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For Vets with PTSD, Finding Help Can Be a Fight

Ex-soldiers with depression, other debilitating symptoms say bureaucracy can feel like their new enemy.

Morgan J. Modjeski 4 Oct 2011TheTyee.ca

Morgan Modjeski is a reporter in Fort McMurray, Alberta.

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Tim Holbrow's UNPROFOR identification: 'Military has tons of great support systems, but once you're out, you're out.'

Former master corporal David Jackson has post traumatic stress disorder, or PTSD. He also considers himself a lucky man.

"I got very lucky. I know a number of guys who came back and a couple of them ate shotguns. One of them killed himself by sticking a grenade down his flak vest," he said.

He served with the Second Battalion of Princess Patricia's Canadian Light Infantry in the 1993 Battle of Medak Pocket, part of the Canadian Forces' contribution to the United Nations Protection Forces and aimed at the "protection and demilitarization" of three U.N. protected areas within Croatia.

Some soldiers who served with that battalion say they saw a number of civilian deaths, when territory controlled by the Republic of Serbian Krajina was destroyed and attacked by Croatian military.

According to a report on Medak Pocket by the UN Security Council, civilians and Serbian Krajina military personnel who were trying to escape were said to have seen bodies where "someone had either badly mutilated it after death or had tortured the victim before death."

Other accounts listed in the report include details about a woman's body with an eye, ear and all fingers on her right-hand cut off. Two people in the report are said to have seen the murder of an 83-year-old blind woman.

"Hundreds of homes were destroyed, virtually hundreds of other buildings were destroyed, most animals were killed or taken, virtually all personal property was destroyed or taken, all vehicles and farm equipment were destroyed or taken, haystacks were fired, and many wells were polluted," it explained.

"Devastation was total," the report concluded after detailing the attack.

Even though much has happened since the battle, Jackson, and other soldiers like him, are still dealing with the effects of such horrific violence. And sometimes, help is hard to find.

"There is a very complicated bureaucracy that's involved," Jackson said, "and it's one of the things that's very hard for soldiers to overcome."

No comprehensive program

As part of the "Review of Veterans' Care Needs" report by Veterans Affairs Canada (VAC) in 2000 and the late 1990s, a review team received responses from over 2,000 Canadian Forces veterans through focus groups, mail-out surveys and on-base contact. The results showed the amount of soldiers suffering from operational stress injuries is quickly increasing.

The number of VAC's clients grew at an annual rate of nine per cent a year, and doubled from March 1990 to March 1999 when it reached 26,600 individuals. The report also concluded that roughly 25 per cent of those individuals had symptoms that "were consistent with, or nearly met the criteria for a diagnosis of PTSD."

The report also stated that 28 per cent reported symptoms of major depression.

Since his release from the military, Jackson has been able to get a sociology degree and is currently going for his Master's in the same field. But some aspects of PTSD still affect him, he said, noting that certain smells and sounds trigger the disorder.

Jackson explained that so many factors affect what benefits a veteran gets from VAC that finding out what benefits veterans are entitled to is a major problem.

"It gets so confusing and it becomes very difficult for soldiers, especially retired soldiers," said Jackson. When he left the military, he says, "there wasn't a comprehensive program put in place, because PTSD was just coming to light."

Jackson said he realized that something was wrong when he was asked to serve another duty with the Canadian Forces. He felt that if he didn't go, any shot of promotion would dissipate and he would be looked down upon by his officers.

When he was serving, the leadership did not have adequate experience dealing with PTSD or how to help soldiers mentally during this kind of combat; they were simply told to do the job, Jackson said.

He felt his leadership would blame him for developing PTSD, saying he wasn't "strong enough." He said that other soldiers were also hesitant to ask for help, and that the leadership saw it as a sign of weakness.

Jackson himself was diagnosed with PTSD by an on-base civilian doctor outside the chain of command -- a diagnosis he thinks may not have happened within the military.

"Killing another human, or witnessing another human being killed, it's not natural. It's not normal... there is a distance between what you know is right and what's happening," Jackson said.

'You're on your own'

Other vets agree, and say that trying to find out what they're entitled to is difficult and frustrating when struggling with PTSD.

Timothy Holbrow held the rank of corporal when he was released from the military, having served in Medak and other tours with the 2PPCLI. He and his wife Jenny say that for the last five years, they've been trying to find out what services are available to them and only recently found out what kind of support they're entitled to.

"You don't know what's there," said Holbrow. "It's different when you're in the military. In the military there are tons of great support systems, but once you're out, you're out. You're on your own."

Holbrow explained that as an infantry solider, he was trained and expected to handle almost anything. For a lot of these veterans, asking for help is a hard thing to do.

"For us to have to go to somebody and ask for help, right away that's unacceptable. That's the mind-set," said Holbrow. "The idea of falling or dying in battle is acceptable. A bullet, a mine, you can live with that, but your psyche getting away from you -- it was totally unacceptable."

Holbrow, who said he still occasionally experiences symptoms of PTSD -- like nightmares, echoes Jackson -- said that asking for help was a career killer. "Had I said anything at that time, my career would have been dead."

Tim's wife Jenny, who has helped Tim deal with PTSD, says the process of finding help is very confusing.

"It could be simplified," she said. "It took a lot of hours, even when he was going through the pension process, and the forms are complicated... and once the claim was through, that was sort of it. As far as looking into if there was anything additional available to us... it was tricky to navigate and very time consuming."

When asked about why support for her and Tim wasn't included in the old Veterans Charter, Jenny explained, "I don't think they were really prepared for it... I don’t think they could have prepared for it, but hopefully it has helped them prepare for what's happening now."

The Holbrows explained that Tim had very little pre-deployment training on how to deal with or identify PTSD before he went into combat. Both feel that if he were better prepared, he may have realized what was happening to him sooner and could have got the help he needed, but at the time PTSD was almost a non-issue.

PTSD support is 'a priority': national defense

In the last decade, the Canadian Forces appears to have realized that getting help with operational stress injuries is a challenge for soldiers and have taken steps to prepare their troops before combat.

A spokesperson for the Department of National Defence (DND) explained that in the last 10 years, the Canadian Forces have organized and put in place a number of programs that will help soldiers deal with "deployment-related problems."

The DND also said much is being done to address the stigma that surrounds PTSD. "The Canadian Forces have a strong internationally recognized mental health program that provides dedicated and responsive care for ill and injured members. [This] emphasizes the elimination of the barriers to mental health care and includes a comprehensive mental health awareness program."

It now offers pre- and post-deployment training that includes pre-deployment screening, examining both medical and psychosocial readiness. Before deployment, all personnel participate in a two-day training program called the Road to Mental Readiness. The program has both interactive and classroom aspects, and helps prepare soldiers and their families for the physiological reaction people have to stress, providing them with methods to reduce it and challenges that soldiers may experience while deployed.

The Canadian Forces also provides post-deployment training and transitional help that assists soldiers through the challenge of returning to life outside the war zone. One form of support are the third-location decompression programs; these include organized sport and educational activities on topics like healthy relationships and how to cope with stress and anger.

Three to six months after a soldier has returned home, an enhanced post-deployment screening takes place. This screening provides "an overview of both physical and psychological health."

The DND stresses that the most common operational stress injuries -- like PTSD and depression -- are "a priority for [the force]'s health care programs."

A spokesperson from VAC also said the government is doing more to help Canada's troops and their families deal with the problems and stigma surrounding operational stress injuries like PSTD, and they feel they have made accessing support easier.

"The Government of Canada recognizes the serious and growing problem of operational stress injuries among our Canadian Forces personnel, our veterans and their families," said information from Janice Burke, director of mental health for VAC, in an email. "This is why we have been taking action to provide our hurting men and women with the help and support they need -- when they need it and where they need it."

Burke explained that the old Veterans Charter was intended for veterans who served in the Korean War, and those who served after Korea but before 2006 -- when the new Veterans Charter was introduced -- were still entitled to a number of the support systems within the new charter.

"The new Veterans Charter introduced a suite of programs/services tailored to the transition needs of the modern-day veteran/family, including: comprehensive medical, psycho-social and vocational rehabilitation services, health benefits, career transition services, new financial benefits, including a monthly earnings loss benefit, permanent impairment allowance, supplementary retirement benefit, Canadian Forces income support and the lump-sum disability award."

Still barriers to break

But despite those resources, soldiers dealing with PTSD say they feel finding out what help is available is still a frustrating challenge, so they look to each other to get help.

Both Jackson and the Holbrows said that the use of social media sites like Facebook have been helpful when it comes to sharing information with other members of the Canadian Forces, and VAC says using social media is important part of sharing information with members in and out of service.

"VAC currently has a Facebook page dedicated to recognizing those who have served their country, a YouTube channel and a Twitter account. The department will continue to seek opportunities to use social media to advance the sharing of information relating to veterans' matters."

Burke also noted the 10 operational stress injury clinics across the country, as well as a number of other programs that are available to veterans, like personalized case management, clinic care managers and peer support groups.

When asked about PTSD being seen as a weakness in the past, Burke explained that it is still a barrier for people seeking support for the disorder, but steps are being taken to address the stigma.

"There have been many efforts by the DND to educate and reduce stigma around operational stress injuries through education... and other anti-stigma campaigns that are making a significant difference," said information from Burke.

VAC has a number of other programs available to veterans. Together with the DND, it says it's working to increase outreach efforts on Canadian Forces bases so that CF members and their families have clear information on the services they have available to them.

The Holbrows say that new support services provided by VAC in the new Veterans Charter are a good thing, but both feel a lot more needs to be done in terms of letting older veterans know what they're entitled to.

Tim added that one of the main problems with the new Veterans Charter is the lump sum settlement. Soldiers used to have their pensions paid out through VAC over a long period of time. However, the new charter supplies soldiers with one large payment, something that could be a major problem for a solider suffering from PTSD.

"You can't have someone who is suffering from PTSD and give them $100,000 and think all is going to be well. It just doesn't work that way," said Tim. "There is obsessive compulsive part of the disorder, and if you give someone [with PTSD] that kind of money, they're going to drink it away or they're going to give it away."

Holbrow said the old and new charter should be combined to include the long-term pension payout from the old charter and the family support from the new charter, but VAC rejected the idea.

"VAC currently has no plans to combine the benefits under the new and old charter as they were designed to meet the different needs of traditional and modern day veterans and their families," Burke responded. "The department considers the new Veterans Charter to be a living document and is committed to enhancing the charter as needed in order to ensure it continues to meet the needs of our veterans and their families."

Jackson echoed Holbrow's concerns about the lump sum settlement, saying that a soldier with PTSD may use the money in a negative way to deal with an operational stress injury.

Even though more programs are being developed to help soldiers suffering from PTSD and other operational stress injuries, both Jackson and the Holbrows expressed concern for future generations of veterans dealing with PTSD, saying that if VAC doesn't fix access problems, more soldiers and their families will suffer.

"It's going to be a huge problem," said Holbrow. "We are old and fat now, but the new generation, like that of my son, is the one you've really got to worry about... it's really going to be horrible."  [Tyee]

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