Military ombudsman says more mental health staff needed

Care for psychologically scarred soldiers has improved dramatically but a "chronic under-manning" of mental health practitioners persists, Canada's military ombudsman warns.
Canadian soldiers patrol an area in the Dand district of southern Afghanistan in 2009. Military ombudsman Pierre Daigle said the need for mental health services will continue long after the draw-down from Afghanistan.

Care for psychologically scarred soldiers has improved dramatically, but a "chronic under-manning" of mental health practitioners persists, Canada’s military ombudsman warns.

In his new report — titled Fortitude Under Fatigue: Assessing the Delivery of Care for Operational Stress Injuries that Canadian Forces Members Need and Deserve — Pierre Daigle notes that treatment is "far superior" to a decade ago when it comes to breaking down barriers to care, removing stigma and providing family support. But a prolonged shortage of mental health professionals for more than five years is driving caregiver burnout and bitterness, anxiety and frustration among injured troops.

The CF target has been 447 mental health workers yet the number has "flatlined" between 350 and 378, putting an "enormous strain" on the system, Daigle noted.

"While it would be naive to believe that there was a magic solution available to rapidly fill this shortfall, there must not be an institutional resignation that little can be done. This is a serious concern," he said.

Last week, National Defence Minister Peter MacKay announced $11.4 million in additional funding for at least 51 new mental health care positions like psychiatrists, psychologists, mental health nurses, social workers and addictions counsellors. That brings funding for mental health in the military to about $48 million.

"Minister MacKay appreciates that the ombudsman focused attention on the health needs of serving personnel," MacKay's spokesman Jay Paxton told CBC News. "Minister MacKay has said time and time again that care for ill and injured personnel is his number one priority and is pleased to have recently committed a 30 per cent funding increase for mental health care professionals in order to provide the care CF members and their families need."

Daigle also notes that while there has been a transition to a more "open-minded culture" among peers and supervisors on mental illness, there are still cases where members are denigrated or openly ostracized.

He criticized DND/CF for failing to create a national database to accurately track the number of personnel affected by stress-related injuries such as post-traumatic stress disorder, and the lack of a performance measurement regime to track the effectiveness of the system.

Daigle's report is a followup to a 2008 probe, and comes after a 10-month investigation with more than 500 interviews

Some members interviewed said they believe the CF’s moral obligation to its members is "waning."

"There is a sentiment that while loyalty and dedication upwards towards the institution are still demanded, probably more so now in this era when CF members are being sent into harm’s way more often than in several professional generations, this loyalty is no longer reciprocated downwards to the same degree," the report reads. "Some see it as an outright betrayal; members are valued until they become ill or injured as a result of operations. If they can not be patched up and returned to the fray, they are ‘thanked for coming out and kicked to the curb.'"

Daigle said the need for mental health services will continue long after the draw-down from Afghanistan, and rejected claims that mental health services provided to CF members are better than those given to civilians. The Government of Canada has a duty and obligation to care for those it sends into harm’s way, he said.

NDP defence critic Jack Harris said those kinds of comments from soldiers are far too common, and contrary to how Canadians want men and women in uniform treated.

The fact that the additional funds for mental health were transferred from the military relocation envelope shows the government is making up a "patchwork" strategy on the fly, he said, calling MacKay’s announcement "pre-emptive damage control."

"He must have known this report was coming out that was going to make the efforts of the government look bad," he told CBC News. "Insufficient attention is being paid to this, and according to the ombudsman’s report, there’s no proper way to even determine whether the level of support is sufficient."

Liberal defence critic John McKay said the ombudsman's report reflects a "regrettable lack of imagination" to combat a systemic problem.

"The government is throwing money at a problem without understanding the problem," he told CBC. "I’m anticipating the ombudsman will have the same report next year – and the year after that – because no one has taken this by the throat and made it their issue."

Many troops become bitter and angry because they fail to get proper treatment after putting their lives on the line.

"The government gives out this message that we are interested in you when you’re a healthy warrior, but we’re not interested when you’re a broken soldier," McKay said.