I call the meeting to order.
Thank you to our witnesses for waiting.
This is our first meeting on our study looking at PTSD and OSI. We are going to be studying the issue over the next several weeks, starting with some foundational witnesses.
Just so you know, you are foundational witnesses. From your testimony today and the questioning, we'll be developing our study over the next several weeks and moving ultimately with a report to Parliament with recommendations for government actions. That's the context of what we're doing.
We welcome Jitender Sareen, professor of psychiatry, from the University of Manitoba, as well as Dr. Shlik, the clinical director at the Royal Ottawa. I'm going to suggest that we begin with Jitender Sareen.
You have 10 minutes to present. Then we'll have a second presentation of 10 minutes. Then the committee with ask questions, and they can direct them to either of you as we go.
The floor is yours. We'll let you know at just around 10 minutes, so if you're running out of time, you might....
Thank you very much for inviting me. It's a pleasure to be here. I really appreciate the opportunity to speak to this important issue for us.
To give the committee a context of who I am, I'm a psychiatrist at the University of Manitoba, and I've worked here for 16 years. I've worked at the Winnipeg operational stress injuries clinic for about seven years, and I've also done work with our team in post-traumatic stress epidemiology research as well as military mental health research and suicide prevention work. Currently I chair the research committee and I'm a board member for the Canadian Psychiatric Association.
Today I'll summarize what we know about operational stress injuries and my suggestions for future work in helping public safety officers in Canada.
An operational stress injury, as defined by Veterans Affairs Canada, “is any persistent psychological difficulty resulting from operational duties performed while serving in the Canadian Armed Forces or as a member of the Royal Canadian Mounted Police.” It is used to describe a broad range of problems which include diagnosed psychiatric conditions, like post-traumatic stress disorder but also other conditions.
Operational stress injuries are associated with substantial morbidity, mortality, health care utilization, and financial cost to our society. They not only affect the member but also the member's family, and it's important that we address these issues carefully.
Here I'd like to underscore that most people exposed to traumatic events are actually resilient. Almost all of us have struggled with trauma and have faced traumatic events, but the vast majority of people do recover. Post-traumatic stress is the signature condition, but other difficulties like anxiety, depression, alcohol problems, and physical health conditions can also result from traumatic events.
It is also important to note that there is a dose-response relationship between the number and severity of traumatic events, for example, seeing dead bodies and being physically assaulted. If there's an increased number of events at work there is a dose-response relationship with mental health difficulties. However, it is really important to understand that mental health problems are a combination of biological risk and protective factors, psychological risk and protective factors, and socio-cultural factors.
Biological factors that are known to increase the risk of operational stress injuries include being female, having a family history of mental health problems, which increases the genetic risk, as well as physical health problems, very commonly, traumatic brain injury.
Psychological factors that are known to be associated with mental health difficulties include an impulsive, aggressive personality style and a highly perfectionist and self-critical cognitive style.
Socio-cultural factors are also very important, including the experience of adverse childhood events, poor social supports, family violence, racism, and poverty and financial stress.
From the international literature, there are six main approaches that are important in the prevention and treatment of work-related mental health problems and post-traumatic stress.
First, prevention strategies include selecting people who are resilient and have little history of severe mental health difficulties.
Second, workplaces that provide systematic training, an organized work environment, and supportive colleagues and managers reduce the risk of mental health difficulties.
Third, the military has developed resilience training programs for personnel and families to help them learn skills in managing stress before they're deployed as well as after they're deployed. At this time we're not aware of evidence-based national resilience training programs that are being implemented among public safety personnel. We're working on developing a mindfulness-based cognitive behaviour therapy course to help people learn coping skills when they enter a stressful job.
Fourth, there is strong evidence that cognitive behaviour therapy and prolonged exposure therapy—another psychological treatment—are useful in treating people who have acute stress disorder and post-traumatic stress disorder. These treatments are delivered by trained mental health providers. Due to the limited number of providers and large number of people who could benefit from this type of intervention, the latest research is testing innovative strategies for providing cognitive behaviour therapy through Internet-based platforms, telephone-based strategies, as well as large classroom platforms.
It is also important to note that medications are important in treating people who are suffering with post-traumatic stress and other mental health conditions. Antidepressants, like paroxetine and sertraline, have been approved for the treatment of anxiety and depression.
Medications that specifically target insomnia, which is often a major concern of people who come to us for care, are very important. Prazosin is a high blood pressure medication that has been shown to be quite effective in helping people with nightmares, sleep difficulties, and PTSD symptoms. Trazodone, another antidepressant, and zopiclone, which is a hypnotic, can also be used.
Benzodiazepines are generally not recommended for post-traumatic stress disorder. However, they can be used carefully among people with severe anxiety. Atypical antipsychotics have also been shown to be effective in people with severe anxiety and depression.
Here it is important for me to clarify that none of the practice guidelines support the use of medical marijuana for PTSD. Although this is a common question from clients, the evidence weighs in the favour that marijuana use can actually worsen PTSD symptoms. I think it is important for us to carefully study the impact of marijuana and medical marijuana in PTSD, not just in short-term outcomes but long-term outcomes, especially around functioning.
Here are some specific recommendations for policy.
Although there is increased awareness of operational stress injuries in public safety officers, we do not have good Canadian information on the prevalence, prevention, and treatment of these conditions in our unique Canadian environment. Much of what we know comes from the U.S. and other countries.
However, we can learn from our Canadian military and veteran partners that have systematically addressed mental health problems and suicide over the last 15 years. Although a lot of work can be done in this area, the military has placed significant strategic initiatives that have been very successful in improving the lives of military and veterans.
The military has invested in getting accurate estimates of mental health problems among their populations by conducting state-of-the-art epidemiologic surveys that are nationally representative. They have also implemented post-deployment screening tools to identify and treat people quickly.
Veteran Affairs Canada has funded a national network of operational stress injury clinics that include interdisciplinary teams to help people recover from operational stress injuries. They've also worked with Queen's University to develop the Canadian Institute for Military and Veteran Health Research, which encourages unbiased, arm's-length research with university partners. Over 35 institutes across Canada are involved with this Canadian institute.
Similar to the approach taken by the military, I suggest that we need to do three things. First, we need to invest in a national mental health survey of public safety personnel. Second, we need to create an arm's-length institute that engages academics, policy-makers, and key stakeholders to advance the knowledge in this area. Third, we need to develop clinics that are funded in partnership with federal, provincial, and workers' compensation boards to help people have quick access to appropriate treatments.
To give a bit more detail around this, there is a need for a national mental health survey, because the rates of mental health problems in this group range from between 10% to 40%. Some argue that because of the selection, people who are public safety officers might have lower rates of mental health difficulties, where others argue that because of the high-stress environment, there are actually higher rates than in the general population. We actually don't know.
A national institute—
Mr. Chair, esteemed members of the committee, Professor Sareen, I'm speaking to you from the Royal and just using the opportunity to acknowledge that we are very privileged to contribute to work on this important topic here at the Royal. The Royal, as you may know, is an academic health science centre and it has been contributing to the leading edge of research on a variety of topics, amongst them depression and suicide.
The Royal has some experience in work with first responder services. For example, we have provided extensive mental health training to nurses within the correctional services. I work at the operational stress injury clinic here at the Royal, and at some other clinical programs at the Royal. I am a psychiatrist and clinical director of the OSI clinic. I have a few notes about the OSI clinics, which Professor Sareen also mentioned in his introduction, which, by the way, was an excellent overview.
The Royal has operated the OSI clinic since 2008, so this is part of the network funded by Veterans Affairs. We provide specialist care and support to the members, and mostly veterans, of the Canadian Armed Forces and also to the current and past members of the Royal Canadian Mounted Police who are experiencing mental health problems, as well as their respective families. I will speak to my experience as a clinician providing services to this particular population. To the issues of public safety officers and first responders we can easily apply some of our experience to that population as well, although, as it was mentioned before, particular aspects of their mental health issues, operational work stress problems, definitely need a further, more detailed survey and study.
We have some experience with paramedic services. Our department of psychiatry has been engaging in a round table around the issues that paramedic services, first responders, are struggling with, and they, in their grassroots-level initiative, have been collecting some data on the impact, on the consequences, on the services required, and this type of work needs to be done in a more coordinated and integrated way.
As was mentioned before, operational stress injuries in public safety officers and first responder types of workers, may be in some ways similar to those experienced by federal police and armed forces personnel and veterans, but there are certain specifics and certain cultures and subcultures that need specific attention. For example, the issues that corrections workers deal with in their day-to-day life and those of paramedics overlap somewhat, but also have many specific differences. This may lead to a certain fragmentation of the system of care and approach. We, on the site, have been witnessing certain developments that may lead to a variety of approaches, a lack of coordination, and the resources, as a result, are not used properly and not accessed in a way that leads to impact.
One obvious aspect, especially from our work with the federal police, which is really important to emphasize, is the importance of promoting a positive culture and perception around the work-related stress and operational stress injuries. To give some examples, Professor Sareen mentioned work done by the Department of National Defence. We found that for one of the programs, which is named road to mental readiness, R2MR, this approach has been adopted now as far as we know by the RCMP as well. The process of training and implementation has been done in various units and this program takes into account the continuum of mental health difficulties in operational work and also provides certain ways to access help and also how to help themselves.
This type of program may be easily adopted by the first responder services, and as was mentioned before, the models of care and expertise of the existing hubs of research and care should perhaps be taken into account, and correspondingly, a data-driven integrated strategy would be very helpful to have with all the input of stakeholders on national and provincial levels.
Perhaps I will stop now.
I will be happy to answer any questions and comments. Thank you very much for your attention. It's definitely a privilege to contribute to this important work.
Thanks to both of you gentlemen. I found it very illuminating, dealing with some of the issues I've been working on as a passionate advocate before I became a parliamentarian. Your work is appreciated. I've also had the opportunity to go to the Royal on a few occasions, so thank you for your work.
I think most of my questions are going to be for Dr. Sareen, based on your testimony here today.
Your comments on medical marijuana struck me because, as you may know, I was veterans affairs minister, and I tried to have a clear discussion on the use of medical marijuana, which as you know, veterans affairs approves when prescribed by a physician.
There's a real divide between use for some symptom relief—which is known for chronic pain or a variety of other things—and some suggestion by advocates and some commercial companies that it is a cure or recognized treatment for PTSD.
That concerned me, so I went out clearly on that because people who are striving for assistance should not be preyed upon by the growing commercial practice. I still get notes from some of the online folks suggesting there's clinical support, and then I look at the article and it's not clinical support at all. Can you talk about that for a moment?
I appreciate your raising it, because I think it's important, particularly for the cohort you talk about, the young person who is trying to transition to a new career and who is looking for symptom relief, that we not hold this out as some solution when it can be more a detriment. I appreciate that.
I also appreciate, because we are starting to look at this, and my colleague Todd Doherty is here, who has been long advocating for a national strategy on operational stress.... Your three recommendations were very helpful. I'm going to explore number two for a moment, on the national institute.
In many ways, the previous government, working with universities, Veterans Affairs, DND, CIMHVR, and Dr. Aiken at Queen's, and their network of I think as many as 25 or 26 universities now.... Is that institute, in some ways, or do you think it could be....? Does it need a broader mandate? Can it be that national institute you're talking about?
Thank you, gentlemen, for being here today.
In the context of this study and related issues, the situation facing corrections officers is being somewhat overlooked. An officer once told me that the people who perform those duties sometimes feel like forgotten police officers, in the sense that most people have no idea that officers on the front lines have to deal with extremely difficult situations.
We have learned that, in recent years, the number of accidents in that work environment has been on the rise, especially in 2014. These are often called accidents, as though these incidents were happening in a factory, but in fact, these accidents are often associated with violence and very troubling situations.
I would like you to comment on the resources that may or may not be available. I actually think this is a major problem. Of course, I mean no disrespect to the RCMP, the Canadian Forces, police forces, and firefighters, but I note that we are talking about them a lot, even though there is often a tendency to forget these officers.
Based on your expertise, can you tell us how it might be possible to learn more about the problems these people face, and therefore provide them with the resources they need?
I appreciate very much, Mr. Chair, the fact that this question was raised. We have had some experience with people who we've worked with in the corrections system through our clinic for veterans, because some of the veterans went on to work in the corrections system. This experience is very cursory. It doesn't give us a big picture, but it does give us some reflection.
For us, it was striking how difficult this work can be, and how little support and how little ability to cope people might sometimes experience. It's not that the support systems do not exist, but perhaps they are just not accessed, not developed, or not supported.
We've heard—again, as was mentioned before, it's hard to find really reliable data—that the rate of diagnosis of post-traumatic stress disorder specifically in correction services is striking, and possibly startlingly high, and it calls for action. Some work can be done on more training, at least in practical experience with mental health nurses.
In correction services, that was provided by the Royal and it seemed to be well received. That is suggested as probably one of the stepping stones in the system. I think the workers in correction services should be empowered by the same tools and systems, including peer support and access to care, with a variety of technologies and options, as any other operational employee would be.
I want to thank our guests, as well as my colleagues across the floor.
As my colleague Mr. O'Toole has mentioned, I'm deeply passionate about this. This is something I'm very familiar with and I have spent a long time working with those who have been inflicted with PTSD. I have had a lot of colleagues, over the years, who have been dealing with this.
I'm going to direct a few questions, but I'm going to do a shameless self-promotion, if I can, because my passion and my belief in this area and why it's so critical—and I applaud this government for taking this on—is that this discussion is long overdue. That is why I tabled Bill calling for a national strategy and the development of a national framework dealing with PTSD in first responders and veterans.
Specifically for the areas of concern that we've been talking about here and some of the intricacies in dealing with what our guests are talking about, there has to be a national strategy that deals with and then can build on the standards and consistencies among all of the levels of first responders or the classification. This means the terminology, the best practices, ultimately the care and education, looking at pre- and post-vulnerability, dealing with the very real stigma attached to PTSD, so that our first responders or veterans have the ability to come forward and have a voice, and that we've armed their colleagues and families with the tools to be able to deal with and recognize the concerns and the challenges as we move forward, and the warning signs, so that we don't lose another person.
I do have a question for Dr. Sareen.
In your testimony before the Senate Subcommittee on Veterans Affairs, you referred to a concept called “the rule of thirds” and you indicated that a third of OSI patients can be expected to have a full recovery, a third will have a moderate recovery that leaves some remaining symptoms but it enables a patient to function well, and another third will continue to struggle over a long period of time
I have to challenge you on this. I'm not quite sure we can erase the traumatic incident from people, which they've experienced. I agree on recovery. I think we can provide resources and the ability to cope and to lead a productive life, but I'm not quite sure that we can fully recover, as with any other mental health issue.
Dr. Sareen, can you provide a little bit more insight as to how you came to that recommendation that there can be full recovery on that? I'm interested in your comments.
Good morning, Mr. Chair and members of the committee. Thank you for the kind invitation to appear before you today as you begin a very important study into the effects of operational stress injuries and post-traumatic stress disorder upon public safety officers and first responders.
With so many new faces around the committee table, I want to begin my remarks today with a brief introduction of the Canadian Police Association, though I am very happy to say that I had the opportunity to meet with many of you during our annual legislative conference in Ottawa. I'd like to thank you for taking the time to meet with our delegates last week.
The CPA represents more than 60,000 civilian and sworn front-line police personnel across Canada. Membership includes police personnel serving in 160 police services across Canada, from those in Canada's smallest towns and villages to those working in our largest municipal and provincial police services and members of the RCMP, railway police, and first nations police personnel.
I should also note that I'm a police officer in the city of Vancouver. I'm seconded from the Vancouver Police Department to the Vancouver Police Union as its president. I'm also the president of the British Columbia Police Association, which is an association of all the municipal police unions in the province of British Columbia, and I am the president of the Canadian Police Association.
I am seconded to these positions while I'm elected in the capacity as president. If I were no longer in that capacity, I would return to my policing career in Vancouver.
Introductions aside, though, the CPA is quite encouraged that your committee has made this important issue one of the first topics you have chosen to study in this new Parliament. As I mentioned, our organization recently concluded our annual legislative conference, at which almost 200 delegates from policing agencies across Canada came to Ottawa to meet with members of Parliament on the need to push the new government to fulfill its platform commitment to establish a national strategy with respect to first responders who are suffering from post-traumatic stress disorder. We're very encouraged by the responses we received from MPs representing all political parties. It can sometimes be an overused cliché, but in this case, protecting those who protect others is truly a non-partisan issue.
Part of the difficulty in this discussion, though, is that there is no single cause for operational stress injuries or PTSD in the first responder community. For some it's a question of a single traumatic event, which is often followed by intense analysis by supervisors, media, and the general public, all with the benefit of hindsight and time, while for others it is built up over years of exposure to some of the worst circumstances. It's almost impossible to predict and extremely difficult to prevent. We also must not forget the role that organizational policy and practices play in this issue.
There's absolutely no question about the urgent need for action. Since April 2014, 77 first responders have taken their own lives. Obviously, not all of these suicides are a direct result of PTSD, but apart from the elevated risk of suicide, almost every officer I know has direct experience and knows a friend, a colleague, a partner who has suffered from what we now recognize as PTSD or operational stress injury.
To illustrate, the Vancouver Police Union recently completed a survey of my own home service in which we reached out to members through their private email addresses to get a better idea of how widespread PTSD might be. In tallying the responses, it became evident that more than 30% of our members meet the criteria to be clinically diagnosed with PTSD.
Surveys conducted in other major police services across Canada by the Canadian Police Association have shown similar results. These results offer a glimpse into the scope of how serious this problem is.
While suicide is obviously the most severe of the consequences that can be suffered, it's far from the only one. Our recent conference heard testimonials from service police personnel regarding their own personal experiences dealing with provincial workplace insurance boards when filing claims for benefits for those suffering from a disease whose symptoms aren't always easily visible. This is why our members have been actively advocating for presumptive legislation to reverse the burden of proof for those who have been diagnosed.
I am pleased to say that a number of provinces have already taken very positive steps in this regard, including Ontario, which is the latest to move in this direction.
Of course, not all the solutions come directly from government, and I will certainly acknowledge that we have work to do ourselves as police leaders, both on the front lines and particularly at the executive level. “End the stigma” is a familiar refrain that recognizes that we all need to work harder to understand the difficulties faced by those who are suffering. It will come as no surprise that in a world like policing, there has been for a long time a culture that encourages our members to tough it out and work through problems while still pulling your weight as part of your policing team, whether on patrol or as part of a specialized unit within the service.
Everyone from partners to supervisors must work harder within the policing structure to understand the signs and to reach out with a helping hand and the necessary assistance when one of our colleagues needs it the most.
I should also note that police associations across Canada have made tremendous progress in recent years in addressing the issue. Employee assistance programs, peer counselling, and psychological health and safety standards are all innovations that have been pushed by front-line representatives.
Despite all of that, there is still a tremendous lack of research into the issue itself, particularly with respect to first responders, and I believe that is one major area where the federal government can play a significant role. While a number of organizations have taken steps to begin to better understand PTSD, there is a lack of focus in this area that could be addressed with federal leadership. As president of the CPA, I'm approached regularly by researchers and groups that want to be more involved. However, without proper coordination, there is a serious concern that any new resources might not be used in the most effective or efficient way possible.
Underlying all of this is one very important point. While any action plan needs to engage professionals across a number of disciplines, from academic researchers to psychiatrists, this must be a process for and by first responders. I firmly believe that for any new project to have the necessary credibility among those who need it the most, it must be driven by those with a serious understanding of the particular culture and environment that is unique to the first responder community, and I hope the committee can help us reinforce this important point. I know the time here today is limited, so while I could continue for some time, I've always found the greatest benefit in appearing before a committee is the opportunity to answer your questions.
I'll conclude here and I'll reiterate my thanks for the invitation here today and for the work you're all doing taking on this study. I know I speak on behalf of my front-line colleagues when I say that we appreciate your efforts and I look forward to seeing some action on this front.
Thank you very much. I'm absolutely delighted to be here today to talk about operational stress injury and post-traumatic stress disorder.
I'm Louise Bradley of the Mental Health Commission of Canada, and I'm joined by Phil Upshall from the Mood Disorders Society of Canada. Together, our organizations are poised to act quickly in a critical area, thanks to internal knowledge, and strong and existing stakeholder partnerships in Canada and worldwide.
Canadian first responders and public safety officers bear the weight of tremendously responsible jobs. These unsung heroes are quick to act in times of crisis, courageously putting their personal safety at risk in an effort to help others. In a relatively short time, the true toll exacted by this work has become the focus of an impassioned national dialogue. The safety risk faced by first responders goes well beyond their physical well-being. That's why it's heartening to see the federal government showing leadership and taking an active role in confronting the reality of occupational stress injuries like post-traumatic stress disorder.
It's important to note that the mental health concerns of public safety officers are not limited to PTSD. They include a range of problems, from depression and somatic and psychosomatic complaints to chronic fatigue and difficulties with alcohol and other substances. We know the suicide rate is approximately 30% higher than comparison groups, while marital problems are twice as prevalent.
Thankfully, the collaborative work spearheaded by organizations like the commission is lending a voice to this quiet crisis. Our efforts are centred on empowering first responders by exchanging knowledge, sharing best practices, and leading cutting-edge research.
Among our seminal work is the adaption of the road to mental readiness program, referred to as R2MR, which is a program that was originally developed by the Department of National Defence and designed to foster stigma reduction and mental health promotion in the Canadian Forces. The Mental Health Commission has taken this excellent blueprint and modified it to reflect the needs of police officers, firefighters, paramedics, and other first responders. Participants are familiarized with a mental health continuum model and provided with a simple, colour-coded self-assessment tool with clear indicators of good, declining, and poor mental health. R2MR also focuses on teaching a set of cognitive behavioural techniques that help manage stress and build resiliency.
Currently, more than 500 police, firefighter, and paramedic organizations across the country are partnering with the Mental Health Commission to deliver this training. Within the federal government, our partners include the RCMP, which has agreed to deliver training to its 30,000 employees. The recognized need for R2MR is overwhelming. Meeting the demand is among our significant challenges.
It's certainly an area where the allocation of more resources would have a significant impact. To date, the Mental Health Commission has also conducted two train-the-trainer courses with Correctional Services Canada—one in English, one in French. They are rolling out R2MR to corrections personnel as we speak. We're also doing work at the provincial level, both in corrections and with other first responder groups.
I'd like to touch just briefly on our efforts to support the training of Ontario's 30,000 regular and volunteer firefighters, which began in February of this year. We are particularly honoured that the R2MR has received the endorsement of the Canadian Association of Fire Chiefs.
Our work with first responders also extends to the provision of mental health first aid. Offered in over 20 countries around the world, mental health first aid consistently offers key results for those who participate in the course, namely an increased awareness of the science and symptoms of mental health problems and decreasing stigmatizing attitudes. The importance of this training also extends to the promotion of good mental health and prevention of mental illness among first responders themselves. In 2013, more than 40 fire departments, 30 paramedic organizations, and 80 police organizations, as well as the Department of National Defence, delivered mental health first aid training.
We're also working to adapt mental health first aid for use by veterans and their families.
As president and CEO of the Mental Health Commission of Canada, I feel very fortunate to be at the helm of this organization at a time when so many positive initiatives are being undertaken. However, I'm even more hopeful about the positive outcomes that may result as mental health becomes an integral part of workplace safety training, for which the commission has given a great deal of time, effort, and research.
Now, more than ever, we're in a position to equip our first responders with life-saving tools and training. As far as I can see, it is a societal obligation. Ultimately, to neglect the mental health of our first responders is to put the welfare of our communities at risk, and that's a risk we cannot take.
I'd now like to turn the rest of the remarks over to Phil Upshall, who's going to tell you about a proposal that will help ensure first responders seek help, and that it's met with informed and supported care.
Thank you for the opportunity, Mr. Chair and members, to be with you today.
My name is Phil Upshall. I'm the national executive director of the Mood Disorders Society of Canada.
Before I start into my quick remarks, I'd like to point out the fact that Syd Gravel is sitting here with us today. Syd is the co-chair of the Mood Disorders Society of Canada's peer and trauma support team. Syd has lived and continues to live with PTSD and its impact, as a former police officer in Ottawa. He's well informed on both the national stage and the provincial stage, particularly in Ontario as it looks at it's WSIB issues. Syd and his co-chair lead our peer support and trauma team, which is the largest peer support team in Canada, and probably in North America, directed specifically at first responders and people who have significant issues with PTSD. If you want to talk to him later on, you're more than welcome to. He's really a great guy.
The Mood Disorders Society of Canada is a national consumer-led, patient-led, and caregiver-led organization. All of our team, including me, have lived with mental illness, at one stage or another. My associate national executive director, Dave Gallson, lives with PTSD, having lost his legs in a terrible accident. It took him a year to recover physically from losing his legs, and it's taken him many years to recover from the PTSD associated with it.
My senior research person and project manager, a fellow by the name of Richard Chenier, is a former RCMP officer whose colleague was shot to death while he was writing up a report. He lived with that trauma for 29 years before he got the proper help.
Now I'm going to have to really go quickly.
As we outlined to the finance committee a few weeks ago, 85% of first responders and veterans dealing with mental illnesses, including PTSD, go to their primary health care provider. Regardless of all the other opportunities out there for help, if someone is going to go for help with PTSD, most go to their family physicians. Sadly, many of them, over half in many instances, leave without adequate care.
I'm not going to remind you of PTSD's significance today. Because of the expert advice you've been given, I won't get into what PTSD is. But from our perspective, PTSD is an issue that does not need to come to fruition, if you like, if early diagnosis is available and if help in the community in which that person lives is available.
Mood Disorders Canada learned about this problem when people phoned us and asked, “Where can we get help? There's no help for us.” We would refer them to the armed forces, Veterans Affairs, or their own police department, and they would always come back saying there was no help.
The first thing we did was ask, “How come?” We held a meeting. It was called Out of Sight, Not Out of Mind. At that meeting, it became very clear that we needed to attack the problem in a very significant way. As an organization with limited financial resources, we chose to focus on one thing, and that was family physicians and health care providers. They are the door. They're the gatekeepers. They're the first ones who see people living with mental illnesses. They are not taught appropriately in their medical training with regard to mental illnesses generally, and certainly not with regard to PTSD.
We have a very good working relationship with the College of Family Physicians of Canada and the shared care community, including all primary care providers. We've talked to them about working to engage them in the business of learning about PTSD, and they're all on board.
Sure. I have a colleague who killed himself on New Year's Eve, December 31, 2014. He was working a project targeting a number of high-level criminals. He was away from home working an excessive amount of overtime for an extended period of time, away from his two young children and his spouse over the Christmas vacation when they were expecting him to be home. There's a lot more to this story but ultimately it appears to have culminated in this police officer becoming so overwhelmed by his circumstances—he also suffered a head injury during that time that was misdiagnosed—that he went to his hotel room on New Year's Eve 2014 and killed himself with his own service pistol.
I'm still supporting his spouse who's now left with no husband and no father to her two children. She has received no benefits. She's now lost the primary provider in the home, and is still now, over a year later, waiting for a response from the local workers' compensation board. I don't want to come across as being critical of the board because they are, of course, investigating and doing all those things, but there's a clear example of something that has resulted in the loss of a life. It's left two children without a father, a wife without a husband, and a lot of questions and uncertainty around their future.
That's just one example. We had four suicides in the police community early this year. I can give you many more examples, and that's just on the personal side. There's an impact organizationally when you have people suffering from operational stress injury or PTSD. The absences from work, the suffering, the issues with their performance that manifest themselves in disciplinary processes, and how that consumes an individual and the individual's family and an organization, and how inefficient that is, it's just a travesty.
That's why this is so important and why we have to get so ahead of it so that we understand it, so that we can diagnose it early, so that we can prevent it, and treat it, and provide people with support so they can stay productive, not just in their personal lives but also professionally.
I'm going to be dividing my time with my colleague Mr. Doherty.
I want to welcome and thank all the witnesses for your frank testimony, personal in some cases, and your advocacy. I've had the pleasure of working directly with many of you in the last few years. Particularly, I think one of the real achievements of the Conservative government was the Mental Health Commission of Canada, and I applaud this new government if it's going to build upon that. I hope to see some of you at the Sam Sharpe mental health breakfast on May 5, which Roméo Dallaire and I host on the Hill each year.
Thank you for your work and the training program that, Mr. Upshall, your organization's been critical in creating for family physicians, because as you said, that's a first point of contact for veterans and first responders, and we need to empower them with knowledge.
My question will really be for Mr. Stamatakis. I had the honour of addressing your group. I talked about PTSD and OSIs and the need for the federal government to share, and the road to mental readiness program is being shared and built upon. Dr. Sareen, who was just before you, talked about the dosage issue and that a single event, as you said, or prolonged exposure can lead to OSIs. How do you track that sort of prolonged exposure at the police level? Is it being monitored now, so that there can be a health check for your members?
I would like to thank the witnesses for being with us today and helping us in our work.
Before I was a member of Parliament and a mayor, I was a school principal and teacher. On a number of occasions, I saw people who were suffering from depression, burnout, or anxiety. I saw how they felt ashamed and weak. They were afraid of being judged by their peers, and they didn't understand what was happening to them.
We are talking about training, awareness, and research tools, but there is a need for cultural change within organizations, in the institutional environment. Some tools have been put in place, and it has been a difficult process. From what I understand, the Canadian Police Association is just getting started. You haven't started talking about this at the international level to find out what other countries are doing.
We see police officers, firefighters, and members of the military as strong people who are immune to weakness. I imagine that there must be work to do, even when it comes to the corporate culture.
Have you taken your research further and involved the managers of these sectors and the police stations to see what could be done?
My question is for all three witnesses.