I fear brevity is not my strength. However, when I participated in the committee that advised the Deputy Minister of Veterans Affairs for nearly four years and which led to, ultimately, the creation of a report that led to the charter—and Admiral Murray was the DM at the time—we debated at length the co-location even of the Veterans Affairs Canada clinics on bases to make it maybe easier administratively and so on.
However, there are still frictions within the forces between those who are veterans and recognize that this is an injury and those who are not veterans and say “It won't happen to me”. That friction was there in the fifties, after World War II and Korea. So that friction is underlying some of the stigma that is brought to those who come forward with the injury. There have been occasions on which the place where the psychiatrists and psychologists work on base is well identified, and on which people watch who go there and the word is passed around and so on.
At senior levels and as you go down there is an attitude of recognizing that post-traumatic stress disorder is an injury—it's not a disease, it's an injury, because our brains are physically affected; there are circuits that are burnt, but also it has physical impacts on us. It's an injury that is to be recognized with the same level of urgency and concern as the guy with his arm dangling. However, in a very Darwinian organization that bases its criteria on the overt expression of courage and determination and commitment, there are still those who have a problem with things they can't see. We are very visual people, so it's hard to see the injury between the ears until you start looking into the eyes of the people and raise a few things, and then you see the impact.
I don't believe the forces have sorted out the culture side yet. They've been fiddling with it and so on, but I really don't think they've cracked that code. Battalion commanders are put through an extensive program before they do go into the battalions. They try to pass it on, but you still get the odd jerk running around who can influence 800 or 900 people. So I think formalizing a culture change in regard to this injury is still not completed.
Also, how the veterans are able to influence the non-veterans is of enormous significance, particularly when you notice that veterans are fighting with those inside the wire and those outside the wire. But we had that in Korea and we had that in World War II.
Off base, you have none of that. No one knows the unit commander is going for a medical review, or wants to go. Off base, it is not within a realm that can permit a stigma or an identification. When I was ADM Personnel at the time, three stars and responsible for the medical system, I kept telling the specialists, “Of course you want the person to come to you to speak about his problem, but you're not allowed to sit there and wait until they hit your door”.
One thing the specialists don't do is go out and sell their product. They have to go into the company levels, down to the platoons. They have to go sniff out what's happening and with their expertise be able to identify some of that stuff. They have to go around to the units and pass on information and bring people to them that way. One psychiatrist and one psychologist in that nature of theatre is not enough. There is a lot of training being done to recognize it at the unit level and so on, but you need a couple of pros there. If you really had a bad scenario, like we did in Medusa when we had a bunch of casualities, one of each simply are overwhelmed. And then you start evacuating maybe people for PTSD or symptoms of PTSD and then you get the whole stigma going.
So you need more there off base and support for them.