PTSD services for veterans to be offered in region

Inside Roméo Dallaire’s brutally revealing new memoir.

Lt.-Gen. Roméo Dallaire’s raw and emotionally devastating new book lays bare his own inner torment.

October 21, 2016



One night after he was medically discharged from the army in April 2000, former Lt.-Gen. Roméo Dallaire drank most of a bottle of scotch in his Hull, Que., apartment before he opened a metal box containing his father’s medals and his 50-year-old razor. Very slowly, he began to slice himself, first his thighs, then his arms.
It was another of Dallaire’s rolls of the dice, another in what has become an uncountable number of attempts, stretching over two decades, to kill himself “accidentally,” through behaviour so reckless it is a wonder he is alive now. Much of it, in Africa to start and later in Canada, involved driving, including reaching 150 km/h on a Quebec road with his young children in the back seat. As UN commander in Rwanda during the still tense days after that nation’s 1994 genocide bled to a halt, Dallaire would drive up, alone and at night, to checkpoints manned by heavily armed teenagers as skittish and traumatized as he was.
The cutting, perhaps the most arresting incident disclosed in Dallaire’s brutally revealing new memoir, Waiting For First Light: My Ongoing Battle with PTSD, was no different in kind, he insists. Deliberate, calculated suicide was a step too far for Dallaire’s almost lifelong military sense of duty, and he points out he did prudently hand over his guns to an old comrade, Gen. Maurice Baril. But bereft of one of his main supports—“the uniform,” as Dallaire calls it, meaning his tribe, his very identity—and overwhelmed with pain, he was willing to take what came.
“I might have cut just once,” he says in an interview, “but the warmth of the blood and the smell of the blood, because there’s a sort of an iron smell, had an incredibly soothing effect. So I thought [I’d] see how much more of that would help, knowing that, sooner or later, if nobody came, I would bleed to death. But I wasn’t looking immediately to bleed to death so much as wanting to feel that release.” But someone came: his sister-in-law, Christine, whose role in keeping Dallaire alive and functioning can scarcely be overestimated. So far someone—or, often enough, blind luck—has always come.

Dallaire was back home in Canada in September 1994, hard at work in a new job in Ottawa as deputy commander of Land Force Command, when his boss, Gordon Reay, called him in for a brief chat. Something new and troubling seemed to be happening in the Canadian Forces, something to maybe keep in mind, the chief of Land Staff told Dallaire: “We are starting to see some issues with guys coming back from [peacekeeping tours in] Cambodia and Yugoslavia,” said Reay, as Dallaire recounts in his memoir. “Fatigue, a few cognition problems, some trouble readjusting. Nothing more. Nothing to worry about.”
Only five months earlier, Dallaire had been the UN’s peacekeeping commander in Rwanda, boxed into a guilt-ridden defensive posture while the worst genocide since the Holocaust unfolded around him. After months of planning, and urged on by radio broadcasts of genocidal propaganda, extremists within the Hutu ethnic group raised their community against the minority Tutsi in an orgy of literally blood-soaked murder—machetes, not sterile gas chambers, were the key tool—and sexual violence.

Dallaire warned UN headquarters about the trouble brewing, and repeatedly pleaded for action and backup. But the world’s major powers failed to act or provide him with troops. Dallaire, a soldier with a mission to protect and orders not to intervene, had to stand by as up to a million people were killed in 100 days.
Already, in the immediate aftermath, Dallaire couldn’t sleep. His right arm was mysteriously fluctuating between sharp pain and paralysis. A voice in the back of his head was incessantly screaming, “Why is the rest of the world carrying on like nothing has happened?” Upon his return flight from the worst wartime experience a senior Canadian officer had undergone since the Korean conflict, there was no one at all, neither politician nor fellow general, to greet him at Mirabel airport. It was a shocking breach of protocol that seemed to underscore how much his own countrymen wanted to ignore the genocide—and that his peers secretly blamed him for the UN’s failure in Rwanda.

But, for all that, Dallaire still didn’t see himself in Reay’s prophetic warning, because in 1994 no one saw post-traumatic stress disorder (PTSD) for what it was. Dallaire learned soon enough that hard work wouldn’t make it go away. A few weeks after speaking with Reay, Dallaire and his wife, Beth, walked into a autumn farmers’ market set up in Quebec City’s old quarter. The “sweet, humid smell” of the cascading heaps of fruits and vegetables pitched him into a living memory. He was suddenly back in the midst of a Rwandan market, absorbing sights and scents: a few blackened bananas and avocados reeking of rot, a crowd of starving women and children storming a food aid truck as it arrived, stripping it bare and fleeing within minutes, those who did not survive—“a couple of women and three children, trampled to death.” In Quebec, Dallaire ran for his car.
Canadians became widely aware Dallaire had not, could not, leave the slaughter behind in June 2000, when it was widely reported he had been found near-comatose from a mix of scotch and anti-depressants beneath a park bench near his Hull home. (He twice asked the ambulance crew to kill him.) And we knew why in 2004 with the release of Shake Hands With the Devil, Dallaire’s award-winning book about the genocide. But PTSD was slow to enter the conversation, and Dallaire kept private the full cruelty of his struggle with it. He is not a man given easily to spilling his guts. He wonders if his graphic honesty, stripping away veils that have hidden two decades of pain, will inspire contempt for his perceived weakness.

Not likely: the twin hells Dallaire describes are far more liable to provoke sympathy. The hallmark of the 1994 Rwandan genocide was its peculiar intimacy and the deliberate obscenity of its sexual pathology. “It’s hard work to kill someone with a machete,” Dallaire says matter-of-factly. “So it was often a blow or two and left to die over the next day.” Blood, litres of it, was everywhere. To this day the stench of it coagulating haunts Dallaire, whose PTSD is especially prone to scent triggers, as much as the iron-tinged smell of fresh blood soothed him once.
And what blows they were. Beyond the rivers and creeks jammed with corpses, the men with their heads split open, the way UN soldiers had to walk in front of their slow-moving vehicles to avoid running over the dead and the still dying—beyond that were the women ripped open, their fetuses beside them, the women “lying in pools of blood, broken bottles between their legs,” the mass rape sites. The horror of the latter is mostly passed over in silence in the memoir, but in conversation Dallaire captures it in the single most appalling description he utters, recalling one site where “we could still smell the sperm.”

There was no relief at all to be found in writing about such memories. “Nothing,” Dallaire says. “It’s not been cathartic, more like digging up evil again and trying to put it into words.” But he had a powerful motive to start digging. Service and duty matter more than anything else to Dallaire, and he could see how a description of his post-Africa life—the story of the other hell—could help fellow sufferers, “because there’s an ugly side to this injury, not just a bad, stupid side, which is about the impacts it has on you. The ugly side is what the darkness does to the inner person and its significant impact on others. Nobody has written really on that because it’s not very nice, and so I thought I’d do that.”
If PTSD has had a face in Canada over the last 20 years, it is Roméo Dallaire’s. His life story, in effect, is a personal history of how Canada, and the modern world in general, has responded to PTSD. “That’s putting a lot on my shoulders,” he protests, before conceding its inevitability and discussing the incomprehension that faced him when he returned to Canada in 1994, an incomprehension he fully shared.
“We’ve always known about ‘shell shock’ and ‘battle fatigue,’ ” he says, “but the military has never really sustained any desire to research it, to figure out how to handle this injury.” Even as battlefield medicine began saving soldiers’ lives at a rate that dwarfed past efforts, there remained what Dallaire calls the “inappropriateness” of tending psychological injuries, “because it was against the fundamental culture of the military, which is so Darwinian.” The military doesn’t like injuries that it can’t see, he adds. “And because you couldn’t see it, because it affected the way guys acted with their colleagues, PTSD was—in a term I’ve used often—an unacceptable injury, not dishonourable but not honourable either. It has taken us two decades to get the regiments to recognize that these guys are injured, they’re not slackers, and if you don’t take care of them, this injury can be terminal. We’ve probably lost well over 40 back home from injuries sustained psychologically on the battlefield.”

So Dallaire was misdiagnosed when he returned home, or, more accurately, not diagnosed at all. No one asked about the genocide, “no one even mentioned Rwanda.” He was tossed immediately into the maelstrom of helping manage a severe Canadian Forces downsizing during the budget-crimped 1990s. “My colleagues and superiors honestly believed that hard work and a stiff upper lip were the way forward.” Those giving that advice included Gen. Reay, whom Dallaire said urged him to throw himself into his work immediately after their little talk about troubling developments among returning troops. The subtext of this instinctive reaction, never made explicit, was that psychological trauma was the realm of the “weak,” the insufficiently committed, and not to be expected among career officers.
His PTSD, left untreated for too long‚ became permanent—Dallaire still takes medication, still has nightmares, still goes to therapy, still becomes unstuck in time—and he learned about its nature and effects as his life unfolded. There is no point in telling victims, or one’s self, to get over it, put it in the past, move on, because there is no past: the memories of the traumatic experience are not memories, but eternal moments of right now. When that Quebec market brought the Rwandan market to Dallaire’s mind, he wasn’t recalling it, he was living it.
“No, there’s no time factor,” agrees Dallaire. “A very close colleague of mine, who was with me over there, ran a program for us with veterans. He got so engrossed with their hurt that it brought back everything that he had experienced in Rwanda. He fundamentally crashed—22 years later. The stress was so powerful that he could not sustain it and he nearly lost his mind.” Another fellow officer from the Rwandan mission hanged himself in 2008. Once the tumble into the living past happens, sufferers become what Dallaire calls “bystanders” to their own actions, people who helplessly watch themselves “doing stupid and ugly things.”
There is a line, not always clearly expressed, in Dallaire’s mind between stupid and ugly. Suicide, as idea and action, straddles it, and the line is also blurred when it comes to family. For all his openness about himself, he is understandably more circumspect about his wife and children. But from scattered references in Waiting for First Light and Dallaire’s careful responses when asked, it’s clear they too bore the cost of his injury.

Roméo and Beth’s three children—Willem, Flower and Guy—were still young when he returned, only 15, 12 and seven. They and his wife had learned to get along without him, or so thought Dallaire, whose response to them veered from a cold disdain for family life to a bitter feeling they had no idea what he’d been through and no desire to know. Once, maybe twice, says Dallaire, channelling what he believes is a common veteran’s experience, your spouse “will listen to you pour your heart out, but next time they’ll interrupt to ask if you remembered to feed the dog.” He was in a constant rage, yelling at his family for no reason, and feeling that “any amount of shouting” was nothing compared to what he had seen. Sometimes, as in that 150-km/h race down the road, he simply didn’t notice them. Working to exhaustion all day and thrashing about in his nightmarish sleep, Dallaire was soon in the spare bedroom.
“You come back a zombie, or at least a foreigner to your family, and everything around you seems so material, so superficial,” he says. The family had a home in Quebec City and he had work in Ottawa, so he made the decision—“which was not necessarily the best one, I’m sure”­—to stay away. He would live alone in the Hull apartment. It wasn’t a good decision for Dallaire, leaving him to rail about alone at night, drinking himself into unconsciousness and, at times, thinking about his father’s razor. If not for Beth’s sister, Christine, her daughter and another niece, who also lived in the Gatineau area and who would come by, alone or together, to sit with him on occasion, Dallaire would almost surely be dead.
It was not good for the Dallaire children either. All three have followed their parents—Beth too is from a military family and is now a UNICEF ambassador and leading advocate of family support centres—into lives of humanitarian and military service. The youngest, the only one who has read Shake Hands With the Devil, recently sent Dallaire an email, prompted by the anger-management therapy he had been undergoing. He asked, “Why didn’t we move to be with you? Wouldn’t it have been better for all of us? For us, but also for you?” Dallaire says, “I didn’t know how to answer.” Lately, he has drawn closer “than I had ever dared hope” to his oldest child, “who came home from his latest mission hurting.” Personal knowledge of how devastatingly PTSD ripples outward has put military families much on the Dallaires’ minds, especially now that evidence is emerging that the teenaged children of PTSD-injured soldiers “are themselves sometimes committing suicide.”

So too is the larger military family. Dallaire did not fully realize how mighty a bulwark his military belonging provided until after it was no more. It’s no accident that both the cutting and park-bench episodes occurred after his unwilling retirement on medical grounds left him feeling “like I was wandering naked in a foreign land.” Or that his latest episode of dangerous driving—in December 2013, Dallaire went from a full stop directly into a pole near Parliament Hill, without any memory of how or why—correlates with a spate of military suicides. Dallaire’s thinking here is much like that of American writer Sebastian Junger in his book Tribe: “Part of the trauma of war is leaving it,” Junger writes, meaning not the actual bullets whizzing by, but the emotional support that soldiers find in a military unit’s cohesion. The military puts its members into the situations that cause their injuries, but it also provides, however badly, the only solace many have afterwards.
There needs to be a new covenant between the military and the nation, Dallaire argues, in part because of his belief that PTSD is not just a physical or psychological injury, but a moral wound.
He tells a story in his memoir. After hearing of a massacre in a village, Dallaire sends a patrol, Canadian soldiers as it turns out. They find a rape site, a ditch full of dozens of mutilated women and girls, most but not all dead. Later, Dallaire sums up the situation with his 26 international contingent commanders: there are no medical supplies; the dying are too injured to be moved and there is no means of transport anyway; the risk of HIV infection is very high. What orders would they issue: do what you can, or move on? Only three countries—Ghana, Holland and Canada—say to intervene. But the Canadian patrol leader never gives that order, because he never has time. His soldiers—“young men, just 19, 20, 21”—have already broken ranks, and are in the ditch trying to provide what comfort is possible.

That is the kind of army Canada has,  says Dallaire, because that’s the kind of nation Canada has evolved into. We have an army that, precisely because it “carries our moral norms into immoral situations,” will be sensitive to the shock and trauma presented by those sorts of conflicts. “There’s been a breaking of the bond between the nation and its military,” he says. In recent years, “we have practically had to beg for the help we need.” If Canada is going to send its armed forces to help the world’s vulnerable, and Dallaire fervently believes it should, “we need a new cradle-to-grave agreement” that Canada will take care of these soldiers, who have suffered injuries on Canadians’ behalf, right up to veterans’ retirement homes. And suicides should be numbered among the war dead.
Dallaire is most alive, and willing to stay that way, when he has a cause and a sense it is progressing, whether that was his work as a senator from 2005 to 2014, his efforts to end the evil of child soldiers or work on behalf of veterans’ rights. But he has learned to think outside the duty box too, in his scarcely hoped-for reconciliation with his children, and in his appreciation of the healing power of art.
A few years ago, Dallaire’s Pakistani deputy in Rwanda, Iqbal Riza, sent him a copy of The Rime of the Ancient Mariner, Samuel Taylor Coleridge’s 1798 Romantic classic of life-in-death and survivor’s guilt. Dallaire “cried for days” after he read it, seeing himself as the mariner with the albatross about his neck, condemned to tell his tale, over and over, to an unresponsive world.
But Riza, described by Dallaire as “very, very intelligent, principled, unfailingly sensitive,” may have known Dallaire better than the Canadian knew himself. Sometimes Dallaire could find in the poem not just a portrait of his fate, but “a sense of eternity,” he says, “which created a friction in me.” The tension was between his belief in the better angels of our nature—and his failure to protect them—and Coleridge’s portrayal of “these endless frictions that essentially pit human beings against each other. That is something that I am still troubled by, to be quite honest.”

Troubled, perhaps, but also eased in his sense of personal responsibility for the genocide. Dallaire ended up framing his memoir between Coleridge’s stanzas, beginning with the one that must have stabbed closest to his heart: The many men, so beautiful! / And they all dead did lie: / And a thousand thousand slimy things / Lived on; and so did I.
The former general is 70 now, and in as good a place as he’s occupied for these 22 years, but one made precarious by the very nature of his injury. First light has broken on Roméo Dallaire, but it’s not full daylight yet, if it ever will be. He knows it. Maurice Baril still guards his guns.

http://www.macleans.ca/culture/books/inside-romeo-dallaires-brutally-revealing-new-memoir/

PTSD program for vets, first responders expanding.

Oct 21, 2016

A program offering mental health treatment and a refuge for military personnel, veterans and first responders struggling with post-traumatic stress disorder is being developed at a scenic river-front pasture in British Columbia's Interior.

Honour Ranch, located on the North Thompson river in Kamloops, will give a new affordable treatment option for personnel struggling with the psychological disorders that can result from the trauma and stress that comes with the job.

The ranch is being launched by the Honour House Society, a suburban Vancouver based group that provides free accommodation and support to personnel and their families who have to travel to B.C.'s Lower Mainland to get health care.

Allan De Genova, the founder of Honour House, said he started the facility after learning about the personal and financial challenges associated with getting health care and the complications that can arise, including suicide, when conditions go untreated.

"They give unconditionally," De Genova said. "When they need help it just doesn't seem like they're getting it."

Having heard of many cases of first responders dying by suicide, he said developing a health and wellness facility that offered treatment for mental health disorders became a priority.

The donation of the Kamloops pasture offers endless possibilities, De Genova said, for creating a serene getaway for teams of personnel and individual veterans and first responders to participate in one-day and longer-term mental health programs.

Susan Hunt, a clinical psychologist who researches and treats first responders, said emergency personnel are about twice as likely to develop PTSD and other mental illnesses compared with the general population because of the frequent trauma they witness and experience.

While employers provide debriefing services after a traumatic event and encourage personnel to get psychiatric help if issues develop, Hunt said those based in rural communities, where specialists aren't available, are either forced to receive therapy by phone or computer or must travel to the physician.

Since Honour House opened its doors in 2010, guests have saved thousands of dollars in accommodation costs and haven't been separated from their families during treatment.

The organization has plans to expand to cities across Canada and is in the early stages of creating Honour Houses in Calgary, Winnipeg and Ottawa.

Hunt says the addition of the ranch will be an invaluable in offering accommodations and a range of therapies on site that are adaptable to each individual. The ranch can also help reduce the stigma around mental disorders that often hinders people from getting treatment.

"They're not going to be alone there, they're going to be amongst peers who are going through the same things," she said.

Military veteran David Scandrett who volunteers with the peer support program, Operational Stress Injury Social Support, said accepting and discussing the mental and emotional consequences of serving is a hurdle for many of the active and retired personnel he's worked with.

"It took me seven years to warm up to this," he said of his own experience joining the support group.

While treatment can vary depending on the needs of the individual and the mental health and social problems they experience, Scandrett said having programs specifically designed for military and emergency personnel makes a huge difference in helping them feel understood.

"We have all worn the uniform… and had that experience and that exposure, so that there is a level of comfort there," he said.

The property for Honour Ranch is being donated by Kamloops resident Rick Wanless, who said he hopes the facility draws more awareness about PTSD.

Programs at the ranch are expected to launch in March.

http://www.mississauga.com/news-story/6922757-ptsd-program-for-vets-first-responders-expanding/

Hey JT the door just opened for you to keep another promise to vets..... A WELLNESS CENTRE!!!

London's Parkwood PTSD clinic for veterans, soldiers, and RCMP officers exanding.

October 20, 2016

With the number of Canadian veterans diagnosed with post-traumatic stress disorder nearly tripling, Parkwood Institute in London has announced a major expansion of its clinic to treat veterans, members of the military and the RCMP.

The Operational Stress Injury Clinic at Parkwood is being expanded from 2,400 square feet to 4,200 square feet, allowing for more clinical staff to care for clients.

Construction is scheduled to start this fall and be completed by next spring.

Psychologist Dr. Charles Nelson said in a statement that PTSD is one of several persistent psychological difficulties, also known as operational stress injuries, that military and RCMP personnel can develop as a result of duties performed during service.

"We are excited to expand our program and provide much needed specialized mental health services to the men and women who have so bravely served our country," Nelson said.

In the past two years the number of referrals to Parkwood's clinic has increased 46 per cent.

http://www.lfpress.com/2016/10/20/londons-parkwood-ptsd-clinic-for-veterans-soldiers-and-rcmp-officers-exanding

Why Is Canada #1 in PTSD?

So long as we ignore the dubious honour, we betray those tasked with protecting us.

August 02, 2016

A century ago, it was “shell shock,” a strange affliction of some soldiers in the First World War. A generation later, it was combat fatigue, and little better understood (U.S. General George S. Patton famously slapped a victim, considering him a malingering coward). Then it became an occupational hazard for soldiers in Vietnam, and acquired its present name: post-traumatic stress disorder.

Since Vietnam, the problem has become somewhat better understood – and known to affect far more people than first thought. A Canadian Forces survey estimates that 11.1 per cent of regular personnel have experienced PTSD at some time, and 5.3 per cent met the case definition at the time of the survey or in the previous year.

Nor is PTSD confined to active soldiers and veterans. The RCMP notes that “Policing poses an increased risk of psychological work-related injuries. Accordingly, approximately 38 per cent of our members who are off-duty sick long-term have cited mental health, including but not exclusive to PTSD, as the reason.”

A recent report says 36 per cent of male corrections officers suffer PTSD. The report quotes Jason Godin, president of the Union of Canadian Correctional Officers: “One in five federal public servants will suffer from a mental-health issue and, you can tell, our numbers are a hell of a lot higher than that.”

They’re not the only ones: the Canadian Mental Health Association says: “Military personnel, first responders (police, firefighters, and paramedics), doctors, and nurses experience higher rates of PTSD than other professions.”

How high a burden?

Clearly the burden of PTSD on its victims, their families, and their communities is immense. The American group PTSD United says: “The annual cost to society of anxiety disorders is estimated to be significantly over $42.3 billion.” The burden on Canada would likely be proportionate.

Or the burden may be proportionately much higher. An article recently published in the British Journal of Psychiatry reports a surprising finding: Canada has the highest lifetime PTSD prevalence rate out of 16 countries worldwide, much higher than countries like Nigeria, Brazil, and Iraq.

The BJP report’s authors gathered population studies on lifetime PTSD and trauma exposure. They discovered that PTSD rates correlated closely with rates of trauma – exposure to combat, natural disaster, physical or sexual assault, physical abuse as a child, and so on.

But, paradoxically, PTSD was far less common in countries more vulnerable to just such traumas – with vulnerability defined as “the likelihood that an individual or group will be exposed to and adversely affected by a hazard.” Brazil’s cities suffer far more violence than Canada’s, but Canadians suffer more PTSD.

We’re #1

In fact, you could almost judge a country’s level of advancement by the rarity of its hazards and the frequency of its PTSD. Canada leads with 9.2 per cent lifetime PTSD prevalence and a vulnerability score of 31.02. Next comes the Netherlands, with 7.4 per cent, and Australia with 7.2 per cent. The U.S. comes in fourth at 6.8 per cent.

By contrast, Brazil’s PTSD rate is 3.2 per cent, and Iraq’s is 2.5 per cent despite a vulnerability score of 59.79 in the survey. Israel (vulnerability score 38.89) survives bombs and rockets with just 1.5 per cent suffering PTSD. Colombia, after a 50-year civil war and decades of drug violence, has a vulnerability score of 49.9 and a PTSD rate of 1.8 per cent. China (vulnerability score 47.87) has a negligible rate of 0.3 per cent. Most dramatically, Nigeria is a zone of eerie tranquility – a vulnerability score of 68.99 and 0.0 cases of PTSD.

Bear in mind that data for these findings were gathered between 2001 and 2007, and more recent events have likely changed them. It’s hard to imagine young Nigerian women escaping from Boko Haram with smiles and jokes about what a lark it all was.

The authors of the report speculate that high-PTSD/low-vulnerability countries “are inhabited by more individualistic cultures” that “may be lacking aspects of social capital such as community engagement and support that could help victims of trauma repair their resources and rebuild their lives.” In other words, it’s your problem; solve it yourself.

Low-PTSD/high vulnerability countries, by contrast, “may foster conditions that minimize comforting illusions and reduce the contradictions brought about when cherished assumptions are invalidated by traumatic events.” If you expect to be traumatized, in other words, you recover faster when you are, and you can count on your friends and neighbours to help.

The macho culture

The report doesn’t deal with specific groups or professions to any great extent, but groups like doctors, soldiers, and police officers must expect high exposure to trauma – and tend to deal with such exposure by imposing a macho culture of toughness on their members.

That in turn raises another possibility: that people in such high-stress occupations suffer far more PTSD than they admit to, and it affects their performance on the job. It might help to explain, for example, the high number of police shootings in the U.S. – 1,146 in 2015, and 561 so far this year – and the fact that blacks and other minorities are shot far more often than whites.

Canadian police shoot only about 15 to 30 persons a year, and Simon Fraser University criminology professor Rick Parent says “about a third” involve a mental health incident. And how strong is the mental health of the officers involved, both before and after such incidents?

B.C. has even set up the Independent Investigations Office to look into officer-involved incidents involving death or serious harm; its 2014-15 annual report says it carried out investigations into 13 fatal cases (seven with officer-involved shooting) and 36 involving serious harm (four resulting from officer-involved shooting). But the report does not describe the state of mind of either the officer or the other person, and searches for “PTSD” and “mental health” on the IIOBC website got no results.

PTSD as occupational hazard

We’re aware of charges made against the RCMP by female officers that they developed PTSD after sexual harassment by their colleagues – suggesting a workplace made dysfunctional by officers already overstressed. We’re increasingly aware of the alcoholism, drug abuse, domestic violence, homelessness and suicide among Canadian Forces personnel. These begin to look like built-in occupational hazards for such professions.

And they pose still more questions. How many young men and women will enter such careers if they’re fully aware of those hazards? What government will send soldiers overseas if a large minority of them are likely to return as invisible casualties – and with a need for a lifetime of support?

Well, maybe we could teach ourselves to endure levels of trauma we now associate with crime-ridden countries like El Salvador, where the PTSD rates are likely near Nigeria’s. That would seem to miss the point of having security forces in the first place.

The issue could even force us to reconsider how we do jobs involving high exposure to trauma. Perhaps we should offer real care to mental health patients, instead of letting them roam the streets until they stop a bullet. Perhaps we should redefine police work and recruit very different kinds of people to do it. Investing more in diplomacy might save us literally a world of military grief.

The Roman poet Juvenal asked: Quis custodiet ipsos custodes? Who guards the guards themselves? Whatever the solution, we won’t find it until we admit we have a problem.

Until then, we will continue to offload the true costs of our health and security onto the very people we ask to guard us.

http://thetyee.ca/Opinion/2016/08/02/Canada-PTSD/

N.L. soldier turned reality star in St. John's raising awareness for PTSD.

Aug 01, 2016 8:52 AM NT

A soldier originally from Newfoundland and Labrador who became a British reality television star is back in this province and helping to raise awareness for veterans suffering from post traumatic stress disorder.

Cassidy Little lost his right leg while serving in Afghanistan in 2011, but his prosthetic leg didn't keep him from taking the top prize in the BBC's The People's Strictly dancing competition.

Even now, while in Newfoundland on a vacation, Little is still busy raising awareness for PTSD.

"I've lost two guys in the past couple months to suicide. These are injuries that are still taking lives long after the war is over," Little said.

"To ignore it is just criminal."

He said one family member who was a former serviceman and another veteran that he was part of a play with in the U.K. suffered with the disorder and eventually took their own lives.

"This isn't something that's away from us, this isn't something that exists out of our reach, it's something that's very very close," Little said.

"You probably walk past people who have been diagnosed with PTSD every single day on the streets."

22 Push-Up Challenge

As a way to raise awareness for veterans with PTSD, Little is taking part in the 22 Push-Up Challenge.

He compares the challenge to the Ice Bucket Challenge for ALS that swept the internet in 2014 and said the challenge is simple — 22 push-ups each day for 22 days, nominating one other person everyday along the way.

Little said there are statistics that that 22 veterans kill themselves everyday in the U.S., and that doesn't include those in Canada and the U.K.

"When I hear statistics like that, it just breaks my heart," he said.

"It breaks my heart is only words — it does genuinely stab me right through."

Little was enjoying the opening of the George Street Festival on Thursday and completed his push-ups for the day right on the street.

"In true Newfoundland style, you guys threw a hell of a party … so we went down," he said.

"In fact, I saw the opportunity so I banged out my 22 press-ups down on the street."

Little said he has nominated his old boss at Christian's Pub and several family members as he competes the challenge.

http://www.cbc.ca/news/canada/newfoundland-labrador/soldier-turned-dancer-ptsd-awareness-1.3703007

Camino Walk serves as PTSD treatment.

July 17, 2016 8:57:51 EDT PM

KINGSTON - Sometimes to heal mentally, one must move physically.



That is what the organizers of the Royal Camino: An Operational Stress Injury Initiative are aiming for.

The Royal Camino is set to take place in April 2017. Organized by The Royal Canadian Regiment (RCR), it plans on bringing seven Canadian Forces veterans from all different trades and occupations to walk The Camino across northern Spain. The 800 km walk will take more than a month to complete.

Retired Lt.-Col. Rusty Bassarab, president of the Kingston branch of the RCR, assistant planner and second in command of the Royal Camino, said the walk was the brainchild of the team leader, retired Master Cpl. Dave Brydon, who previously completed the walk.

"He'd done The Camino and found it had a very calming effect," Bassarab said on Friday. "He started talking to others about how this would be a good treatment for those suffering with operational stress injuries, particularly post-traumatic stress disorder [PTSD].

"He brought the idea to one of our barbecues, we looked at it and decided it was worth investigating. In fact, the more we've done our investigation the more we believe that it has a lot of beneficial effects."

From there the planning began and participants made up of serving or formerly serving Canadian Forces members were selected. Of the four men and three women, ranging in age from 37 to 50, four are from Ontario and one each from Manitoba, Quebec and Newfoundland. Six of the seven have been formally diagnosed with PTSD. Most of the participants also deal with depression; one has been diagnosed with Dyskeratosis Congenita, failure of the bone marrow, due to radiation exposure during their operational tour in Bosnia.

"What we're hoping to do with Camino is to take them out of safe mode," Bassarab said. "There's a lot of anecdotal evidence that exercise is good for the brain, but it's a simple routine. You get up, eat, you walk, you find a hostel, you maybe look around, get some sleep, do it again. For 30-some days."

Many have asked Bassarab why they chose The Camino and not a trail closer to home. The reason comes down to simple logistics and infrastructure along the route. Participants will have a bed in hostels for most of the trip, and restaurants along the route.

Bassarab said for the first couple of the days the group may stick together, but that isn't what the trip is about.

"It's an individual journey," Bassarab said. "It factors into the treatment. Setting your own pace, setting your own goals. If it was just follow along, it's not the same."

Success of the trip will be measured through mental health questionnaires at different intervals along the trip. Before being selected by a board made up of the organizers and practising mental health professionals, the participants completed the Beck's Depression Inventory and Beck's Anxiety Inventory questionnaires. They will also be completed after the walk.

The cost to transport, house and feed the participants is approximately $5,000 each. The RCR has contributed $10,000 from their trust fund, the Canadian Forces' Soldier On program has promised $1,000 per participant, and a gofundme page has also raised more than $12,670. The RCR has also applied for the Bell Truth Patriot Love Fund for a $15,000 support grant.

While residents can contribute at gofundme.com/RoyalCamino, a charity golf tournament is also being organized. Watch for details on The Royal Camino's Facebook page at www.facebook.com/RoyalCamino.

http://www.thewhig.com/2016/07/17/camino-walk-serves-as-ptsd-treatment

Veterans with PTSD forced to wait months for treatment coverage.

Wednesday, Jul. 13, 2016 12:30PM EDT

Veterans of Canada’s Armed Forces who have been diagnosed with mental illnesses including depression and PTSD, or who have recently been released from the military while coping with those afflictions, are being told they must wait several months before the federal government will pay for psychological counselling.

A Globe and Mail investigation has found that at least 62 soldiers and veterans have taken their lives after returning from the gruelling Afghanistan mission. Some of them were receiving medical treatment.

But Matthew Quist, a former captain who was in the regular forces until 2012 and then joined the reserves in 2013, says he wonders if others were diagnosed with depression then forced, like he was, to wait until their claims were processed to find out if Veterans Affairs Canada (VAC) would pay for the counselling they need.


Mr. Quist said the experience makes him concerned for the people he led when he was an officer. “I had a corporal commit suicide when we got back from Afghanistan, and I wonder if he tried to get help but couldn’t access it and then just gave up,” he said in an interview from his home in Winnipeg.

Mr. Quist made it through Afghanistan physically unscathed, but broke his T-12 vertebra during a training mission with the reserves last year. After complex surgery, he could walk, but could no longer work out, drive or go for a run. And he was in constant pain.

“As things drag on and you realize the gravity of what happened, it hits you,” Mr. Quist said. An anxiety attack in which, he said, he felt like his whole body would explode, convinced him to seek help. He went to see a clinical psychologist and was diagnosed with major depression.

“I just can’t pay attention,” he said. “I just get lost in thinking about something. It’s frustrating, because it’s just not myself. I know it’s not me.”

Mr. Quist has yet to be medically released from the reserves but, because he is a Class A reservist, his claim is processed by Veterans Affairs rather than the Canadian Forces. He called the Veterans Affairs department to find out what treatments were available and was told he was ineligible for psychological counselling because his injury was physical, not mental.

“I was incredulous,” Mr. Quist said. “I said, ‘This is 2016. Knowing what we know about injuries and their effects on mental states, you’re telling me that I have no [psychological] treatment benefits for depression relating to a physical injury.’ And they said, ‘Yeah.’ ”

One Veterans Affairs official suggested he start a new claim for his depression and said he would be eligible for some interim coverage while it was processed. But when Mr. Quist called the department to ask about the interim treatment after that second claim was launched, “I was told, again, that treatment is only authorized once your claim has been processed and you have become a VAC client for that condition.”

It took more than four months for the department to agree to pay for Mr. Quist’s psychological services.

“It’s like $170 an appointment. I’m not poor,” he said. “But I don’t want to pay out of pocket because it’s going to wind up being thousands of dollars.”

A Veterans Affairs spokesman said in an e-mail that the department’s standard is to adjudicate 80 per cent of all disability benefit applications within 112 days. But just 56 per cent of disability claims meet that standard, and the average time to process a claim, he said, is 123 days.

When asked why veterans who have been diagnosed with mental illnesses must wait months to get their treatments covered, the spokesman said the department “offers immediate and interim access to counselling through the VAC Assistance Service.”

Veterans Affairs officials say that service will provide up to 20 paid counselling sessions with a “mental health professional,” which includes psychologists, social workers and trained educators.

But the department’s website makes it clear the service is for addressing short-term problems. If long-term or more specialized help is needed, the website says, the veteran will be referred to a “specialist” in his or her community and have to bear the costs until their claims are approved.

Meanwhile, front-line workers at the department are telling veterans no interim treatment is available.

In a 2014 report that found veterans were not getting timely access to mental-health care, the federal Auditor-General said some vets get the treatment they need during the processing period. For others, the auditor said, there was no evidence it was being provided.

Kevin Sweeney, a former Master Corporal who also served in Afghanistan, says it took almost five months, and numerous calls and e-mails, for his medical claims to be approved when he left the military last December. Because his pension was being processed at the same time, he was barely scraping by financially.

Before his discharge, Mr. Sweeney was diagnosed with a major depressive disorder and anxiety related to his overseas deployment. The doctors at the base in Kingston, Ont., had referred him to a psychologist in the community but, once he left the military, the government would not pay for the services until it had completed his paperwork.

“The doctor I have right now, said, ‘Look, don’t worry about it, I am covering it because I know that you need the therapy,’ ” Mr. Sweeney said.

She provided free counselling for five or six months. But he had more problems when the expensive medication he takes for his condition ran out and the department refused to pay.

“My wife has a head injury, so she’s not able to work,” Mr. Sweeney said. “I went to them [Veterans’ Affairs] and I told them: ‘I’ve got depression. I am running out of my drugs. You know that I am having trouble trying to get my pension.’ And the lady that I talked to turned around and said, ‘You should phone Ottawa and tell them that they are holding up your medication.’ ”

Antoon Leenaars, a psychologist and consultant on suicide prevention in Windsor, Ont., who writes a blog about veterans, said the absence of counselling services during the processing time is dangerous.

“We have had incidents here where people have been begging for help,” Dr. Leenaars said. The Department of National Defence is doing a much better job than Veterans Affairs in dealing with psychological issues, he said.

The accountability for the well-being of people who have served in the military does not stop the day they take off the uniform, Dr. Leenaars said. “We need to continue with the same kind of service that they get in the military.”

http://www.theglobeandmail.com/news/politics/veterans-with-mental-illnesses-forced-to-wait-months-for-treatment-coverage/article30900508/

New service to help P.E.I. vets access medical marijuana.

Jun 22, 2016 5:00 PM AT

'We're trying to break down the stigma. This is medicine. We need it'

A new office is set to open in Charlottetown next month offering military veterans advice and assistance in legally obtaining medical marijauna.

The office will be located in the Kirkwood Mews strip mall on University Avenue.

Dennis MacKenzie, a veteran of Canada's military mission in Afghanistan, will serve in a volunteer capacity as head of the P.E.I. branch of Marijuana for Trauma Inc., a national not-for-profit organization.

MacKenzie and other organizers held a public information session at the Best Western Hotel in Charlottetown on Wednesday.

"There was a stigma attached and we are trying to break down that stigma," said MacKenzie. "This is absolutely medication. We need it."

MacKenzie said medical marijuana is most often used by veterans to treat post traumatic stress disorder and chronic pain.

'Amazing' results

The store-front office won't supply cannabis or its derivatives to veterans.

Rather, staff will help veterans obtain the necessary medical prescriptions and file the government paperwork in order to obtain marijuana legally from licensed medical producers.

Jim Grant, a 79-year-old veteran of the Royal Canadian Navy, started using medical marijuana two months ago to deal with intense back pain due to arthritis.

He had been active all his life, was an avid golfer, and had never used marijuana before.

The organization arranged for Grant to be interviewed via Skype by a doctor in Ontario who wrote a prescription.

He now takes oral marijuana capsules.

"The results were absolutely amazing," said Grant. "I'm here to support others who can be helped."

Counselling, yoga

The organization also arranges other types of therapy, including counselling and yoga.

Its services are tailored to military veterans, retired police officers and other first responders, but civilian members of the public are also welcomed.

The store-front office of Marijuana for Trauma is slated to open July 20.

http://www.cbc.ca/news/canada/prince-edward-island/pei-medical-marijuana-veterans-1.3647520

Veterans, active military and RCMP personnel who have Post Traumatic Stress Disorder (PTSD) relating to their job will soon be able to have access to mental health services closer to home.

A partnership between The Centre for Mental Health Research (CMHR) at the University of Waterloo and Parkwood Institute's Operational Stress Injury Clinic (OSIC) hopes to play an important part by providing psychological services and assessments for patients.

The demand for mental health services has increased significantly over the past years as the number of individuals with PTSD has tripled creating a substantial need to aid in their recovery.

"We wanted to be able to provide services in more locations," said Dr. Ian Nicholson, Director of CMHR. "It's not an increase of service but … an increase in the places where the service would be available to them."

OSIC administers support to patients from a large geographical area and Heather Tales, director of veterans care at St. Joseph's, says that they "are always looking for creative ways to extend their services."

"There are only two clinics in Ontario, and we are one of them," said Tales. "We are responsible to serve clients from southwestern Ontario, the Greater Toronto Area, Hamilton Niagara Region and even parts of central Ontario."

On alert

The partnership will not be limited to just mental health services. In the future it also aims to help military personnel who may suffer from depression and drug addiction. But for now, the first step is to provide thorough psychological assessments to determine the needs of the individuals.

Dr. Nicholson says often individuals with PTSD are on alert for potential threat all the time which begins to overwhelm them. They also have difficulty building and holding on to relationships with their family member and loved ones.

"This trauma can begin to seep into the rest of their lives," Nicholson said.


Training

This also opens the opportunity to train psychology postdoc students. Tales mentions how Dr.Shannon Gifford, who's a psychologist in the OSIC clinic in London, worked with Dr. Nicholson and his team which initiated the idea to continue the advancement and training of the psychology postdoc students.

"We have seen wonderful benefits with the training and very positive response from the students who are working with Dr. Gifford," she said.

Dr. Gifford travels to the University of Waterloo to work with students during their training and supervises the assessments done to patients.The students will train and gain experience from the comprehensive assessments conducted to the patients. Students will also be exposed to the military culture to better their knowledge and understanding of the patients that may be under their care in the future.

http://www.cbc.ca/news/canada/kitchener-waterloo/waterloo-region-london-guelph-ptsd-help-veterans-rcmp-1.3548182