Wednesday, December 6, 2017
15:00 – 15:30 (EDT)
Mental Health Advisory Group Members
- Sapper (Retired) Aaron Bedard
- Michael Blais, Canadian Veterans Advocacy
- Dr. Karen Cohen, Canadian Psychological Association
- Colonel Colleen Forestier, Director of Mental Health, Canadian Armed Forces
- Dave Gallson, Mood Disorders Society of Canada
- Glynne Hines, Royal Canadian Legion (Co-chair)
- Ed Mantler, Mental Health Commission of Canada
- Robert Thibeau, Aboriginal Veterans Autochtones
- Dr. Don Richardson, Canadian Psychiatric Association
Regrets
- Sergeant Brian Harding
- Warrant Officer (Retired) Brian McKenna
- Kerry Mould, Canadian Association of Veterans in United Nations Peacekeeping
- Dr. Ruth Lanius, Western University
- Dr. Patrick Smith, Canadian Mental Health Association
Office of the Minister of Veterans Affairs
- Laurel Chester, Stakeholder Relations
- Bernard O’Meara, Stakeholder Relations
Veterans Affairs Canada Officials
- Joel Fillion, Director, Mental Health (VAC Co-chair)
- Faith McIntyre, Director General, Policy and Research
- Michelle Morrison, Senior Analyst, Stakeholder Engagement and Outreach
Expert Spokespersons
- Dr. Alexandra Heber, Chief of Psychiatry, Veterans Affairs Canada
- Dr. Linda Van Til, Epidemiologist, Veterans Affairs Canada
- Dr. Elizabeth Rolland-Harris, Senior Epidemiologist, Canadian Armed Forces
Observer
- Amanda Jane, Office of the Veterans Ombudsman
Opening Remarks
The Director General, Policy and Research Division chaired the teleconference. It was convened to provide Advisory Group members with an advance briefing on the findings of the Veteran Suicide Mortality Study, to be released publically the following day. Members were thanked for their participation on short notice. It was noted that the results shared during the meeting were under embargo until the public announcement by news release on December 7th, 2017. The chair informed the group that following the announcement, stakeholders and Advisory Group members would receive the links to the News Release and Veteran Suicide Mortality Study Report. The chair asked that participants recognize that the subject matter can be difficult, and to be aware of their own well-being in reaction to the sensitivities of the discussion.
Briefing on Veteran Suicide Mortality Study
The Veteran Suicide Mortality Study is a collaborative study between Veterans Affairs Canada (VAC), the Department of National Defence (DND), and Statistics Canada with the goal to:
- enhance the understanding of factors associated with suicide in Canadian Armed Forces (CAF) Veterans;
- to provide updates on suicide trends over time;
- to aid in the discussion of suicide prevention activities; and
- to respond to the public expectation of timely reporting.
This study compares risk of suicide mortality in the Canadian Veteran population to the general Canadian population. Administrative data from DND was linked to 37 years of Canadian mortality data from Statistics Canada, covering Veterans who released from the CAF between 1976 and 2012. Data included Regular Force Veterans and Reserve Force Class C Veterans. It was noted that this report is the first step in developing a picture of suicide mortality within the Veteran population, and that questions from the Advisory Group will help guide further analysis, which will be broadened over time. The chair outlined the key findings from the report:
- The risk of suicide among male Veterans was 1.4 times higher than in the general Canadian comparable population.
- The risk was highest among males under age 25, at 2.4 times higher risk than cohorts in the general population. Veteran males over 55 years old were at lower risk than the general Canadian population.
- The risk of suicide among female Veterans was 1.8 times higher than the general Canadian population, with similar risks for older and younger female Veterans.
- The risk of suicide for both male and female Veterans has remained relatively unchanged over the past four decades and has been consistently higher than the Canadian general population.
The chair noted that in November 2017, the National Canadian Suicide Prevention Service was launched, which enables access to crisis support by phone, text, or chat. Also referenced was the CAF-VAC Joint Suicide Prevention Strategy Action Plan, released in October 2017, to address the risks of suicide among the still-serving and Veteran populations.
Questions and answers from the group about the Veteran Suicide Mortality Study findings included:
Question: What is the reason for the time period of the study extending only until 2012?
Answer: Statistics Canada maintains the database that receives the information from Canadian death certificates, which are the property of the provincial and territorial jurisdictions. There is a four-year lag time for this information to be available from Statistics Canada. At the time the data linkage was done, the latest available data was from 2012.
Question: Were only Reserve Class C Veterans included? What about Reserve Force Class A and Class B Veterans?
Answer: Reserve Force Class C are essentially those Reservists who had deployed. Previous research indicates that Class A and B Reservists mirror the general Canadian population. Therefore, this study only looked at Regular Force and Reserve Force Class C Veterans.
Question: Was the higher risk identified for Veterans under the age of 25 years concluded from a comparison to the overall Canadian general population or against the same age cohort?
Answer: The risk for Veterans under 25 was compared to an age-adjusted cohort of the Canadian population.
Question: What was the actual number of suicides?
Answer: Over the 37 year period, of those who released from the CAF from 1976 until 2012, there were 1421 male suicides and 65 female suicides.
Question: Were VAC staff or former staff consulted and asked to identify possible suicides from their caseloads?
Answer: This study did not include file reviews of individuals, but was completely based on available Canadian data from Statistics Canada and the CAF. However, findings from the study will help inform the Department of future direction from a research, analysis, and program services perspective.
Question: Did the broader general Canadian population data include Indigenous suicide data? Concerns expressed were that First Nations and Inuit populations have the highest rate of suicide mortality in Canada, so efforts in suicide prevention must be broader than CAF and VAC strategies; that other government agencies have the resources to address suicide prevention as well.
Answer: The general Canadian population data used did include indigenous suicide data. Death certificates do not identify someone as a Veteran, which is why the data linkage was necessary to determine Veteran status. At this time, it is not possible to further distinguish Indigenous status from the data. In the future there may be an opportunity to determine Indigenous status within the data. It was also agreed that a whole of government approach was important to address suicide prevention, and VAC is working closely with partners to do so. Noted was the Public Health Agency of Canada Suicide Prevention Framework.
Question: Are there deaths which may not have been reported as suicides?
Answer: The same criteria for identifying suicide for both the Veteran and general Canadian population mean that there is a high confidence in the comparative analysis. However, it is still possible that not all Canadian suicides are captured on death certificates.
Question: How many Veterans who died by suicide had a claim or connection to VAC?
Answer: The relationship to VAC was not part of this study which did not report on names or identifying information.
Question: Was there a number of suicides breakdown per year?
Answer: Yes. The report shows this breakdown in four-year groupings (i.e. 1976 -1982). Although there was some fluctuation from one year to the next, the trend over time showed a consistent elevated risk over the study’s 37 year time period.
Final comments from spokespersons:
- Given the elevated risk for female Veterans, the CAF-VAC Joint Suicide Prevention Strategy Action Plan is being modified to reflect this gender distinction.
- The higher risk of suicide among younger male Veterans confirms the need to keep an increased focus on supporting the transition for this group from military to post-service life.
- This collaborative work is one of many upcoming examples of VAC and CAF working more closely together, as the military experience is one that lasts throughout the life course.
- The Mental Health Advisory Group member co-chair recognized the important work done, and that this will provide the basis for yearly reports. However, the challenge will be how to use this data to improve suicide prevention.
Next Steps
There will be the opportunity in follow-up teleconferences to go through details of the full Veteran Suicide Mortality Study Report, as well as to review the action plan of the CAF-VAC Joint Suicide Prevention Strategy.
Closing Remarks
The meeting chair concluded the meeting by thanking the group members for their engagement and participation on the important mental health file.