Zealand, Australia, Canada, the U.S., and the United Kingdom—and found that the Canadian Forces had the lowest level of stigma among its service members.

The enhanced post-deployment screen that we apply to everyone is a very detailed and thorough evaluation for mental health and physical health problems. It's applied three to six months after deployments of about two months' duration. Formerly, at the time of the Canadian Forces supplement to the Canadian community health survey in 2002, we were finding that it took an average of 5.5 years before people would present for mental health care.

Only a couple of years ago, by the time of that enhanced post-deployment screening, three to six months after return from deployment we found that over half were already in care.

Finally, a U.S. researcher who is very well known and very credible compared U.S. data on stigma to Canadian data and found that levels of stigma in the Canadian Forces were about one-third of those in the U.S. military population.

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

Excellent. Thank you very much.

I have one quick supplemental question to that. Do we expect any ongoing studies? You may not know the answer to this, but is there an expectation that every five years, three years, or ten years there will be follow-up studies on that?

[Col Jean-Robert Bernier]

We have a long list of ongoing studies and planned studies, and it would probably take up more than your time to go over all of them. Some of them are quite significant, including a repeat of the Canadian Forces supplement to the Canadian community health survey, which will be next year. There is another health and lifestyle information survey. There are a wide variety of studies that will help us characterize the impact of the mental health programs that have occurred over the past decade, as well as to see where the current problems and the current needs are today.

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

I'm sorry. Go ahead.

[Susan Truscott]

I would just add that we also do surveys. One is called Your-Say. We do that every six months with military personnel. We also do ongoing surveys with spouses. We ask the member questions about things such as their level of confidence that the Canadian Forces will look after them or their family if they're injured.

It's another mechanism in support of those that Colonel Bernier mentioned, to have ongoing evidence about the confidence of personnel that the system will look after them.

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

Thank you.

You read my mind. My next question was going to be about family and spouses as well. That's excellent.

Lastly, Colonel Bernier, do we have anything to indicate that the remaining stigma is present more in any one aspect of the forces than in others—in the air force or the army versus the navy—or is it pretty much across the board at those levels?

[Col Jean-Robert Bernier]

The indications we have were that in the lower ranks there were higher levels of stigma, and, as it is in many of these kinds of things in the general population, levels of education are sometimes correlated. But we don't have extensive objective data on that.

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

I'd like—

[The Chair, Conservative, Greg Kerr]

Thank you very much for that, Mr. Bernier.

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

I just asked because I have both an air force and the PPCLI in my riding.

[The Chair, Conservative, Greg Kerr]

Now we go to Mr. Lobb for five minutes, please.

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

Thank you, Mr. Chair.

Ms. Truscott, Mr. Storseth mentioned that you read his mind. Would you care to enlighten the committee as to what else you saw when you read his mind?

[Voices]

Oh, oh!

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

Maybe that's an “after 5:30” answer.

One thing I wanted to ask was this. Mr. Bernier, you mentioned that the Canadian Forces had one-third the stigma level towards mental health that the U.S. forces had. I just wondered what the U.S. is not doing that Canada has done well. Help us to understand that, because it's important. It's because we're doing something well, but what are they missing out on?

[Col Jean-Robert Bernier]

I can't speculate, but there are significant differences in the way they have historically viewed and treated mental health conditions. Also, there are significant differences in the support provided to their troops and in the duration of their deployments, for example, and the frequency of their duration. There are just too many variables for us to pin it down to particular things.

But there are many differences in the way the U.S. runs its armed forces, and in particular how it deals with suicide or mental health or stigma, that make it unfair to try to make direct comparisons.

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

Okay.

To any of our guests here today, with the transformation agenda, obviously, there are pillars involved with it, and the final outcome of the transformation is a better outcome for our veterans. One of those in this area, specifically, that we're dealing with today is research. In Mr. Bernier's paper he mentioned working with other NATO countries and—I'll paraphrase—kind of cherry-picking their best practices.

How does that process work? It must be an ongoing process, but just explain to the committee how that process takes place and is actually implemented or at least screened for potential implementation either through VAC or DND.

[Col Jean-Robert Bernier]

Ms. Truscott can answer some of these questions as well, because of her involvement in the technical cooperation program between Australia, Canada, the United Kingdom, the U.S., and New Zealand.

I'm the chairman of the NATO medical and health research committee. We have multiple research task groups. The way it works there is that enough nations have to have a common interest, an aligned interest, and all agree on the specific activity that's to be researched, the specific research question that's suitable and addresses a problem that exists in their own countries. Then each will provide what resources it can to collaboratively address the research question, primarily through literature reviews but sometimes through original research as well, but typically applied to military populations.

One example of a research task group is one on military suicides, specifically, that one of our researchers is chairing. That involves about 15 other countries.

Then the results of those are published, so the best practices, the evidence-based results, are published. Then each individual nation applies it individually, based on the specific parameters and social factors and organizational factors relevant to its armed forces.

There's common funding. There's a wide variety of multinational and also bilateral efforts—for example, primarily with the United States, where we'll sometimes put in a small amount of money and a small amount of research effort and the Americans will put in up to 50 times as much.

I'm not talking here specifically about mental health; for example, we're developing biological defence vaccines—vaccines against biological weapons and other medical counter-measures—where, for one of them, we're paying 2% of the bill and the Americans are paying almost all of the rest, with the British paying a part as well. So for a very small contribution on our part in research, sometimes funding an analytical effort, we're getting a massive return on investment in many cases.

But all of these questions are always aligned so that they're based on a common interest with the common research questions that are equally applicable to all of them, and it has to be that way, particularly with our closest allies, because when we deploy, we deploy together. We'll rarely deploy on an operation alone, so there's a whole effort in NATO to try to be interoperable and to try to standardize all our practices and programs, in medical, health, and all other elements of military operations.

[The Chair, Conservative, Greg Kerr]

Okay. We're up to our time.

I would just point out that we let our witnesses go on at length. We like to get the answers. It's the questioners who we cut off at their time.

That's the end of round one. We'll now go to round two, which is a four-minute round.

I understand that Mr. Chicoine is going to start.

Go ahead, please.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

Thank you, Mr. Chair.

I would also like to thank the witnesses for being here to share their knowledge and observations with us.

I have a question about the findings of coroner Hélène Lord, who conducted an inquest into the suicide of a soldier at the Valcartier base. She indicated that the waiting times were much too long. In fact, the wait for care at the mental health centre on the Valcartier base was 120 days.

I would like to know if any action has been taken to reduce the waiting times so that they are consistent with the 30-day standard of the Canadian Forces, instead of 120 days, as was the case at the time of the coroner's inquest.