Journal of military, veteran and family health, Feb 1, 2023
In 2019, 43% NATO Member Nations (13 out of 23) had incentives or bonuses to support civilians en... more In 2019, 43% NATO Member Nations (13 out of 23) had incentives or bonuses to support civilians entering the Reserve Forces. These nations include: Bulgaria,
Launch of the Veteran Health Files series V eterans Affairs Canada is pleased to join with Canadi... more Launch of the Veteran Health Files series V eterans Affairs Canada is pleased to join with Canadian Family Physician and the College of Family Physicians of Canada to launch a new series-Veteran Health Files. The first article appears in this issue of Canadian Family Physician (page1549). Many family physicians play key roles in the care of military and Royal Canadian Mounted Police Veterans and their families. More than 0.8 million or 1 in 30 Canadian adults self-report military service. World War II and Korean War Veterans account for a quarter of those, and the remainder-about half a million-have served since the Korean War. An increased tempo of Canadian military operations since the first Persian Gulf War in 1990 means that today's generation of family physicians is encountering more Veterans with health concerns arising from their military service. The military context is important to Veterans' health experiences. Many family physicians today have not experienced military life. Growing worldwide interest in the effects of military service on the health of Veterans has led to an explosion of research, making it difficult for family physicians to stay on top of the rapidly emerging information. The Veteran Health Files series will help family physicians understand the military context and inform them of emerging issues in Veteran care. Topics in Veteran Health Files will cover the big 3 Veteran health issues that recur with every war and consume the majority of resources: musculoskeletal disabilities, mental health problems, and unexplained symptoms. Using fictitious cases derived from clinical experiences, the series will cover the life course of Veterans Affairs Canada's military clients, from young
Background. Some veterans, and especially those with mental disorders, have difficulty reintegrat... more Background. Some veterans, and especially those with mental disorders, have difficulty reintegrating into the civilian workforce. Purpose. The objectives of this study were to describe the scope of the existing literature on mental disorders and unemployment and to identify factors potentially associated with reintegration of workers with mental disorders into the workforce. Data Sources. The following databases were searched from their respective inception dates: MEDLINE, EMBASE, Cumulative Index Nursing Allied Health (CINAHL), and PsycINFO. Study Selection. In-scope studies had quantitative measures of employment and study populations with well-described mental disorders (eg, anxiety, depression, posttraumatic stress disorder, substance-use disorders). Data Extraction. A systematic and comprehensive search of the relevant published literature up to July 2009 was conducted that identified a total of 5,195 articles. From that list, 81 in-scope studies were identified. An update to July 2012 identified 1,267 new articles, resulting in an additional 16 in-scope articles. Data Synthesis. Three major categories emerged from the in-scope articles: return to work, supported employment, and reintegration. The literature on return to work and supported employment is well summarized by existing reviews. The reintegration literature included 32 in-scope articles; only 10 of these were conducted in populations of veterans. Limitations. Studies of reintegration to work were not similar enough to synthesize, and it was inappropriate to pool results for this category of literature. Conclusions. Comprehensive literature review found limited knowledge about how to integrate people with mental disorders into a new workplace after a prolonged absence (Ͼ1 year). Even more limited knowledge was found for veterans. The results informed the next steps for our research team to enhance successful reintegration of veterans with mental disorders into the civilian workplace.
This study examined associations between sociodemographic, military, and psychiatric need variabl... more This study examined associations between sociodemographic, military, and psychiatric need variables and past-year mental health service use among active Canadian military members. The likelihood and intensity of services were examined across two provider typesmental health providers and medical providers. Methods: Data were drawn from the first epidemiological survey of mental health in the Canadian Forces, conducted by Statistics Canada in 2002. Survey instruments included the Composite International Diagnostic Interview, which was used to assess mental health and service use. Results: Of the 8,441 military members who participated in the survey, 14.5% (N=1,220) met criteria for having a mental disorder in the past year. However, of the 8,441 only 9.1% (N=767) contacted a mental health provider in the past year for mental health problems; even fewer (N=539, 6.4%) contacted a medical provider. Across the two provider types, the majority of those seeing a provider reported five or fewer mental health visits in the past year. In univariate and multivariate analyses across the two provider types, psychiatric need variables were consistently associated with both greater service use likelihood and intensity. In multivariate analyses, lower military rank was consistently associated with both greater service use likelihood and intensity. Conclusions: Of the entire military sample, only a small percentage used mental health services. The observed associations between military and psychiatric need variables and mental health service use in this study should be used by military health care providers and administrators to increase mental health service use among those most at risk of not using services. (Psychiatric Services 60:358-366, 2009)
Naturalistic comparison of models of programmatic interventions for combatrelated post-traumatic ... more Naturalistic comparison of models of programmatic interventions for combatrelated post-traumatic stress disorder. Australian and New Zealand
LAY SUMMARY Military members want to do well when they leave service. Good well-being is one way ... more LAY SUMMARY Military members want to do well when they leave service. Good well-being is one way of thinking about success in the transition to life after service. The word well-being has different meanings to different people, which can be confusing. To help Veterans, it must be clearly defined. Some see well-being as something inside a person; others see it as how people are doing in the outside world. People can have poorer or better well-being in many areas of life, not just in how they feel. This article describes a way of thinking about well-being that can work for different purposes.
Journal of Military, Veteran and Family Health, 2021
(CIMVHR) was established in 2010 by Queen's University and the Royal Military College of Canada i... more (CIMVHR) was established in 2010 by Queen's University and the Royal Military College of Canada in consultation with key personnel from Veterans Affairs Canada and the Department of National Defence. 1 CIMVHR's mission is to enhance the lives of Canadian military personnel, Veterans, and their families by harnessing national capacity for research. CIMVHR has held annual Forums since 2011, attracting researchers from across Canada and the world to present their findings to a diverse audience of Veterans, family members, policy and program designers, service providers and research colleagues. This infographic gives highlights from analysis of 1,561 Forum podium and poster presentations between 2011-2019, before COVID-19. The 1,341 presentations in 2012-2019 were categorized using four frameworks: the multi-domain well-being framework developed at Veterans Affairs Canada, military members' life cycles, a research methodology nomenclature developed for this project, and the research cycle. 2,3,4,5 The research cycle has five phases: situation (what is happening?), cause (what causes the situation?), solution (how can we fix the situation?), implementation (how do we deliver the solution?) and evaluation (does the implementation work?).
Journal of Military, Veteran and Family Health, 2021
Building capacity in knowledge mobilization: CIMVHR's international research ecosystem has global... more Building capacity in knowledge mobilization: CIMVHR's international research ecosystem has global impact during the COVID-19 pandemic As a pan-Canadian institute with 46 university partners, the Canadian Institute for Military and Veteran Health Research (CIMVHR) also has international reach, in cluding an additional 14 global affi liates and collabo rations with the United Nations, NATO, and the Five Eyes countries: Canada, Australia, New Zealand, the United States, and the United Kingdom. Knowledge mobilization has been a significant focus at CIMVHR, getting the findings of cutting-edge research into the hands of those who can use it to develop policies, pro grams, and interventions. In 2020 and 2021, CIMVHR quickly mobilized its international ecosystem of schol ars, policy makers, and practitioners to take aim at the challenges and opportunities presented by the ongoing COVID-19 pandemic. Additional resources were invested to build capacity in knowledge translation and exchange (KTE), such as the creation of online meeting platforms to replace the CIMVHR annual Forum and other events. While CIMVHR's mandate is to build capacity in military, Veteran, and family health research in Canada and internationally, its eff orts in KTE this past year will have ripple effects globally, as other populations benefit from the science undertaken by CIMVHR scholars and partnering organizations.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
This is a temporary placeholder file. An open access version will be added if it becomes availabl... more This is a temporary placeholder file. An open access version will be added if it becomes available. Pease click on the DOI link to access the publisher version of record.
If citing, it is advised that you check and use the publisher's definitive version for pagination... more If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.
OBJECTIVES: Suicide in recent veterans is an international concern. An association between mental... more OBJECTIVES: Suicide in recent veterans is an international concern. An association between mental disorders and suicide has been established, but less information is available about an association between physical health problems and suicide among veterans. This study extends this area of inquiry by examining the relationship of both physical and mental health problems with suicidal ideation in a representative national sample of Canadian veterans.<br />METHODS: Subjects were a stratified random sample of 2,658 veterans who had been released from the Canadian Armed Forces Regular Force during 1998-2007 and had participated in the 2010 Survey on Transition to Civilian Life. Associations between physical and mental health and past-year suicidal ideation were explored in multivariable regression models using three measures of physical and mental health.<br />RESULTS: The prevalence of suicidal ideation was 5.8% (95% confidence interval [CI]: 5.0%-6.8%). After adjustment for...
Journal of Military, Veteran and Family Health, 2016
Introduction: In Canada, there are an estimated 700,000 Veterans of the Canadian military. Vetera... more Introduction: In Canada, there are an estimated 700,000 Veterans of the Canadian military. Veterans are disproportionately prevalent in sub-populations of males, persons with chronic physical conditions, chronic pain, mental health conditions, and those with disabling activity limitations. Veterans are a population of interest to Canadian researchers, but there is no publicly available comprehensive list of Veterans in Canada. This creates a need for a standard set of screening questions suitable for self-report surveys. This article proposes a series of screening questions to identify Canadian Veterans. Methods: The content of the questions were developed considering self-identity, past Canadian surveys, legislation, and relevant characteristics of Canadian military service. Results: The recommended Canadian Veteran identifier questions are: “Have you ever had any Canadian military service? Was this service with the Regular Force? Reserve Force? Navy? Army? Air Force? Are you curre...
Journal of Military, Veteran and Family Health, 2016
Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an importan... more Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an important concern in the wake of difficult CAF deployments in the 1990s. This article is the first comprehensive summary of findings from subsequent surveys of mental health and well-being in CAF Veterans, undertaken to inform mental health service renewals by CAF Health Services and Veterans Affairs Canada (VAC). Methods. Epidemiological findings in journal publications and government reports were summarized from four cross-sectional national surveys: a survey of Veterans participating in VAC programs in 1999 and three surveys of health and well-being representative of whole populations of Veterans in 2003, 2010, and 2013. Results. Although most Veterans had good mental health, many had mental health problems that affected functioning, well-being, and service utilization. Recent Veterans had a higher prevalence of mental health problems than the general Canadian population, earlier-era Veterans...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
The goal of this study was to identify rates, characteristics, and predictors of mental health tr... more The goal of this study was to identify rates, characteristics, and predictors of mental health treatment seeking by military members with posttraumatic stress disorder (PTSD). Our sample was drawn from the 2002 Canadian Community Health Survey-Canadian Forces Supplement (CCHS-CF) dataset. The CCHS-CF is the first epidemiologic survey of PTSD and other mental health conditions in the Canadian military and includes 8441 nationally representative Canadian Forces (CF) members. Of those, 549 who met the criteria for lifetime PTSD were included in our analyses. To identify treatment rates and characteristics, we examined frequency of treatment contact by professional and facility type. To identify predictors of treatment seeking, we conducted a binary logistic regression with lifetime treatment seeking as the outcome variable. About two-thirds of those with PTSD consulted with a professional regarding mental health problems. The most frequently consulted professionals, during both the las...
Journal of military, veteran and family health, Feb 1, 2023
In 2019, 43% NATO Member Nations (13 out of 23) had incentives or bonuses to support civilians en... more In 2019, 43% NATO Member Nations (13 out of 23) had incentives or bonuses to support civilians entering the Reserve Forces. These nations include: Bulgaria,
Launch of the Veteran Health Files series V eterans Affairs Canada is pleased to join with Canadi... more Launch of the Veteran Health Files series V eterans Affairs Canada is pleased to join with Canadian Family Physician and the College of Family Physicians of Canada to launch a new series-Veteran Health Files. The first article appears in this issue of Canadian Family Physician (page1549). Many family physicians play key roles in the care of military and Royal Canadian Mounted Police Veterans and their families. More than 0.8 million or 1 in 30 Canadian adults self-report military service. World War II and Korean War Veterans account for a quarter of those, and the remainder-about half a million-have served since the Korean War. An increased tempo of Canadian military operations since the first Persian Gulf War in 1990 means that today's generation of family physicians is encountering more Veterans with health concerns arising from their military service. The military context is important to Veterans' health experiences. Many family physicians today have not experienced military life. Growing worldwide interest in the effects of military service on the health of Veterans has led to an explosion of research, making it difficult for family physicians to stay on top of the rapidly emerging information. The Veteran Health Files series will help family physicians understand the military context and inform them of emerging issues in Veteran care. Topics in Veteran Health Files will cover the big 3 Veteran health issues that recur with every war and consume the majority of resources: musculoskeletal disabilities, mental health problems, and unexplained symptoms. Using fictitious cases derived from clinical experiences, the series will cover the life course of Veterans Affairs Canada's military clients, from young
Background. Some veterans, and especially those with mental disorders, have difficulty reintegrat... more Background. Some veterans, and especially those with mental disorders, have difficulty reintegrating into the civilian workforce. Purpose. The objectives of this study were to describe the scope of the existing literature on mental disorders and unemployment and to identify factors potentially associated with reintegration of workers with mental disorders into the workforce. Data Sources. The following databases were searched from their respective inception dates: MEDLINE, EMBASE, Cumulative Index Nursing Allied Health (CINAHL), and PsycINFO. Study Selection. In-scope studies had quantitative measures of employment and study populations with well-described mental disorders (eg, anxiety, depression, posttraumatic stress disorder, substance-use disorders). Data Extraction. A systematic and comprehensive search of the relevant published literature up to July 2009 was conducted that identified a total of 5,195 articles. From that list, 81 in-scope studies were identified. An update to July 2012 identified 1,267 new articles, resulting in an additional 16 in-scope articles. Data Synthesis. Three major categories emerged from the in-scope articles: return to work, supported employment, and reintegration. The literature on return to work and supported employment is well summarized by existing reviews. The reintegration literature included 32 in-scope articles; only 10 of these were conducted in populations of veterans. Limitations. Studies of reintegration to work were not similar enough to synthesize, and it was inappropriate to pool results for this category of literature. Conclusions. Comprehensive literature review found limited knowledge about how to integrate people with mental disorders into a new workplace after a prolonged absence (Ͼ1 year). Even more limited knowledge was found for veterans. The results informed the next steps for our research team to enhance successful reintegration of veterans with mental disorders into the civilian workplace.
This study examined associations between sociodemographic, military, and psychiatric need variabl... more This study examined associations between sociodemographic, military, and psychiatric need variables and past-year mental health service use among active Canadian military members. The likelihood and intensity of services were examined across two provider typesmental health providers and medical providers. Methods: Data were drawn from the first epidemiological survey of mental health in the Canadian Forces, conducted by Statistics Canada in 2002. Survey instruments included the Composite International Diagnostic Interview, which was used to assess mental health and service use. Results: Of the 8,441 military members who participated in the survey, 14.5% (N=1,220) met criteria for having a mental disorder in the past year. However, of the 8,441 only 9.1% (N=767) contacted a mental health provider in the past year for mental health problems; even fewer (N=539, 6.4%) contacted a medical provider. Across the two provider types, the majority of those seeing a provider reported five or fewer mental health visits in the past year. In univariate and multivariate analyses across the two provider types, psychiatric need variables were consistently associated with both greater service use likelihood and intensity. In multivariate analyses, lower military rank was consistently associated with both greater service use likelihood and intensity. Conclusions: Of the entire military sample, only a small percentage used mental health services. The observed associations between military and psychiatric need variables and mental health service use in this study should be used by military health care providers and administrators to increase mental health service use among those most at risk of not using services. (Psychiatric Services 60:358-366, 2009)
Naturalistic comparison of models of programmatic interventions for combatrelated post-traumatic ... more Naturalistic comparison of models of programmatic interventions for combatrelated post-traumatic stress disorder. Australian and New Zealand
LAY SUMMARY Military members want to do well when they leave service. Good well-being is one way ... more LAY SUMMARY Military members want to do well when they leave service. Good well-being is one way of thinking about success in the transition to life after service. The word well-being has different meanings to different people, which can be confusing. To help Veterans, it must be clearly defined. Some see well-being as something inside a person; others see it as how people are doing in the outside world. People can have poorer or better well-being in many areas of life, not just in how they feel. This article describes a way of thinking about well-being that can work for different purposes.
Journal of Military, Veteran and Family Health, 2021
(CIMVHR) was established in 2010 by Queen's University and the Royal Military College of Canada i... more (CIMVHR) was established in 2010 by Queen's University and the Royal Military College of Canada in consultation with key personnel from Veterans Affairs Canada and the Department of National Defence. 1 CIMVHR's mission is to enhance the lives of Canadian military personnel, Veterans, and their families by harnessing national capacity for research. CIMVHR has held annual Forums since 2011, attracting researchers from across Canada and the world to present their findings to a diverse audience of Veterans, family members, policy and program designers, service providers and research colleagues. This infographic gives highlights from analysis of 1,561 Forum podium and poster presentations between 2011-2019, before COVID-19. The 1,341 presentations in 2012-2019 were categorized using four frameworks: the multi-domain well-being framework developed at Veterans Affairs Canada, military members' life cycles, a research methodology nomenclature developed for this project, and the research cycle. 2,3,4,5 The research cycle has five phases: situation (what is happening?), cause (what causes the situation?), solution (how can we fix the situation?), implementation (how do we deliver the solution?) and evaluation (does the implementation work?).
Journal of Military, Veteran and Family Health, 2021
Building capacity in knowledge mobilization: CIMVHR's international research ecosystem has global... more Building capacity in knowledge mobilization: CIMVHR's international research ecosystem has global impact during the COVID-19 pandemic As a pan-Canadian institute with 46 university partners, the Canadian Institute for Military and Veteran Health Research (CIMVHR) also has international reach, in cluding an additional 14 global affi liates and collabo rations with the United Nations, NATO, and the Five Eyes countries: Canada, Australia, New Zealand, the United States, and the United Kingdom. Knowledge mobilization has been a significant focus at CIMVHR, getting the findings of cutting-edge research into the hands of those who can use it to develop policies, pro grams, and interventions. In 2020 and 2021, CIMVHR quickly mobilized its international ecosystem of schol ars, policy makers, and practitioners to take aim at the challenges and opportunities presented by the ongoing COVID-19 pandemic. Additional resources were invested to build capacity in knowledge translation and exchange (KTE), such as the creation of online meeting platforms to replace the CIMVHR annual Forum and other events. While CIMVHR's mandate is to build capacity in military, Veteran, and family health research in Canada and internationally, its eff orts in KTE this past year will have ripple effects globally, as other populations benefit from the science undertaken by CIMVHR scholars and partnering organizations.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
This is a temporary placeholder file. An open access version will be added if it becomes availabl... more This is a temporary placeholder file. An open access version will be added if it becomes available. Pease click on the DOI link to access the publisher version of record.
If citing, it is advised that you check and use the publisher's definitive version for pagination... more If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.
OBJECTIVES: Suicide in recent veterans is an international concern. An association between mental... more OBJECTIVES: Suicide in recent veterans is an international concern. An association between mental disorders and suicide has been established, but less information is available about an association between physical health problems and suicide among veterans. This study extends this area of inquiry by examining the relationship of both physical and mental health problems with suicidal ideation in a representative national sample of Canadian veterans.<br />METHODS: Subjects were a stratified random sample of 2,658 veterans who had been released from the Canadian Armed Forces Regular Force during 1998-2007 and had participated in the 2010 Survey on Transition to Civilian Life. Associations between physical and mental health and past-year suicidal ideation were explored in multivariable regression models using three measures of physical and mental health.<br />RESULTS: The prevalence of suicidal ideation was 5.8% (95% confidence interval [CI]: 5.0%-6.8%). After adjustment for...
Journal of Military, Veteran and Family Health, 2016
Introduction: In Canada, there are an estimated 700,000 Veterans of the Canadian military. Vetera... more Introduction: In Canada, there are an estimated 700,000 Veterans of the Canadian military. Veterans are disproportionately prevalent in sub-populations of males, persons with chronic physical conditions, chronic pain, mental health conditions, and those with disabling activity limitations. Veterans are a population of interest to Canadian researchers, but there is no publicly available comprehensive list of Veterans in Canada. This creates a need for a standard set of screening questions suitable for self-report surveys. This article proposes a series of screening questions to identify Canadian Veterans. Methods: The content of the questions were developed considering self-identity, past Canadian surveys, legislation, and relevant characteristics of Canadian military service. Results: The recommended Canadian Veteran identifier questions are: “Have you ever had any Canadian military service? Was this service with the Regular Force? Reserve Force? Navy? Army? Air Force? Are you curre...
Journal of Military, Veteran and Family Health, 2016
Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an importan... more Introduction. The mental health of Canadian Armed Forces (CAF) populations emerged as an important concern in the wake of difficult CAF deployments in the 1990s. This article is the first comprehensive summary of findings from subsequent surveys of mental health and well-being in CAF Veterans, undertaken to inform mental health service renewals by CAF Health Services and Veterans Affairs Canada (VAC). Methods. Epidemiological findings in journal publications and government reports were summarized from four cross-sectional national surveys: a survey of Veterans participating in VAC programs in 1999 and three surveys of health and well-being representative of whole populations of Veterans in 2003, 2010, and 2013. Results. Although most Veterans had good mental health, many had mental health problems that affected functioning, well-being, and service utilization. Recent Veterans had a higher prevalence of mental health problems than the general Canadian population, earlier-era Veterans...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
The goal of this study was to identify rates, characteristics, and predictors of mental health tr... more The goal of this study was to identify rates, characteristics, and predictors of mental health treatment seeking by military members with posttraumatic stress disorder (PTSD). Our sample was drawn from the 2002 Canadian Community Health Survey-Canadian Forces Supplement (CCHS-CF) dataset. The CCHS-CF is the first epidemiologic survey of PTSD and other mental health conditions in the Canadian military and includes 8441 nationally representative Canadian Forces (CF) members. Of those, 549 who met the criteria for lifetime PTSD were included in our analyses. To identify treatment rates and characteristics, we examined frequency of treatment contact by professional and facility type. To identify predictors of treatment seeking, we conducted a binary logistic regression with lifetime treatment seeking as the outcome variable. About two-thirds of those with PTSD consulted with a professional regarding mental health problems. The most frequently consulted professionals, during both the las...
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