:
Thank you, ladies and gentlemen.
Apologies for the vicissitudes of parliamentary procedure, but welcome to this continuing study of the care of ill and injured Canadian armed forces members.
Because of time constraints, I will suggest to members that we move Ms. Rigg, the director general, civilian human resources management operations, from the second hour to come to the table should members have questions for Ms. Rigg. Do we have acceptance?
Some hon. members: Agreed.
The Chair: Thank you.
Major-General Millar, welcome to our committee on national defence.
With us, members, is Major-General Millar, chief of military personnel; Colonel Scott McLeod, director of mental health, Canadian Forces health services; Colonel Rakesh Jetly, mental health advisor of the directorate of mental health; and from the Department of Veterans Affairs, Michel Doiron, the assistant deputy minister, service delivery; and Raymond Lalonde, director of the operational stress injuries national network. As I said, joining at the table for the time that we have available, Ms. Jacqueline Rigg, director general, civilian human resources management operations. She is also assistant deputy minister, human resources civilian.
We will open with statements.
General Millar, you have 12 minutes.
:
Thank you very much, sir.
Mr. Chairman and members of the committee, my fellow officers and I are very pleased to have the opportunity to talk to you about caring for our own programs—much that you've heard over your adjudications in the last while—and specifically, the care of our ill and injured Canadian armed forces personnel and their families.
I'm very delighted today to have family members from the Canadian Forces and family members from our veterans here with us today. I was speaking with Claude and Jenny as well as Paula, and it's wonderful to hear some of the words and the praises that we have for them as we help our military members get back onto their feet, back into the Canadian Forces, or to transition from our hands to our communities and into the hands of Veterans Affairs.
Joining me, as the chair indicated, is Scott McLeod, my director of mental health, and Rakesh Jetly, my chief psychiatrist for the Canadian armed forces.
When Canadian armed forces members are seriously injured or suffer an illness to the extent that they cannot function in their regular duties, they are admitted into the care of our own program consisting of three phases, as you've heard from Colonel Blais: recovery, rehabilitation, and reintegration. Administered by our 24 integrated personnel support centres across the country, such as Petawawa, which you visited recently, the program is compassionate, tailored to the members' needs, and has no set timeline, as recovery from an injury or illness does not have a schedule. It's a perfect marriage: the IPSCs provide the valuable administrative support while our Canadian Forces health system provides the care.
In some individual cases, the road to recovery is measured in months, where at the request of the member, because of a job opportunity from outside of the military, the process only takes six months. However, more typically, the road to recovery, rehabilitation, and reintegration is measured in years, from the point of injury to when our members no longer need our help. Members like Corporal Glen Kirkland, a budding real estate agent, and Master Corporal Jody Mitic, of Amazing Race fame, are for me the ambassadors of our program as they epitomize how, through their will and determination, combined with the care and comfort that we provide, anyone can overcome injury and illness and move on in life to do amazing things.
Let me briefly describe our programs. Recovery and rehabilitation phases are mostly in the hands of our medical experts who lead in the fields of physical and mental recovery and rehabilitation. Our seven operational trauma stress support centres, such as the one here in Ottawa; our state-of-the-art rehabilitation equipment and centres of excellence; our extensive military health research program, along with our many external partners such as Veterans Affairs, with its 10 operational stress injury centres; the Royal Ottawa Mental Health Centre, which we partner with; and the Canadian Institute for Military and Veteran Health Research form this tremendous network of care and support.
The reintegration phase becomes a shared responsibility among the members, our medical staff, and the chain of command. Reintegration may entail working part-time with another military unit or going back to school for academic upgrading, or it could perhaps be working at Royal LePage real estate in order to acquire an operating license, or it could be working with The Royal Canadian Legion, with Canada Company, or with another government department, all the while receiving a military salary.
One of the purposes of reintegration is to re-instill confidence, self-esteem, and a sense of pride and self-worth, which are key ingredients for military warriors on the road to recovery. Working outside the Canadian armed forces is often more conducive to recovery as working in the military can sometimes be contributory to the ailment. Often members will find a new niche, a new vocation, and actively release to pursue a new beginning outside of the military. For those transitioning out of our care and into the hands of Veterans Affairs, we offer vocational rehabilitation in the form of on-the-job training and an educational upgrade program.
Our latest initiative is the military employment transition program led by Canada Company, where up to 200 employers are offering jobs to our veterans through the “1,000 jobs in 10 years” campaign. Our new military employment transition program features career assessment, market analysis, resumé writing, job search, job coaching, and job mentoring. Currently, there are more jobs than applicants, but this is because we're at the leading edge of the program.
[Translation]
Thanks to the True Patriot Love Foundation and its research into employers' tendency to hire veterans, and thanks to leading companies like Prospect Human Services—which has an 85% success rate in finding jobs for veterans from the Edmonton area—we have set up a single-window job access capability to assist our veterans and mitigate their concerns at the prospect of starting a new career.
For members transitioning into the community and planning to seek outside employment, Veterans Affairs Canada and Department of National Defence staff start working together six months before the member's release.
For veterans who are leaving and have complex needs, an integrated transition plan is prepared—a task that includes the member and all relevant personnel. The plan sees to it that the member's needs relating to medical care, education, future employment and Veterans Affairs Canada support are met.
Once this process is completed, the member either signs the plan, indicating their agreement, or states that the plan is inadequate. There have been few cases in the past where members have disagreed with the plan, but in such cases, the plan undergoes a review to mitigate the member's concerns.
[English]
The focal point for this entire effort is the joint personnel support unit, of which there are 24 integrated personnel support centres across Canada employing 97 civilians and 179 military staff, housing families, spiritual, social, and financial support specialists along with our Canadian Forces health services managers and Veterans Affairs Canada staff in location. This collaboration has greatly facilitated the comprehensive care for our members and their families. You undoubtedly witnessed the care and the compassion of those who work at the IPSC when you visited Petawawa.
The program has been successful at demystifying the stigma associated with getting help. Today, we have 1,924 members assigned to the joint personnel support unit across Canada. Of these, 60% can have some form of mental illness ranging from PTSD to depression and varying forms of anxiety associated with the rigours of military life in general. The fact that our numbers are increasing is indicative that the barriers are coming down slowly, but more needs to be done.
You will have read that we recently lost soldiers to suicide. Our suicide prevention program, our education and awareness, the resiliency training, the screening, our outreach, and research are all a part of our mental health strategy. Although our suicide rate is lower than in the rest of Canadian society, although our rate has not increased since 1995 despite our heavy commitment in Afghanistan, although 2013 was one of the lower rates in years, although those in need can get immediate mental health care from a medical officer, and although we have first-rate mental illness facilities, resources and support, and the best mental health practitioner ratio to service population in NATO, we can do more.
A significant percentage of those who do commit suicide appear not to have a diagnosed mental disorder and were likely suffering in silence. The most prevalent barrier to care is that most of us with mental disorders do not appear to recognize that we have a problem. This barrier is seen in almost 90% of those who have an apparent disorder. The next most prevalent barrier is the desire to manage one's problems on one's own, being stoic and proud. Impacts on career and negative attitudes towards mental health are also common.
The key to success in dealing with mental illness is early intervention. To help our members, we need to accentuate the positives because every time we give the perception that we are criticizing the outstanding work being done by our JPSU and our health services, the less likely it is that those on the fence will come for help.
We need to balance the narrative with stories such as Mr. Sneddon's. Corporal Moe Sneddon's father called the JPSU in Halifax following his son's suicide to say that his son's death had nothing to do with his PTSD but was related to other cause factors. He said that in the note his son left, Corporal Sneddon asked the staff at the JPSU in Halifax to be thanked for their help, as he would not have survived as long as he did without them.
From our suicide investigations, roughly 60% of personnel have deployed, whereas 40% have not. Of the cause factors, the most prevalent triggers are 45% relationship-related, 21% disciplinary career problems, 16% financial, and 10% legal.
De-stigmatizing mental illness, addressing psychosocial factors, greater education and awareness, and building resilience are my areas of focus as we strive to better understand the complexities behind mental illness and enhance our programs to support our men and women and their families.
Regrettably, time does not permit me to describe the various programs. However, we have provided copies of “Caring for Our Own”, our “Mental Health Strategy”, the road to mental readiness pamphlet, our morale and welfare services pamphlet, our comprehensive aide-memoire and benefits, and the programs and services of the Canadian armed forces and Veterans Affairs.
You've heard about Soldier On, the Injured Soldier Network, home modification, vehicle modification, and all of the other benefits. We can address some of those during our question and answer period.
Mr. Chair, thank you very much.
It is my pleasure to be here this afternoon with Major-General Millar and other Canadian armed forces colleagues to discuss how we work together for the care of the ill and injured Canadian armed forces personnel and veterans.
Joining me today is my director of operational stress injuries, Raymond Lalonde. So if we have technical questions, Mr. Lalonde can take them.
[Translation]
I am very new to my role at Veterans Affairs Canada. It is month three for me, as I started in late December. However, I am not new to serving Canadians or to a service delivery, operational organization.
[English]
I joined that from Service Canada, where I was a regional assistant deputy minister accountable for the delivery and administration of programs for the Atlantic region. Prior to that I worked with various senior management positions in the Government of Canada, such as Transport Canada, Public Works and Government Services, and the former Canada Customs and Revenue Agency.
First, in that context I will briefly discuss the VAC—Veterans Affairs—and Canadian armed forces joint steering committee, which I co-chair on behalf of Veterans Affairs alongside Major-General Millar.
[Translation]
Veterans Affairs Canada and the Canadian Armed Forces have distinct mandates, but it is in the care of the ill and injured that our efforts on behalf of Canadians merge. Those we serve may still be in uniform, in the process of being released from the Canadian Armed Forces or former members.
Those who were injured during their service have a right to expect us to coordinate our services and efforts as much as possible to meet their needs, as do the loved ones of those who were killed in service. This is why the steering committee exists.
[English]
The committee brings together VAC and CAF personnel at the senior operational and policy level, fostering a strong working relationship between our organizations to address program and policy gaps and ensure continuity of services received by the ill and injured members and their families as they move, as they transition to civilian life.
It's more than an advisory body. It's a decision-making body that identifies, manages, coordinates, and prioritizes the activities and the initiatives that involve and impact both organizations and those we have the honour to serve.
The committee's recommendations go to our deputy heads for final ratification.
[Translation]
The committee's joint priorities generally fall under the effort to ensure a continuum of services, including in the areas of mental health and family support. There is a focus on joint research, as well, where applicable.
So what does this cooperation look like? At our last discussion on January 14, for example, we agreed to focus on how we can more effectively integrate efforts to harmonize and streamline support to Canadian Armed Forces members in the areas of employment transition, rehabilitation, mental health and suicide prevention.
I look forward to our next meeting, on April 1, when we will continue discussing these issues.
[English]
Now that I've explained a little bit about the steering committee and how we strategically work together, allow me to speak more specifically about VAC and the role in caring for our ill and injured.
As Major-General Millar has mentioned, the CAF has primary responsibility for the care of military personnel while they are still in uniform. CF members may, however, be eligible for VAC disability pensions for a service-related injury even while in uniform.
Following release, VAC is responsible for the care, the treatment, and the re-establishment of veterans into civilian life. We share this responsibility with provincial and territorial governments and with the communities.
[Translation]
Our goal is to ensure the continuity of care the member and their family have come to expect from the Canadian Armed Forces and to do so as seamlessly as possible. This is why, as my colleague explained, our teams work side by side at integrated personnel support centres.
Today, Veterans Affairs Canada has more than 100 employees working with Canadian Armed Forces personnel at these centres on or near bases or wings.
[English]
VAC's responsibility to care for ill and injured CF members begins in most cases before the member leaves the forces. VAC's staff meet with members as they begin their release process to provide a personal transition interview where needs are explored and identified before release occurs. In the last fiscal year there were 4,145 of these interviews completed. The interviews serve to identify potential risks and/or barriers to the successful transition to civilian life as well as offering VAC staff the opportunity to explain the benefits and services available from the department and other service partners for the releasing members and families.
For those who may require individual case management the information provided by the member is then used to create a personalized VAC case plan in close coordination with the CF care and service providers.
[Translation]
In the case of veterans with complex needs, a Veterans Affairs Canada case manager works with them and their family to do a detailed and holistic assessment of their circumstances and to develop a case plan to address their needs, as well as determine potential eligibility for Veterans Affairs Canada programs and services.
:
Mr. Chair and members of the committee, I'm very pleased to have the opportunity to appear before you today as you continue your important study on the care of ill and injured CAF personnel.
In my position as director general of civilian human resources management operations with the assistant deputy minister of human resources at the Department of National Defence, I oversee the operation of six regional civilian human resources service centres. These regional human resources service providers work in partnership with civilian and military managers at National Defence to address the strategic and operational human resources management needs. HR service providers offer leadership, advice, and support services related to human resource planning, recruitment and staffing, employee relations, classification, compensation, and learning. In essence we are responsible for developing and enabling the delivery of services to recruit, develop, and retain civilian employees to effectively support DND/CAF. This includes the recruitment of mental health professionals, which I know is of particular interest to this committee, DND, and ADM HR-Civ to ensure that CAF members receive the support they require.
With respect to staffing, DND, as well as other departments, conducts staffing practices according to the Public Service Employment Act. The PSEA governs how appointments are to be made to ensure a public service based on merit and non-partisanship, in which the values of fairness, transparency, access, and representativeness are safeguarded. In making hiring decisions at National Defence, we always ensure that we maximize flexibilities to meet operational needs and requirements with respect to the PSEA appointment policy.
The care of ill and injured CAF personnel is one of DND/CAF's highest priorities. Today the Canadian armed forces have approximately 400 full-time mental health workers at 38 primary care clinics and detachments and 26 mental health clinics across Canada. These mental health workers include psychiatrists, psychologists, social workers, mental health nurses, and addiction counsellors. We take all opportunities to recruit mental health professionals, including advertising online and in trade journals, recruiting at conferences such as the annual Canada Psychiatric Association conference, and working with the Canadian Medical Association and the Royal College of Physicians and Surgeons.
The reality is that Canada as a whole currently faces a shortage of health care providers. As the Chief of the Defence Staff recently noted, National Defence is therefore in competition for psychiatrists and other medical health professionals with the provinces and territories and the private sector. National Defence's challenge in attracting and recruiting qualified and experienced mental health professionals in a competitive market is due in large part to the limited labour market availability of these professionals in Canada.
An added challenge for National Defence is that the locations for certain positions are either remote or not metropolitan, such as Cold Lake and Bagotville. As is the case in the private sector, it can be difficult to attract medical professionals to these areas.
In light of these challenges, National Defence has been working to address the current shortfall of medical health professionals by reducing red tape and improving incentives. We have engaged our central agency partners, including the Public Service Commission and the Treasury Board Secretariat, to maximize the flexibility within the public service legislative construct to successfully attract and recruit mental health professionals.
To help address the issue of relocation, including to isolated regions, the Treasury Board Secretariat has approved a temporary increase in the maximum amount that can be reimbursed for the relocation of external candidates. Until March 31, 2015 we can reimburse up to $40,000 of the cost of relocation, an increase from the normal maximum of $5,000.
The Public Service Commission has also agreed to refer priority persons to National Defence if they meet our recruitment needs and requirements. A priority person is a person who has entitlement under the PSEA and regulations for a limited period to be appointed ahead of all others to vacant positions within the public service. The person must meet the essential qualifications of the position. In addition the Public Service Commission is facilitating the priority clearance process to reduce the time required to staff a position. Priority clearance is a clearance to staff granted by the PSC when an organization has first considered priority persons for the position in question.
In order to be in a better position to compete with the private sector, we are also offering the top of the pay scale in each of the clinical categories of new hires.
:
Universality of service is an exemption to the charter that ensures that all Canadian Forces members are employable, deployable, and physically fit in accordance with the standards of the Canadian Forces. Indeed, the Canadian Forces is meant to deploy—to Libya, to Afghanistan, and domestically in terms of crises and emergencies. As a result of that, you need a fully fit, functional fighting force to be able to respond to the needs of Canadians.
The charter means that we do not have to hire one of the designated groups, that being the disabled. It also means that when members are no longer able to be deployed, to be employed within their trade, or to meet the physical fitness standards that are reflective of the rigours of war fighting, they too no longer comply with universality of service, and therefore, based on their medical conditions, will be released from our care into the care of Veterans Affairs.
So the exemption to the charter, the universality of service, allows us to ensure that we have a fully fit and functioning Canadian armed forces.
Do I believe it is effective and important? Yes, I do. I fully believe that in order to maintain and be able to meet the three roles and six missions of the Government of Canada for the Canadian armed forces, yes, we need to have that in place.
Now, I do not see the universality of service as a negative thing. It is indeed something that says, if you're no longer fit to fight, can you be employed in another occupation within the Canadian Forces; if not, are there other places that you can be employed in the Canadian Forces, such as the cadets and rangers; and ultimately if not, how can we help you transition from the Canadian Forces, with the requisite benefits from Veterans Affairs, into community life and standing up and starting up your second career?
That is what Michel was talking about in terms of the military employment transition plan. We have a tremendous capacity now to educate, offer employment, and start our members off anew in our communities in their second careers.
Therefore, the universality of service is only one part of the equation. The other part of the equation is all of the other programs we have in place so that, when you no longer meet universality of service, you can do something else inside the military or outside the military.
:
Thank you, ma'am, very much. It's good to see you again. The last time, we were in Afghanistan together.
There is a natural propensity amongst all of us as human beings to think that someone presenting with mental illness has a problem; therefore, we have a different perception of individuals. That's true across Canada, I believe, because in Canadian society we haven't demystified, de-stigmatized, mental health as being not an illness that cannot be reckoned with, but instead, as with physical health in the Canadian Forces, something that we have programs for to get us physically well and mentally well.
Therefore, when I say stigma, it's the stigma about being side by side with your battle buddy in Afghanistan and coming back, and your battle buddy is not having problems but you're having problems, and perhaps you're too proud to be able to admit it and come forward. And as I mentioned earlier, at times the preponderance of thinking is “I don't have a problem, and if I do, I can cope with it myself”. Getting people to feel comfortable that if you're not feeling well when you get up in the morning, you're feeling depressed, you should walk into the clinic, you should walk into your chain of command and say you're just not feeling well. You should call one of your peers. Getting that to be an automatic reaction, as opposed to “I'll see how I feel tomorrow” and then “I'll see how I feel the next day”, is what I mean by de-stigmatizing.
The other issue ma'am, is the career issue. There is a very strong perception, as you've been told, that if I present for mental illness, indeed if I present for a physical problem, there is a potential that I will be released from the Canadian Forces under the universality of service, which we spoke of earlier. Part of de-stigmatizing is our education and awareness about all our programs and our success rate at returning our members back to work, but also, in those cases where you breach universality of service, about the tremendous programs that we have for starting a second career, to set you off on the right foot, to provide you the education and retraining, and also provide you the benefits and support so that you can have a healthy and vibrant second career.