Where to get mental-health help in Canada

Retired Captain Hélène Le Scelleur was medically released from the military while she was working on her PhD that focused on the lack of support for military members transitioning to civilian life.

DAVE CHAN FOR THE GLOBE AND MAIL

THE UNREMEMBERED

Hélène Le Scelleur’s life with PTSD: How she’s seeking to ‘deconstruct’ the soldier within

LES PERREAUX
GATINEAU, QUE. The Globe and Mail Last updated: Friday, Nov. 04, 2016 10:34AM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

After a bomb blew up the armoured vehicle she was riding in, not even a broken sacrum could stop the wave of euphoria that hit Captain Hélène Le Scelleur. She and everyone else in her crew were alive.

Then came four dark, moonless hours waiting for one of two outcomes: rescue or Taliban fighters streaming over the ridge to kill her. It’s hard to come back from a moment like that. In many ways she still hasn’t.

“We sat in that hole for four hours waiting to kill or be killed. It was really stressful and it’s hard to go back afterward and say ‘It’s okay, nobody died,’ ” Ms. Le Scelleur said.

That moment is where a long, successful military career began to fall apart from post-traumatic stress disorder and the accompanying panic attacks, night sweats and alcohol abuse.

This spring, after 26 years, Ms. Le Scelleur, who was a captain second-in-command of a medical company in Kandahar, found herself cast aside by the military. Most painful to her is how the military sent her away just as she was learning to cope with her illness and earning credentials that should have made her among the military’s valued officers.


Ms. Le Scelleur was second-in-command of a medical company in Kandahar.

Ms. Le Scelleur was completing a master’s degree in social work financed by the Canadian Forces in 2013 when the army ruled she was permanently disabled. She carried on with her PhD on her own dime anyway. The working title of her doctoral thesis? “Life in the shadow of the uniform: the transition toward civilian life and identity conversion of Canadian military living with an operational stress injury.” On April 19, 2016 – some two years and four months after she was deemed disabled and still working on her PhD – she was medically released at age 43.

“The knowledge and experience I have could have been tremendously useful within the military,” Ms. Le Scelleur said. “But when you get that stamp of PTSD on your head, it’s over.”

And so, just as she was working on a hypothesis that the military exacerbates mental illness and suicidal thoughts by cutting soldiers off from their social support system, she turned in her ID card and was escorted to the door of National Defence Headquarters. “I started to cry,” she said. “It was hard to believe that’s how it ends.”

Born in Boucherville, Que., Ms. Le Scelleur found an unusual path into the army. She was 17 and a high-school theatre geek where she saw a recruitment drive and was wooed by the chance “to drive big trucks,” as she recalled. She was among the first wave to join the infantry after the ban on women was lifted.

“I played GI Jane for three years. A lot of people wondered what I was doing. I was more of an artist before, but in a way when you put on your uniform it’s like being in character,” Ms. Le Scelleur said. “I felt like I really belonged. I had the flame.”

She shifted into administrative work where she organized soldiers heading to the former Yugoslavia. She went herself in 1996 and 2002 as a reservist and joined the regular forces soon afterward. She studied to become an officer and health-care administrator and was promoted to captain. She was named commander of a field ambulance platoon in time to deploy to Afghanistan in July 2007.


Ms. Le Scelleur (right) tends to a young Afghan girl suffering from a burn at a free medical clinic run by Afghan, Canadian and American medical and dental personnel in Spin Boldak, Afghanistan.

On top of the roadside bombing, stress came in a steady dose for Ms. Le Scelleur on her tour. As the second-in-command of the medical company in Kandahar, she had the high-pressure job of organizing the evacuation of wounded and killed soldiers; twice she had to handle the deaths of her own medics.

One of the medics was a man she had encouraged to come on tour despite some personal hardships. “I wasn’t the one who set the IED [improvised explosive device] but I felt so responsible,” she said. “It was hard.”

Ms. Le Scelleur returned home in 2008 to a new plum assignment as then governor-general Michaëlle Jean’s aide-de-camp. For nearly a year she travelled the world with the governor-general but was soon burnt out. She wasn’t sleeping well, was having nightmares and drinking too much. “I was afraid I was going to cause a diplomatic incident. So I resigned and they put me on the shelf,” she said.

The captain went to therapy and felt better for a couple years. But in 2014, the Parliament Hill terrorist attack sent her into spiral of suicidal thoughts, flashbacks, nightmares and hyper-vigilance. Only the presence of her two children, aged 18 and 4, kept her from going over the brink. “At one point I was sitting by myself with all my meds in my mouth and I thought it was the end. But I had a little kid and didn’t want to abandon him. That’s the main thing that stopped me,” she said.


Ms. Le Scelleur with her son, David Lebel.

Ms. Le Scelleur is back in therapy and taking medication. She’s also back in school working on that PhD and volunteering for Wounded Warriors Canada, a veterans support group. She spends a lot of time thinking about ways to fix the patchwork of services available to veterans across the country and how to ease the transition out for soldiers.

When a person joins the military they have their head shaved, they go to boot camp in Saint-Jean-sur-Richelieu, Que., get a uniform and lose their civilian side. “There’s a construction of the military person. We don’t deconstruct that,” Ms. Le Scelleur said. “There’s an entire reset that’s needed. On paper there are a lot of programs but in the real world the way it’s handled and offered is not the same thing.”

Ms. Le Scelleur is still searching for a better way to deconstruct a soldier when they return to civilian life. But first she has to reset her own soldier within.

Military should treat PTSD sufferers with greater respect: Afghanistan veteran

http://www.theglobeandmail.com/news/investigations/living-with-ptsd-how-a-captain-turned-scholar-seeks-to-deconstruct-the-soldierwithin/article32657355/?reqid=c5b212db-3635-4207-98a8-3ab306fafa50

Retired Corporal Joe Rustenburg with his service dog Vixen. Mr. Rustenburg served two tours in Afghanistan and is vocal about his struggles with mental health.

DAVID STOBBE FOR THE GLOBE AND MAIL

THE UNREMEMBERED

Joe Rustenburg’s life with PTSD: How he found sanctuary and healing

RENATA D’ALIESIO
WARMAN, SASK. The Globe and Mail Last updated: Friday, Nov. 04, 2016 7:29PM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

After his military discharge, all Joe Rustenburg wanted to do was leave reminders of his torn army life behind. The Edmonton-based infantry soldier did two tours in Afghanistan. On his first deployment in early 2006, he went to the fractured nation hopeful and wanting to make a difference. On his second tour, he just wanted revenge for all the friends he lost in the sweltering Afghan desert.

He was showing signs of post-traumatic stress disorder before he went back to the war zone in 2008, but he said it was easy to bluff past mental-health questionnaires and assure military doctors that he was fine. Once he returned home, his health crumbled quickly.

Struggling with nightmares and flashbacks, the retired corporal only slept about three hours a night. To calm his nerves, he smoked two-and-a-half packs of cigarettes a day and got black-out drunk at times. The army had taught the young husband how to kill, but it hadn’t prepared him for how killing would make him feel. His moral compass had shifted.

“Before my first tour, I was a fairly positive person,” the Ontario-raised army veteran said. “And then from my experiences and the trauma that it caused, it made me become dark, cold and uncaring.”


Mr. Rustenburg during a tour in Afghanistan.

In June, 2009, nine months after his second tour, Mr. Rustenburg attempted to end his life. He took all the sleeping pills and medication he could find, drove to a farmer’s field and laid down. He had just been diagnosed with PTSD.

“I didn’t know what was going on. I felt the pain was so intense and I felt that my wife would benefit with me not being there, because she wouldn’t suffer any more,” he recalled thinking. “In reality, that’s not the case, but when you’re in that situation, that’s what you feel is right.”

When Mr. Rustenburg awoke a few hours later, he was relieved to be alive. Deeply alarmed by his suicide attempt, his wife, Melanie, began fighting to get him intensive treatment. He said it took nearly a year before the military sent him to Homewood Health Centre, a 300-bed mental health and addiction facility in Guelph, Ont. At Homewood, specialists reduced his medication and taught him how to cope with his panic attacks and other PTSD symptoms.

He felt so good after his four-month stay that he wanted to return to his infantry group. Instead, he was sent to the Joint Personnel Support Unit, created during the Afghanistan war to help ill and injured soldiers heal. Chronically under-resourced and understaffed, the support unit has struggled to aid many vulnerable soldiers. Mr. Rustenburg said his time in the JPSU sent him into a spiral.

“They totally undid all of the positive work that had been done” at Homewood, he asserted. “By the time the JPSU was done with me, I was in crisis and I was released.”

Medically released from the military in January, 2011, Mr. Rustenburg and his wife moved to La Ronge, Sask., where her parents lived. He needed to get away from Edmonton, and the small northern Saskatchewan town seemed like the perfect spot – remote, quiet and nowhere near a military base. “To me, it was a safe place. It felt like a sanctuary,” he said.

But the fractured veteran was also far from treatment, and not seeing a psychologist or taking medication. Eventually, his mental health worsened and he withdrew into isolation. His wife begged him to get help.


Mr. Rustenburg and his wife Melanie. He credits her with pushing him to get help.

In 2013, Mr. Rustenburg began seeing a therapist again, driving two hours to Prince Albert for appointments. In August, a black labrador service dog named Vixen came to live with him. She was a gift from the Wounded Warriors Weekend group, and helped him tremendously by alleviating panic attacks and nudging him back to reality when he’s having a flashback.

But he didn’t bring Vixen to our interview at the Tim Hortons in Warman, about 25 kilometres north of Saskatoon. The couple moved to the growing bedroom community in February, 2015, to be in a less-isolating location and closer to Mr. Rustenburg’s medical appointments in Saskatoon. He attends therapy twice a week, meeting with a psychologist and undergoing neurofeedback sessions to retrain his brain. He was recently diagnosed with a traumatic-brain injury, the result of a bomb blast in Afghanistan, his doctor suspects. He was approved for medical marijuana in June, and uses it to help him sleep.

Long shut off from others, Mr. Rustenburg struggles to express emotion (the inflections in his voice don’t change as we talk), but he is making progress. He and wife go out on dates now, to the movies, restaurants and hockey games. He’s taking a Brazilian jiu jitsu class, and he’s able to sit in a busy coffee shop and talk with a reporter he’s never met – unthinkable a few years ago.

“The best thing you can do is reach out, get help and talk about it,” he said of dealing with PTSD. “Once you understand what’s going on with you, you can get better and you can manage it.”

And when you fall, he added: “Keep getting up. That’s the biggest thing.”

At 34, Mr. Rustenburg doesn’t know if he will be well enough to work again.

He hopes so, but there is a lot more healing to do. He receives long-term disability payments from Veterans Affairs, which he feels guilty about at times. “But I have to remember I have no career prospects,” he said. The Afghanistan war forever changed his life.

He still has dark moments, especially when the Prairie weather turns cold and bleak. His loving wife keeps his thoughts of suicide at bay, he said. She is studying to become a police officer and has stood by Mr. Rustenburg through his tours and their aftermath.

“She kept me alive when I gave up on life and didn’t want to keep going,” he said when we talked on the phone another time. “I am immensely thankful that she didn’t leave. A big part of my success is Melanie and [spouses] don’t get a lot of credit for that.”

She is by his side through the hour-long phone conversation. “I don’t need credit,” I can hear her whisper. She is Mr. Rustenburg’s rock.

http://www.theglobeandmail.com/news/investigations/living-with-ptsd-after-moving-far-from-his-former-base-a-veteran-found-sanctuary-andhealing/article32657376/

THE UNREMEMBERED
Honours delayed for veterans and soldiers who are dying by suicide

RENATA D’ALIESIO
HAMILTON, ONT. — The Globe and Mail
Published Friday, Nov. 04, 2016 7:23PM EDT
Last updated Saturday, Nov. 05, 2016 9:38AM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

In front of a century-old church in mid-September, Denise and Wayne Stark waited under overcast skies for bagpipers in kilted military uniforms to march toward them and salute. The procession drew curious residents to their stoops and dozens of dignitaries and soldiers to the church’s dark wooden pews.

Five years ago, the Stark family was at this very same church, saying goodbye to their son, Corporal Justin Stark. He had been to the Afghanistan war and back, but the battlefield never left him. The 22-year-old reservist took his life on Oct. 29, 2011, while at the Hamilton, Ont., armoury for a weekend exercise with his reserve regiment.

His parents had no doubt that he was a casualty of the Afghanistan war, but a military inquiry determined otherwise – a conclusion with potential repercussions for how Canada would remember the young soldier.

Death by suicide is supposed to be treated no differently than a death on the battlefield or in domestic operations. If a death is connected to military service, families are presented with the Memorial Cross and Sacrifice Medal, and their loved one’s name is added to the Canadian Virtual War Memorial and inscribed in the Books of Remembrance, which lie in the Peace Tower on Parliament Hill.

But in reality, not all military deaths are treated the same.

The Globe and Mail spoke with 31 families who lost a loved one to suicide after serving on the Afghanistan mission. Many of the fallen military members were traumatized by their experiences at war, but only eight of their families have been awarded the Memorial Cross and Sacrifice Medal.

The military is now reviewing the other cases in the wake of The Globe’s inquiries. The excluded include:

Private Thomas Welch was the first Canadian soldier to die by suicide after serving in the Afghanistan war. He perished more than a dozen years ago, on May 8, 2004, but his name is absent from the Books of Remembrance and no medals have been bestowed on his family. His mother believes her 22-year-old son, who was based in Petawawa, Ont., was suffering with post-traumatic stress.
Sergeant Paul Martin was a long-time infantry solider based in Gagetown, N.B. Diagnosed with PTSD and facing release from the army, he died by suicide on Sept. 8, 2011. His death was connected to his military service, according to a board-of-inquiry ruling, yet his widow has not received the Memorial Cross and Sacrifice Medal.
Captain Brad Elms, a veteran of tours in Somalia, Bosnia, Haiti and Afghanistan, died by suicide two years ago. A military inquiry determined in the summer of 2015 that his death was service-related, but his family hasn’t received medals, either. He had been diagnosed with depression and was showing signs of PTSD.
His widow, Sherri Elms, is disappointed by the delayed recognition. To her, it signals suicide is different than other military deaths.

“It’s almost like it’s still stigmatized,” Ms. Elms said. “If he had been killed in Afghanistan and was repatriated to Trenton on the Highway of Heroes … people would have been tripping over themselves to award those medals.”

Capt. Elms’ suicide occurred just days after Cpl. Nathan Cirillo and Warrant Officer Patrice Vincent were killed in separate attacks in October, 2014. The Memorial Cross and Sacrifice Medal were presented to the families days after the soldiers’ high-profile deaths. Cpl. Cirillo was gunned down while standing guard at the National War Memorial in Ottawa; WO Vincent was intentionally rammed by a car in a shopping centre parking lot in Saint-Jean-sur-Richelieu, Que.

For Pte. Welch’s mother, Anita Cenerini, the lack of recognition of her son’s military service has been crushing. He took his life only three months after returning from Afghanistan in February, 2004.

“It’s so important for me to have the country respect him and honour him, and acknowledge that his death came because he had gone to war for us,” Ms. Cenerini said through tears. “I want people to know how much he gave of himself. He gave so much of himself that he couldn’t survive.”

When asked about the delays in awarding the Memorial Cross and Sacrifice Medal, Canadian Forces spokesman Lieutenant Kelly Boyden said in an e-mail that research is currently being done on open cases to clarify if a ruling has been made and to issue medals “as soon as possible where applicable.”

To speed up the process in the future, National Defence and Veterans Affairs recently signed an agreement to clarify each department’s roles and responsibilities to ensure rulings are made and medals are presented to families in a timely manner, Lt. Boyden added.

He noted that when a death is obviously related to service, the Memorial Cross, also known as the Silver Cross, is awarded immediately. But when it’s not clear, the medal is only presented once it has been officially determined that the death was connected to service.

In cases where a board of inquiry concludes a death is not attributable to military work, the Forces may seek an assessment from Veterans Affairs. In these instances, Veterans Affairs provides an opinion based on service health records and legislative tests.

The Stark family was on the list of the excluded until military advocates fiercely lobbied the federal government to recognize Cpl. Stark. That’s how they got to this moment at the Hamilton church, where a Memorial Cross ceremony was held on Sept. 17.

After a lone bagpiper played Amazing Grace, Ontario’s Lieutenant-Governor Elizabeth Dowdeswell presented three members of Cpl. Stark’s family – his mother, father and sister, Jennifer – with the medals. The ceremony meant a lot to the family, but they also want further recognition of Cpl. Stark and the other Afghanistan war veterans lost to suicide.

The Starks would like to see their son’s name added to Afghanistan war monuments, alongside the 158 soldiers who died on the mission, including six who took their own lives.

“It means he would be recognized for what his contribution was. Being over there, that was directly related to his death,” Mr. Stark said. “Just because you come back, it doesn’t mean you’re finished paying the price.”

Last Remembrance Day, Veterans Affairs Minister Kent Hehr pledged to find a way to commemorate military members who served on deployments to Afghanistan and later took their own lives. “They are part of our military family,” he told The Globe and Mail then. “A veteran is a veteran is a veteran.”

Veterans Affairs spokesman Zoltan Csepregi said the department is working with Canadian Heritage on a national memorial to Canada’s mission in Afghanistan. A design for the memorial has not yet been determined, and more information about the commemoration project is expected in the coming months, he added.

“In the past, the names of individuals have not been included in national war memorials,” Mr. Csepregi noted. “However, this memorial will recognize the commitment and sacrifice of all the Canadian men and women, both military and civilian, who served in Afghanistan, as well as the support provided by Canadians at home.”

If you would like your relative included in the commemoration project of Afghanistan war veterans lost to suicide, please e-mail remember@globeandmail.com

http://www.theglobeandmail.com/news/investigations/honours-delayed-for-veterans-and-soldiers-who-died-by-suicide/article32689193/

THE UNREMEMBERED
Ottawa lacks urgency dealing with suicide crisis: veterans advocate

LES PERREAUX AND LAURA STONE
MONTREAL and OTTAWA — The Globe and Mail
Published Friday, Nov. 04, 2016 8:18PM EDT
Last updated Friday, Nov. 04, 2016 9:16PM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

An advocate brought in to advise Ottawa on veterans’ mental health says the Trudeau government lacks urgency dealing with a growing suicide crisis.

Michael Blais, the founder of Canadian Veterans Advocacy, was named to a mental-health advisory committee struck by Veterans Affairs Minister Kent Hehr. Mr. Blais, himself a wounded army veteran, says they’ve held four meetings and progress is proceeding at a snail’s pace.

“We’ve discussed peripherally that suicide is a problem but nothing substantive has been done,” Mr. Blais said Friday. “There’s no sense of urgency whatsoever from the department or the minister.”

A Globe and Mail investigation has revealed that at least 70 veterans of the war in Afghanistan have died by suicide after returning home. In 31 cases, family members told the stories of their loved ones and revealed details about their treatment and how they died.

In many cases, soldiers avoided seeking treatment for fear their military careers would be over. Others were on waiting lists or were shunted among treatment providers without getting consistent care, or seemed to slip under the radar completely. Mr. Blais said he learned more from the launch of The Globe investigation than he has from Veterans Affairs so far.

Defence Minister Harjit Sajjan said improved mental-health treatment is a top priority for an continuing defence policy review, along with a joint effort with Veterans Affairs to create a suicide prevention strategy. The mandate letters delivered to the two ministers by Prime Minister Justin Trudeau emphasized better care for soldiers and veterans.

Mr. Sajjan, himself a retired soldier who struggled at times with adapting to life in Canada after three tours in Afghanistan, pledged more action is coming. “We are not going to leave any stone unturned. We’re not going to put a resource limit on things,” he said. “Regrettably, some of these initiatives are going to come too late.”

Mr. Sajjan described how the government must smooth the transition between the Canadian Forces and Veterans Affairs, where many soldiers suffering from occupational stress and other mental-health disorders fall through the cracks.

Mr. Hehr said filling the gap between the two systems is a top priority. They cannot wait for long-term reviews and research studies under way before making improvements, he said in a written statement. “Make no mistake, it is difficult for me, it is difficult for our departments, and it’s difficult for Canadians when we hear of a military man, woman or veteran who has taken their own life,” he said.

Military Ombudsman Gary Walbourne urged the Forces to improve how they handle members slated for medical discharge. He said no soldier should be released until all their veterans’ benefits and services are in place. “If we can start closing off some of these gaps, I think we can start fixing some of the issues that we have,” he said.

Five of the 31 fallen profiled by The Globe had been discharged from the military and another three were scheduled for release, including Sergeants Paul Martin and Doug McLoughlin. Both soldiers told their families that they were frustrated with Veterans Affairs over disputes about benefits. Opposition critics who spend a lot of time hearing complaints from soldiers, veterans and their families say they sense a lack of priority around the military mental-health issue. They also point out the government made a lot of promises to veterans that have yet to be delivered, including the restoration of lifetime pensions.

“One thing I hear from veterans is the lackadaisical attitude of the government on veterans’ issues,” said John Brassard, the new Conservative veterans-affairs critic.

Irene Mathyssen, the NDP critic, said the Liberal pace of enacting change matches the “glacial speed” of mental-health-care improvements under the Conservatives. She said the most immediate change the government could enact would be to stop medically discharging soldiers from the military before they have a full support system in place.

“That means training, mental-health treatment, making sure they have a family doctor, making sure they are ready to take on civilian life,” Ms. Mathyssen said. “We have a sacred obligation,” she added, echoing the words used by Mr. Trudeau one year ago in his marching orders to Mr. Hehr.

If you would like your relative included in the commemoration project of Afghanistan war veterans lost to suicide, please e-mail remember@globeandmail.com

http://www.theglobeandmail.com/news/investigations/ottawa-lacks-urgency-dealing-with-suicide-crisis-veterans-advocate/article32689712/

THE UNREMEMBERED
Suicide toll reveals how system failed Canada's soldiers and veterans

RENATA D’ALIESIO, LES PERREAUX AND ALLAN MAKI
TORONTO/MONTREAL/CALGARY — The Globe and Mail
Published Friday, Nov. 04, 2016 5:00AM EDT
Last updated Friday, Nov. 04, 2016 9:55AM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

They were sons of bankers, miners and infanteers. They were strongmen and endurance runners. They were husbands and fathers who took their children camping and taught them how to play shinny on backyard rinks.

All 31 were dedicated Canadian soldiers and airmen who served on the perilous Afghanistan mission. They all came home. All ended their lives.


Most were haunted by the things they saw and did in Afghanistan, their families told The Globe and Mail. Many asked the military for help, but in several cases, their medical assessments and treatment were delayed, even as their post-traumatic stress, depression and sleeplessness worsened.

The families of the 31 fallen spoke to The Globe as part of a collaborative effort to commemorate military members and veterans lost to suicide after serving on the Afghanistan mission, Canada’s longest military operation. Many are speaking publicly about their loss for the first time. And for many of the military members, this is the first public recognition of their sacrifice.

Together, their stories paint a disturbing picture of delayed care, ineffective medical treatment and insufficient mental-health support. The 31 accounts are the most comprehensive public record of Canada’s Afghanistan war veterans lost to suicide – unwitting monuments to a system that is failing too many vulnerable soldiers and veterans.

The 31 fallen are part of a larger troubling statistic. A continuing Globe and Mail investigation has uncovered that at least 70 soldiers and veterans died by suicide after returning from the Afghanistan operation – nearly one-third higher than the 54 revealed by the newspaper one year ago.

Many of their deaths are linked to the Afghanistan mission but they are not counted in Canada’s official toll of 158, which includes six soldiers who killed themselves in theatre. In many ways, they are forgotten casualties of the Afghanistan war, and too often they suffered in silence.

“You don’t want to know what I did there or what it was like there,” Captain Linden Mason told his sister, Jade, after he returned from Kandahar in December, 2010. Her brother had always been her protector, but now he seemed angry and disconnected, and was plagued by nightmares. “You hear about the deaths,” he told his sister, “but you don’t hear how many people are getting hurt or what it’s like, what we see.” He ended his life 13 months after returning from Afghanistan.

Corporal Tony Reed didn’t want to talk either, until one day in frustration, he told his mother: “I cannot go to sleep, Mom, because as soon as I close my eyes that’s what I see, okay? People being blown up. Little kids with grenades. The blood. You can’t imagine the blood that I’ve seen over there.” Cpl. Reed, who was diagnosed with PTSD, died by suicide on Dec. 7, 2012.

The two soldiers are part of a mounting count that includes five members and veterans who took their lives this year and several former soldiers not previously identified by The Globe’s investigation.

The Globe asked families a series of questions for profiles and data analysis. Among these 31 military members and veterans, there are many haunting similarities. In all but six cases, families saw indelible scars left by the Afghanistan battle. In the other instances, there was uncertainty about the health status or other factors that contributed to the mental crisis.

Among the key findings:

Fourteen of the 31 were diagnosed with post-traumatic stress disorder, according to their families and documents obtained by The Globe, while a coroner’s inquiry identified the mental illness in one other case. In another 10, families saw signs of PTSD, but the illness wasn’t diagnosed. Corporal Scott Smith, a father of two, was experiencing flashbacks and hallucinations after Afghanistan, but the ambitious soldier told his mother he feared seeking help would harm his career. “He felt that he would lose face with the military, that he wouldn’t be seen as being strong and what the military wanted as a leader,” said his mother, Connie Smith.
Twenty-two of the fallen received mental-health treatment after their deployment, suggesting the military’s campaign to raise awareness about PTSD and other mental illnesses is working. Many families, however, are critical of the quality of care their loved ones received. One Edmonton infantry solider, Corporal Shaun Collins, asked for mental-health services before returning home from his second Afghanistan tour, but there was no follow-up until he called a crisis line three months later. When help finally came, his family said, he was bounced around among therapists before he turned to a trauma specialist outside the military. The specialist said he was the most severe case of PTSD she had ever seen.
Twelve of the 31 took their lives within two years of returning from their last Afghanistan tour, raising questions about the medical evaluations done after their deployments and the mental-health support provided. Over all, the median time between the last overseas tour and death was two years and five months. Private Thomas Welch’s suicide occurred a mere three months after he returned from Kabul in 2004. The young infantry soldier was the first Canadian Forces member to die by suicide after serving in Afghanistan, The Globe’s investigation uncovered. “He was broken. His soul was broken,” his mother, Anita Cenerini, said. She doesn’t believe he received any substantial mental-health support after his tour.
Once home, many drank to dull their nightmares and help them sleep. Twenty-two struggled with excessive alcohol use.
Seventeen served on multiple overseas missions, many deploying to the former Yugoslavia or Haiti before Afghanistan. Eight completed more than one Afghanistan tour. One soldier, Master Corporal Charles Matiru, went to the battlefield four times, first as an infantry soldier and then with a secretive intelligence unit. His mother, Barbara Matiru, said his mental health worsened with each mission, yet he faced medical-assessment delays that postponed his PTSD diagnosis. “He kept asking for help but he wasn’t getting it. He was desperate,” she said.
Two-thirds of the 31 were in the infantry or armoured corps, which took on much of the combat operations in Afghanistan. More than half had less than 10 years of military service, and the median age at death was 37.
Participation in the Task Force 1-10 deployment emerged most often among the 31 suicides, although it’s not clear why. Nine took part in the 2010 Kandahar rotation, which ran from February to October of that year. The main battle group on that deployment was the 1st Battalion of the Royal Canadian Regiment, based at CFB Petawawa. For Corporal Justin Stark, the tour was his first. The Hamilton reservist kept a war journal. In his first entry, he wrote that he didn’t know if he would make it to his leave, because “you just never know when one step could be your last.” He was 22 years old when he took his life.
Of the 22 soldiers and veterans who were in a relationship, 68 per cent experienced a breakdown in the partnership not long before their suicide. Seventeen were fathers, leaving 40 children behind.
Most of the 31 were still in the Forces when they died. Five, though, had been discharged from the military, and another three were scheduled for release. Three of the five discharged soldiers died within a year of leaving the Forces, while veterans Sergeant Raynald Côté and Corporal Sean McClintock died by suicide several years after their release. Sgt. Côté, a former Quebec infanteer, often referred to his PTSD as a form of brain cancer. He built a dream home after being forced into retirement from military service in 2009, but he faced mounting debt. “He wanted so badly to accomplish something,” said his partner, Marie-Claude Deschênes. “Instead, we were exhausted.”
Suicide is complicated and rarely caused by one factor. But PTSD and depression are treatable, which means it can be prevented.

Although several stresses contributed to the deaths of the 31 fallen, it is clear many were struggling with the after-effects of the Afghanistan war. The Forces only last year acknowledged that deployment may be emerging as a risk factor for suicide, noting there has been a “significant increase in suicides” among those in combat roles and under army command. However, a military spokesperson added that: “We have not been able to identify any specific deployment, including Afghanistan, to be the sole cause of a suicide.”

Neither the Canadian Forces nor the federal government regularly monitor suicides of former military members, but Veterans Affairs last year publicly committed to annually tracking vet suicides for the first time. The inaugural report is expected in December, 2017.

Veterans Affairs and National Defence are working together on a suicide-prevention strategy, mandated by Prime Minister Justin Trudeau last year after The Globe’s initial investigation of military suicides. A draft plan won’t be ready until next fall. An expert panel is currently reviewing mental-health programs and suicide-prevention activities to determine whether improvements are needed.

“It is difficult for all Canadians to hear that our military men and women and our veterans are taking their own lives,” said Veterans Affairs spokesman Zoltan Csepregi. “One suicide is one too many, and we have to do better.”

After last fall’s suicide-prevention directive from the Prime Minister, an external review of the Forces’ health services has finally started in earnest. An expert panel has been asked to evaluate the military’s mental-health programs and suicide-prevention activities and to determine whether they are sufficient.

The panel, whose membership wasn’t released, met for the first time in late October. It’s unclear when the panel will deliver its recommendations, but according to its contract with the Forces, the panel will only examine programs under the military’s health-services branch.

The last review of the military’s suicide-prevention programs was in 2009. That evaluation led to 59 recommendations. Veterans Affairs is participating in the review and in the development of a suicide-prevention strategy.

Retired Lieutenant-Colonel Stéphane Grenier, who created a mental-health education program for the military in 2007, contends the Forces have been too slow to acknowledge the suicide problem. He believes more resources should be invested in social support and expanding mental-health treatment beyond doctors and pills.

“We keep spinning our wheels with suicide and we’re really failing to go the distance,” said Mr. Grenier, who deployed on numerous missions, including to Rwanda and Afghanistan, during his 29-year military career. He is now a consultant on mental health.

“The suicide issue, as serious as it is, is the tip of the iceberg,” he said. “How many other veterans never kill themselves, but literally fall through the cracks, end up homeless and ill to the point where they’re never productive ever again?”

Antoon Leenaars, a psychologist and consultant on suicide prevention in Windsor, Ont., said it’s important to make military suicides visible, so that care can improve for soldiers and their families. He encouraged members dealing with mental illness to seek help.

“There is hope. They don’t need to suffer in silence,” he said.

Author of Suicide Among the Armed Forces, Dr. Leenaars suspects the suicide count among soldiers who served in Afghanistan is higher than 70. He urged the military and Veterans Affairs to take a holistic approach to treating mental illness and include families when caring for traumatized soldiers.

“You have to include the family and the children because there is secondary trauma,” he said. “It’s like walking on eggshells.”

With data analysis by Jeremy Agius

If you would like your relative included in the commemoration project of Afghanistan war veterans lost to suicide, please e-mail remember@globeandmail.com

http://www.theglobeandmail.com/news/investigations/number-of-soldiers-vets-who-died-by-suicide-after-afghanistan-on-rise/article32673192/

THE UNREMEMBERED
Behind the story: How The Globe set out to commemorate Afghanistan war veterans lost to suicide
RENATA D’ALIESIO
The Globe and Mail
Published Thursday, Nov. 03, 2016 2:38PM EDT
Last updated Friday, Nov. 04, 2016 9:15AM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

On last Remembrance Day, newly minted Veterans Affairs Minister Kent Hehr pledged to find a way to commemorate military members who served on the Afghanistan mission and later took their own lives. “They are part of our military family,” he told The Globe and Mail. “A veteran is a veteran is a veteran.”

Days before, a Globe and Mail investigation had revealed that at least 54 Canadian soldiers and vets had taken their lives after returning from their Afghanistan tours. Many of their suicides were connected to the perilous mission, but they were not counted in the war’s toll of 158, which includes six who killed themselves in theatre. Nor were they recognized in military memorials to the Afghanistan mission, Canada’s longest military operation.


Since then, The Globe’s continuing investigation uncovered the suicide count has climbed to at least 70. There is no word yet of any government or military plans to remember these fallen.

“They didn’t die at the war, but they still died after it. It’s still the same,” teenager Élody Martin told The Globe last year. Her father, Sergeant Paul Martin, was diagnosed with post-traumatic stress disorder after returning from Afghanistan in the spring of 2009. The military was about to cut the long-time soldier loose when he ended his life on Sept. 8, 2011.

Élody’s sentiment was echoed by other heartbroken families, who feared their loved ones had been forgotten because their deaths occurred away from the battlefield. Could The Globe find a way to commemorate these war-battered soldiers, while also examining whether the military and Canada did enough to help them recover?

Before reporters Renata D’Aliesio, Les Perreaux and Allan Maki began reaching out to more families, The Globe consulted with mental-health specialists, suicide-prevention experts and veterans’ advocates about its plans for a commemoration project. Telling stories of suicide was a long-held taboo in society and journalism. But social media has changed our conversations, and experts now advocate sensitive reporting of newsworthy deaths by suicide. On social media, rumours and inaccurate information about suicides are rampant. The Globe encountered several instances where suicide speculation in the deaths of soldiers and veterans turned out to be false, after confirming the circumstances of their deaths with families.

Suicide is complicated. Often, a cascade of factors is involved. In many suicides of Afghanistan war veterans, PTSD played a significant role in their deteriorating mental health, addictions and broken relationships. But it is possible their deaths could have been avoided. Mental illness is treatable and suicide is preventable. By not talking and writing about military suicides, we risk failing to understand how we can better help vulnerable soldiers and veterans, along with their families.

In Canada, there is no public list of military members who took their lives. The Globe’s Afghanistan suicide count is based on military statistics initially obtained under access-to-information legislation, Canadian Forces’ updates released since, and nationwide obituary searches that began in 2014.

The obituary searches were necessary to identify the names behind the suicide statistic. A Globe reporter came across Sgt. Martin’s name by scouring more than a decade’s worth of death notices published in online obituary hubs and on military, media and funeral home websites. Suicide is almost never disclosed publicly as a cause of death. The reporter searched the notices for suggestive words and phrases, such as military, tragically, unexpectedly, Afghanistan, Royal Canadian Regiment and PTSD, and for donation requests to programs such as Wounded Warriors Canada and Soldier On.

Through these searches, a long list of possible military suicides was compiled. The Canadian Forces and Veterans Affairs will not divulge whether a member died by suicide. Most medical examiners and coroners won’t either. Only two provinces, Quebec and British Columbia, provide information on cause of death, which meant confirmations had to be done with family or close friends.

Upon the advice of mental-health specialists, The Globe drafted a letter that outlined the commemoration project for families. Where possible, Globe reporters confirmed cause of death before mailing and e-mailing the letters, which included a message of support from Roméo Dallaire, the retired lieutenant-general and former senator.

Several suicides involved Quebec soldiers. We reached out to their families in their mother tongue, collected francophone stories in French, and translated them into English.

The Globe looked into nearly 100 deaths of military members and veterans identified through obituary searches. Fifty-four turned out to be suicides of personnel who had served on the Afghanistan mission, which included Camp Mirage in Dubai. Others had died in road crashes, by heart attack, aneurysm, accidental overdose or other causes. There are at least 16 soldiers who killed themselves after returning from Afghanistan that we haven’t found.

Thirty-one families agreed to share their stories for the commemoration project, many speaking publicly for the first time.

Globe reporters travelled to five provinces to meet with them. Interviews were also conducted by phone. The reporters asked them a series of questions for profiles and data analysis. Families spoke because they believed their loved ones’ military service should be honoured and remembered. They want to shine a light on serious gaps in mental-health care and military policies. And they hope their painful stories will spur improvements to aid other soldiers and veterans struggling with PTSD and other mental illnesses.

Not all families wanted to participate. Some declined because they didn’t want to reopen painful wounds. Others said they preferred to remember in private or were worried their young children would find their father’s profile online before learning how he died from a family member. And some had hidden the cause of death from relatives, because suicide still carries a stigma.

The Globe is grateful to all the families. These stories were extremely difficult to share. They are difficult to tell and they are difficult to read. But we must remember. We will continue to tell more stories of military members who served in the Afghanistan war and later died by suicide. If you would like your relative included in the commemoration project, please e-mail remember@globeandmail.com.

http://www.theglobeandmail.com/news/investigations/behind-the-story-how-the-globe-set-out-to-commemorate-afghanistan-war-veterans-lost-to-suicide/article32662783/

THE UNREMEMBERED
Where to get mental-health help in Canada
The Globe and Mail
Published Thursday, Nov. 03, 2016 12:09PM EDT
Last updated Thursday, Nov. 03, 2016 11:21PM EDT

This article is part of The Unremembered, a Globe and Mail investigation into soldiers and veterans who died by suicide after deployment during the Afghanistan mission.

The stories of Afghanistan war veterans who died by suicide are difficult to read. If you’re dealing with mental-health concerns, help is available in each province and territory. If you’re in crisis, go to your nearest hospital or call 9-1-1 or a crisis line. The Canadian Mental Health Association offers a list of resources and contact numbers, http://www.cmha.ca/about-cmha/contact-us/#.WBxoN2srI2x
The Canadian Forces and Veterans Affairs have programs to help military personnel and their families who are struggling with mental-health issues. They include:

24/7 member-assistance program at 1-800-268-7708. The program provides telephone counselling for issues such as marriage trouble, depression, alcohol or drug abuse and suicidal thoughts
24/7 family information line at 1-800-866-4546. The program offers telephone counselling to military families
The Canadian Forces has information online about its mental-health resources, http://forces.gc.ca/en/caf-community-health-services/mental-health-resources.page

Many services exist outside the military to aid ill and wounded veterans. Here are some of programs that helped the Afghanistan war veterans profiled by The Globe and Mail. They include:

Homewood Health Centre is a 300-bed mental health and addiction facility in Guelph, Ont. The centre has a specialized traumatic stress recovery program. For details, visit http://www.homewoodhealth.com/health-centre or call 519-824-1010.

Project Healing Waters Canada offers fly-fishing instruction and excursions for ill and injured veterans. The program provides camaraderie and a focused activity that gets vets in touch with nature along with teaching them a new hobby. For details, e-mail gervaisjeffrey4@gmail.com or visit http://www.leseauxcuratives.com/

Outward Bound Canada teaches resilience and leadership through outdoor adventure in four provinces and has a program tailored to helping vets struggling with the physical or mental impact of their military experiences and transition back into civilian life. Visit http://outwardbound.ca/course_index.asp?Category=110 or call 1-888-688-9273, ext. 205.

Citadel Canine Society is a Vancouver-based charity that trains and delivers service dogs across Canada to new veterans and first responders with occupational stress injuries for no charge. Visit http://www.citadelcanine.com/ or e-mail info@citadelcanine.com

Can Praxis is a national program with locations in Alberta and Ontario that uses exercises with horses to help veterans dealing with mental illnesses such as PTSD. The program is free, including travel costs, lodging and meals for veterans enrolled in the program. For details visit http://canpraxis.com/ e-mail steve@canpraxis.com or call 403-852-0907.

Wounded Warriors Weekend is an annual event that provides a long weekend of activities, camaraderie and relaxation for vets coping with PTSD and their families. Events are primarily held in Saskatchewan. Visit http://www.woundedwarriorsweekend.org/ or e-mail WoundedWarriorsWeekendFoundation@Gmail.com

http://www.theglobeandmail.com/news/investigations/where-to-get-mental-health-help-in-canada/article32658482/