MPs push government to take action on PTSD in Canadian Forces

Reprinted with permission, The Hill Times, July 20, 2009

Some four per cent of Canadian Forces indicated signs of PTSD, 4.2 per cent depression, and 5.8 per cent either PTSD or depression.

By Cynthia Münster
The upper echelon of the Canadian Forces last month launched a national campaign to shed light on post traumatic stress disorder, but Liberal MP Bryon Wilfert says Canadian soldiers returning home from Afghanistan with operational stress injuries and PTSD, in particular, are falling through the cracks of the system and the government still hasn’t officially responded to the Defence Committee PTSD report.

Mr. Wilfert (Richmond Hill, Ont.), the vice-chairman of the National Defence Committee that recently issued a report on PTSD, said that in its study the committee found there are better treatment facilities and opportunities in Western Canada than there are in Eastern Canada, and reservists are less likely
to receive mental health assessments and attention than Canadian Forces personnel living on bases. He said that government should respond as soon as possible
to the report in order to improve care for the soldiers.

“Clearly, there was better treatment facilities and opportunities in Western Canada than, say, in Eastern Canada for whatever reason. In part that might be because in Alberta they’re closer to cities like Edmonton, whereas in Gagetown [New Brunswick] or Petawawa [Ontario] it’s further away, so their facilities
or support was not as good,” said Mr. Wilfert.

The government has 120 days to officially respond, but a week after the committee released its report, on June 25, Chief of Defence Staff Gen. Walter Natynczyk and Defence Minister Peter MacKay (Central Nova, N.S.) launched the Canadian Forces Mental Health Awareness Campaign, following the committee’s first recommendation
that senior Defence and political personnel address the stigma surrounding mental health injuries in the Armed Forces.

“You’re strong, you’re well-trained, but guess what? We don’t show weakness particularly well and therein lies the problem,” Gen. Natynczyk told an assembly at DND headquarters. “We’re tough and yet we won’t ask for help.”

“Not all injuries are visible and we have to be very open about that, to come out of the shadows to embrace the treatment of these very real injuries,” said Mr. MacKay on the launch of the “Be the Difference” campaign.

The number of soldiers affected by PTSD remains largely unknown, however, the Canadian Forces have the results of 8,200 screening questionnaires. Some four per cent of the respondents indicated signs of PTSD, 4.2 per cent depression, 5.8 per cent either PTSD or depression and 13 per cent were consistent with any mental health diagnosis. These percentages were then applied to the total number of personnel deployed by the Canadian Forces in order to estimate
the number of operational stress injuries the CF could expect of this mission.

Given past PTSD statistics, the report estimates that out of the approximately 27,000 Canadian Forces personnel deployed to Afghanistan since 2002, approximately 1,120 could exhibit PTSD symptoms, 1,176 depression symptoms, 1,824 could show signs of one or both conditions, and 3,640 could exhibit a mental health
concern of some kind.

The report, entitled “Doing Well and Doing Better: Health Services Provided to Canadian Forces Personnel with an Emphasis on Post-Traumatic Stress Disorder,” is the result of a committee study started in February 2008 and reiterates some of the recommendations and general findings of a February 2002 special
report by the Canadian Forces ombudsman, and the ombudsman’s subsequent follow up in December of that year.

The auditor general also looked at the military healthcare system in 2007 and issued some similar recommendations, says Canadian Forces captain Fred Doucette. Mr. Doucette wrote the book, Empty Casing: A Soldier’s Memoir of Sarajevo Under Siege about his experience in Bosnia and his subsequent struggle with PTSD. He now works providing peer support to CF personnel and veterans suffering from PTSD in New Brunswick and was a committee witness. He said many of the
report’s recommendations are similar to those of previous reports and some of them are currently being implemented but “it may be another poke in the ribs.”

“If two people tell you something’s wrong and then three people, four people, you say, ‘Oh, god, I better look at this,’ so it’s more ammunitions in the pouches of the people who are pushing for more support for the troops on the mental health side,” said Mr. Doucette.

Conservative MP Laurie Hawn (Edmonton Centre, Alta.), the Parliamentary secretary to the minister of National Defence, said Canada has probably “the best system in the world” but no system is perfect and everybody, including Mr. MacKay, Gen. Natynczyk and all committee members, are on side for making the military health system “the best it can possibly be.”

“We’re continually making improvements, we’ve opened 20 joint personnel support units across the country, there’s 32 military resource centres, we’ve got 350 mental health professionals working full time, we’re continually trying to hire more, those people are hard to come by and that’s not within the CDS, that’s in society generally there is a shortage of those kinds of folks. So we’re competing with everybody else in that regard, so it’s a continuous process,
we’re continually looking for ways to improve it,” said Mr. Hawn.

The report and campaign come at a time of increased media interest into mental health issues in the Canadian Forces and the ongoing investigation into the suspected suicide of Major Michelle Mendes in Afghanistan last April. Last week Private Sébastien Courcy was the 126th Canadian soldier to die in Afghanistan, who was killed Thursday during a firefight between NATO forces and Afghan insurgents.

According to an EKOS poll that came out last week, support for the war in Afghanistan is slipping, with a slight majority of 54 per cent of Canadians opposing the war and 34 per cent supporting it. Opposition is higher than support in all provinces and strongest in Quebec, where 73 per cent of respondents oppose the mission and 15 per cent support it. Alberta had the strongest support for the mission at 42 per cent, while 45 per cent of respondents opposed it.
EKOS conducted the poll between July 8 and 14, 2009, surveying 2,713 Canadians from across the country over the age of 18. The margin of error for the survey is plus or minus 1.9 percentage points, 19 times out of 20.

Mr. Doucette said there have been many changes over the past few years, and a big difference from the late 1990s and early 2000s, when soldiers were released from service when they showed signs of psychological injury, “they weren’t considered ‘soldierable’ anymore and they were punted,” he said.

But despite increased attention and understanding, the stigma around mental illness in the Armed Forces still lingers.

“As long as soldiers have been soldiering, there’s been mental stresses and problems that go with what soldiers do. A lot of people say for one physical casualty there’s 10 that have a mental health injury and I think their biggest challenge is to change the atmosphere or whatever hindrance there is for those soldiers who are suffering to step forward,” said Mr. Doucette.

“A lot of them won’t open their mouths in fear of being judged, or maybe not being promoted, or maybe losing their job, there is a lot of unknowns that go with it so that’s the biggest thing. You can create the best facility and everything, and the best support, but if they don’t want to walk to it and step in and say, ‘My head hurts for whatever reason,’ it’s not worth it,” said Mr. Doucette.

Mr. Doucette also said the government needs to be building up the support system now and be ready for the soldiers coming out of this war, but also be aware that it may take a decade for PTSD signs to show so the government shouldn’t slash the funds if demand is slower than expected.

cmunster@hilltimes.com

The Hill Times

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