Innovative Delivery of the Road to Mental Readiness Program - Recommendations on how to complement current Road to Mental Readiness Program in operational contexts. (Task 52)

Principal Investigator

Funding Sponsor

Defence Research and Development Canada (DRDC)

Lay Summary

Within the last two decades, initiatives such as the Road to Mental Resilience (R2MR) Program have been implemented by the Canadian Armed Forces (CAF) with the intention to optimize the mental health and psychological resilience of military members. Currently, little is known about CAF members’ perceptions of, and satisfaction with, mental health and resilience training. Understanding how military members perceive mental health and resilience training, including subjective feedback for improvements, can further inform decision-making related to program development. Research conducted as part of Task 52 identifies CAF members’ perceived gaps in the existing training program and discusses recommendations to enhance the training experience.

Literature review on the impacts of COVID-19 on well-being, as well as an integrated knowledge translation and exchange (iKTE) process on implications for the Veteran population and Veterans Affairs Canada (VAC) programs and services. (Task 55)

Principal Investigator

Research colleagues

Funding Sponsor

Veterans Affairs Canada (VAC)

Lay Summary

The impacts of the COVID-19 pandemic are multifarious, and each community will face its own set of challenges during and after the pandemic. Challenges that existed before COVID-19 remain, and others have been exacerbated by the pandemic. Canada's Veterans and the organizations that serve them face extraordinary challenges because of the global pandemic. The goal of this scoping review was to examine and develop an understanding of the influence of the pandemic on the well-being of Canadian Veterans, and more specifically, to understand the emerging needs of the Canadian Veteran population as the pandemic continues to unfold and affect Veterans’ programs and services.

Mental health issues and economic impacts were two of the most consistent consequences of COVID-19 on Canadian Veterans. A population health approach was recommended to address COVID-19 impacts on the well-being of Canadian Veterans. Likewise, the specific impact of COVID-19 relative to age, gender, ethnic groups, and jurisdiction were measured. Female Veterans and Indigenous groups may potentially be experiencing greater health effects. Veterans Affairs Canada (VAC) has taken responsive measures to address the emerging needs of Canadian Veterans regarding financial support programs and service improvement.

This study looks at the implementation of home-based intensive exercise interventions, supervised remotely, to improve balance, mobility and physical activity for military who have suffered a moderate or severe traumatic brain injury.

Authors

Funding Sponsor

True Patriot Love Foundation

Lay Summary

We know that physical activity is good for our overall health and that being physically inactive has negative impacts, which can be worse for individuals who have suffered a traumatic brain injury (TBI). Walking every day helps with mood, cardiovascular fitness, balance, mobility, pain, and overall activity participation. Therapist supervision during exercise programs may increase motivation and support behavioural changes among patients. However, supervision is expensive and is often not accessible in rural communities.

Replacing in-person supervision with remote supervision may reduce costs and increase access to specialized exercise programs. We investigated whether supervision could be provided remotely, and if remote, were home-based exercise programs effective in improving physical activity, mobility, and balance.

We found that remote supervision was possible and effective for this population. Our data showed high adherence to the program, above-average usability of the technology, and positive impact on functional mobility and dynamic balance for dyads (Veterans and/civilians living with the TBI and their family partners). Dyads were satisfied with the program and reported enjoying being in the comfort of their homes.

Our project shows potential in improving accessibility to physical rehabilitation no matter where the Canadian military or Veterans are located.

Literature Review: “Experiences of Persons with Disabilities in the Military.” (Task 51)

Principal Investigator

Funding Sponsor

Director Research Personnel and Family Support (DRPFS)

Lay Summary

This review addresses the need to recognize and learn about the experiences of military members who have impairments and disabilities related to their work lives. It also addresses the need to identify ways to conduct research with military members with impairments and disabilities, a group that may feel marginalized.

We found 177 impairments that affected military members’ work lives. The most common were general mental health problems, military sexual trauma, post-traumatic stress disorder (PTSD), and depressive episodes. Often, military members described day-to-day issues they faced due to the unique nature of military culture, structure and routines. Some issues were due to personal factors, such as their own negative beliefs about having an impairment or disability, or when negative attitudes held by others became internalized, resulting in self-stigma.

Conversely, some of the issues were associated with the institutional environment, most often related to services, systems and policies in the military (for example, concerns about promotion and career progression, or concerns about confidentiality). Other issues were related to the social/cultural environment (such as negative attitudes held by other military members and lack of social support from unit members).

We found 67 accommodations and supports for members of the military and paramilitary who have impairments and disabilities; however, only seven were workplace accommodations. The impairment most addressed by workplace accommodations and supports was PTSD, but overall, workplace accommodations and supports are not well-supported in the research.

Methods of how to best carry out research when working with marginalized groups include qualitative case studies, interpretive phenomenological analysis, net-nography/Internet ethnography, narrative life story interviews, narrative storytelling, and auto-ethnography. More research is needed about the effectiveness of existing workplace accommodations for military and paramilitary members with impairments and disabilities. A clearer definition of workplace accommodation for military organizations and how to implement accommodations in the military culture are also needed.

Exploring the experience of parents of ill and injured Veterans

Principal Investigator

Funding Sponsor

True Patriot Love Foundation

Lay Summary

Programs for military families are often targeted towards the needs of families with young children, while those intended to benefit Veteran families are geared towards the aging Veteran. For those releasing from the Canadian Armed Forces (CAF) due to illness or injury, aging parents may need to step in to support their adult children. This qualitative study explored the experiences of parents of CAF Veterans living with illness or injury associated with military service. Fifteen parents and parents-in-law of Veterans were interviewed, all of whom had symptoms of post-traumatic stress disorder and/or moral injury linked directly to events and stressors during military deployments. Participants reported ongoing commitment to their adult children and their recovery, taking on additional roles and instrumental tasks. Parents’ efforts came at great personal, financial and occupational costs, yet they felt forgotten and marginalized despite their crucial roles in Veteran recovery. Having raised their children, and then continuing to be responsible for them in their recovery and transition, participants saw themselves as part of the military unit whose role and rights should be formally acknowledged. Based on the findings, programs and policies could be developed to create a family-centred circle of care, which would provide a clearer path to navigate the system, and would enable access to peer support, family psychoeducation, couples and/or family therapy, and a broader array of caregiver benefits.

The Experiences of Adult Children of Canadian Armed Forces Veterans Serving between the Korean War and the Gulf War

Principal Investigator

All Authors

Norris, Deborah, PhD; Cramm, Heidi, PhD; Cox, Marilyn, MFSGN; Mahar, Alyson, PhD

Funding Sponsor

True Patriot Love Foundation

Lay Summary

The demands of mobility, separation and risk enhance capabilities and foster resiliency for some military children. It is not known, however, if capabilities developed during military childhoods are sustained through adulthood; similarly, the adaptive responses facilitating resiliency are poorly understood. Retrospective accounts of the childhood experiences of an understudied cohort, the adult children of Canadian Armed Forces (CAF) Veterans who served from the Korean War through to the Gulf War, gleaned through this exploratory study, offer insight into how these experiences shaped adult lives.

Twenty-three adult children meeting the inclusion criteria were recruited for this study through key informants and social media. Participants described their adaptive responses to the demands of separation and relocation, disruptions in schooling, mental health issues, and abuse within the families of origin. Meaning-making was instrumental in adapting to the normative and non-normative demands of military life, enhancing empathy, social skills, and a commitment to public service in adulthood.

Family cohesion and communication were capabilities that enhanced resiliency in these families. The culture of community prominent within base housing of that era was identified as a significant resource, instilling a sense of identity and belonging that remains meaningful for participants to the present day. Implications for contemporary military family support policies and programs were shared by participants.

Literature Review on "Military to Civilian Transition: The Importance of GBA+ for the Canadian Armed Forces." (Task 50)

Principal Investigator

Funding Sponsor

Director General Military Personnel Research and Analysis (DGMPRA)

Lay Summary

When Canadian military members release from service, they do not all share the same experiences, nor do they face the same challenges. Therefore, it is important to shed light on how experiences and outcomes for Veterans differ based on sex, gender, and intersecting factors such as sexuality, race or Indigeneity.

Our team conducted a review of existing research for the Canadian Armed Forces Transition Group on the importance of gender-based analysis plus (GBA+) for military-to-civilian transition in Canada. There is a lack of Canadian research on the topic, but there are extensive international studies and government sources that provide insight into the potential challenges encountered by women, LGBTQ+, Black, People of Colour, and Indigenous members who are medically or voluntarily releasing or facing retirement. Potential challenges include increased vulnerabilities and risks across the various domains of well-being. These manifest in health outcomes, complex trauma histories, employment and housing insecurities, lack of tailored services, social disconnection, and more.

While the vulnerabilities and risks are experienced at the individual (and sometimes familial) level, they are often caused by systemic and structural issues, such as histories of discrimination and marginalization, sexual and gender-based violence, lack of adequate equipment and services, and more. These vulnerabilities and risks are further exacerbated by societal inequalities and civilian lack of knowledge about historically underrepresented Veterans.

We argue that developing policies, programs and supports that result in equitable transition outcomes for all Veterans requires being attentive to sex and gender, and intersecting factors such as sexuality, race, Indigeneity, and more. We recommend that transition programs and policies be tailored to the needs of specific Veteran subpopulations, such as women Veterans; that government and government-funded service providers be educated about the unique experiences and needs of non-traditional Veterans and trained in appropriate ways to support them; and for a commitment to further study the unique experiences and needs of historically underrepresented Veterans in Canada. These recommendations should be adopted in consultation with members of the various subpopulations they intend to serve.