Evidence of meeting #47 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 information.
A recording is available from Parliament.
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
I do not know what the comparison is. I'm sorry.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
All right. Thank you.
Dr. Rolland-Harris, this has been touched on in a couple of questions so far. We talked about tracking the female suicides.
I'm a physician. I've had to learn statistics, and I know the challenges of analyzing data when the numbers are small. I think we both agree it's fortunate that the numbers are small, but it does cause that challenge.
In medicine in general we've had an issue over the years where so much medical research has been gender-based, usually towards males, right from basic science research onward. I was a medical researcher before I was a physician. We always used male rats, because if you used two genders there was too much variation. Hence, you develop medications that might not work for females. Although I understand that putting it in a report is one thing, because, as I say, the numbers are so low you might identify....
Are you looking at methods that can better analyze and maybe get more conclusions from the female population, where it's so challenging?
Senior Epidemiologist, Directorate of Force Health Protection, Canadian Forces Health Services Group, Department of National Defence
Yes. I mentioned the CF cancer and mortality study, CF CAMS, which is one of the big drivers behind the study. It's twofold. One is to be able to have a large enough population so we can look at more specific details, including differences in gender. But we're also, to use a term my colleague from VAC uses, trying to “close” that seam. Rather than just looking at still-serving and then released individuals as two sets of groups in two separate silos, we're looking at what we call the “life course” of the military member. We're trying to get a better picture of what's happening both during and after their service.
Senior Epidemiologist, Directorate of Force Health Protection, Canadian Forces Health Services Group, Department of National Defence
You're welcome.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Dr. Heber, when you have an active patient under the care of a psychiatrist, you have the warm handover you talked about. However, as you pointed out as well, there are many veterans who present later, well after their service is concluded. Of course, these are people who will be under provincial health systems and are going to present to family physicians and emergency departments, which is where I've spent my career.
Has Veterans Affairs been putting out education for primary care medical providers in the field that is specific to the medical and psychiatric needs of veterans and what the warning signs are?
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
Yes. We've started, in the last couple of years especially, initiating relationships with the College of Family Physicians of Canada, with providers, with some organizations, such as Calian, that have clinics and are interested in accepting veterans as their patients. We're looking at all kinds of things to help us make sure veterans are in care so that every veteran has a family physician.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Thank you.
To further expand on that, because again, I spent my career as an emergency physician, I wonder if there been outreach specifically to the associations that govern or train emergency physicians, let's say either the Royal College of Physicians or the Canadian Association of Emergency Physicians.
I ask because this isn't just a concern with veterans, but with people in general. There are so many people who either don't have family doctors or just can't get in.
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
Right, and they show up in the emergency department.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Many show up in the emergency department.
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
Absolutely.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Has there been any specific outreach to the emergency medicine community so that they can be better informed as to where to consult and where to direct the care of these veterans who show up on their doorstep?
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
I just looked over my shoulder at my medical director, and she just smiled, so I actually don't know. But if there hasn't been, that's a great suggestion, and we will look into that.
Really, we would like every front-line physician in Canada to be aware of issues that veterans may present with.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Yes, that's useful. Unlike in a family clinic, you often don't know the patient. You've never met them.
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
Yes, that's right.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
They say emergency medicine is the art of making correct decisions with insufficient information. When a veteran shows up on your doorstep, that is so very true.
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
Yes.
Even for emergency physicians to ask people if they've ever been a member.... Often that question isn't even asked of the patient who comes in.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
I have no further questions.
Thank you.
Conservative
Alupa Clarke Conservative Beauport—Limoilou, QC
Thank you, Mr. Chair, for giving me the floor.
I want to welcome Ms. Heber and Ms. Rolland-Harris and thank them for being here today.
My first question was provided by the person I'm replacing today, Cathy Wagantall, a very honourable woman.
Many veterans have repeatedly told us that a number of their brothers in arms committed suicide after taking mefloquine, an antimalarial drug. One of the veterans who wrote to my colleague, Ms. Wagantall, told us that he personally knew 11 veterans who committed suicide and that all 11 of them had taken mefloquine.
In the 21 years covered and of the 239 suicides recorded, how many of the brave men and women had been in malaria zones?
Do you have this information?
Senior Epidemiologist, Directorate of Force Health Protection, Canadian Forces Health Services Group, Department of National Defence
I don't have it on hand.
Conservative
Alupa Clarke Conservative Beauport—Limoilou, QC
In other words, you don't know how many of the 239 people took this drug.
Senior Epidemiologist, Directorate of Force Health Protection, Canadian Forces Health Services Group, Department of National Defence
Exactly. I'm not saying that the information wasn't collected. I'm simply saying that I don't have it on hand. Therefore, I can't analyze it.
Conservative
Alupa Clarke Conservative Beauport—Limoilou, QC
Okay. I understand.
Ms. Heber, at the Department of Veterans Affairs, could we obtain an answer by making an access to information request or by simply asking the minister?
Chief of Psychiatry, Health Professionals Division, Department of Veterans Affairs
On approximately how many veterans have...?
