Military preps battle plan for mental health

Canadian Forces psychiatrist says there is no suicide epidemic among soldiers

Kim Miller has a reputation for being tough.

"I always had the nickname ‘G.I. Jane,’" she said in a Canadian Forces awareness video. "No one knew exactly what I was going through inside."

As a captain with the Canadian Forces (CF), Miller has faced down plenty of challenges. But when mental health issues became the challenge, Miller was at a loss.

"I was scared. It took me eight years to actually seek help," she said. But eventually, she reached out to the Forces’ mental health services — and it was the best decision she’s ever made, she said.

Miller is just one of many soldiers who shared their experiences in a new awareness video about mental health care in the Canadian military. The video, called Mental Health in the Canadian Forces: You’re Not Alone, is accessible on the CF website.

A surprising number of soldiers volunteered to share their experiences, said Suzanne Bailey, senior staff officer of social work and mental health education with the Canadian Forces in Ottawa.

"Within three weeks, we had over 200 volunteers," she said. "They were all passionate about the fact that seeking mental health care was good for their career, it was good for their family, they found it beneficial personally."

The Canadian Forces has a broad range of resources available for treating operational stress injuries (OSIs), said Paul Sedge, a psychiatrist with the Canadian Forces in Ottawa.

To pre-emptively address these types of injuries, soldiers receive training through the Road to Mental Readiness (R2MR) program before they are ever deployed, said Bailey.

"(We) wanted to give them some really simple tools to manage those situations where fear and panic might come into play, and help them recognize how they might respond in those situations… with the ultimate goal of mitigating longer-term mental health problems," she said.

After a deployment of 60 or more days, soldiers participate in the Enhanced Post-Deployment Screening process, a comprehensive screen for signs of distress or mental health injury.

Assistance is readily available at every military base in the country, said Sedge.

"We have a mental health clinic, or a mental health clinic equivalent, at every base in Canada. So anywhere a soldier goes, they can get access to mental health services…We also have seven of those clinics that have been upgraded to Operational Trauma and Stress Support Centres, so these are mental health clinics that specialize in mental health injuries," he said.

There are also base health and wellness services, family resource centres, health promotion teams and a chaplaincy branch that includes multi-denominational padres.

A free, confidential 800 number, operated by the Canadian Forces Member Assistance Program, quickly connects personnel or their dependents with counselling services. There are also crisis counselling walk-in clinics available.

The CF health services are well equipped to treat mental illness, said Sedge — and if ever a situation arises where there is a gap in care, they are able to provide access through civilian health-care providers.

"So if we have unfilled positions in a clinic, because we couldn’t fill them because we couldn’t find a qualified person, or we couldn’t find someone willing to come here for what the pay was… we can refer them to a community provider. As a result of that, we’ve been able to keep our wait lists down to very respectable levels."

For soldiers, wait times are far better than for the general population, said Sedge.

"For example, (in Ontario), if you go to see your doctor, and the doctor thinks you should see a psychiatrist… you’re probably going to wait six to nine months. (If) you’re in the military, and you get seen by your medical officer and he refers you to see a psychiatrist, you’re going to get seen in two to four weeks," he said.

For psychotherapy from a psychologist, civilians aren’t covered by OHIP, and even third-party insurance coverage is limited.

"If you’re in the military, it’s unlimited — we provide whatever psychotherapy you need, we have our own psychologists and we also access psychologists in the community, and the (soldier) doesn’t pay anything," he said.

For crisis counselling, a civilian would often have to go to an emergency room and wait hours to see a mental health nurse. In the CF, crisis counselling is available on a walk-in basis, and you’ll usually be seen within an hour, he said.

Despite the level of care available, seeking help can be difficult — especially when there are many misconceptions about mental health, said Sedge.

"Stigma about mental illness exists everywhere — it’s not limited to the Canadian Forces," he said.

There is a perception out there that there is a suicide epidemic among Canadian soldiers, said Sedge — but that perception is untrue.

"The suicide rate is not higher among (CF) members, it’s not increasing, and there’s not a suicide epidemic," he said.

Thirteen suicides by soldiers were reported in 2013, according to the CBC, which led to increased scrutiny about the availability of mental health care for soldiers. But a 2013 National Defence report, based on data from 1995 to 2012, found suicide rates among CF personnel are lower than those among the overall population, and there has been no statistically significant change in CF suicide rates since 1995.

"It’s very hard when you see news reports about people suggesting that we don’t have the services available to our members, and members can’t get the care they need," said Sedge. "The reality is quite the opposite."

That’s why the CF has made awareness a priority, so soldiers can be well versed in what resources are available to them. CF is also developing mobile applications to make information about the resources available in the palm of your hand.

"If a person thinks the resources don’t exist, or that the treatment doesn’t work, why are they going to open up and admit they have this illness?" said Sedge. "So we want to reduce those barriers to care by getting the word out that the resources are available, and then showing cases where people have had positive outcomes."

The CF is very focused on eliminating any barriers to soldiers seeking help, said Bailey.

They have a number of stigma reduction initiatives, and involving leadership and peers in communicating those is key.

"When we teach the (R2MR) program, we actually teach it with either retired CF members or currently serving operational military personnel, because they can bring a type of relevance and credibility to the material that we as clinicians can’t bring," said Bailey. "We found that that goes a long way to decreasing the stigma… It resonates a lot more."

To read the full story, login below.

Not a subscriber?

Start your subscription today!