OTTAWA - Some Afghan war veterans who suffer from operational stress injuries are going undiagnosed and aren't getting the care they need "to continue to be contributing members" of society, says a damning report by the military ombudsman.
The assessment says 18 of the 31 recommendations made in a 2002 report on operational stress have not been fully implemented, largely because of the stigma the military culture attaches to mental-health problems.
More needs to be done to prevent soldiers, sailors and air crew from falling through the cracks, including creating a national co-ordinator for issues related to operational stress injuries, ombudsman Mary McFadyen says in the followup report released Wednesday.
"Clearly, the environment in which Canada's military has been operating in recent years has changed dramatically," she says in the 62-page report. "With the mission in Afghanistan, the level and intensity of combat operations have increased substantially. ...
"A significant number of soldiers are returning from overseas deployments suffering with mental health issues. ... It has also become evident that the Canadian Forces and Canadian Forces members are strained almost to the breaking point."
Parts of the military's approach are beset by confusion and discrepancies and progress is slow, says McFadyen, whose investigators interviewed more than 360 people across the country.
"The system is not perfect," she reports. "Indeed, investigators found, and the office is aware of, a number of individual cases where military members and/or their families were not treated fairly by the Canadian Forces or, for a variety of reasons, did not get access to the care and treatment that they so desperately needed.
"Injured soldiers, sailors, airmen and airwomen who have served their country with courage and dedication are slipping through the cracks of an ad hoc system.
"The consequences for individuals who fall through the cracks are often devastating and long lasting."
Mental-health caregivers from virtually every military establishment pointed to myths and stereotypes associated with post-traumatic stress disorder and other operational stress injuries as persistent problems, McFadyen says.
"The negative stigma associated with post-traumatic stress disorder and other operational stress injuries remains a real problem at a number of military establishments across the country," she reports.
In an interview with The Canadian Press, McFadyen cited the case of a suicidal young soldier based at Petawawa, Ont., whose mother appealed to a senior officer for help. She was told her son needed to "suck it up."
"We certainly heard many stories like that," she said. "We talked to family members and they were afraid for their CF member because he wasn't coming forward to get help because he didn't want to be looked at as being a malingerer."
She said the attitude is common throughout the Forces -- a massive organization that is glacially slow to embrace change.
"People are afraid to come forward," she said, contending creation of a national co-ordinator would go a long way toward overcoming the stigma of stress-related illnesses.
McFadyen's report points to Petawawa, 160 kilometres northwest of Ottawa, as particularly problematic. The Ontario base has only one psychologist and one psychiatrist responsible for 5,100 soldiers, many of whom have done several rotations in Afghanistan.
By comparison, the 4,500 troops at CFB Valcartier in Quebec are served by eight psychologists and four psychiatrists.
The ombudsman says the Canadian Forces have not developed a database that accurately reflects the number of personnel affected by stress-related injuries.
"The need for a robust system focused on identifying, preventing and treating post-traumatic stress disorder and other operational stress injuries is even higher today than it was in 2002" and will only increase, she says, noting families suffer and need support, too.
The assessment urges the military to fully implement all the recommendations of the original six-year-old report and makes nine additional recommendations to "address current realities and current problems."
Among them:
- Create a full-time operational stress injury co-ordinator responsible for all related issues, including the quality and consistency of care, diagnosis and treatment, as well as training and education.
- Develop a database of Canadian Forces personnel -- both regular and reserve forces -- affected by stress-related injuries.
- Conduct an independent and confidential mental-health survey of Forces personnel.
- Change the rules governing occupational transfer to accommodate stress sufferers who could continue their military service if moved to another military occupation.
- Ensure military family members have access to all the services and care they need.
- Provide funding across the country for the identification, prevention and treatment of post-traumatic stress disorder and other operational stress injuries.
- Develop a national program to treat and prevent stress and burnout among mental-health care workers.
