“We invested tens of millions of dollars for them to do the job overseas so we’d better be prepared to do what’s needed to take care of them and their families,” said Dallaire, Canada’s first public face of post-traumatic stress disorder. “Veterans Affairs should have been exempt and funded according to the increasing demand, but it didn’t get that pass.”
Early next year, Veterans Affairs will close nine regional offices and it is cutting about 300 jobs and at least $226 million from its budget.
Dallaire, who was medically released from the armed forces in 2000 after being diagnosed with PTSD, says DND has been “chipping away” at programs created to care for casualties because its priorities are elsewhere.
“And when people tell me at Veterans Affairs that the programs won’t be affected because they’ve done studies, it’s nothing more than double talk and camouflage for the fact that they’re cutting.”
After a harrowing, well-documented assignment during the Rwandan genocide, Dallaire returned to Canada in 1994 and became assistant deputy minister for human resources at DND, where he was instrumental in building a system for ill and injured troops.
“There was absolutely nothing for my family or for me in 1994 when I came back,” he said, adding that two of his children eventually needed counselling related to his PTSD. “It took us damn near 15 years to be able say we have something capable of meeting requirements.”
That system includes an internal structure to care for physically and mentally injured serving troops, a series of Operational Stress Injury Clinics across the country to treat veterans with PTSD, and a virtual affiliation with Canadian researchers called the Canadian Institute for Military & Veteran Health Research, a joint venture of the Royal Military College and Queen’s University.
“It all came about because of casualties among those coming back post-mission — suicides, family breakups and the catastrophic failure of people with PTSD turning into drugs addicts, boozing and being thrown in jail,” said Dallaire.
“It was a terrible apprenticeship and we now have an exemplary system, but this is a game of 100 per cent because every human being counts. The system has to meet requirements of all the people, not just the majority.”
The government is using the end of Canada’s fighting mission in Afghanistan as justification for chipping away at services for ill and injured troops at home, said Dallaire.
“Well the war for the casualties is ongoing, if it’s not getting worse,” he said. “At Veterans Affairs, where they once thought they were going out of business because the old vets were dying, they got surprised by the massive escalation of a new generation of veterans with complex and demanding injuries. They responded to it as best they could but then they got hit like everybody else. There’s no value crapping on the system. The political side lost its credibility.”
In contrast, the Obama administration recently announced multibillion-dollar increases to the U.S. Department of Veterans Affairs, including $7 billion for mental health programs, following criticism from politicians and media commentators that veterans were waiting too long for benefits.
Veterans Affairs Canada, which operates on a $3.5 billion annual budget, did not respond to a Citizen request for comment.
Chief of Defence Staff Gen. Tom Lawson concedes that more work needs to be done, but says military leadership “is passionate about ensuring that our members who have sacrificed in service to their country receive quality care and support.
“The CAF recognizes the significant sacrifices our military members and their families make in the service of our country,” he said in a statement. “Collectively, we are committed to reinforcing our mental health programs and support services to meet the increasing complexities and demands of military service today.”
After a Citizen investigation and a subsequent critical report last month from the Defence ombudsman, military brass have agreed to add staff to the malfunctioning Joint Personnel Support Unit — a nationwide system created five years ago to aid ill and injured troops.
Jitender Sareen, a professor of psychiatry and psychology at the University of Manitoba and part of the Queen’s-Royal Military College research system, says with the influx of injured veterans the military is well-placed to help with the international effort to find more effective therapies for PTSD.
“If we’re going to try to understand the neuro-biology of mental illness,” he said, “the military is in the best position to do the kind of studies that will help prevent illness and advance understanding of why one person witnessing or experiencing the same trauma gets ill and another doesn’t. The military is in a fantastic position to do some very interesting work.”
Sareen’s comments echo those of Israeli PTSD specialists interviewed by the Citizen during research in that country.
Psychologist Mooli Lahad, a former chief instructor for the Israeli military’s mental health officers and founder of a community trauma centre in the northern Israeli border city of Kiryat Shmona, says Canada has a “golden opportunity window” to treat its mentally injured soldiers and to add to the international body of research.
“There is a PTSD healing mechanism in the body and if you are catching it within six months over 90 per cent recover,” he says. “The longer it takes — and some of my colleagues suggest that a year is the cutoff point — the more intensive treatment you need.
“After a few years of PTSD the damage has been done to your personality and your immediate environment,” said Lahad, who has consulted on the disorder worldwide. “Your children avoid you, your spouse is walking on eggs and everyone is trying to isolate or pamper you — or get a distance from you because they don’t want your outbursts of anger.
“After three or four years there is much more to cope with. Depression, alcoholism, drug abuse, domestic troubles — it becomes an entity in its own right.”
It also makes economic sense to treat PTSD and other mental injury sooner rather than later, said Lahad.
“Many (untreated) go on welfare or end up in drug and alcohol centres and some end up in prison,” he said. “It’s all very expensive.”
At the Sheba Medical Centre outside Tel Aviv, researchers are developing a virtual reality PTSD lab to enhance exposure therapy, a commonly used technique where PTSD sufferers are encouraged to re-live the trauma or traumas that brought on the injury.
Head of the PTSD clinic Dr. Asaf Caspi concedes there are key differences between the Israeli and North American experience, but there are lessons nonetheless.
“(In Israel) everyone has experienced war in some form or another, either by service in the army or being exposed to terrorist attacks,” said Caspi. “During the second Lebanese war (2006), rockets covered one-third of Israel — rockets fell onto Tel Aviv. So everybody shares the trauma. It isn’t foreign to anybody in this country.”
Partly because of that shared experience and because the Israeli military has been proactive, stigma is no longer a significant issue for PTSD sufferers, according to Caspi.
“Sometimes you find a young veteran admitted into the ward,” he said, “and you see him surrounded by his fellow soldiers and people who served with him. It isn’t perceived as a weakness.”
Unlike in Canada, alcohol and drug abuse is not common among the current generation of Israeli PTSD victims and recorded suicide and suicide attempts among veterans are also fewer.
It’s never too late to get treatment for PTSD says Lahad, recounting the case of a patient who came to him after 38 years of sleeping barely two hours a night.
“As a young person he was a promising scholar who won prizes for his achievements, and he was an excellent athlete,” said the psychologist. “When he came to my treatment centre he was working in a pickle-making factory in charge of the boiler.
“After treatment he was able to sleep four and a half hours a night and was able to hug his daughter who was by then 18. It was the first time in her life that he had hugged her. I was able to reduce his symptoms, but there are many things he will be unable to change.”
Soldiers stricken with PTSD need the best and most immediate treatment available, said Lahad.
“I know the contract with the military is that you’re paid to fight,” he said, “but the contract doesn’t say that you should be mentally disabled forever. You might be injured, yes. You might be killed, yes. But being forever mentally haunted by memories that are treatable? No.”
Original Article
Source: ottawacitizen.com
Author: Chris Cobb
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