Introduction

Webcast archive: Suicide & Canada’s military

This week, we look at risks of - and remedies for - suicidality in Canadian veterans, as well as the effect of euthanasia on members of the military.

Webcast archive: Suicide & Canada’s military

In this episode of Euthanasia & Disability, Amy Hasbrouck, Christian Debray, and Taylor Hyatt discuss:

  • Suicide and Canada’s military

Please note that this text is only a script and that our webcast contains additional commentary.

SUICIDE AND CANADA’S MILITARY

  • This week, we’re looking at the high rates of suicide among Canada’s veterans, the connection between Medical Assistance in Dying (MAiD) and the military’s suicide prevention efforts, and the role the anti-malarial drug Mefloquine may play in mental illness and suicide among veterans.
  • Canada’s Veterans fall into two population groups by age depending on the era of their military service.
    • There are about 48,000 “War era” veterans remaining from World War II and the Korean era, with an average age of 92.
    • Another 600,000 “Armed Forces” veterans include Regular forces and Primary Reserve veterans, with an average age of 58 years.
  • The 2017 Veterans Suicide Mortality Study found that from 1976 to 2012 in Canada:
    • 1,421 male veterans, and 65 female veterans committed suicide;
    • Male veterans had an overall 1.4 times higher risk of dying by suicide compared to the general population, with the youngest males being at highest risk;
    • Female Veterans had an overall 1.8 times higher risk of dying by suicide compared to the general population, and this applied to women in all age groups;
    • The risk of suicide for both male and female Veterans has remained higher than that of the general population, and relatively unchanged over the past four decades. The annual rates demonstrated large fluctuations but no significant increase over time.
  • The Department of National Defence has also released annual studies on suicidality among active Canadian Armed Forces for the past several years. The 2018 report, which compiled data from 1995 to 2017, found that 266 men serving in the Canadian Forces and 15 women died by suicide.  However we could not find information about mental health issues for the entire group.
  • Veterans Affairs has also done a long-term study to determine whether particular groups of veterans are at risk of suicidality at the time of their release from the military. The study showed that:
    • The younger someone is at the time of discharge, the greater their risk of suicide will be in the following few years. Men who were released before turning 34 had the greatest suicide risk. Compared to men released at age 45 or older, men who left the military before the age of 25 were three times more likely to die by suicide.
    • For men who left the military between 1992 and 2012, suicide risk is greatest in the first five years after leaving. After 20 years, their risk of suicide matched the general population.
    • Among women, the risk of suicide increases over time. Suicide rates are significantly higher than the general population in the second decade after release. Over 20 years after release, however, female veteran suicide rates were “not statistically different” from other Canadian women.
    • Female veterans are also more likely than male veterans to have suicidal ideation or psychological conditions.
  • The risk of suicide was greater for both men and women who were junior non-commissioned members (rather than officers) at the time of their release.
  • The Canadian Armed Forces Suicide Prevention Guide, which was written for health care professionals, lists disability, chronic pain, brain injuries, and psychological conditions as risk factors for suicide. However, the guide offers no advice for working with these particular populations.
  • The Centre for Suicide Prevention’s article on military suicides describes the “green culture” which is marked by “secrecy, stoicism and denial;” where confiding in a doctor or therapist about PTSD or sexual assault can be a “career-ending move as there is no expectation of confidentiality.”  The article describes some “protective factors” that can make suicide less likely.
    • Shorter and less frequent deployments;
    • More rigorous screening of new recruits for mental health concerns;
    • Social supports;
    • Psychological protective factors (resiliency, having a sense of purpose and meaning), and;
    • Access to mental health treatment.
  • Veterans Affairs and the Canadian Armed Forces have expanded mental health and suicide prevention services in recent years to address military suicides.  However none of these projects mentions assisted suicide or euthanasia, and the MAiD monitoring system does not track the military status of people who ask for AS/E.  Thus a certain percentage of suicides of current and former military personnel will not be recorded.
  • Veterans Affairs conducts periodic “Life After Service Survey” studies that look at veterans’ social, financial, health, mental health, employment and other aspects of life after service.
  • Appendix 4 of the 2016 study shows veterans’ ratings of their physical and mental health.
    • On a self-rated scale of physical health,
      • 45.5% said they had “very good or excellent” health;
      • 31.4% rated their health as “good;”
      • 23.1% said they had “fair or poor” health.
    • On a self-rated scale of mental health:
      • 55.6% said they had “very good or excellent” mental health;
      • 23.3% rated their mental health as “good;”
      • 21.1% said they had “fair or poor” mental health.
  • Appendix 6 shows that veterans had more physical and mental health problems than the general population:
    • 40.8% of veterans had chronic pain, compared to 21.7% in the general population.  The rates were also higher for back problems and migraines.
    • 29.1% of veterans had arthritis, compared to 13.6% in the general population;
    • 11.9% of veterans had hearing problems, compared to 2.7% in the general population;
    • 20.5% of veterans had depression, compared to 7.4% in the general population;
    • 14.6% of veterans had anxiety, compared to 5.7% in the general population;
    • 16.4% of veterans had PTSD, compared to 1.3% in the general population;
    • 58.9% of veterans “sometimes” or “often” had problems with daily activities, compared to 25.5% of the general population.
  • The Veterans Affairs bureaucracy appears on the surface to be straightforward; one can either contact them online, call a toll-free phone number (including a TTY line) or visit an office in person. However the sheer number of programs, the amount of paperwork to qualify for each one, and the stress of recalling service-related trauma can be overwhelming to many people who need help.  There are some peer-to-peer organizations that provide individual advocacy and support.
    • The Legion is the largest veterans service and advocacy group.
    • Wounded Warriors Canada is a charity that provides mental health services to veterans and their families, including individual, couples and group therapy, equine therapy and service dogs for veterans with PTSD.
    • Veterans Emergency Transition Services (known as VETS Canada) connects veterans with resources, such as affordable housing, government benefits, health care, financial help with living expenses, and employment.
  • Many veterans are also dealing with behavioural and mental health side effects from an anti-malarial drug called Mefloquine given to soldiers beginning in the early 1990s.  Soldiers deployed to Somalia, Haiti, Afghanistan and elsewhere were ordered to take the drug, but not informed of its potential side effects.  Many report symptoms similar to PTSD, including nightmares, psychosis, rage, paranoia, insomnia and tinnitus.  Multiple lawsuits are being filed against the Canadian government.
  • Although the Canadian government no longer uses Mefloquine as a first-line anti-malarial drug (since 2017) the Royal Canadian Legion has called on the Minister of Defence to stop using it altogether until further research can be completed.
  • According to Corporal (Ret’d) Carmela Hutchison, who served with the 734 (Regina) and the 746 (Calgary) Communications Squadrons, military training teaches soldiers that they are (replaceable) parts of a machine whose function is to accomplish a military objective.  They are tools, and another person can always take their place. Many newly disabled veterans, therefore, believe they do not matter once they can no longer perform their military duties. They feel like they have lost their purpose once they can no longer work for their country.
  • Those who promote assisted suicide and euthanasia are sending the same message: acquiring a disability means a person ceases to contribute and becomes a burden. They say that outside of the person’s former role, life no longer matters, and it is selfish to go on living.
  • The suicide prevention efforts of the Canadian Armed Forces and Veterans Affairs Canada will be ineffective and incomplete as long as soldiers believe their careers and benefits will be at risk for disclosing psychological distress, and as long as the MAiD monitoring system ignores military personnel who ask for euthanasia.

ANNOUNCEMENT

  • This is the last webcast before we take our summer break to concentrate on other projects.  If all is well, we will be back on Friday, August 23 with more topics related to assisted suicide, euthanasia and other ending-of-life practices.  Meanwhile you can visit our website at tvndy.ca to view our collection of more than 200 webcasts.