Angela Ayre proudly served in the Canadian military for 14 years until an injury forced her to resign prematurely. Her transition to civilian life was relatively smooth compared to many of her colleagues. Yet the mention of Remembrance Day brings a visceral response of grief and regret.
“It’s definitely a difficult time. It’s hard that I’m still here and other people have lost their lives. And some people have lost their family. It is absolutely a hard time,” says Ayre, 35, pausing to stifle tears.
“(Remembrance Day) is a time to grieve and mourn, but also a time to celebrate.”
That conflict brews inside many active and retired military personnel at this time of year, experts say. While wearing poppies and attending parades on Nov. 11 are ways for Canadians to show respect and gratitude, these events can trigger dark feelings in veterans.
In April, the federal government committed $147 million over six years to expand the Veteran Family Program to help medically released veterans, and their families, with the often difficult transition from active service to post-military life. These veterans, who retired due to physical or mental health challenges, can now get help from the 32 Military Family Resource Centres across Canada, which offer a range of services, including a new mental health first aid course.
Ayre helps coordinate these courses in B.C., provide the veterans, their relatives and their close friends with skills to respond to drug overdoses, suicidal behaviour, panic attacks, psychosis and acute stress.
While she grappled with “losing her identity” when medically released from the military, the former medic at least knew where to go for help. But the transition hasn’t been as easy for most of her friends.
“We get stuck in an area where we don’t know what else to do. Career-wise, job-wise, we just feel lost. For a lot of people, the suicide rate has gone up. That’s a big concern. So mental health is absolutely crucial in the transition,” Ayre said.
There are more than 22,000 former members of the army, navy and air force receiving federal disability payments for a mental health diagnosis, a number that has jumped by 60 per cent in just four years. Three-quarters of those veterans have been diagnosed with post-traumatic stress disorder, according to Veterans Affairs Canada.
It may not necessarily be the case that more veterans are suffering mental health problems, but rather that increased public dialogue and improved social acceptance have encouraged more people to come forward to ask for help, said Oliver Thorne, executive director of Veterans Transition Network.
The non-governmental, charitable organization, which for 20 years has helped veterans adjust to the civilian world, runs two dozen group sessions each year across Canada, including four in B.C. Interest in the courses, which last 10 days spread over several weekends, peak in the fall, Thorne said.
“We definitely see a spike around Remembrance Day of the number who reach out and ask for help,” he said. “Remembrance Day for those of us who are civilians, it is a celebration, a hope that we honour those who served us. For veterans, the remembering is much more personal.
“What we hear from the people who take our programs is that Remembrance Day is a very personal reminder of the things they’ve encountered and the people they’ve lost.”
The Network, formed in 1997 by a University of B.C. counselling professor, Marv Westwood, has offered the 10-day courses for a decade to address issues such as anger, trouble sleeping, feeling down, avoiding public places, dissatisfaction with civilian workplaces, and “seeking out the adrenalin rush of dangerous situations.”
Academics have tracked participants after course completion and report improvements to their health, including an 80 per cent drop in suicidal thoughts, depression symptoms cut in half, and one in three saying self-esteem had increased.
It is not clear exactly how many former and current military members have mental health problems. The number could be much higher than the more than 22,000 receiving mental health disability payments. A recent report by Canada’s veterans ombudsman, Guy Parent, harshly criticized Ottawa for the length of time it takes to grant disability benefits to former soldiers who have applied.
It is hoped that people who need help will come forward now that more services are being offered by community agencies and that mental health is being spoken about more frequently in public, said Tracy Cromwell, executive director of the Military Family Resource Centre in Vancouver.
“Not everyone who is releasing out of the military is broken,” she said. “Most people probably go through transition quite successfully. But there are people (who need help) and we are having trouble finding them.”
She hopes the new mental health first aid course will help, noting it is provided free by her non-profit centre and other locations in Canada. So far in B.C., courses have been held in Vancouver in June and Langley in September, with more scheduled for Chilliwack in November and Prince George, Kelowna and Vancouver in the near future.
The course, developed by the Mental Health Commission of Canada with assistance from veterans, aims to teach how to have conversations about mental illness, how to recognize the most common challenges, and how to decrease stigma and discrimination. It also encourages participants to be willing to help others with problems such as drug use, mood swings, psychoses, and trauma.
“The same way that you or I might attend a first aid course to learn how to take care of a sprained ankle or to stop the bleeding when someone has been cut … we have never really had the opportunity to look at mental health in the same way,” Cromwell said.
Statistics show that nearly 60 per cent of veterans collecting disability benefits for a mental health condition are married or have a common-law partner.
That is one of the reasons Veterans Affairs Canada decided this year to allow medically released veterans and their relatives and close friends to access services at the country’s 32 Military Family Resource Centres, which had previously been open only to active service members and their families. Cromwell’s Vancouver location serves all of mainland B.C., while there are two other centres on Vancouver Island, in Comox and Esquimalt.
“Anything that affects the veteran or the serving member is going to affect their family,” Cromwell said. “It could be their parents, it could be their spouse, it could be children, or it could be a really close friend.”
The courses are also open to people who work or volunteer with former military members, especially with those who are medically released and who often have more trouble adjusting than those who leave military duty of their own volition.
“When a person is released, it is very difficult, and a lot of us do have mental health problems or issues we are trying to deal with and the family is the one that gets first-hand experience of what that’s like,” said Ayre, who works part-time in the Vancouver resource centre.
Ayre entered the military from high school and served from 2001 to 2015, first as a medic and then a clerk. But she was medically discharged after an accident badly injured her back and neck, and she found it hard to adjust to life as a civilian.
After taking the first aid course in June, though, Ayre said it helped her to better relate to her own struggles, those of her former colleagues, and also the veterans who she sees in her office at the Military Family Resource Centre in Vancouver.
“A lot of people with mental health issues, they don’t know how to ask for help because they are stuck in whatever they are going through,” she said. “A lot of my friends and veterans are going through the mental health issues themselves, so it just helped me be a better coordinator at my job and helps me better understand my personal life as well.”
Most of the veterans collecting mental health disability payments from the federal government are male and most commonly 40 to 59 years old.
Nancy Szastkiw, the family liaison officer for the Military Family Resource Centre in Vancouver, says the relatives and friends of struggling soldiers often tell her they notice moodiness, distraction and insomnia in their loved ones — especially in late fall and early winter.
“From the end of October to the end of January are trigger times,” said Szastkiw, a clinical counsellor. The triggers include Remembrance Day, Christmas, and the fact that there were a high number of casualties in those months in Afghanistan during several tours of duty.
“Remembrance Day brings it out because the idea is remembering the fallen, and (these veterans) are not remembering history — they are remembering in their own life,” she said.
The advice Szastkiw offers to these families is to talk to loved ones openly about how they are feeling when approaching a difficult time period, and to “try to be more patient and compassionate at these times.”
And to remember that the poppy is a sign of gratitude and respect, but also one that can bring back difficult memories.
For more information about the mental health first aid courses, email email@example.com.