The military ombudsman is investigating how the Canadian Forces is dealing with soldiers who return from Afghanistan with post-traumatic stress disorder and with their families.

In 2002, before large-scale deployments of troops to Kandahar, the ombudsman's office issued a critical report on PTSD that contained 31 recommendations for change.Six years later the ombudsman is reviewing half of those recommendations that were not implemented, including a call to establish databases on the number of soldiers with stress-related injuries and on soldiers who kill themselves, and another to improve support programs for the families of those diagnosed with PTSD.

The probe is a follow-up on what progress has been made but within the context of Afghanistan, where an estimated 10,000 Canadian troops have served since 2005.

"The big observation we have made is that there needs to be consistent treatment for people no matter where they live," interim ombudsman Mary McFadyen said from Ottawa. "We want to ensure that the Canadian Forces is doing what they can to help families. And from the general observations we have made, it appears that there is more work to be done."

Post-traumatic stress disorder is a psychological injury from a severe stress such as military combat, seeing another person harmed or killed, or learning that a close friend or family member is in serious danger. Symptoms can include flashbacks, nightmares, withdrawal from friends and family and increased aggression. PTSD can lead to depression, anxiety, and alcohol and drug abuse. Successful treatment can take years.

A report prepared for the Public Health Agency of Canada last fall in the Atlantic region called PTSD an emerging mental health issue. The report noted that it is important to anticipate how service in Afghanistan will put soldiers at risk for increased rates of post-traumatic stress disorder, substance use and depression. The Department of National Defence is responsible for helping soldiers with PTSD and their families while Veterans Affairs cares for those who have left the service, although both departments work together when soldiers make the transition to civilian life.

Veterans Affairs, which is not subject to the ombudsman's investigation, is funding a network of clinics in London, Winnipeg, Calgary, Quebec City and the Montreal area that deal with PTSD cases. A new clinic is to open later this winter in Fredericton and another new clinic is to be announced for Edmonton later this year. Three others are to be announced in other regions before the end of 2009.

"If there is a veteran or a member of the Canadian Forces who is experiencing psychological difficulties, nine times out 10 that will have an impact on the family," said Doug Clorey, director of mental health policy for Veterans Affairs. Veteran Affairs is already reporting a three-fold increase in psychological clients over the last five years. Of 10,670 veterans receiving disability benefits for operational stress injuries, about two-thirds suffer from PTSD. While there are no statistics on how many veterans who have served in Afghanistan are seeking treatment, officials expect a surge of new cases as thousands of troops complete tours of duty in Kandahar.

"We think we are seeing just the tip of the iceberg, frankly," Clorey said. "As we have thousands of military people coming back from Afghanistan and other conflicts, we expect this increase to not only continue but to increase." At the same time there is a national shortage of psychologists, psychiatrists, mental health nurses and social workers that can result in year-long waiting times for treatment, he said.

The Canadian Forces has been screening soldiers returning from Afghanistan for medical problems, including PTSD. A military report last year on the screening of 2,700 troops who had returned suggested that about five per cent suffered from service-related PTSD. Another five per cent reported major depression, four per cent reported suicidal thoughts and 17 per cent reported symptoms of high-risk drinking.

Soldiers who require treatment can be referred to one of five Occupational Trauma and Stress Support Centres at military bases in Halifax, Valcartier, Que., Ottawa, Edmonton and Esquimalt, B.C. Department of National Defence officials have not been available for comment this week. The ombudsman's report, which is to include new recommendations, is expected this spring. "We are doing this investigation to see if they are doing everything they can to help people," McFadyen said.


Source: The Canadian Press