Evidence of meeting #29 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 ptsd.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Laura A. MacKenzie  Owner and Master Trainer, K-9 Country Inn Working Service Dogs
Medric Cousineau  Co-Founder, Paws Fur Thought
Danielle Forbes  Executive Director, National Service Dogs
Sheila O'Brien  Chair, Assistance Dogs International, North America

3:45 p.m.

Liberal

The Chair Liberal Bryan May

It's my pleasure to call this meeting to order.

Welcome to meeting 29 of the House of Commons Standing Committee on Veterans Affairs.

Pursuant to Standing Order 108(2) and the motion adopted by the committee on October 27, 2020, the committee is resuming its study on service dogs for veterans.

Welcome to all the witnesses who have taken their time to join us today. I apologize that we're getting starting a little bit later than expected. Votes will do that, unfortunately.

I will introduce all of the witnesses, and then give everyone an opportunity to bring forward their five-minute opening remarks. Once the five minutes are over, I usually give you a one-minute warning, both during your opening remarks as well as during questions. They're timed as well.

To start us off, from Assistance Dogs International, North America, we have the chair Sheila O'Brien. From K-9 Country Inn Working Service Dogs, we have Laura A. MacKenzie, owner and master trainer. From National Service Dogs from Cambridge, Ontario, Danielle Forbes, executive director; and from Paws Fur Thought, Medric Cousineau, co-founder.

As I said, each witness will have five minutes for their opening remarks. We're going to start off today with Ms. O'Brien.

3:45 p.m.

Bloc

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

I apologize, Mr. Chair.

3:45 p.m.

Liberal

The Chair Liberal Bryan May

Luc, go ahead.

3:45 p.m.

Bloc

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

I have a technical question.

We are starting the meeting 15 minutes late. So I would like to know whether the meeting will be extended by 15 minutes, so that we can adjust our calendar.

3:45 p.m.

Liberal

The Chair Liberal Bryan May

Let me confirm that. I believe the technical services are going to be tight. Let me confirm that and I'll get back to you.

3:45 p.m.

Bloc

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

Thank you, Mr. Chair.

3:45 p.m.

Liberal

The Chair Liberal Bryan May

I think we have to stop right at our normal time, but I'll see if I can push it a little bit.

Ms. O'Brien, the floor is yours for five minutes.

I think we might have a bit of a technical problem, so we're going to go on to the next witness.

For five minutes, Ms. MacKenzie, the floor is yours.

3:45 p.m.

Laura A. MacKenzie Owner and Master Trainer, K-9 Country Inn Working Service Dogs

I'm having trouble hearing, actually.

3:45 p.m.

Liberal

The Chair Liberal Bryan May

I'm going to speak for a little bit here. Can you hear me okay?

3:45 p.m.

Owner and Master Trainer, K-9 Country Inn Working Service Dogs

Laura A. MacKenzie

Yes, there you are.

3:45 p.m.

Liberal

The Chair Liberal Bryan May

Go ahead. The five minutes are all yours.

3:45 p.m.

Owner and Master Trainer, K-9 Country Inn Working Service Dogs

Laura A. MacKenzie

Thank you for having me come.

I'm just going to talk a little bit about how service dogs help people with PTSD. I'm going to speak about working with my clients, the things that I have seen and some of the basic things that a service dog can do.

There are a lot of studies out there that have investigated the affects of human-animal interactions that improve the welfare and quality of life of people.

We have found that generally PTSD sufferers suffer from negative moods, periods of depression, anxiety, flashes of anger, reckless behaviour and sleeplessness. One of the main things is that they disengage from relationships with others. They avoid public places. They avoid strangers and they detach themselves from society as a whole. Self-isolation and feelings of despair and hopelessness has led to a suicidal crisis within the first responder community right now.

One of the most significant benefits we have seen with implementing service dogs for individuals with PTSD is that it forces them to interact with society once again. We have found that many of them are embarrassed by their symptoms and they self-isolate. Being part of a group and knowing that others are dealing with the same issue creates a support system for them.

If a program is implemented correctly, it provides a support system to help the individual integrate back into society. The individualized and supported training leads to group classes, group activities, PA—which is what we call public access—and a support system with other handlers who are going through similar circumstances.

We actually don't implement a program dog, which is a dog trained within our program. We have found that self-training or owner training and having the person involved in the training has greatly increased the success of our program because the person is actually involved in the training. We have found that the public access work is even more important with a person with PTSD than the actual obedience training with the dog.

For people with PTSD, one of the main things we have found is that a lot of sufferers of PTSD self-harm. Some of the tasks of the service dog can help out with that. We use the dogs to bring them back to the present. We do an interruption of harmful behaviours. The dog can do this by nudging them, knocking their hands away or refocusing the person on the dog instead of the behaviour they're interacting with.

Once the person has a dog, they become more comfortable and outgoing in public. This allows them to participate in addiction group therapy. They feel more comfortable to go out by themselves and participate. The service dog group also makes them feel that they're not alone and helps encourage the handler to continue with their medical doctor.

We've also found that a lot of people with PTSD are hypervigilant and hyperaware. The dog can do a block. The dog can also be taught to recognize these symptoms. Flashbacks and night terrors are other things that the dog can be taught to recognize.

We can do it with a heart rate increase, a decrease in heart rate, if the person is sweating, if they are pacing, with jerking movements or with anger. The dog can cue in on any change in any kind of behaviour of the person. Once we identify these things, the owner has an opportunity.... The dog can take the person away from a situation or they can use DPT, which is deep pressure therapy, to help the owner feel comfort.

It's a pressure therapy. It's a tactile therapy that will provide comfort and warmth and also helps the person to just regroup. For night terrors, the dog is taught to understand when the person is in distress during sleep and the dog can stop the person—

3:50 p.m.

Liberal

The Chair Liberal Bryan May

That is time, but if you want to wrap up your thoughts, that would be great.

3:50 p.m.

Owner and Master Trainer, K-9 Country Inn Working Service Dogs

Laura A. MacKenzie

Those are some of the ways the dog can help. Regarding standards, I think we need to decide if standards should be established for training, or if standards need to be established for the outcome on how the dog performs.

3:50 p.m.

Liberal

The Chair Liberal Bryan May

Thank you very much.

Next we have Mr. Cousineau.

You have five minutes. Go ahead, sir.

3:50 p.m.

Medric Cousineau Co-Founder, Paws Fur Thought

Thank you, Mr. Chair.

Five minutes is a bit of a surprise, considering that the notes I have are five to 10 minutes; however, we shall prevail.

Ladies and gentlemen, thank you for the opportunity to assist you in establishing the requirements for a federal service dog standard.

The best possible solution to a problem comes from asking the best questions to determine the root cause and decide on the best course of action to solve the problem.

As a direct result of a life-threatening military search and rescue mission off the coast of Atlantic Canada, I am a veteran living life with PTSD. I have battled the demons for over 30 years. I was one of those people who are amongst the 30% to 50% of PTSD survivors who are treatment resistant. My life was an unmitigated disaster, and my family suffered horribly as a result of my injuries.

The best pharmacology and therapist interventions failed to provide me with any relief. I was isolating and cut off from pretty much everyone in my life. I had night terrors every single day. At 4:30 a.m., I would awake shaking uncontrollably, totally soaked in sweat and in a state of extreme panic and anxiety. My life had spiralled to the depths of hell that you cannot begin to imagine, let alone survive. Life seemed hopeless with no way out. I felt abandoned by VAC and, to this very day, information on my case file shocks me. Suicide seemed the only appealing option to end the hell I was living with. Fortunately, by the grace of God, I failed when executing this terminally irreversible decision.

Two factors will separate me from the other witnesses. First, I know this enemy well. Second, and absolutely paramount, is the fact that for eight years and 305 days I have lived on the end of a leash as a service dog handler.

In our house we celebrate “gotcha day”. August 6, 2012, is the day that Thai, my yellow Lab service dog, came into my life. I started to have hope, to laugh, to love and to live again, but inside my left wrist you will notice tattooed “Invictus” with a paw print and a semicolon. This tattoo is my daily reminder to myself that, thanks to Thai, the suicide card is no longer in the deck. However, VAC and the CF are well aware of the high suicide rate of veterans suffering from PTSD.

An extremely important fact is that to date there is no known case of a veteran with a fully trained service dog who has gone on to self-harm. These dogs are a valuable therapeutic adjunct to the war on PTSD. If you ask my wife, she will openly admit that Thai's night terror interventions are one of her most endearing attributes. Thai is so good at her job that she has not missed, and she has become so adept that she can wake me up before things deteriorate.

There is evidence of efficacy. Yes, they work. Scientific studies have proven this, yet certain folks keep demanding more proof and holding out that what a service dog does is not treatment. In fact, you could make the same claim about wheelchairs. They do not treat the underlying injury, but they allow the disabled individual to strive for a quality of life that's unattainable without a medical assistive device. This is not an unimportant distinction.

The Purdue University research study found that veterans paired with trained service dogs experience greater relationship satisfaction and fewer problems in family functioning. Having experienced first-hand the difference that the difference makes, what started as a desperate attempt to reclaim my life morphed into Paws Fur Thought.

To date, Paws is coordinated with organizations like the NS/NU and Ontario commands of the Royal Canadian Legion, along with Wounded Warriors, in funding of agencies like National Service Dogs for the training certification and placement of over 200 service dogs.

Researchers have been asking the wrong question. They keep asking, “Do service dogs work?” when, in fact, they should be asking, “How do they work?” Thanks to science, there's an answer.

MP Doherty recounted an event where a PTSD service dog ratted him out for anxiety, and it does not surprise me, as service dogs do not have an off switch. They do what they are trained to do. I am about to explain in layman's terms what happened.

When MP Doherty started to feel anxious, his reptilian brain, which we cannot control, kicked in. Cortisol is released into your body with other neurochemicals. Dogs have a sense of smell that is unrivalled. They can discriminate a teaspoon of sugar in an Olympic-size swimming pool, a concentration that measures in parts per trillion. Take a moment to think about the employment of dogs' noses: search and rescue, drug detection, bombs, diabetic alert, cancer detection and, most recently, studies to detect the presence of COVID.

When an individual is triggered by a stimulus outside of their control, the reptilian brain activates and you sweat cortisol out of every pore of your body. A dog can detect cortisol and be taught to interact with the handler to mitigate the circumstances. Note the last paragraph on page one of the prescriber guidelines. Cortisol and its links to PTSD have been known.

The science lesson does not stop there. It may seem intuitively obvious that de-stressing the handler in these types of situations is a good thing and a desired result. One of the simplest ways to do this is to flood your system with a neurochemical called oxytocin—a.k.a. the trust hormone. Science has proven that petting your dog has exactly that effect. Your service dog is the readily available all-in-one solution that is both the detection mechanism and the antidote.

Thai and dogs like her allow us to become aware of issues that we are having and mitigate the magnitude and severity of our symptomology using our body's inherent defence mechanisms—no pharmacology required. You can call what a service dog does for their handlers whatever you want, but “effective” heads the list. Thai does not solve the issues of why I am having the episodes I do. That work is done with my mental health care team. She is there to alert me that I am heading for trouble.

Why have I been so passionate and unrelenting in my mission to provide service dogs to others? If you read my book, Further Than Yesterday: That's All That Counts, then you'll understand that all of this was to help the others. As a military leader, our troops are first and foremost our most important asset. Without them, we are capable of nothing. However, this fight has come at the expense of my health. My unrelenting push has seen my trauma issues exacerbated by institutional betrayal, compassion fatigue and survivor's guilt variant.

I could easily have done nothing after I reclaimed my life and broke free from the chains of hell that bound me. Nobody could deny me that—except for myself. The voices in my head will not let me sleep. I carry a huge burden of guilt and shame. I got my life back, and I have not been able to move the yardsticks and provide our troops the relief that I have gotten. This means that my brothers and sisters in arms continue to suffer, battling the demons that I know all too well, but my brothers and sisters in arms are somebody's mother, father, brother, sister, son or daughter. Everybody is somebody's somebody. They are also your constituents.

As I close my remarks, you get two final questions to ponder. If it were your mother, father, brother, sister, son or daughter, would what we're all doing be enough? Would you be satisfied with our country’s response?

I await your questions.

4 p.m.

Liberal

The Chair Liberal Bryan May

Thank you very much, sir, for your comments today.

Now we will go to Ms. Forbes for five minutes.

The floor is yours.

4 p.m.

Danielle Forbes Executive Director, National Service Dogs

Good afternoon, everybody.

Thank you for providing me with the opportunity to speak to the committee on this important issue. I am currently the executive director and co-founder of National Service Dogs. We're based in Cambridge, Ontario. Over the past 25 years we've successfully deployed over 550 service dog teams across Canada.

National Service Dogs was the first program in Canada accredited by Assistance Dogs International to deploy dogs through a PTSD service dog program to veterans. We provide our dogs and our eight years of ongoing support services at no charge to our clients.

NSD values standards and has voluntarily availed itself of the Assistance Dogs International accreditation process, which you're going to be hearing a little bit more about from Sheila. The process in and of itself, though, just so the committee is aware, involves a very intensive, two-day, in-person audit of our programs. These in-person audits occur every five years. They include random reviews of our files, interviews and reviews of our staff, volunteers, clients and dog training processes, our governance model and our financials. We're also required to supply Assistance Dogs International with annual compliance reports.

NSD has also achieved and maintained accreditation with Imagine Canada standards. Not many people are aware, but Imagine Canada sets the standards for charities in Canada. We are one of only a few hundred charities to achieve accreditation with Imagine Canada—out of 85,000 Canadian charities. National Service Dogs along with the Lions Foundation of Canada Dog Guides are the only service dog producers in Canada to achieve accreditation with Imagine Canada.

As I am sitting here with you today, I am actively involved on the Assistance Dogs International standards committee, and have been for almost a decade. I also sit on the legislative and advocacy committee of ADI, North America. Previously I have co-chaired the CGSB technical committee, tasked with developing a service dog standard.

When the topic of standards for service dogs comes up within the community, pretty much everyone agrees that we need them. We need to ensure the dogs being deployed to Canadians are specifically trained to minimize the limitations of a person with a disability. We need to ensure that the dogs are healthy, temperamentally and physically fit for service, and safe for their handlers and the community at large. We need to ensure that service dog providers are ethical, safe, responsive and responsible, not only to their clients but to the dogs they are deploying out. We also need to ensure that the public can feel confident that when they see a dog in a service dog jacket or a guide dog harness, that dog will not interfere with them, their property or their business.

What I have found over the years in conversations on the topic of standards is that there is an assumption or a misconception that somewhere out there is a one-size-fits-all solution that will adequately meet everyone’s needs, and there just isn’t. Any discussion about standards for the service dog community must recognize the need for a multi-pronged approach, as Laura mentioned. Do we want an outcome standard that looks at the teams and the dogs, or a training standard that regulates programs?

Creating standards and regulations for organizations will help ensure that the training of the dogs is ethical and will help reduce fraud. The sad truth is, though, that organizations like National Service Dogs that are dedicated to providing service and guide dogs can't meet the demand within the greater community. We just can't. That leads people to train their own dogs. We cannot deny them the right to train their own service dog, nor do we want to. We want people to be able to benefit from dogs, whether they're ADI program dogs or dogs that are out there. What we concern ourselves with is whether the dogs are safe for the handler and the public, and whether the clients are being looked after.

Any governmental or non-governmental agency seeking a service dog standard must ask themselves if they want to qualify and regulate service providers and dog trainers, or qualify a service dog team in order to assess and verify that said service dog is medically prescribed, providing task-trained support that mitigates the handler's symptoms and needs, is temperamentally sound and safe for the handler and general public, and qualifies as a “legitimate service dog”?

By qualifying and/or regulating service dog providers, you can ensure that a portion of the Canadian service dog users are safe, well trained and supported by their service provider, but this in no way addresses the challenges of qualifying owner or privately trained dogs. They are a significant demographic within the service dog community and, in some cases, they are the victims of fraud, unfortunately.

Currently, processes already exist to assess, qualify, accredit and monitor service and guide dog producers. They exist externally through the International Guide Dog Federation and Assistance Dogs International, who you'll hear from when Sheila gets her mike up and going.

Within Canada, as evidenced by the Alberta Service Dogs Act, the Nova Scotia Service Dog Act—which Medric can speak to in great detail—and the B.C. Guide Dog and Service Dog Act, these are all great examples of legislation that is already working and that you as a ministry already have access to. When it comes to qualifying service dog providers, there's a lot of great work that's already been done.

Where there's really hard work to be done is in developing a fair, equitable and accessible process for qualifying owner or privately trained service dogs. What makes these conversations harder is that many people engaged in the discussion are under the impression that the standards automatically equate to a public policy or legislation. What often gets missed in the conversation is that the standards are a multiphased process. Standards are your backbone and upon that, regulations or public policy is developed, and then the enforcement pieces come on the tail end of that.

The reality is that the development of standards in and of themselves will not meet the needs I've outlined of the community at large. In order for any standards to have true value, there needs to be a regulatory process, a public policy developed that supports not only the standards but those engaging with them, whether it's the clients or the agencies providing the dogs. Then, of course, there's the enforcement mechanism that holds everyone accountable: the users, the producers, the businesses and the public.

4:05 p.m.

Liberal

The Chair Liberal Bryan May

Thank you, Ms. Forbes. We're past your five minutes. Do you want to bring your comments to a close, please?

4:05 p.m.

Executive Director, National Service Dogs

Danielle Forbes

Sure.

Narrowing the focus down to what you guys with Veterans Affairs are interested in, which are standards for the PTSD side of things, I would put forward to you that there are currently already recognized in law through international standards already developed a really good framework from which you as an agency and an arm of government could develop a really good policy.

4:05 p.m.

Liberal

The Chair Liberal Bryan May

Thank you very much.

I believe we have the technical glitches figured out, and I'll go over to Ms. O'Brien for five minutes, please.

4:05 p.m.

Sheila O'Brien Chair, Assistance Dogs International, North America

As you know, my name is Sheila O'Brien. I live in New York. I work for a program called America's VetDogs, which is the largest veterans-only program in the United States. If you remember Sully, the assistance dog of President Bush, my program placed that dog.

I'm happy to say I'm a founding member of Assistance Dogs International. If you live long enough, they make you president or chair, so after 42 years of working in the assistance dog industry, not only as an administrator but as one of the first hearing dog trainers in the world, I find myself as the chair of ADI North America, which oversees 106 service dog training programs and guide dog programs.

We are all very concerned about post-traumatic stress as a disability right now, but it's not a new disability. I strongly believe in following up on these things in terms of history, so I did a little research on it. I have come to the conclusion that veterans, since the beginning of time, if they participated in war, probably suffered from PTSD.

During the American Civil War, in 1865, veterans were suffering from what we now know as PTSD, but they called it a “soldier's heart”. During World War I, in the United States, they called it “shell shock”. In World War II, they called it “battle fatigue”. In Vietnam, they called it the “Vietnam syndrome”. PTSD did not get its name until 1986, and then they had the diagnosis completely wrong, saying that it would only last six months.

We know many veterans now who suffer from PTSD and how devastating it can be, but it was really brought to the attention of the world when the veterans returned home from Iraq and Afghanistan. This large group of young heroes came back and they were not afraid to talk about their PTSD. Many of them came back severely wounded. The signature wounds of those wars were spinal cord injury, which was up 27%, and hearing loss, affecting one out of five of our veterans. Young as they were when they went into war, they suffered from hearing loss at that early age, only to find that now that they're in their forties and fifties, it's worse, as opposed to their sixties and seventies like the rest of us.

Another devastating disability is blindness due to traumatic brain injury. There are not a lot who are suffering that way, but there are some. Another disability is all kinds of mobility issues, including amputations and back and leg problems. The IEDs really struck hard on our young men and women.

When they all started coming back in 2005 and 2006, Assistance Dogs International and the assistance dog industry were only thinking of physical disabilities. We were ready for those young men and women and we were ready to place service dogs, guide dogs and hearing dogs with them. As they started to come back, we started to do our placements, but ironically, no matter how physically disabled they were—and some of them had no arms, no legs or no sight—all that really bothered them and, according to them, what they were unable to cope with was their PTSD.

Therefore, in the industry, the light bulbs went on and the industry started to look at that aspect of our veterans. We had never done this before—never. In all the years that ADI has been around, since 1987, we were all caught up in the physical but came to find out that their spirit or their emotional disabilities were more powerful and had more reign over them than their physical disabilities.

The very first service dog from the Afghanistan and Iraq wars was placed with a young man in 2006. I know that young man personally because he was placed by me at a program in Massachusetts called NEADS.

Again, as more came forth, we started to hear and they were telling us that they were using the tasks that we trained to mitigate their service physical disabilities to mitigate their PTSD.

I had a young man who was a sniper. He had lost an arm and one of his legs was very damaged. He eventually had to have his leg amputated, but at the time he was using a crutch with his service dog, and of course there was the lack of an arm. One the tasks we trained his service dog to do—thinking of the physical—was to turn on a light switch because he liked to read at night and he didn't have a light that was accessible. The brightest light was above him. If he had to get up to turn that light on, he had to get his crutch and it was a big deal. We trained his dog to turn on a light switch, as many programs did.

Well, he was speaking for me at an event. He gets up in front of everyone, and I was thinking he was going to talk about what his dog did to mitigate his physical disability. He said that he was a sniper in Iraq and he is fearful of going into a dark room, so he sends Ruthie in to turn that light on.

The light bulbs went off, so I started a process where I formed a committee that would look into this. The United States Americans With Disabilities Act requires that a service dog has to be trained to task. Could we train tasks to mitigate the disabilities of PTSD?

The veterans helped us because they were using hearing dog tasks to wake them up gently. They were using guide dog tasks to find a door. They'd say to the dog “find the door” and the dog would actually pull them to a door, if they were anxious or something.

4:15 p.m.

Liberal

The Chair Liberal Bryan May

Thank you, Ms. O'Brien.

Could you just wrap up your comments, please?

4:15 p.m.

Chair, Assistance Dogs International, North America

Sheila O'Brien

I will wrap it up.

The ADI standards were based on what our veterans told us. They weren't just pulled out of the air. It took eight years to bring those standards from best practices within the assistance dog industry to standards.

The past three years of those eight years is when we started the standard work. I just want to indicate that when you do standards or when you do anything like that, it's not always all about the dogs. This was a new realm for us, so we added two mental health professionals. One was a doctor who worked only with veterans with PTSD. The other, Dr. Crosson, was a psychiatric social worker who worked with PTSD. By adding them to the group of trainers and ADI program heads, we came up with super standards.

They've been implemented for three years now. Right now, our international standard committee is looking at those standards to make sure that we were on the right path. We really did a good job with those. They've helped our VA, which only provides benefits to those who have ADI or IGDF dogs. Our VA in the United States does not want to be the one to determine if a dog is a service dog and if it's doing its job.

They also are shared with the airlines in North America and Canada. We've been working on that for a long time, so that they have an understanding of what a well-trained service dog does and what training a veteran has had to receive this dog.

My hope is that if you are thinking of making standards, you definitely use the ADI standards.

4:15 p.m.

Liberal

The Chair Liberal Bryan May

Thank you.

I'm sorry. If anybody has been keeping time, they'll know that I've been—no pun intended—very liberal with the clock today for the opening remarks. I am going to have to clamp down a little bit during the questions. I apologize in advance. My job is basically chief interrupter and I have to keep things moving.

Up first for questions, we have MP Brassard for six minutes.