Veterans Affairs Committee on Nov. 15th, 2016

[BGen Hugh MacKay]

The JPSU isn't within my realm, really. I do have case managers who work within the JPSUs to help coordinate the health care of the patients who are in the JPSU. There is no health care delivered within the JPSU as such. The construct of the JPSU is really there to provide all the other kinds of supports necessary for the members and their families, looking at how they need to prepare for transition, looking at their financial arrangements, all those types of things.

The chief of the defence staff did order a review, and we're in the process of looking at JPSU renewal right now. I think Brigadier-General Corbould, who is the commander there now, really would be able to comment better on the functioning of the JPSU itself.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

I bring that up because when we hear stories of suicide, they're often related to the trigger of being transferred to the JPSU, even though their original—

Did you want to speak to that?

[Col Andrew Downes]

I'll happily speak about that, just to set the record straight. I don't have the numbers with me, and it is true that some members posted to the JPSU do die by suicide. There are people who are not posted to the JPSU who die by suicide as well. I think we just need to keep that in mind and not assume that this is the reason behind it.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

I think that's fair to say.

I think my time is up, but hopefully we will come back to that.

[The Chair, Liberal, Neil Ellis]

I have a clarifying question. You talked about in theatre and outside of theatre, and I think you said it was every two years after 40, and before 40....

Is that a questionnaire? What type of screening is that? Are you talking about screening for those who are actually not in theatre?

[BGen Hugh MacKay]

With the periodic health assessment, there is a questionnaire screen that the individual goes through. It's every five years before 40 years of age, and every two years after age 40. Then they sit down with a physician, or a physician assistant or nurse practitioner, and they go through the answers to the questionnaire. There might be some additional questions that come up as a result of the encounter they have with the primary health care provider doing the periodic health assessment.

[The Chair, Liberal, Neil Ellis]

Is that compulsory, for everybody?

[BGen Hugh MacKay]

It's required, yes.

[The Chair, Liberal, Neil Ellis]

Okay.

[BGen Hugh MacKay]

Whether everybody is up to date all the time is a difficult question.

[The Chair, Liberal, Neil Ellis]

Great. Thank you.

Ms. Mathyssen, go ahead.

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

Thank you, Mr. Chair.

Thank you very much for being here, and thank you for your service. We appreciate the information you can bring to this committee, because we are grappling with recommendations and we want them to be the very best.

In listening to all this, it has occurred to me that your objective is to make sure that the men and women who are serving in the Canadian Armed Forces are supported in every way possible and are as healthy as they can be. Obviously, the strength of the Forces and of the nation depends on those individuals.

With that in mind, I'm wondering about something. In the presentation, you said that in terms of mental health providers, 93% of the available positions were filled by July 2016. This seems to be in conflict with some of the things we've heard here—that there were personnel members who knew they were in trouble but who couldn't get the help quickly enough. They had to wait six months, or sometimes more, on a waiting list, because the help wasn't there. Has that changed, or is there still a problem? Do we need that extra 7%?

You said there were challenges in recruiting personnel to some locations. Are those remote locations, the far north? Exactly where would that—

[BGen Hugh MacKay]

I'll start with the last question first. It is usually remote locations. We have had a challenge recently to fill our psychiatrist position in Shilo, Manitoba. We had some difficulty finding psychiatrists to go to Cold Lake, Alberta. In those situations, for example with Shilo, we used the Veterans Affairs Canada OSI clinic in Winnipeg to provide members with psychiatric service.

It's difficult for me to comment on individual stories about how members experienced access to the care. We have set a wait time goal of 30 days for non-urgent mental health care consultation within the Canadian Armed Forces, and that's in keeping with the Wait Time Alliance of Canada's goal for non-urgent care access.

Andrew, I believe, has the data on what our wait times are like at this point in time and what they have been over the last several years. I will ask Colonel Downes to answer that for you.

[Col Andrew Downes]

Certainly. We measure wait times at each of our clinics in the different parts of the mental health department. Just to add a little more precision to what General MacKay said, within our psychosocial services, the benchmark is two weeks. That is, again, for non-urgent, elective care. Obviously, more urgent cases will be seen sooner than that.

Within the general mental health department and the operational trauma and stress support centres, it's 28 days. Over the past year, the average across our system has been 25 days for general mental health and 32 days for the OTSSC.

I should point out that, when you have departments with individuals in them—perhaps in a small clinic, for example, where you have one or two psychologists—if one of them leaves or goes on holiday, it actually makes a big impact on the wait time. When you look across the year, the wait times at different clinics vary. As I said, overall the average is 25 days for general mental health and 32 days for the OTSSC.

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

We've talked about deployment and personnel who suffer from trauma because of combat and those experiences. Is it possible to have an OSI through training? One of the things I am particularly concerned about is the incidence of sexual assault. Have you looked at the situation of OSI outside of combat, and for men and women who have been victims of sexual trauma?

[BGen Hugh MacKay]

It is important to realize that it's not just deployments into combat zones that cause operational stress injuries. They can result from humanitarian assistance and disaster-response activities. We have found that exposure to dead people and disastrous situations can be as difficult for people to deal with as actual combat experience is. There is the potential for somebody in training to be part of, or witness to, an accident. A sexual trauma could very well also potentially lead not to what we would call an operational stress injury as such but to post-traumatic stress disorder. Of course, that doesn't make it an operational stress injury.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Fraser.

[Colin Fraser, Liberal, West Nova, NS]

Thank you, Chair.

Thank you, gentlemen, for appearing here today and thank you for your service to Canada.

I'd like to begin, General MacKay, with you. In your opening comments you talked about a working group under the VAC-CAF steering committee, which I think you said was established to align programs and to analyze the elements associated with the continuum of care. When was this working group set up, and what is the timeline for it to report back or to get its work completed?

[BGen Hugh MacKay]

This working group was established at the end of August, or in early September, I believe, and it was working very hard for several weeks to look at the situation. I believe the goal was for it to have recommendations put forward by mid-November. I haven't seen the final report out of the working group at this point.

[Colin Fraser, Liberal, West Nova, NS]

That's going to be coming very shortly then. That's mid-November of this year.

[BGen Hugh MacKay]

That's correct. It should be.

[Colin Fraser, Liberal, West Nova, NS]

Could the findings of the working group be shared with this committee or could you get back to us on that?

[BGen Hugh MacKay]

I'll have to get back to you on that. I guess it depends on where that information may go.

[Colin Fraser, Liberal, West Nova, NS]

On that working group, are there veterans or former service members involved in the working group who are part of the discussion?

[BGen Hugh MacKay]

The working group involves staff from Veterans Affairs Canada and the Canadian Forces. However, the veterans groups have been advising the Veterans Affairs Canada staff as they've been working on their part of the working group.