Monday, March 3, 2008

Invisible injuries

Mental Health of veterans in Canada

Invisible injuries
The Ottawa Citizen
Published: Friday, February 22, 2008
The country mourns and reflects when a Canadian soldier is killed or wounded on duty in Afghanistan - at least if the injuries are visible.

But when soldiers return from combat with invisible injuries - including mental disorders such as post traumatic stress or problems such as alcoholism - they sometimes slide back into society with little help or attention. Until things begin to go wrong.

Until recently, the military was not particularly sensitive to issues of mental illness. Soldiers are supposed to be "tough," and the resulting stigma around mental illness reduced the likelihood of soldiers getting treatment. Thanks to the efforts of a few brave soldiers, chief among them Lt.-Gen. Roméo Dallaire, attitudes have begun to change, but not quickly enough.

A recent survey suggests the Canadian military has plenty to do if it is serious about erasing the shame and ensuring that personnel whose wounds are psychological rather than physical receive proper treatment.

The survey of 8,441 soldiers - the first to look at the use of mental health services in the Canadian Forces - found an astonishing four out of six soldiers in need of psychological help did not get it, even though it was available. Some said they distrusted military management or the military health system. It was unclear if they feared the impact it would have on their careers.

The survey was conducted at the start of Canada's deployment in Afghanistan, at the request of the Department of National Defence.

Since that time, the Department of National Defence has made changes aimed at soldiers suffering what are sometimes called stress injuries. Those include the creation of the Operational Stress Support System, a program of peer support for afflicted soldiers. The military has also begun what it calls "third location decompression" in which soldiers are sent to a peacetime location outside Canada before they come home from combat.

There is more to do, however. Just think: Even in civilian society, despite vigorous public education campaigns, and despite research suggesting that mental illness afflicts virtually every family and workplace, the stigma remains. The challenge is all the greater in a military environment.

In 2002, then military ombudsman André Marin wrote a scathing report about the treatment of soldiers who were diagnosed with post-traumatic stress disorder. Six years later, little or no action has been taken on more than half of the report's 31 recommendations - including creation of a post traumatic stress disorder co-ordinator for the military and the development of databases to track suicides and soldiers with post traumatic stress disorder.

The American experience is sobering. A U.S. study identified more than 120 homicides committed by veterans of the Iraq and Afghanistan wars. The numbers are disputed by the Pentagon, but it's hard to dispute that they point to a significant problem of untreated mental illness among veterans.

Canadians make a lot of noise about supporting our troops who are doing a difficult mission in one of the most dangerous parts of the world. They deserve real support, both on the battlefield and when they return home.

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