Life-affirming support

iStock; Dan Black/Legion Magazine Archives

Friends and communities are helping prevent veterans’ suicides

When Joe Rustenburg came back from war, he wanted to shut out the world. He had seen buddies maimed and killed during tours with Princess Patricia’s Canadian Light Infantry in Afghanistan in 2006 and 2008. And he’d been wounded in the head by shrapnel from a rocket-propelled grenade explosion. 

He left the military in 2011 with post-traumatic stress disorder and a traumatic brain injury, moved to a small community in Saskatchewan, and hunkered down.

“I wanted to get as far away from the military and other people as I could get,” he said.

Each year up to 10,000 members leave the Canadian Armed Forces, some with suicide on their minds, including Rustenburg, who attempted it twice—in 2009 and 2010.

The CAF’s Life After Service Study asks those leaving about past-year suicidal thinking, recording an increase from 5.8 per cent in 1998-2009 to 10.9 per cent in 2015. More than a third of these veterans said they had not sought help for suicidal thoughts while serving.

Despite this, overall suicide rates of serving personnel were comparable to those of civilians. But it’s a different story with veterans who have already left the military.

In 2010, cross-referencing of 37 years of Department of National Defence and Statistics Canada records revealed the overall risk of suicide for veterans is 1.46 times higher for men (1.8 times for women) than for civilians. But even this may be conservative.

In the United States, male veterans of Iraq or Afghanistan had 76 per cent higher rates of vehicle deaths than civilians—many of these deaths are suspected to be suicides disguised as accidents—according to an unpublished study by the Department of Veterans Affairs cited by The Washington Post.

VAC and the CAF both have robust programs and experienced professionals to respond to, and treat, members and veterans in mental health crises. Most veterans, however, leave the service and simply merge into the communities to which they retire or begin second careers—and vanish from CAF and VAC radar. Only about 18 per cent of Canada’s 658,000 military veterans and just over 13,000 serving RCMP and veterans are VAC clients.

A veteran has to raise a hand and ask for help. Problem is, suicidal veterans are unlikely to ask for help. Help has to come to them. But government programs first have to know the veteran needs help. Catch-22.

What causes veterans to take their own lives is not fully understood. “Suicide is complex,” said the CAF/VAC Joint Suicide Prevention Strategy. “There is no typical case, and there is not a single solution.”

The causes are “multifactorial, complex, varying individually and due to interacting factors,” wrote researchers associated with the Canadian Institute for Military, Veteran and Health Research in a report published in the Journal of Military, Veteran and Family Health in 2019.

“Suicide prevention is everyone’s responsibility,” said the article, “but many wonder ‘What can I do?’”

Plenty, it turns out.

“I wanted to get as far away from the military and other people as I could get.”

“We can’t leave suicide prevention up to one government agency or the health care providers—we all have to pitch in and contribute to it and find a way,” said lead author James Thompson, a medical doctor who retired from VAC’s research directorate a year ago and who has been researching suicide for 38 years.

“Obviously, professional health care plays a key role when somebody’s struggling with suicidal thinking or had attempted suicide,” he said. But friends and community are important; they can point veterans to help. “Veterans in crisis may be unaware of resources available in their own community or from Veterans Affairs Canada,” said Thompson.

Such help may relieve stress and avert a crisis.

“It’s not just intervening at the moment people are thinking about suicide, it’s recognizing they’re beginning to spiral down, and intervening so they never get to that point,” said veteran Woodrow French of Conception Bay South, N.L., who had a 30-year career in the safety industry after leaving the military.

“In safety, we talk of a set of five dominoes that fall leading up to an accident. If you take the one in the middle out, the first two things can happen, but you prevent the following two steps.” It’s the same with deteriorating mental health, he said.

When life’s negatives outweigh the positives—when stresses exceed the ability to cope—is different for each person, according to their life experiences, psychological makeup and social support. That’s why it’s so difficult to predict who is suicidal.

Life stressors can include health problems, chronic pain or permanent disability, loss of a job or home or meaningful activity, low income, being divorced or widowed or separated, loss of a loved one, financial or legal trouble, loss of social support, a change in cultural or social environment, lack of ability to solve problems and make decisions. Family history of suicide or a spate of military suicides also ramps up vulnerability.

“Compared to the Canadian population,” David Pedlar, then director of research at VAC, reported to the House of Commons Standing Committee on Veterans Affairs in 2016, “the prevalence of common mental health conditions…was generally about two to three times higher among the population of CAF personnel released since 1998.”

Up to 10 per cent of regular force veterans divorce within three years of leaving the military. Many veterans’ incomes go down after leaving the military and it can take years to recoup.

The CAF reports 83 per cent of regular force members who died by suicide in 2018 had one stressor and two-thirds had at least three. Stressor can pile on stressor until a vulnerable veteran snaps.

Rustenburg was determined to bear those stressors alone, curled up in his shell. But his community began to draw him out in 2012.

He was invited to join Canadian and international veterans attending the first Wounded Warriors Weekend (WWW) in Nipawin, Sask. He attended reluctantly, supported by his wife Melanie and friends who drove to the event from Edmonton.

WWW founder Blake Emmons, a musician and entertainer, was spurred to action after watching the Remembrance Day services in 2011. “We do such a tremendous job in that ceremony, but I remember thinking, ‘What about the warriors who come home bent and broken?’”

His idea was to invite 10 or 12 veterans for a fishing weekend at his place in White Fox, 14 kilometres from Nipawin. He met with the mayor and president of the Nipawin Branch of The Royal Canadian Legion to see what else might be done to entertain them.

Things snowballed from there. Donations and volunteers poured in. Eventually, he estimates, 400 to 500 people volunteered to help with the free weekend for some 80 veterans.

The lieutenant-governor gave her blessing to a gala fundraiser. Airlines, hotels and motels provided special rates, a bus and volunteer drivers were donated. Food was donated for events and volunteers cooked, served and cleaned up. When it was decided to serve burgers at one event, local buffalo farmers donated hundreds of pounds of meat. A mobile health unit was set up, staffed by medical volunteers and mental health professionals from surrounding communities.

Local folks chipped in where they could: driving veterans around, decorating venues, putting up chairs, volunteering their boats to take veterans out fishing.

An honour guard greeted veterans at the airport in Saskatoon, and a volunteer went door-to-door, enlisting farmers and business owners to stand and wave as the buses went by on the highway north from Saskatoon. People lined the streets in the towns.

“It felt like people actually cared,” said Rustenburg. “This was small town Saskatchewan. Everybody was out with flags and stuff and waving.”

The weekend was supposed to be a one-off, but the lieutenant-governor requested a replay in 2013, this time involving communities north of Regina. Again, hundreds of people volunteered and donated and lined streets and the highway to greet 180 veterans, including Rustenburg, who this time was looking forward to the event. While he was there, he was presented a PTSD service dog named Vixen.

“That really started the process of healing,” he said. He got serious about getting better and moved near Saskatoon to facilitate psychotherapy. Eventually, his horizon widened. He tried equine therapy, took a Discovering the Power in Me workshop. “WWW slowly connected me to other people going through similar things. We made groups from people who went to the weekend” and met others on social media.

“I slowly got to know people from all over who came to help out. I started doing jiu-jitsu as exercise…and you make friends through that, too. Friends who are not in the military.”

Now in Ottawa while Melanie completes university prior to CAF trade and officer training, Rustenburg is in a lot healthier frame of mind. “It feels like I’m in a really good place right now.”

“Suicide is a well-being problem as much as it is a mental health problem,” said Thompson. “I’m talking about all aspects of life…how a person’s doing in terms of their employment, finances, physical health, social relationships, housing, life skills and access to services in their community.

“People can look at those seven domains and ask: ‘How can I help somebody well before they get suicidal?’”

“One person’s injury radiates through the community, and there’s a lot we can do in the community to help…and as a result of that, to prevent suicides,” said French, who is a service officer with the Kelligrews Branch of the Legion. He organized a Mental Health First Aid for the Veteran Community training course.

“We had 20 people in our first course, and that was 20 people who went out into our community with a better understanding of what veterans are coping with.” Attending were veterans, their families, friends and caregivers, and others in the community who might deal with veterans, such as physiotherapists, long-term care workers and community volunteers.

The course, developed by the Mental Health Commission of Canada, is tailor-made to address issues faced by veterans. Funded by VAC, it is offered at no cost to the veteran community.

Any community organization can host the course—presenters are either former military members or professionals who serve the military or veterans community. French’s course was so successful that he organized a second one and there is a waiting list for a third.

“There’s still stigma around suicide,” said Thompson. “The more people know about it, the better able they are to help others deal with it.”

Communities can help in other ways, beginning by simply making veterans welcome. It’s important, he said, to incorporate veterans into the fabric of community life, to provide ongoing opportunities for veterans to mix with other veterans, and separate opportunities for veterans to mix with others in the community. Kelligrews Branch, for instance, holds a regular veterans’ coffee hour.

Military personnel pose with members of the Ottawa Senators during Canadian Armed Forces Appreciation Night after a game against the New Jersey Devils in November 2018.
Andre Ringuette/NHL/Getty Images

Many people think they have to be a mental health expert, have deep pockets or a military background to join the battle to prevent suicide by veterans. But anyone—a single person, small community groups, employers, sports groups, national organizations that have nothing to do with the military—can contribute. It doesn’t have to be a big event, cost a lot of money or require a lot of organization.

It could be as simple as one person asking a veteran to regularly share a cup of coffee, or as complex as the University of British Columbia’s project to become Canada’s first veteran-friendly campus, complete with services and support specially designed for veterans as well as a Legion branch.

Transition from military to civilian life is difficult, said Thompson. “It’s important for the civilian community to recognize they’re in transition…and reach out to them rather than just passively let them exist in among us. It’s hard for them to move from their military culture…and develop civilian identities.”

“So many RCMP and military think the only people who understand us are each other,” said Chris Raabis of Nelson, B.C. “We don’t think anyone will give a shit about us, which is completely not true.”

Raabis never considered himself suicidal, right up to the moment he tried to end his life. Many CAF veterans leave the military to become first responders—police officers, firefighters, paramedics. Raabis chose the RCMP after his military service, which was three years in the primary reserve in the 1990s. RCMP officers are exposed to lots of violence.

“I was no stranger to death,” said Raabis. “I’d been posted in some incredibly violent places.”

He thought he was handling it well, although there were warning signs, if only he or someone around him could have read them at the time. He didn’t recognize the danger signals when he came across a long-forgotten bottle of scotch.

“I don’t drink but I remember thinking to myself, ‘I should just take a drink,’ and later, ‘Let’s go get my pistol.’” He didn’t act on the impulse—that time.

Over time “my marriage was becoming more and more strained. My emotional state was becoming more and more strained. I was having a hell of a time getting motivated to do police work.”

In August, Raabis was called to the scene of two suicides in different communities near Nelson on the same day. The second was a 16-year-old boy. “It was the thing that pushed me over the edge.”

The next day, while riding his mountain bike down a treacherous trail, he thought of a friend who was a downhill cycle enthusiast. “I remember thinking to myself: ‘Bob must have a death wish,’ and I kind of remember having crazy laughter going through my head.” Then he deliberately crashed his bike into a boulder.

He woke up at the side of the trail with a concussion and a broken leg. He was subsequently diagnosed with traumatic brain injury and PTSD, then started psychotherapy.

His new community may not have known him well enough to recognize he was headed for trouble, but they rallied around to help him as he recovered. “What I’m grateful for is that I…came to a community open to offering support. They offered me unconditional friendship and genuinely wanted to be friends.”

He was invited to go mountain biking with people, to go hiking, fly-fishing. “That was it. Getting invited to potlucks and parties and watching games, that was the salvation.”

Raabis advises people not to tiptoe around the subject. “Suicide is one of those things we can’t be polite Canadians about. People won’t ask the question because they don’t want to intrude. Go ahead and rock the boat. Ask how they’re doing, even ask if they’re thinking about suicide. There’s nothing to be embarrassed about; it’s one human being extending love and compassion to another. Check in. It’s critical.”

“Friends and community are important; they can point veterans to help.”

The combination of mental and physical training, general fitness, medical care, comradeship, sense of purpose and leadership are the bricks that build well-being while CAF members are serving. It is known as the healthy soldier effect, a combination of factors with protective benefits for mental and physical health. But that doesn’t necessarily continue when the military career ends.

Society at large cannot replicate the military cultural environment, but piece by piece, as individuals, groups and communities, it can provide new building blocks for well-being.

One person, one event, one group can make a huge difference through what Emmons calls a ripple effect. Growing out of the five WWWs held in Nipawin and one in Slave Lake, Alta., “one guy set up an annual fishing camp and a group got together to form a veterans’ hunt in southern Alberta. I’m seeing this happening in this little community and that little community. The fish and game people, corporate communities, service clubs…they’re stepping up and asking ‘how can we help?’”

Irene and Gerry Purcell of Tobin Lake Trophy Adventures stepped up in 2018 to provide a permanent home for WWW, which can now offer weeklong retreats to smaller groups, more often. When WWW veterans are in residence, the lodge is called Camp Independence.

Here and there in pockets across the country, individuals and communities are contributing to veterans’ well-being.

When regular veterans’ coffee groups were halted by social-distancing requirements, many communities went online, including the Legion’s OSI Special Section Buddy Check Coffee program. As restrictions are lifted, veterans will again congregate at Legion branches and cafes across Canada for chats over coffee. “It encourages veterans in our community to meet people,” said French.

Heroes Mending on the Fly Canada offers fly-fishing outings and lessons in various provinces, with funding from local businesses and Legion branches. It’s not akin to therapy.

 

“They enjoy it because it’s something different for them to do. They come in, they sit down. If they want to talk, they talk. If they don’t want to, they don’t. We don’t force them to be part of the group,” Gervais Jeffrey, the group’s national director writes on the website. “We’re not specialists in mental health. We’re just a bunch of guys who love fly tying and want to help others enjoy it, too.”

But it has been beneficial. “I’ve seen people completely closed in on themselves…coming out and start talking in a positive way…. One guy said the program saved his life.”

Many provinces offer veterans free hunting licences. The Veteran Hunters, a group of CAF veterans, provides training on bow or rifle hunting and expeditions to hunt waterfowl or big game in Canada and, through a veteran-operated group in Africa, even safaris.

Outward Bound Canada has a veterans’ program that organizes free weeklong wilderness expeditions, supported by donations. Music Healing Veterans Canada, with several chapters in Ontario, provides free group music lessons, loaner equipment and companionship to veterans and first responders. VETS Canada’s Guitars for Vets program matches PTSD veterans with used instruments and online lessons, where available.

Across Canada, golf courses frequently allow veterans free play. The Professional Golf Association in the U.S. provides free lessons taught by specially trained golf pros at dozens of courses. The goal, says its website, is to improve health through physical fitness and change statistics on veterans’ suicides.

Nick Noval, one of its instructors, described his experience in Golf Digest’s digital edition. Veterans started the lessons looking blue and dishevelled. A few had not been out of the house in weeks.

“After coming back for three or four more clinics,” said Noval, “they started to look and act differently. They showed up in new golf clothes, they began to talk trash, they high-fived each other. Some opened up about their PTSD and told me that golf had become like therapy…. All I was doing was sharing my passion for the game, and I was helping to change their lives.”

Put veterans with money or housing troubles in touch with organizations offering help. Invite veterans to join curling clubs, a pickup baseball game, a hockey team. Set aside special evenings for veterans at pool halls and bowling lanes. Sponsor educational workshops for veterans. Support art, music, yoga and golf teachers to give veterans free lessons. Hold veteran-appreciation nights at sports events.

Each of these efforts alone may not at first appear to have life-changing significance. But each is life-affirming, and that’s what suicide prevention is all about.


Be concerned when someone…

Talks about wanting to die, feeling hopeless, trapped or unbearable pain

Believes they are a burden to others

Researches suicide or buys or collects the means to do it

Acts unusually anxious, or behaves recklessly or isolates themselves

Shows rage or talks about revenge

Displays extreme mood swings, uses more alcohol or drugs, sleeps too little or too much

What to Do

Ask if the person is thinking about suicide. If so:

Stay with them until a medical or mental health professional takes over

Remove anything that could be used in a suicide attempt, such as weapons, rope, medications, car keys, etc.

If urgent, call 911 or take them to an emergency room


Peer support

Two soldiers who had served in Afghanistan were presented Meritorious Service medals in 2016—but it wasn’t for their contribution in armed combat. Spurred by four suicides in 2013, Master Corporal Jordan Irvine and Sergeant Brian Harding spearheaded Send Up The Count, a social media campaign instrumental in supporting veterans and military members having a tough time psychologically, even guiding some of them off the path to suicide. 

Irvine suggested starting the social media campaign, which is named for the command used by patrol leaders to keep track of their soldiers.

He wrote a post urging others “to check on people you were on tour with, or you sailed with, or sat with in the airport…to see how they’re doing,” said Harding, now serving in the RCMP. “It went viral. In the span of a week, week and a half, it exploded to 9,000 members.” It has since grown to more than 11,000.

Word spread. Veterans in trouble began reaching out to buddies and “in the first two weeks something happened that we hadn’t anticipated—we had our first suicide intervention.”

When contacted by someone in crisis, the network fans out through social media to identify the veteran and get emergency aid wherever he or she might be. But the real strength of the service is in preventing the situation from getting to that point.

“We’re a group you can get at 4 a.m. on the cellphone in your basement,” said Harding. “Or if somebody has had a shitty day and went for a drive and is sitting in their car in a laneway in the woods crying, they can get on their phone and put out a flare for action for help and they’ll find someone willing to talk.

“Someone who needs a supporting hand on the shoulder and some good buddies to talk to right now…that might interrupt the spiral they’re in and stop them getting to the point of making dangerous decisions.”

With pandemic social distancing, more are being left alone with dark thoughts, and demand has increased.

“We’re supporting people who are having a really tough time with this,” said Harding.


Navigating the system

“We cannot express an interest in veterans’ care without being prepared to shoulder some of the responsibility,” said a report by the PPCLI Association, which serves the Princess Patricia’s Canadian Light Infantry community.

A suicide by one of its own in 2016 spurred the association to research the topic and participate in suicide prevention workshops hosted by the Canadian Institute for Military and Veteran Health Research. By the end of 2019, the association had hosted 217 people in workshops of its own across the country.

The association has also taken careful steps to incorporate suicide prevention into its volunteer program, advocate improvements to suicide prevention and treatment services, and help develop a national database of peer support organizations being developed by the Centre of Excellence on Post Traumatic Stress Disorder and Related Mental Health Conditions.

Peer support across the country has never been documented, said Fardous Hosseiny, the centre’s vice president of research and policy. “There’s never been an analysis of best practices to inform development of guidelines and standards.”

The project will produce a list of peer support available area by area across the country, broken down by intensity of support offered.

“It will help veterans and their families navigate the system,” said Hosseiny, and it will help peer-support workers and organizations find the right level of support according to veterans’ individual needs.


Help is available

Call 9-1-1 for immediate help.

Canadian Forces Member Assistance Program

(800) 268-7708; TDD (800) 567-5803

www.forces.gc.ca/en/caf-community-support-services-map/member-assistance-program.page

Mental Health Commission of Canada

Mental Health First Aid Course for the veteran community. (866) 989-3985 www.mhfa.ca

Operational Stress Injury Social Support (OSISS)

Peer and family support for CAF members with operational stress injuries. (800) 883-6094

www.cfmws.com/en/aboutus/DCSM/OSISS/contact

RCMP Support for Operational Stress Injury Program (SOSI)

For retired and serving RCMP regular, civilian and auxiliary members and public service employees.

RCMP.SOSI-SBSO.GRC@rcmp-grc.gc.ca

www.rcmp-grc.gc.ca/fam/sosi-sbso-eng.htm

The Royal Canadian Legion

Free help for CAF and RCMP veterans and serving members and their families to locate resources and support. Benevolent assistance available. (877) 534-4666

www.legion.ca/support-for-veterans/contact-a-service-officer

Send Up The Count

A network of serving members and veterans across the country willing to listen, talk or help in a crisis.

www.facebook.com/groups/sendupthecount

VAC/DND Assistance Service

Round-the-clock help for CAF and RCMP veterans and their families or caregivers.

(800) 268-7708; TDD (800) 567-5803

www.veterans.gc.ca/eng/contact/talk-to-a-professional

Veterans Transition Network

Mental health services for veterans. (844) 236-8387

https://vtncanada.org

VETS Canada

Aid and comfort for military veterans. (888) 228-3871

www.vetscanada.org

Wounded Warriors Canada

Therapy and support for military, first responders and their families. (888) 706-4808

info@woundedwarriors.ca

https://woundedwarriors.ca

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