Fifth anniversary report
October 2022 is a milestone date for the Canadian Armed Forces (CAF) and Veterans Affairs Canada (VAC) Joint Suicide Prevention Strategy (JSPS), as it marks its fifth year of implementation.
The development of a joint suicide prevention strategy stems from a priority in the 2015 Mandate Letters to the Minister of National Defence and the Minister of Veterans Affairs and Associate Minister of National Defence.
This report summarizes VAC’s actions, undertaken since the inception of its action plan five years ago, to help prevent suicide and to enhance the well-being of CAF Veterans and their family members, and also presents the highlights of the past year.
We have taken an evidence-informed and holistic approach to mitigate the mental health effects of service on Veterans by organizing our Action Plan along seven Lines of Effort (see Table 1) which encompass the seven Domains of Well-Being. Five years later, VAC’s JSPS Action Plan has progressed tremendously; the 63 action items are either completed or ongoing, which means they are the object of a continuous effort between CAF and VAC.
This report will be shared with the members of the Joint CAF/VAC Suicide Prevention Strategy Working Group to determine the path forward in suicide prevention for Veterans.
| Line of effort | Domain of well-being |
|---|---|
| 1 Communicating, engaging and educating | Life skills |
| 2 Building and supporting resilient Veterans and CAF members | Life skills |
| 3 Connecting and strengthening Veterans and CAF members through families and communities | Social integration |
| 4 Providing timely access to effective health care and support | Health |
| 5 Promoting the well-being of CAF members through their transition to life post-service | Purpose |
| 6 Aligning protocols, policies and processes to better manage risk and stress | Finances; Housing and physical environment |
| 7 Continuously improve through research, analysis and incorporation of lessons learned and best practices | Cultural and social environment |
Highlights of accomplishments for 2022
Over the past year, VAC has continued to achieve tangible accomplishments that will lead to faster decisions for Veterans who are waiting for benefits and services. We have also increased our oversight of vulnerable Veterans and are continuing to work with CAF to improve the transition process. These improvements to services, amongst others, continue to contribute to supporting the mental health of Veterans and their families – and toward the goal of suicide prevention for CAF Veterans. Below you will find highlights of fiscal years four and five of the VAC Suicide Prevention Strategy Action Plan.
Mental health: preventative measures
- VAC’s Postvention protocol includes outreach and resources in support of families of Veterans who have died by suicide. In August 2022, it was integrated into the Notification Process for Veteran Suicide or Homicide.
- Since the onset of the COVID-19 pandemic, Veterans have been able to access VAC-funded MH services virtually (e.g., OSI Clinics, VAC Assistance Service, and Mental Health First Aid for the Veteran Community). Certain programs are now using a hybrid model of in-person and virtual offerings of their services.
- From April 2021 to December 2022, the Mental Health First Aid for the Veteran Community (MHFA) program offered 38 virtual courses to a total of 451 participants. Over the duration of the JSPS, 177 MHFA courses were delivered in person with more than 3,500 participants by 31 December 2022.
Communicating, engaging, and educating
- VAC has provided awareness sessions to the Department of National Defence’s Sexual Misconduct Support and Resource Centre (SMSRC) on VAC benefits and services.
- A webpage of resources for those affected by military sexual misconduct has been created on the VAC website and is regularly updated with new supports as they become available.
Promoting well-being through transition
- VAC continues to provide peer support during the transition to post-military life by continuing to conduct support and outreach activities through our Operational Stress Injury Social Support (OSISS) program for a range of Veteran populations.
- My Skills and Education Translator was implemented to assist CAF members and Veterans in career transition, by providing them with a centralized resource that can be used to identify post-secondary institutions that recognize prior learning in the form of civilian equivalency.
Providing timely access to effective case management, mental health care and support
- VAC’s network of Operational Stress Injury (OSI) Clinics has expanded to include 10 outpatient specialized mental health clinics and 11 satellite service sites across Canada. The most recent satellite service sites opened were in Red Deer, AB, and Corner Brook, NL in 2022. Multiple sites within the network have expanded: Victoria, Vancouver, Calgary, London, the Greater Toronto area, Quebec City, and the Fredericton OSI Clinic.
- Funding was announced on 23 February 2022 of $139.6 million over two years to extend temporary positions as part of an action to reduce processing times for disability benefit applications at Veterans Affairs Canada.
- A new Case Management Assessment Tool (CMAT) was launched in April 2021 which assesses a Veteran’s risk of suicide to intervene as early as possible if the person is at elevated risk.
- VAC established intake interdisciplinary team meetings for Veterans with complex mental and physical health issues (i.e. a complexity level 3). These comprehensive intake teams of health professionals facilitate early intervention, in providing the supports and services needed at the outset to prevent further exacerbation of a Veteran’s physical or mental health.
- Since 1 April 2022, Veterans applying for a disability benefit for certain mental health conditions receive immediate mental health coverage.
Summary of five-year accomplishments
VAC’s Suicide Prevention Strategy Action Plan includes 63 action items. Fifty-two percent of those have been completed, while the remaining 48% are ongoing actions with continuous effort and monitoring.
Line of effort 1: communicating, engaging and educating
- Media Coverage of Veterans: The Atlas Institute, funded by Veterans Affairs Canada, completed a study to assess the content and tone of Canadian media coverage of veterans specifically as it pertained to post-traumatic stress disorder and suicide. The study aimed to investigate the themes, patterns, and content of Canadian media related to post-traumatic stress disorder and assess compliance with Mindset guidelines when reporting on suicide. The findings of this study suggest that targeted educational outreach is needed so that journalists can responsibly report on Veteran related mental health issues.
- VAC has created a comprehensive communications plan to raise awareness of VAC programs and services among Veterans. The goal is for Veterans to access programs and services earlier in support of their mental health.
Line of effort 2: building and supporting resilient CAF members and Veterans
Veterans in crises are adequately supported so they can maintain and reinforce their resilience.
- Since 2018, the Network of Operational Stress Injury Clinics (OSIC) has been expanding its services or facilities to care for more clients. As of December 2022, there were 10 OSI Clinics and 11 OSI Satellite Service Sites.
- The Veterans Emergency Fund provides Veterans and their families with quick access to financial help in unique or urgent situations to help them meet their immediate needs.
- A training module to guide frontline staff in working with Veterans involved in the criminal justice system was developed in April 2021.
- The Veterans Homelessness Program announced in 2022 will support rent supplements and ‘wrap-around’ services to Veterans as part of a five-year program starting in 2023-2024.
- A file review following a Veteran’s death by suicide is embedded in the Notification Process for Suicide & Homicide, which was recently updated in August 2022.
Line of effort 3: connecting CAF members and Veterans through families and communities
Releasing CAF Members, Veterans, and their families are recognized by Canadians for their service and feel socially connected.
- VAC has established Caring Contacts intervention which constitutes regular outreach to those who have recently experienced a mental health crisis or suicide attempt.
- A Community Collaboration Outreach initiative is underway to foster a whole-of-community response to suicide prevention by strengthening relationships with provinces, federal departments, Veterans Associations, community organizations, and other stakeholders. VAC actively participates in interdepartmental committees for suicide prevention, such as the Federal Framework for Suicide Prevention and the National Collaborative for Suicide Prevention.
- The Caregiver Recognition Benefit supports caregivers with a tax-free, monthly benefit of $1,000 provided directly to them.
- In collaboration with Saint Elizabeth Health Centre, we launched an online resource, the Caregiver Zone, to inform and support caregivers of Veterans. The free resource helps caregivers of ill and injured Veterans learn how to better support themselves and their loved ones through treatment and recovery.
- The Education and Training Benefit provides funding to support college, university, or technical education, including tuition, books, and some living expenses for Veterans.
- VAC also continues to honour and remember all those who served in Canada’s military using a suite of commemorative initiatives that engage Veterans and the general public.
- To help Veterans achieve a successful post-military life and identity, the department is fostering meaningful connections between today’s Veterans and Canadians, notably youth, through outreach activities and by sharing of experiences.
- We have issued a Veteran Service Card to all releasing CAF members and eligible Veterans honourably released and with completed basic training to help Veterans achieve a positive Veteran identity post-service, and facilitate access to well-being supports across the life course as needed.
Line of effort 4: providing timely access to effective health care and support
Veterans receive timely, effective case management, mental health care, and support.
- VAC developed a secure MoveIT electronic drop box to facilitate the safe sharing of clinical documentation between the Department and the OSI Clinics, which are operated by provincial health authorities.
- We continue to collaborate with Talk Suicide Canada (formerly Canada Suicide Prevention Service) to provide them with VAC resources and ensure Veterans and their families are familiar with this toll-free 24/7 crisis line.
- VAC has developed a system portal for the National Contact Centre Network (NCCN) which facilitates viewing of a client’s current status across all domains of well-being by interfacing with the Client Service Delivery Network (CSDN).
- For timely access to treatment, we have established a priority process, called “Yellow Zone”. This ensures that recently released Veterans submitting a psychiatric disability claim and without existing treatment benefits receive timely treatment services.
- Since 1 April 2022, Veterans applying for a disability benefit for certain mental health conditions receive immediate mental health coverage.
Line of effort 5: improving the transition process
The release and transition of CAF members to post-military life can be a period of increased stress. Early intervention is at times required to mitigate any negative impact. Nearly one-third (19 items) of the VAC Suicide Prevention Strategy Action Plan items focused on facilitating a successful transition to post-military life for releasing CAF members. We want to empower CAF Members and their families by being well-informed during their transition to civilian life.
- The Member Transition Task List is a self-guided, customizable tool that keeps track of progress made by transitioning CAF members as they move through each transition task. It has been revised, digitized, and added to the enhanced My VAC Account.
- A single VAC Screening Tool has been implemented to assess risks, identify unmet needs and ensure that necessary benefits and services are in place before release. The data is being shared between CAF and VAC.
- Second Career Assistance Network (SCAN) seminars continue to be offered early in the transition process. As part of the Enhanced Transition Training package, this content has been made available online and is now mandatory for transitioning CAF members.
- A Transition Assistance Initiative allows Veteran Service Agents and CAF Transition Advisors to do check-in calls to releasing members 30 days before release, and at determined intervals post-release.
- VAC has created a transition mini website to help guide Veterans and their families through transition. The website is divided into three sections (before you leave, as you leave, and after you leave) that provide relevant programs and services for each stage.
- The redesigned Career Transition Services program provides transitioning members with a better understanding of how their skills and experience can help them find meaningful post-military employment.
- My Transition 101 Course is a medium to long-term plan that will include mandatory training, as well as individual tracks intended to provide transitioning members with foundational and personalized support.
- Since its inception in 2018, the Veteran and Family Well-Being Fund has awarded $36 million to organizations for 102 projects, initiatives, and research tailored to improve the well-being of Veterans and their families.
Line of effort 6: establish protocols, policies and processes to better manage risk and stress
VAC policies and processes focus on improving the well-being of Veterans in Canada. They demonstrate horizontal integration which ensures the best expertise within the organization is involved in decisions that affect Veterans, to promote Veteran and family well-being.
- VAC has prepared guidelines and recommendations to assist national Case Management in a business process to implement Lethal Means safety for those at increased risk of suicidal behaviour.
Line of effort 7: continuously improve through research, analysis and incorporation of best practices
To inform VAC policy-making, services, and program development, and thus better serve Canadian Veterans, the Department has participated in numerous research and knowledge-sharing initiatives since the inception of the VAC Suicide Prevention Strategy Action Plan.
Knowledge sharing
The 2015 mandate letter to the Minister of Veterans Affairs and Associate Minister of Defence mandated the Minister to create two centres of excellence in Veterans’ care, including one specializing in mental health and post-traumatic stress disorder.
- The Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions (renamed the Atlas Institute for Veterans and Families) has been established to create and share knowledge on Veteran mental health treatments that work. The Centre’s mandate includes knowledge development via applied research and the translation of knowledge into clinical practices and tools. The goal is to improve treatment outcomes by increasing expertise on military and Veteran mental health, suicide prevention, and substance use disorder.
- The Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE) was established to conduct research and help improve the well-being of Canadian Armed Forces (CAF) Veterans, and their families, suffering from chronic pain. The Centre’s mission is to foster a national network of interdisciplinary pain management centres using research and evidence-based strategies to improve care for CAF Veterans and their families. The goal is to improve the well-being of Canadian Armed Forces Veterans, and their families, suffering from chronic pain.
- Besides collaborating with the two Centres of Excellence, VAC also organizes, in collaboration with the Canadian Institute of Military and Veteran Health Research (CIMVHR), many CIMVHR-sponsored events, such as: Proceedings of a Round Table Held to Engage a Whole-of-Community Approach for Suicide Prevention in Serving Military Members, Veterans, and Public Safety Personnel December 2018 (Meehan et al, 2022).
Research initiatives
VAC has published numerous reports and papers that have been made available to policymakers and decision-makers to facilitate improved uptake and knowledge exchange and to aid in the process of evidence-based decision-making.
- The Veteran Suicide Mortality Study is a collaborative effort where VAC works with Statistics Canada to link administrative data from DND to provincial and territorial death records. The Veteran Suicide Mortality Study findings help to better understand the factors associated with suicide in Canadian Armed Forces Veterans; provide updates on suicide trends over time; inform suicide prevention activities; and address public expectations of timely reporting of Veteran health indicators. The study follows Canadian Veterans who have been released from the military since 1 January 1976, and the most current available data is used for each cycle of the study. As new data have become available, VAC has published periodic reports onward (release in 2017, 2019, 2020 and the 2021 report to be released in 2023. The latest report (2021) captured death records up to 2017.
- The Life after service: The Road to Civilian Life (R2CL) qualitative study is a longitudinal study completed in the fall of 2020. The first round of Life After Service (LASS) was completed in 2010 with cycles every three years. The LASS program of research was established to better understand the transition experiences of Canadian Veterans as they move from military to post-military life and the ongoing effects of military service. The goal of LASS is to improve the well-being of Canadian Veterans by better understanding their transition experiences and areas of need.
VAC Research Directorate’s reports and papers
Conclusion and next steps for the Joint Suicide Prevention Strategy
In 2017, with the publication of the Joint CAF/VAC Suicide Prevention Strategy, Veterans Affairs Canada answered the call to action from Veterans, their families, and the overall community. A comprehensive plan for preventing suicide and suicidality, based on the best available evidence, was established and is now either fully implemented or with ongoing action items that are monitored and tracked regularly.
The CAF/VAC Joint Steering Committee will have the opportunity to review this report and discuss ongoing challenges and future directions to continue further developing suicide prevention strategies.
Suicide prevention remains an important priority for VAC. We are steadfast in our commitment to contribute to the increased well-being of Canadian Veterans and their families and to prevent as many tragedies caused by suicide as possible.