I call this meeting to order.
Welcome to meeting number 16 of the House of Commons Standing Committee on Veterans Affairs. Pursuant to Standing Order 108(2), and the motion adopted by the committee on October 27, 2020, the committee is resuming its study on supports and services to veterans' caregivers and families.
Welcome to all of the witnesses who have taken the time to join us today.
From Whelan Psychological Services Inc., we have Dr. John Whelan, lead psychologist. Appearing as individuals, we have Sean Bruyea, captain (retired); Tracy Lee Evanshen; Dr. Heather MacKinnon; and Gerry White, lieutenant-commander (retired).
Each of you will have five minutes for opening remarks, and after we'll proceed with rounds of questions.
Dr. Whelan, the next five minutes are all yours.
Thank you, Chair, and thank you for the invitation.
My comments reflect our clinical work with serving and retired military members, along with some of my research at Mount Saint Vincent University.
I served in the navy for about nine years, then as a psychologist at the military base in Halifax for another 10, and then headed off to lead a clinic of five psychologists for 18 years. During that time we assessed and treated several thousand members and veterans for OSI— primarily operational PTSD and substance abuse. About 40% could be classed as highly invested in treatment and recovery, did their best to stay connected with their families; the remaining 60% were more ambivalent about the need for treatment, and about one-third of those were primarily men who were intensely angry with the military and Veterans Affairs, and were not invested in treatment.
When it comes to veteran caregivers, they're primarily women spouses and partners, in our experience. I think understanding their needs requires a re-examination of our veteran-centric approaches that focus on symptoms and trauma triggers that position family members as passive participants. Their primary role is to attend to the mental and emotional needs of injured veterans. Caregiver spouses are expected to reduce stress and manage potential triggers, primarily dealing with Veterans Affairs Canada, or keeping children quiet in the home, which is a continuation, on some level, of the strength behind the uniform promoted in the military, and as a belief, held among many male veterans, that is premised on taking for granted women's role to manage the home front.
Most of these caregivers are stoic women. Canadian military family researchers have catalogued the extraordinary efforts they expend in seeking out formal and informal supports. They seek out treatment options for their partners while often working outside the home, cleaning, managing bills, cooking and caring for children. Among those we saw, sleep disturbances, anxiety and physical and emotional exhaustion were quite common. They often placed their own needs second.
In our clinic, we routinely asked to interview veteran caregivers during assessment and treatment planning, and sometimes met them privately. Despite fears of creating issues for veteran claims, we heard often about veterans withholding information about their volatility, or spending their days drinking or being disengaged from family life and responsibilities. These caregivers were often quite frustrated with treatment approaches that excluded them and their families. We also received many phone calls from distressed partners whose partners were not clients of Veterans Affairs, so they were left out, despite their obvious needs.
Military veterans are under continual scrutiny, yet we lack a parallel framework to assess the consequences of military OSIs on family members, including vicarious and secondary trauma. In my view, the standing model of “veteran as casualty” excludes the entire family system, which can be a casualty of military service. Veterans' partners receive little direct, practical help in managing their day-to-day lives with former military men with mental health problems. A persistent fear among many of these partners centres around veteran self-harm should they decide to leave the relationship, or even leave the home for errands or to attend work. At other times, veterans would simply leave the home for days following conflicts or disagreements to be alone, to visit buddies, and then show up again unannounced, often throwing families into disarray. This lack of predictability is a formula for all kinds of mental health issues.
In considering the supports needed for veteran caregivers, it is important to acknowledge that spouses, mothers and adult daughters are often given de facto responsibility to manage veterans in between scheduled mental health appointments. In our experience, this vigilance and monitoring role is also handed to adolescents and older children as well, yet none of these people have a say in treatment decisions. They are the ones who call authorities or military buddies to help manage crises. They talk down veterans from nightmares, they contend with drunken tirades and they're expected to be on guard for suicidal indicators. Many partners describe having an additional child at home in terms of reminding their partners to eat, to bathe, to take medications or to organize their days.
Despite our public statements to the contrary, veteran families are often invisible linchpins to veteran recovery status. As noted by military family researcher Deborah Norris, veteran and family well-being is a dynamic, bi-directional process. Family members have a central role in veteran well-being, and vice versa, that far exceeds the effects of medication and individually focused therapies. In sum, no matter the specific individual veteran-centric treatment, it is the social and family context that matters most to veteran welfare and progress.
In Canada we have not explored this intersection of family mental health and family involvement investment in treatment as requisites of veteran health.
It is my view that entire families are often casualties in military service, especially in the case of service-related mental health problems. In keeping with the recent veterans ombudsman's report, families, not just veterans, require assessment of needs and ongoing case management supports.
Thank you, Chair.
Thank you, Chair, ladies and gentlemen.
I feel sincere gratitude to be here. Your study, the accompanying report and the hope for changes will not reverse the tragedies and neglect of the past, but your work can change the future. We as a nation can make up for years of neglect of the most vital, the most critical pillar to veterans' well-being, their families.
I would like to first put on the record that I have gathered evidence regarding the retaliation against our son's carer following articles I authored critiquing Pension for Life. This evidence provides a much-needed insight into the culture of senior managers and their hindering of frontline workers' ability to be compassionate. The evidence is not political but cultural. Unacceptable behaviour by senior bureaucrats has endured through various governments.
Senior officials will likely petition you not to invite me back. That very reason should justify why I humbly request that you would. I recommend that Alan Hunter, my advocate, as well as Tina Fitzpatrick join me to speak to these cultural issues.
Veterans and families are treated as both separate and unequal entities for policy purposes in spite of clear, guiding statements to the contrary. Families are relegated not to the backseat but often to running behind the last car of a meandering train of dizzyingly complex policies for veterans, with an opaque bureaucracy as conductor.
Our families and veterans cannot be separated or diminished in this manner. The veteran is embedded, integral and vital to the family, just as each and every other family member is critical to the family and its well-being. A bridge cannot function if even one support is damaged. The family will only function when everyone is healthy.
Research has told us this for decades. Quite simply, chronic illness not only causes emotional distress in the entire family but impairs the family's ability to support the patient. Families with one member suffering mental health issues suffer the greatest. The negative impacts on the psychological health of the family members are sometimes greater than the direct psychological impacts on the patient.
Canada has more than 35,000 veterans and RCMP members suffering a psychiatric disability resulting from their service, 25,000 with a PTSD diagnosis. Each household member should be given access to VAC-funded mental health care in their own right and of their own accord. How many tragedies could be avoided? It is cruel for families, and veterans for that matter, to be put on a waiting list for a case manager— suffering while a rehabilitation plan is developed in the hope that they might receive mental health care.
Families also need a unique VAC identification to access services of their own accord. The most disabled veterans already have their earning potential paralyzed at a lower rate than when they served. The inability of spouses to pursue their career to the fullest while they care for veterans and children further impacts their earning potential.
Why then are only 1,200 spouses receiving the caregiver recognition benefit when there are approximately 9,000 spouses caring for veterans who are permanently incapacitated and 14,000 spouses caring for veterans with mental illness? Parsimonious programs that discriminate against families have been perennial. Why are non-family members entitled to compensation for escorting a veteran to medical appointments, but families are not?
The lack of support for families of veterans with psychological injuries could explain why only 56% of veterans with a mental disability are married or living common law, as opposed to 71% of Canadians. Veterans Affairs Canada restricts access to programs for the most vulnerable members of the family, our children. Sixteen months after spontaneously cancelling dependent care for our six-year-old son, VAC fabricated new criteria to justify cancelling that care. The program will only pay for basic needs, refusing to recognize the special needs of children. In a glaring omission, the purpose clause of the Veterans Well-being Act has no stated obligation to children or dependants while the veteran is alive.
The wording of the dependant care policy for veterans on medical rehabilitation is generous and compassionate. Decisions need to be broad, flexible and holistic, addressing the unique needs and circumstances of the veteran. One would assume that having a dependant with special needs would be a unique circumstance. However, when veterans' illnesses create the inevitable emotional and psychological burdens upon children, VAC has circled the wagons against these children. VAC will not support any care between the hours of 8:30 a.m. and 3:30 p.m. on school days even when the public system cannot—as if a child's suffering somehow follows a schedule.
Internal emails show a callous insensitivity: “...how realistic would it be for Rehab to swoop in with care when a child when a child is unexpectedly sick? Not Likely—it would need to be predictable....” “Part of the intent here is to avoid fostering dependency on a short-term program.” Perhaps it escaped the observations of policy-makers isolated in Charlottetown away from the daily struggles of veterans and their families. Dependants are dependent.
No attempt to save the Crown money can force a three-year-old to grow up, the missing parts of a brain injury to grow back or PTSD to spontaneously heal, but there is a bigger perceptual barrier deeply infecting VAC. They interpret programs in a manner that sees disabled veterans—and especially their families—as being liabilities, annoyingly dependent on VAC.
Children are haphazardly added to incidental expenses along with mileage and parking. Perhaps this explains why no veterans were granted dependant care for the families in the first four years of the program, or why, of almost 20,000 veterans on medical rehabilitation, only 106 were able to receive dependant care from 2014 to 2019, for a total cost of less than one year's salary of a cabinet or deputy minister.
I have provided you with a list of recommendations in consideration of your report.
I sincerely thank you for all your time, energy and caring for families.
Good afternoon. My name is Tracy Lee Evanshen. I'd like to thank you for the opportunity to speak today and to give you a small glimpse into my life as the common-law partner of a veteran.
I thought the easiest way to explain who I am and what we go through is to give you a sample day in our household.
It's Friday and my boys are visiting for the weekend. We leave Belleville and take the 401 or sometimes highway 2 to the 35/115 and head north. Kevin won't take the 401 if he can help it. It is riddled with triggers and causes stress. He then insists on taking the 407 toll highway. I cringe at the expense, as we must take it to Brampton. Kevin proudly served as a medic, but he was also a paramedic for many years, with the 401 being one of his routes. The triggers are everywhere.
We pick up the boys and head home. A two-and-a-quarter-hour one-way trip can take anywhere from two and three-quarters of an hour to four hours. We get home. Kevin is both mentally and physically exhausted and he goes to bed.
It's Saturday morning. Kevin gets up and follows the same routine every day. He's up, so in his mind everyone else should be, too.
The kids wake up, eat breakfast and head back downstairs to play Call of Duty. One turns it up for the full experience. The other jumps up and turns it down. “Not too loud. Think about Kevin. It will trigger him.”
They give up and move to a movie. One turns it up and the other turns it down. “Think of Kevin. It will trigger him.”
While this is happening, Kevin goes back to bed. He's still exhausted from the drive the day before, so the house must be quiet. Our neighbours let the dogs out and [Technical Difficulty—Editor] talk to them and it doesn't really go anywhere. We call the police. They visit. The dogs stop for about 30 minutes and then they start again. Kevin loses it, gets angry, stomps around and threatens to go up there. I am the buffer. I try to calm him. I try to quiet his mind. I am the go-between. I talk to the neighbours. I talk to the police. Now, I'm mentally exhausted.
I ask my son to mow the lawn. He starts the lawnmower, it backfires and the smell of gas fills the air. Kevin jumps up. He panics at the sounds and the smells. You see, Kevin was on the first plane that arrived into Haiti after the earthquake. The smells he experienced will never leave him. The simple activity of someone else cutting the grass can send him into a tizzy for days.
My daughter puts a pizza in the oven. Cheese drops onto the element and starts to smoke. The smoke detectors go off. She panics, opens the windows and turns on the fans. Kevin freezes, panics and scrambles. The smell of burning sends his PTSD into overdrive.
All of a sudden, a multitude of weapons are being discharged. It's the same neighbour. Kevin tailspins. He panics. It truly sounds like a war movie. I call the neighbour and ask them to please stop.
They say that they have a farm and it's their right.
My clipped answer is that Kevin is a veteran with PTSD. This is a neighbourhood. There are homes with children and animals around them. They have acreage, not an active farm. I understand they want to have fun, but that's what firing ranges are for. It happened daily for months.
Kevin is absolutely done. My boys are confused. I am exhausted. My daughter heads to her friend's to get away from all the noise and the distractions so she can do her homework and attend her Queen's University classes in peace.
The same neighbour is now driving a super-loud dirt bike up and down the driveway. I make supper. We sit down as a family. That goes well until the dogs start barking again. Kevin does the dishes and heads to bed.
I go downstairs and play video games with my boys. The TV is on mute. We pop in a movie and watch it on low. The boys go to bed. I go upstairs and ask myself what I've gotten myself into. Honestly, the thought lasts less than a heartbeat. This man has given me and my children everything he possibly can.
I crawl into bed, but I don't fall asleep. This is when the night terrors begin. I don't want to sleep to ensure he's safe. The dreams start. He kicks, flails, cries out, screams, grabs and punches. You get where this is going. I don't sleep properly. He offers to sleep in another room. No, I need to make sure he's safe. It's time someone was there to protect him.
When he turned 65, his take-home monies went from $2,032 to $932. Let me repeat that. He now gets a whopping $932. At 65, 20% is supposed to be deducted from their pre-65 pay. I guess life ends for a veteran at 65. When they need help the most, they get thrown out with the bathwater. He was unceremoniously released from the military because he was considered old. Sixty is not old.
We are on the phone daily with VAC, the ombudsman's office and human rights to try and get straightforward answers. Those answers are rarely given. We receive responses that go in circles and by the end we are so confused and frustrated that we cave.
We are not uneducated people, but we feel that way each and every time we get responses and not answers, responses that seem to change like the weatherman’s predictions. When we need to make things easier, things are made harder—so much harder.
We have figured out that maybe, as a common-law partner, I am entitled to his VAC benefits but not his military benefits. How does that make sense? We found out that if a veteran is not married by the age of 60, any partnership after 60 will not be recognized. Once married, we have a year to submit this paperwork in order for me to be able to get his military benefits—i.e., pension—but we have to pay into it from what little money we now have coming in.
Veterans Affairs returns upwards of $150 million a year to the government. This money could be used to support veterans and their families no matter what the family unit looks like. They reduced the IRB by 20%, yet give back millions to the government.
I have reached out to groups for support, but I am not married or an active servicewoman. I am common law. I don’t count.
Please know that I am new to this life, and I wouldn't change it. It would be helpful if there was someone who reached out and said, “Hi. Can I help you with anything? Can I explain anything for you? If I can’t, I will find someone who can.”
Veterans have to chase people for help—but it isn't help. It’s more trouble. They give up. They are tired of being marginalized, cast aside and forgotten. As a common-law partner, for the most part I don’t even exist.
Mr. Chair and members of the committee, thank you for allowing me this opportunity to speak on behalf of veterans, veterans' caregivers and families.
I would like to start by telling you about myself. I am former military medical officer who served in both the regular and reserve forces. I have participated in numerous military operations both at home and overseas. I have a unique general practice in Halifax that is composed of former military and RCMP members and their families.
I would like to thank Veterans Affairs Canada for the wonderful help and services that are presently provided to our veterans. There are many positive aspects to the programs available to our veterans, notably for mental health treatment. It is my understanding that veterans' mental health supports are only available to current spouses and their children as long as the veteran gives permission. There are no mental health services for ex-spouses, parents of veterans and children older than 25 years.
Many veterans have been exposed to multiple stressors during their careers. Their spouses and children follow them from base to base, often giving up careers and friends. If a veteran has an occupational stress injury, the family dynamics can be further stressed.
I am a family physician, so I believe the best way I can communicate the issues that I see in my practice is to give examples of how lack of access to mental health care affects spouses, caregivers, children and ex-spouses. These are not just single cases but represent multiple examples from the veteran patient population.
Veterans' families can be subjected to extreme stressors, not only if a veteran suffers from mental health stressors, but physical and financial stressors. When a marriage breaks down, everyone is a loser. The veteran may be getting mental health services via Veterans Affairs, but the ex-spouse receives no assistance. In this case, it is up to the family physician to help the wife. There are no free mental health counselling services available. Often, former spouses face financial losses, have nowhere to live and can only afford legal aid, which is totally unreliable.
Unfortunately, medication dependency such as benzodiazepines and suicidal ideations become a major problem. In one case, we asked Veterans Emergency Transition Services Canada, which is VETS Canada, for housing assistance. In another case, the ex-spouse moved from house to house until she became a senior so that she could get assisted housing. When children are involved, the matter becomes even more complex.
Veterans Affairs Canada only provides mental health treatment to family members when the veteran's treatment or rehabilitation plan has established that doing so will achieve a positive outcome for the veteran. The amount of treatment a family member gets varies from case to case. Children over the age of 25 are not eligible for mental health treatment from Veterans Affairs. I have adult children in my practice who have serious mental health issues and are not able to receive treatment. These mental health issues can be traced back to deployments that the fathers made over 25 years ago.
One patient is both physically and mentally ill. The father has PTSD that arose from these deployments. One child started becoming both physically and mentally ill when the father returned. His mother and he were receiving mental health counselling, which was pulled when the son of a veteran who murdered a police officer was found to be receiving counselling in prison. This caused a review and tightening of the policy. The family has never been able to get further treatment via VAC.
Veterans who have an occupational stress injury and other mental health injuries are often very difficult to live with. They become verbally and physically abusive, drink, hide in the basement and ruminate. The whole family walks on eggshells when the veteran is upset. Veterans who are ill will try to avoid any contact with the outside world. One veteran has multiple cameras outside his house. He is on constant surveillance. One spouse, who was not a patient, came to see me to try to get her husband to stop verbally abusing her in public. This is difficult to deal with. How do you treat the situation, the wife and the husband and not trigger further consequences? I wish this spouse could have received mental health services via VAC. One of these situations got very much out of hand with weapons and a two-day standoff with the police. The situation was diffused with speaking [Technical difficulty—Editor].
One of the spouses reminded me that, when a military member serves, the whole family serves. The veteran says, “These aren't my medals; these are my family's medals.”
Veterans Affairs has made advances in mental health treatment for veterans and for families of those with OSI injuries. These moves are very important. The only problem here is, how do you get to these services? You need a case manager. How do you get a veteran into an OSI clinic? You need a case manager.
I used to be able to call a case manager to help any veteran, but not anymore. They are a rare breed. If veterans with recognized OSI injuries can get help, what about all of the other veterans' families who don't have a case manager? What is there to offer their spouses, caregivers and children, who need help?
Supports and services, including mental health services for veterans, caregivers and families, can be done. The system just needs to be tweaked a bit.
Mr. Chair, and members of the Standing Committee on Veterans Affairs, thank you for having taken the time to listen to me today.
If you have any questions, I will do my very best to answer them.
Thank you very much, Mr. Chairman.
[Technical difficulty—Editor] participate at this standing committee. I don't usually work from notes and I speak a lot locally. When I started my service, I was sworn into the Royal Canadian Mounted Police on my 19th birthday—on May 29, 1974—and served a total of 31 years. I served initially with the Royal Canadian Mounted Police and then accepted a commission into the navy, which was the start of some excellent service and some serious trauma. They both go with the job.
I retired in 2004 after 31 years of service. There are a few people on my computer who are being vastly underscored, mostly by themselves. My treatment was started by Dr. MacKinnon. Dr. MacKinnon and former NDP member Peter Stoffer are probably considered the two patron saints of veterans and their families, and I am not exaggerating.
It seems that a great deal of the care that comes to veterans and their families comes after an incident, and we are hip deep in incidents here in Nova Scotia. What happened in Portapique impacted many mounted policemen, some of whom I trained many years ago. Heidi Stevenson (Burkholder)—that will tell you how far back we go—was a very good friend of mine. The names on the wall keep going, and they shouldn't.
When I retired, I was medically released—mind you, after 31 years—as a result of injuries sustained when I was picking children out of a minefield halfway through a UN deployment to the killing fields of Cambodia in 1992. Even though that happened on August 14, 1992, it never came to light until 2002, and that was only because Dr. MacKinnon saw a few things that she didn't like. She started me down a rabbit hole that is perhaps the reason I'm still alive today.
There are all sorts of facilities in Halifax, and I don't know if it's because I retired as a senior officer or why it would be, but I seem to have better success accessing these facilities and benefits than any other members. If you go to a Facebook page called “UN and NATO veterans group”, you'll see that I am a member. We get together every Saturday morning—about 80 of us—for breakfast, and there are only two officers in the entire group. I am one of them and the other is Commander Fred Maggio, who, like Dr. MacKinnon, was a very instrumental medical officer in the military in Halifax.
I offered to join this group because I wanted to try to address the problem of the difficulties veterans and their families have in being addressed only after there is an incident. I am not very far from Lionel Desmond's home. I'm one hour away from that terrible tragedy. I did not walk in his moccasins so I have no idea what the situation was, but all of a sudden I hear the same rhetoric over and over again: Where did we go wrong? What did we miss? What could we have done?
I will gladly point [Technical difficulty—Editor]. My boss at the time, R. A. Dallaire, said that we should probably talk to somebody about this. But in 1992, for those of you with a poor memory, there was such a great stigma attached to mental health issues that nobody ever went forward. They put a piece of rope up around a beam in the basement instead. There are still people doing that, and I deal with it every day.
My life support system is my beautiful wife. Even though she's the one who many mornings gets me out of bed and gets me to take on the world, there are no benefits whatsoever for her. She is one-fifth of my life support system. My daughter and three grandchildren are the others. They are what keep me going. When things start crossing my mind that I wish wouldn't cross my mind, it is my beautiful wife Jane and my grandchildren who pull me back from the precipice.
We have a veterans memorial park in Bass River, Nova Scotia. Please google it. Once again, another doctor, Dr. Karen Ewing, created a world-class veterans memorial park that is a magnet, a gravitational point for veterans here in Halifax. We muster there for United Nations celebrations. We muster for Remembrance Day. We muster for Holocaust memorial. It's all those little non-VAC support systems that get us through the day.
With my dual background, I started out with the Royal Canadian Mounted Police and then retired from the military. There are so many Mounties here in Halifax, so many Royal Canadian Mounted Police members who still, in many circles, are not even considered veterans. They come to me and ask, how do you address this problem, how do you get access to this, how do you get this benefit, or how do you get a disability tax credit from CRA?
I hope I'm wrong, but it seems that the default setting in response to any query or inquiry directed at VAC is “no”. If 50% of the people who apply for a stairclimber, a TENS machine or whatever, are met with a no, 50% of them say, “Well, I applied for it and they denied it, so I guess we're done.” Then you go to the Veterans Review and Appeal Board and you put in an appeal. Maybe that works, or maybe they will come back again and say, “No, that's not related to your pension condition.”
If you have PTSD and when you get an attack you are shut down muscularly and Dr. Leckey loans you a TENS machine and says, “Here, try this”, and you put it on your neck and start zapping yourself and all of a sudden you can move and can get back to attacking the problem that put you there in the first place, she says, “Wow, it seems to work.” She sends the letter saying, “Listen, I did one of these on a trial basis and did it ever work” They come back and say, “Yes, but it's not related to his pension condition.” Then you want to jump into your car or onto your motorcycle ride up to Ottawa and find this individual who keeps saying no to medical professionals who say this might help. They don't say this will help; they say this might help.
The response or the approach is quite often, and I hate this, I have it written down here, that you have to find an angel, a “VAC angel”, we call them. One of them is on my computer here. She knows who she is. They know what buttons to push. You're not supposed to have to know which buttons to push.
I was in charge of the most unpopular organization in the military, the career manager shop. I would sit my staff down every morning and say, “Listen, let's try to help out more people today than we piss off. You're not going to get them all right, but let's just try to help out more than we hurt. That's the best we can hope for.”
Far be it from me to preclude the analysts' report, but I think recommendation number one might be to just answer the phone.
Gerry, thank you for that.
I have a lot to get to here, but I want to start with Mr. Bruyea.
Sean, thanks for being here. In the time I've known you, over all these years, there's no one who can come to the committee and nobody outside the military who is more prepared than you are with respect to the information that you provide.
In remarks, the ombudsman, like you, used the expression that families should receive care “in their own right”, but you added the phrase “and of their own accord.” What do you mean by that, and what are the obstacles to some of the families receiving mental health care now?
Thank you very much, Mr. Brassard. I'm very humbled by your comments.
The ombudsman was absolutely correct in using the expression "in their own right". That is the availability part of the program. We all know that there are a lot of programs... [Technical difficulty—Editor] said something about accessibility. That would be of their own accord, because accessibility too often is determined by Veterans Affairs and not by the needs of the family member or the needs of the veterans themselves.
I wanted to use the words "of their own accord", which means that if there is a wish and there is a medical need identified by a practitioner outside of Veterans Affairs, then that care should be given—no questions asked and no delays given.
The obstacles to families searching for mental health care.... All of us have identified the need for it here today, so I won't belabour that point, but many technicalities exist today.
First of all, as Dr. MacKinnon pointed out, in order to get the mental health care for the family, the veteran first has to be case-managed.
Once the veteran has put in a waiting period—and for some of those waiting periods, we're talking about months and sometimes more than a year in some districts for a veteran to receive a case manager—then the veteran is admitted to the medical rehabilitation plan, or perhaps it might be a vocational rehabilitation plan. Once they're admitted to a plan, then they have to go on to develop a case management plan with the case manager. Then the case manager has to identify whether that family needs those plans.
The important thing here is that it's not whether the family has a need; as Veterans Affairs says, it's whether the veteran has a need for the family to get the care. When obstacles are presented, such as those that numerous people pointed out—when the veteran doesn't want the family to get care or doesn't even want a case manager—the veteran's family is left in the lurch.
Veterans Affairs has wonderful rhetoric about how families of veterans should be receiving care. Garnier resulted in both good and bad policy interpretations. One of the good ones that doesn't seem to be acted upon is:
Achieving a positive outcome can be compromised if the client is treated in isolation without addressing the effects that the mental health condition has on the family or the effects that the family dynamic have on the patient’s mental health condition.
Thanks, Chair, and tremendous thanks to all of the witnesses today for giving your time and experience.
A particular thanks goes to Ms. Evanshen for painting a very vivid picture of the challenges facing family members, including kids, in a different kind of family permutation. You made the case very well there. Thank you for that.
My fellow committee members have heard me speak in the past about the tremendous concentration of active service people in all three branches, plus the RCMP as well as retirees and veterans of those branches, in Halifax. Every challenge that we can imagine and every uplifting moment that we can imagine that comes with veterans exists here in Halifax. That's why I'm so glad that retired Lieutenant-Commanders Dr. Heather MacKinnon and Gerry White are able to be here.
I want to direct my question first to Heather and will try to split the time in half.
Heather, if I start to get fidgety, it means that I'm hoping to save some time for Gerry.
You have an incredible, unique perspective and practice and you have so much to share. I really want to give you broad leeway on [Technical difficulty—Editor] about the importance of supporting families and caregivers, based on your experience.
It's very frustrating. I can't seem to get help. I try all sorts of tricks, because I've been at it a long time. I can call and I rather beg people to take patients.
I have a situation with a fellow who is 33; he can't get help. His mother and I were on the phone. The father's a veteran; he's a patient, and the son is a patient. I'm going to beg a psychiatrist to see him, but I've also made my plan with the mom, and we decided that what I would do is start him on medication. It would just be nice to get a psychiatrist to confirm the things that are wrong with him, but I'll go ahead with it on my own anyway.
That's the way it is. Sometimes I can get the psychiatrists who are working for VAC to see somebody. I have a situation right now with somebody who was a medic in the military. [Technical difficulty—Editor] severe illness, had four strokes, and we're having a terrible time getting him registered with VAC.
It's just not happening. It's been four or five months, and he's fallen off the wagon, and everything's deteriorating. There is a psychiatrist involved, but we just don't seem to be getting help. Again I'm dealing with his family. I'm dealing with his sister; I'm dealing with other people in his family, because he lives alone. It's a horrible situation. His ex-wife is helping me. Everybody is contributing, but we're not moving forward.
This happened in June. Why isn't he into VAC now? Why hasn't he been registered? We started this in September when he was released from hospital. I don't understand it.
These are the frustrating bits. I will go anywhere for help, and Gerry knows that. I will go to other systems to get help. I'll go through the public system; I'll go through other VAC; I even get veterans to help other veterans. I call on them to help with a situation, if we think somebody needs to be babysat or we're a little bit worried about suicidal ideations.
We work on it. That's what I'll say.
Thank you, honourable member, I appreciate it.
My caregiver is taking care of me even while I'm talking to you. There you go.
For the care and support given by the primary caregiver, which is my wife, if you added all of your salaries together and started paying her that much, it might be half of what she earns.
Just putting up with us, you're a mental health administrator. My wife has retired from 30 years of taking care of troubled children, so God picked the perfect caregiver for me.
Our UN and NATO veterans group here is supposed to help out where VAC cannot deliver the goods. We end up being the primary support organization for our veterans here. There are 800 of us here in Nova Scotia. There are 400 in metro and we are the midnight phone calls and the interventions.
Fortunately I managed to get through life without pills or alcohol or whatever. We are the intervention team—an assembly of veterans from all backgrounds and all histories. If we can, we get VAC to help out.
I'd love to have a caseworker. I've been trying for years. My last one was 10 years ago—a fine gentleman who retired.
Our group here is taking care of our veterans. Then if we can bang down enough doors—if we can get the MacKinnons, the Ottomans and the Dr. Daniel Rasics to push the right buttons—then we will get what we need from Veterans Affairs.
I'm not here to slag. I have been very well taken care of by VAC. I really have. I have no complaints whatsoever with the care I get, but it has taken a lot of door pounding. Sean will tell you that retired military officers don't do really well at negotiating. We like to negotiate at the end of a carbine.
That's it. Thank you for your time.
I took a picture of the wait times with my cell phone. The wait times were one hour and 14 minutes, one hour and 40 minutes, or one hour and 15 minutes. It's a constant struggle. First, you need a response. They then transfer you from one department to another. In the end, they give you a name. Otherwise, and this is the most frustrating situation that can occur, they put you on hold and then disappear. You must then start the whole process over again.
And you start the whole process all over again. It is so frustrating. You just give up, which is almost.... I hate to say it, because I know your staff come to work in the morning wanting to do good for people, but that is not the way it comes across, Mr. Chair. It is not the way it comes across. It seems that they just want you to go away, as Tracy so succinctly put it.
The good news is that we keep dying, so we will go away. You just have to wait us out. We keep dying, but in the meantime, it would be nice to have a little, tiny bit of dignity accorded to us by VAC. I'm sorry, but if I get emotional, it's because it is an emotional procedure.
My dear friend Andy Fillmore knows part of the therapy. He tasks us. He calls veterans and says, “I need you to do an income tax run”, or “I need you to do a food bank run” or “I need you to go and visit this guy”. He knows what the answer is going to be when he calls us. The answer is going to be, “I'm on it, Mr. Member”, and we just go. That's our therapy, but we had to do it all within ourselves. I'm sorry, but we had to do it all within ourselves with the faint hope clause that we will get through or that we will find....
Heather MacKinnon should have retired three or four years ago. We need new guardian angels just to know what buttons to push to get through to Veterans Affairs.
I'm sorry; I apologize.
Thank you, Mr. Chair.
There are the dogs, for instance. I have a dog. I have a big dog. He likes to bark. They have two dogs that bark incessantly, so for Kevin it's like nails on a chalkboard. It's a continual nuisance. Then with the police, I call up, I try to buffer. I've gone up there. I've been threatened. They say, “It's dangerous up here, little lady.” I'm like, “I hope you're not talking to me like that because that's not going to bode very well for you.”
It's always at Kevin's expense. The guns will start going off—same family—with no warning. All of a sudden, Kevin is sitting there, everything's grand, and then all of a sudden a barrage of weapons is being discharged 150 feet from our door. I've seen him hit the ground. I've seen him get angry, go to the bedroom, close the door, go under the blankets and not want to come out. I then go back up there again, and my kids are screaming, “Mom, they've got guns.” I'm like, “I don't care, because Kevin means more to me than a bunch of kids playing with guns.” If they want to try, then good luck to them again. Then there's the dirt bike, which is loud, it goes up and down.
You call the police, they come, and in all honesty we were told once by a police officer, “I'm not going up there, they have guns.” I said, “Okay, I'm pretty sure you have one too, so go on up and take care of this.”
It's continual and it can be something as simple as driving down the road and someone inadvertently cuts you off. It sends him into a tailspin. A backfire, the start of a lawnmower, it's all these things that we take for granted that send him somewhere else, and somewhere to a place where we can't get him back from very easily.
I can't thank all five of you enough for your presentations today. With the presentations and the feedback we're receiving, it will be extremely helpful for our committee to put a report in place that will help veterans. I just can't say enough. To each and every one of you, thank you very much for that information.
As you know, the population of Nova Scotia has the highest ratio of active and retired military in the country. Sometimes people forget that, but we have very high numbers. In my riding of Sackville—Preston—Chezzetcook, it's the highest yet. We have here today what I call team Canada, or team Nova Scotia, I should say. We have Dr. MacKinnon, Mr. White and Dr. Whelan, all three very important individuals, to support the veterans in our communities. How they help each other is just amazing. I know the connections between Heather in her work as a doctor supporting.... I can't say enough about you, Heather. Every time I listen to you, I'm just amazed by the things that you're doing. Mr. White and the support that you're giving, 24/7.... I think of the support that individuals but also VETS Canada provide. Dr. Whelan, the research is so important, and there's a link between all of you for that research, and that's why I think we're able to find some solutions as we move forward.
Dr. Whelan, very quickly, you talked about 40% of the veterans being invested in their treatments while 60% are not. Why is the number who are not invested so high and what can we do to change that?
Thank you, Ms. Blaney. That's an excellent question.
If we take bits and pieces of what everyone has said here today, I think we really need to include a multidisciplinary approach. Mental health research has shown that veterans, especially with severe chronic illnesses, do not get better or progress in their lives unless they have a multidisciplinary approach.
The same would apply for those family members. The members have to be involved in that case management plan. We need to strip all the work and paperwork that case managers have to do so they're freed up to find those practitioners.
For instance, in the United States context, veterans can go to a hospital that offers all the multidisciplinary facilities that can address the veteran. What I would like to suggest is in Canada we don't have that one-stop facility. A case manager has to prove each individual practitioner for that team. Then, the burden is upon us, the other veterans, or the family members, to try to get that team to talk to one another. We can be much more creative about this. We can start working in a team management context.
Veterans Affairs in the United States has 24-hour-a-day mental health care. We can do the same in Canada if we start training and educating practitioners, bringing them into the Veterans Affairs' fold, and offering these services to the families, to the children, and to the veteran, of course.
As you know, Mr. Brassard, I usually come here and advocate for policy change and on behalf of other veterans. It is very difficult for me as a veteran to speak personally about what I go through. I can't tell you all, members of the committee, how difficult it is to see the effects of my [Technical difficulty—Editor] PTSD has on my family.
I'll try to keep it together here, but I can tell you that when they cut off that care, it was devastating. The timing of it, of course, was the immediate link, but as we progressed I discovered that my case manager didn't keep any case management notes as to why she cut off that care. I found that assistant deputy ministers were intruding and preventing all opportunities, including appointments of inquiries resolution officers, to try to find an answer as to how to get that care back.
For me personally and my family, they've watched me spiral out of what was really.... I had advanced so far in my rehabilitation plan up until that day, and then they saw me attend hospital appointments, go to emergency wards once a month at least, and I can tell you, every single appointment, whether it was for mental health care, massage or physiotherapy, was preoccupied with addressing the negative effects of VAC going after my family.
Veterans have very little self-esteem when they come out with PTSD. They have such a low sense of having accomplished anything. Their families are the one solid backbone for them, as we've heard from all testimony today. When that family is attacked, and we're not talking about just not supported, but when the care of a six-year-old boy, our son, was attacked at that time, it was something I'm still recovering from.
Thank you very much, Mr. Chair.
Mr. White, I had the honour to serve with Peter Stoffer, an absolutely fine gentleman, but I can honestly tell you that I have never ever heard anyone use the words “Peter Stoffer” and “saint” in the same sentence.
I have a brief story, if I may. Peter was one of these guys who would go through Parliament and call every single person by name. It didn't matter whether it was another MP, a security guard or somebody in the cafeteria. He called everyone by name. The reason he was able to do that is that he thought everyone's name was “Buddy”.
Mr. White, I'm going to begin with the other patron saint you referenced: Dr. MacKinnon.
Dr. MacKinnon, in your remarks, you talked about the challenges associated with caseworkers or with the availability of caseworkers. This has been a vexing problem over the years. It's certainly one that we inherited and have put a lot of money into, for more caseworkers with smaller caseloads. I would like to hear from you if you could elaborate a bit more on this caseworker challenge. We do hear a lot from the union about it. I would like your advice on how we solve that.
Thank you, Ms. Wagantall.
I think today is a perfect example of how you are all hearing from individuals who are unhindered in their ability to speak openly. That's what we really need. I think the public and Parliament needs to hear this unfiltered information, the unfiltered data that comes to you.
As for the current structure of the advisory groups, yes, they have some of these experts on board for the families, but the problem is that they're co-chaired by bureaucrats. There are always bureaucrats running around the room presenting material, deciding on the agenda and then editing the final reports.
I've heard from various members of various advisory groups that this is in no way conducive to providing independent, authentic and meaningful recommendations. I think it would be to the benefit of all people, Canadians and Parliament, to have these independent advisory groups that are chosen, hopefully by an independent body such as.... Currently it could be the ombudsman, but hopefully an independent federal appointments commissioner.
My caregiver? I'll call her a caregiver. Since I sat down here, my caregiver has given me this glass of water, and she has brought me this box of Kleenex. Clearly, I have a better caregiver than Bruyea. Also, when this conversation is over, she's going to spend the next two hours talking me down from how wound up I am as a result of participating in this.
You can google “roast Peter Stoffer” or “Peter Stoffer roasted”. I was the MC of that roast. I put body armour on him and gave him a name tag that read “Stoffer PD”, and I picked a trade for him—“SD1”. That stood for “shit disturber 1st class”. Pardon the vulgarity, but that's what we need. We need people to go into the corners after the puck. We need people to say that not only is the veteran spiralling out of control, but he's dragging down with him somebody who he stood up with in front of 150 people and who he said he would love until he was dead. He's dragging her or him down with him. That's the problem.
Now, I realize that we're standing at the bottom of a mountain looking at the top, and it's going to be a very tough job to get there. We had the one-stop shopping that Sean was talking about. It was called the Stadacona Hospital, and everything a veteran needed was all in one building. They gradually....
Sorry, Mr. Chair.
Just get in corner after the puck and, above all else, pick up the phone and take the time. It's empathy, as Tracy said. Just empathize. I don't want your sympathy. I want your empathy.