Too many stressed soldiers slipping through cracks: report
'Canadian Forces members are strained almost to the breaking point,' says military ombudsman
Some Canadian military personnel who have post-traumatic and operational stress injuries are not getting the care and attention they need, according to a report released Wednesday by the military ombudsman.
While senior military leaders have talked about a strong commitment to deal with post-traumatic stress disorder, or PTSD, and its devastating effects, the commitment hasn't reached down to the community level, interim ombudsman Mary McFadyen says.
There is a lack of care and support for soldiers across the country, she says in the 62-page report.
When one military officer started having symptoms of post-traumatic stress disorder such as acute depression and blackouts in 2006, he was pushed out by his superiors, he later told CBC News.
"They were looking to manipulate things so that they didn't have to deal with it," said the man, who attempted suicide and whose identity is being protected. "They think it's a weakness in leadership and that you're going to set a poor example for others if you have this."
It's an experience the ombudsman confirmed is happening, based on interviews with 360 people across the country.
The report, released Wednesday, said 18 of the 31 recommendations made in a 2002 report on the issue haven't been fully implemented.
- Create a full-time operational stress injury co-ordinator responsible for all related issues, including the quality and consistency of care, diagnosis and treatment, as well as training and education.
- Develop a database of Canadian Forces personnel — both regular and reserve forces — affected by stress-related injuries.
- Conduct an independent and confidential mental-health survey of Forces personnel.
- Change the rules governing occupational transfer to accommodate stress sufferers who could continue their military service if moved to another military occupation.
- Ensure military family members have access to all the services and care they need.
- Provide funding across the country for the identification, prevention and treatment of post-traumatic stress disorder and other operational stress injuries.
- Develop a national program to treat and prevent stress and burnout among mental-health care workers.
"Clearly, the environment in which Canada's military has been operating in recent years has changed dramatically," McFadyen said in the report.
"With the mission in Afghanistan, the level and intensity of combat operations have increased substantially ... A significant number of soldiers are returning from overseas deployments suffering with mental health issues. ... It has also become evident that the Canadian Forces and Canadian Forces members are strained almost to the breaking point."
All is not equal at military bases across the country when it comes to helping military personnel.
At CFB Petawawa, an Ontario base which has seen many deployments to Afghanistan, one psychologist and a psychiatrist (0.8 of a psychiatrist, the report notes) serve 5,100 military personnel. The lack of mental health professionals forces those needing an assessment for operational stress injuries (OSI) to travel more than 160 kilometres to Ottawa, and the rehabilitative care generally recommended is not available at Petawawa, the ombudsman said.
In comparison, at CFB Edmonton, five psychologists and three psychiatrists serve 6,600 people.
It has been challenging for the military to attract mental health professionals to bases like Petawawa that are not in major cities, said Lt.-Col. Rakesh Jetley, a psychiatrist for the Canadian Forces who has treated patients in Afghanistan.
"The system is not perfect," McFadyen said in the report.
"Indeed, investigators found and the office is aware of a number of individual cases where military members and/or their families were not treated fairly by the Canadian Forces or, for a variety of reasons, did not get access to the care and treatment that they so desperately needed," the report continues.
"Injured soldiers, sailors, airmen and airwomen who have served their country with courage and dedication are slipping through the cracks of an ad hoc system.
"The consequences for individuals who fall through the cracks are often devastating and long lasting."
Jetley said many of the patients he saw in Afghanistan came for a few sessions.
"That really helps to de-stigmatize when you realize that these are injuries just like any other injuries," Jetley said. "You identify them early, come forward, we can fix people up and get them back into their roles again."
An expert on post-traumatic stress disorder said people might be able to function in Afghanistan, but they may fall apart when they get home.
"Their brain is still geared up to be in a war," Dr. Greg Passey said. "So unless we have proficient system to assess, to treat, to ensure transition, there's gonna be a huge impact."
There is also no national database, so people still work with paper records of medical treatments, which makes it difficult to track soldiers who have mental health problems.
Some improvements made
It appears that some progress has been made by the military since 2002. After the original six-year-old report was released, the military has:
- Improved screening before and after soldiers enter conflict.
- Set up and funded support groups across the country to help families.
- Committed to hiring 200 more mental health professionals by March 2009.
But the negative stigma, myths and stereotypes of PTSD and OSI remains a real problem at most military establishments in Canada, the latest report reminds its readers.
With files from the Canadian Press