Why Ottawa ignored the military's PTSD epidemic

It is an oddity of wars that those in charge often miss the obvious, which helps explain Canada's astonishing failure to grasp the full mental toll of our long involvement in Afghanistan.

The reality that both official Ottawa and our military planners have been slow to confront is that the psychological after-effects of war don't decrease after a mission ends. To the contrary they can increase year by year, and last lifetimes.

"I don't think we had any idea of the scale and scope of what the impact would be," retired general Rick Hillier recently told CBC radio in a discussion about the recent spate of military suicides and psychological trauma. "I truly do not."

This is a tellingly blunt assessment of leadership failure from the officer who both commanded troops in Afghanistan and later was the chief of defence staff when Canada took on one of the toughest roles in the whole war — controlling the Taliban heartland in Kandahar.

Hillier has now called for a public inquiry to sort out just why we're failing vets with mental health problems, a call that follows a wave of anger that has been building among veterans and their supporters.

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Beyond the always shocking effect of military suicides there's a growing public perception that the Stephen Harper government hasn't cared enough during a period of budget cutting and restraint about the well-being and morale of former soldiers, many of whom suffer from the debilitating effects of trauma, including PTSD (post-traumatic stress disorder).

As Hillier noted, perception can quickly become reality, which would be an ominous turnaround for Conservatives who always claimed a pro-military aura.

"This is beyond the medical issue," Hillier said. "I think that many of our young men and women have lost confidence in our country to support them."

More than Afghanistan

From my own conversations with many veterans I'd say the cynicism goes well beyond the young, and far beyond Afghanistan.

Some of the angriest voices against the Veterans Affairs bureaucracy come from veterans of the Korea War, now in their 80s, and from middle-aged former peacekeepers who saw too much inhuman conflict while abroad.

There's a strong sense among those who have seen war up close that the rest of us "just don't get" what it does to soldiers, and that the politicians who send troops into combat get it least of all.

Whether that's true or not, an inquiry might uncover why there has been such an unaccountable delay in dealing with the psychological effects of recent conflicts.

It's all the more surprising given that the mental wounds of war have been studied since the First World War, and intensely examined since Vietnam.

We knew a decade ago that a great many of our soldiers were going to experience combat in Afghanistan, and over time close to 40,000 served there.

Yet somehow we didn't anticipate that many thousands would come back suffering mental health disorders?

Even today we've no clear picture of how many, whether still serving or veterans, have psychological wounds from severe depression or full-scale PTSD.

The only government estimate — of almost 15 per cent of those who served — is based on studies prior to 2009, which would be prior to several of the hardest years of our counter-insurgency operations.

Where is the help?

Most ominous still is the finding nearly buried in the same study that notes that the incidence of mental injuries can double with passing years — meaning that  fully 30 per cent of those involved in combat operations may need significant psychological and other support over many years.

Add to that the fact that we have only belatedly acknowledged that many of the 120,000 soldiers who served as UN peacekeepers in atrocity-ridden conflict zones have trauma rates as high as Afghan vets.

At the same time, while the number of those needing help has grown, bureaucratic turf wars and budgetary feuds seem to have delayed the hiring of needed psychiatrists and mental health professionals.

The government is only now scrambling to hire an extra 54 specialists that the Defence Department called for almost 11 years ago.

According to a recent Canadian Press report, the government was reminded by the Canadian Forces ombudsman two years ago that the overall goal of 447 mental health specialists was far from met. Still, by last month the shortfall persisted.

The delay in so critical an area seems due not to a shortage of funds, for the government set aside $11 million, but rather a reluctance to hire during a period when deficit-fighting ruled the bureaucratic mindset.

For several years now, DND has, to please the government, spent several billion dollars less than it has been granted by Parliament. The whole bureaucracy has underspent $10 billion over the past three years to help meet deficit reduction targets.

It's a vicious cycle as those who go to war feel extra mental stress when they sense their sacrifice is unappreciated, and their cause diminished by post-war indifference.

And it doesn't help when Canadians talk a bold game about "supporting the troops" but don't deliver.

Only three months ago, the military ombudsman reported that many military families were still housed in dilapidated, too-small mould-infested base housing and were feeling huge stress because of worries about constant family moves and its effects on their children.

"Unlike their American counterparts" the report notes, our service families even find getting family medical care a challenge. "Military families go through protracted periods of bouncing from one waiting list to the next, rarely making it to the top."

The picture is not all negative, and even critics agree some programs for veterans and current soldiers have improved.

But that doesn't alter the fact that the kind of all-out, well-focused programs to support those who've paid a high psychological price already seems missing.

And even today Ottawa seems confused, almost dazed, as the criticism mounts.