Veterans Affairs Committee on Jan. 30th, 2017

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

I appreciate what you're saying, so can I ask a question? Just very briefly, it sounds to me as though the suicide issue grows over time because of the circumstances of discharging—not due to serving, but to discharging. Do you see that as a key element of the issues with suicide?

[Hélène Le Scelleur]

I think that the entire process only aggravates the situation. When we are isolated, alone, and no one is there to guide us, to help us, the feeling of rejection grows.

I was talking before about de-train. Being able to experience a form of grief, but in a group, might help avoid these kinds of situation that can lead to suicide. If we are isolated, lose this form of identity and brotherhood, and have to rebuild who we are, we no longer have benchmarks. We have nothing anymore. So it's easy to move toward suicidal thoughts.

The men I speak to often say that the woman is at home and will take care of the children. The man, in many cases, gives up. The mother tends to stay. That's one thing to consider.

Thank you.

[The Chair, Liberal, Neil Ellis]

Thank you.

Ms. Lockhart is next.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you.

Thank you to all of you for appearing today.

Ms. Lowther, thank you for coming back to see us again. I understand that you participated with the Mental Health Commission of Canada when they were customizing their mental health first aid program for veterans. That's something we haven't heard about before, so I'm wondering if you could tell us a bit about that and about the actions associated with it.

[Debbie Lowther]

Veterans Affairs contracted the Mental Health Commission of Canada to adapt their mental health first aid program for the veterans community. It's geared toward people like our volunteers, who deal with veterans who may be struggling with mental health issues. A group of about 10 of us met a couple of times to go through the basic mental health first aid handbook and make recommendations on how to adapt certain aspects of that program as they pertained to veterans.

The most specific piece, obviously, was the section regarding PTSD. We did a lot of elaboration on that. We also talked about the instructors for that course. We basically decided that instructors for that course preferably should be veterans themselves. It all comes back to the peer support, to the social support thing. We felt that because the military was such a unique culture, the instructors needed to have that background.

I know that the program is up and running now. It's been offered in a couple of cities across the country, and so far we're hearing good things about it.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Where it is being offered? Who is administering it? Who is offering it?

[Debbie Lowther]

The Mental Health Commission of Canada is offering it. In most places across the country, it's being offered at the MFRCs, or basically wherever there's a location available. That was another thing we talked about in the adaptation process—where to hold this mental health first aid program. We know that a lot of veterans don't like to go back on base. Some suggested having it somewhere on base, that kind of thing, but we know that a lot of veterans, once they leave, don't want to go back on base. That was another recommendation we had: be very careful in choosing the locations for the courses offered.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you. That's very helpful, especially as we know that the government has recently announced a specific investment in mental health across Canada. Perhaps that's an area that can be expanded upon in communities across Canada.

I also wanted to ask you about rural areas. What have you found in terms of delivering services through the VETS program in rural areas? What are the challenges?

[Debbie Lowther]

The challenge in rural areas for us is that, first of all, we don't have a large volunteer base there. There's also a lack of resources. There's the challenge that veterans who live in rural areas also have to travel a fair distance to access the services they may require.

It's challenging, but when we need somebody in those areas, if we don't have somebody, we can kind of reach out and do a lot of networking and make sure that we do have somebody close by who can help out. We also work very closely with Veterans Affairs case managers to almost remotely guide that veteran through whatever their crisis may be at that time.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

When I had the opportunity to go out with the Boots on the Ground crew in Fredericton, we talked about how they were travelling too. That group has travelled into some of the outside areas when called upon to do so.

[Debbie Lowther]

Yes, and they do. Our volunteers are very good. They will travel up to a certain distance. One of the questions we ask them when they go through the screening process is whether or not they're willing to travel to assist a veteran.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you.

Ms. Le Scelleur, I know that when you were working on your Ph.D., obviously you were doing research, but I have a question about the amount of research that's already out there. Did you find that there was a substantial amount of research specific to mental health with the military, or is that an area where we need to be focused as well?

[Hélène Le Scelleur]

Thank you for the question.

As I mentioned previously, in the literature I've reviewed, there is a great deal of medical research on post-traumatic stress disorder and on vocational transition. However, interpersonal relationships and the psychosocial aspect are still rarely addressed in the Canadian literature. There is a little more information on this in the literature from our allied countries, but once again, the same question remains on psychosocial, identity and interpersonal issues.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you.

I think it's interesting that you both brought that up in your testimony. We have actually heard that in our other study as well, that the transition and the identity piece are so important, so I thank you for bringing that to us again in this context of mental health and the triggers that happen through that transition process.

Thank you.

[The Chair, Liberal, Neil Ellis]

Ms. Mathyssen, go ahead.

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

Thank you, Mr. Chair.

Thank you for being here. You put a lens on some of the things we've heard and you've helped us to understand better, and I am very grateful for that.

I have a number of questions. I'll start with Madame Lowther and Madame Le Scelleur.

You talked about the exit boot camp. It's very clear from your description that a very young person, sometimes an adolescent, goes in, and they become an adult in the military. They never became an adult in civilian life. You've both obviously identified something significant here. Have you given thought to what that exit boot camp would look like? What kind of services should be provided so that this human being can refine that adult identity?

[Hélène Le Scelleur]

Thank you for the question.

I enlisted when I was 17. When I left military life last year, at age 43, I had no idea how I could be an adult in civilian life. As mentioned earlier, support groups could be created. I would say that this goes even beyond support groups. I would include learning how to make a budget, to find a doctor and to take the time to discuss returning uniforms.

We receive our service pin at the end of our career. Why wouldn't we have a ceremony in front of family and friends, like a graduation? Why not have one last parade to mark our service? We could receive our pin then, in front of family and friends.

All service members who retire or are injured could take small steps like this, together, the same as when they started their career.

Thank you.

[Debbie Lowther]

I agree with that. We see a lot of veterans who, as you said, become adults in the military, and when they get out, they really have no idea how to function in society, how to do things like paying bills or things like, as my colleague here mentioned, going to the doctor, finding a doctor. We had one veteran tell us that when he was still serving, he was always told when he had a medical appointment or a dentist's appointment. Once he got out, he didn't have a person reminding him all the time. A member who deploys often counts on the spouse at home to look after everything, so once that's over, they need some coaching in basic day-to-day living.

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

You mean life skills.

[Debbie Lowther]

It's life skills, yes.

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

Thank you very much.

To the representatives from the RCMP, I heard two things. The first was that someone who is injured and diagnosed is treated by RCMP doctors who are told by the RCMP establishment what treatment should happen, etc., without consultation with the individual who is receiving the treatment. I was quite astonished by that. How can that that happen? How can that very basic, very personal thing be taken away from the individual? It seems to me that this would make getting better extremely difficult. Your whole sense of self or self-determination has been removed.

Then there's the opposite: being told by others that you have to go back to work when you may not be ready, when you haven't had any input into that, and the opportunity for rehabilitation is taken away entirely. It seems that those two things are happening at the same time.

In addition to that, I wonder what kinds of opportunities there are if vocational rehabilitation is provided in a meaningful way. What opportunities would exist for the individual?

[Sebastien Anderson]

Thank you very much for your question.

In practice, if an RCMP member is required to see a psychologist outside of the Blue Cross program that's offered, their only choice is to select one of the psychologists that the RCMP has on its list as an approved service provider. They have to go to that approved service provider. Service providers are allotted 10 counselling hours at a time, and in order to get another slate of 10 hours, they have to submit detailed briefing notes that include the diagnosis and what was talked about in counselling. All of that is disclosed to the health services office by the service provider. If that information isn't provided, and if the member refuses to allow the psychologist to disclose that information, then the service is cut off. They're cut off treatment. That happened in the two cases that I cited in the case study.

The first one was a member dealing with PTSD. He was on a graduated return-to-work program that was approved by the RCMP. His health care provider, a psychologist, was approved by the RCMP and the member. The RCMP dropped the ball at every step of the graduated return-to-work program, starting with the security clearance that took several months to complete. They put him through the long form that a new employee has to complete, rather than the short form. Next they provided him with a laptop, but to this day, the laptop doesn't have a functional battery; it has to be plugged in. It took three months for the security key to be provided to him. When all of those things were in place, they failed to provide him with any meaningful RCMP work to perform during the graduated return-to-work program.

A line manager then directed him to report to work, in violation of the graduated return-to-work program, and he would have faced discipline if he failed to do that. Ultimately, three years ago, the RCMP cancelled its funding for the treatment being provided by the psychologist. The member remains on sick leave.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Eyolfson is next.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you, Mr. Chair.

Thank you all for coming.

Ms. Le Scelleur, you said that once the diagnosis of PTSD is made, basically the member is steadily set aside. Would you say, in your opinion, that the requirement for universality of service contributes to this?

[Hélène Le Scelleur]

Thank you for the question.

That is absolutely the case.

The criteria are different and depend on whether the person is physically or psychologically injured. As for weapon handling and deployments, the same criteria do not apply to members of the Canadian Armed Forces who are physically injured. If I may say so, there is greater tolerance for physically injured people than for people who have been injured psychologically. However, when they leave the forces, they often pick up weapons and become shooting instructors, among other things. But, according to the system, weapons cannot be used once someone has been diagnosed with a psychological injury.

Basically, this legislation identifies many obstacles, and it should be adapted.

Thank you.