Evidence of meeting #13 for Veterans Affairs in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was australia.

A video is available from Parliament.

On the agenda

Members speaking

Before the committee

Wadham  Professor, Flinders University and Director, Open Door Initiative, As an Individual
Lane  Chief Psychiatrist, Department of Veterans' Affairs, Government of Australia
Hatcher  As an Individual
Meincke  Corporal (Retired) and Host, Operation Tango Romeo, Trauma Recovery Podcast for Military, Veterans, First Responders, and Their Families, As an Individual
Zacharias  President and Chief Executive Officer, Chronic Pain Centre of Excellence for Canadian Veterans
Kowalski  Sergeant (Retired), Director of Operations, Chronic Pain Centre of Excellence for Canadian Veterans

9:10 a.m.

Professor, Flinders University and Director, Open Door Initiative, As an Individual

Ben Wadham

Just quickly, we have something called transition cells. Every brigade will have a transition cell. Veterans can go to that transition cell. There are social transition seminars, where they go to see different organizations that might offer them different pathways.

Transition is very variable. We know that the high rates of suicide are with involuntary discharge and medical discharge. We know that those who have voluntarily left have better outcomes, and we know that if you don't provide any sort of planning and preparation for veterans, then they're more vulnerable than if they did have that support.

The Chair Liberal Marie-France Lalonde

Thank you very much, Mr. Tolmie.

Thanks to both of you.

For our last questions, Madame Auguste will also be addressing you in French. She will have five minutes.

Tatiana Auguste Liberal Terrebonne, QC

Thank you, Madam Chair.

I want to thank the witnesses for joining us. Their comments will be a great help to us.

I would like to talk about the national suicide prevention plan that you referred to earlier.

How does this plan work in your country?

What has been the outcome for veterans?

9:10 a.m.

Chief Psychiatrist, Department of Veterans' Affairs, Government of Australia

Jonathan Lane

I can't really speak to the outcomes with veterans, given that the strategy was only released a few weeks ago, but as I said, that document has been provided.

To talk about it very briefly, well-being underpins the individual and the community, and it is driven by policy as well, policy and services at the government level. When we think about suicide, it's not just about how, when and who it happens to and all those sorts of things. It needs to be taken from a systemic perspective that talks about the individual, the community they came from, the services they engaged with and the agencies that supported those services through policies and various things as well.

Prevention is a primary focus in terms of early help-seeking, reduction of stigma and early access to care. Again, this was discussed, but we look at military competency and training—not just in service-related things, but in suicide and suicidality—for health care providers and members of the community as well.

Then we talk about intervention and aftercare, and then postvention too, because what happens after someone is suicided is that bereavement can impact up to 134 other people in their immediate community. This is family, friends and various other things. That, unfortunately, can have a ripple effect, and we need to deal with the grief response that suicide has caused. Family members, community members, individuals, workplaces and all the other sorts of things need to have access to those resources and tools as well. This relies on a number of critical enablers like governance, embedded lived experience, available and translated evidence, which we talked about before, and then having a capable and integrated workforce to deliver those programs that we talked about before.

That's kind of what we're talking about, in a nutshell.

Tatiana Auguste Liberal Terrebonne, QC

Thank you.

I would like to talk about the community aspect.

A number of the witnesses who spoke to us said that some military members, when they leave the armed forces, like to receive support from peers, from people who served in the forces.

Can you talk about this relationship with peers?

How can this help prevent suicide among veterans?

9:10 a.m.

Chief Psychiatrist, Department of Veterans' Affairs, Government of Australia

Jonathan Lane

Both Ben and I have done a lot of work on this. We look very strongly upon the need for that lived experience and that lived expertise because of the nature of service and then the shared understanding of values, expected behaviours, shared experiences and all those sorts of things as well.

When we talk about community, that's part of what we're talking about. An individual should be able to go to, effectively, a mini community in whatever part of an organization or wherever they are geographically, and it's then up to different organizations and services to help that person fit into that particular community.

Novel ways in which it can be done include things like adaptive sports. Canada hosted the games this year. I was the archery coach for our Australian team from 2017 to 2022. Things like adaptive sports are a massive way of getting people into an adjacent community that also tends to attract a lot of veterans. Those are things outside government and various things people might think of, but they actually work really well.

9:15 a.m.

Professor, Flinders University and Director, Open Door Initiative, As an Individual

Ben Wadham

We have a very strong veteran sector. Recent studies showed that there are about 4,000 different charities attempting to address veterans' needs. Obviously, only a small percentage of those are core organizations.

I mentioned the idea of serving after service. One thing that has been really interesting about the study we're doing on veteran suicidality in Australia is that we have a partner in the U.S. We're not getting the same comparative from the U.S., because the guns used in the U.S. are high-fatality. In Australia, we have a high survivor rate. That's what we're doing; we're talking to those men and women and working out not just what took them to the brink but also what brought them back. Serving after service is a key piece, as well as engagement in the veteran sector.

9:15 a.m.

Chief Psychiatrist, Department of Veterans' Affairs, Government of Australia

Jonathan Lane

It's a key piece in the postvention space as well. This is what we talk about when we talk about education and various other things too.

The Chair Liberal Marie-France Lalonde

Thanks very much to both of you. I know it's late at night in Australia.

On behalf of our committee, thank you very much for taking the time to share your expertise and your experience with us. Again, thank you for your service, both of you, to your country.

On this note, I will be suspending to allow our other witnesses to come.

Again, thank you very much.

The Chair Liberal Marie-France Lalonde

We will resume for our second panel.

I want to say thanks to our witnesses who are here in person and by video conference.

We have, as an individual, Mrs. Amanda Hatcher.

Here in person, we have retired corporal Mark Meincke. He's the host of Operation Tango Romeo, a trauma recovery podcast for military, veterans, first responders and their families.

We also have, from the Chronic Pain Centre of Excellence for Canadian Veterans, Dr. Ramesh Zacharias, president and chief executive officer; and Mr. Cameron Kowalski, retired sergeant, director of operations.

I'm going to allow Mrs. Hatcher to start, for five minutes, and then each of you will have the chance to speak.

Mrs. Hatcher, go ahead.

Amanda Hatcher As an Individual

Thank you. Good morning.

Let me start off by introducing myself. I am Amanda Hatcher, the widow of Master Corporal Shawn Hatcher, who lost his battle to suicide on October 4, 2015. Shawn served 18 years with the Canadian Armed Forces, and during those years, he did two tours in Afghanistan. In 2010, Shawn started to experience suicidal ideation that was observed by a close friend and member. The information was passed on to the social worker of his posting at the time, and the next day she made a phone call to Shawn asking him if he was suicidal. At that time, Shawn stated no, for fear of repercussions on his job, so the option was to post him out—case closed.

In February 2014, while we were posted to Gander, Newfoundland, Shawn attempted suicide and spent 10 days in the intensive care unit of the local hospital. Upon discharge, there was no follow-up from the hospital psychiatrist, but he was told to go home and live normal. What exactly is living normal when a member is dealing with mental health issues? However, I made a call to the employee assistance program, where I was able to get both Shawn and myself in for a total of six sessions. These were six hours in which we were informed that the program was not equipped to handle suicidal members, the first of many failures within the system.

Shawn suffered depression, anxiety and undiagnosed, at that time, PTSD. Not only was Shawn battling his demons, but as his wife, I was going through the battle behind closed doors. Shawn was monitored by the base physician at the time only for depression, and the physician would turn to me for suggestions, as my background was in nursing. While I was his wife, more pressure was added as I would monitor him with his medications, his mental illness, and whatever was necessary to get through the day, all the while wondering if he would attempt suicide again, as the risk was there.

At no time during the suicide attempt of 2014 was Shawn referred or did he receive mental health treatments from Veterans Affairs, nor did it go on the screening for Cold Lake, another failure.

Fast-forward to Cold Lake, Alberta. On October 3, 2015, Shawn attempted suicide for the second time. We had just arrived in Cold Lake on August 31. He was transferred from the Cold Lake hospital to the Royal Alexandra in Edmonton, where he passed on October 4, with myself and our daughter back in Cold Lake.

In January 2016, I attended the board of inquiry into Shawn's death every day for six to eight weeks. Upon the completion of the BOI into Shawn's death, changes in Ottawa would be made within the CAF to benefit or help a member dealing with mental health or to help prevent further suicide. As far as I am aware, I'm not sure if any of these changes were made, as there is no follow-up with the family members of the deceased member. I do want to mention the support I received from the 417 Squadron and the Cold Lake base.

I believe suicide in the Canadian Armed Forces today still very much carries a huge stigma, a taboo. I believe it is the stigma of suicide that needs to be openly discussed. More needs to be done for the mental health of the members who are active and upon release from the Canadian Armed Forces. These men and women served their country with their lives and deserve the treatment they need to function in everyday society. As we all know, some of them never return to Canadian soil the same as they left.

Ten years have passed since Shawn's death, and while the survivor's guilt has eased, the heartache of his death and grief remain. Who knows, if he had received the treatment he deserved, he might be here today, I like to think. Now, as a widow—I don't think one ever fully gets used to that term—I prevail on the services of operational stress injury social support, OSISS, but I am unable to utilize treatment or therapy through Veterans Affairs as I am not entitled, with my husband being deceased. Any therapy services that I have used in the past have all been on my own. Changes need to be made within the mental health system for the benefit of all members—active or released—families and widows.

September 10 is recognized as World Suicide Prevention Day, but when you lose a loved one from suicide and mental health issues, every day is a reminder of how much more work needs to be done for the health and well-being of the Canadian Armed Forces, our veterans, the families and the general society to move forward.

Thank you.

The Chair Liberal Marie-France Lalonde

Thank you very much, Mrs. Hatcher.

On behalf of our committee, I want to say thank you for your service. Thank you for your courage. Our sincere condolences on your loss.

We will now invite Mr. Meincke, retired corporal, to take 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 very much.

For me, the frustrating part about being here today is that I have solutions. I am completely confident that if I had a magic wand and could implement what I need to implement, we could drastically reduce veteran suicide. We could cut it in half today. I have the knowledge. What I don't have is the authority. You have the authority, here in this room today. All you have to do is listen with an open mind and an open heart. I'll do my best to make a case for this.

My name is Mark Meincke. I first reached out to VAC, Veterans Affairs Canada—I'm sorry for the acronyms—for help in 2017. I suffered for 23 years without help or diagnosis. In 2019, I started my trauma recovery podcast in an attempt to help as many veterans and first responders as possible. My mission was really simple: Save lives and relieve pain by making help for PTS injuries easily accessible. I would hope that VAC has the exact same mission.

Being in the system had me quickly realizing that there must be a better way to recover from a PTS injury. I'm now in my seventh year of researching healing modalities from around the world. My show is listened to in 98 countries. I've been working to find out what works and what doesn't. The good news is that I have found numerous healing modalities with significant efficacy. The bad news is that none of the most effective therapies are available directly through Veterans Affairs Canada.

My podcast showcases a comprehensive list of healing modalities. As far as I know, there's no similar list that can be found on the VAC website. I invite Veterans Affairs Canada to share my show on their site, use it for reference or simply call me: Pick up the phone. Let me help them to be aware of the effective resources that are available right now.

Numerous Conservative members of Parliament have joined me on my show to discuss veterans issues, and some of them even consult me on these issues. Unfortunately, I have not yet had a response from the numerous invitations that I've put out to other members of other parties, which is odd, because I'm not partisan. I don't care what party anybody is with. My door remains open to members of Parliament from all parties. If they would like my help in reforming Veterans Affairs, just ask. I'm here. I only care about helping the veteran community. That's all.

A PTSI, a post-traumatic stress injury, is not a weakness, nor is it a choice, and nobody is immune to being injured by it. Whether the injury is a PTSI, traumatic brain injury, CTE or concussion, make it simple: It's brain damage. That's the bottom line. It's all brain damage. The symptoms of any of these injuries are nearly identical, which is a problem for diagnosis, because the symptoms are just about the same in all of them, including mefloquine poisoning, and can be completely debilitating.

I lost my first marriage. My business collapsed. I went bankrupt and my house was foreclosed on, all because of undiagnosed and untreated post-traumatic stress injury. Living with intrusive, relentless suicidal thoughts is exhausting, and being jolted out of my sleep by hyperintense nightmares two to three times a night, devastating. The help offered by Veterans Affairs did not improve my condition. Instead, it made it so much worse.

When the thoughts of suicide became more dominating, I told my OSI-assigned therapist—that's the operational stress injury clinic and that's what we're provided—that I was concerned. I was worried that I was getting closer to the proverbial cliff, and I was concerned that it wouldn't take much for me to be pushed off that cliff. I told her. I told her that I had a plan and that if I were to end my life, it would be by opening my wrists—nice way to go. Her advice to me was to hide the knife that I imagined I would use and that if I hadn't done it yet, I probably wouldn't.

This is an example of sanctuary trauma. The one person I was turning to for help, the person I was vulnerable with, the person I had the courage to tell where I was at and what was happening to me, that one person did not catch me when I was falling. She failed the trust test, and I never returned to that clinic.

Three months after that conversation, I attempted suicide, and it was nothing short of a miracle that I survived it.

After feeling betrayed by the OSI clinic, I took responsibility for my own healing. As a result, I've made a great deal of progress, I'm glad to say. Both the American Veterans Affairs and the Canadian OSI clinics—and this is something you probably don't know, so please write this down—claim that their success rate is 12% to 16%, and this is published by the American VA. To be clear, this means that only 16% of Canadian veterans who seek help through Veterans Affairs actually get it, which means that 84% to 88% of veterans who are seeking help do not receive it.

Now, here's a very short list that hopefully you'll ask me questions about. Stellate ganglion block is very tough to access, but it is legal in Canada. That's huge. Psychedelics have been talked about in this room. There are both legal and illegal psychedelics. The legal ones are ketamine—it's a great place to start—and ibogaine, which is now legal in Texas and is starting to spread across the States; it's a game-changer. Please ask me about these modalities and more.

Thank you, Chair.

The Chair Liberal Marie-France Lalonde

Thank you very much, Mr. Meincke.

I would now like to offer the floor to Dr. Zacharias for five minutes.

Ramesh Zacharias President and Chief Executive Officer, Chronic Pain Centre of Excellence for Canadian Veterans

Madam Chair and committee members, my name is Dr. Ramesh Zacharias. I'm the president, CEO and medical director of the Chronic Pain Centre of Excellence for Canadian Veterans, CPCoE. We're an independent, not-for-profit organization funded by Veterans Affairs Canada.

Let me start by thanking you for giving us the distinct privilege to testify before this committee on this incredibly important issue facing our veterans today. Along with my work at the CPCoE, I have a specialized clinical practice treating veterans and civilians suffering from chronic pain.

Joining me today is retired sergeant Cam Kowalski, a 34-year RCMP veteran.

Cam, go ahead.

Cameron Kowalski Sergeant (Retired), Director of Operations, Chronic Pain Centre of Excellence for Canadian Veterans

Thank you, Ramesh.

Good morning, Madam Chair and committee members.

I'm speaking today as the director of operations of the Chronic Pain Centre of Excellence for Canadian Veterans. I've spent more than half of my lifetime serving as a police officer throughout the country. I had a truly blessed career, but one which was enveloped with tragedy, trauma and stress. It left an indelible mark on me as a human being.

This topic strikes deeply into my personal and professional life. I've lost countless comrades and close friends to suicides, many of which could have been prevented. Following my retirement, a twist of fate through a kind Veterans Affairs case manager brought me to the Chronic Pain Centre of Excellence, where I assumed the role of director of operations.

What I have learned in my time at the CPCoE is that there is a deep connection between suicidality and chronic pain. What is important is not just the stories you've heard—although they have, no doubt, been profound—but also the research being done, which provides optimism for those struggling in isolation. In my darkest days, I was only looking for a glimmer of hope. It took years to come, but there by the grace of God it did. The research we do at the CPCoE is essential to bringing education and knowledge to veterans and their families on suicidality related to chronic pain.

Now I'll turn it back to Ramesh.

9:35 a.m.

President and Chief Executive Officer, Chronic Pain Centre of Excellence for Canadian Veterans

Ramesh Zacharias

Today, I would like to highlight the strong evidence linking chronic pain management with a consequential increase in suicide risk.

From 2012 to 2019, I served as a coroner in the Province of Ontario. During my tenure, I was the investigating coroner in approximately 700 cases. Several of those were suicides, ranging in age from 12 to 88. The motto of the office of the chief coroner in Ontario is “We speak for the dead to help the living”. We need to give a voice to those who are silent today.

Suicide is a complex public health issue. The processes underlying suicide risk are still not well understood. It also continues to be difficult to reliably predict suicide behaviours. However, much is known about the risk and the protective factors for suicide and suicidality, meaning that any organization with a duty of care must do everything in its power to recognize and mitigate the risks that its members may be exposed to.

An abstract from The Journal of Pain in November 2023 states, “Living with chronic pain has been identified as a significant risk factor for suicide. Qualitative and cross-sectional studies have reported an association between mental defeat and suicidal thoughts and behaviour in patients with chronic pain.”

Recent data indicates that male veterans are about 1.4 times more likely, and sadly female veterans are about twice as likely, to die by suicide compared to the general population. Chronic pain and physical ill health significantly increase suicide risk. Timely, evidence-based interdisciplinary pain management can assist in reducing that risk.

I recently presented at an open forum with three veterans, including Sergeant Kowalski and two CAF veterans. The two CAF veterans, who suffered from service-related disabling chronic pain and PTSD, shared their stories of how they had seriously contemplated suicide before engaging in an interdisciplinary pain management program. There is strong evidence in the literature that treating chronic pain can and will reduce the suicide risk in Canadian male and female veterans. We need to keep hope alive. It is time for all of us to speak for the dead to help the living.

Thank you. We are now happy to answer any questions.

The Chair Liberal Marie-France Lalonde

Thank you very much and, again, thank you for your service.

We will start our rounds with six minutes for Mr. Richards.

Blake Richards Conservative Airdrie—Cochrane, AB

First of all, thank you to all of you for being here. Thank you to our veterans for their service to our country. In particular, thanks to Mark and Amanda for your courage in sharing your personal stories with us to help make sure that others don't have to go through what you've gone through. Also, to our other witnesses, thank you for what you do to help serve our veteran community.

I am going to start with you, Mark. You mentioned that your podcast focused on trauma recovery, which you've been doing for a number of years now. The question I have for you is this: What would you say is the biggest barrier to trauma recovery among veterans in Canada?

9:40 a.m.

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

Mark Meincke

It's probably stigma. It's a lot better today than it was five years ago, but it's stigma and access. Veterans Affairs Canada has some decent programs and benefits, but try to get to them: It is a gauntlet. This is why I consider it predatory. It's horrible on purpose. One of the symptoms of a post-traumatic stress injury.... I'm hoping we can somehow legally change the name of PTSD to PTSI. It's actually a big deal. It is a neurological injury. You can see it in a brain scan.

Veterans Affairs Canada makes you jump through flaming hoops of fire and dance on a meat grinder before you get the programs. The benefits I received and the five years it took me to get them.... Holy smokes. Most people, because they hear the stories, don't even try. They're instantly overwhelmed. That's a very, very common symptom. Emotional regulation is the overall issue with a stress injury. Your neurology is fried. You're on 10 all the time. You've had too many “fight or flights”, so the throttle gets stuck on full. If you have a problem, you're always on “kill it” mode. That's no way to live.

When you're already at eight or nine out of 10 for anxiety, and then you have 47 steps and 500 questions to answer, you just say no before you even start. That's why we use service officers. Without the service officers, Blake, I wouldn't have benefits. Almost nobody would have benefits without the service officers.

9:45 a.m.

Conservative

Blake Richards Conservative Airdrie—Cochrane, AB

I hear that kind of story way too often. It's either a service officer or a fellow veteran who happens to tell them how to find some way to navigate through the system from their own terrible experiences.

I know that you were in the room during the previous panel. In the Australian example, they mentioned the fact that they have some of those services available, the mental health services and other things, on a non-liability basis. Basically, they were saying that they're not requiring that there be all these hoops jumped through to prove that it's related to service. They're just there to help the veteran.

If we were to adopt a model like that, would that make a big difference?

9:45 a.m.

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

Mark Meincke

Any bureaucratic barriers you can get rid of will save lives. Just to get into My VAC Account—

9:45 a.m.

Conservative

Blake Richards Conservative Airdrie—Cochrane, AB

Sorry, I'd like to move to a different topic. I have only two minutes before I get cut off here.

9:45 a.m.

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

9:45 a.m.

Conservative

Blake Richards Conservative Airdrie—Cochrane, AB

I think you gave us a pretty good indication there.

I know that you've talked to veterans. In fact, I know that you were also one of the ones who helped Christine Gauthier, one of the veterans acknowledged as having been offered medical assistance in dying. She had it pushed on her.