National Defence committee  What I would give is just general impressions. There are lots of people going through Afghanistan, so you see more of it. On the screening that we do post-deployment, we get more coming in, whereas before, as Dr. Brunet's study in 2002 showed, a lot of people wouldn't even recognize they had a problem, so how could they go for help?

National Defence committee  The study that I read from The New England Journal of Medicine actually captures a population of people who are injured, and then it separates out from those the people who had some kind of head injury with sequelae--so concussion, if you want. Then it looks at that population and says, okay, what's the incidence or prevalence of post-traumatic stress disorder in that group?

National Defence committee  I'm sure I've forgotten some of those questions. First is how the family is affected.

National Defence committee  Post-traumatic stress disorder oftentimes, in fact I'd say much more often than not, will include symptoms like irritability and anger. You can imagine how much that might affect an intimate relationship between a spouse and a member or between the children and the parent.

National Defence committee  So yes, it does affect them a great deal. Right from the start, they're invited to participate, for example, in the assessment process. If a person has a family, social work services are consulted. What I also find is that a lot of times it's the spouse who actually urges the member to get help.

National Defence committee  Well, Edmonton is not as isolated, although psychiatric services for children are pretty rare across Canada, and that's true for Edmonton as well. So if a child needs psychiatric services, they would have the same access as other non-military civilians in the area, which is not always the best.

National Defence committee  Yes.

National Defence committee  First, on the perception of post-traumatic stress disorder, my perception of changes over about 19 years is that there's a lot more awareness, there's a lot of emphasis on it. If you look at the CF survey, there are more prevalent conditions, but the focus is on post-traumatic stress disorder, it seems, right now.

National Defence committee  I'm not sure. Could you repeat the question?

National Defence committee  I can give you some general answers. They come from past experience—work done during other conflicts in other militaries, and work done in civilian psychiatry. You are more likely to develop post-traumatic stress disorder when you have traumatic stress that is more severe psychologically.

National Defence committee  A person's medical information, their medical file, is confidential. There are two pieces of information that go to commanders so they can command effectively. One is whether the person's employment should be limited. Two is the prognosis, or roughly how long their employment should be limited.

National Defence committee  Sir, your question is about the general perception of post-traumatic stress disorder by the military. It's taken very seriously by health care providers, by mental health care providers, obviously.

National Defence committee  Absolutely. There are ongoing seminars, there is ongoing teaching integrated into basic medical officer teaching at all levels. People are being educated about various mental health issues and the effects of stress. Information is being provided, but as you are probably aware, providing them with the right information doesn't always totally eliminate people's biases.

National Defence committee  If I see a person and I'm very concerned about them, I'll arrange for a follow-up. Also, one of the really great things about being in the military is that you're part of a team. You don't work in isolation; you have colleagues and supervisors, and people all watch out for each other.

National Defence committee  You're asking about the issue of compliance when medications are prescribed. Most of the time when the medications are prescribed, they're for symptom improvement. I suppose you could draw an analogy between this and giving someone a Tylenol for a headache. They are free not to take the Tylenol and have a headache.