Record of Discussion – 27 October 2022

Thursday, October 27, 2022
12:00 - 14:30 (ET)

Mental Health Advisory Group Members

  • Dr. Maya Roth
  • Sergeant (Retired) Alannah Gilmore
  • Warrant Officer (Retired) Brian McKenna
  • Dave Gallson, Mood Disorders Society of Canada
  • Dennis MacKenzie, Brave and Broken
  • Dr Gail Wideman
  • Sergeant (Retired) Michael Blais, Canadian Veterans Advocacy
  • Trevor Jenneuve, Royal Canadian Legion
  • Colonel Helen Wright, Director of Mental Health Services

Regrets

  • Cyd Courchesne, Chief Medical Officer, Health Professionals Division (Co-chair)
  • Corporal (Retired) Victoria Jonas
  • Captain (Retired) Tarik Kadri
  • Dr. Don Richardson, Canadian Psychiatric Association
  • Sapper (Retired) Aaron Bedard
  • Dr. Karen Cohen, Canadian Psychological Association
  • Ed Mantler, Mental Health Commission of Canada
  • Captain (Retired) Robert Thibeau, Aboriginal Veterans Autochtones
  • Sonia Poirier, Office of the Veterans Ombudsperson (observer)

Office of the Minister of Veterans Affairs

  • Matthew Mann, Director of Parliamentary Affairs, Minister’s Office

Veterans Affairs Canada Officials

  • Julie Drury, Director, Mental Health (A/Co-chair)
  • Shannon Hartigan, Acting Director, Stakeholder Engagement and Outreach

Presenters

  • Danica Arsenault, Director, Reestablishment and Financial Well-being
  • Tammy MacWilliams, National Manager, Rehabilitation Programs
  • Cory Woodford, National Rehabilitation Consultant
  • Peggy Nash-Butt, National Rehabilitation Consultant

Opening Remarks in Plenary

(Members of all six Ministerial Advisory Groups met in plenary and both the Minister and the Deputy Minister of Veterans Affairs brought greetings and provided updates. The Assistant Deputy Minister, Commemoration and Public Affairs discussed procedural items and how to conduct the vote for a Member Co-chair. Members were then transferred to their individual Advisory Group meeting.)

  • The Deputy Minister welcomed the members and acknowledged that the land from which he was speaking is unceded Mi’kmaq territory; he also acknowledged the ancestral and unceded territory of all Inuit, Métis, and First Nations people and took a moment to recognize the importance of these lands that we all call home.
  • He thanked the members for their understanding given that the meeting was rescheduled from September to October. He also acknowledged the value of stakeholder feedback and highlighted the important role of advisory group members to contribute and influence positive change. The Deputy Minister then introduced Minister Lawrence MacAulay.

Remarks from Minister MacAulay

  • Minister MacAulay welcomed members, thanked them for their commitment, and acknowledged that the work of the advisory groups will make a real difference. He also highlighted that the advisory groups are a space to speak freely and share thoughts and ideas to help the Department live up to its commitment to respect and deliver care to Veterans and their families.
  • The Minister acknowledged the ongoing priority of reducing the backlog, which has decreased by 50 percent since 2020. He also highlighted the recent 43 million dollar investment to address the evolving needs of Veterans.
  • The Minister thanked those who helped secure Juno Beach as commemorative grounds and acknowledged their importance for education.
  • He highlighted the success of the new Mental Health Benefit, which offers automatic support to Veterans to ensure they receive the help where and when they need it.
  • The Minister highlighted key priorities from his mandate letter, including improving performance and client experience for Veterans and their families, ensuring Veterans have access to benefits and services, recognizing and commemorating the efforts of Veterans with a focus on underrepresented Veterans, addressing Veterans homelessness, and launching the Veterans employment strategy.
  • The Minister acknowledged that there is a lot more work to do, and that he and the Department value the Ministerial advisory groups as key assets in ensuring progress continues. He acknowledged the evolving needs of the Veteran community and wants to hear from members on how the Department can best serve Veterans and their families. The advisory groups were created to provide the Department insight, advice, and recommendations on the issues facing Veterans and their families, so it’s important that members speak freely. He then thanked members for their commitment and contributions.

Closing Plenary Remarks

  • The Deputy Minister thanked Minister MacAulay and then provided some additional updates and recent developments, specifically the unveiling of the final bronze caribou monument was unveiled in Gallipoli in September.
  • He addressed a recent news story on Medical Assistance in Dying (MAiD) and underlined that the Department took immediate action to apologize to the Veteran and immediately investigate.
  • The Deputy then provided updates on recent senior appointments at VAC, including Ken MacKillop, the new Associate Deputy Minister, and Pierre Tessier the new Assistant Deputy Minister of Strategic Policy, Planning, and Performance.
  • The Assistant Deputy Minister, Commemoration and Public Affairs, then spoke to procedural items concerning the terms of reference for the advisory groups and the in-camera selection of member co-chairs. She also referenced the Code of Conduct which members are expected to adhere to.
  • Advisory Group members were then transferred to their individual breakout rooms.

In camera selection of Member Co-chair

The group agreed by consensus that Alanna Gilmore and Dennis MacKenzie would share the member co-chair role.

Presentation: Rehabilitation Services and Vocational Assistance Project (RSVP)

The Rehabilitation Program team provided an overview of the project. The presentation included an overview of the current Rehabilitation Program service delivery model and some of its drawbacks. The RSVP project seeks to improve results for Veterans, including consistent high-quality service, timeliness, collaboration, and improved monitoring. To date, the project planning stage and pre-implementation stage have been completed, during which the vision was established and communicated and necessary operational changes were initiated. Currently, the project is in the implementation phase and participants will soon migrate to the contractor. The new delivery model will be fully on line and operational by January 2023. It is expected to result in faster access to high quality services, improved access to information, and tailored rehabilitation services.

Advisory group members asked questions and shared comments about the security of client data, clinic locations, the role of VAC’s existing OSI clinics, the referral process, the role of peer support, and supports provided by community organizations. The RSVP team indicated that Canada’s Privacy Act and federal IT security requirements will continue to govern the program and that the roster of clinics and other service providers---including peer supports such as OSISS and other NGOs—is continuing to grow to reduce wait times, and ensure there are providers identified close to where Veterans live.

A member noted that for many Veterans the biggest challenge in their rehabilitation journey is SISIP. Another noted that while some Veterans have high needs requiring clinical services, others need long term day-to-day supports, which should be part of the program. Another member echoed that each Veteran has their own background and a unique set of needs, such as access to services in other languages, including Indigenous languages, and consideration of the burden of traveling long distances for a short appointment. Members shared their interest in having services closer to them in community as well as virtual.

The RSVP noted that digital/virtual services will be included and that they would follow up with certain members individually to find out more about their concerns.

Presentation: Mental Health Strategy

Meeting co-chair and Director of Mental Health, Julie Drury, started the discussion by providing updates on a few key items:

  • The new mental health benefit that came into effect on April 1, giving Veterans immediate coverage for up to two years while their disability application is being processed. During the first seven months, 5,600 Veterans became eligible.
  • This is the 5th year of the joint suicide prevention strategy and action plan. The Department will be reviewing its accomplishments and looking ahead to what comes next. The Department is also working to reduce wait times for OSI clinic services and are exploring how to support veterans with virtual and e-mental health services.
  • With respect to the Directorate of Mental Health Strategic Plan 2023-2026, there will be an emphasis on e-mental health. There will also be consideration of intersections of mental health and substance misuse, (along with pain). The director also addressed the question of emerging treatments and the necessity for research and a clinical evidence base. The role of enhanced peer support (OSISS and MST PSP) were also discussed.. Advisory group members were invited to share their views. A number of comments were shared,
    • Emerging treatments are evolving faster than VAC already, including cannabis and psilocybin
    • Screening for suicide at all areas of hospital intake has helped to destigmatize and encouraged clinicians and patients to talk about it
    • 80% of patients at one OSI clinic are accessing care virtually. It would be helpful to have guidelines for virtual and/or hybrid; what is the optimal interval between in-person meetings in a hybrid situation
    • Data-driven decision making is not Veteran-centric
    • Often, using chat bots for instance, data doesn’t need to be collected to get a person the help they need
    • Come to veterans and stakeholders first---before the strategy is developed
    • There is a need to honour Veterans lost to suicide
    • Manitoba virtual peer support network is available in Indigenous languages; VAC needs to do better and look beyond English and French
    • Tap into existing successes; stop trying to reinvent the wheel.

Next Steps

One of the member co-chairs noted a number of themes that merit further discussion at a future meeting. These include

  • Digital health and telehealth to overcome the barrier of distance
  • Rehabilitation program – bricks and mortar clinics; inpatient and outpatient services
  • OSISS
  • Need to normalize some of the language: use “wounded”, not “injured”; “killed in action” not euphemisms.
  • Recognizing different needs: depending on gender and sex; combat vs other service, etc. while treating all veterans as such.
  • VAC offices – austere and cold, sand-coloured walls can be triggering, presence of security and glassed-in public areas at VAC are considerably less welcoming than passport office and other government offices; the need to make appointments are read as code for “don’t come in” and treat the Veteran like they are a threat.

VAC staff noted that the next meeting will be in person early in 2023 and committed to ensuring past recommendations of the MHAG are distributed to members.

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