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Record of Discussion – Mental Health Advisory Group Teleconference

Tuesday, June 7, 2016
1330 – 1430 (EDT)

In Attendance

  • Sapper (Retired) Aaron Bedard
  • Micheal Blais, Canadian Veterans Advocacy
  • Joel Fillion, Director, Mental Health (VAC Co-chair)
  • Dave Gallson, Mood Disorders Society of Canada
  • Sergeant (Retired) Brian Harding
  • Major-General (Retired) Glynne Hines (Co-chair)
  • Warrant Officer (Retired) Brian McKenna
  • Robert O'Brien, Canadian Association of Veterans in United Nations Peacekeeping
  • Dr. Don Richardson, Canadian Psychiatric Association
  • Robert Thibeau, Aboriginal Veterans Autochtones

Regrets

  • Louise Bradley, Mental Health Commission of Canada
  • Dr. Karen Cohen, Canadian Psychological Association
  • Dr. Ruth Lanius, University of Western Ontario
  • Colonel Scott McLeod, Deputy Surgeon-General, Canadian Armed Forces
  • Dr. Patrick Smith, Canadian Mental Health Association

Meeting Opens

The objective of the meeting was to review, with the goal of approving, the Mental Health Advisory Group’s (hereafter MHAG or the Group) Terms of Reference (TOR); to discuss the next steps for the Group, and; to establish a date for their next in-person meeting.

The Veterans Affairs Canada (VAC) Co-chair welcomed members and proposed a section-by-section process for reviewing and commenting on the TOR, which was accepted by the Group.

Section 1: Mandate

Given the reference to Royal Canadian Mounted Police (RCMP) in the first paragraph of this section (below), a member inquired whether someone from the RCMP hierarchy be aware of the discussion. It was explained that the RCMP Veterans Association will be made aware of the proceedings and outcomes of deliberations in the same way as other groups. If/when appropriate in the future, a representative of the RCMP Veterans Association may be invited to join the Group.

The mandate of the Mental Health Advisory Group is to provide advice to the Minister of Veterans Affairs and Associate Minister of National Defence to ensure that Veterans, Canadian Armed Forces (CAF), Royal Canadian Mounted Police (RCMP), and their families receive the care, compassion, respect, support, and economic opportunities they deserve.

Clarification was sought on the imperative language used in the second paragraph (i.e., the Mental Health Advisory Group “will”) versus that used in the third paragraph (i.e., the Group “may”). It was explained that the three items in the second paragraph (as well as the first paragraph) were common to almost all Advisory Groups and describe in general terms what they are to carry out or deliver, respective to the main focus of each. The third paragraph points to specific items related to mental health that are written in the Minister’s mandate letter on which the Group could choose to focus its attention. Paragraphs two and three are as follows:

To this end, and within its particular mandate to provide advice, the Mental Health Advisory Group will:

  • examine gaps and weaknesses in the support and services to Veterans, Canadian Armed Forces (CAF) and Royal Canadian Mounted Police (RCMP) and their families that are related to the mental health of Veterans, CAF and RCMP members, including post-traumatic stress disorder (PTSD) and other operational stress injuries (OSI)
  • provide the Minister with advice that prioritizes and addresses the significant gaps and weaknesses in the support and services related to mental health
  • contribute timely input to Veterans Affairs Canada to ensure stronger, more responsive policy and program development

The Group may choose to focus on one or more of the following areas related to mental health in the Minister’s Mandate Letter:

  • Implement all of the Auditor General’s recommendations on enhancing mental health service delivery to veterans.
  • Create a new centre of excellence in Veterans’ care with a specialization in mental health, post-traumatic stress disorder and related issues for both veterans and first responders.
  • Provide greater education, counseling, and training for families who are providing care and support to veterans living with physical and/or mental health issues as a result of their service.
  • Work with the Minister of National Defence to develop a suicide prevention strategy for Canadian Armed Forces personnel and Veterans.

As well, the Group may provide advice on the de-stigmatization and removal of the barriers to care associated with mental health. (Note this item was originally placed incorrectly in the first draft of the TOR as an item extracted from the Minister’s mandate letter. It is corrected both here and in the revised draft of the TOR).

The second bullet extracted from the Minister’s Mandate letter came into question, as several in the Group did not feel their work should apply to “first responders” and should focus instead solely on Veterans. Others said that their work could focus on Veterans while still applying to other clients.

After some debate, it was suggested and agreed upon that in order to move forward the Group could accept the second bullet as it is written since this is how it appears in the Minister’s mandate letter, and revisit the “who, what and the how” later on.

A member requested the inclusion of “and peer support workers” after the word “families” in the third bullet, which would, in effect, broaden the training to Veterans (peers) who help their comrades via other organizations mandated to provide support to Veterans.

  • It was agreed that an inclusive term, broader than families, could be used. While the mandate letter item cannot be altered, an appropriate term could be integrated into the TOR.

The fourth bullet referring to a suicide prevention strategy was also discussed at length. The VAC Co-Chair explained to the Group that work on a Suicide Prevention Strategy had begun in 2010, and a framework and action plan had been drafted in 2014. A majority of Group members felt they should have input, be a part of the dialogue, and even take a leadership role on the strategy. A member reminded the group that suicide is not a phenomenon restricted to, nor most prevalent in, the Veteran community. The VAC Co-chair noted that all such strategies will go beyond their own groups and organizations.

  • Members agreed with the VAC Co-chair’s suggestion that they accept the statement as is and discuss more details at the next face-to-face meeting.
  • Members also agreed to the final bullet and the final paragraph of Section 1.

Section 2: Advisory Group Composition

This section covers the composition of the Advisory Group, the length and renewal of terms of membership. It also contains a list of officials from the Minister’s Office and the Department as well as other stakeholders that may attend the meetings and interact with the Mental Health Advisory Group from time to time.

Members sought clarity on whether they could sit in on other Advisory Groups’ meetings in the same way that this section indicates other groups would be able to do vis-a-vis their MHAG meetings. A Departmental official explained that indeed that is the idea, that there is much cross-over between the mandates of the six Advisory Groups and that it would be not only beneficial but also necessary for groups to interact with each other. The VAC Stakeholder Engagement and Outreach Directorate (hereafter Secretariat) would help to ensure this collaboration.

One member wanted to know the process that would allow the Group’s work, in the form of reports, recommendations etc., to reach the Minister for review. It was explained that once the Group has agreed (quorum respected) that its product is final and ready to go, the Co-chairs or the Secretariat would help usher the item to the Minister’s Office for his attention.

  • With this, members agreed to all of Section 2.

Section 3: Meetings

All agreed without comment.

Section 4: Responsibilities

All agreed without comment.

Section 5: Documentation and Record Keeping

All agreed without comment.

Section 6: Communications

This section contains clauses that, if agreed upon, would limit what the individual members of the Group might share with others (e.g., peers, members of stakeholder organizations or other interested stakeholders) to lines that would be agreed-upon by all members of the MHAG after a face-to-face meeting.

This section sparked some discussion and debate about transparency versus respect for protection of privileged information. One member noted that there has to be some level of trust, and that “what is discussed at the table stays there when it’s of a personal/medical nature.” All agreed in the end that they need to be united in their message, respectful, and thorough—nothing being discussed or developed in meetings or within the Group should “go out half-baked.”

Section 7: Secretariat Management and Support

All agreed without comment.

Section 8: Costs

All agreed without comment.

Section 9: Agreement

Agreed to as amended, and agreement that TOR could be signed by both Co-chairs signifying agreement of members.

Next Steps

Toward the end of the meeting, the VAC co-chair brought up the subject of the Centre of Excellence in Veterans’ care and mental health (hereafter MH CoE), since many of the Veterans expressed interest in it at the Group’s inaugural meeting in Ottawa on May 10, 2016. Members agreed that a sub-group could be formed that would advise on the MH CoE. The Co-chair added that the MH CoE might develop a concept, mission, and mandate for the 'Mental Health Centre of Excellence' as outlined in the Minister of Veterans' Affairs mandate.

Members discussed this at length, with some wishing to submit their own ideas to this potential sub-group since they might each have different ideas, others wanting to know what the thinking thus far has been on the CoE or what has been done so far, and a few suggesting the sub-group be allowed to do their work, call in witnesses etc., without having their “hands tied” by the larger Group.

The Co-chair offered that in the interest of time, and parliamentary process (i.e., submitting in time for Budget 2017 inclusion if necessary) the sub-group might come up with a vision or concept, present it to the larger Group in July (date tbd) for comments and discussion, and then further develop the concept for approval by the MHAG prior to submission to the Minister.

After this, a member volunteered to lead the sub-group. His leadership nomination was seconded by another member, who also volunteered to be on the sub-group. Three other members then stepped forward to be on the sub-group.

The VAC co-chair wanted to ensure the members understood that the CoE sub-group would explore different options and put forward a conceptual idea for the CoE—what its purpose would be, who it might serve, etc. He said he would ask the Secretariat to reach out to other MHAG members who were not able to participate in the meeting to seek their interest in joining the sub-group, to ensure balance and representation.

Next Meeting

The VAC Co-Chair proposed to send the group an email with options for dates of the next MHAG meeting, projected for the end of July or early-to-mid August, 2016.

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