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Record of Discussion – Mental Health Advisory Group Meeting

Tuesday, May 10, 2016
1330–1600 (EDT)
Cartier II Boardroom, The Marriott Hotel, 100 Kent Street, Ottawa, Ontario

In Attendance

  • Sapper (Retired) Aaron Bedard
  • Michael Blais, Canadian Veterans Advocacy
  • Louise Bradley, Mental Health Commission of Canada
  • Dr. Karen Cohen, Canadian Psychological Association
  • Joel Fillion, Director, Mental Health (VAC Co-chair)
  • Dave Gallson, Mood Disorders Society of Canada
  • Sergeant (Retired) Brian Harding (via teleconference)
  • Glynne Hines, Royal Canadian Legion (Co-chair)
  • Warrant Officer (Retired) Brian McKenna
  • Colonel Scott McLeod, Deputy Surgeon General, Canadian Armed Forces
  • Robert O'Brien, Canadian Association of Veterans in United Nations Peacekeeping
  • Dr. Don Richardson, Canadian Psychiatric Association
  • Dr. Patrick Smith, Canadian Mental Health Association
  • Robert Thibeau, Aboriginal Veterans Autochtones

Regrets

  • Dr. Ruth Lanius, Western University

Record of Discussion

This was the first face to face meeting of the Mental Health Advisory Group (hereafter the Group). The Veterans Affairs Canada co-chair led round table introductions. Members indicated why they were there, many as professional mental health practitioners and others with personal and organizational interest in and experience with mental health issues such as Post-Traumatic Stress Disorder.

The Veterans Affairs Canada co-chair stated that the role of the Group was to advise the Minister of Veterans Affairs on how best to address his mandate commitments related to mental health issues.

Presentation

The Veterans Affairs Canada co-chair provided an overview of the Canadian Veteran population, including the kinds and prevalence of physical and mental health issues that Veterans experience in comparison with the general Canadian population (statistics from the 2013 Life After Service Studies). He noted that Veterans Affairs Canada defines a “client” as a Veteran diagnosed with challenges/disabilities, whether physical, mental or a combination of both. Members asked if statistics:

  • on Veterans with mental health problems included those with addictions (yes);
  • are available that compare income levels and financial stability of Veterans with mental health problems, with those of civilians with mental health problems; and
  • are available that compare Veterans with mental health problems related to service to Veterans with the same problems but not attributable to service (since the benefits that Veterans can access would be different for each group).

Veterans Affairs Canada fact sheets with mental health statistics will be circulated to members.

Mandate Letter

The Veterans Affairs Canada co-chair noted there were two main areas in the Minister’s mandate letter that the Group could address:

  • The establishment of a Centre of Excellence specializing in mental health, Post-Traumatic Stress Disorder and related issues; and
  • The development of a suicide prevention strategy for Canadian Armed Forces personnel and Veterans.

The topic of suicide was raised and discussed throughout the proceedings. Members asked:

  • whether a “zero suicide” policy was in place;
  • if more information on the why of suicide was available for them; and
  • if information was available to members currently serving as they transition to civilian life, in terms of education in the area of mental health.

A mental health professional member indicated that mental illness is behind suicide, but a trigger sets off the suicide attempt. That trigger could be anything - financial distress, relationship breakdown, etc. There is not a good understanding of suicide and how to prevent it. Members also learned that a program called The Road to Mental Readiness is a powerful tool used by many organizations in Canada. Group members could be given this same presentation.

Stigma

Stigma around mental health problems was raised often during the discussion. One member commented that stigma prevents military members from coming forward with their mental health issues; many hide mental health issues that could be career limiting and prevent deployment, which is why they joined the Canadian Armed Forces. He felt the Group could discuss the issue more fully. Another noted that there is a nuance to stigma that applies to Veterans which is more about what they believe about themselves as opposed to what they think others think about them. One mental health professional preferred using the term “barriers to care” as opposed to “stigma”.

Terms of Reference

Members reviewed draft terms of reference. They discussed keeping the document at a high level while clearly articulating the issues they would like to address. Some members felt the Group should focus its work and advice on the two elements of the Minister’s mandate letter, plus one other: ways to ensure Veterans are aware of and use available programs (e.g., treatment centres, suicide prevention etc.).

Others felt there are additional topics for discussion centred on Veterans and their unique experiences, including:

  • the de-stigmatization of mental health problems;
  • the importance of peer-to-peer support for suicide prevention and mental health;
  • dedicated in-patient treatment facilities;
  • a dedicated effort on suicide prevention;
  • taking a holistic and integrated approach to mental health, not just treatment, but the other known elements for good mental health: jobs, peer support, etc.;
  • promoting a “no wrong door” approach that empowers Veterans to self-refer; and
  • ensuring that case managers are trained, knowledgeable and aware of all available resources.

Members agreed to review a revised draft Terms of Reference at the next meeting.

Other Points Raised and Issues of Interest

  • Existing programs known to be helpful should be considered. A 10-day culturally-specific retreat involving sweat lodges and peer support was cited as having made profound differences to the mental well-being of Veterans from various cultural backgrounds.
  • Proper training for both formal and informal peer-to-peer support networks.
  • Harmonized, dedicated suicide prevention strategy between Veterans Affairs Canada and Canadian Armed Forces. The supposed gap between military member and Veteran in this area is arbitrary. They need to work hand-in-hand.
  • Inclusion of family organizations in the Group’s consultations to hear how families are affected by a Veteran’s mental health issues. The Group was advised there would be opportunities to work with other Advisory Groups, one of which focuses on families.
  • Centre of Excellence should incorporate training, peer support, the ability to reach out nation-wide to psychiatrists, psychologists and counsellors etc. It should be a fully funded, comprehensive infrastructure. While some of the mental health professionals were not as resolute, many Veteran members of the Group were insistent that the Centre of Excellence would have an infrastructure element that would include an in-patient treatment facility.

Parliamentary Secretary Karen McCrimmon spoke to the Group, noting that mental health is a societal problem, but the mental health of the Veteran community is the focus of the Group and is an issue supported by the Minister and the Prime Minister. She offered to help the Group in whatever role they felt she could play on their behalf. She congratulated the Group on its efforts, adding, “If we do it right, it will make a lot of difference in people’s lives.”

Mr. Glynne Hines stepped forward for nomination and was endorsed by the members as the Group’s Co-chair.

Priorities

The Group agreed that there is significant work ahead and believed it is necessary to identify three priority activities to be pursued over the coming months. The three immediate priorities agreed to were:

  • a comprehensive suicide prevention strategy;
  • a concept and strategy for the Mental Health Centre of Excellence; and
  • identification of peer and family support training requirements and opportunities.

Next Steps

The next meeting will take place in the next few months via teleconference, or in-person at a location convenient for all.

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