Suchergebnisse

In the past 15 years in Canada, as in other nations, the mental health of veterans has emerged as a key concern for both government and the public. As mental health service enhancement unfolded, the need for wider population studies became apparent. This paper describes the renewal of services and key findings from national surveys of serving personnel and veterans.

Introduction: Suicide risk is higher in Canadian Armed Forces (CAF) Veterans than the Canadian general population (CGP). Suicidality is understood to be caused by incompletely clarified, complex interacting combinations of multiple factors. One of the precipitating factors for suicide is thought to be the social identity challenges known to occur in major life transitions. Methods: The 2016 Life After Service Studies survey representatively sampled Regular Force Veterans stratified by two release groups: earlier in 1998 to August 2012 ( n = 1,575) and more recently in September 2012 to 2015 ( n = 1,180). The linked dataset included socioeconomic and military characteristics and well-being indicators in multiple domains. Weak group identity was indicated by weak sense of local community belonging and/or not feeling part of a group with shared attitudes and beliefs. Associations were evaluated with multiple logistic regression. Results: Suicidal ideation, weak community belonging, and perceived difficult adjustment to civilian life were more prevalent in Veterans soon after release (September 2012 to 2015) than in Veterans released earlier (1998 to August 2012). Suicidal ideation and weak community belonging were more prevalent in the Veterans than in the CGP. In the more recently released Veterans, weak group identity was endorsed by the majority with suicidal ideation (93.3%). In adjusted regression models, mental health problems had the strongest association with suicidal ideation (adjusted odds ratio [AOR] = 13.4–79.3); however, weak group identity was moderately strongly associated with both difficult adjustment (AOR = 2.4–4.1) and particularly suicidal ideation (AOR = 3.8–9.0), independently of mental health problems. Discussion: Weak group identity was associated with difficult adjustment to civilian life and suicidal ideation in CAF Regular Force Veterans within 3.6 years after military release. These findings indicate the importance in suicide prevention of attending to social identity during transition to post-military life.

Introduction: The mental health of Canadian Armed Forces (CAF) populations emerged as an important concern in the wake of difficult CAF deployments in the 1990s. This article is the first comprehensive summary of findings from subsequent surveys of mental health and well-being in CAF Veterans, undertaken to inform mental health service renewals by CAF Health Services and Veterans Affairs Canada (VAC). Methods: Epidemiological findings in journal publications and government reports were summarized from four cross-sectional national surveys: a survey of Veterans participating in VAC programs in 1999 and three surveys of health and well-being representative of whole populations of Veterans in 2003, 2010, and 2013. Results: Although most Veterans had good mental health, many had mental health problems that affected functioning, well-being, and service utilization. Recent Veterans had a higher prevalence of mental health problems than the general Canadian population, earlier-era Veterans, and possibly the serving population. There were associations between mental health conditions and difficult adjustment to civilian life, physical health, and multiple socio-demographic factors. Mental health problems were key drivers of disability. Comparisons with other studies were complicated by methodological, era, and cultural differences. Discussion: The survey findings support ongoing multifactorial approaches to optimizing mental health and well-being in CAF Veterans, including strong military-to-civilian transition support and access to effective mental and physical health services. Studies underway of transitioning members and families in the peri-release period of the military-to-civilian transition and longitudinal studies of mental health in Veterans will address important knowledge gaps.

Introduction : La santé mentale de la population des Forces armées canadiennes est devenue une préoccupation importante à la suite des déploiements difficiles des années 1990. Ceci est le premier résumé compréhensif des sondages qui ont suivi sur la santé mentale et le bien-être des vétéran(e)s des Forces armées canadiennes (FAC) réalisés par le groupe des services de santé des FAC et des Anciens Combattants Canada. Méthodologie : Les résultats épidémiologiques publiés dans les revues scientifiques et les rapports gouvernementaux sont les résumés de quatre enquêtes nationales transversales : un sondage des vétéran(e)s participant dans les programmes des Anciens Combattants Canada en 1999 et trois sondages sur la santé et le bien-être des vétéran(e)s en 2003, 2010 et 2013. Résultats : La majorité des vétéran(e)s jouissaient d'une bonne santé mentale, mais un certain nombre de vétéran(e)s avaient des problèmes de santé qui affectaient leur bien-être, leur fonctionnement et leur utilisation des services. Les vétéran(e)s des années plus récentes ont une prévalence plus élevée de problèmes de santé mentale que la population canadienne en général, que des vétéran(e)s plus âgé(e)s et possiblement que la population militaire. Les résultats montrent une association entre la condition de la santé mentale et une transition à la vie civile difficile, la santé physique et plusieurs autres facteurs sociodémographiques. Les problèmes de santé mentale sont directement liés aux incapacités. Une comparaison avec d'autres enquêtes étudiées serait difficile pour des raisons de méthodologie, d'ère et de différences culturelles. Discusssion : Les constatations de l'enquête soutiennent une approche multi-fonctionnelle pour optimiser la santé mentale et le bien-être des vétéran(e)s des FAC, y compris un appui de taille et un accès à des traitements efficaces lors de la période de transition de la vie militaire à la vie civile. Des études longitudinales sur la santé mentale des vétéran(e)s aborderaient les lacunes.

Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an important concern in the wake of difficult CAF deployments in the 1990s. This article is the first comprehensive summary of findings from subsequent surveys of mental health and well-being in CAF Veterans, undertaken to inform mental health service renewals by CAF Health Services and Veterans Affairs Canada (VAC). Methods. Epidemiological findings in journal publications and government reports were summarized from four cross-sectional national surveys: a survey of Veterans participating in VAC programs in 1999 and three surveys of health and well-being representative of whole populations of Veterans in 2003, 2010, and 2013. Results. Although most Veterans had good mental health, many had mental health problems that affected functioning, well-being, and service utilization. Recent Veterans had a higher prevalence of mental health problems than the general Canadian population, earlier-era Veterans, and possibly the serving population. There were associations between mental health conditions and difficult adjustment to civilian life, physical health, and multiple socio-demographic factors. Mental health problems were key drivers of disability. Comparisons with other studies were complicated by methodological, era, and cultural differences. Discussion. The survey findings support ongoing multifactorial approaches to optimizing mental health and well-being in CAF Veterans, including strong military-to-civilian transition support and access to effective mental and physical health services. Studies underway of transitioning members and families in the peri-release period of the military-to-civilian transition and longitudinal studies of mental health in Veterans will address important knowledge gaps.

Post-traumatic stress disorder (PTSD) is one of the common mental disorders in military and veteran populations. Considerable research and clinical opinion has been focused on understanding the relationship between PTSD and military service and the implications for prevention, treatment, and management. This paper examines factors associated with the development of PTSD in this population, considers issues relating to engagement in treatment, and discusses the empirical support for best practice evidence-based treatment. The paper goes on to explore the challenges in those areas, with particular reference to treatment engagement and barriers to care, as well as treatment non-response. The final section addresses innovative solutions to these challenges through improvements in agreed terminology and definitions, strategies to increase engagement, early identification approaches, understanding predictors of treatment outcome, and innovations in treatment. Treatment innovations include enhancing existing treatments, emerging non-trauma-focused interventions, novel pharmacotherapy, personalized medicine approaches, advancing functional outcomes, family intervention and support, and attention to physical health.