Thank you, Mr. Chair.
I would first like to thank the Standing Committee on Veterans Affairs for this opportunity to discuss the issue of combat stress and its consequences on the mental health of veterans and their families.
As in all matters of health, research is critical for achieving the quality of health and health care that we wish for Canada's military veterans. In the preamble to the act that established CIHR in 2000, Parliament recognized that investment in health and the health care system is part of the Canadian vision of being a caring society.
The act went on to establish CIHR's objective: to excel according to internationally accepted standards of scientific excellence in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products, and a strengthened Canadian health care system.
I have believed since I became president of CIHR in 2008 that this vision means little if it does not include a responsibility for the health of those federal employees who put themselves in harm's way in defence of our country and in fulfillment of national security objectives.
Reducing the burdens of mental illness is one of the five research priorities in CIHR's latest five-year strategic plan. In order to address this priority, CIHR is relying on one of its 13 institutes, the Institute of Neurosciences, Mental Health and Addiction. The institute's mission is to promote and support research in order to improve mental health by developing new strategies for prevention, screening, diagnosis, treatment and service delivery. We often forget that Canada has excelled in this area of research. It is in fact ahead of the pack compared to the rest of OECD countries in terms of quantity, quality and the impact of its scientific publications in this field of research.
CIHR investments in mental health research have totalled more than $234.4 million since 2006—$65.2 million in 2009-10 alone. As to post-traumatic stress disorder, CIHR has invested $7.6 million in research since 2006, including $1.7 million in 2009-10. However, this figure can be deceptive, since operational stress injuries can include PTSD as well as a variety of other disorders ranging from depression to hormonal imbalance, for which CIHR is also providing research funding.
For example, new brain imaging techniques have been put to use in looking at the effects of post-traumatic stress disorder on the brain. Neuroendocrinology studies, which look at the relationships between the brain and the endocrine system, have demonstrated significantly lower levels of the stress hormone cortisol in individuals with PTSD. Finally, it is likely that genetics and epigenetics will be key in helping us better understand the factors underlying the susceptibility of certain individuals to post-traumatic stress reaction.
I would now like to turn to some of CIHR's efforts to advance research into the issues affecting military veterans and their families, as well as research in operational stress injuries. You will appreciate that while I am not a research expert on this subject matter, I am pleased to speak to CIHR's efforts to accelerate research in this area.
As the other witnesses mentioned, the mandate of a number of departments is to promote research on the health of soldiers and veterans. These departments have formed specific partnerships with CIHR in this area. The Department of Veterans Affairs and the Department of National Defence have joined us in funding various research initiatives. I think we should build on these first successes to expand and strengthen our framework for action, increase consistency and maximize impact.
To this end, CIHR has started discussions with the office of the surgeon general of the Department of National Defence in order to identify areas of possible cooperation as part of their research initiative on the health of soldiers and veterans.
More recently, I met with the associate deputy minister of Veterans Affairs Canada, and we agreed to get our staff members together as soon as possible in order to set joint research priorities on the health of soldiers and veterans, and to develop a long-term cooperation plan.
Although there is a significant body of American research on combat stress and its effects, the military culture and community in Canada are different, and so are the types of operations in which Canadian troops participate. It is therefore important that we develop a research program of our own to fit the Canadian context.
A particularly noteworthy development for Canadian research has arisen from the November 2010 Canadian military and veteran health research forum in Kingston, which is the creation of the Canadian Military and Veteran Health Research Network, a network dedicated to building a better understanding of the health and well-being of military personnel, veterans, and their families.
Together, CIHR and the network announced in the fall of 2010 a request for applications for knowledge synthesis grants to summarize existing research in this area and determine gaps within the knowledge base.
This call for applications recognizes that military personnel and veterans have unique experiences in the service of their country, which can impact their physical, mental, and social health in a manner not experienced by the rest of the population. It also recognizes the increased need for research on the health and well-being of military personnel, veterans, and their families. We anticipate announcing the results of this competition later this month and subsequently using the data to identify research priority areas.
One of Canada's leading researchers in veterans' health is Dr. Jitender Sareen. He receives funding from CIHR and he testified before you in November.
Dr. Sareen is leading a CIHR-funded team on the study of trauma and post-traumatic stress disorder among soldiers involved in peacekeeping operations. He is also examining soldiers' need to access mental health care and the obstacles they have to overcome in order to obtain care; one obstacle is the fear of stigma in the workplace. The findings of his research have helped the Canadian Forces to create programs for those who need treatment and also to develop strategies to improve the mental health of military personnel.
Also, at the University of Manitoba, Dr. Darren Campbell is using functional magnetic resonance imaging in conjunction with psychotherapy to look at the emotional responses of military personnel with post-traumatic stress syndrome.
Similarly, Dr. Alain Brunet at McGill has led a Montreal-based research team on mental health disorders, including PTSD and related problems resulting from traumatic events in high-risk workplaces, and has been funded to examine treatment available to military veterans with operational stress injuries.
Dr. Gordon Asmundson of the University of Regina led a multidisciplinary team of researchers from Regina and UBC who examined whether exposure therapy—where patients are exposed to prolonged and repeated images of trauma until the images no longer cause anxiety—may be more effective than other methods for treating the disorder. Dr. Asmundson and his team have also looked at delivery of treatment over the Internet.
In 2009-10, Dr. David Pedlar, the Director of Research at Veterans Affairs Canada and a professor at the University of Prince Edward Island, along with a team of experts, received CIHR funding to study the reintegration into the workplace of veterans with mental health conditions.
CIHR-funded researchers are also doing important neural investigation into the brain activity of individuals with post-traumatic stress disorder writ large. For example, Dr. Ruth Lanius is the director of the post-traumatic stress disorder research unit at the University of Western Ontario. Her research focus has been the neurobiology of post-traumatic stress disorder and treatment-outcome research examining various pharmacological and psychotherapeutic methods, including in patients with post-traumatic stress disorder or major depression following motor vehicle crashes.
I could cite other examples of funded research dating back to CIHR's inception to demonstrate our history of funding those with research interests in issues specific to military veterans. I would like, however, to conclude by looking forward and acknowledging that more research is needed.
Canada is approaching the completion of one of its longest and most intense military missions in recent history. The care of these young men and women who served our country in Afghanistan makes even more pressing the need to thoroughly understand the physical and mental demands of military operations. We need to better understand through research what sorts of unmet mental health needs there are for veterans so that we can meet them with outreach and treatment.
We need to recognize that Canadian health research in this area is growing but needs to move beyond its infancy. The old military saying that “no one should be left behind” should guide us in ensuring that we understand and are ready to help veterans with health issues when they have completed their service.
Your work in this study will help us to understand where the gaps are and to set directions for future health research, and I would like to thank the committee for its work. I am pleased to take your questions.