Ombudsman for the Department of National Defence and the Canadian Forces

Ombudsman for the Department of National Defence and the Canadian Forces

December 17, 2008 10:00 ET

Ombudsman Finds Military Members With Mental Health Injuries Falling Through Cracks of Military System

OTTAWA, ONTARIO--(Marketwire - Dec. 17, 2008) - The Interim Ombudsman for the Department of National Defence and the Canadian Forces, Ms. Mary McFadyen, today released a special report, entitled A Long Road to Recovery: Battling Operational Stress Injuries. Accompanying the report is a case study on the state of mental health services at Canadian Forces Base (CFB) Petawawa in Ontario.

This investigation is the second follow-up review of an Ombudsman report released in 2002 evaluating the Department of National Defence and Canadian Forces' systemic treatment of military members with operational stress injuries.

After interviewing more than 360 individuals - including current and former military members suffering from mental health injuries - and thoroughly reviewing all relevant policies, procedures and programs, Ombudsman investigators determined that some military members who suffer from operational stress injuries are not being diagnosed and are not getting the care and treatment they need so that they can continue to be contributing members of Canadian society - either within the Canadian Forces or as civilians.

As part of their review, investigators assessed the level of implementation of the original 31 recommendations from the 2002 report, and concluded that more than half have not been fully implemented to the satisfaction of the Ombudsman's office.

The Ombudsman acknowledged that the Department and the Canadian Forces continue to be world leaders in the field of operational stress injuries and that progress had been made in the past six years to address many of the areas identified in the 2002 report. However, she also noted a number of areas in the military's approach where confusion and discrepancy remains and where progress is slow.

For example, Ombudsman investigators found that myths and stereotypes associated with post-traumatic stress disorder and other operational stress injuries remain a real problem. In fact, mental health caregivers from virtually every military establishment in Canada raised the issue of stigma as one of the biggest challenges still facing the Canadian Forces. In addition, the organization has yet to develop a database that accurately reflects the number of Canadian Forces personnel who are affected by stress-related injuries.

"Dealing effectively with mental health injuries while, at the same time, creating an environment where members are comfortable in seeking care is essential in maintaining the operational capability of the Canadian Forces," stated the Interim Ombudsman. "And given that the consequences for individuals who may fall through the cracks could be devastating and long lasting, the Department and the Canadian Forces cannot accept that even one member of the Defence community may be overlooked."

The office also noted that the Department and the Canadian Forces continue to refuse to implement a critical recommendation: the appointment of a senior officer of significant rank whose sole duty would be to act as national coordinator for issues related to operational stress injuries.

"The first step in addressing any significant challenge or problem is a clear and determined commitment to do so from the senior leadership of an organization," stated Ms. McFadyen. She added, "A lack of national coordination has had a real and negative impact on those suffering from operational stress injuries."

At CFB Petawawa in particular, the need for an overall authority to coordinate efforts between different military and/or civilian specialists is evident in the animosity between the various groups of health care professionals. This lack of trust and respect, combined with the lack of governance, has interfered in the base's ability to provide effective multi-disciplinary care.

In November 2007, the previous Ombudsman conducted a fact-finding visit to CFB Petawawa and found that the isolated base is a prime example of the problems and shortcomings that military members, military families and the caregiver community are facing across the country. For example, the Ombudsman was informed that patients requiring an operational stress injury assessment must travel to Ottawa - a distance of more than 160 kilometres - to receive a diagnosis and care plan. Furthermore, the Ombudsman was told that the type of rehabilitative care generally recommended by doctors in Ottawa was not available at CFB Petawawa.

"Regardless of where they are located, what their duties are, or who they work and train with, all Canadian Forces members are entitled to quality, consistent and timely care when they are injured," stated Ms. McFadyen. "Some of the individual problems found by this office - such as efforts to standardize treatment - likely could have been prevented with the full implementation of our original recommendations."

In assessing the status of the original recommendations, Ombudsman investigators also found new and evolving areas of concern. Most notably, the mission in Afghanistan has substantially increased the level and intensity of combat operations, and a significant number of soldiers are returning from overseas deployments suffering with mental health issues. As a result, the office noted that the need for a robust system focused on identifying, preventing and treating operational stress injuries is even higher today than it was in 2002.

It is also apparent now - in a way that was not evident in 2002 - that the challenges and difficulties associated with operational stress injuries have a dramatic impact on the families of military members who suffer from mental health injuries. However, investigators did not find any evidence of a coordinated, national approach to ensuring that military families are able to access the care and support they may need. Unfortunately, as with military members themselves, the quality and timeliness of mental health care available to family members varies greatly from military establishment to military establishment.

Such was the case at CFB Petawawa, where the availability of services aimed specifically at the overall health and well-being of the family unit was not only insufficient, but was being reduced. During its fact-finding visit, the office heard stories about Francophone family members who could only attend medical appointments if their spouse or a bilingual friend or neighbour could accompany them to translate. The office was also told about families who regularly assumed the expense of driving to Ottawa to get the necessary care for family members.

"When a Canadian Forces member has an operational stress injury, it is a significant challenge for the whole family, not just the member," stated the Interim Ombudsman. "Given the sacrifices that military families make for their loved ones and their country, the Canadian Forces has a moral responsibility to ensure that they, too, have access to appropriate mental health care in order to support an injured military loved one or to deal with the stress associated with deployments.

As part of its follow up, the office also found that much more needs to be done to address the significant shortage of qualified mental health caregivers, including chaplains, social workers, physicians, psychologists, psychiatrists, and mental health nurses. Today's caregivers are carrying heavy caseloads, and many are in danger of burning out. Indeed, the majority of caregivers interviewed by the office stated that stress was a pressing concern, to the point that it was leading some to quit the military.

Insufficient staffing levels emerged prominently in the office's case study. In fact, at CFB Petawawa, reductions and limitations in social work services stem directly from a lack of medical practitioners and specialists. What is worse, even if fully staffed, the base Care Delivery Unit would have an insufficient number of clinicians to treat the personnel that they serve.

"Caregivers are invaluable members of the Defence community, particularly in the battle against operational stress injuries," stated Ms. McFadyen. "More resources need to be allocated to alleviate the burn-out and stress being experienced by many health care specialists, otherwise the Canadian Forces will continue to lose these dedicated professionals."

In releasing A Long Road to Recovery: Battling Operational Stress Injuries and its the accompanying case study, entitled Assessing the State of Mental Health Services at CFB Petawawa, the Interim Ombudsman made 16 recommendations to the Minister of National Defence, which are intended to ensure that all military members suffering from an operational stress injury, and their families, are treated fairly.

A complete list of the recommendations, and additional information on the Office of the Ombudsman's second follow-up report, can be found in the attached backgrounder or on the office's website at: www.ombudsman.forces.gc.ca.


A Summary of Findings from

A Long Road to Recovery: Battling Operational Stress Injuries

Second Review of the Department of National Defence and Canadian Forces' Action on Operational Stress Injuries

December 17, 2008

Background

The Ombudsman's office has been closely associated with the issue of post-traumatic stress disorder and other operational stress injuries in the Canadian Forces since 2002, when it published its first special report on the subject, entitled Systemic Treatment of CF Members with PTSD.

The 2002 report made 31 recommendations aimed at helping the Department and the Canadian Forces identify and treat post-traumatic stress disorder after concluding that it was a serious problem for hundreds - if not thousands - of members of the Canadian Forces. It also found that, at the time, the military's approach to mental health injuries was inadequate and that the organization was not treating sufferers appropriately.

This second follow-up report tracks the progress made by the Department and the Canadian Forces in implementing the office's 31 previous recommendations, and highlights some new and evolving issues and problems. However, the overriding aim of this second follow-up report is to establish whether Canadian Forces members who suffer from post-traumatic stress disorder or other operational stress injuries are being diagnosed and getting the care and treatment they need so that they can continue to be contributing members of Canadian society - either within the Canadian Forces or as civilians. The report also recognizes the dramatic impact operational stress injuries can have on military families and makes recommendations designed to ensure that the families of military personnel have access to the broad spectrum of services and care they need.

Findings

When the Ombudsman's office released its original report in 2002, it made recommendations aimed at helping the Department of National Defence and the Canadian Forces identify and treat post-traumatic stress disorder. While investigating this second follow-up report, Ombudsman investigators found that the Department of National Defence and the Canadian Forces have made progress over the past six years in addressing many of the issues and challenges related to post-traumatic stress disorder and other operational stress injuries. In general, these finding confirm the Chief of the Defence Staff's testimony in June 2008 at the Standing Committee on National Defence that the military "healthcare system is meeting the vast majority of patient needs."

However, investigators also found evidence to substantiate the Chief of the Defence Staff's assessment that the system is not perfect. Six years on, the office continues to find cases where injured soldiers, sailors, airmen and airwomen, who have served their country with courage and dedication, are slipping through the cracks of an ad hoc system.

Ombudsman investigators found a number of areas in the military's approach to operational stress injuries where confusion and discrepancy remains, and where progress is slow. For example, high-level direction and national coordination is still sporadic. Efforts to standardize care and treatment across the Canadian Forces are inconsistent. The collection of national data and statistics is insufficient. Performance measures to evaluate local and regional approaches and programs are lacking. And the strong commitment from senior leadership regarding operational stress injuries has not reached everyone.

Investigators also found a number of individual cases where military members and/or their families were not treated fairly by the Canadian Forces or did not get access to the care and treatment that they needed. Access to quality care still depends on a number of arbitrary factors, including: where the military member lives; the distance of the member's base from the nearest large city; the availability of mental health care professionals; and the attitude of the member's superiors and peers.

In addition, the collection of national data and statistics is insufficient. To date, a national database - critical in understanding the extent of the problem, including the number of Canadian Forces personnel affected by mental health injuries - has yet to be created. With a national database, the Canadian Forces would be much better able to evaluate the impact of various clinical interventions and provide guidance to improve the numbers of treatment successes. In addition, national data could be used to target education and training initiatives where they are most needed and could be most effective.

Some of the individual problems found by Ombudsman investigators likely could have been prevented - or, potentially, alleviated in the future - with the full implementation of the Ombudsman's original 2002 recommendations. Unfortunately, investigators found during this second follow up that a number of important recommendations from 2002 have not been implemented, either in practice or intent. This has hampered the overall coordination of efforts and consistency of care received by military members across the country suffering from operational stress injuries.

At the same time, it became clear that there were new and evolving areas of concern. The environment in which Canada's military has been operating in recent years has changed dramatically. With the mission is Afghanistan, the level and intensity of combat operations have increased substantially, and a large number of soldiers are returning from overseas deployments suffering from mental health injuries. It has become evident that the Canadian Forces and its members are strained almost to the breaking point. It is also clear that this strain significantly increases the demands on families as well.

In moving forward and taking into account these current realities and problems, this second follow-up report focuses on three issues that the Ombudsman's office considers to be critical in ensuring quality and timely care for military members suffering from operational stress injuries:

First, the Department and the Canadian Forces need to strengthen national governance and leadership related to the identification, prevention and treatment of post-traumatic stress disorder and other operational stress injuries, as was recommended in 2002.

The organization has yet to appoint a senior officer of significant rank (and reporting directly to the Chief of the Defence Staff) whose primary duty would be to act as national coordinator - and effective oversight - for issues related to operational stress injuries, including the quality and consistency of care, diagnosis and treatment, and training and education across the Canadian Forces. This position would serve an important practical and symbolic role in helping to bring about culture change in the Canadian Forces and would help to put an end to the ongoing stigma associated with operational stress injuries.

Second, it is now apparent that the challenges and difficulties associated with operational stress injuries are not restricted to military personnel alone. When a Canadian Forces member suffers from post-traumatic stress disorder or another operational stress injury, it can pose a significant challenge for the whole family, often requiring support and assistance from and for each family member.

While Ombudsman investigators found a number of quality programs offered by provincial and municipal governments, local Military Family Resources Centres and local base chaplains to support military families, the investigation did not find any evidence of a coordinated, national approach to ensuring that military families are able to access, in a timely manner, the mental health care and support that they may need.

Although the Department and the Canadian Forces do not have a legal responsibility to provide health care to family members, there are two compelling reasons for them to ensure that military families have access to timely and appropriate services and support. First, as the mental health injuries are often the result of military service required by Canada and the Canadian Forces, and the direct cause of family stress and dysfunction, the organization has a moral responsibility to ensure that care and treatment is provided. A second, more practical reason for ensuring the care of military family members is that it can reduce stress on the operational stress injury sufferer and can speed up recovery time.

Third, Ombudsman investigators found that much more needs to be done to deal with the issue of stress and burnout among Canadian Forces caregivers that is created by a lack of resources and high caseloads. A shortage of caregivers (including chaplains, social workers, physicians, psychologists, psychiatrists and mental health nurses), coupled with an increasing demand for their services, has led to even greater instances of stress and burnout in the caregiver community, as well as increasing challenges associated with the hiring and retention of mental health specialists.

The Ombudsman's office was pleased to learn of the intention of the Department and Canadian Forces to hire an additional 218 mental health professionals by the end of March 2009. It should be noted, however, that the Canadian Forces are one of many employers across the country vying for health care professionals and it may be difficult to fulfill this commitment. This makes it even more essential for the military to retain the mental health care professionals already working in the Defence community.

Moreover, given the very dangerous and demanding nature of the current mission in Afghanistan, it is clear that post-traumatic stress disorder and other operational stress injuries will become an even greater challenge for the Canadian Forces - and a real hardship for Canada's soldiers, sailors, airmen and airwomen - for many years to come.

The Ombudsman's nine latest recommendations will form the basis of the office's future monitoring and reporting on this issue, and will help ensure that all Canadian Forces members suffering from an operational stress injury and their families are treated fairly.

Status Report on the Implementation of the Ombudsman's Original 31 Recommendations

The Department and the Canadian Forces have made progress in the treatment and care of members suffering from operational stress injuries; however, only 13 of the original 31 recommendations in the 2002 report have been fully implemented to the satisfaction of the Ombudsman's office (seven have been partially implemented, and 11 have not been implemented at all - either in practice or intent).



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Recommendation Status
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1. The Canadian Forces develop a database that Not Implemented
accurately reflects the number of Canadian
Forces personnel, including members of both
the Regular and Reserve Forces, who are affected
by stress-related injuries.
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2. The Canadian Forces develop a database on suicides Implemented
among members and former members.
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3. The Canadian Forces conduct an independent and Implemented
confidential mental health survey that includes
former members, as well as Regular and Reserve
components.
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4. The Canadian Forces examine the issue of work Implemented
therapy while on the Service Personnel Holding List
(SPHL) in more detail, with a view to creating
policies and procedures to deal equitably with issues
that arise from members on the SPHL earning secondary
income from employment as part of a therapy program.
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5. The Canadian Forces initiate a program whereby all Not Implemented
units receive outreach training about post-traumatic
stress disorder via the OTSSCs.
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6. OTSSCs be funded to a level that ensures they have Partially
sufficient resources to deliver quality outreach Implemented
training to units on request.
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7. Specific and detailed education and training Not Implemented
objectives dealing with post-traumatic stress
disorder be included in the curricula of all
Canadian Forces educational and training
establishments, and that the performance
measurement criteria for these organizations
reflect these objectives.
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8. Canadian Forces units be mandated to provide Not Implemented
ongoing continuation training about post-traumatic
stress disorder to all members at regular intervals,
in addition to any deployment-related training.
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9. The Canadian Forces make post-traumatic stress Not Implemented
disorder a mandatory part of education and
training at all ranks and that educating Canadian
Forces members about post-traumatic stress disorder
be made a priority.
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10. The Office of the Post-Traumatic Stress Disorder Not Implemented
Coordinator play a central role in the education
and training process by acting as a resource and
advisor for bases, formations and commands.
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11. The Canadian Forces include members or former Partially
members who have experience of post-traumatic Implemented
stress disorder in all education and training
initiatives relating to post-traumatic stress disorder.
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12. Multidisciplinary teams that include all of Not Implemented
the professional specialties with an interest
in post-traumatic stress disorder diagnosis
and treatment, including experienced soldiers,
be used to deliver outreach training. To enhance
training effectiveness and ensure standardization,
such training should fall under the control
of the Office of the Post-Traumatic Stress
Disorder Coordinator.
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13. The Canadian Forces allot additional resources Implemented
to accelerate the implementation of the proposed
mental health education initiatives developed by
the Rx2000 Mental Health Team.
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14. The Canadian Forces develop a standardized Implemented
screening process that involves all of the
pertinent specialists and that is under the
control of a single point of contact.
--------------------------------------------------------------------------
15. The Canadian Forces set up a pilot project to Implemented
determine the most effective ways of allowing
members returning from deployment to be
reintegrated into family and garrison life.
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16. The Canadian Forces provide sufficient Partially
incremental resources to permit all mental Implemented
health caregivers, including padres and social
workers, to access training required to deal
with mental health issues.
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17. The Canadian Forces provide sufficient incremental Implemented
resources for the social work branch to hold an
annual retreat.
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18. The rules regarding occupational transfer be Not Implemented
changed to quickly accommodate members diagnosed
with post-traumatic stress disorder who would
benefit therapeutically from working in another
military occupation.
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19. The Canadian Forces audit and assess the Implemented
effectiveness of policies and procedures designed
to assist Reserve Force members and augmentees
pre- and post-deployment.
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20. The Canadian Forces review policies and procedures Partially
with a view to making them as flexible as possible Implemented
to accommodate the needs of members who have been
diagnosed with post-traumatic stress disorder and
wish to remain with their units for as long as is
possible.
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21. The Canadian Forces review procedures for placing Implemented
members on the SPHL to ensure a greater role for
input from Medical Officers and Commanding Officers.
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22. Units maintain contact with members on the SPHL Partially
bi-weekly, subject to any restrictions imposed by Implemented
the member's treating caregiver, or any desire
expressed by the member.
--------------------------------------------------------------------------
23. The Canadian Forces address resource issues that Partially
are preventing units from properly looking after Implemented
members diagnosed with post-traumatic stress
disorder within their units.
--------------------------------------------------------------------------
24. The Canadian Forces prioritize and accelerate Not Implemented
the efforts toward standardizing treatment of
members diagnosed with post-traumatic stress
disorder among OTSSCs.
--------------------------------------------------------------------------
25. OTSSCs be resourced on a priority basis, and Implemented
to a level sufficient to perform all of their
designated functions.
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26. The Director General Health Services initiate Implemented
a pilot project that locates one OTSSC off base,
to ascertain whether such an arrangement is better
suited to the objectives of the OTSSC.
--------------------------------------------------------------------------
27. The Canadian Forces take steps to deal with Partially
the issues of stress and burn-out created by Implemented
lack of resources and high caseloads among
Canadian Forces caregivers.
--------------------------------------------------------------------------
28. The Canadian Forces take steps to improve support Not Implemented
programs designed for families of members diagnosed
with post-traumatic stress disorder, at all elements
and locations.
--------------------------------------------------------------------------
29. The Canadian Forces continue support for the Implemented
Operational Stress Injury Social Support initiative
and provide resources as required to extend this
or similar programs across the Canadian Forces.
--------------------------------------------------------------------------
30. The Canadian Forces initiate an end-to-end review Implemented
of the rules dealing with confidentiality of
medical information. In the short term, breaches
of confidentiality must be dealt with quickly and
visibly to re-establish confidence in the Canadian
Force's commitment to protect personal information.
--------------------------------------------------------------------------
31. The Canadian Forces create the position of Not Implemented
Post-Traumatic Stress Disorder Coordinator,
reporting directly to the Chief of the Defence
Staff, and responsible for coordinating issues
related to post-traumatic stress disorder across
the Canadian Forces.
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Recommendations to Address Current Realities and Problems

In going forward, the Ombudsman's office calls on the Department and the Canadian Forces to implement the intent of all 31 recommendations contained in its 2002 special report on post-traumatic stress disorder, as well as the following nine recommendations aimed at addressing current realities and problems regarding mental health injuries.

The Office of the Ombudsman recommends that:

1. A full-time position of National Operational Stress Injury Coordinator be created, reporting directly to the Chief of the Defence Staff and responsible for all issues related to operational stress injuries, including: the quality and consistency of care, diagnosis and treatment; and training and education across the Canadian Forces.

2. The Canadian Forces develop a database that accurately reflects the number of Canadian Forces personnel, including members of both the Regular and Reserve Forces, who are affected by stress-related injuries.

3. The Canadian Forces conduct an independent and confidential mental health survey, which should include current and former Canadian Forces members from both the Regular and Reserve Forces.

4. Any changes - formal or informal - to the Accommodation Policy (or the approach taken by the Canadian Forces to wounded members who want to continue their military careers) be applied equitably to Canadian Forces members with both mental health and physical injuries.

5. The rules regarding occupational transfer be changed to accommodate, in an efficient manner, members diagnosed with post-traumatic stress disorder or other operational stress injuries who could continue their military service if they transferred to another military occupation.

6. The Canadian Forces establish and properly resource an organization - at the national level - responsible for working with external agencies and all levels of government, as required, to ensure that military families and individual members of the families of military personnel have access to the broad spectrum of services and care they need.

7. The Canadian Forces provide an appropriate level of funding across the country for the identification, prevention and treatment of post-traumatic stress disorder and other operational stress injuries.

8. The Canadian Forces monitor and assess the requirement for additional mental health care professionals should the challenge associated with mental health injuries continue to grow.

9. The Canadian Forces develop and implement a national program or initiative aimed specifically at assisting and preventing stress and burnout among the mental health care community.


A Summary of Findings from

Assessing the State of Mental Health Services at CFB Petawawa

A Case Study from the Ombudsman for National Defence and the Canadian Forces

December 17, 2008

Background

The former Ombudsman travelled to Canadian Forces Base (CFB) Petawawa in November 2007 to assess the mental health services that were available to military members and their families at the base and in the local area. Since 2002, more than 8,500 Petawawa-based personnel have deployed to Afghanistan. Given this intense operational tempo, and taking into account the hazardous nature of the Afghanistan operation and the isolated geographical location of CFB Petawawa, the Ombudsman believed that this base would be a valuable case study in the office's larger systemic investigation regarding post-traumatic stress disorder and other operational stress injuries.

CFB Petawawa had also been the subject of a number of specific complaints to the Ombudsman's office. Specifically, military members and their families had complained about a lack of appropriate mental health care for soldiers and their families who were desperately trying to cope with stresses related to deployment and, in particular, Afghanistan.

During his fact-finding visit to CFB Petawawa, the Ombudsman met with a number of diverse groups who all had a role to play in managing and/or providing mental health services at the bases, including health care professionals; social workers; chaplains; and members of the chain of command at all levels. The Ombudsman also spoke with a wide variety of military personnel and their families.

Findings and Recommendations

Although the problems and shortcomings related to the mental health services available at CFB Petawawa were much more pronounced and pressing, they were nonetheless consistent with those found across the country during the office's broader follow-up investigation regarding treatment of post-traumatic stress disorder and other operational stress injuries.

During this fact-finding visit, the Ombudsman was informed of two problems, in particular, that were having a real and negative impact on Canadian Forces members and their families at the base, namely: the overall lack of health care at the base, and in the immediate area, to identify and care for individuals with mental health injuries; and the noticeable burnout of military caregivers at all levels.

There was a general consensus amongst those interviewed by the Ombudsman that it was extremely difficult and time-consuming for a Canadian Forces member to get a diagnosis of, and rehabilitative care for, a mental health injury or illness at CFB Petawawa. For example, the Ombudsman was informed that patients requiring an operational stress injury assessment must travel to Ottawa - a distance of more than 160 kilometres - to receive a diagnosis and care plan. Furthermore, the Ombudsman was told that the type of rehabilitative care generally recommended by doctors in Ottawa was not available at CFB Petawawa.

The office also found that the availability of services aimed specifically at the overall health and well-being of the family unit was not only insufficient, but was being reduced. Access to base social work counselling sessions by military families had recently been limited to those sessions in which the military member participates, which served to drastically limit the availability of care since military members are often away from base on training or deployment. It also served to limit the effectiveness of the care available, as family members are often reluctant to fully express their concerns in the presence of their military loved one who may be experiencing severe difficulties.

Additionally, the Ombudsman was informed that there were no services whatsoever for French-speaking family members.

It was also clear during the Ombudsman's visit that the caregivers at CFB Petawawa were struggling to meet the increasing demand for their services with the limited resources available to them. In particular, two issues emerged consistently and prominently: insufficient staffing levels and governance issues.

According to figures provided by the Base Surgeon during the Ombudsman's visit, CFB Petawawa had significantly fewer resources to treat mental health injuries and/or illnesses than other army bases of comparable size, although it is significantly farther away from the nearest city that might be able to provide additional therapeutic or diagnostic resources. In fact, even if fully staffed, the base Care Delivery Unit would have an insufficient number of clinicians to treat the personnel that they serve. The reductions and limitations in social work services provided to military families also stem from a lack of medical practitioners and specialists.

During his visit to the base, the Ombudsman also found that there was no overall authority in place to ensure a coordination of efforts between different military and/or civilian specialists. Thus, although it was apparent that members of the caregiver community care passionately about the well-being of their patients, the Ombudsman observed outright animosity between the various groups of health care professionals. The lack of trust and respect, combined with the lack of coordination, made it very difficult to provide effective multi-disciplinary care.

In general, it was clear to the Ombudsman that Canadian Forces members and their families were not getting the care and treatment that they needed in the Petawawa area to deal with operational stress injuries, the consequences of which could be tragic. It was also clear that these problems could hamper the ability of CFB Petawawa to meet its operational requirements in the future if they were not addressed immediately.

As a result of observations made during its visit to CFB Petawawa, the Office of the Ombudsman has made the following seven recommendations, which, once implemented, should go a long way in improving the quality and timeliness of mental health services and treatment available to Canadian Forces members and their families at CFB Petawawa.

1. The Canadian Forces take immediate action to match the numbers of care provider positions to the needs of Canadian Forces Base Petawawa given the size, activity and location of the base.

2. The Canadian Forces establish and resource an organization - at the national level - responsible for working with external agencies or levels of government, as required, to ensure that military families and family members of military personnel have access to the spectrum of services and care they need.

3. The Canadian Forces provide the permanent resources that would enable Canadian Forces Base Petawawa to liaise with local agencies and municipal governments to identify and to coordinate the care required by and available to military families and family members of military personnel.

4. The Canadian Forces find interim approaches to providing sufficient local health care while waiting for long term solutions to take effect.

5. The Canadian Forces provide resources for additional paid administrative and program assistance to enable the chaplains to minister more effectively to the spiritual needs of military personnel and their families.

6. The Canadian Forces establish a clear governance structure, with clear responsibilities and accountabilities, for the provision of effective and efficient multi-disciplinary care for military personnel and their families at Petawawa.

7. The Canadian Forces take positive action to assist the members of the care giving communities at Petawawa to re-build interpersonal and inter-specialty relationships that are courteous, respectful, trustworthy, cooperative and supportive.

Contact Information

  • Office of the Ombudsman
    Michelle Laliberte
    Communications Advisor
    613-995-8643