War, as you may have gathered, is hell. U.S. Civil War General William Tecumseh Sherman said so back in 1879. And the sentiment has been repeated many times since. There is no surer way to wreak havoc on a person’s psyche than to send him into battle.
The toll that armed combat takes on a soldier’s mental health is no lighter today than it was in General Sherman’s time, but at least we now have the advantage of over a century’s experience with psychiatric and psychological research into, and treatment of, military-service-related mental illness. Post traumatic stress disorder is better understood and more easily recognized than it was even 20 years ago, before the debilitating effects of the Gulf War were studied extensively in veterans. And mental health professionals have become more sensitive to subtle signs of lingering depression and suicidal thoughts in patients who have experienced war — plus, doctors and therapists have a greater arsenal of pharmaceutical and therapeutic tools with which to treat them.
Anyway, the point is, war is still hell, but we have the potential to make it — and the post-war period — considerably less psychologically hellish for soldiers than it used to be. Yet we’re not even coming close to living up to that potential. In the United States, 18 servicemen or women (including veterans) commit suicide every single day. The numbers are much lower in Canada, where our military is far smaller and our service people have seen less combat. But there is concern here too that the 20 suicides in the Canadian Forces last year (eight more than in the previous year) could be a sign of things to come now that thousands of our soldiers are returning to life at home after serving on the battlefield in Afghanistan. They are almost certain to be bringing operational stress injuries with them — problems that could continue to manifest themselves for a decade.
What Canadian Forces Ombudsman Pierre Daigle proposes is that the government hire more military mental health professionals to address the growing demand. He says current staffing levels are about 25% below what they should be, causing soldiers to have to wait too long before being treated, and forcing some soldiers to be seen by non-military doctors and therapists who don’t have the expertise to deal with combat-specific mental health problems.
An increase in spending on military mental health should be a no-brainer. For one thing, it’s simply the moral thing to do. After asking individuals to repeatedly risk their lives for Canada, fairness would dictate that Canada do whatever it can to make these people whole again out of respect for their service. Indeed, the country owes military families a debt too, and families are often just as heavily burdened by a returning soldier’s mental illness as is the solider himself. (Losing a father or mother to debilitating depression can be every bit as heartbreaking as losing a parent on the battlefield.) If we’re going to send men and women onto the front lines to be broken on our behalf, the least we can do is commit to putting them back together again to the best of our abilities.
Naturally there are pragmatic reasons for keeping members of the Canadian Forces mentally healthy as well: untreated or undertreated mental illness and operational stress can lead to severely impaired decision making, irrational thinking and even violence. All three outcomes would be extraordinarily dangerous for anyone serving below or alongside an active-duty service person who was so afflicted. A war zone would amplify the ill effects of a breakdown in frightening ways.
So the government has an immediate interest in treating mental illness quickly and effectively in the field. And there’s a longer term interest in doing so once soldiers have come home. Like any health problem, a mental illness tends to become more expensive to address the more serious it becomes. Since the government will be paying for the treatment regardless, it makes more sense for it to do so quickly and with specialized military mental health professionals since that approach offers the greatest chance at success — and, therefore, the greatest chance at keeping health costs down (not to mention reducing related costs in the areas of unemployment, disability, criminal justice, etc.).
This kind of “early intervention to reduce societal costs” argument is used quite often to justify spending on all sorts of health and public health initiatives, some of them decidedly dubious and some of them exceedingly intrusive, but I think it makes particular sense in the military mental health context since 1) the government is the one creating the primary problem and cost in the first place, 2) there’s generally no question of whether the patient bears responsibility for fostering his illness, and 3) making use of the treatment is voluntary.
After all that is asked of our soldiers, they should be able to count on our support. That includes providing adequate treatment of the mental illnesses that are an inescapable byproduct of the stresses of war.