Increasing reports of PTSD a sign of progress, claims senior DND official

The increasing number of Canadian Armed Forces members reporting post-traumatic stress disorder shows that the military is making progress in “de-mystifying the stigma” around mental illness, says Major General David Millar, CAF chief of military personnel.

“The fact that our numbers are increasing is indicative that the barriers are coming down slowly, but more needs to be done,” said Maj.-Gen. Millar, who appeared before the House National Defence Committee on March 4 to provide testimony as part of the committee’s ongoing study into the care for ill and injured members of the CAF.

Maj.-Gen. Millar reported that 1,925 CAF members are currently receiving care under the military’s Joint Personnel Support Unit, 60 per cent of whom are being treated for some form of post-traumatic stress disorder (PTSD).

But despite the increased demand for mental health services after a decade of involvement in the war in Afghanistan, the number of mental health providers in the military has not increased in over a decade. Roughly 35,000 members have been deployed to Afghanistan since 2001, but the department has only 452 placements for mental health professionals—the same number of placements it had in 2003. Of the 452 placements, only 417 practitioners are currently employed by the department.

Jacqueline Rigg, DND assistant deputy minister for civilian human resources, told the committee that the department is looking to fill the 35 remaining placements across the country and is offering the “top of the pay scale.”

The problem, Ms. Rigg told the committee, is an overall shortage of mental health practitioners across the country.

“National Defence is challenged in attracting and recruiting qualified and experienced professionals in a competitive market due in large part to the limited labour market availability of these professionals in Canada,” she said.

Conservative MP James Bezan (Selkirk-Interlake, Man.) asked Maj.-Gen. Millar what his “metric” was for measuring the military’s success in de-stigmatizing mental health issues among its members, to which he responded that it was “the number of people” coming forward with mental health issues.

“I see more conversations, more open conversations about mental illness and great acceptance both within Canadian society and the Canadian Forces that mental illness isn’t bad— it’s something we can all discuss and treat,” he replied.

Liberal MP Joyce Murray (Vancouver Quadra, B.C.) questioned why the number of mental health providers hadn’t increased since troops were deployed to Kandahar, Afghanistan in 2002.

“So 10 years ago’s goal from before Kandahar deployment of the armed forces is still seen to be an adequate target?” Ms. Murray asked.

“Our current number is 452 based on the services we provide, based on access by our military members to our mental health care providers, but yes, as I mentioned, we can always do more, ma’am,” Maj.-Gen. Millar replied.

The Defence Department has come under increased scrutiny in recent months following a rash of suicides by CAF members and veterans of Canada’s operations in Afghanistan. Maj. Gen. Millar told the committee that nine CAF members have taken their lives since Nov. 25, 2013—five regular force members, three reserve force Class A members, and one reserve force Class B member. The department does not count cases of suicide by former CAF members, he said.

“Outside of the Canadian Forces we do not. We are fully aware of them and we use our internal assessment to determine where we need to improve our mental health system,” Maj. Gen. Millar told the committee.

Also appearing at the committee were Col. Scott McLeod, CF director of mental health; mental health adviser Colonel Rakesh Jetly; and Michel Doiron, assistant deputy minister of service delivery for Veterans Affairs.

The group faced questioning from all sides over the military’s Universality of Service policy that requires CAF members to demonstrate physical fitness, employability and deployability to continue to serve in the military.

Canadian Forces ombudsman Pierre Daigle called on the department to “modernize” the policy in a 2012 report and has warned that it compounds the stigma around mental illness in the military. He reiterated that recommendation in February during testimony to the Senate subcommittee on Veterans Affairs.

“In terms of challenges that remain for the Canadian Forces, the big one in my opinion is getting military personnel to seek help, particularly when the injury is an injury of the mind,” Mr. Daigle told that committee on Feb. 5. “There are two huge hurdles a military member must overcome to seek help: the stigma and the reality of the universality of service, as well as the possibility of being forced to leave the military.”

Committee members questioned whether or not the policy was compounding the post-deployment stress felt by Canadian Armed Forces members and contributing to the growing number of suicides among service members.

Conservative MP Rick Norlock (Northumberland-Quinte West, Ont.) asked whether or not the policy was having a detrimental effect on military personnel suffering from “non-visible injuries.”

“Why [are] we hearing that there seems to be a disconnect between what we hear from the senior chain of command and what’s actually happening in the field?” Mr. Norlock asked Maj. Gen. Millar.

“When we diagnose someone and identify that they’ve breached the universality of service, it’s because we don’t want to put them in a position of more fighting where they would experience another traumatic experience that could really do permanent damage,” he replied.

NDP MP Élaine Michaud (Portneuf-Jacques Cartier, Que.) also pressed Maj. Gen. Millar on the policy, questioning whether or not the requirement was “a contributing factor” to military personnel avoiding treatment for PTSD for fear of discharge.

“[What] do you think of modifying this notion of universality of service, to ensure that our soldiers are overcoming a mental or psychological illness to be allowed to perhaps stay in a position where you don’t necessarily need to be deployed?” asked Ms. Michaud.

Maj. Gen. Millar avoided the question altogether, instead stating the importance for all CAF members to be aware of “the opportunities and benefits that are available to them.”

Ms. Michaud repeated her question, asking for a “yes or no” answer.

“I think it’s more important to explore the benefits we have within our forces,” Maj. Gen. Millar responded.

Sean Bruyea, a retired Air Force intelligence officer who speaks out on behalf of veterans, told The Hill Times that the Universality of Service policy would be “discrimination” under any other institution and contributes to a “structural stigma” around mental illness in the Canadian Forces.

“They have a huge problem with obesity in the military but those people can stay,” said Mr. Bruyea. “I’m wondering why physically obese people can stay, but members that may be suffering a psychological injury are not allowed to stay. It doesn’t make any sense.”

Mr. Bruyea served in the Canadian Air Force for 14 years and participated in the Gulf War before retiring with PTSD. He said that the policy forced him to try to minimize the trauma he experienced following deployment.

“It was the existence of the policy that prevented me from coming forward because I didn’t want to risk getting kicked out,” he said. “It doesn’t make economic sense and it doesn’t make readiness sense, either. These members have a wealth of corporate and technical knowledge that can easily help the organization… It’s a financial disaster and it’s a human relations disaster to pursue a policy like that.”

cplecash@hilltimes.com

Twitter: @chrisplecash

The Hill Times