More than 6,700 veterans from Afghan war receiving federal assistance for PTSD

[Staff Weenie]

Reading through some of these comments, I am not sure exactly what to say, but I feel compelled to wade in with a bit more background than many.

I work at CAF TG HQ, and have for many years now. Every day I see Integrated Transition Plans done for the most seriously ill and inured people we have. We use this means to determine a safe and appropriate time to enable their transition to civilian life. I see about 360 of these files per year. I have also worked at TC Ottawa, when we reached 200 posted in members. I interviewed many of them during their in-clearance. Of all the people we support, my gut instinct tells me that ~75% are for MH issues. This is a very real problem.

Are they faking it? Are they deliberately trying to make it look worse than it is to get more money from VAC? I can't give you exact numbers - I don't believe we collect that data because it's darned hard to prove - but I suspect that probably a few are. My gut instinct with all of my contact with our people was that maybe as many as 5% could fall into that category. And yet I am willing to accept that if I can reach not only the other 95%, but even more so if I can help find all of the people who are still too ashamed or too frightened of stigma to come forward. This is a very real problem.

I've had to review a large BOI on a suicide, and dozens of SI reports on suicide attempts, all for mental health reasons. Sometimes, after a death, I am asked to review every note we have on somebody, even look at their social media accounts to see what we might have missed. I've sat with Combat Arms soldiers, and those of the Combat Service Support trades, as the poured their story out with tears. I've talked to the spouses, and even the children or parents. I've seen the desperation, the confusion, and sometimes the desire to end the pain. This is a very real problem.

I also know, better than most, what they are going through. I've stood with a loaded pistol and thought that one quick action, and the endless nightmares are finally going to be over. I was one of those employed in KAF - about eight months in the R3MMU. I've had people tell me 'you have no right to have PTSD', and 'you guys just drank Timmies and played volleyball at the boardwalk'. I've heard all the derogatory comments, faced the criticism, and reached a conclusion - this is a very real problem. BUT - it's one that we can work on. What does it take - people to stop trying to judge or label their brothers and sisters - the vast majority are not faking it. Don't create a pecking order for casualties - suffering is suffering, regardless of where it came from. Never drive them back under a rock. The longer it takes for them to come forward, the less likely that they can fully recover. Never be divisive, never stigmatize, just accept that there is an issue, analyze it, find solutions on how we can better prepare the young troops coming in today.

 

[BeyondTheNow]

Reading through some of these comments, I am not sure exactly what to say, but I feel compelled to wade in with a bit more background than many.

I work at CAF TG HQ, and have for many years now. Every day I see Integrated Transition Plans done for the most seriously ill and inured people we have. We use this means to determine a safe and appropriate time to enable their transition to civilian life. I see about 360 of these files per year. I have also worked at TC Ottawa, when we reached 200 posted in members. I interviewed many of them during their in-clearance. Of all the people we support, my gut instinct tells me that ~75% are for MH issues. This is a very real problem.

Are they faking it? Are they deliberately trying to make it look worse than it is to get more money from VAC? I can't give you exact numbers - I don't believe we collect that data because it's darned hard to prove - but I suspect that probably a few are. My gut instinct with all of my contact with our people was that maybe as many as 5% could fall into that category. And yet I am willing to accept that if I can reach not only the other 95%, but even more so if I can help find all of the people who are still too ashamed or too frightened of stigma to come forward. This is a very real problem.

I've had to review a large BOI on a suicide, and dozens of SI reports on suicide attempts, all for mental health reasons. Sometimes, after a death, I am asked to review every note we have on somebody, even look at their social media accounts to see what we might have missed. I've sat with Combat Arms soldiers, and those of the Combat Service Support trades, as the poured their story out with tears. I've talked to the spouses, and even the children or parents. I've seen the desperation, the confusion, and sometimes the desire to end the pain. This is a very real problem.

I also know, better than most, what they are going through. I've stood with a loaded pistol and thought that one quick action, and the endless nightmares are finally going to be over. I was one of those employed in KAF - about eight months in the R3MMU. I've had people tell me 'you have no right to have PTSD', and 'you guys just drank Timmies and played volleyball at the boardwalk'. I've heard all the derogatory comments, faced the criticism, and reached a conclusion - this is a very real problem. BUT - it's one that we can work on. What does it take - people to stop trying to judge or label their brothers and sisters - the vast majority are not faking it. Don't create a pecking order for casualties - suffering is suffering, regardless of where it came from. Never drive them back under a rock. The longer it takes for them to come forward, the less likely that they can fully recover. Never be divisive, never stigmatize, just accept that there is an issue, analyze it, find solutions on how we can better prepare the young troops coming in today.

Thank you

 

[BDTyre]

Don't know if you are relating this as an (sarcastic?) example of how hard it was at KAF or as an example of a potential mental health episode.  On the face of it, the immediate reaction of most would probably be "what an arsehole", however my immediate thought when I read this was "hmm, manifestation of stress reaction?, how did this person fare after they got home".  See the difference.

Maybe it's a bit of both? There's always two sides to a story and the side we heard were of the "what an ass" side, but who knows the history of the individual? Was this their first tour, or second or third? Were they about to rotate out or had they just got there? Was it just someone having a temper tantrum because the Timmy's workers were rude, or was it the sign of a bigger problem?

 

[daftandbarmy]

An interesting article about the US experience:

“PTSD is a real thing, without a doubt,” says McNally. “But as a diagnosis, PTSD has become so flabby and overstretched, so much a part of the culture, that we are almost certainly mistaking other problems for PTSD, and thus mistreating them.”

https://www.wired.com/2012/03/the-ptsd-trap/

 

[PuckChaser]

I was one of those employed in KAF - about eight months in the R3MMU. I've had people tell me 'you have no right to have PTSD', and 'you guys just drank Timmies and played volleyball at the boardwalk'. I've heard all the derogatory comments, faced the criticism, and reached a conclusion - this is a very real problem.

You'd have been well within your rights to punch those individuals in the face. I spent 8 hours on sentry at the R3 once, and never wanted to go back after hearing the entire trauma care of an American crew who were in a HMMVW that struck an IED.

We have to be careful to apply "KAF people can't have PTSD" because of the absolute massive breadth of jobs completed on that airfield. There's a huge difference between helpdesk at RC(S) HQ, and the men/women trying to fix shattered soldiers from the battlefield.

 

[Milhouser911]

Let's not jump to conclusions here. If KAF folks had a higher percentage of OSI claims than Combat Arms, then maybe we're doing a piss poor job preparing those folks mentally for a warzone? Or creating toxic work environments that add unnecessary stressors? Or maybe they're more likely to have poor work-rest cycles to keep the beans and bullets being pushed forward?

I think we do a terrible job with mental health in the CAF, and IMO it starts with the lack of any meaningful screening by a psychologist at the recruiting center.

I'll take this line of reasoning in a slightly different direction - as a CSS guy who got dropped out to a FOB, doing daily OP and CP shifts, after going through workup (If you can call what CSS guys do "workup") expecting to be driving a forklift on KAF.  I arrived COMPLETELY unprepared.  We did C7 on an expedient range on Suffield (25M), a no-fail rundown in Wx, and a no-fail live pairs (about 4 minutes from start to finish).  I was given a pistol when I arrived at the FOB - I sure didn't touch one on workup.  I sat a minimum of 3 hours a day behind an ITAS, C6, Coral-C, Vector binos, and/or NODLER, all equipment I didn't touch on workup.  I didn't know how range cards worked when I showed up.  Communicating over a radio, both from the OP and during CP duty?  Of course we didn't cover that.  We may have done organized PT about 6 times during a 9 month workup period, with the majority of our time spent in a canteen, being told we couldn't go to the gym because "something might come up".  *NOTE:  I believe we did TOET on pistol/C6/C9/84/LAW and foreign weapons famil, but we didn't fire anything, and it was all on the floor of the LTF for a small portion of an afternoon - effectively nothing

The only valuable thing I did on workup was TCCC, which luckily got me talking on the radio enough to be functional when dropped behind one on tour. 

I'm incredibly lucky that this was for a quiet winter tour - but the fact remains that the army did a huge disservice to all the CSS guys who were dropped in FOBS and other semi-austere places with zero legit training or prep.  Mental preparation?  We didn't have any preparation to speak of.

(This post is as accurate as I can make it 10 years after the fact through a lens of bitterness)

 

[daftandbarmy]

I'll take this line of reasoning in a slightly different direction - as a CSS guy who got dropped out to a FOB, doing daily OP and CP shifts, after going through workup (If you can call what CSS guys do "workup") expecting to be driving a forklift on KAF.  I arrived COMPLETELY unprepared.  We did C7 on an expedient range on Suffield (25M), a no-fail rundown in Wx, and a no-fail live pairs (about 4 minutes from start to finish).  I was given a pistol when I arrived at the FOB - I sure didn't touch one on workup.  I sat a minimum of 3 hours a day behind an ITAS, C6, Coral-C, Vector binos, and/or NODLER, all equipment I didn't touch on workup.  I didn't know how range cards worked when I showed up.  Communicating over a radio, both from the OP and during CP duty?  Of course we didn't cover that.  We may have done organized PT about 6 times during a 9 month workup period, with the majority of our time spent in a canteen, being told we couldn't go to the gym because "something might come up".  *NOTE:  I believe we did TOET on pistol/C6/C9/84/LAW and foreign weapons famil, but we didn't fire anything, and it was all on the floor of the LTF for a small portion of an afternoon - effectively nothing

The only valuable thing I did on workup was TCCC, which luckily got me talking on the radio enough to be functional when dropped behind one on tour. 

I'm incredibly lucky that this was for a quiet winter tour - but the fact remains that the army did a huge disservice to all the CSS guys who were dropped in FOBS and other semi-austere places with zero legit training or prep.  Mental preparation?  We didn't have any preparation to speak of.

(This post is as accurate as I can make it 10 years after the fact through a lens of bitterness)

This. And thank you for sharing this experience.

Leadership needs to ensure everyone is prepared for war, not just the 'bayonets'. Anything else is simply a failure of command.

In Northern Ireland, everyone in theatre either went through the 'full meal deal' workup with the BGps, or did an 'in country' package of two or three weeks before joining the operational units. With few exceptions, our support trades were as dialed in as our 'gravel bellies', some moreso especially the tpt, sigs, int and med personnel.

Of course, this policy was learned the hard way, unfortunately.

 

[SupersonicMax]

Mental preparation for combat is not something that is done a couple of months before going.  It’s ingrained into someone over years of training where dealing with death (albeit simulated) and danger become part of normal life.  It is an attitude that is bred.  In our PC world where we cannot be seen as “agressive”, it is difficult to teach that to everyone and the expectations of combat are unclear to most. 

 

[daftandbarmy]

Mental preparation for combat is not something that is done a couple of months before going.  It’s ingrained into someone over years of training where dealing with death (albeit simulated) and danger become part of normal life.  It is an attitude that is bred.  In our PC world where we cannot be seen as “agressive”, it is difficult to teach that to everyone and the expectations of combat are unclear to most.

I beg to differ.

I've led loads of 17 - 20 year old soldiers (and Marines), men and women, who came directly from basic training (6 months), through work up training (2-3 months) and into a sh*t storm where everyone, and everything, was trying to kill them - and sometimes succeeded.

They were splendid... every last one of them. It was a humbling experience to command them.

An anthropologist can probably tell you better than I why that works so well, but it does.

 

[Jarnhamar]

One time when I went back to KAF for the night, Pizza Hut was out of pizzas.

Hardest moment of deployment for me........

Well you ARE an ex Dragoon so I can understand how upsetting the pizza thing is

Just kidding but seriously, combat arms signed up to do combat arms things.
Combat arms love telling everyone they were at a FOB or COP and make sure everyone knows they're combat arms.

They love pointing out shit to do with KAF. Pizza, massage parlour, relative safety.  Thing is combat arms would spend a few days in KAF and whine bitch and complain about it the whole time. How shitty it was and all the rules. Couldn't wait to get the #$*& out of KAF and back out.
Fobs and cops wouldn't have existed without KAF.

Staff Weenie-  amazing post and insight, thanks for sharing that.

An interesting article about the US experience:

“PTSD is a real thing, without a doubt,” says McNally. “But as a diagnosis, PTSD has become so flabby and overstretched, so much a part of the culture, that we are almost certainly mistaking other problems for PTSD, and thus mistreating them.”

This is one of the most insightful things I've read about PTSD in a long time.

I'll take this line of reasoning in a slightly different direction - as a CSS guy who got dropped out to a FOB, doing daily OP and CP shifts, after going through workup (If you can call what CSS guys do "workup") expecting to be driving a forklift on KAF. 

I've commented about seeing that stuff on this forum before. People deploying outside the wire who never fired their gun. Didn't know there was more to the body Armor than just the shell. Had zero training. Lots of people slipped through the cracks.

 

[SupersonicMax]

I beg to differ.

I've led loads of 17 - 20 year old soldiers (and Marines), men and women, who came directly from basic training (6 months), through work up training (2-3 months) and into a **** storm where everyone, and everything, was trying to kill them - and sometimes succeeded.

They were splendid... every last one of them. It was a humbling experience to command them.

An anthropologist can probably tell you better than I why that works so well, but it does.

Being effective in your job doesn't mean you are resilient to the effects of war.  Only training and experience can develop this.

 

[mariomike]

Are we as a society becoming less resilient? Are we living in a society where even day-to-day stressors are more than a significant number of us can cope with?

:dunno:

I don't know either.

There is now a medical form where I used to work, to be signed by the applicant's family physician,

"The applicant is being considered for a position where performance in a high-­‐stress setting is part of the workplace.

Do you have any concerns regarding the applicant's abilities, judgement, or mental competence, particularly in view of the potential workplace?"

Not sure if that question is being routinely asked of family doctors by other potential employers?

 

[Loachman]

And how could they predict how any given person could react under circumstances unimaginable to that doctor?

 

[Loachman]

Only training and experience can develop this.

Lots of Private (or Corps-equivalent) Soldiers go into combat with very little experience.

And "experience" can often mean multiple tours in various shitholes with stressors building up.

 

[mariomike]

And how could they predict how any given person could react under circumstances unimaginable to that doctor?

I guess they are curious if the applicant has a history of PTSD?

 

[Loachman]

How many applicants would have much of a history of anything?

This just seems like a pointless CYA thing to me.

 

[mariomike]

This just seems like a pointless CYA thing to me.

Their point might be to save City taxpayers liability.

Since Queen's Park passed presumptive legislation in 2016, PTSD claims against the department have apparently "taken off like a tsunami".
Sometimes described as a "wildfire".

HR then has to find them "suitable", permanent, new jobs on the City payroll: "If the pre-injury rate of pay is higher than the relocated position rate, then the pre-injury rate is to be maintained. It is understood that the pre-injury rate is subject to all wage increases negotiated."

Until they retire, or die.

If an applicant has a history of PTSD, perhaps with a former employer, I can see why the dept. might be interested.

 

[TCM621]

And how could they predict how any given person could react under circumstances unimaginable to that doctor?

They can't but they can make an assessment based on other factors which relate to a person's ability to handle stress. For example, do they have a heart condition, high blood pressure, are they currently on medication for anxiety, do they have a history of unmanaged depression, etc. It is a good starting point that minimizes the chances of getting someone predisposed to stress related reactions in to a job not suited for them.

 

[mariomike]

It is a good starting point that minimizes the chances of getting someone predisposed to stress related reactions in to a job not suited for them.

In addition to the question asked of the applicant's family doctor, it is important applicants know what they are getting into.

There are too many horror stories of successful college graduates, who find out they are not cut out for the job.

The department has pre-employment psychological screening. Such as excluding applicants that demonstrate lower resiliency traits or who were otherwise unstable from an emotional/psychological level to engage in the work.

They also use the Minnesota Multiphasic Personality Inventory (MMPI).

 

[upandatom]

Also curious how much something like blackberries contribute to it; not too long ago, when you were out of the office, you were out of the office. If something came up, you get called back in, but that was for genuine issues. Now people are on electronic tethers, and are expected to answer the most mundane of BS at all hours of the day.  Great to have flexible work options, but I think it leads managers to take advantage of people and not respect down time.

I have to agree with this,

I left the military I had a Bb, was on call 1 week out of 4. Pretty steadily called upon too.

Same thing civi side, my work days are pretty much 12 hour days or longer.

With this remote access people are working non stop. Not only military, but civi side.

It’s a combination of stressors that cause more and more to come out.

Also- have to look at how many were on Mefloquine, as it has been standard practice so far to treat any traumatic incident as PTSD, with counselling and mind and body numbing agents, when in fact for years it could of been due to Mefloquine poisoning.