Interventions in Committee
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View Jean-Pierre Blackburn Profile
Mr. Chair, as far as these budget numbers go, it is important to understand that every action and decision made at the Department of Veterans Affairs is geared toward improving services and benefits for Canada's most deserving citizens.
The changing demographic profile of Canada's veterans, their changing needs and requirements, and our involvement in Afghanistan have all resulted in more modern-day veterans than we anticipated applying for and receiving benefits under the New Veterans Charter. We are also seeing situations where new medical conditions arise at a later date or where additional difficulties affect veterans. As a result, veterans who already receive a benefit are coming back to us for additional help.
I also want to point out that our efforts over the past year to improve the process of awarding disability benefits have contributed to this increased spending. As of the end of February 2011, the number of disability claims processed increased by 15% this year over last year. As a result, we've put $72 million more in the hands of Canada's veterans.
We have also seen an increase in the uptake of the rehabilitation and career transition programs. The year after the New Veterans Charter was introduced, there were just over 1,100 veterans taking advantage of these programs. This year, there were over 3,800, and we are forecasting over 4,600 next year. That's a 22% increase. It is important to keep in mind that Canada's veterans and their families are the main beneficiaries of this spending growth.
Mr. Chair, you will also notice that we asked for an additional $9.4 million to support the veterans independence program. This reflects the fact that Canada's veterans are still in good health. Our traditional war service veterans are living longer and healthier lives, so they are able to remain in their homes with the help of grounds keeping and housekeeping services. This means fewer of them are moving to long-term care facilities. Again, this is another indication that our programs are effective and being well-used by veterans.
In relation to the spending on the Agent Orange program, I made an announcement in Fredericton back in December that the program would be extended. Our government committed additional funding, some of which is reflected in the numbers you see for both this year and next year. Essentially, that allowed us to change the program's criteria. First, we removed a restriction on eligibility. That allowed more widows to apply for the ex-gratia payment. Second, we changed the date in terms of getting a diagnosis. Since the announcement, we have contacted nearly 1,300 individuals to obtain consent to review their file, and we actually have received a number of new applications as well. The bottom line is that as of March 11, 2011, we have approved payments for over 300 individuals.
Once again, these increases speak to a desire to improve the quality of life for Canada's veterans and their families. They also underline some of the fundamental changes made to how we conduct business at the department these days. We are making real progress in reducing the complexity of the processes and programs, overhauling service delivery, strengthening partnerships with the Department of National Defence and others, sustaining the New Veterans Charter, and adapting the department to the changing demographics of our veterans.
As I mentioned, productivity at Veterans Affairs is up by about 15%. We have increased our team of adjudicators, improved our business processes and introduced better monitoring. We are doing a better job of communicating with veterans, giving clearer direction as to the type of information we need in order to be able to move forward with an application.
We have also made certain investments in technology. These are minor investments for the moment, and of course we have to quicken our pace. We will do more on this front.
I must mention other important progress: between January 2010 and January 2011, we reduced the number of disability claims waiting to be adjudicated by 36%. We are processing disability applications faster. As of early this month, March 8, 78% of first applications were completed within 16 weeks. The result, of course, impacts our budget for the upcoming year.
For 2011-2012, we project spending $3.5 billion, an increase of $109.1 million in comparison to the previous main estimates, or 3.2% from the previous year. I wish to point out that expenses related to Bill C-55 will not be added to the budget as long as the law has not been enacted, but we have provided for the costs related to the program. Some projects have already been approved and there are several others to come.
And finally, Mr. Chair, I don't want to leave you with the impression that all we do is spend money at Veterans Affairs Canada. We are very cognizant of the tight fiscal environment in which our country finds itself. There are some decreases in next year's anticipated spending amounting to $85 million. This is due to a decrease in the forecasted number of War Service Veterans who will receive benefits from the department. As such, some program spending has been adjusted downward.
As well, the Veterans Review and Appeal Board has been established as a separate entity under the Financial Administration Act, which means that the expenditure will no longer appear in the department's spending. These estimates represent an important commitment by the Department of Veterans Affairs and the Government of Canada to invest significantly in the health and well-being of Canada's veterans and their families.
I have enjoyed travelling across the country these last few months and talking with our veterans and telling them about the service improvements taking place in their name. Their feedback and yours have been invaluable, as has been the advice from their advocates. I of course plan to continue that dialogue to ensure all of our programs and services are continuously adapted and adjusted to better fit the evolving needs of both our traditional and modern-day veterans and their families.
Thank you, Mr. Chairman.
View Gary Schellenberger Profile
Good afternoon, everyone. Welcome to the 41st meeting of the Standing Committee on Veterans Affairs and, pursuant to Standing Order 108(2), a study of combat stress and its consequences on the mental health of veterans and their families.
Our witness today, from 3:30 to 4:30 via video conference from Vancouver, British Columbia, as an individual, is Marvin J. Westwood, founder of the Veterans Transition Program.
Welcome, Mr. Westwood.
I am Gary Schellenberger, the chair of the standing committee.
If you would like to, please make your address, and then hopefully we can keep our questions short and to the point. We look forward to a very informative hour, sir.
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:32
Thank you, Mr. Chairman.
I will give an address, but just before I begin, can I clarify something? I have been invited to be a witness today. Just for my understanding, I'd like to know how my input will be helpful to your committee. Could you just help me? You do work in a different sphere than I do and I don't want to go on false assumptions. I understand we're talking about the topic--I know that--but how does this help inform your committee and where might this go?
View Gary Schellenberger Profile
We are doing a study on suicide and mental problems within the military, particularly in our military veterans; a lot of it is that our veterans are coming back from Afghanistan and various other deployments with PTSD. So this, we feel...again, in the transition from the forces to veterans, is there a gap there? How can we handle that? Can we affect the mental condition of our veterans better by a better transition from the military life, which they're probably used to, to civilian life?
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:35
Thank you very much.
Let me begin by saying that I really appreciate being invited to make a presentation to this committee, because the issue of soldiers and veterans returning to Canada is, in my perspective, one of the priorities in Canada at the moment.
Why do I say that? I say that because so much of the attention in the media is on, quote, PTSD and suicide and that kind of highly recognized injury, but there are whole other areas of costs to Canada that I think are not addressed. I'll address those in my presentation today.
I want to start with us recognizing that for every soldier who returns, if they have received an injury—and we call them war-related injuries, psychological injuries—not only does the trauma affect them, as you know, but it affects them, their families, and also the communities they return to. If these injuries are left untreated and unassisted, it's my perception from my work of the past 30 years that what happens is that not only do we lose this particular person's contributions to society, but there is a very serious impact on spouses, children, and the workplace.
One of the things I want to remind the committee of, to maybe put this into a term that they use in the health sector, in medicine, and so on, is that they talk about potential years of life lost. We can do cost estimates in our society. When people have injuries, whether physical or psychological, and are no longer able to contribute and function, not only do they lose, but society loses, and it has a tremendous cost to us.
So of course I am very interested in talking today about a program we're working with out here at UBC. It's sponsored by the Legion. It's called the Veterans Transition Program. You will notice the focus: it's the Veterans Transition Program. What I'm saying there is that it's about how we get these men and these women back into being productive, successful citizens of Canada. If they are injured, especially if it's a psychological injury, which the soldiers themselves refer to as an invisible injury, it's not often picked up, they don't access services for a whole lot of reasons that I'll address in a moment, and we are observing an enormous cost in our society. There's a moral issue and there's the economic issue. That's why I'm involved in this.
On the other hand, when in my work I see these same people have successful recoveries from their traumas, be reunited with their families and their children, get back to the workplace, go on to university, college, or technical school, and be productive citizens again, it is really very inspirational to me. So I am actually quite optimistic about what we can do in Canada with assisting veterans back into transitioning into Canadian society. Why do I say that? Because we do have the expertise. We have the medical expertise and we have the psychological expertise to achieve that.
Now, where did I get my training? I learned it in the trenches from the 85- and 90-year-old World War II veterans that I worked with 25 years ago in a project sponsored by Veterans Affairs Canada. I met with them in groups to find out their life stories and to find out how the war affected their lives and their transition back to Canada. There was no doubt in their minds when we finished the project....
In one of their biggest recommendations to me, they said, “Westwood”--they called me Westwood—“the problem with your program is that there's only one problem”. I asked, “What's that?” They said, “It's 50 years too late”. They said they needed to tell their stories and they needed assistance with transition 50 years ago. They said, “We wouldn't be where we are today, carrying the same baggage”.
And they refer to it as baggage, Mr. Chair. We don't use psychological terms too much today because soldiers don't use them. They call it “dropping the baggage”.
Some of these older veterans that both Dr. Kuhl and I.... Dr. Kuhl is a colleague of mine. He's from the Faculty of Medicine and was the director of the palliative care unit at St. Paul's Hospital. A lot of the patients on that unit were these 85-year-old men and women who had served in World War II and the Korean War. He observed--and it's well documented and researched--that if people don't deal with their war injuries, and I'm talking about the psychological injuries, their deaths are very difficult. The injuries are unresolved.
What we're doing now in working with the younger soldiers, based on the recommendations of the senior soldiers, is offering a place in the transition program where they start to drop the baggage by first telling their own stories about how the war has impacted them and their functioning.
I think I need to say that what's unique about the program compared with some programs we offer is that the program is really run by or supported, if you like, by other soldiers. In the team that works together with these modern-day soldiers coming back, we have physicians, psychologists, and therapists, but we have another important part of the team, and that's paraprofessionally trained soldiers. These are soldiers who have had deployments, have returned to Canada, have been through the transition program, and want to give back and be helpful. We train them to work with us. Hence, the soldiers coming into the program feel very confident that other soldiers are there on the helping team, and they have confidence and trust in that.
I've learned the hard way, as I'm sure some of you have who work with veterans, that by and large a lot of them do not trust us as civilians. There are two reasons they don't trust us. Number one is that they say to us as professional helpers, “You guys have not been there, and you haven't served, so how do you understand my story?” That's number one. Number two is that if these services are delivered through the Canadian Forces or through Veterans Affairs, many of the soldiers I meet won't go there, because they don't trust that the information will be kept confidential. So what do they do? They avoid. That's helping no one. It's not helping us and it's not helping them.
Now, some, of course, with the OSISS program...they have developed programs and ways to facilitate, and I really support that, but I have learned two points. Number one is that if you're going to be helping soldiers with war-related traumas, you need to involve returning soldiers. Why? It's because soldiers like helping soldiers. These men and women are highly experienced by the time they come back. They've been there. They have experienced what has occurred, and, with training, they're a tremendous support to any transition team like the one we have operating in this part of Canada.
It was humbling for me as a professional to find out that their respect for me came a great deal from my proving that I understood their lives. I understood their lives by listening to their stories. A veteran who goes to a VAC office sometimes will say to me, “I don't want to go there, because how do I know that the person who greets me at the door understands anything that happened to me?” I started learning very early from them what they need in order to have confidence and what they need to proceed, to feel like entering into some kind of treatment program.
That's the background.
So what have we done? Mostly, we are now serving veterans who are being released from the services. They have had deployments overseas and then they come into the Veterans Transition Program, which occurs over a three-month period, as you can see. It's residential. For the most part, they come into this program with the idea that they want to move away from their service in the military back into civilian life.
But if they have trauma-related injuries, it's almost impossible for them to move back into civilian life. Why? Because if you understand trauma, you will understand that what trauma does to people is alter their thinking. It leads to disorganized thought. They carry all the symptoms where they can be easily triggered and they don't feel safe. What we notice in many soldiers is that they want to isolate and retreat. I'm not telling you anything new, and I know that. You as a committee would be astute enough to know that a typical symptom of someone with a psychological trauma is that they want to go away, hide, and avoid. Why? It's because there is shame involved, especially for a soldier.
Now, we have to understand that soldiers come from a particular culture, and what is that culture? It is a culture that—and I like to think of it this way—values things such as being strong, self-sufficient, and not needing help. If they imbibe that culture and return to this country with an injury, we can all imagine how difficult it is to say, “I need assistance”. That violates everything they have been trained to do. So what my soldiers often would do is avoid getting help.
Well, but they're still suffering. What do they do? You know as well as I do. They avoid, they medicate, and in the worst-case scenarios, the pain is so enormous that they kill themselves.
Right away I think we have to recognize that we can build bridges with these people, these men and women, in different ways. We can also offer services. We have the PTSD clinics across Canada, and they certainly provide a service—symptom reduction—using their conventional methods. VAC's OSISS office helps, but when we look at the statistics of how many people visit those offices, it tends to be a low number.
Why? Because many of them are avoiding our services. We could stand on our heads and do cartwheels, and I still think that certain soldiers would never trust us to give service if they see us as representing a government agency. That's what we're dealing with.
That's by the way of background.
The program that I think I've been invited to talk about has been running now...close to 200 soldiers have been through it. To date, a majority of them are now reconnected with their families. They're showing progress, with many of them going back to school or upgrading employment. Why is that? Well, it works because--notice--the program we're talking about is a transition program rather than a PTSD program. Yes, we treat PTSD, but the latter part of the program is focusing on how you set new life goals and how you get the resources that are out there to get your life back on track.
It's my observation that the best way to help soldiers isn't to feel sorry for them and to give only our medical and psychological services to them, but to remind them that they are contributing citizens, that they can be productive again, and to give them the resources and skills to do that. I'm not pretending for a moment that the program I'm working with is something I'm recommending for everybody, but I think it began as a good pilot project, and it has promise.
Therefore, most recently, we received a lot of financial resources from the Royal Canadian Legion to begin to capacity-build and to train professionals as well as paraprofessional soldiers to create some other teams that could go to other parts of Canada--if invited--to deliver such a program with the soldiers.
It's a group-based program. Why is it a group program? It's because, as I said, soldiers help soldiers. Soldiers know very well how to help one another. They live in groups and they work in groups, so I find this modality highly effective. As the professional team, we set the guidance and the direction for them to move forward.
More recently, we have had follow-up groups for the soldiers. Soldiers are very keen to stay in touch with their unit. They would refer to our program here as a unit, a new unit, and they like to stay in touch with their units when they get home, so what we try to do is have monthly meetings. We're getting that going now.
That's by way of an introduction. There is more that I could say. I think I've said a lot.
I look forward to questions of clarification or more information as needed at this point.
View Judy A. Sgro Profile
Lib. (ON)
Thank you very much, Mr. Chair.
Professor Westwood, it's real pleasure to listen to you this morning--sorry, I mean this afternoon. It has been a long day already.
Many of the things you say are similar to the things we have heard from some of the soldiers themselves. You've talked about the World War II vets and the fact that it's 50 years too late. Often as we're doing this work, we think of all of what we're trying to do for the veterans today, and we think back to what was being done for those folks 50 years ago. Clearly, very little was being done in those days. I think that now we're trying to avoid as many of those past mistakes as possible and to look forward to how we can help many of these young vets who are coming home now.
You talked about the invisible injuries and the men's and women's unwillingness to address them. You were saying that they will do everything they can to avoid that. Clearly, you can't force people to get assistance, so isn't it a case of recognizing psychological problems early on in order to get them into the right veterans transition program--we can call it whatever we want to call it--and to get them into a mindset in which they recognize that as a result of what they have seen and experienced, they are clearly going to have some sort of trauma, whether it's today or tomorrow? Then we could head things off rather than have somebody commit suicide and then realize that overall as a community we failed that individual by not recognizing it earlier.
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:50
Judy, I'm agreeing with what you're saying here. I want to just say that we have found that one of the best ways to invite young men and women in earlier for help is not for us to invite them in, but for other soldiers to do it. They look out for other soldiers. Our soldiers, who are the paraprofessionally trained soldiers, will go out into the community and will invite other soldiers and say, “This happens, it happened to me, and I've been successful, so why don't you come to a meeting?” It's an outreach by the soldiers. I think that's the only thing I have observed that really is effective: because they trust other soldiers more than they trust me as a professional, as a doctor of psychology.
View Judy A. Sgro Profile
Lib. (ON)
I would agree with you. It sounded a little like an AA program. They're more apt to listen to somebody who has been through something than to listen to some professional. Are programs like your Veterans Transition Program available and operating in other countries?
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:51
No. They aren't at the moment, because this is a Canadian initiative.
I just came back last week from the United States. They have a battalion program in Hawaii and they invited me to come down there. I did a presentation to them and today I received a request: could the Canadian approach to this kind of work be brought down as a presentation to them? So there's interest in other sectors. Israel and the United States are two places that I've presented in, for example.
What's unique about the program, which I don't think is anything that special--I think anybody could do it--is the fact that most professional groups don't use soldiers helping soldiers.
View Judy A. Sgro Profile
Lib. (ON)
Is most of the funding that you have received from the Royal Canadian Legion? Am I accurate in that statement?
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:52
I have in the past and was not supported in that endeavour. About 20 years ago, Veterans Affairs supported a study I did with life stories of World War II veterans. I was appreciative of that and was kind of surprised when they didn't seem to want to support this initiative. I think it's because they see that they have their own services.
View Judy A. Sgro Profile
Lib. (ON)
Well, part of the study we're doing today is to look at how we can improve those services.
What is the age range of the men and women that you have had an opportunity to work with? What are the ages?
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:52
On ages, what I've learned, Judy, is that a soldier is a soldier is a soldier, whether they're 25 or 75. The age range of the current program now is maybe 27 to 40 or so, but every now and again.... A few years ago, we were having people from the former Yugoslavia, soldiers that had been back as peacekeepers, so we had people in their 50s and 60s. So the whole range I think would be from 27 to 60 years old. It's never too late.
View Judy A. Sgro Profile
Lib. (ON)
Of course it's not.
Have you been able to figure out how to assess a success rate with many of the men and women you've worked with?
Marvin Westwood
View Marvin Westwood Profile
Marvin Westwood
2011-03-02 15:53
Yes, we evaluate success in two ways.
We have psychological outcome measures. There are two studies we have going. We look at rates of depression and self-esteem and then at other factors like anxiety and depressive thoughts. These are outcome measures.
But to me the most important measure is the part of the study in which we follow them for up six months later and, in some cases, two years later. We look at their active employment and family reunification. If they are actively employed, getting a new career, and back with their families, we see that as progress.
But this doesn't lend itself to the same kind of psychometric measures that you often see in these studies. We follow up with many of them because they want to stay in touch with us. Once they've been through the program, they will often call back or call some of their buddies in the program. We currently have a new research project focused on long-term effects. We'll go back 10 years to assess some of the graduates of the program.
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