The unfortunate cluster of suicides by Canadian Forces personnel, serving and retired, bracketing the recent Christmas break, understandably drew a good deal of media attention – almost all of it negative. Much of the discussion focused on the lack of military support for the victims, on inappropriate compulsory release procedures and on the stigma associated with mental illness.
When it is noted that the suicide rate in the Canadian Forces has been consistent over the past decade, and even a bit lower this past year, it sounds terribly clinical. We are talking about people, not numbers, and one suicide is one too many. However, with a bit of context, numbers can be telling.
While an objective of zero suicides is admirable, it ignores that suicide is the second-leading cause of death in the Canadian male population between the ages of 15 and 34, and that the suicide rate for Canadian males is highest between the ages of 40 and 59, according to Statistics Canada. Those two categories comprehensively cover the age distribution of the Canadian Forces personnel.
Now, consider that the suicide rate in the U.S. military has doubled over the same 10-year period. Considering the dramatic increase in the pace of operations for Canadian Forces personnel over the past 10 years, surely it follows that suicides should have risen dramatically. But they didn't. Could that be suggesting that the Forces' mental-health strategy and treatments are actually working? Probably.
With regard to stigma, it's interesting to note the difference in attitude between the military and civilian communities. Toronto's Centre for Addiction and Mental Health has found that just 49 per cent of the general population would socialize with a friend who had a serious mental illness. By contrast, just 6 per cent of military personnel returning from Afghanistan indicated that they would think less of someone receiving mental health care, according to the Armed Forces. Our soldiers may have something to teach us about tolerance and understanding.
Much has been made about compulsory release procedures, suggesting that injured personnel are dumped on the street by an uncaring military that insists on retaining only fit individuals capable of deploying on short notice. The reality is that there are currently more than 2,000 non-deployable personnel posted to the CAF's Joint Personnel Support Unit. While there, they undergo evaluation and treatment according to their illness or disability. Most will have four years of preparation to transition to civilian life or to return to operational duty. Since 2009, about 1,300 personnel have done just that under the Return to Work program.
Unfortunately, there is a knee-jerk reaction when the words "Afghanistan" and "suicide" appear in the same sentence. The assumption is often that war-zone service has caused post-traumatic stress disorder and driven an individual to kill himself or herself. But the triggers are numerous, and war-zone exposure is not at the top of the list. Divorce, loss of a loved one and loss of a job are more likely factors.
According to the experts, the greatest hurdle to preventing suicide is getting the individual to recognize that they have a mental-health problem. Investigations have determined that that the vast majority of soldiers committing suicide were not receiving care. The mental illness went unidentified by fellow soldiers, leadership and medical professionals and the opportunity for treatment was missed. These results mirror similar findings in the civilian world
There are 26 specialty medical health clinics and seven operational stress support centres across the country. Are they short of staff? Yes. Is shortage of funds the problem? No. There is much competition for mental-health experts (Canada is third in the world for the consumption of anti-depression drugs) and by its nature the military is parked in some pretty isolated areas. That unattractive geography combined with the unreasonable time taken to work a hiring through the red tape within Public Works puts the military at a distinct disadvantage in the competition.
Unfortunately, no program dedicated to eliminating suicide will attain perfection. More must be done, but the fact that our North Atlantic Treaty Organization allies and both the Canadian and American Psychiatric Associations have complimented our military's mental-health program should be reassuring, in contrast to the innuendo so prevalent in some media.
Retired major-general Lewis MacKenzie was the first commander of United Nations peacekeeping forces in Sarajevo.