For soldiers suffering from mental illness, admission often leads to civilian life

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After a recent spate of soldier suicides, military leaders and politicians are urging those fighting a war inside their own minds to seek help, but some sufferers say the admission of mental illness is often the first step to being stripped of a uniform.

Severe psychological problems do not mesh with the rule that all members of Canada's armed forces must be ready to deploy, on short notice, to anywhere in the world. The "universality of service" clause means those with post-traumatic stress disorder, or other mental-health problems, are deemed no longer fit to do their jobs.

Despite Defence Minister Rob Nicholson's contention this week in the House of Commons that no one is kicked out of the military for having mental-health issues, the statistics say otherwise. According to Canada's military ombudsman's office, among the soldiers transferred to a special unit because of medical problems, only 10 per cent eventually return to their original position in the military.

Mike Caufield is one of those whose career is about to end. A 37-year-old sergeant with 18 years of experience, he had wanted to be a soldier since he was a child. But, as a result of his PTSD, he will be medically discharged early next year.

When Sgt. Caufield returned from Afghanistan in 2008, he completed the standard forms to assess mental fitness. While others in his unit gave the answers they thought the military wanted to hear, he opted for honesty – and it was his undoing. Sgt. Caufield was deemed unfit to deploy and given a year to get better. When that didn't happen, the military started the release process.

"At first it was devastating, completely crushing. I don't know anything else; I've never done anything else," said Sgt. Caufield. He has gradually adjusted to the idea of becoming a civilian but, earlier this year, he tried to take his own life. "I couldn't face the prospect of not being in the military any more," Sgt. Caufield said. "I was sick of fighting with myself and everybody around me."

A study by military staff that was released in July found that 14 per cent of Canadian Forces members who served in the Afghanistan mission were diagnosed with a mental-health disorder linked directly to their tour – and more than half of those people were suffering from PTSD.

Defence spokesmen said in an e-mail this week that its severely injured and ill members are transitioned to civilian life only when necessary, and then only when it is determined that they are mentally and physically prepared to do so. Every individual is unique, they said, and it can take several years from the time of injury to complete the reintegration process.

The military's approach to mental-health issues has received praise from NATO allies and the public sector. And some of Canada's top mental-health authorities, including the Mental Health Commission of Canada and the Canadian Psychiatric Association, have lauded the forces' recently released mental-health strategy.

But internally, due to hiring freezes and funding gaps, the military has failed to build a full contingent of mental-health staff.

Soldiers, meanwhile, suggest that the top-level messages encouraging soldiers to come forward with mental-health problems have not been backed up with acceptance down the line.

Wayne Johnston, a 41-year military veteran who has PTSD and has twice made plans to take his own life, said until middle managers like him buy into the assurances being offered, his subordinates won't believe them either.

Captain Johnston said money is a major concern, especially for younger troops who are about to lose a job.

Soldiers with PTSD who are handed a medical discharge often conclude they are worth more to their families dead than alive, Capt. Johnston said. They ask themselves: "How am I going to feed these three little mouths, and how am I going to hold my marriage together with my wife, let alone pay the mortgage and the car payments?"

Modernizing the "universality" clause was one of the key recommendations in a 2012 report of the military ombudsman, which pointed out that the notion of "returning" to civilian life is unthinkable to many members who signed up as teenagers.

The report also noted that, in the past, when combat operations were fewer and less intense, the military was more easily able to find ways around the universality of service clause for injured members. But the growing number of injured soldiers – particularly those with mental-health problems – has led to a rigid structure, the report said, "which spells out in the clearest of terms the limited options available to those deemed no longer fit to fight."

"That's the 800-pound gorilla in the room," says Jamie Robertson, a spokesman with the military ombudsman's office and former lieutenant-colonel in the military. "If you can figure a way out of that and not lead to automatic dismissal for the vast majority, that would encourage people to get treatment."

Because, he says, "at the end of the day, it's about feeding your family, and having a career."

But tweaking the combat-ready rule is challenging for the military, which has struggled to maintain viable fighting forces despite hiring freezes and tight budgets.

Mary Kirby, director of investigations for the ombudsman office, worked on the 2012 report. She points out the overall health of the force must also be a factor – and soldiers shouldn't be hiding in the ranks, without the help they need. "If you are waiting too long, and you are going in too late, then your ability to recoup is going to be much worse."

And worse at home, as well. Often overlooked is the toll these mental-health issues take on the families, who are also isolated while trying to look after sick spouses.

The wife of one soldier who is refusing to seek treatment for chronic PTSD explained in an interview with The Globe and Mail that she is trapped – because asking for help at one of the family resource centres on the base would mean outing her husband. "He doesn't want to end his career," she says, asking that her name and location not to be used. "He loves being in the military, end of story. He keeps hoping it will get better."

Walter Callaghan, a former reservist who was released from the military after developing symptoms of PTSD and is now a graduate student at the University of Toronto studying the disorder in military personnel, says soldiers know how their story ends once they raise their hand and admit to being sick: "It's just a spinning door that you get stuck in, and there's only one way out, and that's on the street."