Panel implores military to adopt more suicide-prevention resources

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An expert panel that reviewed the military's mental-health programs is calling on the Canadian Armed Forces to pour additional resources into preventing suicides.

The panel, which included mental-health experts from several Canadian and U.S. universities along with representatives of the Forces and the Department of Veterans Affairs, has made 11 recommendations in a 35-page report that was released by the military on Thursday.

The 15-member group is proposing that the military hire a suicide-prevention co-ordinator who would be responsible for reviewing what factors are contributing to suicides and identifying gaps in mental-health services and strategies for curbing these deaths. Suicide is a serious public-health issue throughout Canada, claiming about 4,000 lives each year. In the military, more soldiers died by suicide over the past two decades than in training accidents or overseas missions, such as the Afghanistan war.

The Forces have accepted all of the panel's recommendations. The military is currently working with Veterans Affairs to develop a joint suicide-prevention strategy, which is expected to be released later this year.

"This is a priority for both departments," said Colonel Rakesh Jetly, co-chairman of the expert group and senior psychiatrist with the military's directorate of mental health. He said the Forces hope an enhanced focus on suicide prevention will help drive down the number of soldiers thinking about taking their own lives.

An ongoing Globe and Mail investigation has found that more than 70 Canadian military members and veterans who served on the Afghanistan mission have killed themselves after returning home. Suicide is complex and often many factors are involved, such as alcohol abuse, relationship breakdowns and mental illness. The newspaper's profiles of 31 Afghanistan war veterans lost to suicide showed that many of the soldiers were dealing with post-traumatic stress or other mental illnesses connected to their experiences during the dangerous deployment and some were struggling to get consistent and quality care.

The expert panel is recommending the Forces do a systematic review of all soldier suicides since 2010 to analyze risk factors, identify potential treatment gaps and pinpoint measures that could help save other lives.

"The aim really is to try to understand patterns around what are the specific issues that people [who died by] suicide have faced before their death and what are the points of intervention that could reduce deaths," Jitender Sareen, panel co-chairman and head of psychiatry at the University of Manitoba.

Col. Jetly said the Forces hope to have a suicide-prevention co-ordinator in place this year. The panel recommended the co-ordinator be charged with developing a registry for monitoring suicide attempts in the military.

Suicide risk increases greatly after an attempt, Col. Jetly noted. "The most important thing [after] an attempt is to make sure the person is safe and in care."

The expert group, which met over three days in October, found that mental-health care has expanded and is easier to access in the Forces than in provincial medical systems. The military is responsible for delivering health services to its members, while veterans fall under provincial care.

The Forces' statistics show the rate of suicide has increased in recent years in the Canadian army, which shouldered the bulk of Canada's combat operations during the international Afghanistan mission. The army suicide rate among regular Forces males was 33.32 per 100,000 from 2002 to 2015, nearly 2.6 times higher than non-army branches, such as the navy and air force.

The picture is less clear among veterans. Suicides of former soldiers are not regularly tracked in Canada, but a new system is being developed and is expected to report for the first time at the end of this year. The country's only comprehensive look at veteran and soldier suicides revealed that 78 per cent of 934 military suicides documented from 1972 to 2006 involved those who had been released from the Forces. The other 22 per cent were still serving.

Compared with the general population, the suicide rate was 1.42 times higher among male vets and 2.5 times higher for female vets. Indeed, several studies have shown that being discharged from the Forces is a particularly vulnerable time for many ill and injured soldiers. Military Ombudsman Gary Walbourne has recommended that no military staff should be released until their veterans' benefits are in place.

The expert panel also highlighted the need to increase support for soldiers facing discharge.

"Many members were in the military for a long time and that's their identity," Dr. Sareen said. "That is a big stress. There can also be financial stress."

Other recommendations from the panel include involving family doctors in assessing patients for suicide risk, reviewing practices for screening for mental disorders and suicidal behaviour during the military-recruitment phase, and creating a patient and family advisory committee to offer input on the design of mental-health services and suicide-prevention efforts.