Thank you, Mr. Chairman and honourable members of the committee, for your welcome.
I'd like to introduce Andrea Siew, who is with me today. Andrea is one of our service officers in the dominion command service bureau. She is a 28-year member of the Canadian Forces and a recently retired commodore. She has joined us to help with our advocacy for veterans.
On behalf of our dominion president, Patricia Varga, it's an honour to be here again today to discuss the issue of what we call “combat stress”, or operational stress. For those members of the Canadian Forces who have served on operational combat missions around the world, the experience of those deployments may never end. The experience will also affect their families both during and after their deployment periods.
We've looked at a number of factors that will affect how members of the Canadian Forces will react to combat stress. You have that in the presentation before you.
We look at pre-existing vulnerabilities, which include things like age, family background, and their emotional state.
We also look at the training and the organizational environment, which includes such things as how many reservists are in the deployment. A large percentage of reservists are going out on deployments on the operational side now. You can imagine that any casualties that happen in a given deployment will certainly affect the whole psyche and structure not only of that command element but also of those people on that deployment.
Of course there is the nature of the stressors linked to deployment. They include the duration of the deployment--sometimes when Canadian Forces members deploy, they're deployed longer than what they anticipated at the beginning--the number of additional deployments, how many deployments a person goes through during his very short span, and the complexity and the exposure of those deployments. Some deployments are easy. Some deployments are not so easy.
As well, there's the multiplication effect of pre-existing comorbidity problems, such as chronic pain, depression, and things like alcohol and drugs.
Trauma directly affects how individuals define themselves. Some individuals react to trauma more than others do, for various reasons. Those more at risk are sometimes individuals with multiple and/or fragmented personalities. They may have difficulties adapting. They may have changing perceptions of not only themselves but also the world around them.
Trauma will affect soldiers differently based on gender. Female soldiers exposed to trauma will have less PTSD and fewer alcohol abuse problems, but they will most likely suffer from greater levels of depression and eating disorders. It is also likely that their trauma will be associated with increased exposure to sexual stressors, which will require a completely different type of intervention to deal with.
Traumatic effects can be minimized depending on the duration of the exposure and on the environment, such as the workload, the goals and values of the organization, the support of leaders, and group cohesion. Group cohesion is important. Exposure to stressors in early childhood will also reduce resiliency later in life. The more a person is exposed to them, the less likely it is that he is going to suffer in later years.
During deployment, exposure to warfare can be seen in different ways, based on the perceived threat and concerns about relationships that may already be fragile, especially if the deployment is of a long duration--12 months or more--and if one is subjected to multiple deployments.
Research done in the United Kingdom indicates that one should never deploy for longer than 12 months in a three-year period. I hazard to say that some of the deployments today are for a shorter timeframe than that. If you cross that threshold, the rate of PTSD doubles.
Try to take that relationship back to those who went to World War I and World War II. They were gone for four years. They never came home during the four years.
Research in mental health has established a direct link to trauma exposure, operational stress injuries, and suicidal behaviours. Those impacted see themselves as different, but not necessarily in a negative way. They do, however, see their world in negative terms. They develop a we-them relationship with civilians and sometimes with other organizations within the Canadian Forces itself, and often express hostility and contempt toward those outside agencies.
While they live deliberately to the full, they have to deal with a diminished self and they exhibit emotional fragility. Unfortunately, this emotional fragility draws a toll on spouses and children, who actually live the mission through our modern IT connectivity these days. For example, how many times have you heard that six NATO soldiers were killed in Afghanistan? Imagine the impact that has on the families sitting back in Canada, knowing that their people are deployed and not having any idea of what's happening. The world of media brings it closer into the home today.
Families not only live the mission through IT connectivity, but they're also directly affected by the impact of returning injured family members. The bottom line is that they're all casualties. The Canadian Forces and Veterans Affairs must take responsibility for not only the soldiers but also their families. The current status quo is no longer a choice.
It should also be recognized that there are numerous barriers to improved mental health. Some may have no interest in treatment. Some will abandon treatment after too short an intervention period. Young males may be more inclined to refuse the treatment or the intervention. Young males with major problems are often those who leave the Canadian Forces early. They are often alone--marriages have broken down--and they spiral downwards into alcohol, drugs, and homelessness. They go all the way to the bottom. They have not built up the necessary resiliency to actually deal with their conditions. For those silent sufferers, barriers to mental health must be eliminated. The leadership must continue to provide support at all levels. That's starting to change these days. It's starting to happen.
Practitioners need to establish trust. All barriers to access must be eliminated. Treatment must focus on resiliency rather than pathology. What I mean is treat the individual; don't give him a bunch of drugs. Drugs may be a necessary aspect of it, but don't just give him drugs.
Unfortunately, in the CF there is no model that provides prescriptive guidelines for intervention by either Canadian Forces or Veterans Affairs mental health practitioners. This is the norm in the United Kingdom and the United States. In Canada, Canadian Forces and Veterans Affairs mental health practitioners at both the operational stress injury and the operational trauma stress support clinics rely on informative guidelines provided by the Canadian Psychiatric Association.
Additionally, access to a single point of service for Canadian Forces members and their families remains an unattainable objective. A more cohesive approach must be found to deal with the fact that access to mental health services is dependent on the CF member coming forward, self-identifying, and asking for that treatment.
A critical issue is services for family members who are also victims of interpersonal violence. Assistance to families of reservists who come back and are back in their home environment must be improved to break down the sense of isolation. Imagine: they've been trained and deployed, they have group cohesion, they come back, they go through the decompression period, they go back to their home units, and they're isolated.
Programs that can meet the needs of children must be developed, keeping in mind that the needs of children when they're five years old will be different from their needs when they are teenagers.
Though progress has been made, from our perspective significant challenges remain. The OSI and the OTSSC clinics are not always in the right locations. More importantly, there's a profound lack of academic research in Canada on the life course of mental health issues related to Canadian Forces members. We have to rely on information that comes from the United States and elsewhere.
Even though we see the recently announced Canadian Forces cancer and mortality study as a step in the right direction, there needs to be greater coordination between the Canadian Forces and Veterans Affairs on what is needed in analyzing all life-course issues related to the mental health of Canadian Forces members, veterans, and their families.
I'll step back in time. In its day the Legion played a valuable role, and it still plays a very valuable role today. Back when PTSD was not a common community thing you could identify, members came back from World War I, World War II, and Korea and went to the Legion halls where they self-medicated. They closed circle with their friends and buddies they trusted. That's where they got their treatment for PTSD, or what was called “shell shock” back in those days.
We continue to be engaged in various programs, including transition programs for the homeless, such as the Cockrell House in Victoria--a very effective program--and the B.C.-Yukon transition program for those with mental health issues. This has been in place since 1998, in cooperation with both UBC and the University of Victoria. It's a very effective program for treating individuals with PTSD.
The recent Leave the Streets Behind program, which is in partnership with Veterans Affairs and centred out of Toronto, Ontario, is a model that is working well. We're starting to transport that model to our other provincial commands across the country so they can start looking at homeless programs for veterans in their communities.
There's also the Alberta-Northwest Territories command program with Outward Bound. You may have seen some of that on the CBC report Connect with Mark Kelley. They did a report on the Outward Bound program for people with PTSD. The Legion funds members to go on that program. It doesn't cost them a thing.
In Alberta, and particularly in Edmonton, we are supporting the Alberta military family resource centre child program for children of parents who have experienced trauma. So far we've funded eight serials of that program in Edmonton.
While it is said that we sleep to forget, one must not forget the impact of operational stress on Canadian Forces members, veterans, and families. The Government of Canada must provide support to those who served and to their families, who are now alienated through no fault of their own. The status quo is no longer a choice. If we do not become more proactive rather than reactive, we will regress.
At the bottom of the page you will see the various organizations we have consulted. The Royal Canadian Legion makes presentations such as this, and we shop it around to various organizations. The Army, Navy, and Air Force Veterans in Canada, the Canadian Naval Air Group, the National Aboriginal Veterans Association, the Royal Canadian Naval Association, the Air Force Association of Canada, the Royal Canadian Mounted Police Veterans Association, and the Company of Master Mariners all support our presentation here today.
Thank you for the time to make our presentation.