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.
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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.
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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."
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