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Mental health in the military: Majority of troops avoid couch talk

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Mental health in the military: Majority of troops avoid couch talk     
13 février 2008 
First Canadian study to examine mental health among armed forces and barriers to help
http://nouvelles.umontreal.ca/content/view/976/125/.

Mental disorders ranging from depression to alcoholism need to be de-stigmatized among military personnel to encourage troops to seek support when needed, according to a national investigation published in the February edition of the research journal, Medical Care.

“Our findings show more than half of the military members with a mental disorder do not use any of the mental health services available to them,” says lead author Deniz Fikretoglu, an expert in posttraumatic stress disorder, as well as a postdoctoral fellow at McGill University and the Douglas Mental Health University Institute.

As the first national epidemiological survey to examine the mental health of active military over a 12-month period, the study was completed by researchers from the Douglas Mental Health University Institute affiliated with McGill University, the Université de Montréal, Dalhousie University and the University of Prince Edward Island. The team used data compiled by Statistics Canada, based on a questionnaire designed by the Canadian Department of Defence.

The study was nationally representative, since 8,441 Canadian soldiers were surveyed from a total of about 57,000 full time military and 24,000 reservists. The soldiers were questioned on a variety of mental disorders using the World Health Organization’s Composite International Diagnostic Interview. The result? Some 1,220 soldiers met criteria for at least one mental disorder in the past year. The most commonly reported problems were depression, alcohol dependence, and social phobia, although other problems such as posttraumatic stress were also common.

Reticent to seek support
“This was the first study to systematically examine mental health rates and the barriers that prevent military personnel from seeking help,” explained Stéphane Guay, a Université de Montréal criminology professor and director the Trauma Study Centre at the Fernand-Seguin Research Centre of Louis-H. Lafontaine Hospital.

Dr. Guay said military personnel are reticent to seek out support for mental disorders for a variety of reasons. “Foremost among barriers is a failure to acknowledge any need for services and mistrust of military administrative health and social services,” he said, adding that further impediments identified were the belief that a condition is temporary or the inability to identify a problem as a mental illness.

“Mental health disorders are associated with high rates of attrition in the military, which produces a significant economic impact on military organizations,” said Fikretoglu. “It is possible to minimize the burden of mental disorders in the military by ensuring that military members who have a mental disorder seek timely, appropriate care.”

Alain Brunet, the senior author of the study and a researcher at the Douglas Institute, said military personnel must be encouraged to use the mental health services they need – especially after serving their country in war-torn countries. “Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in the health delivery systems to gain the trust of military members,” Dr. Brunet said.

The lead author on this study received support from Veterans Affairs Canada and the Canadian Institutes of Health Research.

For more information:
Sylvain-Jacques Desjardins
International press attaché
Université de Montréal
Telephone: 514-343-7593
Email: sylvain-jacques.desjardins@umontreal.ca [Cette adresse de courriel est protégée contre les robots collecteurs de courriels. Votre navigateur doit accepter le Javascript pour la voir]

Marie france Coutu
Communication Adviser
Douglas Mental Health University Institute
Telephone: 514 761-6131, ext. 2769
Email: marie-france.coutu@douglas.mcgill.ca [Cette adresse de courriel est protégée contre les robots collecteurs de courriels. Votre navigateur doit accepter le Javascript pour la voir]




 
Just to clarify, before someone blows this out of proportion. Not saying it's not a problem, but I'd like to cut some things off.

Some 1,220 soldiers met criteria for at least one mental disorder in the past year.

These 1,220 "met criteria". That doesn't mean that they suffer from a disorder. Wether they did or not wasn't the point of the study. Just that they met criteria.

I'm sure that many answers to the Mental Health Questionaire we filled out on return from Afghanistan could meet certain criteria.

Alcohol intake. Well, I went from an environment of high stress, and no alcohol, to low stress, and lot's of alcohol (lot's of welcome home parties).

Social Phopia. I am sometimes uncomfortable speaking about Afghanistan to people who haven't been, or have no military background.

Mistrust of the system can very well be understood. There are many stories of members who have admitted to having seen disturbing things, and of course, being disturbed by them. And then, according to health professionals, they suffer serious systems, and should be watched.

Like I said, I'm not saying the conditions aren't there, but I want to clarify that the article did not make prognosis on those 12,200, just said they met certain criteria.
 
Sig_Des said:
Just to clarify, before someone blows this out of proportion. Not saying it's not a problem, but I'd like to cut some things off.

These 1,220 "met criteria". That doesn't mean that they suffer from a disorder. Wether they did or not wasn't the point of the study. Just that they met criteria.

Okay,

This is where you lost me....

IF they met the criteria, it owuld mean they reached a level where it affected them.

dileas

tess
 
the 48th regulator said:
Okay,

This is where you lost me....

IF they met the criteria, it owuld mean they reached a level where it affected them.

dileas

tess

Sorry. Not clear enough. What I'm trying to say is, I can put a check in boxes on a questionaire without talking to anyone, and if I checked the trigger ones, I could meet the criteria for a disorder. The study isn't saying that they have them or not. They didn't actually see or counsel them, just said that they meet the criteria for having them. It's not definite. Yes, they very could suffer from a disorder, but then again, they very well could not.
 
How do they distinguish between what 'conditions' they had prior to service and what they got while in service?

BTW, I prefer 'beer talk'.  It's with people you trust, usually thay have had similar experiences, and as a small group you have your own definition of what is 'normal' rather than being compared to the faceless masses...
 
Greymatters said:
How do they distinguish between what 'conditions' they had prior to service and what they got while in service?

BTW, I prefer 'beer talk'.  It's with people you trust, usually thay have had similar experiences, and as a small group you have your own definition of what is 'normal' rather than being compared to the faceless masses...

Good point. I think any study would should take into account that people experiencing problems usually want to discuss them with people who can relate to their experiences in a been-there-done-that kind of way. Not talking to a civilian "couch" doctor who really can not relate to what they've gone through does not necessarily indicate that someone is "not communicating". I've heard a lot of "communicating" and seen some dealing & healing happening over beers that they don't count because it's not "official".

 
It's rather pretty easy to figure out if there was a pre-existing condition or predisposition. A few simple questions on certain criteria in the past can detect this. In this case it is not relevent.

I participated in a research at the Trauma Study Centre at the Fernand-Seguin Research Centre of Louis-H. Lafontaine Hospital which looked at involving the significant other in the help with PTSD. The past was not relevant.
 
ArmyVern (Female type) said:
Good point. I think any study would should take into account that people experiencing problems usually want to discuss them with people who can relate to their experiences in a been-there-done-that kind of way. Not talking to a civilian "couch" doctor who really can not relate to what they've gone through does not necessarily indicate that someone is "not communicating". I've heard a lot of "communicating" and seen some dealing & healing happening over beers that they don't count because it's not "official".

I actually disagree with some of this view.  However, though your statement regarding a stigma towards "couch doctors" exist, a good Doctor will be able to quickly put the person suffering at ease, and proceed with the healing.

Would the Doctor have better chances of helping because they can relate?  Sure, it makes their job easier, but again, a good Doctor will be able to treat the injury.  That would be a kin to saying since a doctor has never treated battle wounds, that thye would not be able to help the soldier heal from his wounds back home.

dileas

tess
 
the 48th regulator said:
I actually disagree with some of this view.  However, though your statement regarding a stigma towards "couch doctors" exist, a good Doctor will be able to quickly put the person suffering at ease, and proceed with the healing.

Would the Doctor have better chances of helping because they can relate?  Sure, it makes their job easier, but again, a good Doctor will be able to treat the injury.  That would be a kin to saying since a doctor has never treated battle wounds, that thye would not be able to help the soldier heal from his wounds back home.

dileas

tess

I don't think we are disagreeing at all Tess. I'm just saying that I know soldiers who prefer to speak with their buds. Factor one after a critical stress incident --- get them talking about it. Soldiers are getting better at doing this amongst themselves.

I'm not saying that "fixes" them -- I'm saying that for some of them, the act of speaking with their buds (even over beers) may be working for them ... it may prevent a further devolution of the mental state downwards.

I'm saying that it's not like the old days where when something happened -- everyone just STFU and carried on being the soldier like nothing had occured. Soldiers talk about it now ... it's not taboo to speak to your peers anymore. For some, getting it out with their peers is all they need, for others it isn't. How many cases of PTSD are avoided because we now promote soldiers getting it out to someone who can relate immediately after a traumatic event rather than tyelling them to 'buck up and carry on'?

The fact they are talking to their peers is a GOOD thing.
 
Sig_Des said:
I can put a check in boxes on a questionaire without talking to anyone, and if I checked the trigger ones, I could meet the criteria for a disorder. The study isn't saying that they have them or not. They didn't actually see or counsel them, just said that they meet the criteria for having them. It's not definite. Yes, they very could suffer from a disorder, but then again, they very well could not.

Further along these lines, I think a better indicator of pathology might be whether any of the boxes ticked are severe enough to interfere with an individual's normally-healthy family and work life.  I suspect (or maybe I read between the lines in the statement by the researchers) that there is merit in consulting a mental health professional of some sort even just to figure out if the mere presence of the triggers is just something that's being managed normally, or is something needing more help.

I don't think it's JUST military folk, though, who may be reticent about approaching professionals for mental health/emotional intervention.  Mental illness still has a pretty big stigma OUTSIDE the CF as well - people who might benefit from counselling or medication may be reluctant to get help lest, heaven forbid, "peole think I'm crazy".  Not to mention a certain percentage of people who may think that because the wound is not visible, it must be a case of malingering.

If yer sick or injured, physical, mental or emotional, you need help, and you shouldn't be ashamed about seeking it - full stop.  Yeah, I know, easier said than done in many cases....

ArmyVern (Female type) said:
Soldiers talk about it now ... it's not taboo to speak to your peers anymore. For some, getting it out with their peers is all they need, for others it isn't. How many cases of PTSD are avoided because we now promote soldiers getting it out to someone who can relate immediately after a traumatic event rather than tyelling them to 'buck up and carry on'? 

The fact they are talking to their peers is a GOOD thing.

I agree 150%, but I guess the question becomes, "how do you get peers who may need more than chatting with his/her buds to cope more help?"
 
ArmyVern (Female type) said:
I don't think we are disagreeing at all Tess. I'm just saying that I know soldiers who prefer to speak with their buds. Factor one after a critical stress incident --- get them talking about it. Soldiers are getting better at doing this amongst themselves.

I'm not saying that "fixes" them -- I'm saying that for some of them, the act of speaking with their buds (even over beers) may be working for them ... it may prevent a further devolution of the mental state downwards.

I'm saying that it's not like the old days where when something happened -- everyone just STFU and carried on being the soldier like nothing had occured. Soldiers talk about it now ... it's not taboo to speak to your peers anymore. For some, getting it out with their peers is all they need, for others it isn't. How many cases of PTSD are avoided because we now promote soldiers getting it out to someone who can relate immediately after a traumatic event rather than tyelling them to 'buck up and carry on'?

The fact they are talking to their peers is a GOOD thing.

Whew,

Okay.  I thought that you were saying something totally different. 

Gimme a break, I haven't taken my meds yet ;)

dileas

tess
 
This is where we see the positive effect of peer support.  A bunch of soldiers, (or a bunch of spouses as in my case) who share the same experiences talking.  I know for myself, sharing what is going on in my head with others helps me sort out what is going on and allows me to formulate my own solutions to my own problems.  Peer support is by no means the end all and be all of "fixing" outselves, but it sure does compliment other things.  And the fact of the matter is, so many times the soldier doesn't recognize, or is ready to admit, there is a problem.
 
ArmyVern (Female type) said:
I don't think we are disagreeing at all Tess. I'm just saying that I know soldiers who prefer to speak with their buds. Factor one after a critical stress incident --- get them talking about it. Soldiers are getting better at doing this amongst themselves.

I'm not saying that "fixes" them -- I'm saying that for some of them, the act of speaking with their buds (even over beers) may be working for them ... it may prevent a further devolution of the mental state downwards.

I'm saying that it's not like the old days where when something happened -- everyone just STFU and carried on being the soldier like nothing had occured. Soldiers talk about it now ... it's not taboo to speak to your peers anymore. For some, getting it out with their peers is all they need, for others it isn't. How many cases of PTSD are avoided because we now promote soldiers getting it out to someone who can relate immediately after a traumatic event rather than tyelling them to 'buck up and carry on'?

The fact they are talking to their peers is a GOOD thing.

Well said Vern. Sometimes it is as simple as just talking to your "fire team partner". For others it might involve going to the next level and seeking professional help.
 
2 Cdo said:
Well said Vern. Sometimes it is as simple as just talking to your "fire team partner". For others it might involve going to the next level and seeking professional help.

Ref to Tess and other comments, I dont have anything against people going to a doctor/psychiatrist and seeking help when they need it, and if ever in doubt of their own sanity then they should.

However, I do see a problem when CF members are judged by the same standards of 'normal' as the general population.  By virtue of the selection process we go through and our exposure to the world during multiple tours, I believe CF members are mentally tougher than your average Canadian, never mind the higher level of physical fitness (in most cases).  In many cases, our ethics and morals are usually different from the average person, often more conservative, i.e. we have a higher level of integrity, we accept responsibility for our actions, action is greater than words, bad guys deserve a bullet not a lawyer, etc.  What is traumatic for a regular member of society is water-off-the-back for many a soldier.  When one of ours gets a case of PTSD or is severly injured and seeks help its because we really need help, not some soft-pedal blow-off. 

Ah, I'm ranting again...

In the end, a professional brain mechanic can help when you really need it, but very few would ever be able to relate to what members have gone through other than nodding their heads and acting sympathetic about it.  To me, having someone understand the situaion experienced is more important than understanding how the mind works or being able to subscribe some feel-good medication.  I expect others will disagree with me on this but Im okay with that too...
 
:warstory:
In 1992 one of our soldiers was killed in a training accident. We went on phone lockdown until it was lifted. This is in the days when we were allowed to drink on ex.
We proceeded to buy a bunch of cheap beer and toasted our comrade and shared stories about him. We toasted him several times!! That was the best "therapy" I've ever undertaken!
We, as leaders, and I know there are many of you on here, must encourage the soldiers to come forward if they encounter any kind of problem, mentally or physically. Sometimes all it takes is a good chat from the Pl WO, or CSM.....and I don't mean "Counselling" either.
We are human too. What affects me may not affect Bloggins ( he's a great guy isn't he?).
Another thing....the people who are sent to decompress soldiers, well, they should have some credibility with the troops. That is my opinion.
Thank you!!
 
Greymatters said:
Ref to Tess and other comments, I dont have anything against people going to a doctor/psychiatrist and seeking help when they need it, and if ever in doubt of their own sanity then they should.

However, I do see a problem when CF members are judged by the same standards of 'normal' as the general population.  By virtue of the selection process we go through and our exposure to the world during multiple tours, I believe CF members are mentally tougher than your average Canadian, never mind the higher level of physical fitness (in most cases).  In many cases, our ethics and morals are usually different from the average person, often more conservative, i.e. we have a higher level of integrity, we accept responsibility for our actions, action is greater than words, bad guys deserve a bullet not a lawyer, etc.  What is traumatic for a regular member of society is water-off-the-back for many a soldier.  When one of ours gets a case of PTSD or is severly injured and seeks help its because we really need help, not some soft-pedal blow-off.   

Ah, I'm ranting again...

In the end, a professional brain mechanic can help when you really need it, but very few would ever be able to relate to what members have gone through other than nodding their heads and acting sympathetic about it.  To me, having someone understand the situaion experienced is more important than understanding how the mind works or being able to subscribe some feel-good medication.  I expect others will disagree with me on this but Im okay with that too...

I refute that statement.

Every health profeesional that I was referred, with regards to my mental health and the suffering I went through, has been a civilian.  Luckily, they did have the experience of treating others that have served, giving that experience. However, none of them served, they were medical professionals that knew how to "Work on the brain".  Medication is only prescribed as an aid to help the healing.  Too many people that I know refuse to take medication, just because of your type of statement.

By making this sort of allegation, you are perpetuating a myth, that these civilians do not understand how to heal us.  And your are therefore impeding the average soldier from getting the help that may be required, as they would feel that you are correct.

Let me reiterate what I asked before, should the soldier that was wounded physically overseas, refuse to have a civilian Doctore help to treat and heal them?  Or how about a Civillian Physiotherapist to help rehabilitate them?  Based on your theory, they do not know what the soldier has gone through, so they would only be going through the motions and subcribing feel good medication to numb the pain.

Unfortunately, you are making observations based on what you think, not what is well known, and that is much more serious and dangerous to the healing process.

Sorry for my rant too..

dileas

tess

 
The trick cyclist I see in Edmonton is on virtually every expert panel on OSIs there is... She's one shit hot shrink, and I don't think I'd be where I am if I'd just shot the shit over a few beers and walked it off.
 
I'm going to have to agree with Tess and Kat (and I think most everyone here is saying pretty close to the same thing really, just in different ways).

None of the civy types that I have dealt with over the years (since '99) have served. Like Tess, I was lucky that they did have experience working with us or other groups that also encounter CI's (critical incidents, not sure what they call them now, changes every time a new paper is published). They have helped me and my family immensely, but you have to ask for the help (which is the hard part sometimes).

Also, like others have mentioned, talking with your buds or a person of some respect can have a great impact as well. The summer of '06 was very difficult for me and I had been posted away from just about everyone I knew. I sought out a few individuals that I hoped would be able to give me some advice on coping being stuck here. Over a few beverages, over a relatively short period of time, their speaking with me had a huge impact on my health.

The biggest thing to me is that there are still huge stigmas attached to mental illness. You should see some of the looks I get when I walk in front of the physio dept into the "crazy" hallway here in Kingston. Or even more important, the lack of eye contact or conversation in the waiting room down at the end of that hallway. If this new study can help reduce those stigmas, then I'm all for it. Where do I sign up?

Wook
 
the 48th regulator said:
Let me reiterate what I asked before, should the soldier that was wounded physically overseas, refuse to have a civilian Doctore help to treat and heal them?  Or how about a Civillian Physiotherapist to help rehabilitate them?  Based on your theory, they do not know what the soldier has gone through, so they would only be going through the motions and subcribing feel good medication to numb the pain.

Hmmm... I admit to biased opinion on the subject, but will not argue with your valid point. 


 
Here we have POPS (Post Operational Psych Screen).

Manditory for all. One interview upon returning to the staging area, one at 90 days at your home loc, and one at 6 months, with possible followups if required.

I did not apprecaite talking to a 24yr old LT within 24 hrs of leaving Baghdad, and I told her what she wanted to hear, just so I could get out of there. She had never been in country, and her only life experience was a text book. The next Psych I spoke to was a MAJ, with a chest full of gongs, and I related much better to her.

At times we gather with mates, and talk about those 'tiwsted' times, and we all seem to have a good laugh, but when we hear of another who has serious issues, its pretty silent.

EDIT: I too felt much better off blowing off steam with a pro, than if I had a few beers in the mess with mates. issues that I have are documented, so should ther be any furter issues, its allready on paper. I am sure I will be fine.

Regards,

Wes
 
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