Veterans Affairs Committee on April 14th, 2021

[Tina Fitzpatrick]

Absolutely.

[The Chair, Liberal, Bryan May]

Thank you, Mr. Doherty.

Up next, we have MP Amos, for five minutes, please.

[William Amos, Liberal, Pontiac, QC]

Thank you, Chair.

I'd like to extend a particular thanks to our witnesses today. These are difficult stories to tell. They're emotion riddled, and I think all of us feel the burden you bear in telling your stories. It's important for Canadians to understand the plight of many veterans' families.

I was particularly struck by the commentary around the negativity towards the bureaucracy—that oppositional feeling. I'm trying to explore this in a different way with you. Oftentimes large institutions, which aren't represented by any one individual but are a collection of individuals and rules and processes, work better if they're given positive feedback on where it is working, because that helps to identify where it's also not working.

I want to go through a list of some of the mental health services that Veterans Affairs provides, at least in this fiscal year and the fiscal year of 2019-20, where $84 million was invested in the following way. If our three witnesses could advise what areas are functioning well, that would be helpful I think.

I see here that there's funding for 11 operational stress injury clinics across the country, 10 of which are outpatient and one of which is in-patient. There is the operational stress injuries social support services. There's the Veterans Affairs Canada assistance service's toll-free telephone line. There's the veteran-specific mental health first aid. There are two mobile apps: the OSI Connect mobile and PTSD Coach Canada. There's the mental health directorate within the department. We've heard some commentary around that already. There's the operational stress injury resource for caregivers. There's the veterans and mental health online tutorial. There's access for medically released veterans and their families to 32 family resource centre sites across the country, as well as the family helpline and familyforce.ca website.

Could each of you comment as briefly or as long as you'd like on what is working?

[Sean Bruyea]

Mr. Amos, I really appreciate your question.

I just wanted to speak to the paradigm by which we have to compliment the bureaucracy so that they let their guard down and do the right thing. It has been my experience over 20 years that when you compliment them, the bureaucrats immediately say, “Hey, we're doing a good job. We don't have to do anything differently.”

The problem is that with the funding for mental health, we have to understand the users first. Let's not understand the bureaucracy. Let's understand the users, the families and veterans first. When someone suffers a mental health illness, it is 24 hours a day. It is seven days a week. It is all year long. It affects everyone around them.

What we need is a comprehensive system that will address that. Veterans need to know that they can get that care. Like Tina said, they can call a case manager, but that's only a half measure. All of the mental health programs at Veterans Affairs are half measures. They only work for those who are persevering, those who are articulate and those who can fight. Veterans who are suffering with a mental health illness need someone—or a team—who will be there all the time, every day. Only with that security can they take the steps to better their lives.

[Allan Hunter]

If I may, “continuum of care” is a term that's used in the medical profession. It's critical, from inception to completion, to make sure that continuum of care happens. All of these programs you mentioned, and we've spent $84 million on these, that's great because at the initial contact, wow, here's a person who leaves with the feeling that “There are some things in place that I might be able to access, and I might not be in this place again.” Then the next piece comes in. “Okay, let's look at your account. Have you filled out this form? Have you filled out that form? No, sir, we didn't find your advocate's consent notice”, even though, in fact, it was in place, and all those things.

As Mr. Bruyea alluded, the programs don't recognize that the person on the receiving end of that continuum of care might not be articulate and might not understand how the systems work. The mark of any great organization, especially the military, is the leadership. The leadership has to say, “We recognize that we're dealing with multicultural issues, educational issues.” A lot of people join the military because life isn't so good in the family. They go in and they get trained in a trade. They come out without a good academic education, and they're thrust out there with “here's a whole pile of money”. They spend it all but they haven't addressed all their problems so they end up coming back. It's very cyclical.

Again, I can tell you from my own experience as a service officer that, indeed, some of the programs have in some of those cases saved lives. However, in other cases, as I've mentioned, people didn't make it. They're no longer with us and their families are left behind to bear the burden of asking themselves, “What could we have done differently?“

I would like to say to everybody in this committee, if you believe that women are not second-class citizens in this system, especially female veterans, do something about it. Don't just talk at committee. Go out there and say, “We are not going to accept our government telling us to continue to put nice platitudes out there, but not to do things to deliver these veterans from the battles they face at home.”

[The Chair, Liberal, Bryan May]

Thank you, Mr. Hunter.

Up next is MP Desilets, for two and a half minutes, please.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Mr. Chair.

Ms. Fitzpatrick, I am repeating myself, but I think you are very brave and I have a great deal of respect for you. You have been interacting with the Department of Veterans Affairs for 15 or 17 years, according to what you said earlier. You said that you have made thousands of telephone calls to the department. Last Monday, in the same committee, the deputy minister of Veterans Affairs, Mr. Natynczyk, said he has reduced the response time to two minutes.

I heard that answer two days ago, and I still don't understand it. I even asked Mr. Natynczyk to repeat it. I don't know whether he was referring to one or several sectors. I am sure the department has nevertheless evolved.

Have you received responses in less than two minutes in recent years?

[Tina Fitzpatrick]

Absolutely not—never. In two minutes...? No. The last time I dealt with the OSI clinic was in 2011. My husband was called and was asked to go to the OSI clinic. There is none in Newfoundland, so he had to go to New Brunswick. He didn't want to go, because he said that he didn't want to go over his trauma. He has seen a psychologist for 17 years now, the same psychologist. He didn't want to go. They insisted that he go to this OSI clinic in New Brunswick.

We both went. We went for five days and we came back. We had no rental car and we stayed in a hotel with no restaurant, so we were told to take cabs everywhere and keep all of our receipts. I came home and did exactly what the girl told me. I kept all the receipts and sent them in. I got a letter back saying that the only receipt that would be paid back was our receipt from the airport to the hotel. That was in 2011.

At that point, I said, “Okay, we're done with you guys.” I hadn't contacted them, maybe for prescription renewals and that kind of thing, but I was done. Then in 2018 I did contact them about the earnings loss benefit, and I was told by Seamus O'Regan in 2018 that I would get an answer. I got an answer two weeks ago—literally two weeks ago.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you.

Mr. Bruyea, I believe that you would like to comment.

[The Chair, Liberal, Bryan May]

Monsieur Desilets, I'm sorry, but we're well past your time. I let the witness finish, but two and half minutes goes by real quick. Possibly that question will come up again in the coming rounds.

Up next we have MP Blaney for two and a half minutes.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you so much, Chair.

I'm going to come back to you, Mr. Bruyea, because I keep thinking about the startling story you told us about your son having to help you with your pills when you were having that incident. One of the things that concerns me greatly is that we're sending veterans home to families, and they have severe challenges. We're sending them home without providing any support to those caregivers and those children. We're not providing any training to say to them that these are some of the things you may expect, here's who to call when those things happen and we're going to support the whole family staying together. I can imagine that when there's that kind of stress it's very hard for the family to stay together.

I'm wondering if you can speak to that, because you talked about your son losing the care and all of these other factors. I really want to make sure that this committee understands the impact on the family and the specific needs of the family of the veteran.

[Sean Bruyea]

Thank you, Ms. Blaney.

I'll quickly give another anecdote of what happened with my son when I went in for the heart procedure in the hospital. My son can't be away from me. At 4:30 a.m., as I'm lying in the hospital bed, I get a call. It's my son and he's crying. He can't sleep. He hadn't slept all night, until 4:30. He needed to hear my voice before he went to bed. That is a burden on a six-, seven- or eight-year-old that is just too much to bear.

When I suggest what can change at Veterans Affairs in terms of this collaborative care, the continuum of care program that's independent, that care team has to include the family members and the veterans, and the family members and veterans get to decide how to deal with the problem. It's not Veterans Affairs saying how they'll deal with the problem. It's the family who gets to say that, and the family gets empowered. Even the children get empowered.

That's what I try to do with my son—empower him—but I would really like some extra assistance to know that he's going to be safe when I'm not with him. That's why we had the care in place, and that's why it was so devastating when it was taken away.

[The Chair, Liberal, Bryan May]

You have about 15 seconds, Ms. Blaney.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Yes, I thought so.

Thank you for that. I will say that what I hope to have happen later on today in this meeting is to add to the motion that we get a response from VAC on this testimony. I will be bringing that forward soon.

[Sean Bruyea]

Thank you, Ms. Blaney.

[The Chair, Liberal, Bryan May]

Thank you.

Next we have MP Davidson for five minutes, please.

[Scot Davidson, Conservative, York—Simcoe, ON]

Thank you.

Thanks, Allan, Tina and Sean.

I'm new to this committee. Thanks for allowing me to take the time today.

Tina, the good news is that I pulled the Auditor General's report on call centres, and it is a damning report. It says, “In addition”—including Veterans Affairs—“none of the call centres had [any] service standards on the likelihood that callers would reach an agent or on the accuracy of the information they would receive.” As well, there were absolutely no service standards. In 2019, there were 208,000 calls to Veterans Affairs, and 43,000 were hung up on or unanswered. That is supposed to be there to serve Canadians, and it's clearly not. That is according to the Auditor General's report.

It's frustrating to me as a new MP to have you here as witnesses—and I often wonder, as a new MP, what building all these reports go to because absolutely nothing happens. She's got to be chock full of reports and nothing happens.

Anyway, I'll get to my questions.

I had veterans reach out to me. Actually, I reached out to a couple of veterans. Just so you know, I have a Silver Cross mother who works for me. Her son, Brian Collier, was killed by an IED in Afghanistan in 2010; he made the ultimate sacrifice. I'll say this to Sean, Allan and Tina: We go through monthly—weekly, even—moments, her and I in the office, where there's a breakdown, and there are absolutely no services for her. I would ask one of you to talk about that because I know time is critical here.

I also have a question about how veterans who receive disability benefits from Veterans Affairs Canada are now able to earn up to $25,000 without its impacting their diminished earning capacity. However, veterans who receive disability benefits from Manulife are apparently not allowed to make anything. I'm looking at whether you have any input on that, because I have some veterans in York—Simcoe, my riding, who are very curious about that.

As well, if one of you could speak to.... Veterans are responsible for paying upfront costs for medication to treat injuries they received while in service. They're waiting over a year, I've been told, to be reimbursed, which is having implications on their health and their finances. To me, this is also shameful.

Unfortunately, I only have five minutes. I have many more questions, but I will start there.

[Sean Bruyea]

Can I go first, Allan?

Mr. Davidson, those are excellent questions, excellent points.

First, with regard to the call centres, that is a perfect example. It seems like such a minor thing, but it's a perfect example of how the bureaucracy prioritizes statistics instead of results. The only concern in Veterans Affairs is how quickly they answer the phone. The concern is not whether it's been resolved, whether there's been follow-up, whether there's been help offered, whether there's going to be a practitioner assigned. That's not the concern. The bureaucracy, just like the case management ratio.... Let's get that case management ratio down, but are we asking whether that veteran actually received true case management? Did they really get help? Did they move on with their life? Did they progress?

In terms of the medication and the upfront costs, I've gone through a number of practitioners who will not deal with Veterans Affairs. It is too burdensome on them. I have to do the paperwork for them. It's absolutely inexcusable. Other practitioners say, “No, I won't see you because I don't want you to have the burden of dealing with it, or me. I just don't want anything to do with Veterans Affairs.” That's a truly sad situation, in my mind.

[Scot Davidson, Conservative, York—Simcoe, ON]

It is truly sad, and I thank you for those comments. Again, I'm on your side on this. This is something that I know we're all going to work together on as a committee. Hopefully another report doesn't go to some building and collect dust, and then everyone's back here in five years talking about the same stuff again.

Allan or Tina...?

[Allan Hunter]

Yes, I can tell you that, many years ago at a stakeholder summit, I was told by Deputy Minister Natynczyk and also the minister for the moment, Seamus O'Regan, that they were going to make sure that they looked into intergovernmental—so, the CRA, Health Canada, all these things—to make sure that anything we're putting out there for our veterans isn't going to be a detriment to their care and continuum of care.

None of that has happened, and that stakeholder summit was in 2016. Here we are, as you alluded to, five years later. We heard a lot of good words and a lot of good promises, but nothing has emerged from that.

[The Chair, Liberal, Bryan May]

Thank you, sir.

Tina, I see you have your hand up. However, we're out of time on this question. Maybe we'll be able to circle back.

Up next we have MP Casey for five minutes.

[Sean Casey, Liberal, Charlottetown, PE]

Thank you very much, Mr. Chair, and thank you to all of our witnesses. There has been very compelling and sobering testimony today indeed. I think I want to start with something that's fairly simple.

Mr. Hunter, you indicated that one of the roles that you undertake is that of a service officer.

Can you explain to us just what that entails?

[Allan Hunter]

Yes, sir. Thank you for the question.

Many organizations have a service office. This is the second organization in which I'm working as a service officer. What happens typically is that a veteran who is having a difficult time navigating the system reaches out to a service officer and, hopefully, gets the program started. I'm a volunteer, so I do this in my spare time.

Depending on the caseload and the people coming to me—I expect it's going to escalate given the latest we have heard about our female veterans—I typically get the cases of people who have almost given up. Sean mentioned—and he's been an advocate for a long, long time—that he had to reach out to me. I typically get the cases in which people have almost given up. They have said, “Look, I fought with VAC. I asked VAC questions”—as Tina has alluded to—“and I have spent years and years trying to get answers.”

I can tell you from my own personal experience that VAC does a good job of answering many phone calls and many questions in two minutes, but more often than not, the answer is “no” or “start again”. Once again, the service officer's role is to try to keep that veteran on this side of the cliff, if you will, and to make sure that they don't do something to cause self-harm.

You have to remember that the next step for a veteran who's being told “no, no, no” could be substance abuse and all the things that go with that. In my opening statement, I alluded to suicide. When a person takes their life, that's the ultimate failure of a nation and of the organization built for them. Again, I can't stress enough that I absolutely have to thank the countless people across VAC who have helped me to keep these people alive, to keep these people going for one more day, one more phone call. As Tina said, some people just don't have that.

When a 47-year-old man takes his life and leaves seven kids behind, we have a system that needs some things that have not been tried before. We've been talking about this. Sean's been a service officer for decades. I have more than a decade. We're talking about the same things now that we were talking about in my first trip to Ottawa. A service officer is the one who is trying to hold on to that individual, male or female, to say, “Let's try one more thing. Let's try one more day.”

[Sean Casey, Liberal, Charlottetown, PE]

Mr. Hunter, thank you for that.

When I asked that question, I already knew what the answer was, but as I heard Ms. Fitzpatrick tell her story and as I heard you introduce yourself as a service officer, it struck me that this is something she could have used.

Is there an availability, is there an option, is there a possibility of her connecting with a service officer in her neck of the woods? How would she go about it?

[Allan Hunter]

There are lots of service officers out there, I can tell you. I'm not sure. I'm going to hook up with Tina later to make sure that we do have.... A service officer and an effective service are two different things. There are lots of organizations that have service officers out there. Typically what they do is take the answer from VAC, give it to the veteran and say, “I'm sorry, but I've looked into it and you don't qualify” or “That only applies on days that end in a y” and different things like that.

If the service officer is committed, the service officer is going to make sure—and I've said this to VAC for a long time.... I'm the guy who is going to help you get to “yes”. Mr. Natynczyk said to me many, many years ago, “I'm the guy who's going to help you get to yes.” I said, “Good. I'm going to hold you to that. I'm going to be the guy who, when I come to you, is not going to waste your time. I'm not going to ask for silly things that people aren't entitled too. I'm going to put facts before you that will allow you and your organization to get to a very easy yes.”

In Mr. Bruyea's case, I put it before them. I got an unsolicited letter from the minister saying that they had examined all of the things, and the answer was still going to be no, even though it wasn't supported in policy. It wasn't supported in any of the case management notes or records, which, unfortunately weren't kept very well.

The service officer has to be able to have compassion and has to understand the system enough to say to, for example, to Ms. Fitzpatrick, “We're going to make sure we get you some resolution. We're going to put a timeline on it. Eight years is not acceptable. For you to have to come forward and testify now to say that the system is just...”. The system is working for the bureaucracy. As Mr. Bruyea said, statistics are being kept, but are we keeping our veterans alive? Are we keeping them in a state where it's okay for them to be at home?

I have a veteran right now who said to me that they couldn't go home right now because they just got an answer from Veterans Affairs and they were terrified that they were going to go home and take it out on their family.