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.”