14% of Afghanistan veterans diagnosed with mental disorder

Nearly 14 per cent of Canadian Forces personnel who were deployed to Afghanistan have been diagnosed with a mental disorder such as post-traumatic stress, a new study suggests.

Since 2001, more than 40,000 Canadian Forces members have been deployed in support of the Afghanistan mission. While research from other countries has found mental health problems among those returning from missions in Southwest Asia such as Iraq, researchers in Ottawa set out to understand the psychological impact among Canadians.

"An important minority of Canadian Forces personnel received a diagnosis of a mental disorder related to deployment in support of the Afghanistan mission," David Boulos and Dr. Mark Zamorski, directorate of mental health, Canadian Forces Health Services Group Headquarters, concluded in Monday’s issue of the Canadian Medical Association Journal.

"Deployment to higher-threat locations, service in the army and lower rank were independent risk factors."

 In total, 13.5 per cent of those whose medical records were randomly reviewed were found to have a mental disorder.

Post-traumatic stress disorder (PTSD) was the most common mental disorder, found in eight per cent of personnel who served in Afghanistan, followed by depression in 6.3 per cent. Another 5.5 per cent had a mental disorder that was judged by a clinician to be unrelated to the Afghanistan deployment.

With PTSD, people tend to cope with it on their own as best they can initially until symptoms affect their functioning, said Major Paul Sedge, a military psychiatrist who has worked at the operational trauma and stress support centres in Gagetown and Petawawa.

"We constantly have to battle the issue of stigma," said Sedge.

"We need soldiers to come forward as soon as possible to get the comprehensive care that is available to them. The longer they wait, the harder it is to treat the illness," he said in an interview with CBC News.

Deployment to Kandahar was associated with almost six times the risk associated with deployment to the United Arab Emirates or Arabian Gulf, and twice the risk associated with deployment to multiple locations including Kabul, the researchers said.

Other studies also suggested that the strength and intensity of traumatic exposure are the greatest predicators for PTSD, Sedge said.

Overall, 29.6 per cent of the those studied used the military's mental-health services after deployment. The authors noted that the study only included diagnoses made by Canadian Forces mental-health services during the followup period, which was a median of 1,354 days or 3.7 years.

Barriers to seeking treatment

It's also possible that clinicians may have favoured attributing a diagnosis to deployment out of a desire to help patients qualify for later benefits. The probability of an Afghanistan-related mental disorder started to plateau after six or more years of followup.

"Even though our combat mission in Afghanistan is over, we need to be prepared to treat and manage combat-related mental health injuries for the next five to 10 years," Sedge said.

Greg Woolvett, whose son suffers from PTSD linked to two tours in Afghanistan, said he thinks the numbers capture only a small fraction of people affected and that services are lacking.

"There's probably double that amount who have PTSD but who have not come forward," Woolvett said.

Woolvett removed his son, Jon, from Canadian Forces Base Petawawa to find him help for a drinking problem and the pain of seeing many of his friends killed in action. He pointed to a disconnect between the chain of command and the military's medical personnel that he said prevents soldiers from getting the care they need.

The study was funded by the Canadian Forces Surgeon General’s Medical Research Program.