Veterans Affairs Committee on March 1st, 2018

[The Chair, Liberal, Neil Ellis]

Good morning, everybody. I'd like to call the meeting to order.

We're resuming our study of barriers to transition and measurable outcomes of successful transition. Today we have one panel joining us. Hopefully, we'll get a round and a half in. Then we have some committee business to do.

Joining us today are the Veterans Affairs and National Defence departments. From the Department of Veterans Affairs, we welcome Faith McIntyre, director general, policy and research division, strategic policy and commemoration, and Robert Cormier, director of field operations, strategic affairs. From the Department of National Defence, we welcome Dr. Alla Skomorovsky, Dr. Dursun, and Colonel Maurais.

We'll begin with the five presentations. Dr. Dursun will start.

[Dr. Sanela Dursun, Director, Research Personnel and Family Support, Defence Research and Development Canada]

Mr. Chair, Mr. Vice-Chair, and members of the committee, my name is Sanela Dursun. I am the director of the personnel and family support research organization at the Department of National Defence, responsible for the Canadian Armed Forces psychosocial health dynamics research, conditions of service and the work environment, and military family research. We conduct research in support of effective and affordable programs, policies, and services for military personnel and their families that enhance individual and family well-being, care for the ill and injured, and prepare members for transition to civilian life.

In the last couple of years, we've pioneered research on the experiences of Canadian Armed Forces members and their families in the transition from military to civilian life. We've developed many external relationships and an international reputation, having collaborated with federal departments such as Veterans Affairs and Statistics Canada, and we have contributed to and led conferences on veterans' health and family well-being. Our defence scientists have participated in numerous international initiatives, including research-sharing groups such as the technical co-operation panel, known as the TTCP, for example, and NATO research task groups. I am a co-chair of the NATO research task group on the transition of military veterans from active service to civilian life.

Today I'd like to highlight two projects, two initiatives, in our organization. In particular, the focus is on the transition of ill and injured members and their families.

The Canadian Armed Forces transition and well-being survey, which was administered this past summer by Statistics Canada, was led by our organization in consultation with our Veterans Affairs partners. The survey sought to compare a sample of 1,000 veterans who were medically released in 2016 with 1,000 veterans who were not medically released in the same year. Spouses were also included in this sample.

Survey questions asked about their health and well-being, activities undertaken to prepare for transition, use of transition services, and family well-being. This study will provide population estimates on the utilization of services, in addition to service barriers or gaps, and various health outcomes. It will also provide baseline estimates for the longitudinal component of future surveys.

Data collection was completed this summer. We had a 70% response rate. The first results will be released by Statistics Canada in March 2018, in just a few days.

The next project I would like to highlight is the assessment of the operational stress injury social support program, known as the OSISS program. We examined in detail participants' experiences with this specific National Defence and Veterans Affairs program, using semi-structured interviews with about 100 participants in the operational stress injury peer support and family support programs across Canada.

We found that participants commonly valued the fact that the program allowed them to meet others with similar backgrounds and experiences. They also valued the fact that the program allowed them to make social connections, to have increased access to support, to exchange information, and to speak openly in a safe environment about their experiences with an operational stress injury.

In addition to the overwhelmingly positive experiences of OSISS participants as well as their family caregivers, some key challenges and barriers were identified. As illustrated by the above examples, National Defence and Veterans Affairs have been engaged in an increasing number of coordinated research activities to better understand the experiences and needs of Canadian Armed Forces members and their families during the transition from military to civilian life. Collectively, these efforts have filled an important knowledge gap and have contributed to a stronger evidence base for enhancing policies, programs, and services aimed at making the transition from military to civilian life more seamless for military members and their families.

Thank you for the invitation to appear before the committee today.

[The Chair, Liberal, Neil Ellis]

Dr. Skomorovsky.

[Dr. Alla Skomorovsky, Department of National Defence]

Thank you, members.

My name is Alla Skomorovsky. I have been a defence scientist in the Director General Military Personnel Research and Analysis at the Department of National Defence for 13 years now. Since 2009, I have been working as a researcher and a team leader for the military families research team. Specifically, my responsibilities include planning, conducting, and communicating social science research on the issues related to Canadian Armed Forces families.

The military family research team's program of research covers three primary domains: the health and well-being of Canadian Armed Forces families, which includes the well-being of spouses of CAF members and children from CAF families; programs and services available for CAF families, which includes evaluating the effectiveness of programs available for CAF families and their awareness of and satisfaction with those services; and, finally, the impact of occupational stressors faced by CAF members on their families in general, which includes CAF families' transitions to civilian life and their well-being and caring for ill and injured military members and their families.

In the remainder of this presentation, I will focus on the research program being developed under this third domain.

To date there has been little research that examined transition-related issues in military families from the perspective of the spouse/partner and from the military member and spouse/partner dyads. Therefore, a research program was developed in the Director General Military Personnel Research and Analysis that examined the impact of transition and illness and injury of Canadian Armed Forces members from the dual perspective: the member and the spouse or partner.

The first phase of this research program that I would like to highlight is the pilot study that we conducted in the fall of 2015. This study examined the key determinants in the well-being of CAF members and their families from both perspectives: the member and the spouse. We administered paper-and-pencil versions to CAF members and spouses who self-identified as ill or injured, and they were completed by 170 full CAF members and 69 spouses or partners.

The results showed that the members' illness or injury did in fact affect their own overall well-being and the well-being of spouses and had an impact on the relationship between the spouses. Spousal caregiver burden was also found to play a major role in the path between the members' health and well-being and the spousal health and well-being.

To follow up on the study, a second phase of this research program, this time an in-depth qualitative study, was conducted to examine the needs of families with an illness or injury going through transition to civilian life. This study had a particular focus on their use, awareness of, and satisfaction with various services and programs available to CAF families going through transition to civilian life. The study aims to examine both perspectives: once again, the medically releasing member or veteran and the family members, and this time including spouse or partner, parents, and, if applicable, siblings.

The qualitative study is in the data collection phase right now. Interviews are currently being conducted across Canada in various locations, including Ottawa, Halifax, Vancouver, Gagetown, Petawawa, Quebec City, and Edmonton. The interviews last about 60 minutes and are being conducted either in person or over the phone, based on the participant's choice. We developed separate moderator guides for the military member and the family member, given the focus of the questions. The participants have a choice of having an interview together or separately.

To date, we have conducted 41 interviews with medically releasing or already released CAF members, or veterans, as well as with 21 caregivers, largely spouses. We are expecting an additional 20 interviews with CAF members or veterans and 15 family members. They are already planned.

Although the study is still in progress, there are already several common themes that we've observed through collecting data. We are observing the impact of military members' illness and injury on their well-being and overall life satisfaction, and on the overall life satisfaction of their spouses or other family members. We also see that there are some issues in obtaining a civilian family doctor for military families and in terms of a lack of clarity with regard to the release process itself.

We believe that examining transition experiences of medically released members and their families in more detail will allow us to better understand the unique changes these families face in the transition process.

Ultimately, this research will place the Canadian Armed Forces in a better position to prepare military families for this important transition and help CAF, DND, and Veterans Affairs Canada, deliver its mandate to provide care and support to CAF members and veterans following the process and following their release from the military.

Thank you.

[The Chair, Liberal, Neil Ellis]

Colonel Maurais.

[Colonel Sylvain Maurais, Department of National Defence]

Mr. Chair, ladies and gentlemen, good morning.

I'm Colonel Sylvain Maurais, a member of the Royal Canadian Chaplain Service. I have served the Canadian Armed Forces as a military chaplain since 1985. Presently, I fulfill the duties of Director of Chaplaincy Services and of Chaplain Branch Advisor. In these functions, I lead the administration of Canadian Armed Forces chaplain recruiting and training, as well as the development of policy, communication, and strategy for the Chaplain Service. The Chaplain Branch is composed of over 200 Regular Force chaplains and over 150 Reserve Force chaplains coming from diverse Christian, Jewish, and Muslim faith traditions.

The Royal Canadian Chaplain Service mission is to exercise moral leadership by offering care, support, and advice for the spiritual well-being of all members of the defence team and military families, always respecting the freedom of conscience and religion of each person.

Our vision is to be a caring and compassionate interfaith chaplaincy that empowers our people morally and spiritually to be strong, resilient, and ready in their noble mission for the defence of security and the protection of freedom and peace at home and abroad. We serve those who serve and as chaplains we are with them in all stages of their military life and career. It begins at basic training where we train with them, we deploy with them, and we also have direct access to family members. We accompany them in times of joy: when they get married; when they have children; for baptisms; and also in times of grief when people are dying and offering their life for the cause of security and peace and when they are injured. We care for the spiritual well-being of all, and we also promote the moral and spiritual development of all, respecting the freedom of conscience and religion of each person.

The care of the moral and spiritual well-being of the Defence Team and families calls chaplains to exercise what we refer to as a “ministry of presence”. Chaplains have nothing to offer but to be with people. We walk with them, we journey alongside them, we accompany them, we know them, and we offer them an attentive, sympathetic, and non-judgmental ear. The more we get to know our flock, the better equipped we are to offer compassion to those who are suffering, to those who are in need, be they sick, wounded, detainees, prisoners of war, or bereaved. We have assisted all the commanding officers in every situation where loved ones needed to be notified of a death.

Chaplains are often on the front lines when dealing with cases of conflict, abuse of power, or professional misconduct in the workplace or at home. Chaplains also make recommendations concerning compassionate cases. In addition, we promote religious freedom. We facilitate the celebration of important moments in people's lives, according to their own spiritual and religious traditions. We facilitate and encourage the promotion of spiritual and religious diversity within the Forces, which includes not only diverse beliefs, but also the freedom to not believe, because that too is a spiritual dimension of human beings.

We do all this work in collaboration with all the Canadian Armed Forces specialists, including those working in health services, the Defence Ethics Program staff, and everyone in personnel support.

The promotion of the moral and spiritual development of all members of the defence community calls on our chaplains to advise the defence leadership on all moral, spiritual, and religious issues that affect the operational effectiveness of the Canadian Armed Forces, the morale of our people and their well-being.

We lean also on the great research that is done by the director general of military personnel research and analysis. We have done great research recently on what we mean by spiritual well-being, spiritual wellness, and spiritual resilience in order to have a common evidence-based definition from psychosocial research that allows us to have a spiritual fitness continuum, with indicators on how people are morally and spiritually healthy. Thank you, DGMPRA.

Also, based on this, chaplains are developing new capabilities to provide training and education on spiritual resilience and moral development. We don't want to have people come and see us just when people die or when people are in great need. We have to be stronger in being part of the prevention of the risk of moral and spiritual injury, through training and education.

Finally, spiritual wellness helps our people, and all of us, to find meaning and purpose in life. It helps us to remain hopeful in hopeless situations. It is the capacity within us to inspire faith in ourselves; in others; and for many, in a higher power, or transcendent reality. It sometimes gives us the strength to forgive ourselves and to forgive others. It is the central development aspect of our moral character, of our values and beliefs. It helps us not only to honour our own beliefs but to be open and respectful of the beliefs of others. Also, it allows us to express the joy and the sadness of life through sacred rituals that help us to believe that there are things that go beyond time and space.

I'm very proud of what we do. I love what I do. And mainly, I love the people of the defence community for what they do for our country. They deserve all the best support they can get.

[The Chair, Liberal, Neil Ellis]

Ms. McIntyre.

[Faith McIntyre, Director General, Policy and Research Division, Strategic Policy and Commemoration, Department of Veterans Affairs]

Good morning, Mr. Chair, vice-chairs, and members of the committee.

My name is Faith McIntyre, and I'm the director general of policy and research with Veterans Affairs Canada. I am also the co-chair of the ministerial advisory group on families, with Sergeant, retired, Alannah Gilmore.

I am pleased to be here today with my colleague Robert Cormier, who is the director of strategic affairs for field operations; as well as my colleagues from the Canadian Armed Forces and the Department of National Defence.

We're very pleased to speak to you today on a very important topic in regard to your work on transition, and specifically in the area of families. Robert and I will briefly touch on research on families, the ministerial advisory group, and programs and services available to families.

A critical part of Veterans Affairs Canada's mission is to provide exemplary client-centred services and benefits that respond to the needs of veterans, our other clients, and their families. Our goal is for veterans and their families to receive the care and support they need when they need it.

Veterans Affairs Canada recognizes that family members play an important role in supporting members of our armed forces while they serve and as they transition to civilian life. The most successful transitions occur when a veteran has a positive state of well-being—a balance of financial, mental, spiritual, physical, and social factors, with family supports being critical.

Research has shown that most veterans transition well from military to post-military life and that military families tend to be resilient, loyal, resourceful, and proud. However, for some, it can be an especially difficult time on the member and the family. Negative impacts of service-related conditions, and military service, in general, on families have been identified. They include divorce, financial insecurity, stress, low life satisfaction, mental health problems, among others. Recent research has focused on the role of interventions aimed at improving family resilience in mitigating the impacts of service-related conditions and military service in general.

In 2016, on behalf of Veterans Affairs Canada, Statistics Canada conducted the Life After Service Survey, which included new content on families. The data were gathered through telephone interviews with veterans who had released from the Regular Force between 1998 and 2015. The family questions that the veterans were asked concerned a variety of subjects.

The majority of veterans, specifically 87% of them, said they were satisfied with their family support. Spouses or partners are the main source of social support for 71% of veterans and the main source of support for daily activities of living for 76%. However, it's worth noting that 28% of veterans reported that their spouse or partner had difficulty adapting to the transition, and 17% said the same about their children. We also reviewed the documentation on the impacts that operational stress injuries have on family mental health and well-being.

In doing so, we found more and more clear proof of the negative effects that operational stress injuries, primarily post-traumatic stress, have on families.

Further to this literature review, Veterans Affairs Canada initiated a qualitative study. Twenty-seven in-depth interviews and three focus groups were conducted. The study examines family impacts of Canadian Armed Forces veterans with mental health problems and whether their families are accessing supports and, if so, whether they are beneficial.

The report will be issued in the coming months. The initial indications support and validate previous findings and anecdotal information: families are resilient; they are important to veteran well-being and to adjustment to civilian life; they can feel isolated and misunderstood; and, families want information and support directly provided to them, not through the veteran. We expect to also see new findings that will help us focus on how best to engage with families and how they can help us to better understand their needs.

Veterans Affairs Canada has six ministerial advisory groups. The one pertinent to note today is the ministerial advisory group on families, whose mandate is to provide advice to the Minister of Veterans Affairs to ensure that families of the Canadian Armed Forces and RCMP veterans are considered when developing policy, programs, and services and that family members are treated with care, compassion, and respect. You have heard from members of this group, including Nora Spinks and Jenny Migneault.

The advisory group identified several recommendations grouped under three themes: recognize and compensate; inform and engage; and, serve and support. These recommendations were presented in October 2016 at a stakeholder summit. The important insights of this group, along with the recommendations of these individuals, who all have a very distinct background, helped shape policy development and programming and will continue to do so in the future.

I will now pass this over to my colleague Robert Cormier, who will speak in particular about the Veterans Affairs programs and services available to veterans and their families.

[Robert Cormier, Director of Field Operations, Strategic Affairs, Department of Veterans Affairs]

Veterans Affairs Canada recognizes the importance of the family and its significance in the health and wellness of individuals. Established best practices recognize the importance of involving family in treatment plans, as families are, in many cases, the first source of support for veterans and are integral to successful recovery. Mental health services are intended to support veterans in becoming or remaining independently functioning in the community. The veteran's family members may be included in mental health services when the veteran's treatment or rehabilitation plan has established that doing so is required in order to achieve positive treatment outcomes for the veteran's condition.

Veterans Affairs Canada offers families a wide range of mental health services. The Veterans Affairs Canada Assistance Service is a consultation and referral service that is available 24 hours a day, 365 days a year. The Veterans Affairs Canada Assistance Service is for veterans, former members of the Royal Canadian Mounted Police, their families, and caregivers and is provided at no cost. In addition, peer support coordinators for families across the country can put the family member in touch with peer support groups. A two-day course on mental health first aid for the veteran community is tailored to address the immediate mental health needs of veterans and the people who care for, and about, them.

Many online tools have been developed to help caregivers, such as the Operational Stress Injury Resource for Caregivers, a self-directed tool designed for caregivers and families of Canadian Armed Forces members or veterans living with an operational stress injury. The mobile application PTSD Coach Canada is a dependable resource when used together with professional medical treatment. Furthermore, a new online tool for caregivers is currently being developed in collaboration with Saint Elizabeth Health Care, in response to recommendations to do more to help veterans' caregivers.

With the knowledge of the fact that when veterans experience difficulty with transition, it is likely that the family also faces challenges and requires support, Veterans Affairs Canada and the Canadian Armed Forces implemented a pilot project in October 2015. The veteran family program includes access to services available through the military family resource centres. The program also provides access to the 24-7, phone-based family information line and the familyforce.ca website, now updated to CAFconnection.ca website. As of April 1, 2018, these services will become available to all medically releasing members and their families.

Partners of transitioning members are welcome to attend second career assistance network sessions as well as transition interviews with a releasing member. For those who are unable to transition successfully, Veterans Affairs Canada's rehabilitation services and vocational assistance program provides eligible veterans and their spouses or survivors with medical, psychosocial, and/or vocational services.

As of June 30, 2017, 196 spouses or survivors benefited from rehabilitation services. These vocational supports may include help to identify suitable employment, job search skills, resumé development, and financial support for training and related costs.

In conclusion, Veterans Affairs Canada recognizes the importance of the family as a veteran's most important ally on the path to transition.

I want to note that every veteran and family's situation is different. However, one unifying experience is the major life change that results from the journey to life after service. Veterans Affairs Canada needs to be there when they need us. The most successful transition occurs when a veteran has a positive state of well-being, a balance of financial, mental, spiritual, physical, and social factors. Financial security is critical. The family plays a key role in supporting a veteran throughout their journey, and Veterans Affairs Canada continues to find more ways to provide support and services to families in recognition of their role in supporting the veteran.

Thank you again for the invitation to speak to you today. I very much appreciate the opportunity to support the work of your committee and to consider what it may hold for the future of Canada's service to veterans and their families in recognition of their extraordinary contributions and sacrifice.

[The Chair, Liberal, Neil Ellis]

Thank you.

We'll begin with questions starting with Mr. McColeman. Six minutes.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Thank you, Chair.

Mr. Cormier, in your title, I noticed that it says director of field operations. Does that mean you're responsible for how the connections are made between VAC and the veteran?

[Robert Cormier]

Correct.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Okay, that's fine.

On that front, do you keep statistics in terms of how veterans connect with you as a director? Are there statistics of how many do it on line, how many do it by walking in the door of a back office? Do you keep those statistics?

[Robert Cormier]

We do.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Okay, thank you.

I want to move on to Ms. McIntyre.

Recently there's been one private member's bill and one other motion put on the floor of the House of Commons. The first one, the private member's bill, is to recognize a sacred covenant between Canadians, not just the Government of Canada but all Canadians and those who have served us in military life. This is as much to follow the European example of the British Parliament passing such a covenant within legislation.

I don't want to pull you into a political argument here. That is not my intent. However, the one thing that struck me between the eyes in your comments today was that you used three words: “care, compassion and respect”. I would think that characterizes most members of Parliament who spend any time around veterans and veterans' families, as many of us do across the country. When you boil down some of the issues they're facing, it boils down to respect. They would like to have the respect and know that.... That's what the British Parliament did. It enshrined it. That's what a private member was trying to do on the floor of the House of Commons.

My question is this. In your work, through families that you've described today and through veterans, how important are those three words?

[Faith McIntyre]

Certainly when we look at what we do within Veterans Affairs Canada, our values are based very strongly on care, compassion, and respect.

I must start by saying that care, compassion, and respect is not only outward facing, but also very much within what we do amongst ourselves within the departments and the partnerships we've built with others. I can't say enough about the staff that we have and the work they do in order to deliver the care, compassion, and respect that is outward facing. The words are very important.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Very important. Okay, that's fine.

I want to move on to Colonel Maurais.

Your work obviously is all facets of the human being. Can I have your opinion, sir, on how important those three words are in your work with veterans?

[Col Sylvain Maurais]

Sir, it is at the heart of our vision statement. Is it at the heart of leadership? It is absolutely essential. That's the reason we say it is a moral and spiritual component of the call to serve. It's the heart of the community.

[Phil McColeman, Conservative, Brantford—Brant, ON]

I would take from those comments that you would have no objection to it being put into the legislation of Veterans Affairs, and that those be stated and forever recognized as a covenant between the people of Canada and veterans. Am I correct in saying that?

[Col Sylvain Maurais]

It's a good question, sir. I can speak for what the chaplaincy represents at the heart of the military community, which has an impact also on the people—namely, that when they leave the forces, they're still part of what I would say is the Canadian military community.

I know how dedicated the people of Veterans Affairs are. I cannot speak on their behalf, but I know they're trying to do everything to embody those vital virtues.

[Phil McColeman, Conservative, Brantford—Brant, ON]

I don't want to make you feel uncomfortable because we know how the government voted and they voted against doing that, okay. I don't want to make you feel uncomfortable by trying to play one side of this argument or the other. In essence, I think what I've heard from all of you is, if there is something that's more important than anything else in terms of families, I've just got to say it, I've heard it so many times, and it's amount to really one word: “respect”. I appreciate the work that you do that carries that forward.

On the study that you're doing, Madam McIntyre, you mentioned, or maybe it was Mr. Cormier, that 27 families were selected. How did that selection process work? How were those 27 determined? What were the criteria?

[The Chair, Liberal, Neil Ellis]

I apologize [Inaudible] short.

[Faith McIntyre]

We contracted that work to the Canadian Institute for Military and Veteran Health Research at Queen's University. I can't speak specifically to how, but it has followed all required research protocols to be able to determine the 27 interviews and three focus groups.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Chair, through you, could I ask that you ask the witness to provide more details?

[The Chair, Liberal, Neil Ellis]

Yes. If you could dig down on that and get that back to the clerk.