OTTAWA - Parliamentarians are asking Canada's defence minister and the country's top military commander to help fight off the stigma that exists among soldiers about post-traumatic stress disorder.
The recommendation comes in a report released Wednesday by the House of Commons defence committee, along with three dozen recommendations about the treatment of soldiers suffering from PTSD.
The all-party committee calls for a "high-profile effort to pursue a modern, enlightened and unequivocal view of mental health issues in the Canadian Forces."
A testosterone-charged image of military toughness has long been identified as an obstacle for traumatized soldiers to seek help. The committee concluded that views "toward mental health issues in the Canadian Forces remain largely negative."
Parliamentarians acknowledged the military has worked hard to remove the stigma of PTSD, but that its "efforts do not seem to gain much traction at lower" ranks.
Public statements by Defence Minister Peter MacKay -- and by Chief of Defence Staff Gen. Walter Natynczyk -- are seen as key to getting troubled soldiers to come forward and seek treatment.
"It's imperative to have that kind of statement," Liberal defence critic Denis Coderre said after the report was tabled in the Commons.
"There has to be a major cultural shift within the department and it requires leadership."
Officials for MacKay and Natynczyk wouldn't commit to making a specific statement related to PTSD, but said both men have spoken often and passionately about the subject.
"Based on his past statements, I don't think there can be any doubt about how he feels about this," said Dan Dugas, MacKay's communications director.
The year-long exhaustive study was released by Conservative committee chair Maxime Bernier.
The report also called on National Defence to commission an independent audit of mental-health services provided to returning veterans, to help identify any gaps.
"For every senior officer or departmental official who told us of initiatives being taken to improve military health care generally, and mental health diagnosis and treatment in particular, we heard at least one junior rank who told us the system was not working for them," says the report.
"The phrase `falling through the cracks' was heard so often it lost its notoriety."
Services for those with traumatic stress should include treatment of alcohol and drug abuse because the two often go hand-in-hand, the committee recommended.
And the link between domestic violence and mental illness should be emphasized to the families of soldiers returning from harrowing overseas missions.
The committee heard expert testimony that of some 27,000 soldiers and aircrew who have rotated through Afghanistan, approximately 3,640 members are expected to exhibit some sort of mental health concern. And of those, roughly 1,120 could exhibit symptoms of PTSD.
The estimate is based upon a mathematical model.
The NDP tacked on a few supplementary recommendations to the report, including one asking for a soldiers' advocate who could get around the issue of stigma, by independently bringing forward the concerns of individual soldiers.
The party's defence critic, Jack Harris, said he agreed with the overall recommendations, but was troubled by the "cheery tone" of the report and felt it could have been more hard-hitting.
Therapist Greg Lubimiv, executive director of the Phoenix Centre for Children and Families in Pembroke, Ont., says his military caseload from nearby CFB Petawawa is surging.
He had 95 cases by the end of May -- up from 12 before the deadly Kandahar mission began more than three years ago. Another 25 families are on a waiting list.
"There's an increase in family violence issues. There's an increase in addiction issues. There's an increase in psychological issues like anxiety, depression, suicidal ideation. And these are similar to any population that undergoes tremendous stress."
Military screening to ensure the mental fitness of soldiers before they deploy can be easily thwarted, Lubimiv said.
Troops struggling with the telltale signs of trouble -- sleep disturbance, paralyzing anxiety, panic attacks -- may say they're fine. Turning down an overseas mission is widely viewed as a major career-limiting move.
"There's not a blood test to say you have PTSD. Those behaviours aren't always able to be observed by those who are doing the screening."
Multiple tours are exacting a growing toll on admittedly overstretched Canadian forces, Lubimiv added.
"One of our findings is that you don't become more resilient when you have more deployments. It seems to be the opposite. More deployments actually seem to be increasing the risk for a soldier to experience a (mental-health) disturbance."
Dr. Lorelei Walsh Park, a psychologist in Oromocto, N.B., near CFB Gagetown, specializes in the diagnosis and treatment of PTSD.
Her military caseload now comprises about 45 per cent of her practice -- up from about 11 per cent in 2007. She attributes much of that jump to the lingering effects of local troops returning from Afghanistan in August 2007.
Within about three months, she started getting calls.
"It's presenting as (patients saying) 'My spouse, he's doing this or doing that and I don't understand why.' And it's a lot of misinterpretation of why the person is behaving the way they are, not understanding that it might be depression or it might be post-traumatic stress disorder."
