National Defence committee  From an, I'll say, Canadian Armed Forces..., I can start with health services. Things in terms of health services—for a suicide attempt or a self-harm attempt—begin with a careful assessment to identify what illness is perhaps causing it. There are illnesses like major depressive disorder and post-traumatic stress disorder, which to lay people may be similar, but they're quite different.

National Defence committee  It's a very tricky question because numbers are always tricky. From the last population-based survey we did in 2013, the lifetime prevalence, I think I read, was 11.1%. That's a lifetime prevalence. It doesn't talk about cause. It doesn't say that it's because of Afghanistan. It could be from childhood, as one of our previous witnesses said.

National Defence committee  It's a very multi-pronged question and it's interesting because I did spend my first four years in Borden, so I know Alliston, Angus, Barrie, the whole area, and I have a lot of pleasant memories of that area. On transition, I think, we are learning more and more, as are our allies, about transition, and one thing that I've been speaking about a lot with my colleagues is the concept of transitions in the plural sense.

National Defence committee  Yes, so the idea—and again, this is the difference between Canada and the U.S.—is that our health care, the provision of health care for our forces, by definition, is in partnership with the civilian health system. You know, we do cross that with federal funding, but we do not have hospitals anymore.

National Defence committee  I think there's always a potential gap in the sense that people may have health needs 24-7 and our clinics are now sort of ambulatory care. We're sort of daytime. We're not open on weekends typically, and those types of things. So after hours, we rely on the civilian system almost exclusively across the country in terms of emergency rooms and things like that.

National Defence committee  I'm a complete believer in leveraging technology, and I think the simpler we make things for people, the better, yes.

National Defence committee  Yes, on the staffing, again, I will commit to providing the numbers on specific staffing. When I last checked, about 90% of all of our positions were filled. That has been a sort of a steady state for the last few years. A lot of it is due to normal attrition. Often we have challenges when a lot of the civilian clinicians who work are spouses of military members who get posted and moved around, which becomes part of the issue.

National Defence committee  I appreciate that. Thank you very much.

National Defence committee  My pleasure.

National Defence committee  I absolutely share the concerns. We are asking our soldiers—and service members in general—to do some things. We're going to unfamiliar ground. As somebody who has been around long enough...I was in Rwanda a few years ago and saw a lot of death and a lot of suffering in places like that.

National Defence committee  That's an excellent question, because the answer is that in 30 years of working in mental health, specifically in the last 20 years, and sadly being involved with virtually every suicide investigation we've had in the CAF, certainly in the last 10 years, I've never truly seen this specifically stated by a patient or by their family as a reason for the person's not coming.

National Defence committee  I'll start with that. The whole science of going from intent, to ideation, to attempt—either serious attempt or “not serious attempt”—then to the actual suicide act is a bit.... There's some debate in academia as to how somebody transitions through it. Are there differences between serial attempters versus completers?

National Defence committee  Thank you very much. Madam Chair and members of the Steering Committee on National Defence, I am the Chief of Psychiatry in the CAF. I have several key roles, including advising the leadership on mental health issues. I'm the senior mental health clinician of the CAF. I conduct and facilitate a great deal of mental health research related to military members, and serve as the CAF representative on international committee meetings within NATO and beyond.

National Defence committee  Thank you.

National Defence committee  I probably could be, ma'am, but what time do you think?