National Defence committee  If I may just add to that, our road to mental readiness program does have a module for family members through which they receive similar education and language around the mental health care that we provide to the service member.

National Defence committee  Quebec City hasn't been a particular issue, although at every clinic from time to time we might run into a difficulty in finding individuals. For example, at CFB Shilo we went a couple of years without having a psychiatrist on base. It was not for lack of trying, just for lack of availability, but we've since been successful in filling that position.

National Defence committee  I'm not aware of anybody who has been working beyond their scope of practice. If there have been cases where that has been identified, the leadership in the clinic would take care of that. We have a very well-trained workforce. As we've discussed, within our clinics the staffing levels are good.

National Defence committee  Perhaps I can just chime in on that. I'm not sure exactly of the circumstance you're speaking about, because we do have a full-time military psychiatrist there and she's still there now. There are also civilian psychiatrists who work in the clinic. I'm not sure if there was perhaps a gap while people were on leave or something like that, but there has not been a time when there were no psychiatrists in Petawawa.

National Defence committee  JPSUs, as I think you know, are not part of the health care system. These are organizations that exist to support members when they're ill or injured. We don't necessarily have visibility on who's posted there and what the specific diagnoses are. We continue to provide them with care, regardless of the reason that brings them to the JPSU.

National Defence committee  I don't have the exact number in my mind, but we have more psychiatrists per capita in the Canadian Forces in our clinics than there are in the civilian sector.

Veterans Affairs committee  Specifically related to addictions, we have recently convened a working group to look at the addictions issues with an addictions treatment process within the Canadian Forces. We have just recently hired an addictions specialist to help give us some advice on all of this. We're aiming to personalize the care to match the needs of the individual with the services that we can offer them.

Veterans Affairs committee  I think you've touched on a few important facts, including the fact that mental illness is more common in people of lower socio-economic status and lower levels of education. That is typically what we see in younger members of the Canadian Forces. Many of them are still studying at school.

Veterans Affairs committee  There is not, as far as I know, a formal mechanism to get feedback. These aren't designed to be clinical interventions. We don't want to encumber the process or make it such that someone would be scared to come forward to ask these people for help, knowing that the commanding officer might find out, for example.

Veterans Affairs committee  I imagine they would have some insights on that. I think the role, though, is really to facilitate the access to care. As clinicians, we then have a chance to talk to those people as well and to find out what's going on. In fact, they're more likely to really open up to us about that, because they're protected by confidentiality.

Veterans Affairs committee  Stigma is a big issue, but we really believe we've made significant headway in stigma reduction. I think people are coming forward for care. We have evidence that people are coming forward for care in numbers higher than in the civilian sector. We feel that the willingness of people to talk to peers and supervisors about their mental illness is another sign that we've cracked through a little bit.

Veterans Affairs committee  Do you mean the suicide data?

Veterans Affairs committee  Generally, people of lower rank are more likely affected by mental illness.

Veterans Affairs committee  Yes.

Veterans Affairs committee  I can't speak to how they decide this, but ideally you would want to have people at different ranks within a unit, I'd say. Rank does matter in the Canadian Forces. If somebody more junior were to approach a senior person, it might not be taken the same way as if a peer of the same rank did so.