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Results: 1 - 7 of 7
View Peter MacKay Profile
Mr. Wilfert, I would encourage any and all input from this honourable committee in any studies you undertake. I agree with you that the priority has to remain the men and women in uniform, and the services provided to them.
I was proud this weekend to announce another of the joint personnel support units, which I know you're familiar with. They are really designed to bring together all of the various support services and programs available to the men and women in uniform, veterans, and their families, and make them more accessible, more readily available, and more easily understood, and to also increase things such as mental health care professionals. We still have a goal to double the number of mental health care professionals. This is particularly challenging, as you can appreciate, in certain remote areas where we have smaller Canadian Forces stations and bases. We want to try to have a standard of care that is available to all.
We've made significant investments in the care and treatment of grievously injured veterans as well. This remains a focal point of the Department of Veterans Affairs, but we naturally work very closely with the department.
I'd like to take this opportunity to share with you another initiative that we hope to have in place very soon. It is to allow for, and in fact encourage, the continued service of those who have been injured in combat and in the line of duty. I've undertaken quite extensive discussions with the assistant deputy of personnel, as well as the Chief of the Defence Staff and others.
I would share with committee members the very poignant and quite humbling experience of having seen two of our injured soldiers who have returned to Afghanistan with the Van Doos regiment. Both of them suffered very serious injuries, yet they are serving actively in Afghanistan. The Chief of the Defence Staff and Chief Warrant Officer of the Canadian Forces promoted them while they are serving in Afghanistan, just this past week. It was certainly a very emotional and morale-boosting experience for the troops present to see this happen, and to see the absolute courage and conviction of these soldiers to return to Afghanistan after having suffered grievous injuries there on previous tours.
We hope to institutionalize that, by the way, to make sure that members are encouraged and embraced, should they choose to stay in uniform after having suffered those injuries.
Tim Wall
View Tim Wall Profile
Tim Wall
2010-12-14 11:05
Thank you.
On behalf of the Canadian Association for Suicide Prevention, our board of directors, and our members across Canada, I want to thank this parliamentary committee for providing us with the opportunity to speak to you today about the intentional injury side of injury prevention.
Over the past two decades, close to 100,000 Canadians have died by suicide. Last year, almost 4,000 Canadians died by suicide, more than the total number of fatalities from all other unintentional injury-related deaths and homicides combined. Death by suicide is the leading cause of death over all other injury-related fatalities. Yet suicide, like injury prevention in general, has been largely ignored by the federal government.
Canada ranks in the top third of countries with the highest suicide rates. Suicide is not the result of a single cause; it is complex. Suicide prevention requires a multi-faceted approach.
Suicide is the result of an interaction of complex biological, psychosocial, and spiritual factors that can include social isolation, trauma, stress, family violence, poverty, poor mental health, and physical and mental illness.
In Canada, suicide prevention is fragmented, disconnected, and lacks a national vision. There is currently nothing under mental health or injury prevention that unifies suicide prevention in Canada.
If one examines the impact that suicide and suicide-related injuries have on our already overburdened health care system, the cost is alarming. It is estimated that in Canada there are in excess of 88,000 visits to emergency departments for suicide-related behaviour.
In 2004 over 7,000 Ontarians were admitted to hospital for suicide-related behaviours. Of this group, permanent partial disabilities were suffered by almost 1,500 people and 76 suffered permanent total disability.
Given the need for hospital and/or rehabilitation services and additional family support following a suicide attempt, the estimated cost of non-fatal suicide-related behaviours ranges anywhere from $33,000 to $308,000. There are many other economic costs associated with intentional injury deaths, but they fade in comparison to the price that is paid by the families of those who died by suicide.
Over three million Canadians, and no doubt some of us in this room today, have known the pain and anguish that comes when someone we love dies by suicide. What adds to this tragedy is knowing that many of these intentional injury deaths were preventable. Sadly, when someone dies by suicide, the pain is not gone. It is merely transferred to their family, their friends, and their community. Their injuries are largely invisible and mostly suffered in silence.
The Canadian Association for Suicide Prevention is made up of a group of dedicated volunteers. Since it began in the 1980s, CASP has conducted its work with no public funding or support from the Government of Canada. CASP and its board have volunteered thousands of hours to promote suicide prevention on a national level, often at great personal sacrifice.
For the past two decades, CASP has done the yeoman's share of the work without support, acknowledgement, or encouragement from federal sources. Up until now, we have only heard silence from Ottawa. The Government of Canada contributes to the stigma and the problem of suicide by its silence, rather than publicly and vigorously declaring its support for suicide prevention. Thank you for helping to break the silence.
While the United Nations, the World Health Organization, every other developed country, and every province and territory recognize suicide as a major public health issue and a priority, the Government of Canada has yet to do so, and has demonstrated little leadership on this intentional injury issue.
Your thoughtful and courageous decision to make the intentional injury of suicide part of this injury prevention discussion gives us hope.
As the UN recognized in 1993, suicide is not the responsibility of a single sector domain. It belongs to public health, mental health, social wellness, and injury prevention. No one can say this is not my problem or responsibility, and yet that has been largely the message we have heard from the Government of Canada.
To date, the federal government's response to our pleas has been that this is a provincial and territorial responsibility and not theirs. Suicide, as a serious intentional injury, is in fact everyone's responsibility. Everyone has a role to play, and that includes the Government of Canada.
Our national government has, in the past, demonstrated leadership and has worked collaboratively with the provinces and territories on numerous public health issues and pandemics, such as H1N1, SARS, and AIDS. It is now time for our national government to get involved, in a meaningful way, in addressing Canada's suicide pandemic. Our national government can no longer ignore the injury prevention issue and simply pass it off as a provincial and territorial issue and walk away.
While our federal government has made important investments in suicide prevention in first nations communities, it has failed to take action beyond this very limited and selective response. It has made no investments in suicide prevention outside of first nations communities.
The good news is that suicide-related injuries are preventable. We know what to do. We can do it, and we must do it together. For the past six years we have been offering the Government of Canada the gift of a national strategy for suicide prevention that was developed by CASP in 2004. I have a couple of copies that I brought with me today. It is a gift that keeps being returned. We invite you today to accept this as our intentional injury prevention gift in the spirit in which we are giving it. Please, let's work together to save lives and comfort those who grieve.
Over 15 years ago the United Nations and the World Health Organization recognized suicide as a major public health issue but didn't confine responsibility to a single domain. In 1992 the United Nations asked Canada to take a lead role in developing international guidelines for suicide prevention, which were later adopted by the UN, in 1996.
The UN guidelines and the subsequent World Health Organization guidelines asked that every country develop both a national suicide prevention strategy and a national coordinating body. Shortly afterwards, countries around the world began developing their strategies. To date, all developed countries have national strategies--all of them, with the exception of Canada. All of these countries overcame obstacles. Why can't Canada? In fact, not only has Canada failed to act on and recognize the UN and WHO guidelines, it has yet to even acknowledge suicide as a national public health issue.
Currently, suicide prevention is no more than a footnote on the Public Health Agency of Canada's website. Once an international leader in suicide prevention, Canada is now not even a follower. We are shamefully out of step with the rest of the world. It is now our turn to learn from other countries and follow their example.
So what can the Government of Canada do? The Government of Canada can do for suicide prevention what it did for mental health, which was to recognize mental health as a priority issue and establish the Mental Health Commission of Canada. When the Mental Health Commission of Canada was established, they were mandated to develop a national mental health strategy.
It is important that we not confuse the Mental Health Commission of Canada's strategy with a suicide prevention strategy. And note that in their excellent report, Towards Recovery and Well-Being, only one passing reference is made to suicide prevention.
We are asking that the Government of Canada do the following: formally recognize suicide as a serious public and community health and injury prevention issue and policy priority; appoint and adequately fund a national suicide prevention coordinating body that will serve as a knowledge broker; promote knowledge exchange, best practices, research, and communication; commit to working collaboratively with the national coordinating body, the provinces, and the territories on establishing a national suicide prevention strategy; and mandate and adequately fund the national coordinating body to develop and implement a national suicide awareness and education campaign.
In conclusion, too many lives are being cut short and are being deprived of a future that could be hopeful and fulfilling. Too many people and families are being deprived of loved ones who would have continued to enrich their lives and their communities.
There are hundreds of thousands of people in this nation whose lives have been forever altered by a tragic and needless suicide death. Some of them are your constituents. Some of them are maybe your neighbours, your friends, your families, and even your colleagues here in Parliament.
Suicides are preventable. When asked what you did to help prevent suicides in Canada, how will you answer?
There is hope, and with your support, we can and will save lives, and heal those who grieve.
View Peter Stoffer Profile
Thank you.
I'm not sure if you've had a chance to see it yet, but last Sunday The Chronicle Herald, a newspaper in Nova Scotia, did a really interesting article on military personnel who had been more or less forced out of the military.
One of the biggest problems I find for service personnel is that when they're no longer deployable, it means they're no longer employable within the military. They get, in their words, “kicked out” of the military. Some veterans have even said that what DND has done is offload the problem onto VAC.
In the private sector, where I used to work, in the Canadian airlines there was a thing called “duty to accommodate”. When you became injured, there was a responsibility on the company to try, as well as it could, to accommodate you to go back to work. I don't think that applies to the military, because many service personnel who believe they can still work in DND have been asked to leave. They're being “3(b)'d”, which means medically released from the military. That adds a tremendous amount of stress to them and their families.
As you know, sir, the DND is a culture. It's a way of life. It's in their DNA. It's who they are, and all of the sudden that is gone, for whatever reason, through no fault of their own and because of an injury. Now they have to go into a completely different world that they haven't been adjusted to for quite some time.
I'd like you to expand on something for a second. If you don't have the answer for it now, could you provide it later?
First, how many DND personnel who are serving right now receive a VAC pension? Then, on the question of the duty to accommodate, is DND doing a good enough job of keeping injured soldiers within the department, or are you finding a rush out the door--once you're injured, you're no longer employable with DND?
Pierre Daigle
View Pierre Daigle Profile
Pierre Daigle
2010-11-30 16:13
All of those questions on this issue are so important. We take good note of the concerns, because we will do, as I said, this third follow-up to our report.
I hear about duty to accommodate when I go around the country, and I will look into it more deeply. It seems to be tied to universality of service. They can accommodate, but if at some point you cannot fulfill the operational function, then you are released under those terms.
I know there was some initiative for getting onto the priority list for public service transfer and so on, but people are concerned out there about all those things. You know, even in the public service there are people who are not happy when they see all those ex-military people taking over what they say are their positions. But in the outreach discussions I have, I do tell them that the military members I have met would not ask for more than to stay in uniform. This is what they want to do. They're not the ones asking to go elsewhere.
So this is all part of the impact of those physical and psychological injuries, and that will be part of my third follow-up.
View Lise Zarac Profile
Lib. (QC)
Would you say there's more suicide when a soldier has been physically injured? Do you have any studies demonstrating this? Has it been followed?
Jitender Sareen
View Jitender Sareen Profile
Jitender Sareen
2010-11-18 16:50
The short answer is no, there has been no study to look at that. The long answer is that with post-traumatic stress disorder and depression and alcohol problems, soldiers who are physically injured are more likely to develop post-traumatic stress and depression. Post-traumatic stress and depression are linked with suicide. The soldier often has the reminders of the trauma--they have physical pain and physical injury--which often then leads them to have depression. They might not be able to go back to work with the way they feel.
So we think that likely is an issue, but there is no specific evidence around it that I'm aware of. We can look at it.
Mary McFadyen
View Mary McFadyen Profile
Mary McFadyen
2009-02-25 15:34
Thank you, Mr. Chair.
I would like to begin by thanking the committee for inviting me to testify this afternoon. I am pleased and honoured to be here today in my capacity as General Counsel for the Office of the Ombudsman for the Department of National Defence and the Canadian Forces to discuss our recent report on operational stress injuries.
The ombudsman's office has been helping to ensure the fair treatment of Canadian Forces members suffering from post-traumatic stress disorder and other operational stress injuries since 2002.
At that time, our office made 31 recommendations aimed at helping the Canadian Forces identify and treat operational stress injuries, while at the same time ensuring the fair treatment of all Canadian Forces members.
Over the next few minutes, I will highlight some of the key findings from our most recent report released in December 2008 and the areas where we have found progress has been made by the Department and the Canadian Forces.
I will also underscore some of the areas where we feel more work is required.
Finally, I will highlight some new and evolving issues and problems identified during our most recent investigation.
It is clear from our most recent review that the Canadian Forces has made progress over the past few years in the way it approaches individuals with operational stress injuries. We found evidence of improvements in the Canadian Forces' attempts to prevent, identify, and treat operational stress injuries. Unfortunately, it is also clear that there continue to be cases where injured soldiers, sailors, and airmen and airwomen who have served our country with courage and dedication are slipping through the cracks of an ad hoc system.
During our investigation we discovered that more than half of our original 31 recommendations had not been implemented, either in practice or intent. I believe this has hampered the consistency of care received by the military members across the country who are suffering from mental health injuries.
We also identified a number of areas where progress continues to be slow, particularly with respect to high-level direction and national coordination, the efforts to standardize care and treatment across the Canadian Forces, and the collection of national data and statistics.
Access to quality care still depends on a number of arbitrary factors, including where the military member lives, the distance of the member's base from the nearest large city, the availability of mental health care professionals, and the attitude of the member's superiors and peers.
We were also disappointed to learn that a national database has yet to be created. This database would accurately reflect the number of Canadian Forces personnel who are affected by operational stress injuries. A tool of this kind is critical to understanding the number of Canadian Forces personnel affected by mental health injuries, the extent of the problem, and what needs to be done. Without a national database, the Canadian Forces is unable to evaluate the impact of various clinical interventions and to target education and training initiatives where they are most needed.
Regardless of where they are located, what their duties are, or who they work and train with, all Canadian Forces members are entitled to quality, consistent and timely care when they are injured—whether the injury is physical or psychological.
Some of the problems identified by our office likely could have been prevented with the full implementation of our original 31 recommendations.
At the same time, when we conducted the latest investigation, it became clear to us that new areas of concern had emerged in the six years following our original report. The environment in which Canada's military has been operating in recent years has changed dramatically, particularly in light of the level and intensity of combat operations in Afghanistan. And it is evident that the Canadian Forces and its members are strained almost to the breaking point. This strain also significantly increases the demands on families, caregivers, and mental health care providers.
Taken into account these current realities and problems, we focused on three issues that we considered to be critical in insuring quality and timely care for military members suffering from operational stress injuries.
First, there is a need to strengthen national governance and leadership related to the identification, prevention, and treatment of post-traumatic stress disorder and other operational stress injuries.
Our original report in 2002 stressed the need to appoint a senior officer of significant rank reporting directly to the Chief of the Defence Staff. This officer's primary duty would be to act as a national coordinator for all issues related to operational stress injuries, including the quality and consistency of care, diagnosis and treatment, and training and education across the Canadian Forces. The position would also serve an important practical and symbolic role in helping to put an end to the ongoing stigma associated with operational stress injuries.
Second, it is now apparent that the challenges and difficulties associated with operational stress injuries are not restricted to military personnel alone. When a Canadian Forces member suffers from post-traumatic stress disorder or another mental health injury, the whole family suffers. It may also require support and assistance for each family member.
Our investigators found a number of quality programs offered by provincial and municipal governments, local military family resource centres, and local base chaplains to support military families. Unfortunately, we found no evidence of a coordinated national approach that would ensure that military families are able to consistently access the mental health care and support they may need.
Although the department and the Canadian Forces do not have a legal responsibility in this area, there are compelling reasons for them to ensure that military families have access to timely and appropriate services and support.
First, as mental health injuries are enough the result of military service, and the direct cause of family stress, the Canadian Forces have a moral responsibility to ensure that care and treatment are provided to families.
A second, more practical reason for ensuring the care of military family members is that it could reduce the level of stress on the operational stress injury sufferer and speed up recovery time.
Finally, as part of the broader investigation we also found that much more needs to be done to deal with stress and burnout among Canadian Forces caregivers. This stress is created by a lack of resources and high caseloads. The majority of caregivers interviewed by our office stated that personal stress or burnout was a pressing concern to them, to the point that it was leading some of them to quit the military.
The department and Canadian Forces had informed us, during our investigation, of their intention to hire an additional 218 mental health professionals by the end of March 2009. I understand now that the deadline has been extended to 2010.
Hiring more mental health care workers would be a positive step towards resolving the issue. However, we have concerns that it may be difficult for the Canadian Forces, as just one of the employers across the country vying for health care professionals, to fulfill this commitment, even with this extension to 2010. This makes it even more essential for the military to retain the mental health care professionals already working in the defence community.
Given the very dangerous and demanding nature of the current mission in Afghanistan, it is clear that post-traumatic stress disorder and other operational stress injuries will become an even greater challenge for the military for many years to come. In many respects, this will be a generational challenge for the department, the Canadian Forces, and the Government of Canada as a whole.
We acknowledge that the Canadian Forces has made some progress over the past six years in generally dealing with the issues and challenges related to post-traumatic stress disorder and other operational stress injuries. However, much more needs to be done to ensure that Canadian Forces members suffering from operational stress injuries are diagnosed and receive the care and treatment they need.
Addressing these outstanding issues and implementing the recommendations made in our report will help our Canadian Forces members in many years to come, whether in the Canadian Forces, if they stay, or in their lives as civilians.
At this time, Mr. Chair, I stand ready to take any questions you have. Thank you.
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