National Defence committee  It's something we screen for all the time. It's very typical when we see people in OTSSC for their assessment that they have a diagnosis of PTSD, alcohol abuse or dependence, and major depression. It's a pretty common triad we see.

National Defence committee  First of all, those would not be given out in mental health. If somebody has chronic pain disorder, they would be seen by their family doctor, their general duty medical officer. They may be referred to a pain specialist and some of these people may be prescribed opiates for their pain.

National Defence committee  No. We often see people who have, for example, post-traumatic stress disorder and a chronic pain disorder. That's not unusual. Of course, in those cases the treatment becomes more complex and we usually have more people involved.

National Defence committee  We might see them then or it may be when they come in for their assessment in the OTSSC. We also do a general physical and medical history and we may find that, in fact, here's somebody who has been having chronic pain for several years. If that is in fact the case, what we do is send them back to their medical officer to have that followed up.

National Defence committee  Alcohol abuse is often seen in conjunction with post-traumatic stress disorder. Post-traumatic stress disorder, and this has been borne out in the literature, in research, is probably the most comorbid psychiatric disorder we know of, in other words, where there are other co-existing mental health conditions.

National Defence committee  Thank you. Absolutely.

National Defence committee  Thanks for the question. Thank you very much. I didn't have a huge part, but because our OTSSC was providing services in Petawawa we were certainly bringing the issue forward that they needed something of their own. In terms of spouses and families, according to the National Defence Act we only cover military members in terms of health care.

National Defence committee  Thank you for the question. There are two parts to that. First of all, the wait times, and then the difference I've seen in how people suffer from the days when I first started working in this field until now. I gave the example from the Royal Ottawa hospital, of the difference, at times, being 12 weeks in our system to 12 months in the provincial health care system.

National Defence committee  Well, here's what I can tell you. You're right, we worry about a 12-week wait time. Although, in Petawawa now they do not have a 12-week wait time. They probably have a two-week wait time. Our wait time in Ottawa is about 12 weeks now. We work on that. By comparison, my friend and colleague, Dr.

National Defence committee  It has to do with our resources first of all. The second thing I want to say is that we have a system of support within mental health services so that if somebody needs care immediately, they get it. It's very much like you would see in an emergency department, where physical trauma cases are staged and some people are given priority over other people in much the same way.

National Defence committee  I'm a psychiatrist. I can empathize with you, but I cannot cure you.

National Defence committee  I'm going back in my mind and trying to think of the series of events. In fact, they do have an OTSSC in Petawawa now. It was set up, in fact, in 2010 and had, as most of these kinds of specialized clinics do, some growing pains in terms of trying to, first of all, attract clinicians to the Petawawa-Pembroke area to work.

National Defence committee  Thank you. Thank you, ladies and gentlemen, for inviting me here today, and thank you for all the good work you're doing in studying the care of the ill and injured members of the Canadian Forces. As you may remember, I appeared before you last November with the surgeon general, and I'm delighted to be back.

National Defence committee  Well, again, for people who've come forward for treatment, as General Bernier said, again, whether it's illicit drugs or alcohol abuse, we would be treating these people and they would have the appropriate medical employment limitations put in place. So that for a period of time, until they've completed their treatment and no longer had that problem, one of the medical employment limitations would say something like “this person cannot be deployed for x amount of time while they're in treatment”.

National Defence committee  Generally, it seems to be that that's what happens. Certainly, if somebody on their recruit medical said, “Yes, I've had a psychotic episode”, they would be looked at very carefully. But I think that even for people who wouldn't tell us, if they're going to have a psychotic episode early in their career, they're going to come to our attention fairly soon—