Veterans Affairs Committee on March 20th, 2017

[John Brassard, Conservative, Barrie—Innisfil, ON]

Thank you, Mr. Chair.

The veterans advisory group that the Minister of Veterans Affairs set up is hosting a meeting this week on mental health. One of the issues they are going to be discussing is suicide. Are either of you invited to that meeting?

[Dr. Alexandra Heber]

Yes, I am presenting at that meeting on Wednesday. It's the mental health advisory group of the Minister of Veterans Affairs.

[John Brassard, Conservative, Barrie—Innisfil, ON]

First of all, I'm glad to hear that.

Dr. Harris, you're not going to be there?

[Dr. Elizabeth Rolland-Harris]

No, I'm not invited.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Here's the thing, and you've spoken about it. As a committee, we're studying mental health issues and suicide prevention. You mentioned that Veterans Affairs and the Canadian Armed Forces are studying mental health strategies and suicide prevention strategies. We now have an advisory committee that's going to be dealing with this in a one-day summit on suicide. Do we have too many cooks in the kitchen to deal with this issue? Are there way too many people involved in this? I ask because ask because nothing is getting done.

It's frustrating on my part to hear about all these studies, advisory groups, and meetings, and yet seemingly there is not much being done in the way of implementing a strategy. It seems that a lot of people are running around justifying their existence, but nobody is really doing anything. I'm just wondering about this. When do we get to that point where stuff is actually done in order to deal with this issue?

[Dr. Elizabeth Rolland-Harris]

I don't think I'm particularly well placed to answer that question realistically.

[Dr. Alexandra Heber]

Let me answer that question. We do a great deal.

We do a great deal in Veterans Affairs Canada. As I said, from 2000, on the whole issue of suicide, even though, as I said before, there are challenges for our knowing about suicides in the veteran population, we have worked on putting many things into place, both for suicide prevention and for getting people access to mental health care.

Again, as I said, we know that leads to.... It's one of the most important things for us to do to help prevent suicides. All of our case managers receive suicide prevention training, and that training is updated every year. Also, any front-line worker at Veterans Affairs Canada now receives suicide prevention training. If you phone and somebody answers the phone, they've received that kind of training. They have a sense of what to do if they are concerned about the person on the other end of that line.

In addition to having case management and front-line workers who, again, can coordinate care for anybody who comes in and has a service-related mental health injury, they can be referred to an OSI clinic. If they're in an area where there are no OSI clinics, we have 4,000 mental health providers in Canada who we can access from Veterans Affairs Canada to serve our population.

[John Brassard, Conservative, Barrie—Innisfil, ON]

With all of the things you're doing and all of the studies that are going on, are we ever going to get to a point where we can actually prevent this from happening?

[Dr. Alexandra Heber]

You know—and Elizabeth said this—we really believe that one suicide is too many, but I think that if you look at any population, you can see that suicide does occur. Will we ever be able to prevent every single suicide? I don't know, but that's what we're working towards.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Dr. Harris, statistically, I want to ask you about prescription drugs and opioids as a means to treat those who are suffering from PTSD, perhaps, or from an occupational stress injury. Have you statistically kept track of how many of those who commit suicide are on these types of medications?

[Dr. Elizabeth Rolland-Harris]

The MPTSR keeps track of what medications individuals are on at the time and preceding their death, and anecdotally we haven't seen anything—

[John Brassard, Conservative, Barrie—Innisfil, ON]

Does that form part of a report?

[Dr. Elizabeth Rolland-Harris]

We don't report on opioids specifically within the MPTSR annual reports, no, but the numbers would be very small, so we probably wouldn't be able to.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Recently, the Department of Veterans Affairs reduced the amount of marijuana that can be prescribed from 10 grams to three grams. Were either of you consulted in that decision at all?

[Dr. Elizabeth Rolland-Harris]

No, but I'm not a physician.

[John Brassard, Conservative, Barrie—Innisfil, ON]

I understand.

Doctor, were you consulted in that decision at all?

[Dr. Alexandra Heber]

I'm sorry. I need you to repeat your question about what Veterans Affairs Canada has done.

[John Brassard, Conservative, Barrie—Innisfil, ON]

They reduced the amount of marijuana allowed for veterans from 10 grams to three grams a day.

[Dr. Alexandra Heber]

Let me say first that Veterans Affairs Canada does not prescribe or authorize marijuana or any medications. What we do is fund treatments, and we fund marijuana to a certain extent. Before, Veterans Affairs Canada was funding up to 10 grams per day of marijuana for an individual. That amount will be cut down based on the amount that's funded—not Veterans Affairs. If a family physician, for example, is authorizing the marijuana and feels strongly that this person needs more than three grams, he or she needs to consult a specialist physician on the reason that the person is receiving the marijuana, and do another assessment and say, yes, this person needs more than three grams a day.

[John Brassard, Conservative, Barrie—Innisfil, ON]

I'm aware of the process. I'm asking whether, as the chief of psychiatry, you were consulted on this decision. Were you consulted on this decision to reduce it from 10 grams to three grams?

The reason I'm asking is that we had the minister here, who said he had consulted broadly with a wide range of professionals. As the chief of psychiatry, were you consulted on this decision?

[Dr. Alexandra Heber]

This decision was actually made before I started working for Veterans Affairs Canada, but I know the people who sat on the expert panel who were consulted. They included—

[John Brassard, Conservative, Barrie—Innisfil, ON]

Your predecessor?

[Dr. Alexandra Heber]

I had no predecessor. These were experts in using marijuana for medical purposes.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Eyolfson.

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

Thank you for coming.

Dr. Heber, I have a bit of a bias on this particular issue. I'm an RCMP brat.

We have been talking about the Canadian Forces members and their suicide rate. I know the numbers are probably smaller, just from the fact of the number of members who have served, but how did the suicide rates among RCMP veterans compare with Canadian Forces veterans?