I call this meeting to order.
Welcome to the 23rd meeting of the Standing Committee on Veterans Affairs.
Pursuant to Standing Order 108(2) and the motion adopted on Monday, October 3, 2022, the committee is resuming its study on allegations that medical assistance in dying was offered to a veteran, unprompted, by a Veterans Affairs Canada employee.
Today's meeting is taking place in a hybrid format pursuant to the House order of Thursday, June 23, 2022. Members are attending in person in the room and remotely using the Zoom application. The proceedings will be made available via the House of Commons website. Just so that you are aware, the webcast will always show the person speaking rather than the entire committee.
For those participating virtually, I would like to outline a few rules to follow. You may speak in the official language of your choice. Interpretation services are available for this meeting. You have the choice, at the bottom of your screen, of floor, English or French. If interpretation is lost, please inform me immediately, and we will ensure that interpretation is properly restored before resuming the proceedings.
When speaking, please speak slowly and clearly. When you are not speaking, your mic should be on mute. I would also like to inform the committee that all witnesses attending the meeting virtually have passed their technical testing.
I'd now like to welcome our witnesses.
Today we have, by video conference, Colonel John D. Conrad, retired. We also have Mr. Mark Meincke, retired corporal and host of Operation Tango Romeo, a trauma recovery podcast for military, veterans, first responders, and their families. By video conference, from the Royal Canadian Legion, we have Carolyn Hughes, acting director, veterans services, national headquarters; and also by video conference, we have Oliver Thorne, executive director, Veterans Transition Network.
We are going to start with Colonel John D. Conrad.
You have five minutes for your opening remarks. Please go ahead.
It's a real pleasure to participate in this deliberation with this committee. It's a real honour. I'm hoping that I can make a valid contribution.
I think there's a lot for the committee to pull apart, and I do confess that I may not be the best in terms of being up on the issue. I've read everything available in the media and have followed the story quite closely. I do think, though, as we move forward, that I can share some value from my own experiences with Veterans Affairs and the frontline staff who take our calls and deal with our challenges.
I'll be very keen to listen to my colleagues and to the deliberations this morning. What I think may have happened.... In my own experiences, the staff at Veterans Affairs are always super supportive young people and always willing to go that extra mile. I can easily imagine, looking inside the circumference of this particular issue, a well-intended comment going astray, and that's not to situate the estimate or the discussion, but rather to point to one area that I think really could use attention in our Department of Veterans Affairs, and that is a bit of a focus on cultural awareness and training of our own staff at this government ministry.
Any time that a soldier deploys in the Canadian Armed Forces into any country—whether it's sea, land or air—there is always pre-deployment training and always a segment of cultural awareness that talks a bit about the country into which you're going. I wonder sometimes.... I'm not pointing fingers, but I wonder about the ability of what I gather is a stretched government organization to conduct its own internal cultural training and awareness training.
Veterans are a very unique lot in terms of their makeup. We are all very different. We come from different walks of life and different ethnic backgrounds. One common thread, though, through all the brothers and sisters who make up the Canadian Armed Forces and stand as veterans, is a commitment to service, that element of self-sacrifice, and the ability or the desire or the ethos to carry on, no matter how arduous your conditions or how arduous the mission set in front of you. It sounds trite. These words sound so simple to present to the committee, but at the same time, these are values of which we are deeply possessed and which are very fundamental to our being, and they're not as common in our highly polarized society today.
I did want to address in my opening comments this aspect of training, education and cultural awareness for our Veterans Affairs staff. I've always found them wonderfully supportive. It's so easy to say the wrong thing with mental health struggles—wounds to the mind—which are very real. You have ups and downs and you are never completely free and clear. You need daily maintenance on your mental health injury, and it would be easy for even a well-qualified clinician to say the wrong thing. I'm wondering, as we begin this dialogue and continue the conversation, about that fundamental element of internal training.
Perhaps I should leave it there and turn the floor back to the chair.
Thank you, Mr. Chair. Thank you to everybody for having me here today.
My opener changed last night, as I stood at the War Memorial for the first time and put my hands on the side. I'm not exactly storming the beaches of Normandy here today, but I got about 30 minutes of sleep last night.
I am not here lightly, and I am under some duress as I sit here, because I am an injured veteran. I have been in the system since 2017. It was the hardest phone call I've ever made in my life.
I receive veteran benefits, and I have veteran benefits in the works. I would be remiss if I didn't mention that I feel uncomfortable with the testimony I'm going to provide today, because although it should be unlikely, I have a legitimate fear that my current benefits and ongoing claims may be affected as a result of my testimony, which is not quite as generous to Veterans Affairs as the colonel you just heard.
My name is Mark Meincke. I'm an army veteran who served with the Princess Patricia's Canadian Light Infantry. In 1994, I served as a UN peacekeeper during the genocide in Croatia. For the record, it was not ethnic cleansing—I hate that word—it was a genocide. Ethnic cleansing is a euphemism. I was on rotation for Operation Harmony. As a result of my service and numerous incidents that happened during my tour, I was injured with PTSD. Of course, in 1994, nobody had a clue what the heck that was.
I went undiagnosed for 23 years. If you want to see a 23-year train wreck, I'll give you my biography. That is a common story. I've run into Vietnam veterans and Korea veterans, people in their seventies and eighties, who are just now reaching out for help.
When I made that first phone call, it was a thousand-pound telephone. For some reason, in my distraught mind I decided to reach out to the Legion; it just seemed like the reasonable place to go. I got lucky. They took the ball and they ran with it. They were Johnny-on-the-spot. Bing, bang, boom, I got a veteran claim in.
The very first thing I said was, “I don't want any money and I'm not saying that these problems I'm having are from my service.” I was not saying that, because that's what we do. We say, “No, it couldn't be me. I know I need help, but I know that I can't afford the help, so maybe you can help me. But I'm not saying it's from my service.” It took me over two years to accept that what I was suffering through absolutely was as a direct result of my service. Genocide has a funny way of doing that.
As part of my healing journey, I took 10 months before I actually could see a therapist. To fill that gap, at the OSI clinic they did something called.... The name always escapes me. It's a stopgap measure that none of us likes and that has little to no value because of how it's operated. But it was something. It got me in the system and it got the ball rolling.
As I attended one of the 10-week programs or whatever it was, a fellow veteran who runs peer support put his hand on my shoulder and said, “Let's talk. You should come to peer support.” I said, “No, that's not for me, man. Peer support? What am I going to do? Hold hands and sing Kumbaya? That's not me.”
But he convinced me, and I went. It grew, and then I became a peer support facilitator a year later. People would drive for two hours to be a part of that group. From that, it evolved into a podcast, because I wanted to scale what I was doing to help more people. Now it's the largest of its kind in the world. People find help and access resources through my podcast.
As a result of that, the veteran this is all about came to me directly and gave me two recordings, which were said on Thursday to not exist. They are in my possession and they are on my phone.
That VAC caseworker did not inform him of services. Not only did the VAC caseworker offer MAID, but doing so was unprompted, and it was pushed after it was refused twice. You'd think saying no twice would do it, but it did not.
I have the transcript here. Of course, I cannot get a hold of the veteran because he was so distraught he left the country.
I will refer to the transcripts that I made personally to answer any and all of your questions.
Honourable chairman and members of the Parliamentary Standing Committee on Veterans Affairs, it's a pleasure to appear before you on this subject. I'm pleased to be able to speak to you this afternoon—I guess it's still morning—on behalf of over 250,000 members and their families.
I am the acting director of veterans services at the national headquarters of the Legion. I am also a retired military health care administrator. I've been assisting veterans, including still-serving members, RCMP members, those who have retired and their families, for over 15 years in various roles. My last job in uniform was taking care of the ill and injured here in Ottawa before they were released from service.
We support your study regarding medical assistance in dying. First I want to remind you very briefly about how we can be knowledgeable and able to speak on this topic. The Legion has been assisting veterans and their families since 1926 through our legislative mandate in both the Pension Act and the Veterans Well-being Act. We are the only veterans organization in Canada that helps veterans and their families with representation to Veterans Affairs at all levels and at all levels of appeal to the Veterans Review and Appeal Board for disability entitlement for their service-related injuries and illnesses.
We do this through 27 professional command service officers and their assistants, located across the country from coast to coast to coast. They are trained professionals who are government security-cleared and who provide free assistance to veterans and their families to obtain benefits and services from Veterans Affairs. Please note that you do not have to be a Legion member. We will help all veterans.
Through the legislation, the Legion has access to service health records and departmental files to provide this comprehensive yet independent representation at no cost. Last year, our service officers represented over 4,000 claims to VAC, including appeals to the Veterans Review and Appeal Board. Additionally, we met and spoke with many more thousands of veterans regarding their benefits, and I believe we can speak confidently and with credibility about what service officers can and cannot recommend when it comes to the topic of medical assistance in dying.
In answer to what this meeting is about, medical assistance in dying has been the subject of much debate in Canada. It is a deeply complex and extremely personal issue. There are legal and moral considerations that must support autonomy and freedom of choice and protect those who are vulnerable. The Canadian justice system is quite complex and has set out strict protocols, guidance and stringent safeguards that medical practitioners must adhere to regarding this subject.
We were shocked and saddened to hear recently that a veteran was apparently advised about medical assistance in dying by an employee of Veterans Affairs. Veterans contacted us through our veterans services department by phone and by email and were quite angry about the allegation when it was made.
One veteran stated to me personally that Veterans Affairs Canada needs a better grasp on the effect this has had on the veterans community and that many veterans have been angered and retraumatized by this situation, seeing it as “an extension of the perception of deny, delay, and die from VAC to veterans.”
Often, a veteran will ask a command service officer for medical advice, such as which treatment option they should go with or which medical professional. We strongly believe and always advise veterans that they need to discuss their concerns with their doctor or other health care professionals who would understand their unique, personal and private health in detail. This includes any discussions surrounding medical assistance in dying. Quite simply, we are not medical professionals and are not qualified to endorse or provide any medical advice or suggestions regarding any form of treatment.
Regarding the mental health impact on a veteran of receiving advice about medical assistance in dying, as we are not medically trained, we can speak only to what we have seen and heard from veterans and their families.
Veterans Affairs case management and veterans services are there to establish a relationship to help veterans with their identified goals, to assess whether there are any barriers to achieving those goals and to identify the information and services available for the veteran to achieve their goals.
Trust is essential in this case management for the veteran to feel comfortable in seeking the supports and services they deserve and require, and to feel that someone cares and is trying to help them. If medical assistance in dying is ever suggested, trust can be broken, and suspicion and anger come to the forefront, with loss of self-worth leading to an inconceivable setback for future well-being. We feel that anyone living—
Thank you for the opportunity to be here today.
My name is Oliver Thorne. I am the executive director of the Veterans Transition Network, which is a registered charity that provides transition and mental health counselling programs for veterans across Canada, for men and women, in English and French.
We're also a registered service provider for Veterans Affairs Canada, meaning that Veterans Affairs will cover the cost for veterans who attend our program through their claim with Veterans Affairs. This makes up approximately 25% of the veterans who attend our programs. For the remaining veterans, we pay the cost of their attendance through charitable donations.
Given that we provide bilingual services, I prepared part of my testimony for today in French. Unfortunately, my French is not perfect, so I will answer all questions in English.
Reading the news that a Veterans Affairs case manager offered medically assisted dying unprompted to a veteran is deeply troubling, and it seems to run counter to the entire purpose of the department.
This is a very complex subject, but since I have a limited amount of time, I will focus on four major elements that convey my point of view.
First, our organization provides mental health services. Suicide is the worst possible outcome for veterans suffering from post-traumatic stress disorder. The focus of our programs and the goal of our organization is suicide prevention by improving veterans' mental health and facilitating their transition.
Reducing suicide is an achievable goal, because PTSD is a treatable disorder. Leading mental health authorities like the Mental Health Commission of Canada and the American Psychological Association have published countless papers about evidence-informed treatments that are available for PTSD and depression and that can reduce symptoms for those who seek them.
Because of the work we do on our programs at VTN, we also know that PTSD is treatable. Over the past 10 years, we've had 1,500 veterans from across Canada attend our programs and, throughout that time, we've undertaken program evaluation research to measure the impacts of those programs on the veterans who attend. Our evaluation shows significant reductions in PTSD, depression and suicide. In particular, one of our evaluations in 2016 showed that 80% of veterans with frequent suicidal thoughts on day one of the program did not have frequent suicidal thoughts at the end of the program and a year and a half later.
There are many other programs and services like ours that also provide this type of support. Again, these are treatable disorders, and quality of life can be improved.
Third, due to military culture, veterans are unfortunately often reluctant to go get help. As a result, they often seek help only when their suffering has become intolerable. That's why it's important that when veterans finally do seek help, our system is prepared to respond quickly with quality services. If not, they risk disengaging from the assistance process altogether and consequently becoming more vulnerable.
I would just add that I think this speaks to the very moving testimony that Mr. Meincke provided regarding the challenge of reaching out and asking for help. It is absolutely vital when veterans make that call that the system is ready to receive them.
Finally, with medical assistance in dying becoming available for mental health disorders in 2023, we must consider the issue of access, both for MAID and for veterans services. According to the Government of Canada, there is a 90-day assessment period before medical assistance in death can be provided, but earlier this year, the Auditor General reported that the median wait time for veterans applying for a disability benefit is 39 weeks, which is 273 days.
This means that for veterans who are ill or injured as a result of service, many of them could wait three times longer for access to that service than they would for medical assistance in dying. We cannot have a system that offers veterans medically assisted death faster than it offers them access to evidence-informed care that they rightly deserve because of their service to Canada.
Thank you for your time.
First of all, let me say that we have a couple of veterans with us today.
Mr. Conrad and Mr. Meincke, thank you for your service to our country.
Mr. Meincke, you didn't have much opportunity to share a lot about your interactions with the veteran in question, which sort of led to this study, but you did of course indicate that you have had some interaction with him, and pointed out one thing that contradicted what we were told last week by the officials from Veterans Affairs, which was that there were no recordings. You indicate that there are in fact recordings and that you do have them in your possession. I wonder if you could help us to understand a little better what actually happened in this case, with, I note, the first-hand knowledge that you have of it, of course.
We were told last week.... First, we were told there was one.... It sounded like we were told that there was one incident, but there was very careful wording that was used there, and we later found out during the course of the meeting that there were in fact at least two veterans this has happened with, so I wanted to ask you about this, with your knowledge of what occurred here.
We were told that the conversation was only surrounding benefits that were available to the veteran and that medical assistance in dying wasn't proposed. You've indicated to us that in fact it was pushed, and it was pushed numerous times, despite insistence from the veteran that he wasn't interested. Can you tell us a bit more about how that conversation played out?
First, the recordings I have were recorded by the veteran himself. He recorded them because of the initial call, when he was offered MAID. These are two apology phone calls that were made by the VAC manager, who called to say that she was sorry and that the VAC caseworker also, through the manager, expressed regret.
It was from those conversations where his primary concern with his VAC manager was.... I'm kind of torn, because I can't give you the exact.... I have to paraphrase in order to not be violating his privacy, so I'm walking a thin line here. His primary concern was not for himself. I'm not going to give you the medical help that he was asking for, obviously. It was not PTSD, but it was something similar. Again, I'm torn. But either way, he was asking for help, assistance, support and resources—that I can say.
His primary concern was that during his original phone call with the VAC service agent, somehow in that conversation he was told that they had done it before and they could do it for him, and the one they had done it for, who completed MAID, they are now supporting his wife and two children. This was his primary concern, to find out what the heck they were talking about.
Now, the idea that it's just talking about services.... His response to that was asking about the legality of it. First he asked why they were asking him this, and he was told, “Well, just thought you should know, if up the road....” He told them, “But I'm in a good place right now.” He expressed to me that things were sunshine and roses prior to this phone call. He was feeling good about life. Post-phone call, he left the country because he was devastated by this phone call. It's called “sanctuary trauma”, where the place you go for help steps on your neck. That's what happened here.
I want to thank all of the witnesses today, especially our veterans who served and who continue to live with some of the challenges.
Mr. Meincke, I can't thank you enough for sharing, for your strength, and for building a podcast to help more veterans around the country and maybe around the world. That's extremely positive and very important, and I thank you for your continued service in that area.
This is a very difficult topic of discussion, and it should never, ever have happened. It's really unacceptable that it happened, and I thank all those who are sharing some particular information around that.
It is also very important to note that it is not a service offered by Veterans Affairs to speak to MAID. The minister made it very clear that more training, immediately, was needed, and is in effect being done as we speak. We need to know some suggestions of other things that we can do to make it right.
I want to ask a question of all presenters today, and maybe we can start with the same row of presenters: Colonel Conrad, Corporal Meincke, Carolyn and then our final speaker as well.
Back in 2021, we brought forward a program, $140 million, to ensure immediate mental health support for veterans, meaning that you didn't have to wait for your application to be processed. You could make an application right off the top and you'd have the services right away. That's what was shared by a number of you today, that we need to make sure there is no wait time when talking about mental health.
I'd like to hear from you quickly whether you know if people have accessed that and if you have any comments to make. It is crucial. We need to do more. We need to be immediate in our services, and that's the objective of that. Even if your application is denied, you still have two years of service.
We'll start with Colonel Conrad, please, and then Corporate Meincke.
Thank you for the question. I find that $140 million surprising.
I didn't talk about myself during the opening five minutes. I'm in my office. I work in the provincial public service here, in Alberta, but, for four years of my life, I did not work. I lost both my parents during COVID and have recently tried to come back just for mental health—for support. As I mentioned on the front end, you can have bad days and good days. It took a long time to come to this meeting. I agree with what Mr. Meincke said about that 1,000-pound telephone.
The wait line is extremely long when trying to get services for support out here. The advice I've received is to use a civilian practitioner, because of the backlog the Edmonton operational support clinic is undergoing. Of course, that seems like a lot of money for immediate treatment. I'm already in the system—not to make this about me. I hate the way that sounds. I do find that shocking. I don't look at this every day, but, from my narrow perspective, I'm not seeing it. I'm seeing a lot of my soldiers waiting to get help. I don't want to get in front of them just because my cheese is slipping off the cracker again.
That would be my thought. I'd better keep it brief.
I don't know of anybody who's been able to access help quickly.
One main symptom of PTSD, which has to be respected when we enter the mental health system, is that we tend to have a very common aversion to any kind of administrative burden. Any sort of barrier to entry is...the word “predatory” comes to mind. “Deny, deny, deny until they die” is one of the common phrases within the injured veteran community. That is the perception of VAC.
I say this as somebody receiving VAC benefits, but it was five years of clawing and scratching, and it was the most gruelling meat grinder of a process before I was finally able to receive the benefits I now receive. It was brutal. It was one of the most gruelling things I've ever endured, and I've endured some stuff. It has to be kinder.
It's human nature. People can be vindictive. Here I am, contradicting....
I listened to the live testimony on Thursday, and there were three points that I believe to be untrue. One, I do not believe that the call was not recorded. I do not believe that, and neither does the veteran. That's part of the transcripts. I believe that is untrue.
It was also avoided that MAID was pushed, as opposed to, “Oh, by the way, this is something that may be offered.” It was pushed, because he said the words in the transcript. He asked, “Why did you ask this of me? Why are you talking about this?” She was saying, “Well, you know, just in case, up the road....” She was pushing it like a bad used car salesman. It was pushed and he asked about the legality of it. “How is this legal?” he asked the VAC manager. How is this legal? This can't be legal. You can't push this on people.
That is not reflective of the testimony that I heard on Thursday, and that makes me angry, because integrity is doing the right thing, regardless of the consequences. I know that I'm threatening two people's jobs today by saying this. I'm aware of that, and that is why I fear for my benefits. Two people, I believe, were not speaking the truth on Thursday and they could lose their jobs over it. That's why I'm nervous.
I want to thank all of our witnesses today. Of course, there's a special thanks to the veterans who served us so well. I'm sad to hear that the return service is not as good.
There's a special recognition to you, Mr. Meincke. My grandfather was also in the Princess Patricia, so it's very good to be in this space with you today.
One of the things I want to say is that it sounds, Mr. Meincke, like you have a relationship with the veteran who experienced this, and I want to thank you so much for assisting that veteran. I also want to ask you to pass on my thanks to them for being so brave to bring this forward. It's not easy, as you said and outlined very clearly before, to speak up. I want to say thank you, through you, for making sure that this incident didn't go invisible, and for making it seen. I want to pass that on.
I think part of the testimony that we heard very clearly, both in the last one and in this one, is about the importance of having these conversations recorded so that things can be reviewed in a meaningful way. Based on the testimony we heard last week from the department, it was clear to me that if a veteran calls in to get support through the call centre, all of those are recorded.
However, if the worker calls from their office directly to the veteran, those calls are not recorded. There seem to be, from the department's perspective, some concerns about privacy, which really don't make sense to me, that a call coming in is less private than a call going out. I'm not sure I understand that analysis.
I think what I will do today is ask all of the people who've testified if they have any thoughts about the importance of maintaining recording so that we can test for these kinds of incidents, so that there is some way for accountability, and whether there are any concerns of privacy for the veteran in making sure that these are recorded.
I'm going to go in the way in which we started. First I will go to Colonel Conrad.
I can't speak on what's recorded by VAC or what isn't, but I'm very concerned that it should always be the veteran's choice. If they're talking about their families or other personal information, it should be the veteran's choice.
That's really the only comment I have, because, as others have said, there are always records through notes, through My VAC Account and through client notes in the computer system. There are always notes and a track of something.
In some cases, I believe it should be the veteran's choice as to whether they want to speak about personal issues or not, but it's also there to protect the VAC employee.
I want to thank all the witnesses here, as well, especially those who have served. Thank you for your service.
When I left the meeting here last week, I didn't feel very good about it, quite frankly. I was upset. Over the weekend, on Friday—I have to say ahead of time—the veteran we are talking about reached out to my office. I've had lengthy discussions, like you, Mr. Meincke. There are transcripts and messages that we went over since the weekend. I just want to make sure, before we begin.... The individual we're talking about is non-partisan. He has no link to any party, first of all. The other thing I want to say is.... Quite frankly, his concern, as you said so well, is about other veterans who perhaps had the same experience, and how that could affect them. Before we even begin, I wanted to say that.
I was quite disappointed with the . I was quite disappointed with the deputy minister for the fact that if that was my brother, my sister, my father, a friend or anybody, what happened.... I've seen the documentation. I can't share it, either, at this particular moment in time. I haven't even shared it with my colleagues, quite frankly, to honour this gentleman. The apology, as far as I'm concerned.... I would think an individual at the top should have called this person. Obviously, they suffered from post-traumatic stress, and to leave them hanging after the fact is unacceptable. This came out in August.
Do you think that the apology, and how that went forward, was meaningful?
The first thing I would advise is a focus on professional education and professional development of the caseworkers themselves.
I know that budgets are tight, but we do not spend enough on this government department. When you talk about the disposable income that the Government of Canada has and where things get invested, we are not a large interest group when it comes to garnering votes.
The department should put some money, preferably an increased amount of funding, into training its own. That cultural piece is absolutely vital, because you don't know—
My question is for Mr. Thorne.
Mr. Thorne, we know that for women, the suicide rate is 1.9 times higher among female veterans than in the general population. We also know that for female veterans under the age of 25, the rate is 2.5 times than the general population.
Among men, the suicide rate among veterans is 1.4 times that of the general population.
On average, one suicide occurs every nine days.
My question may sound ridiculous, but would you agree that it's unacceptable and totally inappropriate to say the words “medical assistance in dying” to a veteran suffering from post-traumatic stress disorder?
Yes, absolutely. I would agree. It feels silly to have to say that, but if that's the question, I absolutely agree. I question the ethics of it and even the legality of it.
I am not in any way well versed in MAID as a topic, but in preparation for today's testimony, I did some basic research. My understanding is that the only person who is qualified to discuss MAID is a primary care provider, meaning a physician, a nurse or a psychiatrist. It seems to me that a case manager would not fit that definition, so I don't understand how or why this would be discussed by a case manager with a veteran.
Even more troubling, from Mr. Meincke's testimony, is the idea that the case manager said now they are looking after the surviving spouse and child. It almost seems to incentivize the idea of medically assisted suicide, which is completely unthinkable.
I want to come back to just a short summary.
Right now, when a call is made to VAC through the call centre, it's recorded. We heard from the department that when it's a call out, it doesn't get recorded; if it's a direct call to a service agent, it's not recorded.
I appreciate that what we heard is either that it should be recorded or that there should be some sort of accountability given to the veteran, whether or not the conversation is recorded. I think we heard clearly from the department that neither is done, and I want to thank everybody for clarifying that point.
The point that I would like to come back to—and I'm going to start with you, Mr. Meincke—is around the idea of sanctuary trauma. With regard to veterans who are reaching out, I appreciate the multiple levels of testimony that talk about how hard it it is to take that step. I think it is for anyone, but for a person who has served, who has committed to be a protector, it is even harder to take that step.
I'm wondering about the impact of going somewhere where you're hopeful you'll get help and then someone not being there for you in the way you need it. What does that mean in terms sanctuary trauma? What do workers need to know about that, so we don't see anything like this ever happening again?
Last year, after years of struggling horribly with suicidal thoughts I didn't want in my head—I call them “intrusive thoughts”—and trying to beat them away, I felt as if I was getting closer and closer to a cliff. I talked to the therapist provided by VAC, and her solution was, “Just hide the knife you would use. If you haven't done it yet, you probably won't.” That would be an example of sanctuary trauma.
Two months after that happened, in July 2022, I attempted suicide. I saw it coming. I said, “I see it coming. I need some help.” I have never been back to that clinic. I called that clinic and asked to speak to a manager or something, in order to tell them about this experience, because this shouldn't happen to people. There was no exit interview, concern or follow-up. I was on my own. Thank God I have resources because of my show, but that's sanctuary trauma.
The breach of trust that creates.... I will never go back to that clinic, and that was after years of being there.
Thank you so much, Mr. Chair.
Thank you all for being here, and for being as brave as you are, today, sharing this truth from your hearts.
Mr. Meincke, I want to mention that I was horrified when MAID was first brought in. The first place my mind and heart went to was our veterans and the potential danger involved in this.
It amazes me to hear you all say, today, that you would serve again and encourage those you love to serve, in spite of having been in theatres where you and your comrades faced death and peril, and where you participated in and witnessed incredible violence. Many have faced abuse from those who they thought would be their mentors and have their backs. You're facing challenges with your relationships and all of these things, while trying to fit into a civilian world, and yet you would still encourage them.
The one point I'm hearing is.... The whole issue that breaks the camel's back is sanctuary trauma.
In a quick, five-minute speech I got to do in a take-note debate on mental wellness, I spoke to this and said that sanctuary trauma is what happens to the spirit and mind of a veteran when they experience the failure of their government to fulfill its promise to take care of them and their families.
Would you agree with that picture? Am I painting it right?
Until this testimony today and the news story that came out in August, medical assistance in dying was not on my radar as a significant issue for the veterans we are serving. I think this has been a serious wake-up call.
Suicide has been on our minds for the 10 years that we've been operating and for the almost 25 years that our program has been around. Again, it is the worst possible outcome, and our entire reason for existing is to try to stop that outcome, so suicide has always been on our minds. The possibility of suicide through medical assistance in dying for a mental health disorder—again, that we know to be treatable and when we know that people can improve—is worrying. Absolutely.
I'm not qualified to speak about MAID holistically, but with our focus and the work that we do with veterans, we know that they can get better. We've heard from many veterans who don't believe that they can get better, and then they do. They make progress and their quality of life improves.
My fear is that we are offering a vehicle for people to end their lives when there are treatment options available, but those treatment options are more difficult to access than medically assisted death.
I want to thank the witnesses for joining us, particularly Mr. Meincke.
I appreciate your bravery. Thank you. After all that you've gone through, you continue to support....
I apologize. Trauma is not easy for those of us who have gone through it, so I want to commend you for your bravery today.
Colonel Conrad, I also appreciate your contributions, and I'm sending you my condolences for your loss.
Colonel Conrad, in your opening, you recommended cultural awareness training to make the VAC team aware of the sensitive nature. I think you even said “wounds to the mind”. Continuing Mr. Casey's questions, can you elaborate on any additional advice for training for VAC?
I spoke about money and budgets earlier, and I almost regret doing so. It becomes so cliché. What I would encourage VAC to do is be more interested in the leadership function of their own department, be more interested in their own people and in developing them and supporting them.
I am sorry if the words sound harsh, but I've often felt when I'm talking with someone on the phone, trying to get help and trying to navigate this long process—the delay, delay, delay—that it is a function, but it is not the fault of the front line. I've always felt that there's a real absence of executive leadership in this department. That might be unfair, because.... I'm in Alberta. I'm not tweeting about this every day. I'm trying to pick up a first down and keep my life moving forward.
Thank you for your question. I think I would encourage the senior executive level of the department to be more interested in leading their people. It's such an earthy ministry and such a focused one.
I'll leave it there. Thank you.
I've often felt, when I'm talking to VAC trying to represent myself and soldiers, that you are really talking about a foreign country in terms of the constituency you represent. I feel that there are courseware and educational opportunities that would communicate what this regiment of Canadians—some of our best heart's blood—is really like.
This incident we're talking about today is really reprehensible and concerning. You can sense, in the wider community that I've dealt with at VAC on the phone, that there's an essential goodness and a willingness to help. There is such a gap between the world that these men and women know, such as soldiers, sailors, airmen and airwomen, and what a caseworker knows. If we could just bridge that....
When you get to know us, it's easier to support us. It's easier to imagine how hard it is for some of our servicemen and women who serve in other roles to have that jacket and tie on, or how hard it is just trying to make it through the day without a drink or without harming themselves.
One of the recognized standards for treating trauma is prolonged exposure therapy.
Our program is what you might call talk therapy. We have a group of veterans who are together with specially trained psychologists and returning program graduates—what we call paraprofessionals. These are veterans who have been through the program themselves. They return to act as the bridge between the veterans and the psychologists running the program. To Mr. Conrad's point, that helps us to be culturally informed and competent in working with veterans.
Our approach to trauma is, in a very titrated and controlled way, revisiting challenging moments in people's military service or, indeed, any point in their life that has affected their day-to-day functioning. We're able to revisit—
I'd like to recognize the service of those who are participating today.
I've been sitting here for quite a while just absorbing this. I came in with some questions and I'm just throwing them out. I'm going to ask questions that I feel I should be asking after hearing some of the testimony.
I would ask this question of the room: What is the mandate of Veterans Affairs?
The mandate of every organization that we've had speak to us—the Legion, Veterans Affairs and Mr. Thorne's organization—is to help those in need, to make them feel valued and to make them feel supported. We're having a conversation right now that completely throws that out the window.
I would ask myself what would happen if a young student went in to talk to a student counsellor in school. What if they said that they were having a hard time and having issues, and they were given the same answer as the person we're talking about was given, which is that there is a way to end their life.
I'm really struggling with where we're going right now in society and the message that is coming out of Veterans Affairs.
Mr. Meincke, based on your knowledge, was a physician ever included in the conversation with the individual who went through with MAID?
On the topic of suicidality, our staff undergo first aid mental health training in order to be able to respond to suicide or suicidal ideation. Specifically on our programs, all of our facilitators are registered mental health professionals—either psychologists or registered clinical counsellors—and the peer supporters, the paraprofessionals I mentioned earlier, the veterans who work alongside our psychologists, undergo specialized training with our organization as well.
In terms of how we address suicide, we address it largely through the reduction of symptoms and distress that would give somebody suicidal ideation. Our program is designed to address post-traumatic stress, depression and anxiety, but also isolation.
We see very often that for those who are struggling with suicidal ideation, they are perhaps suffering with depression or post-traumatic stress, but what we also see very often is moral injury: either witnessing or engaging in something in the line of service that runs core to who they believe they are and their values as a person. This injury is particularly nefarious, because it produces an enormous amount of shame in the individual who suffers from this. Shame leads to isolation, and isolation leads to a lack of peer support, and all of this leads down the line towards suicide.
Our intervention is designed to bring people together in a group, to get them comfortable with one another and to teach them skills for understanding why these experiences are affecting them the way they do. If we create a safe environment, these individuals can share with one another some of these difficult moments in these stories. They can reduce that shame, reduce the isolation and learn skills to cope. They go out into the world after the program with a peer support network of those individuals they took the program with.
That is our approach to reducing suicidality.
In terms of how our coordinators or our staff would respond to medical assistance in dying, they have been instructed not to discuss it with anybody who brings it up. If they are asked, they must refer the person to a physician or a primary health provider.
I, too, would like to welcome our guests today. I thank you for your service as well. It's incredibly important.
We've heard a lot of testimony, and there are a lot of questions where we could go in different directions.
Mr. Thorne, first of all, you mentioned in your testimony PTSD and suicides and what happens in suicide prevention, of course, and you mentioned the fact that vets are reluctant to reach out for help.
This left me wondering: Is there a process in place for veterans when they finish their military service and they go off to live a civilian life? Is there some kind of process whereby vets are monitored? Is there some form of follow-up by VAC with these people who have finished their service as members of the military? Are you aware of any of that?
I think that is in the process of being built out and has been over the course of the past few years. Specifically, this would be the transition group within the Department of National Defence. Previously, it was known as the JPSUs, the joint personnel support units.
Those have all been rebranded or relaunched as transition centres, if you will, across Canada, the idea being that preparation for transition will become a standardized part of military training throughout a military individual's career, but that as they approach their release from the military, that training within the transition group will ramp up, with the hope of better preparing them for the transition from military to civilian life.
This work has been ongoing for a number of years. We are hopeful that this will help the transition process, because what we often see is folks who slip through the cracks. Again, because of that reluctance to reach out, they sit there and they continue to deteriorate. Their symptoms deteriorate until they reach a point of crisis, and that's what we hope to avoid.
Well, I'm not sure. From what I've heard today and what I know about Veterans Affairs, I'm not sure that they're harnessed to adequately deal with it. The apologies I've seen in the press....
I agree with the earlier comment that, if this was my department, I would be making, at the very least, a phone call. This is a horrific breach of trust, because suicide is what we all work against in terms of recovering from PTSD. You can be whole again, so this is fundamentally concerning. I'm not sure they can get there from here on their own.
It's my honest belief that it's too late. From what I understood, the apology in the press was four or five days in the making. During that time, deputies and ministers would be scrambling to make sure that they had their best face forward, that they had all the facts, and if that's all you're doing, well, I'm sorry but that dog won't hunt. I'm not sure that Veterans Affairs on their own can rectify this.
Thank you so much, Chair.
I would like to take this opportunity to come back to Colonel Conrad.
I'll ask you one question. Then, if we have time left, I'll ask you another one about the civilian provider.
I want to go back to the conversation I had earlier with Mr. Meincke about sanctuary trauma. I really appreciate some of the things you've shared today, and I'm wondering if you could speak a little bit about the impact of sanctuary trauma. You indicated earlier that there needs to be more fulsome training, which I hear is something that you're speaking about very clearly. You also talked about the fact that there might need to be help from outside of VAC.
Please talk about sanctuary trauma and what kinds of supports you think would be imperative to make sure things like this don't happen again. We obviously hear it's a lot broader than just this incident.
I'll try to be brief. Thank you for the question.
My experience with getting help.... I wandered in the woods for about four years of my life where I did not work. PTSD grasps so seamlessly with your own sense of self, it's like the devil touching you on the sleeve. It's almost impossible to see it in yourself. In my case, I wanted to deny it. I didn't want to admit that I was wounded. I wanted to go on. I had a friend, not dissimilar to Mr. Meincke, who was really instrumental in bringing me in from no-man's land.
When I started to reach out, the process was to deny: “We won't accept your claim” or “We need more of this.” I was at the point where my mind was what it was, and my back was out. I had a major heart attack and was on disability from this job. You have trouble feeding your family, and to hear the approach on the phone that “Well, you're going to have to do this” or “We need more of that”.... I was at the point where I was selling my medals on eBay to try to make mortgage payments on my farm.
It's a fundamental misunderstanding of who we are. I wanted to be good again. I didn't know what was wrong with me. I knew I couldn't walk straight. I knew the fundamental misunderstanding with the person on the phone. I'm not a quitter. I'm even having trouble putting it into words for you today.
To answer your question, for me, attitude and understanding are such important qualities in an institution, in a thinking institution. The name of this ministry is Veterans Affairs Canada. How can you not know us so well? How can you not be absolute experts on Canadian veterans, when that is your single point of focus in taking care of the men and women who have served this country?
I come back to education. It starts at the top. I have long said that at the top end of this department they don't seem to get that they are not an insurance company. They don't seem to get that they're in the business of taking care of human beings who would have given their last breaths to protect you, and many of them have.
Here's what we know. There was a veteran who came to Veterans Affairs seeking help for injuries and trauma that he was dealing with as a result of his service to our country. Instead of being offered support or resources to help deal with the issues he was facing, it was suggested that he maybe consider medical assistance in dying, and it was pushed on him, despite his insistence that he wasn't interested. It's caused him to spiral downward, from what we've heard from you, Mr. Meincke.
Despite what we were originally told, which was that this was an isolated incident, it turns out that there's at least one other veteran this has occurred with, and that veteran is no longer with us. Now his family is being supported. It leaves one to wonder how many others there might be and how many other deaths might have resulted from this.
We were told that the identity of this veteran wasn't known to the officials, yet we've heard from you, Mr. Meincke, that a letter was sent to the individual, so clearly his identity was known and is known to the Veterans Affairs officials.
There are a lot of contradictions here, including the one that you shared about recordings. I agree with you. I find it hard to believe that there wouldn't have been a recording of that phone call. I think just about everything we do with an organization like Veterans Affairs or other large organizations is recorded. We all know that. You mentioned yourself that on every phone call with them, you always get an indication that the phone call will be recorded. It is hard to imagine this phone call wasn't recorded. Given all the other contradictions we've seen, I find it hard to believe that it doesn't exist.
I have some questions I'd like to ask, but there's a motion I'd like to move. I'm going to move it. I'm firmly of the belief that this should be one that we will all support quickly and easily. We can pass it and move on, and carry on with hearing more of our witness testimony today.
Given all of these contradictions, I really think we need to hear again from the minister, the deputy minister and the assistant deputy minister, who were here with us last Thursday. We have to clear up the contradictions here.
I'm going to move that we ask the minister, deputy minister Paul Ledwell and assistant deputy minister Steven Harris back to the committee to hear on this issue for two hours, and that that happen within the next month, before November 24.
I think the minister should appear. This issue needs to be cleared up, and I would hope that they would want to appear as quickly as possible. I was simply allowing for scheduling. I know that can be an issue, but I would strongly suggest that this meeting happen as quickly as it can.
Following that, we can probably, as a committee, determine what our next steps would need to be, if any, but I do think it's important that there are lots of contradictions here that need to be cleared up as soon as possible. I would think the minister and his officials would want to clear those up as quickly as they can, as well.
Although I'm leaving that latitude for them, I think it should be strongly suggested, when we write to the minister, that they not leave it for a month, and try to come as quickly as they can, but we obviously need to give some flexibility for scheduling.
I can add something to that, Mr. Chair.
My understanding is that as a committee, the decision had been made to have three meetings. We've only had two, so there obviously needs to be another one.
I don't know if there are other witnesses we still could hear from on this, and we also don't know what might come from the meeting that we have with the minister. In my mind, I think we should be prepared as a committee to make that decision following that meeting—whether there need to be more meetings, and how many of them there should be.
Thank you so much, Chair.
I agree with this motion. I think we've heard things today that make all of us concerned. It's important for us to be accountable to the veterans who've served us so well and to make sure that we help with that accountability.
I also know that the committee requested very clearly in the last meeting that when this work at the department is done, they would send us a report as soon as it is completed. Once that report is completed and sent to the committee, I think we can take the next step in what we want to do, but I don't think we need to wait until then for the minister and the department to come. Hopefully we can allow the chair to see unanimous consent and we can have the minister and the department in quickly. Then, if we have to call them back again because of the report that we receive, that is something we can respectfully do.
At the end of the day, this shows all of us coming together to work hard for veterans. I think that's where our focus has to remain.
Let me take a moment on behalf of the committee members, as well as myself, to thank all of the witnesses who have come before us today. I'd like to acknowledge them.
I thank retired Colonel John Conrad; retired Corporal Mark Meincke, host of Operation Tango Romeo, trauma recovery podcast for military, veterans, first responders, and their families; Carolyn Hughes, acting director, veterans services, national headquarters, The Royal Canadian Legion; and Oliver Thorne, executive director, Veterans Transition Network.
Mr. Meincke and Mr. Conrad, I must tell you that your testimony was very moving. We hope that your health improves in the days and years ahead. So, I thank you for being here in committee.
I'd like to remind committee members that this Thursday we will study the report on survivor pension benefits in camera. We will also consider the motion that was passed today. This is to advise you accordingly.
Thank you. I'd like to acknowledge the entire team with us: the interpreters, the clerks and the rest of the team.
The meeting is adjourned.