ARCHIVED - Response from the Chief of the Defence Staff on the Office's Case Study on the State of Mental Health Services at CFB Petawawa

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27 October 2008

Mrs. Margaret Brandon
Director General Operations
Office of the DND/CF Ombudsman
100 Metcalfe Street, 12th Floor
Ottawa ON K1P 5M1


Dear Mrs. Brandon,

Thank you for your letter of 8 August 2008, which offers me the opportunity to comment on the Ombudsman Case Study related to health services at CFB Petawawa, prior to your report being finalized.

The CFB Petawawa case study report was reviewed in depth by the Chief Military Personnel (CMP), the Director General Personnel and Family Support Services, the Surgeon General, and the Chaplain General. Consolidated comments on the recommendations made in the report are enclosed.

I note that your report is based on a visit that was conducted by the former Ombudsman in November of 2007. Around the same time, similar concerns were being raised within the army leadership, notably the difficulties that CF personnel at CFB Petawawa were experiencing in accessing mental health services. Subsequently, CMP and the Surgeon General thoroughly investigated the CFB Petawawa situation and they instituted a number of changes that address recommendations in your report. 

I am pleased to report that “caring for families” has become a key CMP priority and will certainly remain so for the next few years. In that regard, I will be implementing initiatives that are intended to provide a more structured spectrum of family support services that are also better integrated to existing federal and provincial programs and mandates.

Once again, I am glad for this opportunity to comment on your CFB Petawawa health services case study. Should you have questions or matters you wish to raise, please feel free to contact the Office of Major-General Semianiw, CMP.


General W.J. Natynczyk

Enclosure: 1

DND/CF Comments on the Recommendations – Ombudsman Interim Report: “Ombudsman Case Study: Health Services at Canadian Forces Base Petawawa”


1. The Canadian Forces take immediate action to match the numbers of care provider positions to the needs of Canadian Forces Base Petawawa given the size, activity and location of the base.


In 2003/2004, under the auspices of the Mental Health initiative of Project Rx2000, a detailed analysis of the mental health resources required at each CF health care centre was conducted. The allocation of professional and support staff at each location was calculated using a formula based on the population served. The following table depicts the military population of Petawawa, Valcartier, Edmonton, and Ottawa at the time of the initial project analysis with the corresponding requirement for psychiatrists and clinical psychologists and total mental health staff. Valcartier, Edmonton and Ottawa were allocated more staff owing to the fact that they also function as regional centres that provide specialized secondary mental health programs including an Operational Trauma and Stress Support Centre (OTSSC). Petawawa receives this secondary support from the Ottawa clinic and OTSSC.  

BaseBase Population (2004)PsychiatristsPsychologistsTotal MH Staff by 2009
Petawawa 4464 2.2 4 3.7
Valcartier 5940 3.2 9 45.2
Edmonton 4443 3.3 5 38.3
Ottawa 6136 3.5 6 38.5

The original Rx2000 plan for Petawawa identified a requirement for 31.7 staff to be in location by 31 March 2009. As of August 2008, the Petawawa clinic has 18 mental health staff in place. Hiring the additional complement of mental health care providers has been challenging because of a Canada wide shortage of mental health professionals and the fact that it is difficult to recruit professionals willing to re-locate to a small and relatively isolated location such as Petawawa. Innovative hiring practices to improve the success in recruiting mental health professionals, such as flexible hours, higher salaries, and a signing bonus, have met with minimal success. A concerted effort to hire additional staff will continue.

In the interim, an additional military Social Worker was posted to Petawawa and more military staff will be posted to Petawawa as they become available (e.g. a military Psychiatrist will be posted to Petawawa in 2009 once they have completed their studies and obtained their certification to practice). In addition, the Ottawa mental health clinic has augmented their support to Petawawa. For example, a military psychiatrist visits Petawawa one day per week to provide general mental health services; and, a social worker, psychologist and civilian psychiatrist from the OTSSC program in Ottawa visit Petawawa two days per week on a three week rotation schedule to provide therapy. The Ottawa clinic is also developing a tele-psychiatry capability to augment local services in Petawawa and other sites.

2. The Canadian Forces establish and resource an organization – at the national level – responsible for working with external agencies and all levels of government, as required, to ensure that military families and individual members of the families of military personnel have access to the broad spectrum of services and care they need.


The CF will continue to foster its relationship with other federal government departments, provincial health ministries, and other agencies or organizations involved in the delivery of mental health services and programs to the families of military personnel. The Chief of Military Personnel, through his Director General Personnel and Family Support Services, will have the responsibility for developing these linkages.

To support the execution of these (and other) responsibilities, and as part of a broader plan to enhance military family services, Director General Personnel and Family Support Services will establish a CF Family Secretariat at the national level. The CF Family Secretariat will assist families in their navigation of services and resources, identify emerging and systemic family issues, and liaise/advocate with external agencies and all levels of government as required.

To support CFB Petawawa in determining family mental health requirements and gaps, Director General Personnel and Family Support Services staff convened a meeting in Petawawa in July 2008 of all relevant family mental health stakeholders. Attendees included Ontario ministry officials, staff of Veterans Affairs Canada, as well as local community and CF mental health service providers. Director General Personnel and Family Support Services are using the results of this consultation to continue to support the community’s efforts in ensuring a spectrum of care for families of military personnel.

3. The Canadian Forces provide the permanent resources – at the local level – that would enable Canadian Forces Base Petawawa to liaise with local agencies and municipal governments to identify and to coordinate the care required by and available to military families and family members of military personnel.


Director General Personnel and Family Support Services provides public funding to the Petawawa Military Family Resource Centre to assess community/family need, maintain a comprehensive listing of resources in the local area, and identify gaps in services as they become apparent.

In addition, as part of the broader plan to enhance military family services, Director General Personnel and Family Support Services will fund a family liaison officer through Military Family Resource Centres to support the work of the Joint Personnel Support Units currently being established at a number of CF locations, including Petawawa. These personnel will be key to identifying and coordinating family care at the national level.

4. The Canadian Forces find interim approaches to providing sufficient local health care while waiting for long term solutions to take effect.


As previously stated, the Ottawa mental health clinic has developed a number of interim solutions to augment their support to Petawawa. This includes sending a military psychiatrist to Petawawa one day per week, and sending a small team from the OTSSC to Petawawa two days per week on a three week rotation schedule. Another initiative which is being developed to augment services at Petawawa is telepsychiatry. The Surgeon General will continue to monitor the requirement for additional support to Petawawa.

5. The Canadian Forces provide resources for additional paid administrative and program assistance to enable the chaplains to minister more effectively to the spiritual needs of military personnel and their families.


Unlike Health Services, which are centrally controlled by DGHS, Chaplain Services is not. Every chaplain position and all resources related to the provision of chaplain services are owned and controlled by local commanders. A requirement to add additional resources needed to provide more comprehensive services must be resourced at the local level. Additional resources for administrative and program assistance to be utilized by the chaplain team as identified in the Interim Report would be a local requirement for a commander and would require planning in the normal process leading up to the deployment.

During every pre-deployment planning phase, senior chaplains at the operational and strategic level are engaged in receiving information from and advising tactical level chaplains in how the rear-party chaplain team will maintain an acceptable level of chaplain services to base and units, including programs and activities in base chapels. Since the commencement of Task Force Afghanistan, chaplains at all levels have advised commanders of the need to maintain quality level services in chapels and on bases. Without exception, commanders have provided extensive financial resources to chaplain leaders in order to augment the chaplain team while unit chaplains are deployed. Consistently and without exception, commanders have given whatever resources chaplain team leaders have asked for, resulting in a one-for-one hiring of Reserve of Civilian chaplains to replace the deployed padres. This fact should not be lost in the midst of what is being presented in the recommendation made by the Ombudsman.

Military chapel programs are coordinated and run under the direct leadership of the senior chaplain. By its very nature as a faith-based community, chapel programs are run by volunteers who are members of the chapel. This is a central pillar of any faith-based community, civilian or military. While the Ombudsman suggests that the CF provide financial resources to augment the volunteers who are deployed, the reality is that this would be a very difficult reality to put in place and could provide considerable unforeseen challenges with other volunteers. Chapel communities are unique entities on military bases. What might seem like a solution from a macro viewpoint, in reality could cause serious problems in the long-term. As with any organization, once a program is put in place it quickly becomes an expectation. To suggest that chapel programs should be run by salaried personnel, even on a part-time basis, would fly in the face of what a faith-based community is and how it functions in support of its membership. Military chapel communities are a dynamic part of what chaplains provide to military members and their families. The civilian equivalent does use paid professionals to run programs, but only in the very large faith communities. Rarely do small communities have the ability to fund these programs and certainly military chapels are so small that due to numerous issues, it may not be a viable option.

Despite the concerns presented above, chaplains at the local level are able to identify resources required to provide a high quality of services to military families. The concerns and recommendation expressed in the Ombudsman Report can be forwarded to team leaders who can seek whatever resources are required to maintain the chaplain services required, including resources required to run chapel programs. Experience shows that commanders at all level of the chain-of-command are always eager to provide whatever resources chaplains require to maintain a high quality of chaplain services.

6. The Canadian Forces establish a clear governance structure, with clear responsibilities and accountabilities, for the provision of effective and efficient multi-disciplinary care for military personnel and their families at Petawawa.


The governance and functioning of the mental health services in CF clinics has been reviewed and is now well defined and has been communicated to clinic leadership and professional staff. The issue in Petawawa at the time of the Ombudsman’s visit was related to a work place conflict primarily involving one employee who no longer works in the Petawawa clinic. In addition, a Major Social Work Officer was posted to the clinic in February 2008 to provide clinical leadership which has alleviated the stressful work environment that had existed. In 2009, a military psychiatrist will be posted to Petawawa to provide additional professional leadership and clinical capacity. From a national perspective, the Surgeon General is nearing completion of a mental health professional – technical governance directive that will clearly codify the interdisciplinary principles and oversight for mental health services.

7. The Canadian Forces take positive action to assist the members of the care giving communities at Petawawa to re-build interpersonal and inter-speciality relationships that are courteous, respectful, trustworthy, cooperative and supportive.


The Surgeon General became aware of the interpersonal and unprofessional conduct of a select few mental health care providers at Petawawa in September 2007 and subsequently ordered a Staff Assistance Visit (SAV) to the clinic. The SAV team identified issues that required corrective action by the CF Health Services Group chain of command. Corrective action was taken that included the dismissal of a staff member, appointment of a new clinical leader, and increased oversight from the mental health clinic and OTSSC in Ottawa. There are also plans to post a military psychiatrist to the clinic in 2009. In addition, the Deputy Surgeon General and senior mental health staff within CF Health Services Group HQ is monitoring the situation closely. Workshops are being planned to help staff develop skills to work in teams. For example, the focus and theme of the national CF Mental Health training workshop being held in Toronto in February 2009 is “Interdisciplinary Care” and role development. The staff at Petawawa will also be receiving a 4 ½ day educational program on Cognitive Behavioural Training in September 2008, delivered by McMaster University.

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