Canadian Forces Step Up Efforts to Fight Stigma of Mental Illness

OTTAWA—Three months after Steven Lively returned from central Africa in 1996, the former Canadian Forces solider started experiencing constant panic attacks, migraines, and anxiety.

It was two years following the Rwandan genocide. He was in Africa to observe the survivors who had fled to neighbouring countries and were trying to return to Rwanda.

“It was a feeling of complete helplessness,” he said. “You come home from a mission and before you know it you’re overcome with a very strong sense of guilt.”

He encountered mass graves and other horrors of human suffering, including children and babies dying.

Yet, due to the military’s rules of engagement to guard the soldiers’ safety, “there was absolutely nothing that I could do. I was unable to stop and provide any kind of assistance.”

The resulting guilt manifested as depression, anxiety, nightmares, and flashbacks, along with other severe symptoms that included headaches, fibromyalgia, and irritable bowel syndrome.

“I didn’t understand all these things that were part of post-traumatic stress disorder that we now know. Back then, I had no idea what was happening to me,” said Mr. Lively, who now works with the Joint Speakers Bureau (JSB) of the Department of National Defence (DND) to provide education and awareness on mental health and operational stress injury (OSI).

He is among a group of speakers who conduct pre- and post-deployment education within the military. All are former military personnel who have been diagnosed with post-traumatic stress disorder (PTSD) or another OSI resulting from military operations, such as anxiety, depression, substance use, or psychological difficulties relating to chronic pain.

Just as it is in society at large, stigma surrounding mental illness is significant within the military.

Over one third of Canadian Forces members will not come forward for mental health treatment due to their fear of stigma, according to a study published in the February 2008 edition of Medical Care, a journal of the American Public Health Association.

Meanwhile, as Canada plans to end its combat role in Afghanistan by July 2011, a House of Commons committee report from last November estimated that 3,600 Afghanistan veterans could develop psychological problems, including PTSD.

The military is making efforts to educate soldiers and their families as well as all levels of leadership.

“The backbone of our organization is to try to eradicate stigma within the Canadian Forces in regards to mental health injuries,” said Mr. Lively. “We’re taking those negative experiences and reusing them in a positive way to educate our peers and colleagues.”

In pre-deployment training, the group talks about experiences that the soldiers may encounter, and the signs and symptoms of mental illness. Another program provides social support for soldiers suffering from an OSI.

And when troops return from a mission, rather than going home directly as they did when Mr. Lively was serving, they now spend from one to three weeks in an isolated location for what’s called “third location decompression.”

“It’s an opportunity for trained social workers, psychologists, psychiatrists, and peer speakers and educators to speak to the troops, . . . so if they do happen to sense any depression or anxiety, the message is to get help immediately, not to wait, and not to be afraid of stigma,” Mr. Lively said.

The JSB is starting to share its curriculum and model with civilian first-responder agencies such as paramedics, firefighters, and police forces. And the military now has programs to support spouses and families.

It is completely different from the experience Mr. Lively and his wife, Marcia Mills, met with during the seven years when they had no support at all.

The family “rolled in and out of one anxiety state into a more severe panic attack, back to an anxiety, and then ultimately collapsed with exhaustion for a day or two or a week, and then it would just start all over again,” said Ms. Mills.

Mr. Lively’s symptoms were dismissed as a “normal” part of returning from deployment. It was assumed they would go away with time.

Unfortunately, they didn’t, but got worse instead as he continued to be deployed. By the time he was diagnosed with PTSD, nearly five years had gone by.

“I had lost much body weight, and I was so sick at this point that the military made a decision that I was going to be medically released. I was unfit for military duties.”

That was in 2001. But he was left with no treatment program in place. “There were no doctors, no therapy plan. There was absolutely nothing for myself, or for my wife,” he said.

It was not until another two years later before they found a program within the DND that started to turn their lives around.

Over the seven years, Ms. Mills became her husband’s advocate, working with doctors, psychologists, Veterans Affairs Canada, and other organizations to try to find treatment.

Today she speaks out to others on the issue but remains “ready to step in if things are going bad” for Mr. Lively, who still has flashbacks occasionally if something happens that triggers memories of the trauma in Africa.

The couple was among the recipients of the 2010 Inspiration Awards presented by the Royal Ottawa Foundation for Mental Health last Friday to honour people who have educated and inspired others as a result of their own experiences of mental illness.

Ms. Mills found that after having the chance to step forward and share with others, “you find out that people are generally very supportive.”

The more awareness campaigns there are and the more people speak out, it gives a voice to others who have been suffering mental illness, as well as their families, she said.

It empowers them to say, “Here I am, and this is who I am, and I’m going to carry on.”

The website of the Royal Ottawa Foundation for Mental Health’s You Know Who I Am campaign features videos depicting Steve and Marcia’s story as well as stories of others helping to break the stigma against mental illness.

The Royal Ottawa Mental Health Centre is presenting a year-long series of free public lectures celebrating 100 years of care in 2010. The next lecture—INVISIBLE WOUNDS: Recovery for Veterans and Their Families—is on Thursday, March 11, 2010, from 7 to 9 p.m., free admission at the Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario. Click to RSVP for the lecture.