Good morning, everyone.
Today I will be talking about suicide prevention, which is obviously a very complex topic.
For military personnel and veterans, the risk factors for suicide are, for the most part, the same as those for the general population. They include mental illness, drug or alcohol use, isolation, grief, loss of relationships and chronic pain. However, we all know that the suicide rate is higher in this population, and it seems that some factors pose a greater risk for members of the Canadian Armed Forces.
I don't have enough time to talk about all the factors today, so I want to focus primarily on the unique processes of enlisting in and being released from the armed forces as well as notions of identity. I will base my remarks on the clinical observations I've been making for over a decade with this clientele.
It won't come as news to you if I say that enlisting in the Canadian Armed Forces is a professional commitment unlike any other. It involves developing a new personal identity that merges with one's professional identity. Ideals such as public service, common good, defending shared values and strong camaraderie are prioritized, and military personnel give up some of their self-determination and individuality to prioritize the collective, in some cases risking their lives to do so. These career choices must involve individual sacrifice, and it is those sacrifices we ask of them that later increase the risk of suicide.
While in the military, people must endure physical discomfort and pain, set aside their negative emotions and avoid focusing on their mental state, which is considered to interfere with the achievement of the ultimate goal: to act as one. It's a very taxing lifestyle for the family, as it can involve being uprooted, moving and straining support networks.
Being wounded on the job and no longer able to perform the same function within the group can trigger distress. When a person can no longer be part of the institution like their peers, they may struggle to manage mental states that have been ignored for some time. They may experience shame and humiliation in relation to their weaknesses and difficulty defining themselves as an individual. That is a direct legacy of their years of training and service.
Of course, that's in addition to the burden of enduring pain on a daily basis, having nightmares, mentally reliving difficult events, experiencing worsening mood and coping with a whole new allergy to stress and pressure because of an operational stress injury. Added to that is the stigma still associated with mental health issues. Many people find it difficult not to equate psychological problems with weakness.
As I said at the beginning of my remarks, today I want to discuss suicide risk related to the nature of enlistment in the forces.
It won't come as news to you when I say that the moment people leave the armed forces, they enter a period of high risk for depressive episodes. I've seen this in my clinic. Suicidal thoughts may emerge. There are a lot of things we need to consider. The absence of continuity of care is experienced as a loss of stability. The repetitive, redundant assessments former members must undergo can ratchet up humiliation and shame when they have to face their shortcomings. They may become intensely angry when they find their experience has become run-of-the-mill and bureaucratized. Aggression and humiliation are two documented risk factors for suicide.
Furthermore, the expectation that former members of the military will be successful at self-determination after serving 15, 20 or 30 years in the forces may simply be unrealistic. It makes them feel terribly inadequate because they feel they have to prove themselves when they have just devoted years of their lives to serving their country. Let's not forget that we have, to some extent, trained these people to think in dichotomous terms, sometimes strictly in black and white with no shades of grey. While this served them well in the field, it is detrimental to them in times of distress.
Although they were undoubtedly designed with the intention of providing effective guidance and support to Canadian veterans, the standardized rehabilitation services currently available from Partners in Canadian Veterans Rehabilitation Services seem to me to be largely unsuited to veterans and do not allow for adjustments to be made for those who are vulnerable and whose military identity was all they had. Those people are the reason I wanted to testify today.
I am very aware of the complexity involved in supporting these men and women as they leave the Canadian Armed Forces, often with significant and chronic injuries. I also recognize the generosity of the programs in many respects, as well as the progress made in destigmatizing mental health in the forces. However, I believe that if we want to think about suicide prevention among veterans, we need to consider the nature of what is asked of them in the course of their service and the fact that the transition to civilian life, a very difficult process, is in fact a process of acculturation in their own society. It's a process in which they experience alienation from civilian society once they are released from service.
Good soldiers pay attention to their psychological health. A psychological diagnosis should therefore never end a military career if it is dealt with, as was unfortunately the case in the past. I'm told that times are changing and that young military personnel are less concerned with rigid and harmful conceptions of mental health. I hope that's true.
In closing, in one of this committee's reports on the release of Canadian Armed Forces personnel, I read that it was recommended that Veterans Affairs Canada be able to process all veterans' claims and that veterans be assigned a civilian family doctor before being allowed to leave. I think this is a very good example of what could really make a difference in the lives of some former military personnel and reduce their feelings of helplessness, humiliation and frustration around the profound identity loss they must grapple with. It remains our responsibility to take care of these people, who have sacrificed some of their health to public service.