Veterans Affairs Committee on May 4th, 2023

[The Vice-Chair, Conservative, Blake Richards]

Thank you, Ms. Blaney, and I'll go to Mr. Tolmie.

[Fraser Tolmie, Conservative, Moose Jaw—Lake Centre—Lanigan, SK]

Very similarly...Mr. Samson, I think what you've explained is more clear than what was brought forward a couple of weeks ago. I'm willing to support it for the analyst and then see where we go from there.

Thank you.

[The Vice-Chair, Conservative, Blake Richards]

Mrs. Wagantall.

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

Yes, thank you, Chair.

I'll comment as well. I believe I was on that same trip, and it was very well done.

I want to make sure that if this is something we're looking at.... I deeply appreciate the analyst for putting this together for us. I would also like to encourage us to have the steering committee, which has representation from all parties around this table, meet with him to discuss and possibly even make contributions in terms of suggesting who we should see and where we should go.

[The Vice-Chair, Conservative, Blake Richards]

That's a good suggestion as well. Thank you for that.

Go ahead, Mr. Desilets.

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

Thank you, Mr. Chair.

I don't want to put any pressure on the analyst, but since we're at the end of April and the trip—which is more of a mission than a trip—would likely happen over the summer, we need to get a move on.

In principle, I am fully in favour of this type of mission. It's different, and I think it's very relevant to see people in their communities and to visit the organizations that we talk about, hear about and read about. Being there, on the ground, would be a major boon to our study.

[The Vice-Chair, Conservative, Blake Richards]

Thank you for those comments.

I hope that gives our analyst what he needs. I think there was some direction from a couple of the members on what they'd like to see.

I didn't really see anyone disagreeing with those things, so you could try to incorporate that into preparing a plan, particularly around trying to make sure you get input from all the members or all parties through the steering committee, as needed, so we can ensure that we have something together that reflects what everyone hopes to see. If we can do that, we'll do that.

I didn't get a sense that I needed to call a vote. It looks like we have unanimous consent to go ahead.

(Motion agreed to)

We can go back to our witnesses. We still have some time left for some questioning.

Mr. Samson, first of all, you still have four and a half minutes.

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

Thank you, Chair, and again, thank you to all the presenters.

I would like to begin with the institute. I'll make a comment prior to going to questions.

Research is crucial to helping us move forward and create programs, supports and benefits right across the table, but research is more recent in the centres of excellence based on chronic pain and PTSD. It is somewhat new in a sense. We are learning more and more about it and we are moving towards that target, but we can't forget the challenges to women. The purpose of this study on women is to make sure our focus ends up being on those challenges.

First of all, how are we doing with the sharing of information? In Dartmouth we have the OSI clinic, which is extremely important and supportive of our veterans. We have two centres of excellence. Are we talking to each other? One is for PTSD, and the other one is for chronic pain, but if we're talking about women, we need the two of them. What discussions are being had? What sharing is taking place between the OSI clinic and others? That was the objective of the centres of excellence—to share the wealth of knowledge.

I will start there. If we have time, my second question will be about data, because I think Dr. Rodrigues made reference as well to some of the challenges that are more particular to studies on women.

Let's start off.

[MaryAnn Notarianni]

I'll start with the first question.

Absolutely, partnerships, mobilizing knowledge and sharing information are core parts of our mandate. You gave a couple of examples of systems stakeholders. We have an organizational memorandum of understanding with the chronic pain centre of excellence. We meet frequently. We collaborate on projects. There is regular information sharing. We actually have projects under way that are looking at chronic pain and PTSD. That's work we're doing together.

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

I'm always careful. I know there is great work being done in transition and great work being done in sharing, but do we have a lens on women?

[MaryAnn Notarianni]

Yes. Both our organizations are looking to apply a sex- and gender-based analysis plus lens to the work we do. Even if the example I gave wasn't specifically about women, it's about including that lens throughout whatever work we're doing together.

You mentioned operational stress injury clinics. Those are other examples of stakeholders we have relationships with. A couple of us have had the pleasure of meeting with folks at Dartmouth who have different work under way, at the moment not specifically on women.

What I'll comment on, though, again, is a newer organization. It's about building these relationships and hearing from them about what they're seeing. It's important to have those relationships so we can understand their needs and mobilize some of the research and some of the training opportunities that may take a specific focus on women to that audience.

Again, we're connected with the operational stress injury clinics. They're a great resource in terms of providing quality care to veterans.

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

Thank you.

Madam Rodrigues, with respect to that point, you talked about the importance of asking the right questions in surveys. I think that's crucial. I agree 100%. I know that we need to be asking the right questions, and often enough we're not.

When we talk about small samples, why can't we survey all women who have left the military in the last 10 years? When I talk to Statistics Canada, it says you have to have a significant number to draw some information, so I say ask all of them the questions, instead of asking just 20% of the population.

Are we able to maybe expand that to every woman who in the last 10 years joined or left the military?

[The Vice-Chair, Conservative, Blake Richards]

I have to ask that the response be quite brief, please.

[Dr. Sara Rodrigues]

I'll try to be brief.

Ideally, you would survey the entire population and try to get as large a sample as possible when you are doing quantitative studies. However, finding the population and encouraging them to participate in research can be difficult. While you might have a very broad recruitment effort, you might see small numbers of people, particularly if the researchers have a very sensitive topic or if the population is difficult to reach. If you don't know how to find them, that can pose challenges to serving more people or getting a larger sample size.

We're hoping to overcome some of those challenges by working directly with the community to design that community and help us identify where we find people to participate in research.

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

Thank you. That was lots of information in a short period of time.

Thanks, Chair.

[The Vice-Chair, Conservative, Blake Richards]

Thank you.

We started about five minutes late, so I think we still have time to wrap up the third round.

Mr. Desilets, you have two and a half minutes. Go ahead.

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

Thank you, Mr. Chair.

Earlier, Dr. Rodrigues, you said more research happens in the States. You mentioned the quality of the research, and I really appreciated that. It's about more than just gathering figures. Scientifically speaking, the data have to be usable.

Since the Americans do more research than we do, do they have better outcomes? Do they have lower rates of mental health problems or suicidal ideation?

Is everything okay, Dr. Rodrigues? Is your answer going to be lengthy?

[Dr. Sara Rodrigues]

I apologize. I'm not familiar enough with the data to comment on whether or not the rates are lower in the U.S. population. I'm sorry.

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

Is someone able to answer that question? Does having a significant body of research lead to lower prevalence rates?

No? All right.

I have another question for you, Dr. Rodrigues. My understanding is that we nevertheless collect quite a bit of data in Canada and that we do a decent job of it. We gather the information, but we have trouble reaching the populations and identifying the causes of higher prevalence rates, for example, the higher suicide rate among women. What do you say to that?

[Dr. Sara Rodrigues]

I apologize. I don't have the translation.

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

Is there a problem with the interpretation?

[The Vice-Chair, Conservative, Blake Richards]

Is there a problem with the interpretation?

All right.

Mr. Desilets, would you mind repeating the question?

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

Very well. I'll take it from the top since I don't know when the sound cut out.

My understanding from the comments we've heard is that we collect a lot of data and the organizations collecting the data co‑operate well. That's the foundation. That's good.

Once we have the data, they should help us understand the causes of certain issues, but that's easier said than done. That's what I've gathered from the witnesses we've heard from during our five or six meetings on this study. For instance, why is the suicide rate higher among women? Logically, once we've identified the causes, we should be able to come up with solutions.

I don't want to sound pessimistic, but after five or six meetings on the issue, I get the feeling that we are still at stage one. Am I wrong?

Dr. Rodrigues, can you answer that?

[Dr. Sara Rodrigues]

Sorry, but I didn't get the interpretation.

[The Vice-Chair, Conservative, Blake Richards]

I'll ask that you keep it fairly brief.