Where do I go?
Evidence of meeting #43 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was research.
A recording is available from Parliament.
Evidence of meeting #43 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was research.
A recording is available from Parliament.
4:50 p.m.
Special Advisor, Vanier Institute of the Family
If you like, I could add something.
You talked about transition and the loss of identity, but I think it's important to also, perhaps, reframe that. It's the loss of sense of purpose that puts people like me in crisis. If you want to compound that with the stresses Mr. Kitchen referred to, all you have to do is break our circle of support. Right now, the government has structured transition to break the circle of support. DND and Veterans Affairs do not act as a continuum in the transition spectrum. They act as two separate entities, with separate frameworks and separate operating methods. To the family and the veteran in transition, that feels like it is breaking their circle of support.
We don't lose everyone. The question came up about how we screen for post-traumatic stress. An example of the circle of support is actually outside the establishment, but connected by the establishment. My own case of mental health diagnosis, post-traumatic stress, was done by a civilian psychiatrist who I was referred to by my GP at the base. My military doctor said, “I'm not sure what's going on. Let's refer you to someone who might be able to explore further.” The reason I showed up at my GP's was because of my circle of support, my family and friends. My wife said, “There's something wrong.” My friend said, “What's going on?” when I broke down one day at work for no good reason.
There's an important element there of continuity of care even if you're not case-managed. Continuity of care means you feel supported during transition. That's the effect that government should be an active partner in delivering.
4:50 p.m.
Liberal
February 15th, 2017 / 4:50 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Thank you, Mr. Chair.
Thank you, everyone, for coming.
I'm a physician. I've practised emergency medicine for 17 years, so of course, we would often see the different aspects of mood disorders either previously diagnosed presenting or sometimes we would see a first diagnosis. Mr. Upshall and then Mr. Gallson, in reference to mood disorders, one of the things we have always known about is the link—in young people, particularly, but in all groups—between substance abuse and mental illness. The link is clear; the causality isn't as clear as a chicken-and-egg thing. We do know, and I've diagnosed this on more than one occasion, that when a young person is brought in with a drug problem, it turns out their symptoms of mental illness actually predated the drug use.
4:50 p.m.
National Executive Director, Mood Disorders Society of Canada
They're self-medicating.
4:50 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
They're self-medicating, exactly.
We suspect that there are many people walking around who are in the justice system because of their substance abuse. They have been drunk driving, and have been fired from their jobs for their substance.
Is there a concerted effort, as part of your education of health care providers, to say that if there's a substance problem of any sort, one of the first things you should look for, in addition to treating the substance abuse, is an underlying mental illness?
4:50 p.m.
National Executive Director, Mood Disorders Society of Canada
It comes up, but it's not a principal goal of ours, to be frank. It would be if we had more money to provide the services. Then, we could. One of the issues with emergency physicians, who I love dearly.... However, with the triage pyramid, the difficulty was, unless you were suicidal, you were down with slight abdominal pain. Very few people going into emergency could wait the eight to 10 to 12 hours that slight abdominal pain required.
On our website is Jenny's story. Jenny is the daughter of one of Canada's past assistant chief public health officers. She was what we call a cutter—you would have seen a number of them. The effort it took us working collaboratively with her to get her help was beyond belief. This was a senior public health officer in Canada, and it was in Ottawa.
We met with the emergency physicians. The willingness to accept mental health issues as important when they appear in emergency room settings has not been what I would call receptive. I would hope, over time, that the recognition, as we continue to educate, will indicate that it doesn't have to bleed to be an emergency. Psychosis is just as much an emergency as a heart attack. We would argue that if you like, but my opinion—
4:55 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
No, I couldn't agree more. Psychosis and depression kill the same way heart attacks do.
4:55 p.m.
National Executive Director, Mood Disorders Society of Canada
Yes, exactly. We're on the same page.
We support the federal government in its efforts to push the provinces to put more effort and money into mental health resources. What we're hoping, with the minister of Health and her efforts on mental health issues, is that the minister herself will start to say, “Look, addictions and mental health are too closely aligned to be separate.”
We need all the provinces to bring mental health and addictions together, and then we can work with community groups that are combined in the provinces. Federally, addictions are here, and mental health is over there. I'm sure I'm not telling you anything, but the silos in addictions and mental health, particularly in research and in clinicians, are beyond belief. It's incredible.
4:55 p.m.
Liberal
David Graham Liberal Laurentides—Labelle, QC
Ms. Pizzuto, I have a quick question for you.
I come from a large rural riding. It's a little smaller than the state of Vermont, and so I'm always concerned how somebody who needs services like yours can find them. How does someone who needs to call the crisis line find the crisis line to call in the first place?
4:55 p.m.
Acting Community Relations Coordinator, Distress Centre of Ottawa and Region
That's a good question.
It's on the Internet, if they have it. If they don't, we try to get our cards and pamphlets out to as many doctors' offices, libraries, lawyers' officers, and counsellors' offices as we can so that the number is there. We try to spread the word from mouth to mouth so, if they happen to disclose to a friend or family member, that friend or family member might know of our service and refer them to it.
4:55 p.m.
Liberal
David Graham Liberal Laurentides—Labelle, QC
In the case of John, have you reached out to Veterans Affairs yourself to see how they can help from the other side, or do privacy laws block that?
4:55 p.m.
Acting Community Relations Coordinator, Distress Centre of Ottawa and Region
Yes.
4:55 p.m.
Liberal
David Graham Liberal Laurentides—Labelle, QC
At what point does the urgency of a situation trump the privacy laws to allow you to intervene in some other way besides—
4:55 p.m.
Acting Community Relations Coordinator, Distress Centre of Ottawa and Region
When there's a life immediately on the line. John's life is, to some extent, always on the line, but if his life were immediately at risk, we would have to overstep confidentiality. In this case, it would be outside of our service mandate to reach out to Veterans Affairs on his behalf.
4:55 p.m.
Liberal
David Graham Liberal Laurentides—Labelle, QC
Can you do it in a non-specific way? Like, we have this situation, what can you do for us? Or not even that?
4:55 p.m.
Acting Community Relations Coordinator, Distress Centre of Ottawa and Region
I suppose. It goes back to John's willingness to even deal with Veterans Affairs. At the end of the day, if he's had it with them, he's not going to seek out their support no matter what we do.
4:55 p.m.
Liberal
David Graham Liberal Laurentides—Labelle, QC
That's a good point.
If we get to the point where Veterans Affairs does have the confidence of some veterans, and we want to rebuild John's confidence, how do we bring him back in? I'm not sure how to phrase this. Veterans Affairs is going to have to change over time to accommodate people like John. How do you bring them back in? How do you convince them that it's okay now, you can trust them now?
4:55 p.m.
Acting Community Relations Coordinator, Distress Centre of Ottawa and Region
Don't let them leave in the first place.
4:55 p.m.
Liberal
David Graham Liberal Laurentides—Labelle, QC
That ship may have sailed. I'm trying to figure out how to....
4:55 p.m.
Acting Community Relations Coordinator, Distress Centre of Ottawa and Region
Yes.
4:55 p.m.
Special Advisor, Vanier Institute of the Family
Peers bring more of us out of basements than anybody else. It's peers who get us to understand that we can go somewhere and seek help. The service offered here, if it connects people to another peer or makes them aware of other peer services, could become a potential referral that eventually leads to a referral to seek professional help.
I'm not scientific, but the best case I know of with people I have commended and people I have worked with is peer referral.
5 p.m.
Liberal
The Chair Liberal Neil Ellis
Thank you.
Mr. Kitchen. I believe you're splitting your time with Mr. Shipley.