Veterans Affairs Committee on Oct. 24th, 2022

[The Chair, Liberal, Emmanuel Dubourg]

I call this meeting to order.

Welcome to the 23rd meeting of the Standing Committee on Veterans Affairs.

Pursuant to Standing Order 108(2) and the motion adopted on Monday, October 3, 2022, the committee is resuming its study on allegations that medical assistance in dying was offered to a veteran, unprompted, by a Veterans Affairs Canada employee.

Today's meeting is taking place in a hybrid format pursuant to the House order of Thursday, June 23, 2022. Members are attending in person in the room and remotely using the Zoom application. The proceedings will be made available via the House of Commons website. Just so that you are aware, the webcast will always show the person speaking rather than the entire committee.

For those participating virtually, I would like to outline a few rules to follow. You may speak in the official language of your choice. Interpretation services are available for this meeting. You have the choice, at the bottom of your screen, of floor, English or French. If interpretation is lost, please inform me immediately, and we will ensure that interpretation is properly restored before resuming the proceedings.

When speaking, please speak slowly and clearly. When you are not speaking, your mic should be on mute. I would also like to inform the committee that all witnesses attending the meeting virtually have passed their technical testing.

I'd now like to welcome our witnesses.

Today we have, by video conference, Colonel John D. Conrad, retired. We also have Mr. Mark Meincke, retired corporal and host of Operation Tango Romeo, a trauma recovery podcast for military, veterans, first responders, and their families. By video conference, from the Royal Canadian Legion, we have Carolyn Hughes, acting director, veterans services, national headquarters; and also by video conference, we have Oliver Thorne, executive director, Veterans Transition Network.

We are going to start with Colonel John D. Conrad.

You have five minutes for your opening remarks. Please go ahead.

[Colonel, Retired) John D. Conrad (As an Individual]

Good morning.

It's a real pleasure to participate in this deliberation with this committee. It's a real honour. I'm hoping that I can make a valid contribution.

I think there's a lot for the committee to pull apart, and I do confess that I may not be the best in terms of being up on the issue. I've read everything available in the media and have followed the story quite closely. I do think, though, as we move forward, that I can share some value from my own experiences with Veterans Affairs and the frontline staff who take our calls and deal with our challenges.

I'll be very keen to listen to my colleagues and to the deliberations this morning. What I think may have happened.... In my own experiences, the staff at Veterans Affairs are always super supportive young people and always willing to go that extra mile. I can easily imagine, looking inside the circumference of this particular issue, a well-intended comment going astray, and that's not to situate the estimate or the discussion, but rather to point to one area that I think really could use attention in our Department of Veterans Affairs, and that is a bit of a focus on cultural awareness and training of our own staff at this government ministry.

Any time that a soldier deploys in the Canadian Armed Forces into any country—whether it's sea, land or air—there is always pre-deployment training and always a segment of cultural awareness that talks a bit about the country into which you're going. I wonder sometimes.... I'm not pointing fingers, but I wonder about the ability of what I gather is a stretched government organization to conduct its own internal cultural training and awareness training.

Veterans are a very unique lot in terms of their makeup. We are all very different. We come from different walks of life and different ethnic backgrounds. One common thread, though, through all the brothers and sisters who make up the Canadian Armed Forces and stand as veterans, is a commitment to service, that element of self-sacrifice, and the ability or the desire or the ethos to carry on, no matter how arduous your conditions or how arduous the mission set in front of you. It sounds trite. These words sound so simple to present to the committee, but at the same time, these are values of which we are deeply possessed and which are very fundamental to our being, and they're not as common in our highly polarized society today.

I did want to address in my opening comments this aspect of training, education and cultural awareness for our Veterans Affairs staff. I've always found them wonderfully supportive. It's so easy to say the wrong thing with mental health struggles—wounds to the mind—which are very real. You have ups and downs and you are never completely free and clear. You need daily maintenance on your mental health injury, and it would be easy for even a well-qualified clinician to say the wrong thing. I'm wondering, as we begin this dialogue and continue the conversation, about that fundamental element of internal training.

Perhaps I should leave it there and turn the floor back to the chair.

Thank you.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you, Colonel Conrad, for your opening statement.

Colonel, I'd like to say thank you to you for your service in the army.

I'd like to invite Mr. Meincke to give his opening remarks for five minutes, please.

[Mark Meincke, Corporal (Retired) and Host, Operation Tango Romeo, Trauma Recovery Podcast for Military, Veterans, First Responders, and Their Families, As an Individual]

Thank you, Mr. Chair. Thank you to everybody for having me here today.

My opener changed last night, as I stood at the War Memorial for the first time and put my hands on the side. I'm not exactly storming the beaches of Normandy here today, but I got about 30 minutes of sleep last night.

I am not here lightly, and I am under some duress as I sit here, because I am an injured veteran. I have been in the system since 2017. It was the hardest phone call I've ever made in my life.

I receive veteran benefits, and I have veteran benefits in the works. I would be remiss if I didn't mention that I feel uncomfortable with the testimony I'm going to provide today, because although it should be unlikely, I have a legitimate fear that my current benefits and ongoing claims may be affected as a result of my testimony, which is not quite as generous to Veterans Affairs as the colonel you just heard.

My name is Mark Meincke. I'm an army veteran who served with the Princess Patricia's Canadian Light Infantry. In 1994, I served as a UN peacekeeper during the genocide in Croatia. For the record, it was not ethnic cleansing—I hate that word—it was a genocide. Ethnic cleansing is a euphemism. I was on rotation for Operation Harmony. As a result of my service and numerous incidents that happened during my tour, I was injured with PTSD. Of course, in 1994, nobody had a clue what the heck that was.

I went undiagnosed for 23 years. If you want to see a 23-year train wreck, I'll give you my biography. That is a common story. I've run into Vietnam veterans and Korea veterans, people in their seventies and eighties, who are just now reaching out for help.

When I made that first phone call, it was a thousand-pound telephone. For some reason, in my distraught mind I decided to reach out to the Legion; it just seemed like the reasonable place to go. I got lucky. They took the ball and they ran with it. They were Johnny-on-the-spot. Bing, bang, boom, I got a veteran claim in.

The very first thing I said was, “I don't want any money and I'm not saying that these problems I'm having are from my service.” I was not saying that, because that's what we do. We say, “No, it couldn't be me. I know I need help, but I know that I can't afford the help, so maybe you can help me. But I'm not saying it's from my service.” It took me over two years to accept that what I was suffering through absolutely was as a direct result of my service. Genocide has a funny way of doing that.

As part of my healing journey, I took 10 months before I actually could see a therapist. To fill that gap, at the OSI clinic they did something called.... The name always escapes me. It's a stopgap measure that none of us likes and that has little to no value because of how it's operated. But it was something. It got me in the system and it got the ball rolling.

As I attended one of the 10-week programs or whatever it was, a fellow veteran who runs peer support put his hand on my shoulder and said, “Let's talk. You should come to peer support.” I said, “No, that's not for me, man. Peer support? What am I going to do? Hold hands and sing Kumbaya? That's not me.”

But he convinced me, and I went. It grew, and then I became a peer support facilitator a year later. People would drive for two hours to be a part of that group. From that, it evolved into a podcast, because I wanted to scale what I was doing to help more people. Now it's the largest of its kind in the world. People find help and access resources through my podcast.

As a result of that, the veteran this is all about came to me directly and gave me two recordings, which were said on Thursday to not exist. They are in my possession and they are on my phone.

That VAC caseworker did not inform him of services. Not only did the VAC caseworker offer MAID, but doing so was unprompted, and it was pushed after it was refused twice. You'd think saying no twice would do it, but it did not.

I have the transcript here. Of course, I cannot get a hold of the veteran because he was so distraught he left the country.

I will refer to the transcripts that I made personally to answer any and all of your questions.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you, Mr. Meincke. You will be able to answer questions that members will ask you.

I would like to thank you for your testimony today and for your service, Mr. Meincke. Thank you so much.

I would now like to go to Ms. Carolyn Hughes.

You will each have five minutes or less for your opening remarks.

You have the floor.

[Carolyn Hughes, Acting Director, Veterans Services, National Headquarters, The Royal Canadian Legion]

Thank you.

Honourable chairman and members of the Parliamentary Standing Committee on Veterans Affairs, it's a pleasure to appear before you on this subject. I'm pleased to be able to speak to you this afternoon—I guess it's still morning—on behalf of over 250,000 members and their families.

I am the acting director of veterans services at the national headquarters of the Legion. I am also a retired military health care administrator. I've been assisting veterans, including still-serving members, RCMP members, those who have retired and their families, for over 15 years in various roles. My last job in uniform was taking care of the ill and injured here in Ottawa before they were released from service.

We support your study regarding medical assistance in dying. First I want to remind you very briefly about how we can be knowledgeable and able to speak on this topic. The Legion has been assisting veterans and their families since 1926 through our legislative mandate in both the Pension Act and the Veterans Well-being Act. We are the only veterans organization in Canada that helps veterans and their families with representation to Veterans Affairs at all levels and at all levels of appeal to the Veterans Review and Appeal Board for disability entitlement for their service-related injuries and illnesses.

We do this through 27 professional command service officers and their assistants, located across the country from coast to coast to coast. They are trained professionals who are government security-cleared and who provide free assistance to veterans and their families to obtain benefits and services from Veterans Affairs. Please note that you do not have to be a Legion member. We will help all veterans.

Through the legislation, the Legion has access to service health records and departmental files to provide this comprehensive yet independent representation at no cost. Last year, our service officers represented over 4,000 claims to VAC, including appeals to the Veterans Review and Appeal Board. Additionally, we met and spoke with many more thousands of veterans regarding their benefits, and I believe we can speak confidently and with credibility about what service officers can and cannot recommend when it comes to the topic of medical assistance in dying.

In answer to what this meeting is about, medical assistance in dying has been the subject of much debate in Canada. It is a deeply complex and extremely personal issue. There are legal and moral considerations that must support autonomy and freedom of choice and protect those who are vulnerable. The Canadian justice system is quite complex and has set out strict protocols, guidance and stringent safeguards that medical practitioners must adhere to regarding this subject.

We were shocked and saddened to hear recently that a veteran was apparently advised about medical assistance in dying by an employee of Veterans Affairs. Veterans contacted us through our veterans services department by phone and by email and were quite angry about the allegation when it was made.

One veteran stated to me personally that Veterans Affairs Canada needs a better grasp on the effect this has had on the veterans community and that many veterans have been angered and retraumatized by this situation, seeing it as “an extension of the perception of deny, delay, and die from VAC to veterans.”

Often, a veteran will ask a command service officer for medical advice, such as which treatment option they should go with or which medical professional. We strongly believe and always advise veterans that they need to discuss their concerns with their doctor or other health care professionals who would understand their unique, personal and private health in detail. This includes any discussions surrounding medical assistance in dying. Quite simply, we are not medical professionals and are not qualified to endorse or provide any medical advice or suggestions regarding any form of treatment.

Regarding the mental health impact on a veteran of receiving advice about medical assistance in dying, as we are not medically trained, we can speak only to what we have seen and heard from veterans and their families.

Veterans Affairs case management and veterans services are there to establish a relationship to help veterans with their identified goals, to assess whether there are any barriers to achieving those goals and to identify the information and services available for the veteran to achieve their goals.

Trust is essential in this case management for the veteran to feel comfortable in seeking the supports and services they deserve and require, and to feel that someone cares and is trying to help them. If medical assistance in dying is ever suggested, trust can be broken, and suspicion and anger come to the forefront, with loss of self-worth leading to an inconceivable setback for future well-being. We feel that anyone living—

[The Chair, Liberal, Emmanuel Dubourg]

Ms. Hughes, I'm sorry. Your five minutes are up. You will be able to answer some questions.

[Carolyn Hughes]

Okay. Thank you.

[The Chair, Liberal, Emmanuel Dubourg]

Also, thank you for your service as a lieutenant.

Now I would like to invite Mr. Oliver Thorne to speak to us for five minutes or less, please.

[Oliver Thorne, Executive Director, Veterans Transition Network]

Thank you very much.

Thank you for the opportunity to be here today.

My name is Oliver Thorne. I am the executive director of the Veterans Transition Network, which is a registered charity that provides transition and mental health counselling programs for veterans across Canada, for men and women, in English and French.

We're also a registered service provider for Veterans Affairs Canada, meaning that Veterans Affairs will cover the cost for veterans who attend our program through their claim with Veterans Affairs. This makes up approximately 25% of the veterans who attend our programs. For the remaining veterans, we pay the cost of their attendance through charitable donations.

Given that we provide bilingual services, I prepared part of my testimony for today in French. Unfortunately, my French is not perfect, so I will answer all questions in English.

Reading the news that a Veterans Affairs case manager offered medically assisted dying unprompted to a veteran is deeply troubling, and it seems to run counter to the entire purpose of the department.

This is a very complex subject, but since I have a limited amount of time, I will focus on four major elements that convey my point of view.

First, our organization provides mental health services. Suicide is the worst possible outcome for veterans suffering from post-traumatic stress disorder. The focus of our programs and the goal of our organization is suicide prevention by improving veterans' mental health and facilitating their transition.

Reducing suicide is an achievable goal, because PTSD is a treatable disorder. Leading mental health authorities like the Mental Health Commission of Canada and the American Psychological Association have published countless papers about evidence-informed treatments that are available for PTSD and depression and that can reduce symptoms for those who seek them.

Because of the work we do on our programs at VTN, we also know that PTSD is treatable. Over the past 10 years, we've had 1,500 veterans from across Canada attend our programs and, throughout that time, we've undertaken program evaluation research to measure the impacts of those programs on the veterans who attend. Our evaluation shows significant reductions in PTSD, depression and suicide. In particular, one of our evaluations in 2016 showed that 80% of veterans with frequent suicidal thoughts on day one of the program did not have frequent suicidal thoughts at the end of the program and a year and a half later.

There are many other programs and services like ours that also provide this type of support. Again, these are treatable disorders, and quality of life can be improved.

Third, due to military culture, veterans are unfortunately often reluctant to go get help. As a result, they often seek help only when their suffering has become intolerable. That's why it's important that when veterans finally do seek help, our system is prepared to respond quickly with quality services. If not, they risk disengaging from the assistance process altogether and consequently becoming more vulnerable.

I would just add that I think this speaks to the very moving testimony that Mr. Meincke provided regarding the challenge of reaching out and asking for help. It is absolutely vital when veterans make that call that the system is ready to receive them.

Finally, with medical assistance in dying becoming available for mental health disorders in 2023, we must consider the issue of access, both for MAID and for veterans services. According to the Government of Canada, there is a 90-day assessment period before medical assistance in death can be provided, but earlier this year, the Auditor General reported that the median wait time for veterans applying for a disability benefit is 39 weeks, which is 273 days.

This means that for veterans who are ill or injured as a result of service, many of them could wait three times longer for access to that service than they would for medical assistance in dying. We cannot have a system that offers veterans medically assisted death faster than it offers them access to evidence-informed care that they rightly deserve because of their service to Canada.

Thank you for your time.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you, Mr. Thorne.

Your French is impeccable. Feel free to speak to us in French.

To start the first round of questions, I invite the committee's first vice-chair, Blake Richards, to take the floor for the next six minutes.

You have the floor, Mr. Richards.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Thank you.

First of all, let me say that we have a couple of veterans with us today.

Mr. Conrad and Mr. Meincke, thank you for your service to our country.

Mr. Meincke, you didn't have much opportunity to share a lot about your interactions with the veteran in question, which sort of led to this study, but you did of course indicate that you have had some interaction with him, and pointed out one thing that contradicted what we were told last week by the officials from Veterans Affairs, which was that there were no recordings. You indicate that there are in fact recordings and that you do have them in your possession. I wonder if you could help us to understand a little better what actually happened in this case, with, I note, the first-hand knowledge that you have of it, of course.

We were told last week.... First, we were told there was one.... It sounded like we were told that there was one incident, but there was very careful wording that was used there, and we later found out during the course of the meeting that there were in fact at least two veterans this has happened with, so I wanted to ask you about this, with your knowledge of what occurred here.

We were told that the conversation was only surrounding benefits that were available to the veteran and that medical assistance in dying wasn't proposed. You've indicated to us that in fact it was pushed, and it was pushed numerous times, despite insistence from the veteran that he wasn't interested. Can you tell us a bit more about how that conversation played out?

[Mark Meincke]

Thank you.

First, the recordings I have were recorded by the veteran himself. He recorded them because of the initial call, when he was offered MAID. These are two apology phone calls that were made by the VAC manager, who called to say that she was sorry and that the VAC caseworker also, through the manager, expressed regret.

It was from those conversations where his primary concern with his VAC manager was.... I'm kind of torn, because I can't give you the exact.... I have to paraphrase in order to not be violating his privacy, so I'm walking a thin line here. His primary concern was not for himself. I'm not going to give you the medical help that he was asking for, obviously. It was not PTSD, but it was something similar. Again, I'm torn. But either way, he was asking for help, assistance, support and resources—that I can say.

His primary concern was that during his original phone call with the VAC service agent, somehow in that conversation he was told that they had done it before and they could do it for him, and the one they had done it for, who completed MAID, they are now supporting his wife and two children. This was his primary concern, to find out what the heck they were talking about.

Now, the idea that it's just talking about services.... His response to that was asking about the legality of it. First he asked why they were asking him this, and he was told, “Well, just thought you should know, if up the road....” He told them, “But I'm in a good place right now.” He expressed to me that things were sunshine and roses prior to this phone call. He was feeling good about life. Post-phone call, he left the country because he was devastated by this phone call. It's called “sanctuary trauma”, where the place you go for help steps on your neck. That's what happened here.

[Blake Richards, Conservative, Banff—Airdrie, AB]

It is incredibly alarming to hear this account, that it was pushed upon him, to the point where it caused him to be in a far worse place than he was prior to the phone call.

Also, we hear there was another veteran, and that was followed through with in that case. We weren't, obviously, informed of that. Can you elaborate on what you know about that? Other than this one individual, was there any conversation that you're aware of about others?

[Mark Meincke]

No. In the recording, there's that.... There's my knowledge of those recordings, which I transcribed, but also my personal conversations. I spoke with this veteran for well over two hours, perhaps more, over a few different phone calls and numerous emails. These were outgoing calls to this veteran—outgoing.

However, he wrote at length on My VAC Account, so you have it in writing. There is a record of all this interaction, in writing, on his VAC account. I don't know what the rules are for privacy, but it is in writing on his account. To say that there's no record of what happened is not true.

[Blake Richards, Conservative, Banff—Airdrie, AB]

I really appreciate your enlightening the committee, because it certainly sounds as though the story we heard last week was not actually accurate in any way.

[Mark Meincke]

I wish we had more time, because it gets worse.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you so much.

Now I'd like to invite MP Darrell Samson, for six minutes, please.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Thank you, Chair.

I want to thank all of the witnesses today, especially our veterans who served and who continue to live with some of the challenges.

Mr. Meincke, I can't thank you enough for sharing, for your strength, and for building a podcast to help more veterans around the country and maybe around the world. That's extremely positive and very important, and I thank you for your continued service in that area.

This is a very difficult topic of discussion, and it should never, ever have happened. It's really unacceptable that it happened, and I thank all those who are sharing some particular information around that.

It is also very important to note that it is not a service offered by Veterans Affairs to speak to MAID. The minister made it very clear that more training, immediately, was needed, and is in effect being done as we speak. We need to know some suggestions of other things that we can do to make it right.

I want to ask a question of all presenters today, and maybe we can start with the same row of presenters: Colonel Conrad, Corporal Meincke, Carolyn and then our final speaker as well.

Back in 2021, we brought forward a program, $140 million, to ensure immediate mental health support for veterans, meaning that you didn't have to wait for your application to be processed. You could make an application right off the top and you'd have the services right away. That's what was shared by a number of you today, that we need to make sure there is no wait time when talking about mental health.

I'd like to hear from you quickly whether you know if people have accessed that and if you have any comments to make. It is crucial. We need to do more. We need to be immediate in our services, and that's the objective of that. Even if your application is denied, you still have two years of service.

We'll start with Colonel Conrad, please, and then Corporate Meincke.

[Col (Ret'd) John D. Conrad]

Thank you for the question. I find that $140 million surprising.

I didn't talk about myself during the opening five minutes. I'm in my office. I work in the provincial public service here, in Alberta, but, for four years of my life, I did not work. I lost both my parents during COVID and have recently tried to come back just for mental health—for support. As I mentioned on the front end, you can have bad days and good days. It took a long time to come to this meeting. I agree with what Mr. Meincke said about that 1,000-pound telephone.

The wait line is extremely long when trying to get services for support out here. The advice I've received is to use a civilian practitioner, because of the backlog the Edmonton operational support clinic is undergoing. Of course, that seems like a lot of money for immediate treatment. I'm already in the system—not to make this about me. I hate the way that sounds. I do find that shocking. I don't look at this every day, but, from my narrow perspective, I'm not seeing it. I'm seeing a lot of my soldiers waiting to get help. I don't want to get in front of them just because my cheese is slipping off the cracker again.

That would be my thought. I'd better keep it brief.

[Mark Meincke]

I don't know of anybody who's been able to access help quickly.

One main symptom of PTSD, which has to be respected when we enter the mental health system, is that we tend to have a very common aversion to any kind of administrative burden. Any sort of barrier to entry is...the word “predatory” comes to mind. “Deny, deny, deny until they die” is one of the common phrases within the injured veteran community. That is the perception of VAC.

I say this as somebody receiving VAC benefits, but it was five years of clawing and scratching, and it was the most gruelling meat grinder of a process before I was finally able to receive the benefits I now receive. It was brutal. It was one of the most gruelling things I've ever endured, and I've endured some stuff. It has to be kinder.

[The Chair, Liberal, Emmanuel Dubourg]

Mr. Meincke, I'm sorry to stop you there, because the time is up. We'll have other possibilities.

I'd like to invite Luc Desilets, the committee's second vice-chair, to take the floor for six minutes.

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

Thank you, Mr. Chair.

I'd like to thank our witnesses. I thank two of the witnesses for their military service.

Mr. Meincke, am I to understand that the person who recorded those words isn't willing to provide the transcripts?

[Mark Meincke]

Yes, that is correct.

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

Okay. We will have to respect that.

The two deputy ministers who appeared before the committee last week said there was no recording. In your opinion, are they aware of the fact that the conversations were recorded?