Veterans Affairs Committee on June 7th, 2017

[Veronica Hancock]

Potentially there is, Ms. Wagantall. We're very interested in doing some research in this area.

We have an investigation under way through our Repatriation Medical Authority, the statutory body that sets the rules under which compensation claims are determined. They're doing a literature review, basically, and presently looking at and checking the current evidence for whether there is a need to have statements of principles in respect of chemically acquired brain injury caused by mefloquine or the related drugs. That report is due to come out within the next couple of months.

In light of whatever evidence is revealed in that investigation, we propose to develop a research proposal jointly with the Department of Defence, and we'd be absolutely open to an international collaboration on that. In fact, we have had conversations about our mutual research interests with our colleagues in the Canadian Veterans Affairs department on a regular basis anyway, so we're very happy to add that to the list of things that we would consider.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you very much.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Eyolfson.

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

Thank you very much.

I'd like to talk about transition from active military service to becoming a veteran. Our experience in Canada is that somewhere in the vicinity of 77% of veterans will transition very well to post-military life, but about 23% do report difficulties in that transition. One of the things we've noticed is that it isn't always related to being ill or injured. Sometimes these people are healthy when they're discharged, but they still have trouble transitioning. How do those kinds of numbers compare with the Australian experience?

[Liz Cosson]

Thank you.

I'll start. I'd like to then invite Kate Pope to talk about the transition work she's doing and Lisa Foreman to talk about our Prime Minister's employment program, which is supporting our transition.

Certainly those numbers do resonate with us. We have about 5,500 who separate from our Australian Defence Force each year, and about 20% of those are separating for either medical or administrative reasons.

We have been undertaking interviews with veterans and their families over the last 12 months. We have established a transition task force to help better inform what we need to do to assist with transition. What we are finding is that those who are not leaving voluntarily find it extremely challenging and difficult to make that step from their service life into civilian life.

We're putting in place a number of initiatives to support them during transition. We're working closely with the defence department and the Australian Defence Force in looking at how we can ensure continuity of care for those who are separating for medical reasons. Our Veterans and Veterans Families Counselling Service has some programs to support the veterans and their families to make that step and to understand what their experience might be post-transition. As I mentioned, Lisa Foreman and her team are leading a program for employment, which was launched by our Prime Minister last year.

That's just by way of introduction. Maybe I can open it up. Do you want a little more detail on the employment program, or counselling, or on the transition task force? Then I can coordinate the answer.

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

Yes, we don't have a lot of time, but maybe it could be just a brief overview on the elements of what the transition involves.

[Liz Cosson]

Okay.

Kate.

[Kate Pope]

I'm Kate Pope, and I'd be happy to answer that question.

We are looking at all elements that really comprise a successful transition being about a full life after leaving the military and moving into civilian life. There's a focus on employment and on health and medical well-being, and access to the Australian medical system in the usual way once people leave the military, in which all medical services have been provided for them. It's about housing. It's about social connections. It's very crucially about their families. And, certainly, when we hear of the struggles with transition, the families' experiences are very similar to what you were describing. Families struggle in that environment as well. It's about employment for spouses, education for children, and basically reintegration into civilian life. When we talk with veterans, similar to the way you described it, those who find it difficult can face some significant challenges, and transition always comes up.

We also had specific consultations with female veterans, and they have also very much emphasized the challenges here. So the work we're trying to do, as Ms. Cosson was describing, is to smooth that transition. One of the ways we are working to do that is through our early engagement program. We would like to consider serving personnel to be clients of Veterans' Affairs from the day they enlist right through to the end of their lives, so that the transition is not this sudden drop and they contact us only when they're in crisis, but instead that they have a relationship with us and they know the services we can provide and it's a whole-of-life continuity of a caring relationship, which is what we're working to develop now. Our hope is that we can make it a positive experience and smooth that challenge at the point of transition with a focus on healthy and productive lives and then healthy aging. We really want to focus on early intervention for medical conditions so that we treat early, we get the best results we can for the veteran, and we save money for the government as well.

[Liz Cosson]

One of the key things for us was that information sharing with Defence, so 12 months ago we initiated a program so that we would know everyone who enlists in the Australian Defence Force now. We have visibility of everyone who enlists and we also have visibility of any injury sustained during service, which the Department of Defence notifies us about. So we start to bring them into the Department of Veterans' Affairs before they need us.

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

All right. Thank you.

I have only about 30 seconds left. Among those who have difficulty transitioning, what would you estimate would be the most common defining factors?

[Liz Cosson]

The most common factor for me would be their getting into employment. They don't recognize the skills that they have. They're unable to translate their experiences to their CV for civilian employment. We have programs to help them do that and to get back into employment so they don't rely on welfare.

[Lisa Foreman]

The other thing I would add is about the way that they're discharged. Have they gone voluntarily? Those who leave voluntarily, who choose to discharge, seem to be in a much better state of mind and state of health compared to those who are discharged medically. They often fight it right until the very end because they want to stay in Defence. So when they're discharged and they come to us, they're angry and actually grieving because they've lost their career. I think that's a problem and I would add it to the previous answer.

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

Thank you.

[The Chair, Liberal, Neil Ellis]

Thank you very much.

Ms. Mathyssen.

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

Thank you very much, Mr. Chair.

To the Australian Department of Veterans' Affairs, thank you very much. We're extremely grateful to have access to your expertise.

I was very interested in what you said about the potential for a co-operative study between Australia and Canada's Department of Veterans Affairs in regard to mefloquine. I'm sure you know that this committee has been working on a study in regard to mental health and suicide prevention, and mefloquine has come up. It's been referenced by both experts and veterans with regard to the veterans who were given mefloquine during deployment. I have some concerns about our ability to finish this study. We're very close to the end of this session, and we'll be going away for the summer. If we prorogue, this study will be lost. But we'll see when the time comes.

I'm very concerned that this work will go astray, particularly in light of the fact that you said Veterans Affairs Canada has indicated an interest in co-operating with your department to look at the impact of mefloquine. First, can you give us a sense of what has been determined in regard to that co-operative study? Second, obviously there was something that compelled you to look at mefloquine. Was it the anecdotal reports from veterans? Was it concern from the medical community? What precisely prompted the decision to look at a potential study?

[Veronica Hancock]

Thank you, Ms. Mathyssen.

Just to correct the record, our discussions with Veterans Affairs Canada have ranged across our mutual research interests. We haven't at this point specifically discussed mefloquine, but I certainly would like to convey the impression that we are very willing to consider adding it to our list of mutual research interests. The issues that we have primarily focused on in relation to our mutual research interests to date include transition, mental health generally, homelessness, and suicide, but as I said, we'd be very open to considering some joint work on mefloquine as well.

The interest in Australia has very much been sparked by some concerted lobbying efforts from affected individuals, including Professor Quinn, to whom your colleague referred earlier. Those concerns have been raised for some time now. There has been some research internationally. Mefloquine is used across the Australian community as an anti-malarial. Outside defence circles, it's still being used, and it has been used for quite some time.

One of the reasons we're interested in the literature search currently being undertaken by our Repatriation Medical Authority is that they're looking at the consequences of exposure across the whole population, which gives potentially a much better idea of numbers. From a research perspective, in Australia the number of people who have taken mefloquine as an anti-malarial is so small it's very hard to get robust evidence. We're hoping that by looking at numbers across the broader community we'll be able to get a better picture of the situation.

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

Thank you.

I'm assuming that other drugs were used instead of mefloquine in regard to anti-malarials.

[Veronica Hancock]

Yes. In Australia the first-line drug is doxycycline. That's by far the most widely used.

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

Thank you.

There has also been discussion in this committee on military sexual trauma, and we are hearing from both men and women as it pertains to their experiences in the armed forces.

I see you have support for individuals who have experienced sexual or physical abuse in the Australian Defence Force, and that you provide counselling and special services, case management, and group programs to about 20,000 current and former Australian Defence Force members and their families each year.

Can you describe the process for how those who have suffered sexual trauma come forward and how their evidence is treated? How do they get into these counselling sessions? I'll be very frank. Here, concern has been expressed that the counselling sessions that are offered are not particularly tailored toward those who come from a military background and that culture.

Is that part of how you put together your programs? Could you simply describe the process and the program?

[The Chair, Liberal, Neil Ellis]

I apologize, as we're about 30 seconds over time. I'll give the member another 30 seconds, if you can answer that quickly.

[Lisa Foreman]

I'll take 15 seconds.

We've just had a royal commission into abuse of children by institutions. Defence was one of those institutions. We have changed our rules for how members who have suffered abuse claim compensation. I'll leave it at that. That's what we've done. At one end, we've made it simpler for those members who have suffered abuse to come forward and claim compensation.

I'd be happy to talk about that some other time, but I'll pass to Stephanie to talk about the counselling aspect.

[Col Stephanie Hodson]

Very briefly, I think the big points are that they can start counselling immediately. We don't require them to apply for compensation. Often we will get people through our telephone line, and then they are put into face-to-face counselling.

We do a lot of effort. We consistently provide free training to a network of 1,400 counsellors. A lot of the counsellors in our network are actually ex-military mental health professionals, but importantly it is about keeping a very free and readily accessible service that is military aware.

We have put a lot of work into making sure that our counselling service is military aware. Anything to do with sexual assault will be handled very carefully, and we work very carefully with the specialists in the area as well. Sometimes we need to refer....

[The Chair, Liberal, Neil Ellis]

Mr. Bratina.

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

Thank you.

I would like to direct my questions to Mr. Orme.

Sir, you are the deputy president for the Repatriation Commission.

Is that correct?

[Craig Orme]

Yes, sir.

The Repatriation Commission is the statutory body set up to oversee the respective acts, the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Commission, which was established to oversee the act and to work in concert with the department very closely on behalf of veterans.