Veterans Affairs Committee on March 6th, 2017

[Kim Basque]

We suggest that the same health care team follow the veteran, whether he is an active member of the military or a veteran released from the Canadian Forces because of the state of his or her health. Of course that would help the transition. Ultimately, it would in a way eliminate that transition. The same health care team would take care of the same member, whose needs would evolve. Since the request for assistance continues to be fragile among male military members, it is important that it be received with an eye to its particularities. You have to continue to build the trust that was created, rather than changing the caregivers.

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

Thank you.

We know and have heard over and over again how important families are to the overall well-being of the veteran. To what degree does your organization interact with family members? I'm thinking not just about how they support and help the veteran, but also how they survive themselves.

In previous testimony, we heard there's an increase in suicide among the children of veterans, which is very troubling. How do you interact with families?

[Kim Basque]

Our association does not provide services to citizens who are not feeling well. We have suicide prevention expertise, but we work with several partners who offer clinical services, such as in the suicide prevention centres. Our expertise takes that into account.

In Quebec, the way we intervene has changed. A few years ago, for instance, we mistakenly believed that the fact that the person who was feeling troubled phoned for help himself meant that he would be easier to help. But no research has shown that recovery is easier if the person asks for help himself. What we know about suicide in fact makes that assumption all the more inappropriate.

In Quebec, we have adapted the services provided so that we can provide assistance to family members who ask for help, and of course we support them when they do so, when they express worry over someone else. The services offered by the suicide prevention centres and the integrated health centres take that reality into account.

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

I think this is a very important thing. In Ontario you have to reach out for help yourself. A family can't do it for you. It's extremely frustrating.

You talked about the tools and the outside agencies. We've also heard that there's a real sense of a military family. Are you finding—

[The Chair, Liberal, Neil Ellis]

I'm sorry, we're out of time.

We will have next, Mr. Fraser.

Thank you.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much, Mr. Chair.

I thank our two witnesses for their presentation, and for having come to speak with us about this highly important topic. The information you have shared with us will be very helpful to our committee.

You spoke about the importance of families and people close to the members in these situations. Can you tell us how, when suicide is a risk, it would be possible to intervene earlier with the help of families and friends? How could we rally these people around the veteran in such situations?

[Kim Basque]

Suicide prevention is everyone's business, but it is also the business of the loved ones of the suicidal person. Suicidal people always give clues about their distress. People don't always pick them up. We don't always have access to the total picture. Every individual has a piece of the puzzle, and it is when you assemble all of these pieces that you can understand what state the person is in, what needs have been expressed and what signs of distress we should recognize.

As for the care that needs to be provided to the suicidal person, the family has privileged information. The resources and care we can provide to the loved ones will also help them to get through the crisis, to play their role properly and to become a bit more solid.

[Catherine Rioux]

They have to be aware that there are dedicated suicide prevention lines that exist, for instance in Quebec. A Canadian suicide prevention line will be available soon. Pilot projects are being set up. That line will be for the civilian population, but also for military members and loved ones. Indeed, the families are sometimes grappling with enormous issues, they can be worried and in a state of extreme vigilance. So it is important to let the families know that these resources exist and that they can be supported by suicide prevention specialists.

In a suicide prevention strategy, post-intervention is extremely important. If we prepare a strategy we have to think about post-intervention mechanisms. What do you do after someone commits suicide? How do you announce things? How do you protect his environment, his colleagues and his family, among others? We can do prevention work with those people, who are in fact more likely to commit suicide themselves after someone's death.

[Colin Fraser, Liberal, West Nova, NS]

It is important to include such people in the process. Indeed, the sooner you intervene in a suicide situation, the better the outcome.

Is that correct?

[Catherine Rioux]

Yes.

[Colin Fraser, Liberal, West Nova, NS]

Ms. Basque, I believe you spoke about online services in connection with your organization.

Based on your experience, can you tell me whether persons in crisis use online services? Perhaps they will not communicate by any other means. This is new for some veterans, but it is a modern means of communication. Do you think some people will only use online services?

[Catherine Rioux]

Yes, we do. Experiments were conducted all over the world. Some of them were in Canada, but I would say that we are not very advanced in this area. In Quebec we lag behind in this regard. Certain tests have shown that the Web allows us to reach other types of clientele, for instance people who would not go to meet caregivers or who would not use the telephone to ask for help. As we were saying earlier, that is the case for people who are more isolated. Young people today also communicate very little by telephone.

We can offer other means of interaction, such as text and online chat. In certain countries, there are online interventions. In this way we can establish a first contact and then speak on the telephone to create a therapeutic alliance. That can be done online, remotely. For some people it is less intimidating. They will open up more and can choose how often they want to be in touch.

There are all kinds of models that exist currently. In Quebec, the Centre de recherche et d'intervention sur le suicide et l'euthanasie, CRISE, is devoting a lot of effort to studying that.

In short, there are things to explore in this area but unfortunately, we are lagging behind. This lag not only pertains to the military, but also civil society.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much.

[Kim Basque]

We have to provide the services suicidal people need where they are. If it is the Web, we must be present on the Web. If it is on the phone, we have to be present on the phone. If they are in a physically isolated location, but are nevertheless in touch with someone once a week, that person has to be vigilant and encourage them to request assistance.

[Catherine Rioux]

After someone commits suicide, people often discuss the death and express their distress and their disarray on social networks. This is distressing for suicide prevention workers, such as the people who work in schools. People don't know exactly what to do. There are potential solutions that can be proposed. We have to put something in place in order to allow those workers to identify the people who are the most vulnerable in these discussion forums and social networks.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much.

[The Chair, Liberal, Neil Ellis]

Thank you.

Unfortunately, that ends our time for testimony today. I do apologize.

I'd like to thank your organization and both of you for all you do for our men and women who have served.

Also, if you would like to add anything to your testimony, please send it to the clerk, who can then get it to the committee.

With that, I will adjourn for one minute sharp and we will then have about five minutes of committee business. I apologize to the committee that I do have to keep you afterwards. Everybody who doesn't need to be here can leave and we'll start the committee business in one minute.

[Proceedings continue in camera]