Nearly 1 in 4 Afghan veterans suffer from mental illness, study shows

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Nearly a quarter of combat veterans and more than 13 per cent of all troops who served in the wider Afghanistan mission up to 2008 have suffered from mental illness, two new studies show.

Canadian Forces researchers closely examined the medical records of nearly 3,000 soldiers to take two of the clearest snapshots yet of the heavy mental-health toll paid by troops who served in Afghanistan.

In one study of 792 frontline soldiers who fought in Afghanistan in 2007, some 20 per cent suffered from posttraumatic stress disorder, while 3.1 per cent suffered other mental illnesses such as depression.

In a larger national study, researchers examined medical records of 2,045 soldiers who served from 2001 to 2008 and found 8 per cent suffered from posttraumatic stress disorder and another 5.2 per cent suffered other mental-health illnesses over a follow-up period averaging five years.

Previous studies relied on shorter follow-up periods and self-reporting to show PTSD among 4 to 6 per cent of Canadian soldiers who served in Afghanistan.

The national study was weighted to properly reflect the rank, age, gender and theatre of operation, as well as combat and non-combat roles of all 37,000 soldiers during an eight-year time frame.

Commodore Hans Jung, the Canadian Forces surgeon general, says it is too early to say the incidence of mental-health injuries has peaked, but he believes it has levelled off.

"I think we're in a plateau. The combat mission has terminated, the amount of high-end traumatic exposure is going to diminish," Cmdre. Jung said. "Exactly how much we can't exactly say until we have more experience in the Kabul transition."

The surgeon general said the national study is the first among Canada's allies to look in-depth at medical records to study mental illness. He described how researchers went through a "painstaking process" sifting through electronic and paper records dating back to 2001.

Cmdre. Jung said the military's system of mental-health treatment was set up anticipating illness would rise, so he doesn't see immediate need to boost services within the military.

Retired soldiers may soon pose a different challenge. Veterans Affairs has long been criticized for its handling of complicated mental-health cases. But most of the soldiers who saw the heaviest fighting from 2006 until earlier this year are still in the military, giving researchers confidence they have an accurate picture.

The smaller study of combat veterans from Canadian Forces Base Gagetown found about one-third of PTSD cases have successfully been treated. Forty-five per cent of patients were able to return to full duty, while 48 per cent could only perform limited duties.

About a dozen of the 792 soldiers studied, or 1.6 per cent, were medically released from the Canadian Forces because of serious mental illness. They are now eligible for care through Veterans Affairs.

Nearly 65 per cent of the 170 stress-injury cases were diagnosed more than a year after the Gagetown troops returned from Afghanistan in August, 2007, pointing to the need for lengthy follow-up care. It was only in 2010 that the number of new cases diminished to one or two a month.

"People are still coming forward from Chicoutimi and Swissair," said Colonel Rakesh Jetly, head psychiatrist for the Canadian Forces. The Chicoutimi submarine fire killed one seaman in 2004, and the military was deeply involved in recovering bodies and wreckage after the 1998 Swissair crash.

One of the more encouraging statistics in the Gagetown study showed 98 per cent of soldiers diagnosed with mental illness sought treatment. Soldiers and their superiors are better prepared to recognize signs and get help, said Major Paul Sedge, the psychiatrist who conducted the Gagetown study.

"The attitude has changed dramatically over the past 10 years," Maj. Sedge said.