War kills, and fatalities continue after soldiers leave the battlefields and return to what should have been the comfort and sanctuary of their homes.
Peace was shattered in rural Nova Scotia on January 3 when war veteran Lionel Desmond shot his wife, mother and 10-year-old daughter before turning the gun on himself. Desmond had been struggling with post-traumatic stress disorder (PTSD) following his deployment to Afghanistan in 2007.
The murder-suicide has raised questions about the adequacy of and accessibility to mental-health supports available to military personnel who suffer from PTSD. A study comparing trends in the prevalence of suicidal behaviour and the use of mental-health services between Canadian military personnel and the general population from 2002 to 2013, published in the Canadian Medical Association Journal in May 2016, found that from 2012 to 2013, personnel in the Canadian Armed Forces (CAF) had a 32 per cent increased odds of thinking about suicide and a 64 per cent higher odds of planning suicide.
The findings are mirrored in the 2016 National Defence report on suicide mortality in the CAF, published in November. By using Standardized Mortality Ratios to compare suicide rates between the general Canadian population and the CAF from 1995 to 2015, researchers found that those with a history of deployment had an increased risk of suicide compared to those who had never been deployed, although this difference was not statistically significant. Military personnel who were part of the army command also had significantly elevated risks of suicide relative to those who were part of other commands from 2006 to 2015.
Suicides are often multi-factorial, and inadequate access to mental-health support is only one of the contributing factors. According to the CAF report, nearly 93 per cent of those who committed suicide had accessed mental- and non-mental-health-related care within a year prior to their suicides. A whopping 64 per cent of those who died by suicide in 2015 had at least two mental-health disorders at the time of death, and more than half of the Regular Force males who ended their lives had at least three concomitant stressors prior to their deaths.
Addressing the problem of suicides among military personnel requires a focused and sustained effort in taking a deep, hard look at the lives of soldiers who return from battlefields years down the road. Unlike physical injuries, the psychological trauma and pain of witnessing death — even killing as part of operational duties — does untold damage to the human psyche. It carries a shame and pain so deep that soldiers who return to their civilian existence often find it hard to talk about what they have seen, done or failed to do on the battleground. That disconnect can lead to alienation, social difficulties and marital problems.
Bringing the topic of PTSD out into the open will help to destigmatize the issue. Creating a system to track the physical, mental and social well-being of post-deployment soldiers is also important. Indicators of an individual on a downward spiral include leave of absence, access to mental healthcare and substance abuse — all or some of which signal the need for timely, active intervention that could pull soldiers from the brink of “thoughts that do often lie too deep for tears,” in William Wordsworth’s words.
Jean Lian is the editor of OHS Canada.