Evidence of meeting #31 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 pcvrs.
A recording is available from Parliament.
Bloc
Marie-Hélène Gaudreau Bloc Laurentides—Labelle, QC
Thank you very much.
I'd like to hear your opinion, Ms. Massunken.
We're talking about trust and a unique population. We're told that, sometimes, veterans have to switch care providers.
How can we successfully support our veterans if the trust relationship is not tangible?
What can happen to these people when care providers pass the buck and there are delays or a lack of clarity?
What are the repercussions?
Clinical Director, Mindspa Mental Health Centre Corp.
I think the consequence of that is the lack of continuation of their care and support. Once they have established that trust with the provider, the likelihood of their symptoms improving continues to grow. When that's disrupted, then we'll see a disruption in their wellness, and that's a significant part of it.
In terms of building on that trust, because it's such a unique population, going back to the point Oliver made around competency, it's about ensuring that there is a level of cultural competency and understanding the uniqueness of the military culture. It's about understanding the importance that culture has in terms of how they're managing their symptoms, especially if it's a trauma symptom or a moral injury symptom.
Being able to understand the culture allows for there to be better engagement and better support offered to them as well, but that trust comes only when the culture is understood.
Liberal
The Chair Liberal Marie-France Lalonde
We will now start our second round with Mrs. Wagantall for five minutes.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Thank you, Chair.
Mr. Thorne, you've been here many times, and I would like to cut to the chase.
You made three recommendations that you felt needed to be addressed. So many veterans are struggling because they've lost their providers and they've had to do assessments again, and it's a very difficult environment. In your first recommendation, you said that in relationships between providers that exist now with PCVRS, there needs to be an investigation as to how and why those particular relationships are there.
Can you put that into words in the form of a recommendation we could give to this committee to send to the government?
Chief Executive Officer, Veterans Transition Network
I think the recommendation centres around trying to gain a greater understanding of how affiliate providers who receive referrals are selected. We were presented with simply two options and not a lot of clarity as to what it actually meant to choose either one of those options.
In the experiences we've had, speaking with veterans in our network and with other providers, we have encountered a lot of confusion about how affiliate status is assigned and how it fits with the existing services that have been serving veterans for years and sometimes decades. I think our recommendation is to understand more clearly how that process occurs and if there's an existing relationship of some kind between PCVRS and some or many of those affiliate providers.
Hopefully, that offers a—
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Okay. Thank you.
You spoke a bit about that “out of network” experience. I interpret that as meaning you don't fit. Is that basically it?
I will say about your particular organization that it is incredibly effective. Across the country, you also have an advantage that, yes, you can fund, and you would not turn someone away. When an organization like that or a PCVRS has that option, it concerns me that you aren't treated like all of the others. Is that what you're referring to, that this needs to be reviewed? Why in the world is that even there?
Chief Executive Officer, Veterans Transition Network
Yes. My confusion is that a program that is research evidence-based, run by licensed mental health professionals, has a 25-year history and has been built from the ground up specifically to support the mental health of veterans from service-related injuries and transition somehow does not qualify for referral. Again, I think the model is a good fit for clinics. In a way, perhaps because we are built from the ground up to be accessible to veterans, to be national, to be bilingual and to be gender-specialized in our programs, those things almost make us a bad fit for the existing classification or taxonomy system of PCVRS. I think that's an issue. Because we're national and because we don't fit the model of a stand-alone clinic, we don't fit their criteria to be an affiliate provider. Well, those are the things that make us a specialist veterans' provider.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Thank you.
I have one more question. You mentioned that maybe the problem is that you are “mission-driven”. Does that also mean you are not profit-oriented, and maybe that's a problem? Why are you saying that being mission-driven seems to be a problem? It seems irrational.
Chief Executive Officer, Veterans Transition Network
I think it's an issue because we keep a very lean administrative staff and a very lean overhead. That structure is part of the reason we felt we could not consistently meet the administrative requirements of an affiliate provider. We chose that as a network, but again, it was not made clear to us what that choice meant—that one option meant we would get no referrals whatsoever.
To answer your question, no, we are a non-profit. We are a registered charity.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Thank you very much.
In my last 10 seconds here, let me say that I'd certainly like to see your organization have the role it should have within VAC's prospective PCVRS.
Thank you for being here again today.
Liberal
The Chair Liberal Marie-France Lalonde
Thank you, Ms. Wagantall.
Mr. St‑Pierre, you have the floor for five minutes.
Liberal
Eric St-Pierre Liberal Honoré-Mercier, QC
Thank you.
I have a question for all three witnesses.
I'd like to build on my colleague's excellent question.
Was it appropriate to lump veterans and their specific circumstances into a single group?
I'll start with you, Ms. Massunken.
Clinical Director, Mindspa Mental Health Centre Corp.
Is it appropriate to group them into one single group? I think we always want to be able to look at each individual's presenting concerns and presenting needs and treat them accordingly. Despite there being some similarities and some common threads among the groups, there will always be differences among them. It's important to take those into consideration.
Liberal
Manager, Clinical Services, Broken Squirrel Wellness Ltd.
Yes, I think there are definitely such differences, even when you start to narrow in on the population. Just as we are unique human to human, the experiences that these men and women go through are affecting them in different ways as they come home. You can look at the spectrum of mental health diagnoses that we see among our veterans who come into the clinic—how it presents, how they are moving through that and how it's impacting their lives. It's unique from case to case, and it can be so complex when you look at all the layers that go into it. I think that's really a challenge when it comes to trying to standardize rehabilitative care.
While I understand there is a place where it is helpful from a treatment team, as well as giving structure to the person receiving care, there needs to be an element of flexibility that honours the complexity and the depth to which these folks are affected, and care there to support them until they get back to that place where they feel they can integrate and have a quality of life.
Chief Executive Officer, Veterans Transition Network
The short answer is no. We cannot treat them as one population. I think if providers do not recognize military culture and the military population as a unique population in and of itself, they're doomed to fail. Within that, there are many considerations for the populations that exist within the Canadian Armed Forces and veterans.
Our women's programs across Canada are adapted programs, because 60% of the women we serve have experienced military sexual trauma. That is a reality of the population we serve—it is a reality of that population within the Canadian Armed Forces—so we must adapt to it both culturally and programmatically. Our French programs are not just translations; they are cultural and programmatic adaptations to specifically address the unique challenges that veterans in Quebec struggle with.
I'm going to say this in French, and I apologize in advance for that. We want to provide the same level of service to all veterans across Canada.
Liberal
Eric St-Pierre Liberal Honoré-Mercier, QC
Thank you.
I'll turn to you, Ms. Massunken.
According to the MindSpa Mental Health Centre, what factors have a positive impact on outcomes for veterans?
Clinical Director, Mindspa Mental Health Centre Corp.
I didn't get all of the question. What types of factors influence...?
Liberal
Eric St-Pierre Liberal Honoré-Mercier, QC
Yes, what kinds of factors positively influence the veterans?
Clinical Director, Mindspa Mental Health Centre Corp.
I would say having community would be a positive factor that influences their wellness from a mental health standpoint. Whether that's a social network or community network, it's something similar to what they were used to while they served, but that's a huge and significant part to their wellness. Having that social support and being able to lean on that support in different environments has been a significant aspect, I would say, to their wellness.
Liberal
Eric St-Pierre Liberal Honoré-Mercier, QC
Are there any barriers to veterans accessing mental health services, such as those you offer in your clinic?
Clinical Director, Mindspa Mental Health Centre Corp.
I feel like we've done our best to work through and identify some of the barriers, whether it's a language barrier or a geographical barrier or a regional barrier. I think one of the biggest barriers that continue to exist for some would be the stigma around mental health and accessing mental health care—what this would say about me, whether this is a sign of weakness, or what this might bring up for me.
Liberal
Eric St-Pierre Liberal Honoré-Mercier, QC
Very quickly, Mr. Thorne, you mentioned a review of network designation. Can you elaborate on that in 10 seconds?