Operational Stress Injuries and the Canadian Military

Prepared by: Dr. Meghan Fitzpatrick

HISTORICAL OVERVIEW

The physical consequences of war are visible all around us, from the soldiers who never come home to the ill and injured who live with the scars of conflict. War’s impact on mental health is also deep and lasting, even though it is often harder to see. Militaries and governments alike, including Canada’s own, have struggled to understand, properly treat, and compensate those psychologically affected by their time in uniform.

Early Misconceptions and Limited Support

Over the past century, the psychological impact of war has been described in various ways — beginning with 'shell shock' during the First World War, followed by terms like 'battle fatigue,' and eventually recognized more formally as 'post-traumatic stress disorder' (PTSD). Today, the term operational stress injury (OSI) is often used to describe different mental health conditions that may develop in response to someone’s experience of prolonged stress, combat or loss.

Throughout the first half of the 20th century, treatment options for those suffering from psychological injuries were limited. Moreover, the compensation systems in place for veterans living with disabilities were not intended to support those with mental health conditions.

During the First and Second World Wars, Canadian and other Commonwealth governments calculated disability pensions for veterans based on several factors, including how an injury would affect the person’s strength, mobility and capacity to rejoin the workforce. Unfortunately, it was more difficult to establish the impact of psychological conditions, like depression and anxiety, and the consequences of these conditions on someone’s professional and personal life. At the time, government officials and doctors also widely believed that people with mental health injuries were predisposed to break down because of a personal or family history of mental illness. This meant it could be difficult for veterans to prove their disability was directly related to war service. Longstanding stigma around mental illness also meant that many never sought help or compensation at all.

Expanding Mental Health Care

Since then, there have been big improvements in how we understand and treat these types of conditions. There is also greater social acceptance towards seeking help, including within the military community. The work of veterans globally, in the wake of conflicts like the Vietnam War (1955-1975), spread vital awareness of war-related trauma.

In Canada, people like Lieutenant General (Retired) Romeo Dallaire, who struggled with his own mental health after serving in places like Rwanda (1993-1994), helped to raise awareness about the need for better care for military members impacted by operational stress. Over the past few decades, the Canadian government has invested more heavily than before in the development of mental health resources for veterans. This includes a network of OSI clinics and support centres.

Ongoing Challenges and Resilience

Though these are important changes, compensation remains a problem for many veterans. Some believe that the current pension system still does not treat psychological injuries as seriously as physical ones. Many veterans also continue to find it hard to get the full support they need in the immediate transition from military to civilian life.

There remains a lot we need to learn about how war and military service affect mental health in the long term. Moreover, it is important to recognize that some people experience positive personal changes, even after going through such difficult experiences. Those who live with the invisible wounds of war continue to be important, contributing members of society. They may need support—but have unique strength, insights and experiences that benefit their fellow Canadians.

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