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Christine Whitecross
View Christine Whitecross Profile
Christine Whitecross
2015-05-25 15:45
Thank you, Mr. Chair and committee members, for the opportunity to appear before you today to provide an update on the progress the Canadian Armed Forces strategic response team is making in dealing with inappropriate sexual behaviour in the forces.
You will remember that the external review authority's report and the action plan developed by the Canadian Armed Forces to deal specifically with Madame Deschamps' 10 recommendations were released to the Canadian public on April 30, 2015.
Let me start by saying that the past 17 working days since the release of the action plan indeed have been very busy. As I stated at the time of the release, inappropriate sexual behaviour is a complex problem that defies quick fixes and band-aid solutions. To successfully address it, our approach centres on identifying and treating its fundamental root causes rather than simply addressing the symptoms. Madame Deschamps' insight and analysis is absolutely pivotal in this approach. So, what has transpired during the last two and a half weeks?
First, we have reaffirmed that the strategic response team's mission is to enhance the operational readiness of the Canadian Forces by eliminating incidents and impacts of inappropriate sexual behaviour to the extent possible.
The goal is a Canadian Armed Forces that upholds a culture of dignity and respect for all. These are core Canadian values that the institution exists to defend in Canada and around the globe. In other words, in the long term we will enhance the fundamental Canadian Armed Forces' culture to the point that inappropriate sexual behaviour will not be tolerated either by targets of such behaviour or by anyone who witnesses it.
In the short term, we will trigger positive shifts in behaviour through increased awareness of acceptable norms, expectations, responsibilities and accountabilities by engaging with both the chain of command and grassroots membership across the organization.
Additionally, the recently formed Canadian Armed Forces strategic response team on sexual misconduct, which I lead, continues to grow and mature. It is noteworthy that this is the first time in the Canadian Armed Forces' history that an entity has been formed for the sole purpose of addressing this important issue. I have assembled a highly capable, multidisciplinary team consisting of civilian personnel, military members and former military members with the appropriate combination of required skills and experience.
We have identified four major lines of effort critical to achieving the objective. As described in our action plan, the first is to understand the problem. The second is to respond effectively to incidents of inappropriate behaviour, including enhancing the process of reporting. The third is to better support victims throughout the process. The fourth is to prevent occurrences from taking place in the first place.
We have already made considerable progress in several of these endeavours. In terms of understanding, my team has carefully examined Madame Deschamps' report and has begun considering how best to address each of her 10 recommendations.
For example, a key recommendation in Madame Deschamps' report was the creation of an independent centre to deal with inappropriate sexual behaviour. She provided us with several examples, including those established in the United States and Australian militaries.
The analysis of an independent centre will be the focal point of the strategic response team's planning and development in the coming weeks. Accordingly, my team and I recently met with American officials on their SAPRO model and Australian officials on their SeMPRO organization. Both consultations were very productive and provided the team with better insight into a field-tested, proven option with the potential to illustrate how a similar construct could be developed to fit the needs of the Canadian Armed Forces or the Department of National Defence.
In addition to these two visits, members of the strategic response team visited the Peel Regional Police and the Canadian Army Command and Staff College to open discussions about educational opportunities. They attended an international workshop in Geneva that brought together a broad spectrum of international experts on the core facets of sexual harassment and sexual assault in organizational environments. They attended a conference on gender-based analysis plus in security and defence operations held in Ottawa. They met with Ambassador Schuurman, the NATO secretary general's special representative for women, peace and security.
A key component of the behavioural and cultural change I alluded to earlier is connecting with the Canadian Armed Forces members at every level of the organization, including at the pointy end, to both increase awareness of the Canadian Armed Forces' response to Madame Deschamps' report, and to inspire open dialogue and personal reflection on the problem of inappropriate sexual behaviour in the forces. This is quite similar to the approach previously employed in shifting internal stigmas and behaviour surrounding post-traumatic stress disorder and operational stress injuries, which we largely succeeded in doing in the late 1990s and early 2000s.
With members of my team, I began connecting directly with the men and women of the Canadian Armed Forces across Canada starting on May 1, the day after the release of the report. Through a series of town hall meetings, individual question and answer sessions, discussions with the local chain of command, as well as interactions with interested local and regional media, the strategic response team is reaching out to Canadian Armed Forces members and setting the conditions for ongoing dialogue.
I open each session with the acknowledgement that this is a serious problem within the Canadian Armed Forces and that al though no one wants to discuss inappropriate sexual behaviour, it is important to start the discussion. So far, we have been to six bases and wings where I have briefed approximately 5,300 military personnel at 16 general sessions. The questions, comments, concerns, and perspectives in these sessions have brought to light both positive and negative personal experience anecdotes and reinforced two realities: one, the problem is highly complex; and two, while there is a collective will to move the organization forward, there is little consensus as to the gravity of the existing problem.
In the next few months, I look forward to completing the town halls at all 33 bases and wings to ensure that the majority of Canadian Armed Forces members have an opportunity to hear and understand what the team is doing, ask questions and express opinions, and learn about the direction being taken by the Canadian Armed Forces.
Similarly, my team and I will continue our focused consultations with both domestic and international entities that are dealing with a problem similar to ours. This includes military, government, police, and other non-governmental organizations that are able to provide us with applicable insight on best practices and lessons learned.
One of the reasons the Canadian Armed Forces' response to the problem of inappropriate sexual behaviour will be more effective this time is the heightened emphasis on outcome measurement. Even the most elaborate plans and outputs mean little if they do not translate into tangible outcomes and results on the ground. To this end, my team is studying program evaluation methodologies to ensure we are able to measure how effective the changes we implement actually are in practice.
Reporting will go hand in hand with performance measurement. Starting in the fall, I will deliver to the Chief of the Defence Staff my first quarterly report on the Canadian Armed Forces' progress in responding to the problem of inappropriate sexual behaviour. The report will also be released to the Canadian public. We are fully committed to open, transparent dialogue with external stakeholders. Over the past 25 days we have interacted with a total of 88 different media agencies in group and individual engagements. My team and I are committed to standing up and being held to account on this crucial imperative and will continue to be actively engaged with the public, Parliament, and the media.
We have also begun to examine how we can improve the Canadian Armed Forces' approach to training and education in order to shift culture towards enhancing the level of dignity and respect. As well, the team, in conjunction with other Canadian Armed Forces and Department of National Defence personnel, is reviewing existing policy to assess its clarity, coherence, appropriateness, and applicability. As part of this endeavour, all terminology and definitions pertaining to inappropriate sexual behaviour will be thoroughly examined.
Inappropriate sexual behaviour remains a complex problem, one that quick fixes will not solve substantively or sustainably. My team is focused on creating innovative, meaningful change tailored to the needs of the Canadian Armed Forces members and based on best practices and lessons learned from a wide range of sources. This is a no-fail mission for the Canadian Armed Forces that my team and I are completely and utterly committed to.
Thank you.
Jean-Robert Bernier
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Jean-Robert Bernier
2012-06-05 16:20
Mr. Chair, ladies and gentlemen, I am Colonel Jean-Robert Bernier, Deputy Surgeon General of the Canadian Forces. I am accompanied by Colonel  Gerry Blais, the director of the Joint Personnel Support Unit and of Casualty Support Management.
I am very happy to be here today and to have the opportunity to talk to you about the Canadian Forces Case Management Program.
The Canadian Forces health services national case management program was implemented as a result of identified gaps in the health care system, especially for transitioning CF members to civilian life. Since its inception, registered nurses have been employed as case managers to help thousands of Canadian Forces members in coordinating the myriad services they need to cope with their physical and mental health challenges.
Although many challenges influenced the program's evolution over the past decade, dedicated nurses continue to deliver professional and high-quality services to Canadian Forces members. The feedback from the case management satisfaction surveys reveals that the program is extremely valuable, both to CF personnel and to their families.
The program currently employs 57 case managers who continue to meet the many challenges arising from the medical complexity of their clients' needs. Although the work environment and the demands are in constant transformation, the program's mandate remains the same: to assist our members either in returning to duty or in making the transition to civilian life.
CF health services nurse case managers lead the coordination of health care and support to serving CF members in partnership with the joint personnel support unit and its integrated personnel support centres, for which Colonel Blais is responsible. As part of the CF health care team, they are responsible for developing an integrated action plan in conjunction with their patients, Canadian Forces members, integrated personnel support centre personnel, partners such as Veterans Affairs case managers, and other outside agencies.
This plan helps CF members recover by ensuring continuity in the monitoring and coordination of in-hospital and home care support. Health services case managers continue to provide support and advice even after Canadian Forces personnel return to duty. If the CF member is leaving the forces, they help with the transition to Veterans Affairs services, if required, and to civilian life. The program is focused on the client and family and applies evidence-based treatments and best practices. Because it's integral to the military health care system, it provides continuity of care and acts as a bridge between health services and other elements of the Canadian Forces and its services.
Constantly striving to improve, the case management program is currently assessing a new work tool, Intermed, which is used to determine the degree of complexity of our clients' transition process. In addition, our case managers are in constant contact with our partners at Veterans Affairs Canada, whether through bilateral groups or on a routine basis in the joint personnel support units, ensuring that we share common work tools and providing for the best possible communications between our organizations.
We have many collaborative initiatives with Veterans Affairs to make transition to civilian life as seamless for CF members as possible. These include referral forms, a trial assessment tool, shared electronic and computerized tools, and a new process for disclosure of health information that will involve electronic tracking and transfer to Veterans Affairs. Following a pilot project currently initiated at bases in Edmonton, Valcartier, and Trenton, this process will eventually be nationally implemented.
Other initiatives will include the sharing of program processes and structure through common staff training, joint workshops, and symposia to enhance partnership, harmonization of program and policies in order to enhance continuity of care throughout the transition, online training for case managers for common subjects, shared working groups and committees, and development of a joint quality management review process to assess the transition process and strengthen continuity of care.
To further improve our case management program, we will seek its accreditation during our next cycle of review by the national health quality assessment authority, Accreditation Canada. We will jointly also pursue opportunities with Veterans Affairs to increase our program leaders' knowledge, increase networking through common service delivery training for program managers, maintain a national-level stakeholder committee, increase outreach activities, and link with other organizations, such as provincial and international case management learning networks and organizations, such as the National Case Management Network, and seek more innovative service delivery models. We will also share our information and training on quality improvement, identify outcome measures, and review our service delivery to improve efficiency and effectiveness.
Mental health problems account for a large portion of our case managers' workload and contribute enormously to our case complexity.
However, the mental health team, as an integral part of our health system, has access to the case management program. This allows for rapid access and intervention, ensuring that our members are quickly taken in hand and given access to our full range of services as soon as possible.
As well as assisting CF personnel on a daily basis, the CF health services case management program has long been working collaboratively with the directorate of casualty support management and Veterans Affairs in striving to provide CF members with the best services and benefits to meet their needs.
Our greatest challenge in the transition of CF members to civilian life is in helping them access family physicians and mental health providers within the provincial civilian health systems. Although we continually seek and receive support in this regard from local and regional civilian health authorities, the Canadian Medical Association, the academic deans of university faculties of family medicine, the Royal College of Physicians and Surgeons, and other health authorities, this is an area over which we have little influence in the context of national scarcity and limited access to these health professionals.
In summary, despite increasing demand and the growing complexity of the cases associated with the operational commitments of the Canadian Forces, the introduction of new policies and our new partnerships, Canadian Forces health services managers, through their commitment, are continuing to meet daily challenges, helping to perpetuate the success of the case management program.
Thank you for your attention. I would be pleased to answer your questions.
View Tarik Brahmi Profile
View Tarik Brahmi Profile
2011-10-25 9:44
Fine. I just wanted to make sure about that.
I would like to continue along the same lines as RAdm Smith. He touched on the question of keeping up medical skills. I am sure that the skills needed to treat those wounded in action are different from normal medical skills.
Could you tell me whether the physicians and nurses deployed in Afghanistan will get programs that will allow them work in war zones once again and will maintain or improve those specific skills? Or are they going to come back to Canada and do completely different work?
Jean-Robert Bernier
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Jean-Robert Bernier
2011-10-25 9:44
After their civilian training, all our medical personnel receive specialized training. So all those employees receive normal training, whatever their area, as clinicians, for example, as paramedics, as medical technicians, as surgeons or medical specialists. At the same time, they are also placed in university trauma centres in each region; that is especially the case with clinical specialists. Even in peace time, here in Canada, they continue to be exposed to very complex trauma cases. Before every deployment, they get a great deal of additional training. At the same time, they have professional training programs, such as going to conferences specifically on combat medicine. There are two training centres for trauma injuries, one in Montreal and one in Vancouver. There, all our personnel work together as a team and get additional training on combat injuries. In basic training, which is held in the school at Borden, personnel are trained to deal with disaster victims, chemical and biological weapons, tropical medicine, and so on.
Our medical technicians receive very specialized training in tactical medicine. They learn to care for war injuries in realistic combat conditions, with smoke or explosions, in the cold or dark. In addition, all medical units receive training in teamwork so that their skills are at a high level from the moment they arrive in Afghanistan, or any other theatre of war, and from the first injury they have to treat.
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