Suicide rates among Canadian soldiers are far higher than those in Britain, according to newly released statistics by the U.K. Ministry of Defence.
In 2013, five suicides were reported in the British regular forces compared with 13 for their Canadian counterparts, in a force one third the size. There have also been five others in Canada so far this year.
One possible explanation for the discrepancy is that "at this point in time, the Brits are providing better service" for their veterans, says Michael Blais, co-founder of Canadian Veterans Advocacy, a non-profit group focused on improving the lives of veterans.
Another may be the way the two countries deployed their troops in Afghanistan.
British troops may be more resilient to the aftereffects of combat because they had shorter deployments than those in the Canadian regular forces, said Nicole Meszaros, a senior public affairs officer for the Canadian Forces.
Longer deployments increasing risk
According to a study by King’s Centre for Military Health Research at King’s College, London, prolonged combat missions in Afghanistan are behind the most significant mental health burdens facing British soldiers, but these problems can vary in important ways.
Neil Greenberg, an academic psychiatrist at King's College and the senior author on the study, said regular and elite forces suffer higher rates of alcohol and post-deployment aggression than they do post-traumatic stress disorder, which has a correlation to suicide.
"We found high rates of PTSD and risk of suicide in those who are on deployments longer than six months. We also found reservist combat troops are also at higher risk," he said.
Britain's defence ministry reports that military suicide rates have been declining since the 1990s, at least partly it seems because of government efforts.
In recent years, for example, the British military introduced the Enhanced Mental Health Assessment (EMHA) program to help ensure mental health issues are identified at an early stage in a soldier's career.
"This program has helped ensure that primary care and mental health practitioners across the country are now able to facilitate early diagnosis of mental health issues and ensure all personnel at risk are provided with the most appropriate treatment," says Lizzy Jackson, a defence ministry spokesperson.
“Canadians don’t have a peer support program like EMHA, they have the Operational Stress Injury Social Support program, but that only helps to get troops back into their units as quickly as possible,” said Greenberg, who has also looked at Canadian Forces data.
The Canadian government reports that it has invested $11.4 million into the mental health system for the entire armed forces. But at the Canadian Veterans Advocacy group, Blais says that is not enough.
"The outreach in Canada is beginning, but we have men and women who can't get in to see a psychiatrist for five months. This could end in catastrophe if we don't provide the treatment in an expedient and effective manner," he says.
Part of the problem in Canada may be a kind of stigma that soldiers face.
Canadian veteran Chris Dupee served in Afghanistan in 2008 and 2009 before joining the Joint Personnel Support Unit, the Canadian Forces' mental health unit. He said he saw a trend among his fellow soldiers who were afraid to come forward to the military with their mental health issues because of the strong stigma attached to it.
"I denied that I had PTSD. I didn’t get help. The warrior culture in the military is you are supposed to be tough, to soldier on.
"And it wasn’t until about a year after deployment in Afghanistan that I put myself through the system to get help," he said.
Dupee said Canada does have a lot of resources and programs for treatment, but most soldiers don’t feel they can come forward or even realize they may have a problem.
"Anytime a soldier commits suicide in Canada it always hits close to home, and I wanted to make an example of myself by breaking the silence. So I started Military Minds as a way to connect soldiers together and to the resources available to them," Dupee says.
Military Minds was originally created to offer employment for soldiers who were ending their term of service, but is now one of the largest organizations in the world raising awareness of the stigma around PTSD.
“I look at the British as more sophisticated in the way they handle mental health issues. In Canada there is no organization that wholeheartedly just wants to help the troops," Dupee says. "There's money and power and political manoeuvres; in the meantime they are forgetting about the soldiers. It's a miracle Military Minds is still standing."
Going through the system
British veterans Cpl. David Soppitt and Sgt. Mark James Turnbull both served in Afghanistan. Both were medically discharged, and both are suffering from extreme PTSD resulting from combat in Afghanistan.
"It's like being in a black room with a demon that you are fighting constantly, but since I began seeing my psychologist a few months ago I feel like I will be able to live a normal life," Cpl. Soppitt said.
Sgt.Turnbull has attempted suicide several times, and now takes a cocktail of anti-psychotic medication. It helps him get through the day and raise his five-year-old daughter. He is an extreme case and has to fight everyday to want to live.
Although the system in the U.K. is well funded, it’s only when you are out of the military that you get access to an abundance of resources, says Soppitt.
Dupee, from Military Minds, is also on medication and said that in Canada this is often the first line of treatment.
Jennifer Wild, a clinical psychologist at Oxford University, treats British soldiers who are suffering from PTSD says that is the wrong approach. "Medication is not recommended — there is no good medication for PTSD. A pill does nothing for their PTSD symptoms [so] there are few instances where I would go to medication first."
In her practice Wild uses cognitive behavioural therapy, which is proven to work on PTSD. Most of the treatment happens outside of the office, where she is able to find reminders and triggers for patients in order to help them work through the traumatic memory itself.
"Solders may feel ashamed or excessively guilty about an action they took or didn’t take, and may be judging themselves on superhuman standards," Wild said.
The soldiers she has treated have certainly felt stigmatized by the military, she says. But treatment has helped them become better equipped to deal with their mental health issues.
"As a veteran you have all the help you could ever need, but while you are in the military you're meant to be tough and to soldier on," Soppitt said.
When you come out and say you have mental health issues, you know your military days are over, both he and Dupee say.
Dupee said when a soldier is medically discharged in Canada they are given a lump sum payment, a payment that’s woefully inadequate.
He said, often it’s $100 000 for these young guys who are mentally unstable.
"That's going up their nose, down their throat, into a vehicle, that money's gone in a year. Now he's screwed, he's not capable of work because his mental health won't allow it.
"If someone were to trip and fall in Wal-Mart, they'd get paid a hell of a lot more than a soldier who’s given his mental health or a limb for his country. It's messed up," Dupee said.
Dupee and his colleagues have identified three major problems in the Canadian system: employment services for soldiers just coming out of the army; the division between the government and charitable organizations in regards to power and money, and the lump sum payment.
It's all about the message
Both Canadian and British soldiers returning from Afghanistan go through a mandatory decompression stage in Cyprus. Here they talk about mental health issues before returning home. Both Dupee and Soppitt, while from different countries and different missions, said that in their experience this decompression does nothing.
"You just want to get home, nobody cares to listen to what they have to say, it’s just about getting through the checklist of items to make sure they have done their due diligence," Dupee said.
Peer-to-peer support is the key to solving these problems in Canada, he suggests. It’s not about the message, it’s about who the message is coming from.
"There is something to be said about a friend who has been through the same experiences as you, bouncing your thoughts and emotions off that person rather than a psychiatrist," Dupee says.
Even though the Canadian mission in Afghanistan has ended, the war on mental health continues for thousands of soldiers. The British forces’ mission in Afghanistan is expected to end in December.
"It remains to be seen what the longer-term psychological impact of serving in Afghanistan will be, and what social and health-care services might be required for this small, but important group of veterans who are at the highest risk of mental health problems," Greenberg said.
Statistics Canada is scheduled to release the most comprehensive study on mental health ever conducted on the Canadian Forces in November.
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