‘Burnt out’

by **Accer** Sat 06 Nov 2021, 1:57 pm

Veterans Affairs staff swamped by number of vet cases assigned to them

By Lee Berthiaume . The Canadian Press
Posted November 6, 2021

This past June, Marie-Paule Doucette was asked if she felt she had enough time to help Lionel Desmond in the months leading up to Jan. 3, 2017 — the evening the Afghan war veteran shot and killed his wife, daughter and mother before turning the gun on himself.

The question came near the end of two days of testimony before the Nova Scotia inquiry examining the circumstances surrounding the tragic event. Throughout, Doucette had laid out the many challenges she faced as a case manager at Veterans Affairs Canada.

In particular, Doucette had shared a long-standing source of frustration and concern for veterans and their advocates, an issue Ottawa has repeatedly promised — and even now failed — to address: the sheer number of veterans assigned to case managers.

“This is not me dismissing Lionel Desmond or his problems, but he is one of anywhere from 35 to 40 people needing co-ordinated services,” Doucette told the inquiry. “I understand when you say things like: `Could you be more proactive?’ Of course I could, if I had 10 people on my caseload.”

Case managers help veterans with severe disabilities develop plans for their successful re-entry into civilian life after veterans leave the military for medical reasons. They are responsible for co-ordinating the different medical and financial resources needed for that transition. In 2018, a parliamentary committee found veterans without case managers had a harder time understanding what support is available.

“They’re your Sherpa,” says Jarrett Cranston, one of the more than 15,000 veterans with a case manager. Cranston was forced out of the military last year due to post-traumatic stress disorder after 15 years as a pilot. “They are your primary point of contact.”

When they were first elected to power in 2015, the Liberals promised case managers would not be assigned more than 25 ill and injured veterans. The pledge came after deep cuts by Stephen Harper’s Conservative government had seen the ratio skyrocket to a high of 40 to one.

The Liberals have doubled the number of case managers, but Veterans Affairs says they still, on average, have 33 veterans assigned to each of them. Virginia Vaillancourt, national president of the Union of Veterans’ Affairs Employees, says many have even more than that.

This past summer, the union surveyed those case managers about their workloads. The result: While a fraction reported having 25 or fewer veterans assigned to them, the majority had more than 35. Some had more than 50.

“So we know the caseloads are still excessive,” Vaillancourt says. Most case managers also reported feeling they couldn’t properly support veterans — and that their workloads or work situations had negatively affected their own mental health.

Meanwhile, an internal review released in 2019 found case managers spent more time filling out paperwork than helping veterans directly. The same report found most veterans saw significant improvements in their physical and mental health when they had case managers.

Steve Sykes is a former aviation technician and flight engineer whose 25 years working on military airplanes and helicopters left him with a long list of neck, back and knee injuries. Sykes says he doesn’t blame his first case manager for quitting in 2019.

“She basically wore herself out,” he says from his home in Calgary. “She burnt out because of dealing with us, which I can understand. I never knew at the time what a case manager’s caseload was or what they were dealing with. But I kind of got it.”

He added: “I couldn’t even imagine having 40 or 50 people like me to deal with on a regular basis.”

Meanwhile, Sykes says he was unable to get the help or treatment that his case manager was supposed to set up. That added to his tension and stress. Eventually, his relationship with his girlfriend ended.

Cranston has similar stories about calls not being returned. When they were, he recalls fighting with his case manager over the nature and extent of his injuries _ and the needed treatments.

“So that was a case where bad communication between a case manager and a veteran led to delays in services, denial of services,” he says. “And if nothing else, increasing my PTSD and my anxiety.”

Cranston now has a new case manager who is much more responsive, but he says he had to wait four months to get one.

“I don’t want to say it’s a slap in the face, but it kind of is. Like you’re asking for help and you’re being told: `No, sit down, shut up and wait. We’ll get to you when we get to you.”’

An internal presentation prepared for senior officials last year and obtained by The Canadian Press through the access-to-information law describes the “political commitment” of 25 to one as “the elephant in the room” and “one of our biggest challenges.”

Not only has the department failed to achieve that target, added the September 2020 presentation, but the ratio is “not based on true complexity” of cases. In other words, two case managers could have the same number of veterans but still have different workloads.

Veterans Affairs says it remains committed to reducing the number of veterans per case manager, with the 25-to-one ratio still the notional target.

But when asked what it is doing to meet that target, the department said it is working to better match veterans to staff based on their level of need. It also said it is working on ways to ease the administrative burden on case managers so they can spend more time with former service members.

“The goal is always to ensure veterans are provided the appropriate level of assistance to meet their needs when they need services,” Veterans Affairs spokesman Marc Lescoutre said in an email.

Back at the Desmond inquiry, Doucette said she was given the former soldier’s file six months after he had asked for a case manager. She also spoke of the challenges of trying to help dozens of veterans at the same time before she left in 2018.

“We were always told from the beginning that VAC’s aim was 25 veterans to one case manager. Unfortunately, that’s not something that I’ve experienced.”

Global News

by Garrison Thu 11 Nov 2021, 9:16 pm

Veterans Affairs case managers are feeling 'overwhelmed, frustrated,' says union president

Nov 11, 2021

by **Vizzer** Sun 14 Nov 2021, 4:40 pm

Excessive workloads hurting veterans and staff, former case manager alleges

Published Sunday, November 14, 2021

OTTAWA -- A former case manager with Veterans Affairs Canada is speaking out about the overwhelming caseloads, lack of support and toxic work environment that she says are putting severely disabled veterans at risk.

"It's hard to put your head down at night and feel like you did your job properly," Lucy Hirayama told The Canadian Press in an interview. "You're there to help the veteran, and you can't help them because you're overloaded with work."

Hirayama's decision to come forward follows a series of articles by The Canadian Press that looked at some of the most pressing challenges facing veterans today, including the large number of former Armed Forces members with complex needs assigned to individual case managers.

The series referenced testimony from the Lionel Desmond inquiry in June from Desmond's case manager about the challenges she faced as she juggled dozens of files before the Afghan war veteran shot and killed his wife, daughter, mother and himself in January 2017.

It also included firsthand accounts from some of the 16,000 ill and injured veterans with case managers about the added difficulties they have faced, in large part because the people tasked with helping them are too busy to respond to requests for assistance.

Yet while the problems are well known within Veterans Affairs, Hirayama says not enough is being done to address the issue and support overworked case managers before they themselves burn out and leave.

"You go into a workplace because you want to help people," she said from her home north of Calgary. "And we end up becoming so damaged working in that toxic work environment that we walk out of that place with mental-health problems ourselves."

Hirayama joined Veterans Affairs as a case manager in Edmonton in May 2019 after seven years as a federal parole officer. She says she was told at the time that she should have no more than 30 veterans assigned to her, but that did not prove to be the case.

"The average caseload is not 30 by any means," she said. "It's about 50 in the Edmonton office. It's about 50 to 60, and that's normal."

The Liberal government promised in the 2015 federal election to reduce the number of veterans assigned to individual case managers to an average of 25 to 1, after the number topped 40 to 1 under the Conservatives. Six years later, the promise remains unfulfilled.

Veterans Affairs says the average case manager across Canada has 33 veterans assigned to them, while those in the Prairies have about 37 clients on average. The Union of Veterans Affairs Employees, which represents case managers, says the real numbers are much higher.

One of the consequences of those excessive caseloads is that the department's 425 permanent and 50 temporary case managers often don't have time to properly monitor and talk with at-risk veterans, said Hirayama.

"When a veteran is saying `I need emergency funds,' at that time it's the case manager's responsibility to kind of take a step back and say, `Okay, well what's happening here in your file right now that you're falling behind,"' she said.

"If a case manager has the time to go and be an advocate for that veteran, a lot of times maybe the whole situation could have been avoided."

While case managers are expected to check in with veterans in person as much as possible, another consequence of the crushing workload often sees workers assigned to veterans who are not in their area. Hirayama recalled handling the file of one particular veteran who lived several hours away.

"This veteran was suicidal, and if I was in the same city, I would have made sure that I would have gone and met him and had a little bit of face-to-face time," she said. "A lot of times that can really defuse a situation like that as well. But you can't do that."

Hirayama said case managers face other problems, including a lack of training, poor computer systems and excessive paperwork. But she says many ultimately burn out because of their caseloads, which puts even more of a burden on those who remain.

"The staff turnover rate is horrendous because of the fact people get there and can't do their job," she said. "Then they leave and you get dumped with these really challenging clients. And that's why they need case management, because their cases are so challenging."

The UVAE surveyed case managers earlier this year, with the vast majority saying they couldn't properly support veterans and that their workloads or work situations had negatively affected their own mental health.

Veterans Affairs Minister Lawrence MacAulay has said the government will hire more case managers, as the Liberals promised during the most recent election, but has so far refused to provide any other specifics, including when and how many.

The department says it is implementing several initiatives to improve efficiency and reduce the administrative burden, all of which will help reduce the case management ratio. It adds that a recent survey found three in four veterans are satisfied with the service they have received.

Opposition parties, veterans' advocates and others have nonetheless called on the government to immediately address the shortage of case managers at Veterans Affairs.

Hirayama says she went on sick leave in January 2020 after an incident with a veteran triggered post-traumatic stress disorder from her previous job. She officially tendered her resignation earlier this month.

She said she feels free to speak out now that she left , but many others are afraid to come forward because of the potential professional repercussions. She's hoping that by speaking out publicly, Canadians will demand action.

"What are we risking? Are we risking the lives of more veterans again?" she said. "To me, this is very much life and death for a lot of them."

https://www.ctvnews.ca/politics/excessive-workloads-hurting-veterans-and-staff-former-case-manager-alleges-1.5665801