Mental Health Healing
© 2013 FrontLine Defence (Vol 10, No 4)

Former CDS General Walt Natynczyk retired in December 2012. A tireless advocate for soldiers, sailors, airmen and women, and special forces under his command, he agreed to share with FrontLine readers his personal ­perspective on mental health issues of ­military members and their families.

In retirement I have been able to reflect on many aspects of my service. One of the most serious challenges we faced during my tenure as Chief of Defence Staff was our treatment of mental health within the Canadian Forces.

This issue was re-ignited by a recent discussion with a soldier who I sat beside on a commercial flight. We talked at length about mental health and the way the Canadian Forces prepared our folks for combat, the mental health diagnosis and the treatment we offered our men and women in uniform to deal with the unique stresses of military life. Then this confident, tough, Non-Commissioned Member shared with me that he was suffering from PTSD and was recovering. I'd like to share some pertinent points of this discussion and my own thoughts on this issue of paramount importance for military and civilian leaders.

The soldier I met on the flight had three tours of combat duty in Afghanistan. It was great to hear that he was pleased with the medical support he was receiving for PTSD, especially so as he was serving as a Reservist on part time duties.

I am always relieved whenever there is a mental health treatment success story because hearing about them is so rare. ­Generally, folks don’t wish to share their personal stories or expose their private ­suffering. This great soldier had done everything right and was headed on the path to recovery. When he realized his personality had fundamentally changed and began drinking too much, he asked for help. As a result, he received the treatment he needed promptly, he stopped harmful self-medicating with alcohol, and was able to take ownership of his life.

Furthermore, he was leading by example, sharing his personal story with his subordinates, knowing that some of them were suffering from PTSD as well. As a result, those in need also sought medical treatment.

I reflected on his story and compared this example to the advice I offered our sailors, soldiers, airmen and women and Special Forces troopers in the numerous town-halls we conducted. Realizing that we need to protect our men and women not only in combat, but also while at home, it became clear that we wanted to do better when it came to mental health. We were losing too many of our men and women and their family members to mental illnesses, depression and suicide. In my view, even one death was too many!

A host of mental health specialists advised me, as a senior leader and commander, on preventing mental illness and assisting those in need. I was able to come to grips with the complexity of this ailment by professing five principles: resilience through education, early diagnosis, swift treatment, peer support and personal ownership.

Education is the essential ingredient to create mental resiliency in our men and women in preparation for the stresses that lay before them. We generally know how our bodies function, and we can understand a physical injury or illness. Few of us truly understand how our minds function, nor do many of us feel comfortable discussing this issue openly. Yet that is precisely what we must do to make a difference.

Previous generations of service men and women went to war and kept their demons to themselves. They returned home with misunderstood ailments, were misdiagnosed and often left to their own devices. From what we know now, it is not surprising that alcoholism, depression and isolation followed.

Providing our folks with the knowledge of the mental health symptoms is essential in building mental resiliency. The Canadian Forces "Road to Mental Readiness" is a world class training program that educates our folks on what normal mental health feels like (the Green Zone); explains the signs for concern, which tell us we should initiate coping strategies (the Yellow Zone); and details the symptoms of a serious mental injury, when we need to seek professional help (the Red Zone). Empowering our folks with this knowledge is so important to permit early self-detection of a mental health illness.

Early diagnosis is essential in successful mental health treatment. However, due to the “invisibility” of this illness, the onus is on the individual to take ownership and step forward. For so many, it is a difficult step to make. Our warrior ethos has the unintended consequence of creating a stigma, such that many will deny they have a problem, and some will avoid or refuse care.

Speaking to 30 soldiers suffering with PTSD in Edmonton a couple years ago, I found out not one of them walked into a clinic on their own. It was their battle-buddies, family and friends who encouraged them to seek treatment. This was a problem. To address this shortcoming, the Canadian Forces created the "Be the Difference Campaign" to encourage our men and women to look out for each other and to be understanding of those suffering from mental illness.

Recently, I spoke with a retired soldier, a true hero who was awarded a medal for valour for his actions in combat. As I visited him in hospital he related to me that he did everything possible to avoid detection, diagnosis and treatment because he was scared to be labeled. We need to do better!

Once a diagnosis is made, prompt medical treatment is essential to a recovery. It would appear that the longer the gap between diagnosis and treatment, the more probable that the suffering souls will harmfully self-medicate and exacerbate their failing condition by withdrawing from or pushing away family and friends whose support they so desperately need. Numerous examples of our men and women becoming addicted to alcohol, drugs and medications as they await treatment are all heart-wrenching. I give credit to both the military and civilian professionals who are doing so much to treat our suffering men and women. Much more has to be done in this regard.

A community of compassionate peers, family and friends is essential to enable the suffering to identify their illness early, and then create the environment to support their recovery. Maintaining the stability of the peer group of battle-buddies, strong spouses and partners and a work environment that is free of stigma will contribute to successful treatment of the suffering. Where we have supported this network of community, we have seen successful treatments. Where we have (unknowingly) posted the suffering away from their peers, or where there is a troubled and fractured relationship, often depression and substance abuse set in to create havoc with the medical treatment. Family stability and community care are vital to recovery.

Finally, it is most important to remember that, as difficult as it may be, so much of the onus for a successful recovery rests on the individual who must come to grips with the reality of their mental illness, to break free of the fear of being stigmatized, and take that first step toward their own recovery – to reach out to the health community.

It was heart-warming when I gave this sort of speech in Kabul last summer and a soldier came up to me and said that he ­followed this advice and he has recovered and was completing another tour. When I spoke on HMCS Fredericton, returning from the Gulf, and mentioned the link between PTSD and sleep disorder, and if you treat one illness, you treat the other ailment, a Petty Officer stepped forward and said that I had described his case. He took ownership and he was well enough to complete a deployment.

It is the responsibility of leaders, both military and civilians, to adopt a mental health vocabulary into their everyday language to set the example and to address the perception of stigma. They must lead to encourage those who are suffering to step forward, to provide them with treatment and to support them and their families so that they can take ownership of their lives and recover.

We do so much to prepare and to protect our men and women when we send them into operations so that they will achieve their missions and mitigate the dangers to their lives. If we can address the stigma of mental health, we will be protecting our soldiers, sailors, airmen and women and special forces troops around the clock, at home in Canada and while deployed around the world. We will also assist their families and sustain them through the trials of an uncertain world.

General Walter J, Natynczyk retired as the Chief of Defence Staff (2008-2012) after more than 38 years of service with the Canadian Forces. He recently accepted new responsibilities as president of the Canadian Space Agency.
© FrontLine Defence, 2013 issue 4