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Mental Health and the Canadian Forces - Recent Articles

the 48th regulator

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http://www.torontosun.com/news/canada/2011/02/07/17187191.html


Veterans Affairs failing vets in crisis: Ombudsman

By JESSICA MURPHY, PARLIAMENTARY BUREAU
Last Updated: February 7, 2011 7:53pm

OTTAWA – Veterans Affairs is failing former Canadian soldiers who've reached a mental health breaking point, Veterans Ombudsman Guy Parent told a House of Commons committee Monday.
“People at Veterans Affairs need to be trained to deal with people in crisis,” he said, noting the department is currently unable to help veterans who need quick access to care.
“The complexity of the process doesn't allow for a response to immediate needs.”
The bureaucracy and red tape involved can also be harmful to people suffering mental illness, Parent told the all-party committee.
“The more times people have to tell their stories, the harder it becomes for them.”
Parliament's Veterans Affairs committee is currently studying the effects of combat stress on soldiers and their families.
The most common illness found in Canadian Forces members is depression, followed by alcohol dependency, social phobia and post-traumatic stress disorder.
But it's harder to get solid information on how many veterans are suffering without being properly treated from combat stress injuries, Parent said.
It's one of the major concerns highlighted by the ombudsman - the lack of a system in place to track former soldiers.
“If you know where people are you can find out how they are doing,” said Parent. “We put the onus on the individual, whereas the onus should be on the department.”

Copyright © 2011 Toronto Sun All Rights Reserved
 

the 48th regulator

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We're not ready for our troops

John Ivison, National Post · Saturday, Feb. 19, 2011

Canada's combat troops return from Afghanistan this summer, but the ghosts of the war will continue to haunt many of its veterans for years to come. The great tragedies to come won't be played out in public on the Highway for Heroes, but in private, as soldiers struggle to come to terms with things they've seen and done.

The scale of the problem is hard to gauge. Officially, the Department of National Defence said the specific numbers of those who are expected to develop operational stress injuries (OSI) such as post-traumatic stress disorder are not available.

But when Brigadier-General Hilary Jaeger, the Surgeon-General of the Canadian Forces, appeared before a parliamentary committee in 2008, she estimated 27% of those coming back from Afghanistan will "have some difficulties" and 16% of those deployed will indulge in "hazardous drinking behaviour."

Since over 35,000 members of the Canadian Forces have served in Afghanistan, that suggests around 9,000 soldiers -- most of them still serving--could struggle with a range of mental health issues, ranging from depression to anxiety attacks.

The Department of Veterans Affairs notes it has seen an explosion in the number of OSI cases -- to 13,000 men and women from 2,000 a decade ago. The fear is that a significant number of returning veterans will leave the Forces and fail to adjust to civilian life, spiralling downward into substance abuse, homelessness and suicide. One outreach project by Veterans Affairs in Vancouver's Downtown Eastside found 33 homeless veterans, most in their mid-30s.

This helps explain why Peter Mac-Kay, the Defence Minister, was at CFB Trenton on Friday, announcing the establishment of five new personnel support centres dedicated to the care of ill and injured soldiers and air men and women, to add to the 19 "one-stop shop" centres already in existence.

The Conservatives have faced a rough ride from advocates of veterans' rights, culminating in rallies across Canada before Remembrance Day. Vocal criticism from recently departed Veterans' Ombudsman Pat Stogran, as well as Sean Bruyea -- who became the public face of veterans' calls for better treatment after the government was judged to have breached his privacy rights--has led to strenuous efforts to win back what should be a natural Conservative constituency.

In addition to $2-billion in financial enhancements for veterans, the government has been scurrying to respond to a special report on battling OSI that criticized the "lukewarm leadership and commitment at the national level" to tackling post-traumatic stress disorder. The "Long Road to Recovery" report was released two years ago and made a series of recommendations, including an increase to "appropriate" levels of funding to identify, prevent and treat OSI.

The authors found that the situation had improved since a similar study was carried out in 2002. For example, five clinics specifically designed to treat OSI had been set up in major cities across the country (there are now 10).

But the report also noted the system is failing to diagnose and treat a significant number of service personnel. "In some cases, injured solders, sailors, airmen and airwomen who have served their country with courage and dedication are slipping though the cracks," the authors concluded.

Kirsty Duncan, the Liberal Veterans' Affairs critic, recently followed up on the special report to see if its recommendations were being implemented. The progress has been decidedly uneven. As the Defence Department admitted, it is hard to judge how big a problem we are facing, since there is no catalogue of stress related injuries. However, the military said that a new health information system is expected to be completed by March, 2012, which should allow the government to get a better handle on how extensive its response needs to be.

Another area of concern was the shortage of mental health practitioners operating in the Canadian Forces. The government responded by saying it would hire an additional 218 specialists, taking the total to 447. But the numbers Ms. Duncan received suggest there are still large gaps. There are currently 350 mental health workers employed by DND (there are problems hiring enough skilled workers apparently). Yet even those numbers are misleading. Of the 350, only 32 are psychiatrists and 61 are clinical psychologists. The bulk of the rest are social workers, chaplains and addiction counsellors.

There is also a problem with uneven coverage across the country. Service personnel in Halifax and Esquimalt can be assessed and treated within a week but those in Valcartier and Ottawa have to wait a month. "Four weeks is a long time. What if you are in a rural area? And what if you are suicidal?" asked Ms. Duncan.

The Conservatives appear to have awoken to the fact a mental health crisis among veterans is looming but the solution seems to be to plug gaps wherever they appear.

As Ms. Duncan put it: "We know the impact of the First World War and Second World War, so why aren't we prepared? We are going to bring all these people home -- people who put their lives on the line. Canada owes them a sacred trust to give them the medical help they need and the benefits they deserve."

jivison@nationalpost.com---------

BY THE NUMBERS

27 Percentage of Canadian Forces personnel returning from Afghanistan who will have "difficulties," according to the Surgeon General

16 Percentage of returning personnel who will have "hazardous drinking behaviour"

2.2 Percentage of returning personnel with anxiety disorder

3.6 Percentage of returning personnel with major depressive disorder

3.5 Percentage of returning personnel with minor depressive disorder

3.4 Percentage of returning personnel with Post-Traumatic Stress Disorder

35,000 Number of Canadian Forces individuals who have served in Afghanistan for at least 30 days

387 Number of mental health practitioners working for the Forces

32 Number of psychiatrists

159 Number of social workers

1 Number of weeks of wait time for assessment and treatment in Halifax

4 Number of weeks of wait time for assessment and training in Ottawa

13,000 Number of veterans identified with operational stress injuries (OSI) today

2,000 Number of veterans identified with OSI a decade ago

National Post

© 2011 National Post, a division of Postmedia Network Inc. All rights reserved. Unauthorized distribution, transmission or republication strictly prohibited.



 

the 48th regulator

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http://www.edmontonsun.com/news/edmonton/2011/03/19/17683666.html

City solider back from Afghanistan is one of hundreds still battling PTSD

By JEFF CUMMINGS, EDMONTON SUN

Last Updated: March 19, 2011 6:00pm


Mike Mleinek at CFB Edmonton on February 16, 2011 in Edmonton, Alberta. (EDMONTON SUN FILE)

Hard luck.

That’s what is spelled out, tattooed on the knuckles of Cpl. Mike Mleinek.

The burly 33-year-old soldier had the eye-catching tattoo done a few weeks after he arrived back in November 2006 from his first nine-month mission in Afghanistan.

“That’s what I’ve been through, it’s been nothing but hard luck,” says Mleinek.

“It’s what I’ve been dealing with while I was (in Afghanistan) and when I came back.”

Mleinek says a countless number of “small events” in the war-torn country triggered symptoms of post-tramatic stress disorder. However, he didn’t realize there was a life-changing problem until several months after a family vacation in Disneyland, a trip taken immediately after his deployment. Endless crowds of tourists got to him in Disneyland — dubbed the Happiest Place on Earth.

Being in lineups and other confined spaces with so many people had him on edge, and in retrospect, he says, may have triggered what he later recognized as panic attacks.

“I felt like things were out of my control,” says Mleinek, who during the vacation found himself occasionally reaching for his sidearm even though he was no longer carrying a gun.

“I was so used to carrying a weapon and I had no control of what was going on.”

Mleinek is among 1,100 Canadian soldiers who have shown signs of PTSD after serving in Afghanistan. He is just one of 3,500 people who have suffered from a mental illness related to deployment between 2002 and 2008, according to figures from the Canadian military.

Mleinek, still based at Edmonton Garrison, believes the numbers are even higher since it takes so long for some soldiers to realize they need help with their symptoms.

He says the symptoms he suffered in Disneyland only flared in the months after the family vacation. His temper became harder to control and going out grocery shopping with his family was a constant struggle — the crowds of shoppers triggered anxiety attacks.

Sleeping was also a struggle. Mleinek says he still suffers consistent nightmares and flashbacks.

It was a full year after his mission that Mleinek acknowledged he was in dire need of help. He was admitted three times to hospital for suicide attempts.

“This isn’t an injury where you realize, hey, your leg is broken,” he says.

“I had a problem talking about my symptoms because you don’t want to be seen as being weak, but I wanted those nightmares to stop. I went through some very dark days.”

Mleinek says a psychiatrist at the Canadian Force’s new Operational Trauma and Stress Support Centre in St. Albert connected him to a “soldiers-only” support group — something he credits for saving his life.

Speaking with other soldiers about their PTSD battles finally helped him open up. They had all been there.

“The soldiers in my support group have all been through what you’ve been going through,” says Mleinek, who visits the St. Albert centre twice a week for treatment.

“You are not dealing with PTSD on your own. They know what it’s like to go on for four days and not sleep.”

And still, he would return to Afghanistan in a heartbeat.

“This is my job,” said Mleinek, who hasn’t yet been cleared for deployment.

“I want to be alongside with my soldiers. I signed on the dotted line and I would go again. There is no life like it.”


Copyright © 2011 Edmonton Sun All Rights Reserved
 

the 48th regulator

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http://www.edmontonsun.com/news/edmonton/2011/03/19/17683711.html


Retreats help relieve depression

By JEFF CUMMINGS, EDMONTON SUN

Last Updated: March 19, 2011 6:11pm


A former Edmonton soldier who plowed an SUV into a garrison building 10 years ago is now operating a wilderness camp, helping other soldiers cope with PTSD.

Christian McEachern, 40, a former member of the Princess Patricia’s Canadian Light Infantry who quit the military in 2001, created an organization in 2006 called the Canadian Veteran Adventure Foundation. It takes mentally and physically wounded soldiers on weekend outdoor retreats — which include everything from golfing to whitewater rafting in Kananaskis.

Some soldiers struggling with PTSD fall into less than healthy habits, like overeating, and the retreats can help pull them out of their associated depression.

“It’s not a magic pill that makes the PTSD go away,” said McEachern, now a professional whitewater rafting guide based out of Calgary.

“It’s just a way to introduce to them some healthy and fun activities. It’s a way to make them smile again.”

McEachern became a face for PTSD when he crashed the vehicle through the Edmonton Garrison headquarters in March 2001.

He was convicted of dangerous driving, mischief, assault and operating a motor vehicle with a blood-alcohol level over the legal limit. He was given a 14-month conditional sentence.

At the time, he lashed out at the military for doing too little to help soldiers with the disorder, which he has suffered from for years following service in Bosnia and Rwanda.

And after finishing his degree in eco-tourism and outdoor leadership, along with collecting donations to financially run the weekend trips, McEachern says he is still battling with his disorder.

“My PTSD is always going to be there,” said McEachern.

“I still get nightmares and I have been like that for years, but I still want to help people get their spirits back.”

McEachern says he hopes his foundation can do more events for soldiers, a reason why he is still actively trying to find more funding through private donations.

If you would like more information about the foundation, check out www.CanadianVeteranAdventureFoundation.com.

jeff.cummings@sunmedia.ca

Copyright © 2011 Edmonton Sun All Rights Reserved
 

ballz

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Shared with the usual caveats...

http://news.ca.msn.com/top-stories/cbc-article.aspx?cp-documentid=28115878

Adolescents in military families are often burdened by additional emotional stress when a parent is deployed to Afghanistan, according to a new Canadian study.

University of New Brunswick researchers released a study on Thursday that examined students at Oromocto High School, near Canadian Forces Base Gagetown, who recently had a parent serving in the Canadian mission in Afghanistan.

The UNB researchers reported the teens worried their parents would not return home or would come back "different."

And that stress caused concerns at home. The young people felt a sense of responsibility for the emotional stability of their other parent and for any younger siblings at home.

A teen would also feel additional stress if the parent remaining in Canada was having difficulty with the other parent being away on the military mission.

Adolescents reported feelings of isolation in attempting to deal with those problems, the study reported.

In particular, adolescent girls took on a large share of the family's emotional burden when one parent was overseas.

Once the deployment wrapped up, the psychological stress would be prolonged if the returning parent developed post-traumatic stress disorder, said Deborah Harrison, the study's lead investigator.

"We found that family life was almost always negatively affected by an injured parent's symptoms of anger and depression," Harrison said in a news release.

"Some adolescents reported needing to go through a process of grieving the loss of their family as it had been before the deployment. They also reported feeling very isolated — along with their families — by the stigma against non-physical injuries that exists in rank-and-file army culture."

Canadian Forces Base Gagetown, in Oromocto, near Fredericton, is one of the largest training bases in the Commonwealth.

Harrison's study is a part of a larger study into the mental health and wellbeing of adolescents in military families.


The last sentence really makes sense of the whole thing... because the whole time I was reading it I was thinking "it takes a team of university researcher's to conclude this?"
 

Wookilar

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CMP issued a memo 2 Feb 11 re: studies similar to this. This study in particular was mentioned by our CoC. I'm not going to post it as I didn't write it, therefore not mine to release to the public. I'm not sure of the rules regarding stuff like that so I`m going to wimp out and play it safe.

However, I can reinforce the message: Be careful of what you get involved in. Make sure you understand the questions they are asking your kids. Be extremely careful of personal/private information. While studies of this kind could be very valuable, only if they are done properly and they take steps to ensure the health and well being of the families involved (and especially the kids) is not further damaged.

Wook
 

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A bit more detail from the U of NB:
The findings of the first-ever Canadian study of adolescents in military families were released today in Oromocto, N.B., by a team led by University of New Brunswick researcher Deborah Harrison.

The study found that students from Oromocto High School who recently had a parent deployed to Afghanistan worried that the parent would either not return home or would return home “different.”  They felt a sense of responsibility for the emotional well being of the parent and younger siblings remaining at home, and experienced isolation in trying to cope with their problems if the parent remaining at home was stressed or preoccupied by the deployment.

Adolescent girls in particular assumed a large share of the family’s emotional burden
during long deployments.

Dr. Harrison, principal investigator and sociologist, says that once families are reunited after deployment, the psychological stressors continue if the returning parent has developed Post Traumatic Stress Disorder.

“We found that family life was almost always negatively affected by an injured
parent’s symptoms of anger and depression,” said Dr. Harrison.  “Some adolescents reported needing to go through a process of grieving the loss of their family as it had been before the deployment.  They also reported feeling very isolated–along with their families–by the stigma against non-physical injuries that exists in rank-and-file army culture.”

The above interview findings were part of a larger study on the mental health and well being of adolescents in Canadian Forces families.

What the researchers didn’t expect to find, in their 2008 survey of all the students
at Oromocto High School, was that there is virtually no difference between the mental health of adolescents from Canadian Forces families and that of their civilian peers in the same community.  Also, Canadian Forces adolescents have a more positive attitude towards
school than their civilian peers.

Representatives of the research team and its partner in the project, New Brunswick School
District 17, are discussing these and other findings at a two-day symposium in Oromocto this week, which will conclude with recommendations aimed at enhancing the support provided during deployments by the District’s schools.

David McTimoney, superintendent of School District 17, says Oromocto High School already has some helpful programs in place and hopes that recommendations from this week’s symposium will lead to even better support services for teens in Canadian Forces families.

“I am proud of the strategies that our district student services team has already developed, in an effort to respond to the needs of our students who are touched by the challenges of deployment in the Canadian Forces,” said Mr. McTimoney.  “Participating in this
research project and symposium is allowing us to have a second look at our work and determine where improvements can be made.”

This research initiative was undertaken by researchers at UNB, the University of Alberta, Ryerson University, and York University, in partnership with NB School District 17; and was funded by the Social Sciences and Humanities Research Council of Canada.

Oromocto (population 9,000) was the town chosen for the location of this study because it is developed around Canadian Forces Base Gagetown; one of the largest military training
bases in the Commonwealth.
 

medicineman

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Three letters come to mind : D-U-H. 

I should commission a study like this and get a hundred thousand dollar grant to study and conclude the obvious...pay my mortgage off sooner that's for sure.

MM
 

Sig_Des

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The results of the study would have been easy to predict. I would have loved to see a comparison between the teenage children of people with other high stress careers, and see how the results matched.

Personally, as an Army brat who also attended OHS, I would have liked the study to also go into detail on how many actually of those military-family teens planned on joining the military regardless of the stress. I can think of about a dozen kids from when I was there who entered the CF. And I know the numbers are similar for other generations of the school.
 

muffin

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My kids and I heard this on the radio this morning and my son said "Well that study was a waste of money... of course it stresses us out when they send Dad away!"  :p
 

the 48th regulator

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http://www.thestar.com/opinion/letters/article/977351--conservatives-putting-veterans-lives-at-risk


Conservatives putting veterans’ lives at risk

April 19, 2011


Medical care for veterans is the responsibility of the federal government. In June 2009, the Harper government introduced new guidelines that make it virtually impossible for veterans to get the health care they need.

Veterans can no longer automatically receive medical care as they have since before World War I. Instead, a physician needs to submit a request to Veterans Affairs for permission to assess the patient and another request to be allowed to treat them. This process can take weeks and often months. No other Canadian citizens are subject to restrictions like this when it comes to accessing standard medical care. This delay and uncertainty can put veterans’ health and even lives at risk.

This is especially true for my patients, many of whom suffer from post traumatic stress disorder (PTSD), depression, and substance abuse. When discharged from the military because of PTSD, soldiers are likely to be depressed, unstable and even suicidal. These veterans must be treated immediately to keep their symptoms from getting worse. Having to wait for approval from Veterans Affairs can mean the difference between life and death for some veterans.

These problems do not stop once a veteran is approved to receive care. Instead, Veterans Affairs only approves a specified number of appointments (“occurrences”) at a time. Once this number is used up, a physician must submit a new request and once again wait to receive permission before resuming treatment. This new policy endangers the veterans who are most ill by interrupting their care.

According to the Canadian Medical Protective Association, it is unethical and potentially dangerous to delay treatment while waiting for new approval. The government has set up an unworkable bureaucratic nightmare for both the physician and the injured soldier. Decisions regarding appropriate treatment are taken away from the doctor-patient relationship and put in the hands of a distant bureaucracy. Physicians will be unable or unwilling to take on new patients under these conditions.

Veterans deserve to receive the health care that they need when they need it. Because many suffer from severe and even life-threatening conditions, they often need prompt access to care. These veterans served Canada and now it is time that their government serves them. That means electing a government that will restore automatic access to health care for our veterans.

Janet McCulloch, Psychiatric MD, Kingston

© Copyright Toronto Star 1996-2010
 

ballz

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That is troubling... I wonder what the purpose of the red-tape is supposed to be... certainly doesn't sound like it is accomplishing it.
 

the 48th regulator

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More than 450 Petawawa troops sought mental health help in 10 months: documents
By Sue Bailey, The Canadian Press – 18 hours ago

ST. JOHN'S, N.L. — About 450 troops from Canadian Forces Base Petawawa sought mental health counselling within a 10-month stretch last year, say internal military records.

Between January 2010 and last October, there were 458 new requests for help on the eastern Ontario base. Issues ranged from addiction to stress to family reunion tension after combat tours in Afghanistan, say documents obtained by The Canadian Press under the Access to Information Act.

The records offer a rare glimpse of anxieties shouldered by troops on a base hard hit by death and injury during repeated missions in Kandahar's lethal insurgency zones.

Of the 155 Canadian soldiers killed in Afghanistan since 2002, about one-quarter were stationed at Petawawa. Most troops who sought help last year reported stress or anger issues, problem drinking, mood swings and struggles settling back into family life.

"We're dealing with trauma, we're dealing with stress and we're dealing with loss," said Lt.-Col. Rakesh Jetly, a senior military psychiatrist.

It's carnage on a scale not seen since the Korean War, he said.

"And then the reunion stress is something that is quite unique as well because it's not so easy just to pop back into your life and act as if nothing has changed."

Across the Canadian Forces, about five per cent of 17,678 troops who'd completed post-deployment screening by last June — more than 880 people — reported symptoms suggesting post-traumatic stress disorder or depression.

Soldiers who'd seen the most combat had four times the risk of PTSD or depression, says a military analysis of the survey.

Just over four per cent of respondents reported high-risk drinking with symptoms of mental health problems, while 13 per cent said they drank excessively without such symptoms.

Jetly says the number of people who flagged signs of PTSD and depression has declined slightly from a rate of six per cent in 2006. And a big change is the number of troops who, once screened three to six months after returning from a tour, said they were already in counselling, he said.

More than half of those who mentioned problems said they were already in care — a big leap from recent years when it wasn't unusual for soldiers to say they'd coped with symptoms for at least five years before getting help, Jetly explained.

"It's not necessarily bad news that a lot of people are in care."

Early treatment means "a much better prognosis of getting better, being able to carry on with your life as a parent, as a colleague, as a son, as a daughter and as a Canadian Forces member as well."

The military has worked hard to reduce the stigma of mental breakdown as it improves services, Jetly said. Efforts have included operational stress injury clinics across Canada, and a national awareness campaign urging troops to seek help or support those who do.

"There are actual concrete examples of people that are suffering illness and it's not like ... you go for care for a while, then you're kicked out.

"You can stay in (the military), you can have a meaningful career. If you can't have a meaningful career, we're going to aim for a meaningful life. We're going to transition you to Veterans Affairs and get you skills so you can still be part of your family.

"We've created a system where, for the most part, people are buying into that."

Counsellor Greg Lubimiv, executive director of the Phoenix Centre for Children and Families in Pembroke, Ont., works with military parents and their kids.

The centre is located about a 30-minute drive from CFB Petawawa.

"I think there are more soldiers coming forward but certainly I'm still hearing about soldiers who are reluctant to be identified within the military," he said.

"Families will say we prefer driving to Pembroke even though we have a (counselling) office right on base.

"There is hesitation, there is worry, there is concern," despite dramatically increased acceptance of mental health issues by the military, he said.

The Phoenix Centre is one of few across Canada to receive significant funding — more than $200,000 a year — to counsel military families off base in the community, Lubimiv said.

The stigma that still exists against mental breakdown in mainstream society is exacerbated in the Canadian Forces, he added.

"As a soldier, you're built to be strong and tough and to make good decisions and do what you need to do in the best way possible.

"If something threatens that, you don't want people to think you're not a good soldier."

Copyright © 2011 The Canadian Press. All rights reserved.
 

the 48th regulator

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http://www.winnipegfreepress.com/opinion/westview/post-traumatic-theory-stressed-121017034.html


Post-traumatic theory stressedWhy American troops suffer PTSD at seven times the rate of Brits inexplicableBy: Gwynne Dyer

Posted: 04/30/2011 1:00 AM | Comments: 5

American and British soldiers have been fighting in Iraq and Afghanistan for about the same length of time, and their casualty rates have been about the same.

More than 30 per cent of the American troops subsequently suffer post-traumatic stress disorder (PTSD), a condition that involves memory suppression and uncontrollable anxiety. Only four per cent of British troops do. It's a statistic that suddenly undermines long-held assumptions.

My own long-held assumption, in this case, was that the rise of PTSD in Western armies was mainly due to a major change in the way they trained their troops. Before 1945, like all the other armies, they just trained soldiers to shoot. After 1945, they started training their soldiers to kill people.

The change was triggered by a discovery that Gen. S.L.A. Marshall made during the Second World War. He sent out teams to interview American infantry companies immediately after combat, with a guarantee that each soldier's testimony would remain absolutely confidential -- and he learned that up to 90 per cent of those American infantrymen had found it impossible to kill enemy soldiers.

They did not run away, they may even have shot their weapons into the air -- but they simply could not look down the sights and kill another human being. At the last moment, they became conscientious objectors.

Marshall had stumbled on the single most important fact about the modern battlefield: most of the soldiers present were not really taking part in the battle. Moreover, this secret refusal to kill could not be solely an American trait, or else the U.S. Army would have lost every battle it fought against the Germans and the Japanese. In fact, it was true of every army that fought in the Second World War.

Significantly, however, it was only the private infantrymen, alone and unobserved in their foxholes, who silently refused to kill (but never admitted it to their comrades). Men on crew-served weapons like machine-guns, whose failure to do their duty would be seen by their comrades, did what the army expected of them.

The lesson U.S. military leaders drew was that while the soldiers' private morality made it hard for them to kill, the right training could overcome their moral inhibitions. So they changed the training.

By the early 1950s, U.S. Army basic training sought to lay down reflex pathways that bypassed the inhibitions, by training soldiers to snap-shoot at human-shaped targets that only appeared for a few seconds. They also addressed the problem directly, psyching their young soldiers up until they believed that they actually wanted to kill.

It worked: by the time of the Vietnam war, 90 per cent of American infantry were firing their weapons in combat -- and trying to kill their targets. Other Western armies adopted the same training techniques, with equally impressive results. But there is an obvious psychological price to be paid for all this, or so it seemed.

The Vietnam war in the 1960s was when the incidence of PTSD among American veterans began to soar. They had been tricked into doing something that was morally abhorrent to them, and that was why so many of them fell apart afterwards.

Veterans of earlier wars had suffered higher-than-average levels of alcoholism, depression and suicide, but that was nothing to compare with the PTSD plague that infected the new generation of veterans. The psychological manipulation they had been subjected to seemed to be the key -- but then along comes this statistic saying that American soldiers are seven times more likely to suffer from PTSD than British soldiers.

The research, led by Neil Greenberg, a commando-trained naval officer and professor of mental health at King's College London, even points out that while the mental-health risk increases for American soldiers who do several tours of combat, there is no such link for British soldiers.

So what is actually going on here? American writer Ethan Watters' recent book, Crazy Like Us: The Globalisation of the American Psyche, offers a highly subversive answer. It is that American society has been permeated by psychoanalytical beliefs about the fragility of the human mind.

This creates an expectation, he argues, that people who have been through horrible experiences will be traumatized. The veterans are simply falling in with that expectation, and exhibiting the symptoms that the theory says they should be showing.

In Britain, where the psychoanalytical approach never got such a hold on popular culture, this expectation is much rarer -- and so are the symptoms of PTSD.

Watters then goes on to speculate that the very high incidence of PTSD in American veterans is also due to the decline of religion, patriotism, and other belief systems that once gave a kind of meaning, however imaginary, to human suffering.

This is just ideologically driven nonsense: Britain, where the PTSD rate is seven times lower, is also less nationalistic and far less religious than the United States.

But Watters' core question remains. Is PTSD really caused by what happened to veterans while they served in the military, or by the expectations of the civilian society they returned to afterwards? Suddenly, there is a case to answer.



Gwynne Dyer is a former military

historian whose award-winning book War was republished in an updated

version in 2004 by Random House.
 

George Wallace

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Tess

Prior to 1950, many of the armed forces around the world were made up of members who had at one time been hunters and fishers.  People who had actually killed and cleaned game.  Our current populations are largely metropolitan and not that many of our members have been avid hunters and fishers who had to rely on their skills to provide food for their tables.  For Gwynne Dyer to place the fault on our Training Systems is a little bit of a faulty assumption on his part.  Our Western Society has radically changed since the Second World War.  We have become much more urbanized.  Even if you want to throw in violent urban gangs, you will find that even they do not face the blood and gore that would have been accepted by a hunter/fisher.  They shoot and scoot, not needing to approach their victims.  Our society, other than in video games and the movies, is usually far removed from any blood and gore.  When today's young soldiers actually face it, they will naturally handle it much different ways than previous generations. 

I think Gwynne Dyer has missed a lot in his analysis of what causes PTSD.
 

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George Wallace said:
Tess

Prior to 1950, many of the armed forces around the world were made up of members who had at one time been hunters and fishers.  People who had actually killed and cleaned game.  Our current populations are largely metropolitan and not that many of our members have been avid hunters and fishers who had to rely on their skills to provide food for their tables.  For Gwynne Dyer to place the fault on our Training Systems is a little bit of a faulty assumption on his part.  Our Western Society has radically changed since the Second World War.  We have become much more urbanized.  Even if you want to throw in violent urban gangs, you will find that even they do not face the blood and gore that would have been accepted by a hunter/fisher.  They shoot and scoot, not needing to approach their victims.  Our society, other than in video games and the movies, is usually far removed from any blood and gore.  When today's young soldiers actually face it, they will naturally handle it much different ways than previous generations. 

I think Gwynne Dyer has missed a lot in his analysis of what causes PTSD.

I agree.

I also find although useful, people who study the reasons why may be overthinking it.  I beleive with todays information technology, that Modern Soldiers have questions to answers at their finger tips.  This allows them to understand, and help break the stigma, and giving more the confidence to fix the injury and carry on.  Where as in the past, people were embarrassed, and less prone to come forward at an earlier stage, causing the injury to fester and get worse.

Man, I should get published  :blotto:

dileas

tess
 

Old Sweat

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Decades ago - like in the fifties or sixties - I remember reading an article suggesting that American soldiers had a much higher rate of cases of battle exhaustion then did the British because North Americans were more "Mom" oriented. It just as easily could have been because the Americans took it more seriously, but that's my opinion. Lord Moran, Churchill's personal physician, wrote a book on the subject in which he argued that everyone has a breaking point that they eventually reach sooner or later. The subject is too complex and too serious for pop psychologists, or for rank amateurs like me, to comment competently.
 

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Old Sweat said:
Decades ago - like in the fifties or sixties - I remember reading an article suggesting that American soldiers had a much higher rate of cases of battle exhaustion then did the British because North Americans were more "Mom" oriented. It just as easily could have been because the Americans took it more seriously, but that's my opinion.

As recently as July 2010. New York Times: "V.A. Is Easing Rules to Cover Stress Disorder":
http://www.nytimes.com/2010/07/08/us/08vets.html

During World War Two, the USAAF was studied by the RCAF-RAF ( they were combined in Bomber Command ):
"Morale never became a major problem, as it did on some 8th Air Force stations during the terrible losses of 1943 and early 1944. An RAF doctor seconded to study aircrew spirit at one American station reported in dismay: 'Aircrew are heard openly saying that they don't intend to fly to Berlin again or do any more difficult sorties. This is not considered a disgrace or dishonourable.' "
"There was great fear at the top of the service ( RCAF-RAF Bomber Command ) that if an honourable path existed to escape operations, many men would take it. 'LMF ( Lack of Moral Fibre ) could go through a squadron like wildfire if it was left unchecked. I made certain that every case before me was punished by court-martial, and where applicable, by an exemplary prison sentence, whatever the psychiatrists were saying.' "
This station commander went on to become "one of the most distinguished post-war leaders of the RAF".
Bomber Command page 214.

Old Sweat said:
Lord Moran, Churchill's personal physician, wrote a book on the subject in which he argued that everyone has a breaking point that they eventually reach sooner or later. The subject is too complex and too serious for pop psychologists, or for rank amateurs like me, to comment competently.

Lord Moran asserted  that war cannot "turn men into cowards...it was only bad stock that brought defeat."
Moran: Anatomy of Courage 1945 page 22-23.
See also: "The Cream of the Crop: Canadian aircrew 1939-1945" by Allan D. English.
http://books.google.ca/books?id=FcGov3199u4C&pg=PA72&lpg=PA72&dq=%22it+was+only+bad+stock+that+brought+defeat%22+moran&source=bl&ots=QJvdVCdwiw&sig=lEDClIbS89-q4XCMmE0TgoueKo4&hl=en&ei=hQ6_Tci2EsT40gHC08DNDA&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBoQ6AEwAA#v=onepage&q=%22it%20was%20only%20bad%20stock%20that%20brought%20defeat%22%20moran&f=false



 

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http://www.cbc.ca/news/canada/story/2011/06/14/ptsd-soldiers-redeploy.html


Canadian military redeploying soldiers with PTSD


By CBC News
CBC News
Questions are being raised about a little-known Canadian Forces policy of re-deploying soldiers diagnosed with post-traumatic stress disorder.

A former elite soldier with the Canadian Forces says post-traumatic stress disorder caused him to descend into what he describes as his "train wreck years."

Steve Lively says he ballooned to 240 pounds, grew his hair down to his lower back and suffered from severe alcohol and drug addiction.

"It was self-medication to deal with what I was going through," said Lively, 46, who suffered from post-traumatic stress disorder (PTSD) after serving on a number of tours, including to the Congo, Uganda and Rwanda.

He keeps a picture of himself from that time on the wall of his office: it's a reminder of a low he never wants to descend back into.

His PTSD became worse with each deployment and eventually Lively left the military. He now works for National Defence and speaks to soldiers about PTSD.

Cases like Lively's have raised questions about a little-known Canadian Forces policy of re-deploying soldiers diagnosed with the anxiety disorder caused by experiencing a traumatic event.

Ottawa psychologist Ken Welburn, who counts current and former soldiers among his clients, used to help soldiers re-deploy after suffering from post-traumatic stress disorder, but now believes that was a mistake.

"I think that soldiers with PTSD should not be re-deployed into a war zone," said Welburn, director of the Ottawa Anxiety and Trauma Clinic. "If you go back on another deployment it's like going into the sun after a bad sunburn. You are going to pay for it."
Soldiers treated before re-deployment

The military won't reveal how many soldiers with PTSD that it has sent back to the frontlines, but the practice has been happening during its 10-year mission in Afghanistan.
A virtual reality

Soldiers, often more comfortable with video games than a psychiatrist's couch, are benefiting from a new treatment for post-traumatic stress disorder. But it's only available south of the border.

Nearly 50 hospitals in the U.S. offer virtual reality (VR) therapy. The system recreates a patient's traumatic memory, walking them through the scene repeatedly to lessen panic.

"You think, 'This is a video game. Why am I doing this? This is dumb,'" U.S. soldier Jason Skinner said about his initial reaction. But he now credits the system with saving him from a breakdown after serving in Iraq.

Dr. Robert McLay, research director of mental health services at San Diego's Naval Medical Center, says 75 per cent of soldiers treated there with VR therapy showed significant improvement.

In Canada, soldiers receive traditional exposure therapy - repeatedly talking about the upsetting incident. Dr. Rakesh Jetly, the Canadian Forces' senior mental health adviser, said there's insufficient research on VR therapy.

"We have a responsibility to our soldiers and to the taxpayers to provide evidence-based practices," the doctor said.

The Canadian Forces' senior mental health adviser, Dr. Rakesh Jetly, says the military ensures soldiers get treatment and have time to heal before re-deployment. Before a Canadian Forces member who suffered from PTSD is sent on a tour, they must successfully complete six to nine months of pre-deployment training.

"It's a good news story," said Jetly. "We're not sending people that are ill, that are having nightmares, that can't sleep, and you know drafting them and throwing them on the back of a plane and sending them to war."

Even though Lively recalls coming home after his tour in Rwanda following the genocide to find himself terrified of dangers lurking around every corner of his Ottawa neighbourhood, he's circumspect about the practice of re-deploying soldiers who have suffered from PTSD.

Some soldiers find returning to the battlefield a form of exposure therapy by facing their demon and others only suffered a mild form of PTSD and feel ready to return, he says,

"And then there are the few cases where soldiers have been diagnosed and they've gone back on mission, and unfortunately something has happened where it's retriggered it, and it's only exacerbated the situation and made it worse," said Lively.

"But there's no real black and white answer to it, because we don't know the true number of soldiers that have been diagnosed, that are going back into theatre," said Lively.
Fear being kicked out of army

The controversial practice of redeploying soldiers who suffered from PTSD partly stems from a decades-old military rule called Universality of Service. It states that members of the forces must be fit or capable to deploy on operations.
Your News

Are you a member of a military family affected by PTSD? Share your story. [http://www.cbc.ca/news/yourcommunity/2010/05/your-news-share-your-stories-photos-and-video.html]

The rule has created a catch-22 that prevents some soldiers from admitting they are sick.

"They're afraid they will be pushed out of the military ... they'll be deemed medically unfit and just non-deployable," says Lively.

American Larry Syverson has been fighting to draw attention to the practice of re-deploying soldiers who suffered from PTSD by the U.S. Army. His son, Bryce, served in Iraq then suffered a breakdown and ended up in an American military hospital on suicide watch.

"I figured because of the problems ... he couldn't have a gun," said Syverson. "I thought his deployment would be over."

Days after Bryce told doctors he was able to be around his gun without wanting to use it on himself, he was sent back into combat, says Syverson.

"I was like, 'This is crazy! You know he was just under suicide watch?'" recalls Syverson.

"PTSD is not something that just goes away," says Syverson. "You have it for the rest of your life. And to think that, 'Oh well, they're doing OK now we'll give 'em a gun, we'll send 'em back,' who knows when that's gonna happen that it comes back. And it will come back."
PTSD may skyrocket

The Canadian Forces says such an extreme case wouldn't happen here because Canada only sends back those soldiers who are cured of PTSD.

"The point is that there are soldiers in fact that think they're ready and I will say, 'No, no you're not,'" says Jetly.

Civilian rule of thumb, says Jetly, is that one-third of people recover fully from PTSD, meaning they are no longer symptomatic.
Tips?

If you have any information about this story or other investigative tips, please email investigations@cbc.ca [investigations@cbc.ca].

Symptoms can include flashbacks, difficulty sleeping, feeling emotionally numb, memory troubles, avoiding activities once enjoyed, irritability or anger and self-destructive behavior.

Lively suspects that the numbers of soldiers who are diagnosed with post-traumatic stress disorder will skyrocket in the next few years as Canada winds down its combat operations in Afghanistan.

"Now they'll have time to actually sit back and reflect on exactly what it is that they're going through," said Lively. "They're not deploying so it's more time to actually consider what's going wrong in their lives.

"We are seeing the tip of the iceberg right now."

Copyright © CBC 2011
 

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Jean-Rodrigue Paré, International Affairs, Trade and Finance Division, Post-traumatic Stress Disorder and the Mental Health of Military Personnel and Veterans, Publication No. 2011-97-E, Parliamentary Information and Research Service, Library of Parliament, 14 October 2011

Table of contents
    1 Introduction
        1.1 The Human Cost of Military Operations
        1.2 The Social and Public Issue
    2 What is Post-Traumatic Stress Disorder?
        2.1 Nature of the Disorder and Diagnosis
        2.2 From “Shell Shock” to Post-traumatic Stress Disorder
        2.3 Post-traumatic Stress Disorder Today
        2.4 The Prevalence of Post-traumatic Stress Disorder in Veterans
            2.4.1 United States
            2.4.2 Australia
            2.4.3 United Kingdom
    3 Operational Stress Injuries in Canadian Soldiers and Veterans
        3.1 From Soldier to Veteran: The Division of Responsibilities
        3.2 Operational Stress in Military Personnel
        3.3 Post-operational Stress in Veterans
        3.4 The Risk Associated with Operational Stress Injuries: From Absenteeism to Suicide
    4 Looking to the Future
        4.1 Scope of the Problem
        4.2 The Current Capacity of Veterans Affairs Canada
        4.3 Monitoring of Veterans
    5 Conclusion
    Notes
PDF version attached if link doesn't work.
 
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