Part-Time Soldiers with Full-Time Injuries: A Systemic Review of Canada’s Primary Reserve Force and Operational Stress Injuries

Since 2002, the Office has been tracking the issue of operational stress injuries and the adequacy of the health care provided to members of the Canadian Armed Forces.

Report


Progress report on the status of recommendations:

Recommendation 1

It is recommended that the Department of National Defence and the Canadian Armed Forces improve the clarity and administration of Reservists’ entitlement and eligibility for health care, periodic health assessments and future Reserve employment by:

  • Completing the revision of Queen’s Regulations and Orders, Chapter 34 – “Medical Services,” that has been under review since 2009, to clearly identify all entitlements to care for all Reservists.
  • Incorporating the requirement for Reservists to undergo routine periodic health assessments (or to have their medical readiness determined) into the revised Queen’s Regulations and Orders Chapter 34 – “Medical Services” (along with associated policies and directives). Once this requirement is codified, ensure that the appropriate resources are in place to guarantee Reserve medical readiness.
  • Confirming in Canadian Forces Military Personnel Instruction 20/04 that Reservists whose Medical Employment Limitations so allow may be eligible to obtain new employment despite the existence of a temporary medical category.

Recommendation 1 status:  Accepted  Not implemented

The Queen’s Regulations and Orders, Chapter 34 is still under review with an expected completion date of September 2019. The target date for completion of the Canadian Military Personnel Instruction 20/04 is now summer 2018 (previously slated for spring 2018).

Recommendation 2

It is recommended that the Department of National Defence and the Canadian Armed Forces take measurable steps to improve the knowledge and awareness of the entitlements available to all Reservists, especially those who may be ill and injured, by:

2.1 Making any relevant documents, policies, procedures and forms easily accessible on the internet and on the Defence Information Network, and ensuring this information remains current.

2.2 Committing the resources required for the development and implementation of a communications plan. This would include activities, products, timelines and metrics to reach and inform Reservists.

2.3 Ensuring that training on entitlement to health care (currently provided by the Field Ambulance Medical Link Teams) is effective and mandatorily provided to Reserve units.

2.4 Ensuring that Reserve units have the appropriate number of training days to provide mandatory training to their members, and that such training is completed.

Recommendation 2 status:  Accepted  Not implemented

The new Military Benefits Browser developed by our Office will address the gap in information available online. A communications plan has yet to be developed and no information has been provided specific to training on entitlement to health care. No concrete steps have been taken towards implementing this recommendation.

Recommendation 3

It is recommended that the Department of National Defence and the Canadian Armed Forces strengthen the responsibility and capacity to follow-up with Reservists by:

3.1 Establishing a consistent and meaningful approach to contacting Reservists who are non-effective strength; especially those with a deployment history, and document the efforts made to reach them, even if unsuccessful.

3.2 Establishing an oversight mechanism to ensure the consistent completion of post-deployment follow-up activities at the unit level, and reiterating the responsibilities of the chain of command in this regard.

3.3 Flagging to the chain of command when a Reservist is non-effective strength and cannot be reached.

3.4 Ensuring that the Field Ambulance Medical Link Teams are properly resourced to effectively deliver their mandate.

3.5 Taking the necessary steps to fill all established mental health positions, and reviewing the mental health staffing requirements for the 2016 paradigm.

Recommendation 3 status:  Accepted  Not implemented

No action has been taken to strengthen the responsibility and capacity to track and monitor Reservists. We have insufficient information to determine whether the Field Ambulance Medical Link Teams are properly resourced. With respect to the mental health positions, Canadian Forces Health Services has seen an increase in the number of clinician and support personnel, currently 459, however, 31 vacancies remain. Canadian Forces Health Services also requested funding for 10 additional positions for psychologists and psychiatrists.

Next steps

The Office will follow up on the outstanding recommendations and provide an update in fall 2018.

Definitions

Accepted

DND/CAF have indicated that they accept the recommendations.

Not Accepted

DND/CAF have not indicated that they accept the recommendations, or have indicated that they do not accept the recommendations.

Met / Implemented

Work completed to date fully or largely meets the intent of the recommendation, including circumstances where the recommendation has been implemented to the extent demonstrably possible within existing DND/CAF authorities.

Partially Implemented

Work is underway to address the substance of the recommendation, and it is reasonably probable that additional progress will be made;

Work began to address the substance of the recommendation, but one or more aspects of the recommendation have since become objectively un-implementable or overtaken by events.

Not Met / Not Implemented

Work to address the substance of the recommendation has not begun;

Work completed to date does not largely meet the intent of the recommendation, work started on implementation of the recommendation.

Unable to Assess

Insufficient information is available to make an assessment, including in circumstances where DND/CAF has not yet provided adequate responses.


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