By Sandrine Murray
A conversation about mental health is not always easy if you don’t know what to say. For Canadian Armed Forces members, this can be a difficult challenge. Discussing a mental health issue for some military members may feel like revealing a weakness. But they’re not the only ones affected by mental health issues. It also affects their families and close ones. Without having lived through the same experience, spouses and friends may not know how to help their loved one if they’re dealing with a mental health problem or illness.
Stories about mental health issues are often highlighted in the media when a veteran dies by suicide. On January 5, a Toronto Star editorial highlighted the need for Canada to do more for the veteran community after a Canadian veteran living with post-traumatic stress disorder (PTSD) was found dead in an apparent murder-suicide in Nova Scotia. Back in 2014, another Star story revealed that suicide claims more soldiers than Afghan combat.
The Canadian Forces has been working to adapt and create an environment that removes barriers to care. At a mental health panel on February 7 by the University of Ottawa’s Telfer School of Management, Lieutenant-Colonel Suzanne Bailey explained the continuum model they developed for mental health discussion, and to get members the care they need.
The Canadian military has seen mental health awareness increasing in the workplace, especially since 2013, says Bailey. Canadian Forces members are now more likely to talk to a colleague or a supervisor about what they’re dealing with, rather than trying to cope on their own. Before, she says, it was different.
“They weren’t recognizing it, and they weren’t comfortable coming forward to seek care,” said Bailey.
The most recent survey done by the Canadian Forces in 2013 provides the most current data available to estimate the presence of PTSD in serving personnel. Of over 8,000 personnel surveyed, 11.1 per cent met criteria for PTSD at one point in their life. Most members who deploy on operations do not develop PTSD, but those deployed to higher-threat locations tend to be more susceptible.
At the panel, pocket-sized handouts labeled “The Road to Mental Readiness” outlined the Forces’ continuum model for mental health. Starting on the far left of the spectrum is the colour green, which means healthy. Someone in the green has normal mood fluctuations, a good sense of humour, and generally good sleeping patterns. Moving towards the right on the horizontal scale, the colour changes to yellow. At this point the individual is increasingly irritable, nervous, or procrastinates more than usual. By orange, the person is considered injured. Anger, anxiety and avoidance mean they should access care. “Talk to someone, ask for help,” indicates the handout. “Get help sooner, not later.”
Finally, the red is at the end of the spectrum, and means the person is “ill.” The previous symptoms are heightened. Work performance is affected. Red means a member would need to seek help before being ready for deployment. Instead of seeking help, Bailey says CAF members often prefer to manage their mental health issues on their own, and downplay their mental state to be allowed for deployment. The continuum is a way to increase awareness. It’s not a diagnostic tool, but can be used by individuals to help them gauge the state of their mental health.
“It’s not a one-way street,” she said. “You can recover from mental health problems and illnesses.”
This is important for members, but also the Forces. They need their members to be at their optimal performance for operational success, explains Bailey.
In terms of mental health, Major-General Wayne Eyre says service in the military can be compared to the life of an athlete. Physical and mental preparation is key. And it can easily be forgotten that this preparation benefits, not hinders, personnel.
“Military service makes us stronger,” he says.
Operational stress injuries (OSIs) must be cared for, he says, but developing coping skills for the challenges military service requires is also important, he explained. “Let’s build them,” he says. “They’ll be better able to withstand the rigours of military life.”
Since June of last year, Mental Health First Aid Veteran Community classes have also been available. Developed by the Mental Health Commission of Canada and funded by Veterans Affairs Canada, these classes are offered at no cost to members of the veteran community.
These courses have taken place all over Canada and are geared to Canadian Armed Forces veterans, their families and friends, as well as caregivers and health providers. Course participants learn how to support people developing a mental health problem or experiencing a mental health crisis.
Steve Walsh has been a nurse for 20 years, and is one of the instructors of the Mental Health First Aid course. There are two important elements to the class, he explained. For one, it doesn’t train someone to be a therapist. As in a physical first aid class, trainees learn how to support and encourage someone to get professional help, if need be. Secondly, the ideas of resilience and being strong ring strongly in the military, which may make members hesitant to seek help. Breaking down that stigma and barriers, and creating an environment where people feel they can speak out is crucial.
Like ABC, Mental Health First Aid has its own acronym called ALGEE. They’re not steps, but actions that facilitate a conversation about a mental illness or problem.
These actions are: Assess the risk of suicide and harm; Listen non-judgmentally; Give reassurances; Encourage the person; and lastly, Encourage other supports. Generally, Walsh says support persons or family members are more familiar with topics on depression and anxiety. However, the idea of suicide renders those same people more uncomfortable.
A common misconception is that mentioning suicide when talking to someone who may have a mental health illness is a bad idea because it plants the idea in their heads. In fact, it’s usually the opposite, Walsh says. It allows people to go and talk about what they may have been too afraid to discuss themselves.
Instructors who give the course understand the Forces. They undergo a five-day training session prior to giving a class, and use evidence-based practice like case studies catered to those in the military. Artwork by veterans in the handouts allow for a more personal touch. The class itself gets people together, explained Walsh. Mental health is a heavy load for caregivers to carry as well, so the class helps them gain the tools they need to recognize signs of mental health problems and illnesses.
But it also creates a network of support for people to know they are not alone, creating a space where conversation can freely flow.