Suchergebnisse

Introduction: Post-deployment screening within the Canadian Armed Forces (CAF) aims to identify individuals with mental health problems. However, as screening is a time-consuming process, it is important to consider ways to reduce the time required, including the use of shorter scales. The scale currently used to assess posttraumatic stress disorder (PTSD), the PTSD Checklist (PCL-C), is lengthy, although validated shorter versions have been developed that have not yet been evaluated in the CAF population. Methods: Three brief versions of the PCL-C were evaluated in this study: the PCL-2, PCL-4 and PCL-6. The operating characteristics of each scale were examined using the screening and diagnostic cut-offs of the full PCL, as well as clinician ratings of PTSD being of major concern, as the standards for comparison. Optimal cut-offs for each scale were determined based on a combination of sensitivity, specificity, area under the curve (AUC), and prevalence of disorder compared to the full scale. As well, correlations with other measures of health were examined. Results: Although all three scales demonstrated good psychometric properties, the PCL-6 showed the strongest properties of the three scales. Optimal cut-offs were similar to those found in past research when calibrated against the PCL-C screening cut-off for PTSD and to clinician ratings. As well, it exhibited high correlations with other measures of mental health. Discussion: This research provides evidence for the acceptability of brief measures in screening for PTSD in military members following deployment. In particular, it points to the advantages of using the PCL-6, with cut-offs in line with those recommended in past research.

LAY SUMMARY The challenges associated with the COVID-19 pandemic have the potential to not only adversely affect mental health in general but also to emphasize and widen disparities in mental health across demographic groups. In particular, research suggests that women have been disproportionately affected by the pandemic psychologically, socially, and economically. However, the state of mental health in the Canadian Armed Forces (CAF) during the pandemic and the impacts of gender on mental health outcomes are currently unknown. This study uses data collected early in the pandemic to examine the state of mental health of CAF Regular Force members and the impacts of gender and family status. Although most members were doing well, a notable minority were experiencing mental health issues at potentially clinically significant levels, with women more likely to experience depression and anxiety than men and women with children less likely to experience functional impairment as a result of their symptoms. The findings provide a snapshot of the mental health of Regular Force members during the pandemic and suggest the importance of considering gender and family situation in understanding mental health.

Introduction: The Survey on Transition to Civilian Life (STCL) was created to measure the adjustment outcomes of recently released Canadian Armed Forces (CAF) members. The survey was administered to a sample of CAF regular force members released from 1998 to 2007. The aim of the current study was to examine resources that promote the successful adjustment to civilian life. Specifically, the goal was to conduct a secondary analysis of the STCL that examined the roles of mastery and social environment (that is, community belonging and satisfaction with support) in the transition to civilian life, as well as how these variables correlate with health and life stress. Methods: The sample data were used to conduct Kendall's tau correlations. Prevalence estimates, 95 per cent confidence intervals, and ordinal logistic regressions were conducted using weighted data that accounted for the complex survey design to ensure findings were representative of the sampled veteran population. Results: Ordinal logistic regression results revealed that mastery, satisfaction with types of social support (friends and family), and a sense of community belonging acted as potential protective factors that were associated with easier adjustment to civilian life for Veterans with physical health conditions, mental health conditions, and higher levels of life stress. The first model showed that the odds of an easier adjustment were lower for those who were more stressed (adjusted odds ratio [AOR]=0.13), self-reported a physical health condition (AOR=0.53), and self-reported a mental health condition (AOR=0.23). The second model revealed that the odds of an easier adjustment were lower for those Veterans dissatisfied with their family relationships (AOR=0.42) and their relationships with friends (AOR=0.47) and those with a very weak sense of community belonging (AOR=0.39), and they were higher among those with high levels of mastery (AOR=3.93). Discussion: The results of this study point to the importance of personal characteristics and aspects of the social environment in the adjustment to civilian life among military veterans. As well, ensuring a successful adjustment to civilian life may lead to better outcomes, such as enhanced mastery, following transition.

Introduction: The goal of this study was to identify factors associated with the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) measures of health-related quality of life (HRQOL) in former Canadian Armed Forces (CAF) Veterans after transition to civilian life. Methods: Data were taken from the 2010 Survey on Transition to Civilian Life, a national computer-assisted telephone survey of CAF Regular Force personnel who released during 1998–2007. Multivariate linear regression models were developed using a variety of socio-economic, military, health, and disability characteristics. Results: Mean age was 46 years (range 20–67 y), and 12% of the participants were women. Higher age was associated with lower PCS but higher MCS scores. High ratings of mastery and high satisfaction with life were strongly associated with higher scores on both the PCS and the MCS. Most chronic physical health conditions were associated with poorer PCS scores, in particular chronic pain, musculoskeletal conditions, cancer, gastrointestinal conditions, hearing problems and, to a lesser degree, chronic mental health conditions. The only chronic condition associated with poorer MCS scores was presence of one or more mental health conditions. Both activity limitation in major life domains and needing assistance with activities of daily living were negatively associated with PCS scores, whereas only the latter was negatively associated with MCS scores. Discussion: The models suggested protective factors and identified characteristics of subgroups vulnerable to poor HRQOL after accounting for confounding. Findings can be used to identify those at high risk who may benefit from targeted interventions and to develop health promotion and prevention strategies for Canadian Armed Forces personnel in transition to civilian life.

INTRODUCTION: Due to the unprecedented impact of COVID-19, there is a need for research assessing pandemic-related challenges and stressors. The current study aimed to assess key concerns and general well-being among members of Canada's Defence Team, including Canadian Armed Forces personnel and members of the Department of National Defence (DND) Public Service. METHODS: The COVID-19 Defence Team Survey was administered electronically to Defence Team staff in April and May of 2020 and was completed by 13688 Regular Force, 5985 Reserve Force and 7487 civilian DND Public Service personnel. Along with demographic information, the survey included assessments of work arrangement, pandemic-related concerns, general well-being and social and organizational support. Weighted data (to ensure representation) were used in all analyses. RESULTS: The majority of respondents were working from home, with a small minority unable to work due to restrictions. Though many concerns were endorsed by a substantial proportion of respondents, the most prevalent concerns were related to the health and well-being of loved ones. The majority of respondents reported their partner, family, supervisors, friends, colleagues and children provided general support. Half of the civilian defence staff and one-third of military respondents reported a decline in mental health. Women, younger respondents, those with dependents and, in some cases, those who were single without children were at risk of lower well-being. CONCLUSION: The pandemic has negatively impacted a substantial portion of the Defence Team. When responding to future crises, it is recommended that leaders of organizations provide additional supports to higher-risk groups and to supervisors who are ideally positioned to support employees during challenging times.

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.