Veterans Affairs Committee on Dec. 8th, 2016

[Michel Doiron]

I believe there is. I think there's more we can do on that. Don't forget, if we study PTSD and mental health, that information will be made available to first responders. We share information. My first career was as a paramedic first responder. We can help more people than veterans. But I think there is more we can do—because science advances in early determination, early detection, how to treat it, what works, what doesn't work—to make sure the veteran gets to what we like to call the “new normal” as early as possible. Maybe they'll never be able to work again, but at least we can take care of them.

[The Chair, Liberal, Neil Ellis]

Thank you.

Ms. Wagantall.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you, Chair.

Thank you for being here again today. This is very helpful, and all these programs show a significant concern and care for our veterans. When I look at the full list, the reality is that something is still not working for a cohort who struggle significantly. That is what we're trying to deal with.

There's a new VAC office opening in Saskatoon, correct?

[Michel Doiron]

It's open.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

It's not fully operational, but it's open and it's there. Will an OSI clinic be part of that dynamic? Reply really briefly.

[Michel Doiron]

Yes, we're opening a sub in the Saskatoon area. I don't have dates.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

I have to tell you that this is huge because we can't find our veterans, but when they have something they want to be found for, they're pretty accessible. It's good to hear this is happening because obviously we have veterans there who have suffered because they have to travel and they don't want to leave home and all those dynamics. I hope that's going to be significant for them.

You mentioned that 4,000 mental health professionals are available. We hear this a lot. How many of those are psychiatrists at any one time? Can you say that this month we have this many registered?

[Michel Doiron]

I can get you that. I don't have that with me, but we do have the breakdown of who they are.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Do we know where they are? Then you can be able to say that this many are here, this many are there, that type of thing?

[Michel Doiron]

Yes. The way it works is that the mental health professionals register, as the doctor said, with Medavie Blue Cross. Essentially, we pay the mental health professional to provide the service to the veterans in their location. As you've mentioned, OSI clinics aren't everywhere. Even though we do telehealth and other stuff, sometimes we need somebody to do an assessment on site, so we have them across the country.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Again, this is a huge issue we hear a lot in Saskatchewan where no psychiatrist is available.

[Michel Doiron]

Absolutely, and I met with their minister of health, and I was told exactly what you're telling me.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Good, we're on the same page.

I also hear from a certain segment of veterans that they cannot get in to see a psychiatrist. What are the barriers to their being able to be treated by a psychiatrist?

[Michel Doiron]

In terms of barriers to being treated, the access is pretty good for our OSI clinics. They may have to wait two weeks but generally speaking.... We report on our accessibility, following an OAG report. We're doing pretty well. Can we do better? We can always do better everywhere, but I think we're doing pretty well there.

Certain areas of the country lack psychiatrists. As an example, we had to delay the opening of the OSI clinic in Halifax by maybe a couple of months because we could not get a psychiatrist.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

That's not too bad—a couple of months—in light of the bigger picture.

[Michel Doiron]

It isn't, but it is when you have the money and you have the commitment and you want to do it and you can't open because....

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

I want to move on from there.

You were saying what areas we need to have more research in. One of them you mentioned was pain management. In light of what we're hearing right now with regard to the decisions made around marijuana and concerns about the amount versus what they would like to see, that kind of thing, and then the concerns about addictions, which are all valid, do you see value in doing a pain management study comparing what veterans are being prescribed as pharmaceuticals and the effects of that versus the effects of marijuana, and the dynamics of the two?

[Michel Doiron]

Our first step will be to do the research on marijuana. We're partnering with our colleagues at CAF to do proper research on the benefits of cannabis for medical purposes.

I'll follow up on your question. I had not thought about doing that type of study at this point. Right now we just want to know if marijuana works and what the long-term effects are, whether it is addictive or not.

We did this about six months ago and we're doing it again now. We looked at the usage of opioids and benzodiazepines among our veterans using marijuana. We do track that. Six months ago, when I asked for that, there was no decrease in the usage of opioids for the people using marijuana.

People say your total usage has gone down. Absolutely, it has because our number of veterans has gone down. However, in the population using marijuana and opioids, it has not gone down. We're redoing that study now to make sure; has there been a change in six months?

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Could I suggest that you make sure you put the ask out there to speak to caregivers who are dealing with the treatment of veterans, and talk to individuals as well? Is this the kind of situation, again, where any kind of evidence provided by individuals who should be part of the study, are not part of the study?

[The Chair, Liberal, Neil Ellis]

Give us a quick answer, if you could, please.

[Michel Doiron]

Yes.

[The Chair, Liberal, Neil Ellis]

Okay, thank you. Great.

The next is a three-minute round. Ms. Mathyssen.

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

Thank you, Mr. Chair.

You mentioned the issue that VAC will pay for treatment, and that's very important, but today I saw a report from the veterans ombudsman that veterans have to pay their own expenses while they're waiting for a disability award. We know that pressure, stress, can trigger a mental health breakdown.

These expenses are not reimbursed if they precede the disability approval. I wonder if you could comment on that fact.

[Michel Doiron]

Prior to the NVC they were covered. I meet with the ombudsman on a monthly basis. We have a very good relationship. Post-NVC that was one of the issues.

I think we have highlighted, in the reports you've seen, that the department agrees. There's some work we have to do, but it's legislative. It's not just our saying we're going to change this. It's in the timelines in the act. It's a legislative change that has to be done.

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

Are those who are responsible for that piece aware and know they have things to do?