Veterans Affairs Committee on May 4th, 2023

[Dr. Mary Beth MacLean]

Certainly some of the conditions you mentioned would be easier, although it would be costly to have presumptive conditions. You'd save on the administrative side, but you'd pay a lot more on the program side.

I understand that Veterans Affairs is looking into this. That was the reasoning for that study in the first place, to look at what other countries were doing in terms of presumptive rulings.

I have been retired from Veterans Affairs for a year and a half, so I am not sure where that is right now.

Dr. Courchesne or Ms. MacKinnon might know more about that.

[The Vice-Chair, Conservative, Blake Richards]

Perhaps if they do, we will have an opportunity to have a further round for that.

Thank you for your response and for keeping it fairly brief.

For the last round of the second round of questioning, we have the Liberal Party and Mr. Darrel Samson for five minutes.

Sorry, are we changing that up?

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

Yes, Churence will go first.

[The Vice-Chair, Conservative, Blake Richards]

We'll go to Mr. Churence Rogers, and it sounds like he may be sharing his time with Mr. Samson.

[Churence Rogers, Liberal, Bonavista—Burin—Trinity, NL]

Thank you, Mr. Chair.

First of all, welcome to our guests today.

Thank you for sharing with us some important information, which hopefully will help us put together a very strong report following this study.

Ms. Notarianni, when you were speaking earlier, one of the comments you made was that women vets warrant special attention.

What I want to ask for the benefit of the committee is, why would you say that, and what are some examples of the kinds of special attention that women vets deserve? If you could drill down on that a bit, I'd appreciate it.

[MaryAnn Notarianni]

I think that's why we're all around the table today. That's what the witnesses have been bringing to bear.

Women have served in military for a very long time. In terms of women being in a majority or almost all of the roles in the military, it's been several decades now, yet there are still a lot of gaps in the research. You've been hearing that from a number of witnesses who have come forth.

There are a lot of gaps in veterans mental health in general. However, if we don't take a focus on the needs of women—who are, again, a fast-growing group of veterans—I think we risk further marginalizing them.

We don't want to miss the opportunity.... When I say that it warrants special attention, we also recognize that what brings you folks to this study to begin with is that we need to look at it. We need to take a look that's considerate of sex- and gender-based analysis plus when we're looking at veterans' issues, and it's long overdue. We recognize that it is for us, organizationally, among our priority areas. We've honed in on women veterans as well.

If you aren't asking the questions, and if you aren't engaged with the women veterans specifically, you're going to miss that opportunity. We don't want to miss that. We want to be advancing the knowledge and ensuring that there is an ability to tailor care to meet the unique needs of women veterans while still serving and that all veterans have enhanced care and opportunities.

[Churence Rogers, Liberal, Bonavista—Burin—Trinity, NL]

Thank you very much for those comments.

Dr. Rodrigues, both of you mentioned some of the gaps in data and data collection. Some of the past witnesses we've heard from have said the same. To your mind, what is needed for better research? Are there data variables that need better focus or refining to promote better or more accurate data collection in the future?

[Dr. Sara Rodrigues]

As I mentioned in an earlier response, it's not that there's a shortage of data about women veterans. We have some challenges when it comes to the quality of that data. That isn't a comment on study rigour, by any means. We have many good-quality studies. We just don't have enough women in them. Many of the studies that are available don't have enough women in the sample, which makes it very challenging for us to conduct in-depth analyses beyond comparisons between men and women.

Further to that, because cell counts in some of these studies are so low, it makes it difficult to actually do an analysis or interpret findings with confidence. Further to that, it makes it even more challenging to do intersectional analyses—for example, of women of colour, or women who might live in rural areas—because your cell counts are even lower than that. That presents an additional challenge if we want to do sex- and gender-based analysis plus in that respect.

As I mentioned, many of those studies are population-level studies designed for performance measurement and surveillance. That is valuable information to have. We really believe in complementing quantitative research with qualitative research, because qualitative research has the power to change the nature of the questions that we ask in quantitative findings. We can use qualitative work to inform the quantitative studies that we do.

We also believe in the power of community-based research and participatory action models of research that can bring the interest and the needs of the community into the study design. We can then empower communities to help shape research, which then empowers them to participate in research in the numbers that we need them to participate in.

I hope that's helpful.

[Churence Rogers, Liberal, Bonavista—Burin—Trinity, NL]

That's excellent. Thank you very much.

If you have any special recommendations for our committee that you want to articulate, we'd certainly like to see them.

[The Vice-Chair, Conservative, Blake Richards]

I think what Mr. Rogers is trying to get at is that if you have some recommendations, you could send them to the committee.

I believe that's what you were getting at.

[Churence Rogers, Liberal, Bonavista—Burin—Trinity, NL]

That's it.

[The Vice-Chair, Conservative, Blake Richards]

That would probably help us with our time, so that would be appreciated. You can certainly do that through the clerk. We welcome that at any time, whether it be now or later. If things come up at some point later, or things come to mind that you think would be good recommendations for our committee, please do share them at any time.

That goes for all our witnesses, of course.

That concludes the second round, and we have time for a third. We'll go in the same order as in the previous round.

Starting things off is the Conservative Party for five minutes.

Over to you, Mrs. Wagantall.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you again, Chair.

I'm excited to ask some questions now to the two ladies with Atlas.

You worked through your process to come up with a relevant topic for study. I'm really pleased to see you determine that our new study will explore how women's experiences in the service might relate to mental health outcomes as women veterans. We have talked a lot about military sexual trauma. That's clearly been a key issue for women in the military—and not just women, but that was a big part of many of their experiences.

I would like to ask you a question around a previous witness we had. I don't know if you've read or studied anything that we've already looked at. Donna Riguidel has developed a business, a consulting group called Survivor Perspectives Consulting Group. In real time in the military, she had these experiences. As a result, desiring healing and a change in the culture, they have developed this program that is in real time in the military. You would be looking at individuals who faced military sexual trauma or were perpetrators. They have found a way to bring them together. The healing taking place, and the testimonials and whatnot are significant.

I wonder if that could be part of your study, so you literally would see the difference in those who have already left under that added stress of military sexual trauma versus those who have had the care they needed in the midst of being in the military.

[Dr. Sara Rodrigues]

Can I ask you to kindly rephrase the question, please, for my understanding?

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Sure. Military sexual trauma is happening, and we know it has a significant impact on women in the military and how they deal with life after serving. There is now a program created by veterans who were in the military or are still serving, and it has been implemented in the Canadian Armed Forces. You have a situation here where you would have an opportunity to see healing taking place and impacting that sense of worth before they become veterans. I think what we want to do is follow this research to find a way to have healthy women serving and coming out of the military.

Is the mental health of the women who serve in the armed forces something you would see as important to engage in, to see if it has a purpose moving forward?

[MaryAnn Notarianni]

I'll comment on that. We heard that testimony and have an awareness of that program, and there may be other interventions. I think, from what I'm hearing you say, you're giving an example of something that's happening, whether it's evaluation data or some program data that's come out to suggest what is powerful and what can be helpful for people.

From Atlas Institute's perspective, part of our mandate is to look at evidence-based practices and increase their uptake or increase information and awareness about them. While I won't commit or comment and say specifically we'll be doing something about that, military sexual trauma is another priority area of focus for us. It's important that we are aware of programs that have good evidence and that have program models that are informed by evidence that we could share information about.

Again, I'm not commenting specifically on that one, because my awareness is minimal, but the spirit of that is something we have an opportunity to look at. In Canada there is an opportunity to do that. What are the made-in-Canada programs that are happening that could be helpful towards veterans' feelings around MST? How do we get the word out? Knowledge mobilization is key, and it's a key role for us.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

I really appreciate that, thank you. You explained what it was I wanted to say.

[MaryAnn Notarianni]

I'm glad I helped interpret. Thank you for the question.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

This question is for Dr. Courchesne.

My colleague spoke with Ms. MacLean about presumptive conditions lists. We know that when paratroopers jump out of planes 100 or 200 times, or whatever it is, they are going to have knee problems. I've heard concern about this.

You've worked extensively. Are there things you would recognize, based on the type of service the individual gave, that would definitely fit into a list like that and would meet the needs? This is what we're about, the needs of our veterans.

[The Vice-Chair, Conservative, Blake Richards]

Keep the answer fairly brief, please. Maybe what I can ask you to do is try to summarize it the best you can, and then, if you want to share some more information with the committee, again, you can share that with the clerk, since you're going to be sending some information anyway.

[Dr. Cyd Courchesne]

I will. Thank you, Mr. Chair.

I would say that we have changed a lot of our decision-making algorithms to the point at which—tinnitus was mentioned—the rate of approval is so high that you would consider it to be presumptive. My understanding is that there is some legalese around that, which I don't understand—things about regulations, acts and things like that, and I would not be the person to answer that, but PTSD, tinnitus, hearing loss and cumulative joint injury are all things that are at very high approval rates.

Thank you, Mr. Chair.

[The Vice-Chair, Conservative, Blake Richards]

You did quite a good job there of summarizing it quickly. Thank you for that. We appreciate it.

We will now turn to the Liberal Party for five minutes. Mr. Samson.

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

Thank you, Mr. Chair.

I would like to thank the people who provided us with information today, as well as the two people who chose a career in the military.

Before I get to my questions, I'd like to put forward a motion, if I may.

It's already gone out to the committee members. Here it is:

That the committee ask the analyst to prepare a travel plan as part of the study on the experience of women veterans. This proposal would include options for places to visit, as well as possible witnesses and organizations that the committee could meet.

I can explain the rationale for the motion, if the committee likes.

Does everyone have a copy of the motion?

Very quickly, because I don't want to take time from our presenters, I feel that this would enrich and enhance our study. If we go to visit women veterans in their communities, in front of their people and in a less formal environment, we're going to hear and gather a lot of very good information.

With the trip we did in 2017 on indigenous veterans right across the country, they were extremely happy that our committee would displace itself from Ottawa, go into their communities, listen to their stories in front of their people and visit their cemeteries and their monuments, etc.

In the analysis that could be done, we could keep in mind regions that maybe have not come forward in testimony here, so that we can capture a much greater focus right across the country.

I move this motion. Thank you.

[The Vice-Chair, Conservative, Blake Richards]

Thank you.

Mr. Samson has moved a motion. The motion is in order. He has given 48 hours' notice. However, in this case it's not even required for him to do that.

I will point out for our witnesses once again that this happens sometimes. Unfortunately, we are given only two two-hour meetings a week, and members have to move motions. Unfortunately, it does sometimes interrupt the proceedings we would otherwise have. Hopefully, we can deal with it as quickly as we did the other one and move back to testimony.

He has moved a motion. I will take speakers.

I see Mr. Tolmie and Mrs. Wagantall. I guess Ms. Blaney was on Zoom—I didn't see—so I think she was first. I'll go in the order of Blaney, Tolmie and Wagantall for a list of speakers.

Ms. Blaney, the floor is yours.

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

Thank you so much, Chair.

I'm not sure I'll support the actual trip, but I'm more than willing to have a look at what the analyst puts forward. I will vote in support and hope we can get this done quickly, so we can get back to the witnesses.

Thank you.