Special Report

Assessing the State of Mental Health Services at CFB Petawawa

December 2008

II. Lack of Appropriate Health Care

The Ombudsman’s assessment of the mental health services at CFB Petawawa focused on the care and treatment available to:

  1. Individual Military Members: The care provided to individual military members suffering from mental health injuries, particularly but not solely those linked to military deployments.
  2. Military Families: The care provided to a military member’s family to help them cope with mental health injuries linked to military deployments; and
  3. Individual Family Members: The care provided to individual family members, which may be, but is not necessarily, linked to deployment stresses.

Individual Military Members

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 the on-site psychiatrist at the base was prevented from diagnosing operational stress injuries. Patients requiring an 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 (e.g., cognitive behavioural therapy) was not available at CFB Petawawa.

The Ombudsman was also informed that treating the symptoms of mental health injuries – both before and after a clear diagnosis – was the responsibility of the general duty physician at CFB Petawawa. However, in order to be effective, this type of care requires far more time and attention than is generally the case in caring for physical injuries. This, in turn, adds significant strain on a medical system already trying to cope with a very high volume of patients. It also means that some military members are simply not getting the level of care and attention that they need to deal with their operational stress injury, including post-traumatic stress disorder.

Military Families

A number of the groups that met with the Ombudsman – including chaplains, social workers and senior and junior non-commissioned members – noted that mental health injuries are rarely, if ever, suffered by a military member alone or in isolation. As one soldier said, “If a Canadian Forces member has an operational stress injury, the whole family has an injury.”

Furthermore, the Ombudsman was informed that family members can and do experience mental health injuries and illnesses as a result of military deployments, whether or not the military member actually sustains one. Given the number of casualties suffered in Afghanistan by military members from CFB Petawawa and the ongoing – and detailed – media coverage of all major combat activity, military families face considerable stress, indeed a level of stress probably not experienced since the Korean War in the early 1950s.

Although the Canadian Forces is responsible for providing medical care to military members, military families residing in Canada have their health care covered by the province in which they live. In the case of CFB Petawawa, military families are covered by the Ontario Health Insurance Plan. That being said, there was a general consensus amongst military members, military families, caregivers and the military chain of command at CFB Petawawa – and, indeed, across the country – that the Canadian Forces has a moral responsibility to ensure that appropriate care is available for military families where they live and work. The consensus was even greater for those stationed at more isolated bases such as CFB Petawawa. The previous Chief of the Defence Staff seemed to support this view when he stated (in CANFORGEN 159/07) that:

I will also continue to ensure that the highest degree of support is given to the wounded, and to the families of our soldiers, sailors, airmen and airwomen injured or killed in the service of Canada. This is a principle of responsible leadership I expect all in a position of authority to implement.

Unfortunately, the reality at CFB Petawawa does not reflect this statement. Military personnel, family members, and caregivers all told the Ombudsman 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.

This was particularly obvious around the time of the Ombudsman’s visit, since access to base social work counselling sessions by military families had recently been limited to those sessions in which the military member participates. This 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.

It was clear during the Ombudsman’s visit to Petawawa that military families were extremely troubled by the loss of these important services. If Canadian Forces social work services are not readily available to military families, family members are left with four options:

The option of going without help is simply unacceptable. Families who seek assistance are generally those who recognize that they cannot cope alone, often because they have reached a crisis point or recognize that they are approaching one. To leave them without a place to turn, especially in dealing with problems and challenges created by military service, is grossly unfair. Nor is it prudent. The consequences to families, family members and/or the community as a whole of ignoring mental health injuries and/or illnesses or of refusing to provide appropriate care and treatment are potentially devastating.

At the same time, the Ombudsman was advised that military families wanting to use other social service providers in the Petawawa area have few options. Indeed, mental health services in the Petawawa area are extremely limited – both in terms of numbers and specialities – and are not easily accessible. The Ombudsman was also informed that there were no services whatsoever for French-speaking family members.

Military families seeking assistance in Ottawa often had a difficult time in locating, and getting timely access to, appropriate mental health specialists. Moreover, the considerable distance between Petawawa and Ottawa, coupled with the fact that care and treatment may be required weekly or even several times a week, limits the viability of this option for many military families in need of help.

In terms of seeking other types of services from the Canadian Forces at CFB Petawawa, the Ombudsman was informed that military families have only two options: the Military Family Resource Centre and Canadian Forces chaplains.

Military Family Resource Centres are the front-line organizations located across the country and around the world that provide military families and family members with programs and services in support of Military Family Services Program goals, one of which being “to help families of Canadian Forces members manage the stresses associated with the unique characteristics of the military lifestyle.”

The Petawawa Military Family Resource Centre offers a number of preventative and educational programs, as well as short-term assistance to, and referrals for, families in crisis. These programs are designed and delivered to help military family members develop the skills, gain the knowledge, and make personal connections that will help them to better withstand the stresses that are put on military families, and to help avoid or reduce the negative effects of these stresses. There are also programs designed to assist families and family members, on an emergency basis and for short periods of time, when there is a crisis. Finally, there is information available on, and referrals to, services that are beyond the scope of those provided by the Military Family Resources Centre at Petawawa.

Although the Petawawa Military Family Resource Centre provides an essential service, and substantial assistance, to military families in the area, it does not have the mandate to provide ongoing therapeutic care – medical, psychiatric, psychological or social work. Nor does it have access to the resources that would be required to provide such care. The centre, therefore, has very limited capacity to provide additional mental health care or to replace the loss of social work services previously provided to military families.

As part of their responsibilities, Canadian Forces chaplains have always been expected to provide spiritual care to military members on deployment, as well as to military members and their families on base in Canada. Furthermore, since the pastoral role is understood to include the need to minister to the whole person, Canadian Forces chaplains routinely provide assistance to their parishioners in the form of counselling, advocacy or referrals.

At CFB Petawawa, chaplains informed the Ombudsman of a dramatic increase in the demand for their services as other caregiver options have become less accessible, as waiting lists get longer, and as other services are increasingly not provided to family members. Several chaplains also expressed their concern to the Ombudsman regarding the overall state of mental health well-being amongst Canadian Forces members and their families.

Individual Family Members

Civilian members of military families in Petawawa who require individual care or treatment from a mental health or social services professional are no different from residents of small towns across Ontario - they often have few, if any, options available to them. There simply are not enough doctors and other specialists to provide the care that is needed. Moreover, professionals capable of providing this type of service or care in French are even scarcer, which is an increasing problem as more Francophones are posted to Petawawa. Even when options are available, they are difficult to access for those individuals without personal transport, due to limited public transit options.

This long-standing problem was acknowledged by nearly every Canadian Forces member who had a family living in the Petawawa area. We were told of situations where people had finally found someone to provide appropriate care, only to be posted, or to find that the caregiver was leaving the area and that they would have to start the process over again. We were told of family members who could not drive whose medical appointments had to be cancelled because they could not afford the taxi fare and military member could not get the time off (or was on deployment) and so was not available to drive them. We heard stories about Francophone family members who could only attend medical appointments if their spouse or a bilingual friend or neighbour could go along to translate. And we heard stories about families who regularly assumed the expense of driving to Ottawa to get the necessary care for family members.

Although the mental health care challenges faced by military families in Petawawa are not uncommon in other small towns across Ontario and Canada, there is one important difference: the families living in Petawawa are there because they have a family member in the military who has been posted to CFB Petawawa to meet the operational requirements of the Canadian Forces.

Given this fact, and the fact that mental health injuries or illnesses amongst military family members are often the direct result of military operations or obligations, the Ombudsman’s office believes that the Department of National Defence and the Canadian Forces have a moral obligation to ensure that there is reasonable access to mental health care and social services for military families – even if a legal obligation does not exist. It also makes practical (and operational) sense to ensure that military family members have appropriate care and support. If a Canadian Forces member is confident that his or her family is receiving the assistance that they need, that member will be better able to focus on their military mission.

It is important to note that military families in the Petawawa area often require greater per capita access to certain types of services and care than the population as a whole. Members of military families are subject to stresses not experienced by most civilians: their loved ones spend significant periods of time away from the family, sometimes in very dangerous circumstances; and the family is located in a geographic area that is often far away from their own geographic (and even linguistic) roots.

This problem received significant prominence last year in March 2007 when the Ontario Ombudsman investigated the unacceptably long wait times for mental health services for the children of military members in Petawawa. Due to a lack of resources, children were having to wait up to six months for treatment. Ombudsman Ontario recommended that the Province of Ontario ensure that the Phoenix Centre be adequately funded, and that the Provincial Ministry of Health meet with the federal government to resolve the matter in the long term. As a result of the Ontario Ombudsman’s work, the Government of Ontario provided $2M contingency funding to provide children’s mental health support to communities – from which the Phoenix Centre received funding in order to improve the mental health services in the Petawawa area. At the same time, then Minister of National Defence, the Honourable Gordon O’Connor, committed $100,000 to the Petawawa Military Family Resource Centre to help fund a joint program with the Phoenix Centre. Although this was a very positive development, we were advised that wait times at the Phoenix Centre are again increasing. Moreover, this targeted funding did nothing to address the availability of mental health or other medical and social services that are needed by but not always readily available to military families in the Petawawa area.

In CANFORGEN 093/08 (issued in May 2008), the previous Chief of the Defence Staff committed to building “a stronger, more responsive capability to assist and support the men and women in uniform, veterans and their families as they deal with mental health issues.” However, as a result of the Ombudsman’s broader follow-up report on post-traumatic stress disorder and other operational stress injuries, it is clear that the quality and timeliness of mental health care available to military families and family members varies widely from military establishment to military establishment. Where bases are located in or by large urban centres (e.g., Edmonton and Valcartier), there is generally an appropriate level of care available to family members. On the other hand, when a Canadian Forces member is posted to one of the more isolated bases, his or her family often finds it extremely difficult to access the type of care and support they need in the surrounding community. This is certainly the case in Petawawa.

Previous | Table of Contents | Next