Veterans Affairs Committee on Feb. 13th, 2017

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Bratina.

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

Thank you.

I want to tell you all that we've heard a lot of testimony at our committee about the problems, and we're hearing a lot about potential solutions and studies. That's really positive. I'm sure we all agree that this is a good meeting today.

Ms. Bradley, I'm going to quote you forever, that “Province A doesn't know what Province B is doing.”

[Voices]

Oh, oh!

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

In Hamilton 10 years ago, we had lead exceedance in our water. This week, cities across Canada are finding out that there's lead in the drinking water: “Oh, what are we going to do about it?” We already looked at this 10 years ago.

That brings me to you, Dr. Merali. I know that exposure to lead at levels generally considered safe is showing in more recent studies to be problematic, especially with regard to depression and behaviours and so on. You did the brain imaging. I know that some of the other researchers have found a decrease in the frontal lobe.

As regards our topic, are there predictors of behaviour that you could test even in recruits, as well as veterans, to see whether they might be predisposed to mental behaviours?

[Dr. Zul Merali]

Yes.

I think that's a very important and loaded question, in the sense that what if you were able to detect something, then what would you do? I've had discussions with people in our military mental health centre, and one of the dialogues we have is that if you were to detect somebody who was likely to be at risk, does that mean that you don't deploy them? Would that be the right thing to do?

That's a question that needs to be answered. I don't have answers for you, but that's an issue. I think the fact that we need to be able to monitor, to see some of the risk and resiliency factors, is a given, but whether we do that prior to deployment is a separate question that's more loaded.

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

Thank you.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Mr. Champion, thank you for your service.

Thank you all for being here.

I don't have a lot of time and I've got a couple of pages of questions.

First off, to Dr. Mantler and Ms. Bradley, can you tell me what percentage of your services are given to veterans? Have you calculated that? Basically, you're the Mental Health Commission of Canada and you deal with mental health in all areas, but to what extent would it be to veterans? Maybe I missed that.

[Louise Bradley]

I'll start.

We don't actually provide services as such. The mental health first aid and the R2MR are programs that are train-the-trainer based. We've recently done the one for veterans.

Do you want to add to that?

[Ed Mantler]

Regarding the programming of the commission, the bulk of it is really knowledge exchange, coalescing research, and spreading that research to put it into action, and doing so in a way that is intended to address all Canadians. It's difficult to pull out specifically what proportion is going to veterans and what's not. Much of the work of the commission has been focused in workplaces.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Great, thank you.

Dr. Merali, people are very visual, and when you put something like this out, they key on to it, and they see nice red and green things. I do have a bit of a background in research, so it's nice to see this study. I'm wondering, with the PET study, what was the size of the population that came with this. This is one snapshot of one individual, but across the board, what would be the percentage that would have this type of...?

[Dr. Zul Merali]

I think one of the studies was about 32 in the treatment group versus matched controls.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

When you look at this, we're looking at those with PTSD and a control group. Have you also done it with a group that might have had a long-term history of opioid use?

[Dr. Zul Merali]

No. We have—

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

No?

[Dr. Zul Merali]

We have not. We do have a treatment program for opioid addiction at The Royal. In terms of the imaging studies, we have not done them.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Do you have one with veterans who might have used cannabis to an extent?

[Dr. Zul Merali]

In terms of the imaging studies?

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Yes.

[Dr. Zul Merali]

No. The imaging facility is a multi-modal imaging set-up that does FMRI, PET, SPECT analysis, as well as EEG right in that same machine. It is highly sophisticated, and we are building capacity to bring experts who can do different modalities of imaging. The PET one you're looking at there, the person who did that study is now part of our team, and that's exactly what we plan to do.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

You mentioned that a lot of this is looking at cannabinoid receptors. You did bring up the issue of the limited research out there on dealing with the benefits or non-benefits of cannabinoid use and the use of cannabis by veterans for whatever reason. Do you think that would be a worthwhile study that we as a committee should be looking into, not only the use of cannabinoids, but also what effects may have occurred with changes from ten grams to five grams to three grams?

[Dr. Zul Merali]

Yes, absolutely. I think that's critically important. The fact that people are using it is backed up by anecdotal data. Some people find it highly beneficial, but there is no single large-scale study that looks at the clinical efficacy to see whether it's really effective in a measurable way and, more importantly, whether safety is an issue with the use of those cannabinoids. They have other effects, cognitive effects, effects on concentration and on sleep, etc. that need to be looked at very carefully.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

Ms. Weber, I didn't really hear what cost you were looking at for putting into service the use of the therapy dogs.

[Liane Weber]

We expect therapy dogs to cost anywhere between $2,500 and $3,500 maximum. It really depends on where the animal is coming from and if the animal has been spayed or neutered. We will have all the accessories and medicines that are required, and of course, we actually pay the home and training provider where the animal will stay. One of the things we do have the ability to do is to reduce these costs with veterans being able to offer their services, with manufacturers of dog food, collars, crates, and any type of accessories we require. It's between $2,500 to $3,500 maximum per animal. The recipient is then responsible for any further food or vet visits that are required.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.