Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Wednesday, July 03, 2013

Military study into mental injury underplays problem, say experts

OTTAWA — A new Department of National Defence study claiming that 13.5 per cent of Canadian soldiers who served in Afghanistan returned home with mental illness severely underestimates the problem, say specialists in military mental health.

Of the soldiers who deployed, eight per cent have post-traumatic stress disorder (PTSD), says the study by David Boulos and Mark A. Zamorski titled Deployment-related Mental Disorders Among Canadian Forces Personnel Deployed in Support of the Mission in Afghanistan, 2001-2008.

The DND study, drawn from a pool of 30,513 troops who served in Afghanistan up to 2009 — two years before the final combat deployment ended — was published Tuesday in the Canadian Medical Association Journal.

But in the often confusing numbers game surrounding Post-traumatic stress and other war-induced mental injury, the DND study even appears to undercut some of the department’s previous estimates.

The real number of mentally injured Afghan veterans is likely twice the number reported in the study, says retired Brig. Gen. Joe Sharpe, one of Canada’s foremost authorities on operational stress injury in the Canadian Forces.

Some military personnel are still afraid of coming forward and admitting they are having emotional problems, said Sharpe.

“There’s a stigma with mental health issues in society as a whole but in the military it’s probably worse,” he said. “There’s a fear of being labelled a faker, which is a favourite shot that comes from people who aren’t well enough educated about it.

“And a lot of young guys and girls don’t want to take the risk of being labelled a faker and that’s also a big deal,” he added. “Then there is a fear of losing your job, of being shuffled off into the JPSU (Joint Personnel Support Unit) which is ultimately the path out. Plus when you’re part of the military you’re part of a family. It’s bad enough dealing with a mental health issue you don’t want to deal with being divorced from the family at the same time.

“And like a lot of civilian counterparts, mental illness is something you don’t want to admit to yourself.”

DND declined to make Boulos and Zamorski available for interview with the Citizen. Though it’s normal practice for authors of medical studies to discuss their work with media when it is published in professional journals, DND instead provided a three-page written summary listing the department’s numerous mental health initiatives followed by a list of its own questions and answers on the study, most of which reiterated information found in the study itself.

(The Canadian Medical Association Journal says it never comments on articles it publishes and referred all questions to the authors via DND’s public affairs department.)

But in the written analysis published in the CMAJ, the authors call their study “a precise and methodologically rigorous estimate of the impact of the Afghanistan mission on the risk of mental disorders during continued military service.”

They add that this study, and future research with the same group, will have an impact on mental health care within the military.

However, the authors also acknowledge that despite its “precise and methodologically rigorous estimate,” the study has limitations because it doesn’t include servicemen and women who “had mental issues that resolved without care” or who will fall ill in the years to come; those who sought care outside of the Canadian Forces; and those who retired from the Forces before seeking help.

Those categories and others could add thousands more troops to the tally, say experts.

Jan Stroud, a clinical social worker who treated many Afghan veterans at CFB Petawawa before leaving last year, agrees that the DND figure of 13.5 per cent is low.

“There are people who served in Rwanda and Bosnia who are just coming forward now,” she said.

Stroud is critical of the military for adopting a one-size-fits-all treatment model. “This approach doesn’t appear to be for all soldiers. When DND says, ‘We’ve increased the number of psychologists and psychiatrists — nobody is being turned away,’ it is a very limited picture. There are many who just try to live with their symptoms.

“The military are not prepared to individualize situations,” she added. “They came up with standard criteria and fit the soldier to the criteria. But I think they have found out to their peril that the criteria aren’t always accurate.”

When the Afghan conflict was at its height, the military had effective mental health education programs that targeted all Canadian Forces personnel, said Sharpe, but when Canada’s combat role ended in 2011 and the federal government began cost cutting, education ceased to be a priority.

“In the last five years we have been drifting backwards on the education front,” he said, “and that really erodes the understanding level. As you erode understanding you increase the stigma. It’s almost a one-for-one.

“We should be telling people at all rank levels about mental health issues,” Sharpe said. “We should be telling people how to recognize it in themselves and how to recognize it in others — in your buddies and subordinates and influencing policy to make the CF a much more mental-health friendly workplace.”

Ninety per cent of troops studied were male and the vast majority were regular forces. More than half of the troops surveyed were deployed in Kandahar and Kabul where most of Canada’s 150-plus military fatalities occurred.

The majority of those who suffered mental injury served in Kandahar.

Canada has deployed 40,000 servicemen and women to Afghanistan since the combat mission began in 2001.

DND, which says it conducted the study to better understand the psychological impact of the Afghan mission, has two more studies in the pipeline — a near-completed study into Operational Stress Injury (OSI) and another Statistics Canada survey into the state of mental health in the Canadian Forces.

Military mental health specialist Sharpe warns that a major wave of mental illness among veterans is only three or four years away.

“That’s a significant concern in my mind and I know in my other people’s minds too,” he said. “We’ve seen it in the American and other militaries that it takes four or five years for these issues to come to the fore.”

Original Article
Source: ottawacitizen.com
Author: Chris Cobb

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