Evidence of meeting #27 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 dogs.
A video is available from Parliament.
Liberal
The Chair Liberal Bryan May
Great, and that's a good point to end on. I'm afraid that is the end of our first half of today's meeting.
I want to thank you, Mr. Holt and Mr. Lohnes, for joining us here today and helping us with this study.
I'm going to suspend for a very brief two-minute break to allow the clerk to do the sound checks for the second hour. I will hand it over to the clerk, and we will suspend for two minutes.
Thank you.
Liberal
The Chair Liberal Bryan May
Okay, we are good to come back.
First of all, I apologize to the witnesses joining us now for the technical delays, but I appreciate your sticking with us today.
Appearing as individuals, I have Colleen Anne Dell, professor and centennial enhancement chair in one health and wellness, University of Saskatchewan; Darlene Chalmers, associate professor and associate dean of undergraduate studies; and joining us from Wounded Warriors Canada, Philip Ralph, director, health services.
I thank you all for joining us. I understand that Dr. Dell and Dr. Chalmers will be combining their opening statements for a total of 10 minutes.
I will turn it over to you to start us off in the second half of our meeting.
Dr. Colleen Anne Dell Professor and Centennial Enhancement Chair, One Health and Wellness, University of Saskatchewan, As an Individual
Great. Thank you so much.
I want to start by acknowledging the land that we're sharing across the country today and any animals that you might have around you, given that a lot of us are working from home.
Thank you for this opportunity to share the expertise from our office. For five years, we've been doing research with service dogs specifically, and for 10 years with animals in a general therapeutic manner.
We're going to make five key points today and hopefully they will help contribute to the committee's discussion. I want you to keep in mind what MP Doherty said in his observations about the emotion attached to service dogs, because we're going to return to that. There's something really important to note about it.
Our first point is the research question that's really important to our team: What is the extent to which service dogs are beneficial to veterans' wellness and how are they beneficial? This is similar to the past work of our office on the role of indigenous culture in helping people heal from addictions. It's about how it works; it's not about questioning if it works. That would be disrespectful. This approach also recognizes the lived and living experience alongside scientific evidence, which we know is emerging in the service dog field.
In asking this research question, we know that service dogs are one distinct category of canines with a job. However, they're also domesticated animals that live with us in our households. The domestication of dogs has occurred over thousands of years, and there are really solid implications from this that we can't negate. For example, the vast majority of Canadian households identify and treat pets as family members. This is even more likely among veterans who are paired with a service dog. This cannot be lost in the discussion. We often refer to this as a human-animal relationship or bond, or in academia we call it “zooeyia”, and this connection is incredibly powerful. Even in the pandemic we could see it beyond veterans.
That's the important question to us.
Second, research is still emerging, as we know, on service dogs and their benefits, and our team has produced quite a fair amount here in Canada over the past several years. What we've concluded to date is that this issue is very complex and that service dogs are a source of personalized support and a complement to treatment.
How does this happen? Service dogs are sentient beings with the ability to bond with humans, and they're task-trained to have technical skills to assist veterans. It's in this former role that service dogs generally provide what humans cannot or choose not to provide. We found this in our work with people in recovery generally from problematic substance use with their pets. It's also emerging in our current study with veterans.
We focus on substance use because it is a high risk factor—substance-use disorder from having a PTSD diagnosis. In a couple of our findings, we found that service dogs are a source of personalized support, as I said, and a complement to treatment. In a 2016 qualitative study, we saw that they assisted with decreasing the problematic use of substances and prescribed medications. They also supported physical health, a sense of psychological acceptance, a social connection and a spiritual purpose, which today we refer to as “moral injury”.
In an exploratory study in 2017, we identified a decrease in problematic substance abuse again, decrease in PTSD symptoms and a decrease or stabilization in use of medications that usually have reported negative effects, such as psychiatric medications. In phase one of our pilot study in 2019, we saw a reduction in problematic alcohol and opioid use and PTSD symptoms.
Underlying all of this is the human-animal bond. It's not just the technical skills the dogs have. This is what's emerging from the American research as well. Right now we have a SUAP grant from Health Canada, and we're working alongside 12 service dog organizations to help them learn about problematic substance use with their veterans, to use evidence-based practices and to look at peer support.
We have done several studies with veterans and have a lot of findings from them that we can discuss later, but I'm going to turn it over to Darlene now.
Dr. Darlene Chalmers Associate Professor and Associate Dean of Undergraduate Studies, University of Regina, As an Individual
Thanks, Colleen.
Thank you, everyone, for allowing us to be here and share with you.
I'm going to present to you three more points.
The first one is just building on and talking further about service dogs being a personalized support and a complement treatment. Service dogs perform technical tasks for the veteran. For example, interrupting a nightmare is one form of task. In our research, we consistently hear that service dogs are a source of support in veterans' wellness. We often learn that this is because some veterans are not receiving adequate formal support elsewhere.
In our experience, service dogs and animals generally can be an entry point for relationship development with an individual seeking and receiving care. In this way, the service dog is one pathway into veterans' lives. Thinking about that, professionals working with veterans need to be aware of the role of service dogs generally for PTSD and how to incorporate service dogs into their practice.
Service dogs can also be a barrier for veterans seeking and receiving care, and these concerns reside primarily at the systems level. A veteran with a service dog being denied counselling or service at a counselling office is a concern. A veteran being denied housing because of a service dog is a concern. There seems to be no standard experience across the country. There's a need for health care and allied professionals to be educated about the role of service dogs and the benefits in veterans' lives.
This leads to the fourth point, which is around standards. There is certainly a need for leadership in this area. While on our end, we're doing the research to establish the efficacy of service dogs and how they assist with the wellness of veterans, there appears to be a void and conflict as well as confusion about standards across the provinces and territories. The lack of consensus with the Canadian General Standards Board process several years ago has likely had many unintended and negative consequences. The lack of national standards has resulted in individual provinces taking assorted approaches to service dog public access. It is also leading to individualized policies being developed by organizations that are not experts in this area. For example, a university campus might be doing that.
We're making this statement to offer the insight that part of the lack of consensus during that process may have been that standards are trying to be made for dogs that are not doing standardized jobs. For some service dog organizations, the job of the service dog is more around the bond, that human-animal bond, and less the technical skills and vice versa, so service dogs are not trained in standardized ways.
A caution from our perspective about standards development is the need for a made-in-Canada approach that fits within our context, for example, provincial and territorial human rights service dog policies. As well as our point, the service dog organizations vary significantly in the programs that they offer and how service dogs are trained. These and other significant points need to be considered in standards development.
That all said, the goal of each service dog training program is likely very similar in intent, and that's to improve veteran wellness.
Our fifth and final point is linked to the need for standards. It's around our research team's adoption of a patient-oriented approach to our research in the area of veterans, PTSD and service dogs. This translated for us into the first veteran group, Audeamus, with Mr. Lohnes, who was speaking earlier. It was suggested that we as researchers really needed to train a service dog alongside the veterans in the program as part of an informed research process. A key finding for us from that process and based on our experiences is making sure that service dog welfare is at the centre of our conversations.
Service dogs are not tools. They're not devices for human welfare, even though they are complements in veterans' treatment and supports to them. They provide both technical skill and the benefits of the human-animal bond. As one researcher, van Houtert, and others wrote in 2018, they concluded that the lack of knowledge regarding the welfare of psychiatric service dogs creates risks for both human and animal welfare.
I'll end it there. Thank you.
Liberal
The Chair Liberal Bryan May
Thank you. That's exactly on time. I very much appreciate that.
Now we go over to Mr. Philip Ralph, director of health services with Wounded Warriors Canada.
You have five minutes, sir.
Captain N) (Retired) Philip Ralph (Director, Health Services, Wounded Warriors Canada
Good afternoon. It's my pleasure to address the committee today on behalf of Wounded Warriors Canada as your committee continues to examine the ways to better support Canada's veterans and their families. Before I address the specific topic of service dogs for veterans, I believe it would be helpful to present a broader perspective on the mission of Wounded Warriors Canada.
Wounded Warriors Canada today stands as a national mental health service provider for veterans, first responders and their families. Our services offer culturally appropriate group-based interventions that are clinically facilitated and grounded in evidence that draws upon leading trauma research. In addition, we offer programs designed to create trauma-informed workplaces. These 10 clinically facilitated evidence-informed programs are at the heart of all that we do. Our investment in service dogs is in addition to these core programs.
Given that clinically facilitated evidence-informed programs are at the heart of what we do as a national mental health service provider, there is a simple question: Why has Wounded Warriors Canada invested approximately $3 million for the provision of service dogs for veterans and first responders since 2013? The answer to us is simple. These investments are based on the life-changing effects that we have seen and that have been demonstrated in significant studies that have been produced in the last decade.
The finding of a study funded by Veterans Affairs Canada through Université Laval reaffirmed the efficacy of properly trained and well-behaved service dogs. Most recently, in 2020, Purdue University in the U.S. found that the task of disrupting episodes of anxiety ranked among the most important and often used tasks among service dogs.
The findings of a randomized trial study released on January 5, 2020, commissioned by the U.S. Department of Veterans Affairs showed that participants paired with a service dog experienced a reduction in the severity of PTSD symptoms compared with participants paired with an emotional support dog, and had fewer suicidal behaviours and ideations, particularly 18 months post-pairing.
Wounded Warriors Canada funds providers that screen, intake, train and pair these amazing dogs with their handlers. Program eligibility for funding is measured against three core principles: one, the establishment of a consistent, defined, transparent and measurable national standard for all funded PTSD service dog providers irrespective of their province; two, formal recognition of all Wounded Warriors Canada funded service dog providers across the country that meet or exceed the standards that are published and are willing to work in a co-operative manner with other Wounded Warriors Canada funded service dog providers; and three, the implementation of a clinically informed set of prescriber guidelines applicable to all applicants for a PTSD service dog.
This process is seeing results. In November 2020, following a six-month, three-phase process established at our national service dogs conference, which was held in Victoria in February 2020, just before the country locked down because of the current pandemic, we welcomed Fire Team K-9's located in Pembroke, Ontario, as our latest probationary Wounded Warriors Canada funded service dog provider.
Due to the ongoing support of the veteran and family well-being fund, Wounded Warriors Canada is currently looking at adding another provider, which will help veterans in the Meaford area and in the province of New Brunswick. We anticipate that the review process will be completed by the second quarter of this fiscal year. We will continue to seek providers that are willing to work collaboratively within the framework of our three key principles.
Our program would not be at the maturity that it is without the amazing and ongoing support of Canadians. Having said that, we remain amazed by the commitment and professionalism of our providers, who continue to lead and set an example in working in a collaborative and congenial manner in an often siloed space.
I know that the committee will hear from Dani Forbes, the executive director of National Service Dogs in the coming days. We are proud to have National Service Dogs as one of our funded providers. Dani did outstanding work on the Canadian General Standards Board standards committee. She is someone we rely on as a leader in training our nation, along with Mike Annan of Vancouver Island Compassion Dogs. Both Dani's and Mike's advice is key when we look to add a provider to our group.
Dani's and Mike's organizations have gone through the further rigorous steps to become ADI- accredited as well.
I hope the committee will listen carefully to Dani's words, especially with respect to standards, when she appears before the committee, as I'm just hearing today how important this standards piece is over and over again.
Both Médric and Jocelyn Cousineau have recently been awarded the meritorious service medal for their leadership in this space. This is both well deserved and long overdue. We are proud to have Paws Fur Thought as part of our group. They were among the first to recognize the need for prescriber guidelines, and their wise counsel is invaluable.
While I look forward to the committee's questions, I do have one ask of government, and with this ask I will conclude my remarks.
There is a glaring and obvious need for national standards when it comes to service dogs in Canada. We as an organization applaud and appreciate the earlier efforts of the Government of Canada to establish those standards through the Canadian General Standards Board process. The committee worked hard; however, the need for unanimous consensus proved to be its Achilles heel.
When it comes to standards, we work with our own published set of standards, which are informed by the hard work done at CGSB and provinces like British Columbia that have established standards. However, it is ultimately the role of government to establish standards. Service dogs are about the health and wellness of our veterans, first responders and ultimately the general population.
There's one thing this current pandemic and history informs us of. When it comes to the health of Canadians in general and veterans in particular, the government must lead from the front.
Thank you.
Liberal
The Chair Liberal Bryan May
Thank you very much, sir.
Leading us off with questions, we have Mr. Fillmore for five minutes.
Liberal
Andy Fillmore Liberal Halifax, NS
Thanks, Chair.
Thanks to the witnesses for making themselves available today and for sharing their expertise and knowledge. It's very much appreciated.
I'm not sure whether you were able to listen in on the first half of our meeting today, where we heard the wonderful testimony from General Holt and Corporal Lohnes from Audeamus. It was fascinating and enlightening. I find some connection and overlap with the testimony from professors Dell and Chalmers, and I want to dwell there for a moment.
The picture that is becoming clear to me is that there's a great complexity here. We are needing to train the trainers who train the dog. We're needing to train the dog, and then we're needing to train the veteran and the dog together so that they pair successfully. I think there were prescriber standards. There is a lot around this.
I'll go back to one thing that Corporal Lohnes talked about. He opened his remarks by talking about this fundamental question: Are you present and are you safe? I regret I wasn't able to ask him to unpack that a little bit, but I wonder if, at a foundational level, you can talk about that question and how the dog's presence in that question affects the answer.
I'll ask that to either Professor Dell or Professor Chalmers.
Professor and Centennial Enhancement Chair, One Health and Wellness, University of Saskatchewan, As an Individual
I'll start, and I'll give it to Darlene.
Absolutely, and what we know about the dog itself is that dogs live in the moment. Dogs are very present. That's what happens when the veterans are with the dog, and we see that in all types of contexts. Even when we're working in prison with dogs, it helps people be in the moment.
When you are working with the veteran and they are working with the dog who is in the moment, they are also taking that on. They're also doing things like tactile touch. That's going to help them calm down, or whatever it is that the dog's trained to do, and the veteran, as you were saying there, is trained to do that at that time as well.
The dog is not this big magical thing that's going to fix everything. The dog is a complement to the other services that are going on in that veteran's life, and this is what we say all the time.
I'm going to slip this in before I give it to Darlene. The welfare of that dog is absolutely essential, and I think we always need to start from that, because it's not a tool.
Associate Professor and Associate Dean of Undergraduate Studies, University of Regina, As an Individual
I'll add to that. Thanks, Colleen.
The idea of being present and safe, as Colleen mentioned, being in the moment and focused helps to create some additional safety for that veteran.
I think about the training that we've done with Audeamus, and being out in the public and being able to experience that as we were training service dogs alongside veterans. Those dogs are also providing a support, in the moment, in that public space.
That support might be, as one example, where a veteran may be experiencing hypervigilance. That dog can be there to nudge that veteran, cue that veteran and be a support alongside them to ensure that the veteran is safe in terms of whatever plan is put in place for them to be able to remove themselves from that situation or stay in that situation if they have to, and then be able to regain focus and carry on.
When I think about present and safe, that's an example that comes to mind for me, MP Fillmore.
Professor and Centennial Enhancement Chair, One Health and Wellness, University of Saskatchewan, As an Individual
That's where you're going to have a connection as well. As Chris said, if there is no connection, if it is just an obedient dog, it's just not going to work in the way it should. It won't work unless there is that really strong connection.
Liberal
Andy Fillmore Liberal Halifax, NS
Right, so it's becoming a member of the family and becoming a partner. As you said, it's not just a dog's skill set that we're talking about here. It really is about a relationship. You're making that really clear. Thank you for that.
Maybe I'll preface this next question by saying that we've been looking at this question of standards. It's easy to fall into the abstract a little bit, the mechanical route—that you need to do this, and you need to cover that—but at the end of the day, this really is about this relationship and the personal experience of the veteran with the animal.
To help us bring it out of the abstract, maybe take us through a day in the life of a successful pairing of a veteran and a dog. What is that dog giving to that veteran? What are the interactions? Maybe you could just sort of paint a picture there.
Liberal
Liberal
Associate Professor and Associate Dean of Undergraduate Studies, University of Regina, As an Individual
Sure. I'll just jump in quickly.
I think what that dog is giving to the veteran is the support and opportunity to be able to function in day-to-day life. It might be establishing routines, supporting the veteran, having daily routines set up and being able to get to their appointments, resuming some of the activities that a veteran may have done previously in their life before their injury—and it's mutual.
Colleen—
Liberal
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
Thank you, Mr. Chair.
Good afternoon to the witnesses. Thank you for joining us today.
Ms. Dell, something bothers me a little. I have a hint of an answer, but I'd like your opinion.
A pilot study conducted at Laval University in 2018 seems to show that service dogs have a very positive influence on sleep. They would also decrease socialization disorders, anxiety and depression related to post-traumatic stress disorder. However, according to this study, there appears to be no effect on the use of medication.
I gather that you do not see it the same way. Since I have a lot of questions, could you tell me briefly how you explain that?
Professor and Centennial Enhancement Chair, One Health and Wellness, University of Saskatchewan, As an Individual
Sure. They were looking at prescribed medication and they didn't see a decrease. We have found a decrease in prescribed medication, and so have some of the studies coming out of Purdue and so forth. We also looked at other types of substances, like alcohol, marijuana and things like that. The VAC study didn't, but again it was a preliminary first study. It was the same for us.
I keep saying here is an exploratory; here's a preliminary. We are in our fifth year now. We have a much broader, stronger study, but we're growing. With that evidence base, if we had this meeting five years from now, we would be saying something different. Underlying all of that is that we as a society do not recognize what animals contribute to our lives.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
I may be wrong, but we may not be comparing the same variables. Our studies may not be on the same type of dog or the same type of training. So we may well get different results. For example, some studies focus on the qualities of certain breeds of dogs. But that does not change the fact that they are probably all good dogs and good projects.
Ms. Chalmers, what are your thoughts on the need for standards in Canada?
Liberal
The Chair Liberal Bryan May
We can have a very brief response. That's time, but I'll allow for a quick response.
Go ahead, please.
Associate Professor and Associate Dean of Undergraduate Studies, University of Regina, As an Individual
Thank you for your question.
There is a great variety in dogs and programs right across Canada. Based on our multiple interactions with veterans through our research projects, we've learned that these gaps and inconsistencies in the standards—provincial and territorial—really have an impact on veterans. I agree that it's right and important that we need to acknowledge that each individual dog handler and each dog team is unique. However, as Mr. Lohnes stated, regardless of that, we still need a consistent standard nationally.
I'll stop there.
Liberal
The Chair Liberal Bryan May
Thank you very much.
Up next we have MP Blaney for two and a half minutes, please.