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My experience with the CAF mental health system

SonaSonic

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Hey all,

With all the controversy and media attention surrounding how we treat our members and veterans, especially as it applies to mental health and suicide prevention, I thought I would provide my personal story and perspective.

Back in May, my spouse and I separated after four years together.  She felt like she wanted to spread her wings and see the world before settling down and being a grown up.  I was devastated and blind-sided.

In the following weeks and months, I had interactions with several members of the CAF medical staff:

Personal
The biggest barrier to coming forward was me.  It wasn't that anyone or anything was stopping me.  It's that there is still a definite stigma in our system that asking for "help" is bad; that we should just suck it up and solider on.  I tried holding out for about two weeks after our separation.  I wasn't sleeping well, I was constantly tired, I was drinking a lot, I wasn't focused, and I was constantly feeling anxious.  Finally, I found the mental health contact information through the DIN and called CFMAP.

CFMAP
CFMAP is a free and confidential referral service.  I called them and explained that I needed to talk to someone.  The woman who answered was professional and the service was quick (just a few minutes wait time).  She asked if I was suicidal, I said no.  She asked how bad I was feeling on a scale of 1 to 10, explaining that if it was urgent I could see someone that night (I think it was about 10pm on a Saturday).  I said I was okay if I had to wait a few days.

I was given a list of several counsellors in my area and with hours that suited what I wanted.  I chose one and was given their contact informaton.  I was told they would be contacting me within 48 hours.

The Counsellor
The counsellor was quick to call me and set up an appointment.  A few days later I had my first appointment. The counsellor, to my surprise, was not a psychiatrist or psychologist... she had a Master of Arts degree in psychology.  The office also specialized in gambling addictions and financial counselling more than mental health and personal counselling.

The good thing about this counsellor is that they're outside the CAF/DND 'system'.  The bad thing is that you need to go back to CFMAP and request additional sessions if you need more than that.

The CAF Mental Health Team
After one session with the counsellor, I called the CAF mental health team.  The counsellor I was referred to could see that my questions/complaints were going to take more than three sessions, and the CAF counsellors could offer as many sessions as were needed.

They too were quick to respond to a voicemail message I left.  They asked if I was suicidal, to which I said no.  They explained, however, that they would not set up any appointments by phone: I would have to come in and check in, at which point I would be triaged and served depending on the urgency.  This was one of the most terrifying parts, because it felt like there was the possibility that they would keep me for a period of time for evaluation and not let me leave.

So checking in was terrifying.  The receptionist was discreetly marked (I walked by it several times).  The 'waiting room' for mental health was also fairly discreet and away from the rest of the hustle and bustle.  I waited and was seen by a civilian counsellor.  She was friendly, asked again if I was suicidal, and suggested that I use up the counselling sessions through CFMAP before returning to the military counsellors.

My chain of command
The time came that I knew I had to tell my chain of command.  Not that I expected them to do anything, but I knew my head was out of it enough that it had the potential of affecting my work/me needing the time to attend counselling.  I spoke to my Sgt who was understanding.  She said it would be kept confidential and said if I needed to speak to her I should feel free to ask.

Back to the counsellor
I had my second session with the counsellor. It felt more like a factual interview than her really 'helping' me with anything.  At the end of that session she asked "So, do you need a third session?" I felt like I was a nuisance in her financial planning business... it was as if she was asking "so... are we done yet?"  I said I would let her know.  She said if she didn't hear from me shortly she would close my file.

That's been my experience in interacting with the CAF mental health system.  Now, for my perspective:

The Good:
- Everyone was quick and professional.  There was very little waiting.
- Finding information is very quick.  A DIN search for the mental health contact info and a Google search for CFMAP was all it took. The information is there.
- Almost every level was quick to ask if I was suicidal to gauge the level of intervention that would be needed.
- I did end up telling a few other guys at work who I'm close with about the situation.  Their support has turned out to be far better and greater than what the counsellor offered.  Lean on your buddies when you need them; chances are they've been through similar circumstances.

The Bad:
- I don't know how this counsellor was put on the CFMAP counsellors' list, but she was not well suited to my problems.  Who made that mistake, I'm not sure.
- There is still a stigma for seeking mental health services.  I don't know where it comes from, but it's still there.
- There is too much pressure to 'resolve' the complaint within three sessions.  How do I know how long a problem will take to 'resolve'?  It seems unfair that the pressure is placed on me to ensure the issue is 'resolved' within the budgeted amount of time, rather than the counsellor communicating with CFMAP to ensure I received the help I needed.
- I don't know whether my Sgt informed higher in the chain of command, or kept it to herself. I would *hope* that she informed them so they too could be aware, but I was never told if she did.

And, the big one:

- There has been no follow up.  Not from CFMAP.  Not from the CAF counsellors.  Not from my chain of command.  It's been three months and no one has called me to say "hey, how are you doing?"  "Hey, what's going on?"  "Hey, just checking that you're okay."  IMO, this is our greatest weakness.  I let everyone know that I was not suicidal, but if I was to commit suicide, how would CFMAP, the CAF mental health team, or my counsellor know - they never called to ask.  At the very least, I would expect them to follow up.

Anyway, that's been my experience  :salute:
 
Sona- thank you, this is useful and informative, and it's awesome of you to have shared your experience with 'the system'. I hope more people will do so, these kinds of clearly laid out examples help to figure out where the strengths and weaknesses are, and to demystify what happens when folks step up and say they need to get checked out.
 
Has anybody ever looked at any link between stress, vitamin depletion and mental health issues within members of the forces? 

Just a thought that I've had after being in a number of years and experiencing and seeing first hand some of the effects of stress and fatigue.
 
Such an... odd... question I think... but I guess all's fair in the interest of science?

Mine is not vitamin related... I will promise you that!
 
Good day,

I just completed basic training, and I really need to see a psychologist. I'm worried about my results getting attached to my pers file, so I am considering seeing a civilian psychologist. The only problem is is that they are very expensive and I don't have the money. Are there any military psychologists that do 'anonymous' sessions?

CFMAP only has counselors, as far as I'm aware..

Does anyone have any suggestions?

Thank you
 
CFMAP counsellors are clinical psychologists or clinical social workers as a rule.

Asking to see a psychologist doesn't go on your pers file, since it's a health issue, so it will go on your medical docs, which isn't the same thing.

Hope that helps.

MM
 
You should keep in mind that there are no uniformed psychologists in the Canadian Armed Forces.  Any psychologist you see will have the same confidentiality levels.  It is very rare that you will self-refer to a psychologist, you will normally need a referral from a military or family doctor.  In the military health care system you will then see a mental health nurse or social worker for 'intake' and initial assessment (symptom review) before being referred to a psychiatrist, a psychologist or a social worker for further assessment and to begin a treatment plan if appropriate.  In civilian health care environment, depending on where you live and whether you have previously seen a particular psychologists , it can take a significant time period to get to an appointment with a psychologist and often, for a referring doctor to find one that has the appropriate expertise to assess/help/treat you and that has a immediate opening in their schedule.  Many family physicians and military general medical officers have some experience with psychological, general mental health and social disorders.  Therefore, IMHO you are jumping some hurdles to go straight to a psychologist and not all psychologists have the same area of expertise for assessment and treatment:
Clinical neuropsychology.
Clinical psychology.
Community psychology.
Counselling psychology.
Educational and developmental psychology.
Forensic psychology.
Health psychology.
Organisational psychology
 
Thank you both for your reply.

I would like to go to a military health clinic, but still, what I am worried about is if my medical docs are reviewed in the future when I am up for promotion, and my supervisors read about my past mental health problem.

Basically what I am saying is that I am worried this will impact my career.

Thanks again.
 
Medical files are not reviewed by promotion boards.  Doctors, Med Techs and HSO are very protective of them.  Your supervisors do not have access to them.

If you are ever given medical restrictions, your chain of command will only receive a form (I think a 2088) that states things like "Unfit field" or "PT at own pace" or similar things - never "Member thinks he is the reincarnation of Jimi Hendrix.  Keep away from the CO's guitar collection."  or "Member has been diagnosed with syphilis, chlamydia, gonorrhoea and cooties".  The CAF medical system takes patient privacy very seriously.


If you break a leg, no one thinks twice about you going to see a doctor.  Mental health issues can be injuries as well, and are equally in need of treatment. 
 
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