Veterans Affairs Committee on June 12th, 2012

[Col Jean-Robert Bernier]

I cannot talk about individual cases because privacy laws prevent me from doing so. However, I can say that this is a problem that affects the Canadian population as a whole. Last week, an Ottawa newspaper, the Ottawa Citizen, indicated on the front page that the Ottawa Hospital has a one-year waiting list, just for an assessment, not for treatment. These wait times are much shorter in the Canadian Forces. There are problems in certain areas, such as at Valcartier and Petawawa, but we have the government's permission and the resources required to hire twice as many mental health professionals than in the civilian sector in Canada. The current number of professionals in Canada, compared with the population, is higher than all NATO countries.

That is what we have, but we always want to improve. We would like to fill all these positions, but we are having a lot of difficulty doing that because there is a major shortage of these professionals in Canada. That's why we are establishing and strengthening our ties with professional societies. For example, a job fair was recently held in Quebec City. Our mental health employees made a number of presentations on military issues, including post-traumatic stress syndrome, and we do the same during scientific conferences attended by professional associations. As a result, 10 psychologists in Quebec did express interest following the job fair. We are increasing our capacity and our ties with these professional associations in the context of these scientific conferences to try to arouse more interest.

We also have an agreement that allows us to hire mental health professionals and pay them higher salaries than what is permitted by the public service. However, despite all of that, we have difficulty finding them, like all the other health care institutions in Canada, because of the shortage.

[The Chair, Conservative, Greg Kerr]

Very briefly, please, Mr. Chicoine.

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

Has any thought been given to using clinical psychologists? I don't think the Canadian Forces is using these professionals. When our troops are deployed abroad, the Canadian Forces doesn't include clinical psychologists.

What is the opinion about hiring these psychologists?

[Col Jean-Robert Bernier]

We are currently using clinical psychologists in all our large mental health centres. However, they are civilians and not military personnel. During deployments, we use psychiatrists, mental health nurses and social workers with special skills, as well as our general practitioners, who have some specific skills.

Given how we are currently organized, we don't need the skills of clinical psychologists during deployment operations, but we do use them, for example, for decompression in a third location, in Cyprus, after lengthy deployments. That is the case if we are able to deploy civilians, if we need them and if we determine that it would be necessary for operations.

We are constantly assessing our needs with respect to all the professions and all the skills in all areas of health care.

[The Chair, Conservative, Greg Kerr]

Thank you.

Now we'll go to Mr. Harris, for four minutes, please.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

Thank you, Mr. Chair.

Mr. Lourenso, I want to get back to you, as you were not able to give a response. I need you to give some words of assurance to some of the people over there who have a faulty belief that it's impossible to transform or make something better unless you simply throw more money and more people at it.

I know that's a wrong mindset, and I know that your commitment to veterans who have health issues, mental health issues and others in this case, is to give them the best possible service you can. I just need you to expand a little on that and maybe give some reassurances for the folks across the way that you are on the right track.

[Carlos Lourenso]

Absolutely. As you've heard from previous witnesses, the department has undertaken a variety of different measures to try to streamline and make more effective the types of services we're providing to clients. Our focus is to ensure that those who need us the most will have the people in front of them and beside them that they need to help them.

We've tried to streamline the administrative activities that exist in the department: the processes, the mailings, the forms, all the paperwork, all the various items that people do on a day-to-day basis, and automate them, rid ourselves of multiple client signatures and multiple forms for different purposes.

That enables us to take the people we have—and other resources as well, because it's not only the people we have in our offices. We have instituted Integrated Personnel Support Centres, we have OSI clinics; we have access to 200 critical case managers and to over 4,000 mental health providers across the country. So we've expanded the base of potential service points for clients well beyond the borders of our department, to ensure that veterans who are scattered across the country—not only in large urban centres and not only in centres where there is a higher percentage of CF members and so on—have a variety of different supports and different ways to interface with the department and get a much broader spectrum of services than they may have needed in the past.

We know that today's veterans, unlike the veterans of previous years, who were confined to an age cohort that was maybe four or five years apart—those who were in World War II and so on—have a very broad age range and therefore a very broad range of needs. As a department, we need to respond to that, and ensure that the types of services and the way we service veterans corresponds to that wide scope of need as well.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

I would imagine that during all these changes and the streamlining, one of the challenges you have would be to get the word out to the veterans who need help that you have a new way of doing things, so they shouldn't come to you looking for the old, slow, and even more complicated way. They should try your new streamlined service; you think they'll like it. That must be one of the challenges, and some of the vets who have problems may not have caught on to the new and efficient streamlined way you want to do things now. That's the challenge: to get those folks comfortable with it so they can be better served.

[Carlos Lourenso]

Absolutely. One of the greatest transformations we've had to undertake is moving away from having offices that were concentrated in certain urban centres and having a way to be able to branch out and reach out to veterans in the various environments they live in, whether it's in rural centres, near bases, or in urban centres. We've had a very active approach going out to bases, working with our colleagues in DND, establishing Integrated Personnel Support Centres, where we have VAC employees, DND employees, and members, and changing our online systems, our websites, our ability to interface with a younger cohort of veterans who demand that kind of online service. So outreach has been a key component of what we're trying to do.

[The Chair, Conservative, Greg Kerr]

Thank you.

I know Colonel Blais was trying to get in there with a comment.

[Colonel Gerry Blais, Director, Casualty Support Management, Department of National Defence]

A lot of what I was going to say, Mr. Lourenso just indicated. The Integrated Personnel Support Centres have allowed a lot more of that face-to-face contact, especially with the younger veterans, because now we have Veterans Affairs on the Canadian Forces bases and we bring them into Veterans Affairs, so they do get that face-to-face contact.

Also, when we brief all the reserve units and regular force units on the care of the ill and injured and the benefits available, we bring Veterans Affairs Canada staff with us so they can get the word out as well.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

Excellent.

[The Chair, Conservative, Greg Kerr]

Thank you very much.

Now to Ms. Perreault, for four minutes, please.

[Manon Perreault, NDP, Montcalm, QC]

My questions are for Mr. Lourenso and have to do with the Veterans Independence Program and support at home.

I really want to understand what the program is about. I imagine that when this program was created, it met the needs of veterans who are now ageing. They may be in institutions. Have these institutions been modified to meet the needs of the new cohort of young veterans? These people have different needs, after all.

[Carlos Lourenso]

The veterans independence program has been described as probably the most generous broad-scope home care program in Canada. I would hazard to say there is no provincial program in Canada that has the scope of services the VIP program has.

The program was designed at a time when most of the veterans were not very old but were getting older. The program was initially designed in 1981. The services from that time have undergone a lot of change in the last 15 or 20 years. We now have a program that has an abundance of services, that are designed to support a very elderly client, for example, such as personal care and nursing services in the home and so on.

At the same time, if you are a younger veteran who has had a catastrophic injury, an amputee, for example, and you need assistance with your yard maintenance, housekeeping, being able to get to services and so on, the program makes all of those types of services available to a younger veteran who has different needs.

We are constantly looking at the program and designing small changes to enable it to be much more suited to a younger population.

[Manon Perreault, NDP, Montcalm, QC]

Excuse me for interrupting. That means that people who benefit from this program probably undergo annual or periodic assessments, meaning that someone who uses the program may not necessarily receive those benefits for his or her entire life.

[Carlos Lourenso]

True. The program is designed in a way that it is able to help people either for a long time, in terms of chronic needs, or through a transitionary-type period. In other words, somebody comes back from service and they need certain supports at home. The program can be employed to help them in conjunction with other programs—rehabilitation programs, career transition services, and so on.

The VIP program can be instituted for a shorter period of time. A person's needs are assessed by case managers at different points in time and the program is modified accordingly.

[Manon Perreault, NDP, Montcalm, QC]

Are there currently individuals who might need the support of the program but can't access it?

[Carlos Lourenso]

Any veteran who has a service-related injury and requires the services available under the veterans independence program, generally speaking, would be able to receive the services of that program. I think that's the easiest way to answer it.

[Manon Perreault, NDP, Montcalm, QC]

It's a program—

[The Chair, Conservative, Greg Kerr]

Thank you very much. We're at the end of our time.

It went quickly, didn't it?

[Manon Perreault, NDP, Montcalm, QC]

My time is already up.

[The Chair, Conservative, Greg Kerr]

Now to Mr. Lizon, for four minutes, please.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much, Mr. Chair.

I would like to thank the witnesses for appearing at the committee.

I would like to direct my question to Professor Sareen, and then I would like other witnesses who would like to comment to do so.

Usually our capable chairman tells me I am out of time. Therefore, if we run out of time, please do it in writing.

[The Chair, Conservative, Greg Kerr]

You still have a minute or so left.