NOVA SCOTIA HOUSE OF ASSEMBLY
Tuesday, November 21, 2023
Peer Support: Community Facilities
Printed and Published by Nova Scotia Hansard Reporting Services.
VETERANS AFFAIRS COMMITTEE
Chris Palmer (Chair)
Danielle Barkhouse (Vice Chair)
Hon. Steve Craig
Hon. Ben Jessome
Hon. Tony Ince
[Chris Palmer was replaced by Melissa Sheehy-Richard.]
[Tom Taggart was replaced by Dave Ritcey.]
Legislative Committee Clerk
James de Salis
Administrative Support Clerk
Chief Legislative Counsel
Atlantic Centre for Trauma, EHN
Collette Currin, National Director, Military, Veterans, and First Responders
Jane Calder, National Manager, Veterans and RCMP
Dr. Belinda Seagram, Executive Director
Deb Eaton, Manager of Corporate Affairs
Replenish Around Shipmates Veterans Society
Trent Nurse, Chair
Rally Point Retreat
Bob Grundy, Co-Founder
Johan Grundy, Co-Founder
Heather Cook, Wilderness Trail Development Coordinator
HALIFAX, TUESDAY, NOVEMBER 21, 2023
STANDING COMMITTEE ON VETERANS AFFAIRS
THE CHAIR: Order. I call this meeting to order. This is the Standing Committee on Veterans Affairs. I am Danielle Barkhouse, MLA for Chester-St. Margaret’s and Acting Chair of this committee. Today we will hear from presenters on the topic of Peer Support: Community Facilities.
Please turn your phones off or put them on silent. I will note that there’s construction next door, so you will hear drilling from time to time. In case of emergency, please use the Granville Street exit and walk up to the Grand Parade.
I will now ask the committee members to introduce themselves for the record by stating their name and constituency. I will start with MLA Sheehy-Richard.
[The committee members introduced themselves.]
THE CHAIR: I would also like to note the presence of our Chief Legislative Counsel Philip Grassie, and our Legislative Committee Clerk Tamer Nusseibeh.
The topic, as I said, is peer support. I want to welcome the witnesses. Thank you all for coming. I would like each one to introduce themselves, and we will start with Jane Calder.
[The witnesses introduced themselves.]
THE CHAIR: We will now move on to opening remarks. I think Jane - would you prefer Jane or Ms. Calder?
JANE CALDER: Jane is fine.
THE CHAIR: Let’s start with Jane.
JANE CALDER: As I said, my name is Jane, and I work at Edgewood Health Network. I’m here representing the Atlantic Centre for Trauma, which is located in Nictaux in the Annapolis Valley, Nova Scotia. It’s one of 10 in-patient facilities within Edgewood Health Network or EHN Canada. All our facilities are fully accredited. Three of these centres, of which the Atlantic Centre for Trauma is one, are dedicated exclusively to treating members of the military, veterans, and first responders.
Our highly specialized treatment programs address mental health, addiction, and trauma disorder as either primary or concurrent conditions. We also have intensive out-patient treatment programs, which provide the same offerings but for those with less severe symptoms.
The Atlantic Centre for Trauma medical team consists of 24/7 nursing support, and is overseen by a psychiatrist and medical director. Medically supervised detox is offered, as well as ongoing medical supervision. We have a multi-disciplinary clinical team that includes psychologists, social workers, registered psychotherapists, and support counsellors. Treatment programs include psychoeducation, cognitive behaviour therapy, dialectical behaviour therapy, skills, acceptance and commitment therapy, relapse prevention, and one-on-one psychodynamic therapy to develop the knowledge, skills, and confidence required to sustain ongoing recovery.
The complexities of post-traumatic stress disorder and moral injury are addressed primarily with cognitive processing therapy, as well as prolonged exposure and EMDR where preferred. Also, we’re approved by Veterans Affairs Canada, rTMS and ketamine treatments are also delivered on a case-by-case basis.
We have adjunct staffing and services that provide nutrition, exercise, massage, physiotherapy, art, and nature immersion. We provide comprehensive discharge planning and reporting to ensure continuity of care for veterans. We work with VAC case managers and community providers to ensure a seamless transition. Our programs all include one year of aftercare consisting of weekly two-hour groups, as well as a strong alumni network to sustain a sense of community.
We also offer veterans’ families the ability to enrol in our Family Education Workshop to help educate family members on mental health, trauma, and substance-use disorders. Helping family members understand their impact and develop their own inner and community resources provides a fundamental support to the family system.
THE CHAIR: Dr. Seagram, I think you have opening remarks?
DR. BELINDA SEAGRAM: Landing Strong, as I mentioned, is in Windsor, Nova Scotia. We’re really thrilled to be here today to speak to you about what we do.
Our mission is really creating a safe landing spot for veterans and first responders who are suffering from operational stress injuries. Most of them have PTSD, anxiety, depression, often substance use, and family breakdown. The vast majority of people who come to us - pretty well 100 per cent - have had PTSD. Often, they have other issues they are struggling with, and so it can be complex.
At least 15 of the people who’ve been through our services in the past couple of years have already been through intensive programming. We do not see ourselves as in competition with in-patient care. We’re part of a continuum of care. We offer quite a number of programs. I’ve provided them to you in your handouts. I’ve got paper copies as well, if anybody would care for them - extensive programming.
What makes Landing Strong a bit different is that we provide intensive day treatment programming for people in their home communities. We believe very strongly that healing takes place within caring communities. We need to not disappear or vanish. We’re there for people as long as they need us to be.
We offer family programs as well as programs for those who are injured. We’ve had March Break camps. We do Care for the Caregiver series. We did a very popular Date Night series, which brought people from across the province - amazing. We had people who’d drive three hours to come for a date with their partner because they don’t go out in public otherwise.
When we look at who comes to our facility, primarily we’re about 66 per cent military and VAC, and the rest are first responders, and family members as well. I took a snapshot last May. We had about 57 per cent male and about 38 per cent female, and we had at that point 5 per cent non-binary. That number shifts around.
What’s interesting is that very few people are fully insured. Quite a few people are partially insured, and we’re getting a growing number who are completely uninsured. The good news is that we don’t turn anybody away. The bad news is that a fair number of our uninsured people are veterans. We have some systemic challenges that are facing our veterans. I’ve identified a few of those. First of all, getting access for culturally appropriate trauma-specific clinical services - there are often long wait times for care, as you know, in many facilities. There can be extended delays in gaining authorization for group programmings.
People who are in transition from the military are particularly at risk. Usually, they’re not eligible for funding. If they have the courage to pick up a phone and they come to us saying they’re not okay - the vast majority of them are suicidal - we do not turn them away. We generally can’t get any funding from VAC for a good year for them, because group programming is not fundable unless they already have a recognized psychological condition and are approved for group work.
It’s interesting to note that Nova Scotia is very unique. There’s a layering effect that’s happened to stresses in our province. Whether it’s been the floods, the forest fires, the mass shooting, the Merlo Davidson class action lawsuit - anti-police sentiment has affected many. The withdrawal from Afghanistan, the current unrest in Ukraine and the Gaza Strip, and of course we have the Swissair legacy, which continues to weigh a heavy toll.
We’re very much focusing on meeting veterans on their terms. When they call, they need services immediately. If they have the courage to call, they’ve generally been thinking about it for years. They don’t sleep the night before. If they show up, I am not going to say, I’m sorry, you don’t have funding. We welcome them in. We need ways of being able to provide proper care for them, and finding out funding mechanisms that don’t make that difficult. Pretty well everyone is eventually given authorization. It’s not uncommon. It takes a good year though, and we’ve generally given them a year of services prior to that.
We want services to be efficiently, effectively delivered. We give services that are based in science. It’s leading-edge treatment for post-traumatic stress, and it’s a continuum of care. People can stay engaged as long as they need for however long they need, and they can join our Maintaining Health series. We have a series of programs they can do in an intense way throughout one year or two years - whatever meets their preference - and then they can come once a month and stay engaged as long as they need or take additional programs. We’re always developing new content.
We’re providing a comprehensive solution. We’re well established. We’ve had over 195 people through our programs. The vast majority who’ve been through our programs have taken more than 150 hours of clinical care. We’re quite excited about that. People don’t just tend to take one program. Once they take one, they tend to sign up for the whole series.
I think I’ve mentioned some of the funding challenges, and I believe my three minutes have probably run out. Thank you very much for your time.
THE CHAIR: Mr. Nurse.
TRENT NURSE: My name is Trent Nurse, and I run RAS Veterans Society. In the Navy, RAS is Replenishment At Sea, and we call it Replenish Around Shipmates. I don’t have any professionals on staff - it’s me, my wife and treasurer, and we just do everything. We have a 60-acre property; we have trails on it. People show up - they veg, basically. They just sort of do what they want, no pressure. If they ask for advice, we talk.
Peer group is every two weeks. We do 10:00 a.m. until 1:00 p.m. in the afternoon, and usually it’s 4:30 p.m. or 5:00 p.m. by the time everybody leaves. It’s unsupervised. I’m the mediator. You need a mediator to stop people from going off the rails or whatever, but I find that peer group with a social worker doesn’t work. No offence to people who have social workers at their events. I’m not going to sit in a room with 10 or 25 other people and talk about my feelings with a person who’s never been there. If you’re a veteran, that’s fine. If you’re a first responder, that’s fine. I’m not going to do a talk.
I’ve had people tell me they feel nervous if they have a person there who’s not a veteran or not a first responder. It seems like people are just jotting stuff down, and it doesn’t work. I find the thing about these events is that we’re all a unit. We’ve all been through the same thing - the veterans understand. Any veteran or first responder who’s in a room understands our humour is dark. I’ve had people go at events: What are you trying to tell me? What are you saying? But we understand. It’s what we do.
I suffer from complex PTSD, and most people in the Navy do as well. Multiple things over multiple years under the age of 25, and they end up getting complex PTSD. The Army is a little different. Afghanistan, a single event - you can trace that single event. We have multiple events: man overboard, whatever you want to call it. Whatever your trauma is, it seems like it’s communicable over the years. We try to take that in hand and know that, and deal with the people who are there - case by case is the best way, I find. Some people show up on a Sunday and just want to talk for a couple of hours and have advice. I’ve had Veterans Affairs, and we do that as well.
In conclusion, my take on peer groups is that we need a lot more of them, and they need to be easily accessed because people with PTSD, you can’t rely on people to show up. I have 20 people a week say, I want to come to your peer group, and then they don’t come because anxiety takes over and stuff. We need to get an easier way to do that, people slide in and slide out at their own - we don’t have any sign-ups. You can come and leave.
THE CHAIR: Mr. Grundy.
BOB GRUNDY: I’ll do my best to speak up. I’m fighting Parkinson’s on top of my PTSD, so the two of them do not play well with my brain.
Because we’ve got so much information on our website, I won’t bother boring you with who we are, who I am, and whatnot. The information is there for anybody who wants to actually find out.
Peer support facilities, which we are championing across this country and working in concert with organizations from Wales, England, and Australia as well, fit in best at the very beginning of a trauma. After people have gone through the important facilities that will help them defeat their addictions that they typically develop within first responder communities and veterans communities - and we know the senior health world to the hospitals.
We’ve chosen to work on a temporal program. Visitors are at our place for less than two weeks. Guests are there for two weeks to six months. Following that, people are considered residents. We don’t put a timeline on how long they can come and stay. We also do not charge people for coming to Rally Point. The first eight years were primarily funded by my pension, and by the hard work of veterans across this country to raise money to keep it alive.
I’m not sure if any of you are familiar, but our taxes are extremely high, and they want us to pay hospital-level insurance costs. As the grassroots that most of us are, those provide challenging financial restraints.
We focus on a peer-support level. We have no doctors at our facilities. We take care of everybody as part of the team. Our approach for helping our peers is an adaptive approach based on what the individual needs, not what the system says that they need. We try to provide them the opportunity to have a purpose back in their lives.
When we served in the military - and I did do 35 years of service - we had a purpose. When we stopped that, we did not have a purpose. Merely existing is not a purpose for us. We served with our back straight and our chest out, and we did it so that this country could survive and not be faced with what goes on in the rest of the world. To this day, we have succeeded.
There’s so much more that we would love to be able to tell you. Hopefully that will come out in the questions. For right now, and as proof that what we do works, I’m going to pass it over to Heather, and she will continue for us.
THE CHAIR: Ms. Cook.
HEATHER COOK: I’ll take over from where Bob started out at the beginning, where peer support facilities should be intertwining with our mental health system. I think that having gone through what I’ve gone through - I was a Mountie for 10 years and retired five years ago. I left to figure out my path beyond that, and try to fit in somewhere and find that purpose. Once I ended up at Rally Point, I have had time in places like Homewood and those treatment facilities that are intensive treatment for PSTD, teaching us those tools.
What was missing in my process was that place to go to integrate all of those skills that we’ve learned through all that intensive training, and have that community sense where we can test those skills, try some new things, try to develop some new skills to decide if we’re going to be a part of a purpose. Or maybe we want to try something else and that’s our purpose. Maybe we recognize that this wasn’t quite our thing, and we need to do something else.
Rally Point is a piece of the puzzle that I felt was missing from my treatment. I’ve noticed a repeat pattern that things failed when I didn’t have that setting, and go back into my life and move on and try to get that help again, so I’d go back into that intensive treatment. There seems to be that case throughout the veteran community of repeat going back to those intensive facilities. That’s an expensive amount of money that’s being spent on those in-patient programs.
Where Rally Point Retreat fits in is, I think, right after one of those traumatic events happens. The organization that happened in - whether it’s the first-responder community or veteran community, military - it’s good that they can handle some of that, but there also needs to be this other place where those members individually can go to speak freely about what’s gone on. It’s not structured. It doesn’t have your colleagues within it - in a sense of the person who was there with you at that traumatic event - or, say, your bosses or the managers or those people who are going to decide where your career goes. That piece needs to be addressed.
My own personal experience was that there was a whole bunch of legalities behind it as well - of what happened, and what I could and couldn’t say regarding the lawyer side of things. To have that open community, to have that place where peers who have been through that, and have kind of gone through the work and worked out those issues, they can talk to those topics, but not in the sense where we’re facing criticism or facing the potential that we might lose our job out of this situation that we’re speaking freely at.
I think it also fills that gap where you’ve left an intensive treatment facility - say, a two-month program in a place - and you’re expected to go back to where you lived with maybe very minimal support systems in place and return to some of your organizations, if you’re still working. A lot of the time, I felt that I didn’t have the support that I had - whether it was taken into account that I was alone, and I didn’t have family or supports or a partner or anything like that. It was kind of like throwing you right back into the fire without knowing, and that you hopefully have taken away those skill sets, and have the power to implement them perfectly in every scenario.
I find that Rally Point gives me that place to go and work in almost a communal situation, test out those skills, and work with them every single day. It’s 24-hour support at that point, where if there’s something going on, there’s somebody within that community I can talk to. I think it’s a missing piece in the overall system, and I think that’s part of why we wanted to come here today to try to bring to light.
Thank you for your time.
THE CHAIR: Thank you. I noticed during introductions that we missed one MLA. I will pass it over to MLA Craig to introduce himself.
HON. STEVE CRAIG: Thank you all for being here today. My apologies for being late. There was a little bit of traffic, but that doesn’t excuse me, because everybody else here was on time.
My name is Steve Craig. I’m the MLA for Sackville-Cobequid. I’ll have a couple of questions and comments as well.
THE CHAIR: Now that all introductions and opening statements are done, we’re going to open the floor for questions. I ask that you wait until your name is recognized. This is in order for Legislative TV to turn on your microphone. This is a raise-your-hand committee. We’ve already had one.
HON. TONY INCE: My question isn’t specific to anyone. It could be open to anybody who would like to answer.
What specific initiatives or joint programs with provincial government departments are being undertaken to address the mental health needs of our military through community facilities?
THE CHAIR: Mr. Grundy.
BOB GRUNDY: I’m hoping this is the right answer, Chair. On the 23rd of this month, we’ll be entertaining the folks from the Nova Scotia Community College military-connected program, which is just starting. We hope that we might be able to collaborate so that those military members who take that program, if they have PTSD, will have a place that might be able to facilitate their training, that actually understands what PTSD does and how it operates in the brain.
THE CHAIR: I will allow follow-up questions if it has to do with the original question. MLA Ince.
TONY INCE: I don’t have a follow-up.
THE CHAIR: MLA Craig.
HON. STEVE CRAIG: Sincerely, thank you all for being here. I am the son of a Second World War and Korean conflict Navy man. I’ve been involved in the military all my life, pretty well - a member at the Legion out in Sackville, and we have a buddy coffee check every month. I was recently proud to present a Quilt of Valour.
Being a dependant, I see a lot of what goes on in families, and also to people who have been close to my dad and involved. Again, thank you very much for all you’re doing. Our present and future veterans deserve all the attention they can get, and for each and every one of you in doing what you can, my sincere thank you.
I’ve got a general question that anybody can approach. We all have a series of questions that we’ve looked at and vetted before we did this. Unfortunately, we don’t have time and I’m talking way too much. We have around 40,000 veterans here in Nova Scotia. Unless you know what’s going on - you know people to contact, and you know if you have an issue, if you can identify it or if a family member can - how do you get the word out that there is help? I recognize that the help is not the same for everybody. It’s not a one-size-fits-all type of assistance.
How do you get the word out? If you can also tell me a little bit of the process once you’re contacted, what happens there? Like Heather, how do you engage people after they’ve been through this continuous help that they get, and they want to give back?
THE CHAIR: Mr. Nurse.
TRENT NURSE: I’d like to touch base on a little bit there. I think the help is there. It’s just that people with PTSD have a hard time taking it. I’ve called people, given my address, offered them money for gas, “I’m coming,” and then that morning, “I can’t, I’ve got an appointment,” or I’ve got this, or I’ve got that.
The brain is a funny thing. It wants the help. It needs the help - it’s just not going to go get it. You need a push. For me, it was my wife who said, “Enough is enough. You need to go get help.”
You don’t know it changes so slowly, and your brain betrays you so much that you just don’t know that it’s happening. In my opinion, the help - people know it’s there, they just can’t reach out and take it unless they have that little push.
THE CHAIR: Ms. Cook.
HEATHER COOK: I started out on my journey working on myself, but it got to a point where I was then seeking out opportunities to become a peer support worker. I actually took on the Mood Disorders Society of Canada’s Peer Support Team, so I did the training through that avenue. Then through there, there was just a passing of a name - of a place that was doing something. At the time, I didn’t think much of it and thought, “Pass that, I’ll go back and do what I was hoping to do as my career,” and then that didn’t work out.
My career kind of took me across Canada. When it didn’t work out, I reached back out to that one peer support trainer who had mentioned this place out in Nova Scotia and reintegrated into that. I just asked them, “Is that an opportunity still?” He gave me the name, hooked me up with these guys, and sent an email bio to Bob and Jo at Rally Point.
That piece of getting the word out - every single one of us has the ability to have that conversation in our day-to-day. Just planting that little seed of somebody might need this down the road, they’re going to go back on that when they need it. It is ultimately up to that individual person to finally get to that space of, okay, I do need help, and I need to look at what my options are, do that research and find that.
Having that web page, having those other peers who are in the community who are talking freely about it, there isn’t that much of a stigma about it in that sense, because you are talking about it. The more you get that word out, the more that seed is planted, the more likely they’re going to seek that out. It took a year for me to have that seed planted to then finally following up on it, ending up here in Nova Scotia and being a resident.
THE CHAIR: Dr. Seagram.
BELINDA SEAGRAM: The best promotion by far is word of mouth. Word spreads quickly. We have a number of ways of disseminating information. We go to many conferences, national level and provincial level, do keynote speaking addresses. We get word out that way. We have quite a strong social media presence. We try to create a virtual community of support through PTSD Hero Comics, the idea of modeling what recovery could look like in an accessible way.
We do a lot of special initiatives. I guess this is also answering the first question - partnering with other government organizations, ESDC, VAC, ACOA, the Department of Communities, Culture, Tourism and Heritage, doing special initiatives so word can get out about special things that people can join and get involved in.
Nobody with PTSD puts up their hand and says, I’d like to join a group. We tell them that’s normal, that’s okay. Come in, we’ll give you a little bit of individual support. Let’s just start with a phone conversation. Do you want to come in? Do you want to do it in person? Let’s do it over Zoom.
If we can get them in, then we talk about the group. They all say no initially, but then we say: That’s okay, but FYI, people who do group programs in addition to individual get better twice as fast. It’s multi layers of reaching out, which we found to be most effective.
THE CHAIR: Mr. Grundy.
BOB GRUNDY: The missing element to help that people can get at the peer support level is the non-recognition by VAC and WCB that peer support is an effective way of helping people deal with mental health issues. Unfortunately, institutions with doctors have far more visibility because it’s evidence-based. Peer support is not evidence-based. It’s only been around since humanity has been around.
THE CHAIR: Ms. Calder.
JANE CALDER: I agree with a lot of the sentiments that Dr. Seagram said. Word of mouth is very important. We use that through our alumni network. We hold alumni events for veterans who have attended treatment, and it’s a great peer support network that they can stay connected post-recovery. A lot of the other ways that we put the word out have already been mentioned, like conferences, working with community providers and other veteran groups.
THE CHAIR: MLA Sheehy-Richard.
MELISSA SHEEHY-RICHARD: I just picked up on something that you mentioned, and I’m hoping that you can elaborate on it. I think I heard you say that you’re delivering virtual supports now too. I’m really happy to hear that, because sometimes the first step is not wanting to leave the home or come to somewhere that maybe seems not comfortable or safe. Can you provide me with a little bit more insight on the program, how it’s going, but more importantly the impact of the number of individuals you’re now able to reach?
THE CHAIR: Dr. Seagram.
BELINDA SEAGRAM: It was by necessity that we flipped to virtual during COVID. We were one week into COVID, and then the mass shooting happened. That was our primary population we’re serving. The number of people requesting services doubled, so we quickly flipped. We really had to adjust our service delivery model quite significantly, and found out ways of making experiential programming for people from their homes. It allows us to go into rural and isolated communities, and allows people who are not yet ready to step into buildings.
What’s been very interesting, though, is that since COVID, every single person who was in the online programs has been coming in person. They will frequently drive three hours to be there to say, “We want to see people, we want to have that shared space.” We doubled the number of people we were serving when we went virtual, but we’ve maintained it - most of them coming individually. If we have people who need that virtual program, we continue it as well.
THE CHAIR: Ms. Calder.
JANE CALDER: We offer three virtual programs. We call them Intensive Outpatient Programs. They are on Substance Use, Mood and Anxiety, and operational stress or Workplace Trauma. The benefits of that have been mentioned already - that you can really work with people who live in really rural, isolated communities. You do need a wi-fi connection, of course, so that might be an issue in parts of Nova Scotia because that has come up a few times. The benefit of that is you can work with people where they are in their home, and it’s a program that they can be involved in while they’re living their day-to-day life, if they’re working or looking after their families, or just being a part of their own life.
MELISSA SHEEHY-RICHARD: I was curious: Is it in group settings as well, or is it just one-on-one?
JANE CALDER: Yes, the programs I mentioned earlier are group programs. With each one of those programs, there are four days that are two-hour groups, and each week you have a one-on-one individual counselling session with a counsellor.
BELINDA SEAGRAM: We do both individual and group programming. Landing Strong is associated with Seagram & Associates. We work symbiotically and make sure people have the opportunity for both.
THE CHAIR: Mr. Nurse.
TRENT NURSE: We also do both.
THE CHAIR: Okay, perfect. Now we move on to MLA Jessome.
HON. BEN JESSOME: Dr. Seagram, you referenced the growing number of veterans who are uninsured. Can you expand a little bit more on how that restricts their ability to recover or progress, and how the coverage or support that Veterans Affairs Canada provides - how does that help in instances where these vets are not insured? I’m assuming you’re speaking to health insurance.
BELINDA SEAGRAM: Yes. What happens is if somebody would like to have services, they call. If they do not yet have a recognized condition, they have to be assessed. In order to be assessed, you have to see a clinician and go through this comprehensive assessment. We can do that for them, and we can do that quite quickly, but even after we submit it, there is generally a six-month to one-year wait where they’re processed. So they’re not eligible for any kind of group coverage during that time. They can often get some individual coverage, but no group coverage. That’s the norm, not the exception.
We have people who are in the military. They’re very much at risk. They’re transitioning out. There aren’t funds to pay for them to do programs while they’re in the military, or even if we’ll give them the programs for free, they’re often not allowed the time off to do it even though they might be in the transition units. I see them as being at particularly high risk as they’re reaching out, asking for help, and not necessarily being allowed to access it. Then they’re transitioning in to the VAC system and dealing with the delays there.
Even once we get coverage, for every single program they take, we have to find a case manager, write up an approval, get approval, and then we have to write a report after every single program, then ask for approval, and wait authorization for the next program. For each person going through, say, our series of eight programs, there probably are - there are eight requests for approval waiting for feedback, changing case managers, things getting lost. There are just so many levels of bureaucratic challenges that we face, it’s not uncommon that we’re waiting six months to a year after the program date to find out whether they’re even authorized to do it or whether we can get paid for it.
THE CHAIR: Would anyone else like to respond to that question - add to it? MLA Jessome, do you have a follow-up question?
BEN JESSOME: Yes, please, Chair. Thank you, Dr. Seagram, for that response.
Mr. Grundy, you mentioned as part of that - the subject of coverage for certain things. You recognize that peer support is not something that is covered or recognized as an approvable method of treatment by Veterans Affairs Canada and, I believe you said, WCB. Can you expand on that a little bit too, please?
BOB GRUNDY: We were told that because it’s not evidence-based - that was one of the shortcomings of peer support. I was then pointed toward the minister in charge of Veterans Affairs Canada who I talked to very early in our beginning. At that point, we were told that it was because we don’t have a number of some sort that CRA can quantify in some way and go, oh yes, there’s a number that we can hold responsible - or something along that line.
I anticipate what should happen across the country - and Nova Scotia will probably be the leader in this - is that we figure a way to make peer support facilities at a standard level that have the Mood Disorders Society of Canada peer support training or the MHI peer support training, since Nova Scotia has embraced MHI as one of its key factors for peer support. I would recommend that we have those agencies - and there were nine at the time when we talked last with this committee, six within Nova Scotia’s borders alone - who wanted to work as a collaborative team, so that if one location was not in a good spot for a peer, we knew of others we could recommend they check out, and would be able to take them on.
We’ve even had both psychologists and psychiatrists at Rally Point. We’ve asked them what more - what’s the next step. They pointed out to us that when you’re leading the way on something, it’s difficult to tell what’s missing, because it’s still being discovered. A well-known author and psychologist from Nova Scotia - an ex-military chap, to boot - pointed out that there needs to be more facilities such as Rally Point across the country, not fewer. Since we started in 2015, I’ve seen at least 18 start and fail, usually due to funding - sometimes due to the number of peers they can get to help build their numbers up to take care of it.
What we need to do is look at how to actually - I’m sure this is the wrong word - quantify peer support so that it has a level that’s accepted, so that we can have a standard. I hate going there, because that’s what we did in the military, but it seems to fit. We need a standard that these places would live up to. I’m sure this is what the facilities with doctors have to live up to already. I believe this would be a workable solution across the country, not just in Nova Scotia. Did that answer your question, sir?
THE CHAIR: MLA Ince.
TONY INCE: Thank you all again. My next question is open for just about anybody who can answer it.
I have a friend who, growing up, for years he experienced as a youth and a child the trauma that his father experienced being in the Second World War. It really had an effect on him growing up. My question is: Given the potential long-term effects of trauma exposure on children and youth, which specific programs are in place to ensure the support for families and youth of veterans is available? Can anybody give me an idea?
THE CHAIR: I saw Mr. Grundy’s hand up first.
BOB GRUNDY: I hope I don’t take up all your speaking time. Right from the outset of forming Rally Point Retreat, we recognized immediately - because we’ve got kids - that families are the collateral damage that are often invisible. The really cool thing is that they recognize something is not right before we do. So this is how we take care of this: We recognized that, and we set up a place in Rally Point itself for the kids. They have to know that they are not the problem. They’re not the reason that mom and dad fight, or parents or partners, I’m not sure what the correct term is. This white hair means I’m old. It really does.
To further that purpose, we’re in the process of developing a board-type game for families and friends of people living with PTSD - we already know the answers - for those people who live with them, so they can better understand what it’s like to live with somebody with PTSD. I’ll give you an example. In a huge room like this, and if it was your turn perhaps, honourable member, the person to your left would roll the dice for you. We’re not in control at all times, and the biggest way to show that is you need double sixes, but you don’t get to roll them. The guy next to you has to roll them for you.
THE CHAIR: Jane, I thought I saw your hand up.
JANE CALDER: We have a family program for anyone who’s enrolled in our programs. Unlimited family members, whoever they identify, can join the program. It is a virtual program, but we’re in the process of revamping it for members of the military, veterans, and other first responders right now. More to come there, but we do have a program right now that’s offered virtually. It’s a 12-hour program.
THE CHAIR: Belinda, I thought I saw your hand.
BELINDA SEAGRAM: We have a number of initiatives. We were very fortunate to receive funding from ESDC last year, which allowed us to go into the schools, and also host at our centre ongoing programs for children who’ve been identified as being at risk. Quite a few of our members, both sets of parents themselves have PTSD and are first responders or veterans. We immediately brought all those children into our community, so whether it’s at our March Break camp or ongoing series - those are the couples who are often coming to our Date Night series. Out of the 12 couples who come to the Date Night series, probably eight of them, both members had PTSD and were veterans or first responders.
It’s really something. We’ve had piecemeal funding for those kinds of efforts. We get the money, we roll with it, we take a breath, and we look - okay, where can we find the next piece to make the next program roll? The Care for the Caregiver series - we’ve been able to access funding through VAC for that where there are more intensive programs for caregivers. Also, we’ve been able to run them through the Emotions Management and Healthy Living programs - pretty extensive, ongoing support.
THE CHAIR: Mrs. Grundy.
JOHAN GRUNDY: We do embrace the family, because they do feel the effects of the PTSD. They can in turn transmit it down the family line. That is why, from the beginning, we have welcomed the families to Rally Point. Family is whatever family means to that person. Family is whatever family means to that person. It could be a spouse, it could be mom and dad, it could be a single parent with children, but welcoming them to Rally Point to find out, as Bob said, that they’re not the problem.
We found out many years later that our oldest daughter thought that she was the problem, and she wasn’t. It was the PTSD manifesting. It is a way that we can help the families, the spouses - whoever is the closest to the person with the diagnosis - understand the emotional, the physiological life with PTSD, and help them to learn coping mechanisms and methods that they can help their loved one.
One in particular that we use is using all five senses. If your person is triggered for whatever reason, look at the five senses. What did they see, what did they smell? Help them work through the triggers. The families need to know how to do that, not just mom, dad, whoever has gone to therapy and now they’re back and they’re okay. That’s just a piece of the puzzle. The rest of it happens at home and the family being able to say, I got this, I know what to do when a trigger happens - or knowing how to plan ahead a little bit. An event is coming up. Okay, a couple of days before, you start easing into the event and help that person with the PTSD to get through.
THE CHAIR: MLA Ince, do you have a follow-up question?
TONY INCE: No. Thank you all very much.
THE CHAIR: MLA Burrill.
GARY BURRILL: Dr. Seagram, I wonder if we could go back to this point you were making earlier about the inadequacy of VAC’s funding model. The situation described is not the usual we’re used to thinking about when we think about the public mental health system - that people would be funded for some one-on-one work, but not for group work. The common model in our public system is that people who often are dealing with depression and anxiety but not a psychiatric-type diagnosis can avail themselves of group work, but not one-on-one support. Often when people leave the public mental health system and go to the private mental health system, it’s in order to get the one-on-one services that they’re not funded for. It sounds like the opposite of the situation that you did.
I wonder if you could explain a little bit. How does this work? What is the rationale for this?
BELINDA SEAGRAM: I think it all has to do with at what point a member is deemed to have a recognized mental health condition, and the time it takes for that to happen, and the backlog and wait time on that. Once someone has that recognized condition, and if they’re assigned a case manager who will support the program - we have some case managers who are very supportive. We are a VAC-recognized program, but some are just not as hesitant. They’ll say yes to some, no to others - very hard to know. We actually find it easier to get access often when people don’t have case managers, and we can just go through the authorization centre.
It’s very case manager specific, and it has to do with at what point the system catches up with veteran needs. That lag time is generally 6 to 12 months after they’ve had their assessment. The assessment itself can take a couple of months to occur.
GARY BURRILL: You’re saying then that it’s less a clinical matter, a clinical approach, if I’m understanding you right, than it is an administrative problem and an administrative inconsistency.
BELINDA SEAGRAM: It is 100 per cent a funding-related concern. When people will reach out, we can set them up immediately with programs, and they’re hopping in immediately, but generally we can’t get the funding for them for a good year. We don’t get it retroactively, so we’ll give them often six months to a year of services and we just take the hit on that.
THE CHAIR: MLA Harrison.
LARRY HARRISON: My question is for Ms. Calder. Can you say a little bit about how your organization collaborates with the health care providers and the corporate partners? I’m assuming that they refer often to the programs.
JANE CALDER: Yes, we work with community providers. Any mental health provider, physicians, nurses, psychologists, social workers - anyone who would be working in the community - if they’re aware of our programming, they can make a referral to us. If it’s a veteran, we’ve talked about their access to funding. Usually, the veterans we work with have a VAC case manager. If not, we can help get that set up. It does take time - that’s correct. All of our programs are VAC approved, so once they’re referred to us, it’s quite easy to get them into our program.
THE CHAIR: Ms. Currin, would you like to make a statement?
COLLETTE CURRIN: My apologies, but I was wondering if you wanted me to add to what Ms. Calder had already mentioned about our Blue Cross program?
THE CHAIR: Yes, if you would like to - just to remind everyone that you’re still here and add you into the conversation, if you’d like.
COLLETTE CURRIN: Thank you. I believe Ms. Calder is covering it sufficiently. We work with the Canadian Armed Forces, RCMP, and Veterans Affairs Canada, and are put through highly stringent measures in order to achieve Blue Cross funding, based on accreditation and a bunch of staffing standards, et cetera, just to ensure that we can offer that consistent high level of service.
LARRY HARRISON: This collaboration approach - what is the impact on the numbers with respect to the collaboration approach?
JANE CALDER: I’m not sure what you mean by impact of numbers.
LARRY HARRISON: Well, the collaboration approach will bring people in. What is the impact of that approach with respect to numbers in the programs?
JANE CALDER: Do you mean how many referrals we get from the community?
LARRY HARRISON: Okay, yes. That would be one way of putting it.
JANE CALDER: I actually don’t have those numbers on hand, but I know we can provide that to you after, where referrals come from.
LARRY HARRISON: Would that represent the highest number, do you think, in the programs?
JANE CALDER: No, actually. I think most of our referrals come from our VAC case managers.
LARRY HARRISON: I just want to say that you guys are doing terrific work. My goodness. It’s so needed, and you have a passion for it, so thank you.
THE CHAIR: Mr. Nurse.
TRENT NURSE: I’d just like to clarify something for a second. Veteran coverage - you’re not going to be out until you’re diagnosed. I just want to make sure people know that. I noticed you were looking at - we were trying to get funding for veterans.
As a veteran, you’re going to be diagnosed before you’re released. That’s on you to get your coverage. I know guys are slow and don’t want to do it, but when you show up to their place, you should have your VAC number, your diagnosis and your condition before you even show up. I don’t know - maybe it’s different stuff they’re trying to qualify for, but at that point - you’re not a veteran until there’s a reason to be a veteran.
If you’re in the military, you’re not going to get kicked out for nothing, you know what I mean? You’re going to have a diagnosis when you get out. I just want to make sure you’re clear. They’re not kicking you out in the street without a diagnosis. You’re out for a reason. Then it’s on you.
The problem in the military is that you’re taken care of your whole life. You’re told to go here. You’re told to wear this; you’re told to wear that. When you get out, you’re on your own. You can’t walk into a building and say: My pay is screwed up. You’ve got to call people. Here’s the problem with veterans - we’re back to the PTSD again. We put it off - I’ll do it next week.
BELINDA SEAGRAM: I think you’re right. Many veterans are released with diagnosed conditions, but quite a few do not have them yet when they reach out. It’s not uncommon that we have people who’ve been out for five, six, ten years - hiding out, and they’ve never actually been diagnosed or properly assessed. They’ve not been released with any recognized condition. They’ve opted to leave, or they were kicked out. Often, they’ve opted to leave, or they’ve retired. It’s not uncommon, particularly with RCMP, but with many long-term serving veterans that their symptoms become more noticeable after their release, or because of fear of career impact, they’ve been hesitant to self-identify while still serving.
THE CHAIR: MLA Sheehy-Richard.
MELISSA SHEEHY-RICHARD: I had a few different questions, but the conversation sort of led me back to - what I have kind of seen, having a husband who’s a veteran firefighter, which is nothing compared to what folks are going through, but a lot of our local volunteer firefighters are retired RCMP, retired EHS, or retired military members. Just from being involved in that tragedy this past Summer, and being hands-on with the folks in the scene, I think what we’re seeing in Nova Scotia is that the trauma from service, and the trauma from volunteers, and the trauma from all of the things that these same individuals tend to be going on.
This is a very hard conversation to have today because what all of you are doing collectively is working collaboratively but separately, and meeting needs that tend to be getting more significant as life impacts are continuing. There are just so many levels that I see from some of the traumas, and how, when all this is happening, you talked a little bit about the family supports. I would like to know a little bit more about - and I’m not sure which of you would like to talk about it - how do you then support the families? That really piqued my interest because it’s very difficult. You can never, ever begin to imagine what they’ve seen. If Mr. Nurse wanted to start, and then maybe Dr. Seagram, they could give two perspectives on that.
TRENT NURSE: First off, I want to thank your husband for his service. Trauma is trauma. To us, three years or 30 years in military - regardless of when you come in the door. As far as family support, my wife - I knew my wife 30 years in July. She handles the wives more so. If a husband and wife come to peer group, and the wife drove the husband because of medical or whatever, or they’re on cannabis and can’t drive or whatever, they will come and sit with my wife, and have tea and they’ll talk. Basically, it’s a group therapy for them as well. That’s my aspect.
BELINDA SEAGRAM: Family support - you’ll have to help me here. I just got thrown off by this queuing thing.
THE CHAIR: MLA Sheehy-Richard, would you like to reiterate your question?
MELISSA SHEEHY-RICHARD: Sure, it was kind of long-winded. I do know quite a bit about your good work, being from my constituency, but I never really had a deep dive until you talked about the Date Night. Could you talk about some other examples? I like that idea of how the wives meet in their particular peer support group, but how do you do that programming for the families - what that looks like on a broader spectrum?
BELINDA SEAGRAM: It’s interesting - we have so many military members who are also volunteer firefighters. We have paramedics who are volunteer firefighters. The intersectionality is quite incredible. I would say that, actually, the poorest-funded people of the whole crew are definitely the volunteer firefighters. Forty per cent of the people coming to our program have zero funding. A large percentage of them are volunteer firefighters.
In terms of the programming, people just need to call and say they’re just looking for some family support. When we have specific initiatives, we can advertise them. It’s funding-dependent, but VAC has been terrific about funding the family programs for those with recognized conditions. They will fund the children’s programs and they will fund the families. Where we’re having to do a lot of freebies is for our first responder populations who often do not have coverage. I could give you a whole detailed thing of why the firefighter insurance policy does not work. That’s a whole separate discussion.
There’s a lot of free programming going on, just to make sure people aren’t turned away. I’d be happy to have a more in-depth conversation about the breadth of services.
MELISSA SHEEHY-RICHARD: How about an example - do you have one currently right now, a snapshot of today?
BELINDA SEAGRAM: The Care for the Caregiver series is continuously running, so as soon as we have enough people signed up, we launch a program. All of our programs, we never have wait-lists. The second we have 10 to 12 people, we launch. If we have 24 people signing up, we run two programs. We’ll run as many programs as we need to make sure there’s no need. Care for the Caregivers is ongoing, same with the Emotions Management and the Healthy Living programs. If we have family members interested in any of those, we will absolutely. We’ve had some organized groups coming to us and saying, hey, there are a whole bunch of wives’ associations here or partners. We’ve had adult children joining these groups. We’ve got a group of 12, we all know each other, will you run us a program? Absolutely, we’d be happy to do that for you.
Those are the ones immediately. The children’s programs, the Date Night and the family programs - those all ended December 2022 when our funding dried up. We’ve had a lot of requests for more dates, so I’m hopeful we’ll find funding sources for those.
THE CHAIR: MLA Jessome.
BEN JESSOME: I want to go back to the subject of peer support not being covered. I’m hoping that someone at the table can help elaborate on what work goes into establishing - I’ll use the word of Mr. Grundy - a baseline, or validation, that this type of treatment and support is a credible way to provide support.
Can anybody speak to how this - perhaps Dr. Seagram. Medicine and health care are fluid, so at what point does something gain the distinction of being a credible method of treatment? Does it require x-number of years to do a study? What sort of an organization would take that on? Maybe government is the entity to take that on, but maybe it’s somebody else. I’m just trying to understand the process of how it would get to a point where peer support can achieve the validation that the system appears to require.
THE CHAIR: I will start with Ms. Cook. She raised her hand first.
HEATHER COOK: Each of you has received a printout of some of our notes that we have there. If you look down into the value added to the lives of veterans section, there’s a note of a Mental Health Commission of Canada report that’s been done multiple times. I think the original one was in 2010, and it was revisited again in 2016. Within that 140-some-page document, there’s a whole bunch of evidence to show that peer support work and peer support workers serve a valuable role.
I think just the fact that the government is putting committees together constantly, year after year, making these reports and having these research sessions done, should show that it’s important that this needs to be implemented. I think the hard part is that step isn’t being taken now to actually implement it. How do we set up that standard? Nobody knows how to do that. I think that’s what we wanted to bring a light to: you recognize what that importance is, but there are no action steps moving forward into implementing it.
Rally Point has been running for eight years now. It’s coming out of his pension. It’s his home that he opened up - Bob and Jo’s home that they opened up - to anyone and everyone who’s served their country, and come out the other side of PTSD and trauma, and the effects of that. They’ve done everything they can to put that word out there. They’re getting some traction to have Nolan Young, the MLA for Shelburne, to back us and to get our voice heard. This is years in the making, and we’re still at this point of how we keep this sustainable and running.
These guys are doing it out of their own pocket. Each one of us who comes there, we’re there for free. That’s lovely, that’s amazing. I want to help out. I help out in a way of offering my service to help build trails, to help develop that community, and help build it and bring their vision to light. If you don’t know what Rally Point’s vision is, it’s huge. It is to help out with our transitioning members off the street, if they are out of housing. We’ve dedicated 202 acres of land that’s deeded to the Rally Point Society to build cabins, and have actual teams of veterans come out there, build those cabins, and give them that purpose to give back to their community.
We’re sitting back, trying to figure out how to get the funding we need for it. We keep going around in circles of the studies that are being done by the government. These reports are being written - 2010 they go back. That’s 12 years ago. How do we step forward and out of the circle?
THE CHAIR: Mr. Grundy.
BOB GRUNDY: When the Premier visited Rally Point, we had a discussion about it at the time. The River Valley Resilience Retreat people were in from Saskatchewan. They are making grounds that we have not had the opportunity to make, even though we have spoken to the head of the WCB in Nova Scotia. He authorized us at that time to work in collaboration with Saskatchewan - since they use WCB as well - are working with RVRR because they have more need to keep their first responders responding, and because their WCB is willing to work with them. In fact, they actually provided part of their setup money. We’re working in concert with them to try to make the same advancements in Nova Scotia.
THE CHAIR: Dr. Seagram.
BELINDA SEAGRAM: I think it’s an excellent question. I like to think of it as a large continuum. At one end we have peer support facilities, in the middle we have community-based non-profits, and at the other end we have hospitals. Somewhere in the middle we probably have more intensive in-patient programs.
I believe we work quite well collaboratively within this province. I think it’s a really positive spirit among all the organizations working together. We tend to refer people to peer-run facilities, they tend to refer people to us, we’ll refer to the in-patient. It’s all very collaborative. One of the challenges is the funding does not encourage collaboration. I think one of the hardest done by are the peer-run facilities. They’re often not eligible.
Once you have the presence of registered clinicians with registered health care numbers, you have oversight, you have a board of directors. You need quite a level of infrastructure to be eligible for grants. Even then, you often have to have charitable status, which is a whole other step. Being a non-profit alone isn’t enough. You often need to have charitable status. Then you’re eligible for grants.
We do program-by-program, hour-by-hour billing. We’re seeking to try to get program recognition so that we can get one authorization, and then we’re good for a year or two of programs. Some of the larger facilities have that ability to - I think probably to advocate a little bit or lobby more effectively with the government and get that one-stop-shop approval, so that someone can go to in-patient care for $60,000 or $100,000 a pop, where we’re trying to get hour-by-hour approval.
In my mind, one of the solutions is having more program-level funding and approvals across the continuum. It’s not only dependent on the people at this end of it, but that someone at a peer health branch is eligible for some level of funding, and someone who’s in a non-profit community-based care is also eligible, so there aren’t so many hoops to go through, and we can continue to work collaboratively with each other.
THE CHAIR: Mr. Nurse.
TRENT NURSE: Funding. Let’s talk about funding for a second. Mine is nonexistent. I run a little 50/50 - the Nova Scotia Veterans 50/50 Draw - and it comes out of my own pocket. People who come to our events actually donate, or whatever like that. I don’t charge. I’m not going to charge a veteran for their health care. That’s ridiculous.
As far as the big politicians and stuff like that, I met with every politician in the area. All they want to do is get a vote. Sorry, everybody in the room who is a politician, but the fact is that you don’t listen to what we’re trying to tell you at all. You have an agenda, and we have an agenda, and they don’t meet.
The problem is that we’re trying to help and I’m getting hindered every day by funding - funding, funding, funding. I am a charitable organization. I have charity status through a charity that we’re part of. It makes no difference. The way government has it set up now is that a person who only gets 80 per cent business - to get the company support, they get 20 per cent back of their donation. So if they give you $10,000, it’s only two grand they’re getting back. They’re not going to do it. That’s why you see, when you go to Walmart and these places, and they ask if you’ll give a dollar to charity - they’re taking that money and getting free money from it.
That’s my two cents on funding. It’s a nightmare.
THE CHAIR: MLA Jessome, do you have a follow-up question?
BEN JESSOME: Not right now.
THE CHAIR: MLA Craig.
STEVE CRAIG: Thank you very much for the open and honest conversation. Certainly, part of the Veterans Affairs Committee’s job is to help ensure that the military community feels as though they’re understood and respected. To your point about politicians, there are politicians around here, Mr. Grundy, who do indeed care. We just need to be able to demonstrate that in some fashion.
Certainly, I’ve been hearing a number of things. The trauma and its impact coming - we all experience trauma. No doubt about it. My dad, he talked about the thing that bothered him through his career was turning firehoses on those from Korea who were trying to escape. His job was to ensure that they didn’t get on board the vessel, for whatever reason. That is one instance that he told me about. Not anything else, but he told me that. I have a cousin whose husband was lost on HMCS Kootenay. That impacted our family greatly as well.
So trauma comes whether you’re individual or family member or whatever. It impacts us all. Again, what you’re doing is very important and very much appreciated by me.
The collaboration that was spoken of, versus competition - it took me back to: how do you get the word out? Word of mouth, and you’re working together to do that.
It was mentioned about the funding, and the Workers’ Compensation Board of Nova Scotia. I don’t know if you’re aware of it or not, but right now they’re undergoing a survey. I don’t know if you’ve taken advantage to get into that survey and express your thoughts on funding - and for peer funding in particular. Peer funding to me, as you say, we’ve been doing it since Adam and Eve, I guess. That makes sense. You didn’t have to empirically show that it worked. I’m a huge believer in it, especially when it comes to the military. You go in as an individual, you’re a teammate, you’re one of a unit. You work together. Your peers, you count on, you rely on them. Why would you not do that - look for that help in this case, in this part of your life? It makes perfect sense to me.
The question I have is around that continuum of support - the continuum not only of what’s available, but the individual on that journey through support from the beginning, to maybe the non-acceptance, to the full acceptance. At what level do you not need support? It’s rhetorical for me, but I’d like to have some of you express your thoughts on when does a member - a veteran - not require support any longer?
BOB GRUNDY: When we’re dead.
TRENT NURSE: I agree.
BELINDA SEAGRAM: I agree. I think it’s a life-long type of support we’re looking at. It’s not a one-stop shop.
JOHAN GRUNDY: I think there are waves, and there are times when you need the support - you need the input of your peers, you need that clinical boost. There are times when you’re feeling 10 feet tall and bulletproof, and you just go at the world on your own. But everybody needs a tune-up. Most definitely, it’s a life-long journey. There is no point where you can say, I’m good. Look out, because you don’t know what’s coming around the corner. That’s why the system is there. That’s why the continuum of care is there, so that when you turn that corner, if it isn’t what you expected, then you have people with you, behind you, and around you to help you buffer and continue to the next corner.
HEATHER COOK: I agree as well. It’s something that needs to continue all through life. The frequency of how often somebody’s reaching out for that will give you a good indicator of where they’re sitting and how they’re feeling. When you start noticing things going downhill and they start accessing it frequently, that’s also a piece for anybody working at Veterans Affairs to notice - okay, what’s happening? Let’s start checking in with them again and seeing what they need for support. It’s an indicator piece for you as well.
THE CHAIR: Mr. Grundy, you raised your hand?
BOB GRUNDY: I did. I’m hoping my brain is working satisfactorily at this point. That was a tongue-in-cheek answer. It was a true answer, but it was tongue in cheek. If, after a traumatic event has taken place - I’ve taken this information from the University of Maastricht in the Netherlands - within six months, if we could start treatment and recognize, we could actually get help to people so it did not become a life-long ailment. Unfortunately, it’s very difficult to catch you in the first six months. In the first responder community or in the military communities, it’s just difficult. Our own personal safeguards that we put up - our own shields, if you will - almost stop us from getting the help that we need.
The military, the first responders, the CSMs do their best following traumatic events to try to shortcut that, and get the help to the people. I’m not sure if you’ve noticed, but a lot of military people are alpha-type people. They want to advance, and we need these guys to advance. It’s very difficult for them to say they have a problem. Something significant has to trigger that first before they’ll recognize it, so the six months is usually not a containable number. However, if it was, yes, we could probably stop a lot of this that continues to happen to us. It just doesn’t go that way.
THE CHAIR: MLA Craig, do you have a follow-up question?
STEVE CRAIG: A comment. Your brain’s working fine from where I sit, sir, and tongue in cheek was very appropriate. I agreed with all of your responses, certainly the alpha side of it. My dad was a navy chief at 5’5” and a half. You’d think he was 10 feet tall.
The area of concern that I have - and I agree with you, Ms. Cook and others - it goes like this: on top of the world to the valley. That’s where I think peer support is extremely important. Family and peer support are extremely important. You don’t often know it. I want to thank you for all of your candid answers. Rest assured that you certainly have the support of a lot of people around this table. Chair, I’ll go back to you.
THE CHAIR: Mr. Nurse.
TRENT NURSE: I’d just like to agree with Mr. Craig. It is highs and lows - it’s a rollercoaster. I see people come in and they’re not treated. My wife can tell you, it’s like this. We want to get somewhere like this. It’s just little days. I’m not going to say I’m special or we’re special because we had PTSD and we want to be treated special, but the problem is that you’re letting a person who’s been trained in society that could - you know. That peer group is great for us. Someone says something and you see smiles around the room because everybody goes through the same thing. Usually you think you’re alone, but you’re not. That’s my take on peer help.
THE CHAIR: MLA Ince.
TONY INCE: The question I was going to ask I’m diverting from because Mr. Nurse raised something. This question will be open to everyone again. I’m just curious - I’ll just ask it. Has anyone ever experienced or seen or been aware of someone who has served, leaving and not getting a medical or an assessment?
THE CHAIR: Dr. Seagram.
BELINDA SEAGRAM: One of the reasons Landing Strong started when it did - it had been an idea for a long time, but I had a wait-list of people needing services. I found myself driving an active service military member to the hospital, concerned he was at risk for self-harm, and being turned away - advocating, saying he needed in-patient care, and it was declined. A year of lobbying, and he took his life two days before he was informed that he had been admitted to care.
Absolutely, there are people who are falling through the cracks. Like everybody else here - I took my mom’s inheritance, in my case, to start up Landing Strong because at some point, you’ve got to come to that decision where you realize this is just money and people’s lives are at stake.
I think everybody’s at the table because they have lived experience, and on some deep level it’s touched them personally. I think it’s been similar for everybody. Probably each of you has a deep personal interest in this topic or you wouldn’t be at the table with us. I suspect many of us have had that type of occurrence.
THE CHAIR: Mr. Nurse.
TRENT NURSE: Yes, there are people who can get a voluntary release from the military. They can put on the show, they can do a voluntary release. Six months later, out the door and you never see them again - and you find out. I have three people right now who are trying to change their category on release, which is fairly easy to do. You just need a professional to say they have PTSD that’s through military service, and we can get that changed.
Yes, there are people who do fall through the cracks, who are looking for help but don’t think the help is there that they want, because the PTSD is blocking their judgement of what they should have. Great question, by the way.
THE CHAIR: Mr. Grundy.
BOB GRUNDY: Timely question, very timely. Yes, since we’ve been operational, we’ve had a number of ex-members and vets come through with no coverage at all. The time that they left the military, it just wasn’t as prevalent as it is today. There’s a great amount of energy being expended to try to protect our service personnel to make sure they can leave almost the way that they came in - of solid, sound mind. Unfortunately, they’re seeing shit throughout the world that just ain’t good. I’m not too sure if there’s a more poetic way to put that, but those are the real words. The world’s getting worse, and they’re going to see worse and worse stuff, and after it’s been seen, smelled, heard, felt, it just doesn’t go away.
JOHAN GRUNDY: From our personal experience, if I can share, Bob was diagnosed with PTSD a number of years ago, and he was still serving. He continued to serve. Just dogged determination is what kept him going. It wasn’t until after he retired and suddenly did not have the grindstone to push against anymore, didn’t have the uniform to put on anymore, all of a sudden he looks in the mirror and wonders: Who is this person looking back at me?
We moved down to the country - so we were in a whole new area - and for the very first time, he wasn’t military anymore. He grew up in a military family, and then entered the military himself. Once all of that was stripped away, all of those little demons that had been put away in little shoeboxes decided to come out and play.
That’s what happens to a number of members, first responders, and RCMP. They can keep it up as long as the grindstone is there, but take that away and all of a sudden, the emotions come back. That’s where new purpose, new supports, and new help has to come into place to help them deal with their new normal. Yes, a number of them sneak out without the diagnosis, but it’s most definitely just waiting under the surface to come out.
TONY INCE: The original statement that talked about getting out, being diagnosed and you get your card, actually made me think back to 30 to 35 years ago. I’m just wondering - I asked that question because I was framing it 30 to 35 years ago. Is it still as prevalent today - people are getting out and not being medically assessed?
JOHAN GRUNDY: It hasn’t changed. The mentality in a lot of situations is hide it until you get out. Keep it under wraps. Don’t let anybody know because a lot of people feel that once word gets out that they have something wrong, then they don’t have the confidence of their peers anymore. That can impact their advancement. That can impact their families. If they’re holding on to get that one more promotion so that their family is set, and if they let somebody know that they’re hurt, their whole future plans can explode. A lot of people still come through the system and don’t say anything.
We had one gentleman who stayed with us for a year and a half. He got out on a regular release, but it wasn’t until he spent some time with us and got to find out what PTSD is all about to realize that he has it. He was able to go back through the system, get his diagnosis, and be able to move forward. He’d been out for years and didn’t want to admit to anybody that anything was wrong.
TRENT NURSE: That’s the unfortunate thing about the military - you get lost in the crowd sometimes. It’s unfortunate, but it happens.
BELINDA SEAGRAM: I do the assessments for psychological conditions for people who were diagnosed while they’re in and those who have not been. Of all the assessments that come to me, I see more people who were not previously diagnosed than I do people who were identified while they were in. I would say not being diagnosed is the norm, not the exception, in my practice.
HEATHER COOK: I was thinking about it, mostly because this next part is going to be a little personal too. I think the hard part was that - I’ll use myself as an example of speaking up, looking for help and trying to get that through the RCMP, which also covered through Veterans Affairs Canada. I had planned going 35 years with the Mounties, and a very significant incident happened very early in my career. I sought help. I looked out for that help. It was almost a deterrent for others to see how I was treated. I spent the last seven years of my career fighting health services because they put that stamp on my piece of paper and said, we need to move her out. The rest of my career was fighting to prove that even though I was diagnosed with PTSD, I was still able to do that job. They thought otherwise.
I can’t even begin to touch on any part of what happened through those seven years, but that has more lasting effect on my mental health than the original incident that caused that to even be a part of it. The damage that’s being caused by organizations not taking accountability for their actions is continuing this on, and it’s exacerbating the outcome. They’re letting go of members who don’t necessarily need to be let go, but also setting that precedent that if you speak out and you ask for help, you will be released - and not in a fun way. It’s huge.
THE CHAIR: We wrap up this committee at around 3:40 p.m. MLA Burrill is going to be the last questions of the day. MLA Burrill.
GARY BURRILL: That’s not very far from now.
THE CHAIR: We can stretch it.
GARY BURRILL: A pretty obvious theme, I think, from all of your presentations is the enormous healing power of peer-related work, and the failure of VAC to adequately recognize this. To someone who is hearing about your work from a distance, this is very strange sounding, since peer support work is not a new thing. The notion that peer support work has a powerful clinical impact - both in group and in one-on-one work - this is now a decades-old clinical understanding, a deep part of mental health strategies all around the world, including in our country.
Does anyone want to offer a comment? What is the problem at Veterans Affairs Canada that this is not recognized?
THE CHAIR: Mr. Nurse.
TRENT NURSE: Pretty short answer: Veterans Affairs Canada is an insurance company, and at the end of the day they’re going to try to save money.
THE CHAIR: Would anybody else like the opportunity to answer that question? MLA Burrill, you have enough time to ask one more question.
GARY BURRILL: No, that’s fine, thank you.
THE CHAIR: We are going to wrap up with nine seconds left. Would anybody like to make some closing remarks? We’ll start with Dr. Seagram.
BELINDA SEAGRAM: I just think it’s really important and helpful to think about - as you mentioned, Johan - recovery is very much not an event. It’s a journey. There are peaks and there are valleys. There are times for intensive clinical support, and there are times when peer support is perfect. That importance of us all working together and being funded in a way that allows us to work together is really helpful.
THE CHAIR: Mr. Grundy.
BOB GRUNDY: Thank you very much, all of you, for listening to us and taking in what we’ve had to present. I invite every one of you down to Rally Point Retreat to see exactly what a peer-support facility looks like. It is one of the models that is being touted across the country for others to try to start in their own provinces. Being as you are the Veterans Affairs Committee, it would be good for you to see where exactly you can recommend your constituents to at least sample having the effect of not only peer support, but of non-clinical support. We look nothing like a hospital.
Thank you, all, and stay safe.
THE CHAIR: Mr. Nurse.
TRENT NURSE: Your healing journey is what we call it. It’s your healing journey. I always tell my members, people who show up for advice: It’s your healing journey. Take charge of it. Don’t let the government - I’m not anti-government - don’t let people dictate your healing. You know your own body best. Your mind’s going to betray you, but you sort of get on track with the nurses, the doctors, and the peer group. Like I said, your healing journey - take all the advantages of everything you do, and make sure you get a good health care team. That’s all I say.
I invite anyone up to RAS. We’re an hour and a half from the city, and a half hour from you, Mr. Ritcey.
THE CHAIR: I would like to take this opportunity, on behalf of the committee, to thank all of the witnesses. This was very informative, very enlightening, and very powerful. I appreciate that. You are now free to leave.
We will take a five-minute recess. That means we will be back here at 3:47 p.m.
[3:42 p.m. The committee recessed.]
[3:47 p.m. The committee reconvened.]
THE CHAIR: Order. Now we’re on to committee business. Correspondence, I think you’ve all received a copy of the Strongest Families Institute and their request to appear before the committee. Is there any discussion?
STEVE CRAIG: The Strongest Families Institute is, I think, a wonderful organization. They actually reside out in my neck of the woods, and I’ve met with them a number of times. They do a lot of work virtually, and self-help for others too. I would like to suggest that we send this. First of all, accept the correspondence, and then consider having them perhaps at the next agenda-setting meeting that we have. Those are my thoughts. I don’t know if you need a motion for that or if we’re just having a conversation.
THE CHAIR: MLA Burrill.
GARY BURRILL: I think our system works well - that each caucus considers the things that they think would be priorities and brings them to an agenda-setting meeting. It seems to me, the place to refer this to is to the caucuses to see if they would wish to bring this forward in an agenda-setting meeting as one of the priorities that they would name.
STEVE CRAIG: I guess that’s something I didn’t think had to be said because I thought that was what would happen. If we take it forward to an agenda-setting meeting, then all caucuses would have before that meeting delved into this.
GARY BURRILL: I’m not disagreeing. I’m just saying I think it’s a good system that nothing comes before the committee unless one of the caucuses evaluates it amongst all the other important issues - this is one of the three, four, two matters that we would wish to bring forward. That’s our prioritizing system. I don’t see any reason why this submission would want to be in any system other than that one. I recommend it to the caucuses to make a judgement as to whether they would want to set it out as one of their priorities, then we’ll make a decision on the basis of those recommendations when we would do agenda-setting.
THE CHAIR: What I’m hearing from both MLAs is that this letter will be sent forward to their own individual caucuses for consideration. Is there any further committee business?
MELISSA SHEEHY-RICHARD: There wasn’t other business. Just as I was talking to the witnesses, the Workers’ Compensation Board link that was brought up, they asked if maybe the clerk could share the link for the survey that Workers’ Compensation Board has on their website. That way, we don’t have to track down their addresses. Maybe it could come directly from the clerk, if that’s possible.
THE CHAIR: Yes, we will make sure that they get a copy of the WCB program.
BEN JESSOME: At least a couple of different government members on a couple of different occasions have expressed some support for our caucus’s intention to try to expand the mandate of this committee to include military families. I’m wondering if the government could commit to bringing forward an update on the next steps for that at our next meeting.
THE CHAIR: I think that is something that the committee will take back to their caucus for discussion for the next Veterans Affairs Committee.
MELISSA SHEEHY-RICHARD: I’m just substituting today, so I don’t have details on that, and I think MLA Craig is as well. We can’t really comment.
THE CHAIR: MLA Jessome, do you find that a fair statement?
BEN JESSOME: No problem. I guess my intention would be to continue to ask that question until there’s some sort of an actionable, as was suggested would be sought after by members of the government who are on this committee.
THE CHAIR: Are there any other comments from any other MLAs? MLA Ince.
TONY INCE: My question - and I’m going to rely on those who’ve been at committees and everything else. We’ve just had a very powerful meeting with some stakeholders who had really highlighted the challenges around funding. I was wondering if this was doable. We are the only committee in the country. I was wondering if there was some possibility for us to reach out to other provinces to see if they might want to consider having a committee such as this - because of strength in numbers. They all have veterans. I don’t know if it’s doable. All of us having committees might give us more power to be able to provide some advocacy for those individuals or organizations that are being challenged with funding.
THE CHAIR: Just to be clear, MLA Ince, you’re asking us to reach out to other provinces for them to start up veterans affairs committees?
TONY INCE: To at least consider it, yes.
THE CHAIR: MLA Craig.
STEVE CRAIG: Thank you, Chair, and thank you, MLA Ince.
I’ve been back and forth on this, and I’d like to make a motion similar to, perhaps, what might accomplish the same type of thing - that would be a more direct approach, if you will. I’d like to move that the Veterans Affairs Committee write Veterans Affairs Canada relaying the funding administrative concerns of the witnesses who appeared here today around peer support services.
THE CHAIR: MLA Ince, do you have a statement toward that?
TONY INCE: I would agree with that, but again, it’s my only concern - and I just want it noted - that being the lone wolf, so to speak, they may ignore us. I was only trying to consider and look at it from a broader perspective - that if other provinces had a committee like this, all of us writing letters might get more movement.
I’m not disagreeing with you. I like your suggestion. I think we should move on it, but I would also like to add, is it possible for us to recommend?
THE CHAIR: I think those are two separate issues. We have a motion on the floor. I would like to call the question.
All those in favour? Contrary minded? Thank you.
The motion is carried.
We will write a letter to Veterans Affairs Canada to explain the information we have heard today in regard to funding and peer support.
In regard to MLA Ince’s question, we can direct the clerk, Tamer Nusseibeh, to reach out to see how that is done, and then come back to the committee to explain that, so we can have a clear understanding of our next steps, if that’s something that we all agree on.
The motion is carried.
Seeing no more communication. Knowing that we have two minutes left, I would like to get this out before we stop the clock.
The next meeting is December 19, 2023. The topic is The Impact on Veterans and Military Families Amidst a Cost of Living Crisis. The witnesses will be the Department of Community Services, the Department of Intergovernmental Affairs, the Emergency Management Office, the Halifax & Region Military Family Resource Centre, and the Nova Scotia/Nunavut Command of the Royal Canadian Legion.
Seeing no hands up, we will adjourn.
[The committee adjourned at 3:58 p.m.]