Evidence of meeting #20 for Veterans Affairs in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was often.
A recording is available from Parliament.
4:35 p.m.
Liberal
4:35 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Thank you, Chair.
Thank you all for being here today. What you contribute to the possibilities, I'll say, for veterans is huge and it means a great deal to hear from all of you.
Dr. Passey, I know you somewhat from those I hear from who have had your services. Especially, as you mentioned, in Saskatchewan, Alberta and British Columbia, out west, you have made a huge impact on veterans' lives. I really appreciate the fact that you say “my veterans”. That's ownership. That's passion, and I hear that from people who served the way you're serving.
Sometimes I think you'd like to retire. Have you retired? I don't think...no. You talked about the frustration of lay people overruling medical specialists, so I interpret from what you talked about in your experiences with denial that the lay people overruling are VAC, and the medical experts and specialists are people like yourself who can diagnose and say this is what this individual needs. Is that fair?
4:40 p.m.
Psychiatrist, As an Individual
That's absolutely correct. It's not only on the caregiver allowance, but I've seen and I've been overruled with regard to a diagnosis of PTSD, the origin of the PTSD, and we've gone all the way up right through VRAB. In one case, we went to the court two times, and the court told VRAB to change their decision, and we had to go there twice before finally the lay decision was overruled and the professional diagnosis was accepted. This happens all the time in Veterans Affairs—
4:40 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Which only increases that level of sanctuary trauma and PTSD exacerbation I would think. Is that correct?
4:40 p.m.
Psychiatrist, As an Individual
Absolutely. It's devastating every time a veteran's turned down, because they've walked the walk, they've lived the life and they know what is true. Every time it's denied, it feels like they're being told that they're lying.
4:40 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
I'm sorry, I don't mean to interrupt, but I have so many questions.
On that note, we look at what it costs and the dollars that we hear are constantly being shovelled into VAC to help with all of these needs, yet it seems it's going into a sinkhole somewhere. When you talk about PTSD and with the little bit of experience I have in listening to members who suffer....
Does anyone go over anywhere and serve in the military where.... First of all, there's the anticipation of the potential for a scenario that would be very frightening to me, but I know you prepare for it. Then there's actually being there in theatre and actually experience a crisis. I sometimes think that Canadians think you only get PTSD if you have some kind of single horrific experience, when it's the culmination of service. Wouldn't you say? You've been in the service for 22 years.
4:40 p.m.
Psychiatrist, As an Individual
It can be both. You can have one fairly significant traumatic event, or it can be an accumulation of a number of smaller events.
In my experience, the soldiers, the men and women who develop PTSD in theatre—it doesn't have to be in theatre; it can be in Canada—are able to continue doing their jobs. Their problem is when they come home. Particularly, they have problems when they have to interact with their family and friends and stuff. That's where it really shows up.
I've sent people back on tours with PTSD and they've done okay. The problem is when they get back home.
4:40 p.m.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
I have one minute left.
I can't help but think about that commercial you see on TV about getting the right tires and everything. They call it the “Midas touch”. It just touches something and it turns to gold.
If you look at the stresses and the costs and the complications of this entire situation, wouldn't it be best, like you say, to give the Midas touch here and say thank you, not to send them to VRAB three and four times but to simply deal with those conditions?
What percentage of our entire armed forces are we talking about here, and why do we not do that? What is the barrier to doing the right thing?
4:40 p.m.
Psychiatrist, As an Individual
That's a difficult “brief”.
With the research I showed that we did in Yugoslavia, we were running at 12% to 15% with PTSD. Out of Afghanistan, it was running at about 5% to 7% initially. It can go higher than that.
The benefit of the doubt used to be given to the veteran. It is no longer being given to the veteran. Like I say, lay people have these little diagrams, and if you don't fit in this box, then you're denied. That's a problem. This could be dealt with very easily with adequate resources and better training of those resources.
Have a little empathy—seriously. As a civilian, you'll never understand what it's like to serve in the military. Have a little empathy and realize that these people are struggling.
4:45 p.m.
Liberal
Sean Casey Liberal Charlottetown, PE
Thank you very much, Mr. Chair.
Welcome to all of our witnesses.
I'm not sure whether you are aware, but there was a federal budget handed down yesterday that included some substantial new investments that should benefit veterans and their families. I'm going to ask some specific questions in connection with those investments to get your reaction and perhaps your advice on them.
To recap—this comes to a point that was discussed by our panel today—there's $140 million dedicated to cover mental health treatment costs for veterans with PTSD, depression and anxiety while they sit in the backlog. While they're waiting for their claims to be approved, there's a $140-million envelope to treat them.
There was an additional $15-million injection into the the veteran well-being fund to support the veterans through COVID-19 recovery, including homelessness, employment retraining and health challenges. There was $236 million dedicated, between Veterans Affairs and Department of National Defence, to expanding work to eliminate gender-based violence and sexual violence.
I'd first like to bring our female witnesses into this discussion. I want to start with you, Ms. Boutette, because of your background in housing and wraparound services.
In addition to what I just mentioned, there was $45 million for a pilot project to reduce veterans homelessness through rent supplements and wraparound services, such as counselling, addictions and finding a job.
Given that you work in this area, what advice would you have for the government in putting this pilot together? Secondly, what is the impact on a veteran's family when there are wraparound services and housing supports?
4:45 p.m.
Chief Operating Officer, The Perley and Rideau Veterans' Health Centre
That's an excellent question. Thank you.
I'll start with the last part of your question around supports for families when a veteran is struggling with homelessness. One of the real challenges is that veterans who are in that position are often cut off from their families. Often they do not have that close relationship. That becomes very difficult.
When we start to think about advice for government about dealing with veteran homelessness, so many of these issues as well are tied to mental health, PTSD and substance abuse. I think we really need to approach it with that lens and work with established organizations and agencies that are on the ground already doing work in that area, certainly experts in mental health and substance abuse almost first and foremost.
There's also very good evidence to show that providing stable housing for individuals, first and foremost, is a good place of stability and foundation for dealing with other mental health challenges and other supports that might be helpful. First, people need a roof over their heads.
I think several of the witnesses this afternoon have spoken to the importance of working with people who understand their reality, who are with them and certainly who share their lived experience. That can't be underestimated in this situation.
4:45 p.m.
Liberal
Sean Casey Liberal Charlottetown, PE
Thank you.
Ms. Bart, welcome back. I'd like to talk to you a little about the veteran well-being fund from your perspective as a caregiver, an authority and an author in that domain.
With the COVID recovery, undoubtedly there has been additional pressures on caregivers. The veteran well-being fund is there specifically to address those challenges. There's a $15-million injection into the fund in the budget.
What advice would you have for the government with respect to that envelope of funds that was committed to yesterday?
4:50 p.m.
Chair, Caregiving Matters
My comment on the budget would be that it's not enough; make it more. It's not going to solve all the problems. Yes, it will help. If the system were easier.... I love this expression: People don't care how much you know, they want to know how much you care. Make the system stronger. Put more money into it. Find the money. These people are worth it.
If I were a caregiver now to a veteran receiving a thousand dollars a month, and I was truly doing 24-7 care, I would be insulted. Is that all I'm worth?
4:50 p.m.
Liberal
4:50 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
Thank you, Mr. Chair.
My question is for Mr. Gauthier and Mr. Passey.
I gather that the current definition of “family caregiver” doesn't take into account the extent of the assistance provided to the veteran, but rather the severity of the veteran's situation. Please correct me if I'm wrong.
If a veteran is suffering from severe post-traumatic stress disorder, for example, but can still bathe, dress, and feed themselves, their caregiver or caregivers won't be recognized as such. That's my interpretation of the situation. I would like you to briefly confirm whether this is your interpretation as well. If so, I find this definition very harsh and restrictive. I obviously disagree with it. I feel that it minimizes the severity of the mental health issues that plague veterans.
Mr. Gauthier, what changes should be made to this definition to make it more inclusive for caregivers and families?
4:50 p.m.
Association du Royal 22e Régiment
These criteria seem to have been established with Korean War or World War II veterans in mind. For the new generation of veterans, the major issue is post-traumatic stress disorder, or PTSD. Yet this issue is never talked about enough, nor is it sufficiently considered in the decision-making process. Perhaps it's time to look at some studies and to take PTSD seriously. This disorder is as devastating as any physical injury, such as a severed leg.
This is what I'm seeing when I learn about PTSD. Some men with this disorder ask for help, but sometimes case managers deny them help outright. As a result, the men end up losing their minds and even dying by suicide. Men with PTSD are no longer independent. They can't leave their homes, they're afraid and they're alone.
One of my warrant officers died by suicide as a result of PTSD. His family had abandoned him because of his condition. He didn't receive any counselling. However, if he had received counselling, he wouldn't have died by suicide when his family abandoned him. That's why a family caregiver is extremely important. PTSD must be taken into account when it comes to dealing with members of the new generation of veterans.
4:50 p.m.
Liberal
The Chair Liberal Bryan May
Thank you very much.
I'm sorry, Luc, for the interruption, but you're well past your time. Two and half minutes go by fast.
Up next, for two and a half minutes, is MP Blaney, please.
4:50 p.m.
NDP
Rachel Blaney NDP North Island—Powell River, BC
Thank you, Chair.
Dr. Passey, I'm going to come back to you for one more question, and then I have another one to follow. If I interrupt, I apologize in advance.
I really appreciate what you said about vicarious PTSD, and one thing really struck me. You said, “we're not tracking all the suicides,” and I immediately thought of the caregivers and the pressure there must be on those families. They literally feel like their job is to keep veterans alive. I can't even imagine that day in and day out.
I'm wondering if you have any testimony that would help us understand what a caregiver experiences when they are literally trying to keep a person alive.
4:55 p.m.
Psychiatrist, As an Individual
Professionally, that's exactly what I've been trying to do over these last many decades. It's difficult because sometimes you will lose your sense of hope. Again, I come back to the idea of having a huge responsibility but not having the power to implement the changes. It is absolutely horrible to have to deal with the scenario where your veteran is semi-stable and then Veterans Affairs comes in with a denial or whatever. Then everything blows up again.
The pressure on the caregiver is also part of what causes relationships to end. These people are not superheroes. They are providing services that are equivalent to a superhero's, but they don't have that resilience. Sometimes the circumstances just blow through their resilience.
All I can say is that it's hard, whether you're a professional like me or a caregiver. It's difficult to have to deal with this day in and day out, never knowing from minute to minute if there's going to be a huge blow-up of whatever.