Homecoming: The Casualties of War
Back for another in-depth examination of Canada’s military, Esprit de Corps Editor Scott Taylor hosts a new documentary on the state of veterans’ mental health. The hour-long piece explores the impact the decade-long War in Afghanistan had on the families of the fallen, those who suffered physical and mental wounds and the public and private support services that are in place to assist them.
►The Standing Committee on Veterans Affairs recently studied front-line health services for Canada’s veterans.
According to their May 2012 report, Canada is isolated from the U.S. and other allies in not providing clinical psychologists in uniform.
“Military members have access to psychologists from operational stress injury clinics, but these are civilian psychologists working off military bases. In addition, military members must be referred to them by DND case managers. These are cases that have reached a degree of severity that could have been mitigated by making military psychologists available.”
The committee called for National Defence and Veterans Affairs to consider the potential benefits of integrating clinical psychologists within Canadian Forces units.
Both departments jointly operate 10 Operational Stress Injury Clinics – only one provides residential services for psychiatric patients. The committee pointed to a lack of mental health care in emergency situations.
- The NDP response to the report called for “better support for those suffering from PTSD and other mental health concerns.”
- The Liberals called for immediate integration of clinical psychologists and access to emergency psychiatric care.
The government’s official response to the report pointed to increased outreach with veterans and funding for mental health care and research.
And on the question of psychiatric care:
DND/CF currently employs 51 civilian clinical psychologists that work as part of an interdisciplinary team of civilian and military psychiatrists, psychologists, social workers, mental health nurses, addictions counsellors, chaplains, and support staff at the DND/CF Operational Trauma Stress Support Centres. Initiatives are in place to give civilian providers an understanding of the military culture and work environment, and CF members highly value the specialized expertise of these health care professionals. Our Government constantly evaluates the level of care it provides to CF members and DND/CF will continue to consider hiring additional civilian clinical psychologists and to assess the feasibility of adding military clinical psychologists.
Post Traumatic Stress Disorder (PTSD) and other mental health disorders appear to be more common in veterans than active members of the armed forces, according to research.
1) re-experiencing a significant trauma experience involving actual or threatened death/injury for at least one month after the fact;
2) efforts to avoid conencted thoughts and activities; and
3) physical symptoms including poor sleep, anger and irritability, and trouble concentrating.
Stress, lack of support, and bereavement are seen as aggravating factors.
Read the official definition for PTSD from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
►Through the ages
The effects of war on the minds of those fighting has been chronicled from the famed battles of Ancient Greece, through the Middle Ages, and into the era of modern warfare.
Swiss doctors from the 17th century used “nostalgia” as a term for mental health issues related to combat. The U.S. Civil War saw many soldiers abandoned to roam the countryside after being declared psychologically unfit for duty.
The term “shell shock” was used during the First World War to describe reactions to the fierce sound and fury of artillery exchanges. octors assumed repeated exposure to artillery produced concussions and “micro-bleeding in the brain,” according to historian Richard A. Gabriel. Terms evolved into “war neurosis” and than “gross stress reaction” by the early 1950s.
Nearly 40 per cent of the 800,000 U.S. soldiers directly exposed to combat during the Second World War were permanently discharged as “serious psychiatric cases,” according to research. READ MORE
Vietnam veterans returning to North America in the late 1960s were receiving mental health treatment in greater numbers. One American study later concluded that up to 830,000 out of 2.8 million Vietnam veterans had partial or full PTSD.
Psychiatrists cointed the term “catastrophic stress disorder,” which officially became “post-traumatic stress disorder” in 1980.
By 2008, the RAND Corporation estimated that 300,000 of 1.64 million U.S. armed forces members in Afghanistan/Iraq could have PTSD or depression.
►How will the Afghanistan mission affect public policy even after combat is over?
A 2011 Library of Parliament study predicted that of the 25,000-35,000 soldiers expected to be released from service over the following five years, at least 2,750 would suffer from severe PTSD, with 6,500 officially dignosed with a mental health problem.
Here are some more numbers from the study:
- Research suggests that PTSD is two to four times more common in combat veterans than the general population;
- Vietnam–related PTSD among U.S. veterans remained at 2 to 17 per cent as of 2011 — more than 35 years after the last troops left Saigon;
- National Defence reported in June 2011 that only five per cent of active personnel reported PTSD or depression within six months of returning from deployment;
- Veterans Affairs, in contract, reported PTSDin 11 per cent of veterans released between 1998 and 2007; 23.5 per cent if depression, anxiety, and other mental health disorders are included. For those receiving disability benefits after 2006, the number soared to 42.5 per cent and 59.9 per cent, respectively.
- Mental health needs for veterans are expected to double by 2016.
- “Each year, over 20% of all veterans can be expected to suffer from the symptoms of operational stress injury, which will take the form of sever PTSD for half of them. These percentages will be twice as high for veterans who are clients of (Veterans Affairs).”
The 2001 census reported on PTSD in active Canadian military personnel:
- 2.3% among a sample size of 8,441 personnel
- This number doubled for those with combat experience
- The number reached nearly 10 per cent for those witnessing atrocities, according to the LoP, who argued “at least 30 per cent of soldiers involved in combat oeprations risk suffering from PTSD or major depression during their lifetime.”
Physical and mental disability payments can reach nearly $299,000 (100-per-cent disability). About 15 per cent are at or below the five-per-cent disability level, which results in an approximate $14,930 payment.
Charities have also tried to pick up veterans who need support.
WATCH: Wounded Warriors officials appear at the Senate’s veterans affairs subcommittee (Dec. 5, 2012)