Veterans Affairs Committee on Dec. 8th, 2016

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Bratina.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Thank you.

I'm intrigued by the percentage of non-medical releases. Is it 61%?

At which point in their service would they typically make the decision to leave? Are they 10-year guys, 20-year guys, or 40...?

[Michel Doiron]

They're all over the place, if I can use that terminology. It depends. For some of them it's usually when they can no longer meet universality of service they leave the forces, and that could be by injury, by health issue. There are various issues. You could have a person with two years' experience, or one with 35 years. Once they've reached universality of service....

You're talking about the non-service-related. They're also all over the place because if somebody comes in for five years and decides they want another life.... I don't know the statistics of the releasing per age. CAF probably has that; we don't. We see the average age of release as around 36, which I believe was the last number I saw, so probably more mid-career.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

These would be deployable individuals who could meet universality of service but have just decided they want to move on.

[Michel Doiron]

Yes. That's the 60% I was talking about.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Do they get the full scope of veterans' programs available to them at that time?

Typically I would see that the people with some traumatic reason for departure would be up to speed, but if somebody says they've had enough of the army, then....

[Michel Doiron]

All regular forces are offered and are supposed to have a transition interview. I'll put the reservists aside for a second.

Regular forces are offered and they are supposed to have a transition interview. Last year the number who got one was in the high nineties. That's what we've done in the past. That is more of an “are you doing okay?” The person says he's doing fine and you go through the check marks, asking if he has a job and, “yes, he has a job he's going to”, etc.

We're realizing that they're not disclosing. They're leaving the armed forces for whatever personal reason. Maybe they don't even know. Sometimes they don't know. They just don't want to do it any more. They arrive outside the armed forces and realize that they have an issue. The new guided support we're offering is that transition interview, but much further. It's spending the time with the healthy soon-to-be veteran to make sure things are covered and to make sure that if they were injured.... It could be a bad knee. Sometimes it's not always mental health. I know that today we're talking more about mental health, but we ask, “Have you applied for a disability award?”, “Is your medical record up to date?” They come to us and if the medical record is not up to date, it takes time to release, medically or non-medically.

We do all that while they are still in uniform, prior to releasing, regardless of whether it's service related or if they're walking out regularly.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

To our topic today of mental health and suicide prevention, were you suggesting that when someone leaves and says, “I did my service to my country and I'm gone”, and then two, three, or five years later a depression sets in or there could be...?

[Michel Doiron]

I'll let the doctor take that one.

[Dr. Cyd Courchesne]

What our research has shown is that for the people who medically release they come to us right away. We do a warm transfer. After that when we look at the trends of when people come to us for services it's anywhere from two years after release to 40 years after release. It's possible that we'll see someone who has been released for 30 years and all of a sudden, because they're hearing a lot about Bell Let's Talk and mental health, and the stigma of mental health, they might realize, wait a minute I think I have that.

They come to us at any time. There are no spikes. After those medical releases come to us immediately in the first 18 months after release, they can come back at any time from two to 40 years. They could develop a depression or they could just realize late that perhaps there's something wrong with them and then they'll come to us.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

In the quick facts on your handout, there's reference to awards, disability benefits, and so on. Are they able to access mental health services prior to the award being presented?

[Michel Doiron]

For some of the services, absolutely. Some of our services are linked to the disability award, but for all the services I mentioned you don't even have to be a client. They can have access to all of that.

On the PTSD side, or mental health side, we try to accelerate the evaluation or the determination of the award quicker. According to the last stats I saw, 94% of people coming to us with mental health issues are being approved on first application, and a lot of them are within the 16-week standard. We're actually doing quite well. That's our average for mental health. When you hear it's a bit longer than 16 weeks on the mental health side, we typically are lower. The only thing is that we need to have the diagnosis and that sometimes can be an issue.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

I wonder when the families would become eligible.

[Michel Doiron]

With the 1-800 numbers, they can go anytime.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Right. Thanks.

[The Chair, Liberal, Neil Ellis]

Mr. Rioux.

[Jean Rioux, Liberal, Saint-Jean, QC]

Thank you, Mr. Chair.

I would like to thank the witnesses for being here today.

My questions might not be as sophisticated as those of my colleagues who have more experience here than I do, as I am a new member of this committee.

In a document, it says that the proportion of serving members suffering from PTSD tends initially to be close to that of the general population, and so forth. Does the same apply to mental illness?

[Dr. Cyd Courchesne]

Yes.

[Jean Rioux, Liberal, Saint-Jean, QC]

So the same applies.

[Dr. Cyd Courchesne]

The same applies. One person in five will suffer from a mental health condition in their life, and it will affect everyone around them. In short, we can say that nearly all Canadians are affected by this reality in one way or another. The statistics are the same.

[Jean Rioux, Liberal, Saint-Jean, QC]

Thank you.

When candidates are recruited, is there some assessment of their mental health? Some people experience crises while they are serving. When it is determined that they present a potential risk in this regard, either initially or later on, and that they must be relieved of their duties, does Veterans Affairs Canada immediately look after their transition to civilian life? Does it happen in a natural way?

[Dr. Cyd Courchesne]

Earlier in my career, I was responsible for recruiting medical personnel into the Canadian Forces. That said, this is perhaps something that you will have to ask the Canadian Forces, because Veterans Affairs Canada is not responsible for recruiting medical personnel. If I had not had that job, I would not have been able to tell you that because I would not have known it.

I don't know if there have been changes since I left my job with the Canadian Forces. You would really have to ask the Canadian Forces how their medical personnel goes about identifying mental health problems among recruits.

[Michel Doiron]

I will talk about the transition to civilian life.

We work closely with Canadian Forces health professionals to facilitate the transition of members to civilian life. Whether the person has been with the Canadian Forces for two years or 35, when a member has a mental or physical health problem, we are contacted.

The Canadian Forces would of course like to allow the member to continue serving. Their first goal is to reintegrate or retrain that person, because training a soldier is expensive. Regardless of the person's occupation, it is a major investment. The Canadian Forces invest a great deal in their personnel.

Once it has been determined that the member cannot be reintegrated into their unit, we are contacted and we work closely with the member to provide guided support. We have to assist the member and support them throughout the process. This person's goal in life, their career, is to be a member of the Canadian Forces. As a result of psychological or physical injury in combat—there are different kinds of injuries—from one day to the next, the person can no longer be a member of the Canadian Forces. That is traumatic. Suddenly the person has a lot of forms to fill out and has to make some decisions. In addition, their mental health may be suffering. At that point, we work closely with the Canadian Forces to facilitate the member's transition to civilian life. The guided support is a way of working even more closely with that person.

The changes proposed by the committee in the last session have allowed us to intervene much earlier in the process. Thank you for that. Under the previous act, our responsibilities began the day that the member was no longer in uniform. We still work with the Canadian Forces, but as a result of the changes proposed by this committee, we can play a more effective role in this process.

My deputy minister always says not to say six months, but often we become involved from six months to a year before the person leaves the military, working with Canadian Forces health professionals. We work as a team to ensure a smooth transition.

[Jean Rioux, Liberal, Saint-Jean, QC]

There are 11 major centres in Canada for people suffering from operational stress injuries.

How many are there in Quebec? Can you describe the services offered in Sainte-Anne-de-Bellevue? Does that facility treat people from Quebec only or are there also people from all over Canada there?

[Dr. Cyd Courchesne]

We have a clinic in Quebec City. Our clinic in Montreal is located at the Ste. Anne's Hospital. This clinic primarily serves people from the Montreal area, but the residential program is open to anyone in Canada.