scholarly journals The Value of Longitudinal Research and the Contribution of the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey

2021 ◽  
pp. 070674372110196
Author(s):  
Nicola T. Fear
Keyword(s):  
Mental Health ◽  
Longitudinal Research ◽  
Armed Forces ◽  
Canadian Armed Forces

scholarly journals Rationale and Methodology of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): A 16-year Follow-up Survey: Raison D’être Et Méthodologie De L’enquête De Suivi Sur La Santé Mentale Des Membres Des Forces Armées Canadiennes Et Des Anciens Combattants, 2018 (ESSMFACM)

2020 ◽  
pp. 070674372097483
Author(s):  
Tracie O. Afifi ◽  
Shay-Lee Bolton ◽  
Natalie Mota ◽  
Ruth Ann Marrie ◽  
Murray B. Stein ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Survey ◽  
Military Personnel ◽  
Armed Forces ◽  
Well Being ◽  
Canadian Armed Forces ◽  
Statistics Canada ◽  
Health And Well Being

Objective: Knowledge is limited regarding the longitudinal course and predictors of mental health problems, suicide, and physical health outcomes among military and veterans. Statistics Canada, in collaboration with researchers at the University of Manitoba and an international team, conducted the Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS). Herein, we describe the rationale and methods of this important survey. Method: The CAFVMHS is a longitudinal survey design with 2 time points (2002 and 2018). Regular Force military personnel who participated in the first Canadian Community Health Survey Cycle 1.2—Mental Health and Well-Being, Canadian Forces Supplement (CCHS-CFS) in 2002 ( N = 5,155) were reinterviewed in 2018 ( n = 2,941). The World Mental Health Survey–Composite International Diagnostic Interview was used with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition ( DSM-IV) criteria. Results: The CAFVMHS includes 2,941 respondents (66% veterans; 34% active duty) and includes data on mental disorder diagnoses, physical health conditions, substance use, medication use, general health, mental health services, perceived need for care, social support, moral injury, deployment experiences, stress, physical activity, military-related sexual assault, childhood experiences, and military and sociodemographic information. Conclusions: The CAFVMHS provides a unique opportunity to further understand the health and well-being of military personnel in Canada over time to inform intervention and prevention strategies and improve outcomes. The data are available through the Statistics Canada Research Data Centres across Canada and can be used cross-sectionally or be longitudinally linked to the 2002 CCHS-CFS data.

scholarly journals Course and Predictors of Major Depressive Disorder in the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey: Cours et Prédicteurs du Trouble de Dépression Majeure Dans l’Enquête de Suivi Sur la Santé Mentale Auprès Des Membres des Forces Armées Canadiennes et des ex-Militaires

2021 ◽  
pp. 070674372098467
Author(s):  
Murray W. Enns ◽  
Natalie Mota ◽  
Tracie O. Afifi ◽  
Shay-Lee Bolton ◽  
J. Don Richardson ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Work Stress ◽  
Armed Forces ◽  
Childhood Adversities ◽  
Major Depressive ◽  
Canadian Armed Forces ◽  
Military Members ◽  
Veteran Status

Objectives: The present report is the first study of Canadian military personnel to use longitudinal survey data to identify factors that determine major depressive episodes (MDEs) over a period of 16 years. Methods: The study used data from the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) collected in 2018 ( n = 2,941, response rate 68.7%) and linked baseline data from the same participants that were collected in 2002 when they were Canadian Regular Force members. The study used structured interviews to identify 5 common Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders and collected demographic data, as well as information about traumatic experiences, childhood adversities, work stress, and potential resilience factors. Respondents were divided into 4 possible MDE courses: No Disorder, Remitting, New Onset, and Persistent/Recurrent. Relative risk ratios (RRRs) from multinomial regression models were used to evaluate determinants of these outcomes. Results: A history of anxiety disorders and post-traumatic stress disorder (RRRs: 1.50 to 20.55), mental health service utilization (RRRs: 1.70 to 12.34), veteran status (RRRs: 1.64 to 2.15), deployment-associated traumatic events (RRRs: 1.71 to 2.27), sexual traumas (RRRs: 1.91 to 2.93), other traumas (RRRs: 1.67 to 2.64), childhood adversities (RRRs: 1.39 to 1.97), avoidance coping (RRRs 1.09 to 1.49), higher frequency of religious attendance (RRRs: 1.54 to 1.61), and work stress (RRRs: 1.05 to 1.10) were associated with MDE courses in most analyses. Problem-focused coping (RRRs: 0.73 to 0.91) and social support (RRRs: 0.95 to 0.98) were associated with protection against MDEs. Conclusions: The time periods following deployment and trauma exposure and during the transition from active duty to veteran status are particularly relevant for vulnerability to depression in military members. Interventions that enhance problem-focused coping and social support may be protective against MDEs in military members.

scholarly journals Patterns of Attrition in the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS)

2021 ◽  
pp. 070674372110026
Author(s):  
Shay-Lee Bolton ◽  
Tracie O Afifi ◽  
Natalie P Mota ◽  
Murray W. Enns ◽  
Ron de Graaf ◽  
...  
Keyword(s):  
Mental Health ◽  
Armed Forces ◽  
Canadian Armed Forces

scholarly journals Association of Child Maltreatment and Deployment-related Traumatic Experiences with Mental Disorders in Active Duty Service Members and Veterans of the Canadian Armed Forces: Association de la Maltraitance des Enfants et des Expériences Traumatisantes Liées au Déploiement Avec les Troubles Mentaux Chez les Membres du Service Actif et Les Anciens Combattants des Forces Armées Canadiennes

2021 ◽  
pp. 070674372098708
Author(s):  
Tracie O. Afifi ◽  
Jitender Sareen ◽  
Tamara Taillieu ◽  
Ashley Stewart-Tufescu ◽  
Natalie Mota ◽  
...  
Keyword(s):  
Mental Health ◽  
Child Maltreatment ◽  
Mental Disorders ◽  
Panic Disorder ◽  
Military Personnel ◽  
Armed Forces ◽  
Active Duty ◽  
Ptsd Symptoms ◽  
Canadian Armed Forces

Objective: Mental health among military personnel is an important public health priority. It is known that military personnel experience a high prevalence of child maltreatment and deployment-related traumatic events (DRTEs) and both are related to mental health outcomes. However, few, if any, studies have examined the cumulative and interactive effects of child maltreatment and DRTEs on mental health disorders in a sample of active duty service members and military veterans. Methods: Data were from the Canadian Armed Forces (CAF) Members and Veterans Mental Health Follow-up Survey collected in 2018 ( N = 2,941, response rate = 68.7%), a 16-year follow-up survey of CAF Regular Force members interviewed in 2002. Five types of child maltreatment and 10 types of DTREs were assessed for impact on mental health. Mental disorders included past 12-month generalized anxiety disorder (GAD), panic disorder, social phobia, and major depressive episode (MDE). Past 12-month symptoms of posttraumatic stress disorder (PTSD) were also examined. Results: The prevalence of any exposure to child maltreatment and DRTEs was 62.5% and 68.6%, respectively. All types of child maltreatment were associated with increased odds of past 12-month PTSD symptoms and mental disorders with the exception of physical abuse and GAD as well as childhood exposure to intimate partner violence and panic disorder. Cumulative effects of having experienced both child maltreatment and DRTEs increased the odds of past 12-month PTSD symptoms, GAD, social phobia, and MDE. No interaction effects were significant. Conclusions: The prevalence of a child maltreatment history is high among active Canadian military and veterans. As well, child maltreatment may increase the likelihood of mental disorders across the life span. This may be especially true for individuals who also experience DRTEs. Understanding these relationships may provide insight into developing effective interventions for military personnel and veteran mental health outcomes.

scholarly journals Lifetime Prevalence and Comorbidity of Mental Disorders in the Two-wave 2002–2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): Prévalence et Comorbidité de Durée de vie Des Troubles Mentaux Dans l’Enquête de Suivi Sur la Santé Mentale Auprès des Membres des Forces Armées Canadiennes et Des ex-Militaires (ESSMFACM) en Deux Cycles de 2002 à 2018

2021 ◽  
pp. 070674372110006
Author(s):  
Jitender Sareen ◽  
Shay-Lee Bolton ◽  
Natalie Mota ◽  
Tracie O. Afifi ◽  
Murray W. Enns ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Personality Disorder ◽  
Mental Disorders ◽  
Alcohol Abuse ◽  
Armed Forces ◽  
Lifetime Prevalence ◽  
Canadian Forces ◽  
Canadian Armed Forces

Objective: The current study used the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to (1) examine the incidence and prevalence of mental disorders and (2) estimate the comorbidity of mental disorders over the follow-up period. Method: The CAFVMHS (2018) is a longitudinal study with two time points of assessment. The sample is comprised of 2,941 Canadian Forces members and veterans who participated in the 2002 Canadian Community Health Survey: Canadian Forces Supplement. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) was utilized to diagnose Diagnostic and Statistical Manual-IV post-traumatic stress disorder (PTSD), major depressive episode (MDE), generalized anxiety disorder, social anxiety disorder (SAD), and alcohol abuse and dependence. Self-report health professional diagnoses were assessed for attention deficit hyperactivity disorder (ADHD), mania, obsessive compulsive disorder (OCD), and personality disorder. We established weighted prevalence of mental disorders and examined the association between mental disorders using logistic regression. Results: In 2018, lifetime prevalence of any WHO-CIDI-based or self-reported mental disorder was 58.1%. Lifetime prevalence of any mood or anxiety disorder or PTSD was 54.0% in 2018. MDE (39.9%), SAD (25.7%), and PTSD (21.4%) were the most common mental disorders. There was a substantial increase in new onset or recurrence/persistence of mental disorders between the two measurement points (16-year assessment gap); 2002–2018 period prevalences were 43.5% for mood and anxiety disorder and 16.8% for alcohol abuse or dependence. The prevalence of self-reported ADHD, OCD, any personality disorder, and mania were 3.3%, 3.0%, 0.8%, and 0.8%, respectively. Comorbidity between mental disorders increased over the follow-up. Conclusions: This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort. These findings underscore the importance of prevention and intervention strategies to reduce the burden of mental disorders and alcohol use disorders in these populations.

scholarly journals Course and Predictors of Posttraumatic Stress Disorder in the Canadian Armed Forces: A Nationally Representative, 16-Year Follow-up Study: Cours et prédicteurs du trouble de stress post-traumatique dans les Forces armées canadiennes: une étude de suivi de 16 ans nationalement représentative

2021 ◽  
pp. 070674372198916
Author(s):  
Natalie Mota ◽  
Shay-Lee Bolton ◽  
Murray W. Enns ◽  
Tracie O. Afifi ◽  
Renée El-Gabalawy ◽  
...  
Keyword(s):  
Mental Health ◽  
Stress Disorder ◽  
Armed Forces ◽  
Care Utilization ◽  
Canadian Forces ◽  
Canadian Armed Forces ◽  
Nationally Representative ◽  
Mental Health Care Utilization ◽  
New Onset

Objective: This study examined baseline risk and protective predictors and interim correlates of the persistence/recurrence, remission, and onset of posttraumatic stress disorder (PTSD) in a 16-year prospective, nationally representative sample of Canadian Forces members and veterans. Methods: The 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey is a prospective study of 2,941 regular force service members and veterans who participated in the 2002 Canadian Community Health Survey on Mental Health and Wellbeing: Canadian Forces Supplement ( n = 5,155; ages 15 to 64 years; response rate 68%). PTSD diagnoses in 2002 and 2018 were used to create 4 groups: (1) no lifetime, (2) remitted, (3) new onset, and (4) persistent/recurrent PTSD. Multinomial regressions were conducted to identify predictors of PTSD courses. Results: Female sex, being a junior noncommissioned member (vs. officer), and land (vs. air) operations in 2002 were associated with all PTSD courses relative to no lifetime PTSD (relative risk ratio [RRR] range: 1.28 to 3.65). After adjusting for sociodemographic variables, baseline predictors of all PTSD courses included lifetime mental disorder, history of mental health care utilization, all trauma type categories (deployment-associated, sexual, “other”), and the number of lifetime traumatic events (RRR range: 1.14 to 8.95). New (“since 2002”) traumas, transitioning to veteran status, and alcohol dependence were mostly associated with the new onset and persistent/recurrent PTSD courses (RRR range: 1.79 to 4.31), while mental health care utilization and greater avoidance coping were associated with all PTSD courses (RRR range: 1.10 to 17.87). Protective factors for several PTSD courses at one or both time points included social support, social network size, and problem-focused coping (RRR range: 0.71 to 0.98). Conclusions: This is the first population-based survey to examine the longitudinal course of PTSD in Canadian Forces members. Prevention and intervention programs focused on bolstering social support and active coping strategies as possible protective factors/correlates may help mitigate the development and persistence of PTSD.

Gender-related differences in mental health of Canadian Armed Forces members during the COVID-19 pandemic

2021 ◽  
pp. e20210012
Author(s):  
Kerry Sudom ◽  
Eva Guérin ◽  
Jennifer E. C. Lee
Keyword(s):  
Mental Health ◽  
Armed Forces ◽  
The State ◽  
Depression And Anxiety ◽  
Family Status ◽  
Health Issues ◽  
Demographic Groups ◽  
Canadian Armed Forces ◽  
Regular Force ◽  
Clinically Significant

Lay Summary The challenges associated with the coronavirus disease 2019 (COVID-19) pandemic have the potential to not only adversely affect mental health in general, but also to emphasize and widen disparities in mental health across demographic groups. In particular, research suggests that women have been disproportionately affected by the pandemic psychologically, socially, and economically. However, the state of mental health in the Canadian Armed Forces (CAF) during the pandemic and the impacts of gender on mental health outcomes are currently unknown. This study uses data collected early in the pandemic to examine the state of mental health of CAF Regular Force members and the impacts of gender and family status. Although most members were doing well, a notable minority were experiencing mental health issues at potentially clinically significant levels, with women more likely to experience depression and anxiety than men and women with children less likely to experience functional impairment as a result of their symptoms. The findings provide a snapshot of the mental health of Regular Force members during the pandemic and suggest the importance of considering gender and family situation in understanding mental health.

Retrospective cohort study of outpatient mental health visits in children and youth in Canadian military families

2021 ◽  
Author(s):  
Alyson L. Mahar ◽  
Heidi Cramm ◽  
Isabel Garces ◽  
Alice B. Aiken ◽  
Simon Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Military Families ◽  
Armed Forces ◽  
Well Being ◽  
Children And Youth ◽  
Health Services Use ◽  
Physician Visits ◽  
Outpatient Mental Health ◽  
Canadian Armed Forces

LAY SUMMARY This study tried to answer the question “Do children and youth in military families have a greater risk of emotional and behavioural problems than children and youth in the general population?” The authors used routinely collected health data from children and youth in Canadian Armed Forces families who relocated to Ontario, matched to data from children and youth in non-military families. They compared outpatient mental health services use, such as physician visits, and the reasons for those visits, such as depression. They found that children and youth in military families were more likely to visit a physician for specific mental health diagnoses than children and youth in the general population. More programming and resources supporting the mental health and well-being of children and youth in military families may be needed.

scholarly journals Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

2019 ◽  
Vol 55 (5) ◽  
pp. 581-588
Author(s):  
François L. Thériault ◽  
R. A. Hawes ◽  
B. G. Garber ◽  
F. Momoli ◽  
W. Gardner ◽  
...  
Keyword(s):  
Mental Health ◽  
Major Depression ◽  
Administrative Data ◽  
Armed Forces ◽  
Clinical Encounter ◽  
Incidence Rates ◽  
Occupational Factors ◽  
Mental Health Resource ◽  
Canadian Armed Forces ◽  
Regular Force

Abstract Purpose Major depression is a leading cause of morbidity in military populations. However, due to a lack of longitudinal data, little is known about the rate at which military personnel experience the onset of new episodes of major depression. We used a new source of clinical and administrative data to estimate the incidence of major depression diagnoses in Canadian Armed Forces (CAF) personnel, and to compare incidence rates between demographic and occupational factors. Methods We extracted all data recorded in the electronic medical records of CAF Regular Force personnel, at every primary care and mental health clinical encounter since 2016. Using a 12-month lookback period, we linked data over time, and identified all patients with incident diagnoses of major depression. We then linked clinical data to CAF administrative records, and estimated incidence rates. We used multivariate Poisson regression to compare adjusted incidence rates between demographic and occupational factors. Results From January to December 2017, CAF Regular Force personnel were diagnosed with major depression at a rate of 29.2 new cases per 1000 person-years at risk. Female sex, age 30 years and older, and non-officer ranks were associated with significantly higher incidence rates. Conclusions We completed the largest study to date on diagnoses of major depression in the Canadian military, and have provided the first estimates of incidence rates in CAF personnel. Our results can inform future mental health resource allocation, and ongoing major depression prevention efforts within the Canadian Armed Forces and other military organizations.

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