Mental Health Service dogs

Photo: Combat Camera

By Military Woman

Question - What do you think about service dogs for veterans with mental health challenges?  

Answer – Veteran or civilian, healthy or sick, there are many benefits for humans to spend more time with animals, especially dogs.  

One of the many benefits of animals is their potential to be a calming influence on stressed out humans. This trait has made it commonplace for purpose-trained and certified therapy animals, usually dogs, to be made available in stressful public settings such as airports, hospitals, courts and mental health counselling sessions.

People who feel chronically stressed or anxious for any reason may find benefit, with their physician’s support, from an emotional support animal. Since no specialized training or testing is required, these animals are generally not allowed in public spaces except in some special circumstances such as airplanes.

While an emotional support animal does not require specialized training, nothing stops people from getting it. Training can include things like teaching your dog to recognize when you are having nightmares and to wake you up. Training your dog to complete mental health related support tasks does not require you to have a formal mental health diagnosis or recognized disability status.

So what is a service or assistance dog? Many are familiar with purpose-trained dogs who assist people that are sight-impaired, autistic, mobility-challenged or epileptic. Such dogs are traditionally breed specific, professionally trained and tested to ensure their behaviour is safe to be allowed into the public domain. These dogs will usually also have been taught three or more specialized tasks unique to their specific human’s formally declared disability needs. The North American standard for these types of service dogs is generally recognized as those set by Assistance Dog International (ADI) .

The VAC website defines mental health service dogs as “extensively trained to respond precisely to specific disabilities of their owners including individuals with mental health diagnoses such as PTSD. Service dogs are trained to detect and intervene when their handler is anxious; contribute to a feeling of safety for their handler; and promote a sense of relaxation and socialization.”

So what are the differences between a mental health service dog and an emotional support dog? One difference is that a mental health service dog is examined and certified to be safe in all public settings, and emotional support dogs are not. Another difference is that veterans seeking a service dog must have a federally recognized disability requiring the presence of the animal in all settings. A third difference is who pays. Generally a veteran pays all costs related to an emotional support dog but often has the costs of a service dog (up to $50k) paid for by interested fundraising charities. There is also a federal tax credit available to help defray additional and ongoing service dog costs.

As it stands, there are lots of good folk, charities and dog trainers alike, all doing the best they can. Unfortunately, there are others working hard to charge veteran charities top dollar for under-trained, and in some cases inhumanely trained, service dogs. This chaotic non-standardized state of affairs in Canada impedes researcher’s ability to produce quality, intersectional, peer-reviewed service dog research. Without a standardized and enforced national training and certification standard for mental health service dogs, everyone stands to lose. 

One way around the growing minefield of vendor related conflicts of interests is for the government of Canada to follow the example set by the US Department of Veterans Affairs—which supports the training of breed-specific dogs to ADI standards for veterans, by federal penitentiary inmates.

In other words, one way to support mental health service dogs for veterans could be to build a Canadian not-for-profit dog training and certification capacity. This would also allow for standardized dog training, certification, and reproducible GBA+ (gender-based analysis plus) research to provide, once and for all, the evidence based impact of mental health service dogs on veterans – women and men.

Nothing About Us Without Us!

By Military Woman

Question: What does it mean when people from the military sexual trauma community say “Nothing About Us Without Us”?  

Answer: The motto “Nothing About Us Without Us” is used to remind decision-makers of their responsibility to learn from and be accountable to those most impacted by their decisions.

First used in the 1980s by activists for disability rights, “Nothing About Us Without Us” is now a global movement that has expanded into many other advocacy areas including patient, women and veteran rights.   

Over the last decade, patient feedback through representation on civilian hospital boards, committees and research ethic boards has become routine. To best serve military patients throughout their lifespan, the military medical system needs to be similarly anchored and informed by patient feedback. To achieve this goal, the capturing of lessons learned from veterans is essential. Hopefully one day soon Canada will have an equivalent feedback mechanism to the US’s “Veterans Experience Office.” Nothing About Us Without Us.

Furthermore, DND/CAF and VAC now widely acknowledge a need for more diverse voices at all decision-making levels. The follow-on challenge then being how to ensure its the “right” voices that are newly invited to the table. Everyone of us can help to identify missing representation voices and advocate for their inclusion, even if it means us personally stepping down to make room for those more directly impacted to be heard. Nothing About Us Without Us.

Many defence related decisions are based on defence policies that come from defence research findings. To all the defence researchers, please consider co-creating your future research alongside those with lived experience in the topic of your study. The most value-added and relevant research results are likely to occur when your research question is co-developed and your research project co-designed with those having lived experience. Nothing About Us Without Us 

Public perceptions about the military are known to be largely dependent on the media’s coverage. To the talking heads who have never themselves served in uniform, please don’t assume you can speak for military women just because we share the same biological sex. Please find and amplify the voices around you that do have direct lived experience and allow us to speak for ourselves. Nothing About Us Without Us. 

To the political decision-makers who ask military women to speak about their sexual misconduct experiences despite knowing the significant emotional toll it takes on us to do so–please don’t exploit us for your personal or partisan gains. Nothing About Us Without Us. 

To the CAF/DND Ombudsman who has volunteered his office for an expanded investigative oversight role, our lived experience suggests there to be cause for concern. The Ombudsman’s Office was originally created in 1989 specifically to address the growing number of military sexual harassment and assault cases; and yet, a simple review of thirty-plus years of subsequent Ombudsman systemic investigations, reports, statistics, strategic plans, priorities, and interactions with Justice Deschamps demonstrates little proof of commitment to, or interest in, his office’s original raison d’etre.  Furthermore, common sense along with the lessons already learned from the RCMP’s newly formed Independent Centre for Sexual Harassment Resolution suggest that any truly “independent” office would not be run or staffed with members from the same institution to be investigated. Nothing About Us Without Us. 

Lastly, a word to Justice Arbour.  Whatever recommendations you make to the military in the days ahead, a core issue is how to fix broken trust. Whether from military sexual trauma, moral injury, institutional betrayal, sanctuary trauma or operational stress injury – trust has been broken by many against many.

To regain the trust of serving members, veterans, and the Canadian public, CAF/DND and VAC need to be, and be seen, as trustworthy institutions. Those that have been harmed the deepest and most directly must be allowed to be listened to and heard. Their healing is a necessarily prerequisite to healing the institution.

For all these reasons and more, this is why you may hear a military sexual trauma community member say, “Nothing About Us Without Us!”

Peer support services – one size doesn’t fit all

By Military Woman

Question: Should everyone with military-related trauma have access to government funded peer support services?

Answer: Yes, of course they should – but don’t they already? Since 2001, the Operational Stress Injury Social Support (OSISS) program, jointly funded and run by CAF and VAC, has been providing peer support services to all those with persistent psychological difficulty resulting from military operations, whether training, domestic or international. So, given that mandate one might have incorrectly assumed that OSISS also provides military sexual trauma (MST) peer support. 

Although some leaders within OSISS have made individual efforts to welcome all those with mental anguish as a consequence of their military service, the OSISS program has a history of excluding those with MST. A variety of reasons have been cited for why MST support has not been formally included within OSISS programming including the questioning of if MST is “operational”.

So, what exactly is MST if not an operational injury? That remains to be seen, as the federal government is still working on its own definition of what MST is; a definition that will hopefully capture the diverse physical, mental and spiritual dimensions of this workplace injury. Harm from MST arises from the initial sexual trauma(s) and/or the subsequent institutional betrayal and moral injury from dysfunctional workplace responses often aggravated by mandatory reporting requirements. MST causes real symptoms, dysfunction, pain, and suffering which together constitute an undeniable and serious occupational, if not operational, stress injury. With time, more and more people are viewing MST as a bone fide operational stress injury (OSI). Many MST cases occur while on operations or training.  Other MST cases occur during the 24/7 operational like tempo often demanded by normal military life. Yet others consider MST and OSI to foundationally be moral injuries and thus with similar peer support needs and benefits.  

Another reason cited for excluding MST from OSISS services was lack of funding to provide the specialized clinician oversight required for MST peer mentor screening and training to ensure both the health and wellness of the MST peer mentors and quality control of their services. Also, some of the MST community expressed a preference for peer support services in single, vs mixed, gender group settings. 

The Veteran Ombuds reviewed all of this in her recently published investigative report “Peer Support For Veterans Who Have Experienced MST,” which validated the need for improved access to MST peer supports. The Minister of Veterans Affairs is presently working with CAF to use the 2021 federal budget funding tailored for the development of an online and in-person peer support group for those who have experienced MST.

So what would the ideal MST peer support program look like? 

 A logical and sustainable way to ensure equitable peer support program quality and access, would be to work collaboratively within the already long-standing OSISS infrastructure. Using the newly available funding , OSISS could be rebranded into an “Occupational” Stress Injury Social Support service provider and a gender-based analysis plus (GBA+) completed to ensure all programs are flexible enough to meet the varied needs of people with different types of service-related trauma(s). New MST aware clinical staff could be hired to ensure all OSISS peer mentors were trauma, and specifically MST, informed.  OSISS could then offer groups online and in person, in the language of the person’s choice, with single or mixed genders, focusing on three service streams -  combat, MST and a combined group open to any military specific trauma(s).

The new federal funding could also allow for an evidence-based update to military-related trauma peer support programs to include the rapidly growing understanding of the importance of moral injury. Peer support that normalizes our various internal responses to external traumatic events may well be the way of the future. Regardless, let’s agree that everyone with military-related trauma exposure distress or symptoms should have equitable access to government funded peer support programs and services. Let’s get these long overdue MST peer support programs up and running!

Louise Arbour – We have Recommendations

By Military Woman

Question: What would your recommendations be for Louise Arbour?

Answer: As you may know, Supreme Court Justice (Retired) Louise Arbour has been named to lead a review of sexual misconduct in the military. While there has been some grumblings that this is just a repeat of the review conducted by Justice Deschamps in 2015, in fact the scope of Justice Arbour’s mandate is much wider and this time all report recommendations are binding. We at Military Women offer a few recommendations for Justice Arbour’s consideration.

1.     Choose your words carefully. Sexual misconduct is an extremely broad term that can mean many things, ranging from an one-time inappropriate sentence in an email to a premediated tortuous gang rape. The term is often used as an euphemism to downplay or avoid the direct naming of rape, sexual assault, sexual coercion and/or sexual harassment.  Please be precise in your word choices and always provide definitions for your key terms—including what “independent” review or “external” monitoring systems actually means.

2.     Talk about power—not sex. As Dr. Alan Okros PhD (Dallaire Centre of Excellence) is fond of saying, “If I hit you with a shovel, you wouldn’t call it inappropriate gardening.” Although the acts of misconduct may be sexual in nature, they originate from power imbalances. Sexual misconduct being but one of many possible negative outcomes from abuses related to military power imbalances.  

3.     Do not call sexual misconduct a women’s issue.  Politicians and journalists have undone decades of hard work by women in uniform to not have sexual misconduct or military sexual trauma (MST) labeled as “women’s issues.” Women constitute just over 15% of the military and, while women are more likely than men to be victims of military sexual violence, the total gross number of men victimized is actually higher than the total number of impacted women. Male victims of MST were co-sponsors of the recent sexual misconduct class action lawsuit and have also repeatedly spoken out to the media about their experiences.

4.     Look beyond legal issues. The politicians, lawyers and police have all to date, not surprisingly, focussed their action item lists on legal issues around sexual misconduct reporting, investigation, and justice systems. Quite unfortunately absent, are non-legal areas such as the military health care system which is responsible for the prevention, identification, support and treatment of sexual misconduct case health and wellness sequelae. Given that MST is an acknowledged military specific occupational hazard and the direct cause of ongoing workplace injuries and illnesses, the military medical system’s absence from many of the MST discussions and system reviews is inexplicable.

5.     Understand the culture. Canadian military culture is different from other Canadian organizational cultures. We urge Justice Arbour, therefore, to seek input from those with lived Canadian military experience to anchor and inform her recommendations. Without a demonstrated understanding of military culture, it is highly likely that the recommendations will once more not be internally embraced by CAF members (or veterans).  

We believe that Justice Deschamps’ (2015) decision to describe the military culture as a “sexualized” work environment although understandable, was unintentionally harmful. How? The absolute refusal by so many women and men in uniform to accept the validity of the “sexualized culture” descriptor directly contributed to the internal pushback to Justice Deschamps report and recommendations. Lived experience input may have suggested  “male-dominated”, “masculine assumed” or “male locker room” as alternative descriptors that may have been better accepted internally.

At the end of the day, understanding military culture through a sex and gender intersectional lens is essential to conducting an external review of sexual misconduct in the military. In addition to reaching out to the many experts on military culture, such as Drs. Karen Davis and Maya Eichler, we strongly urge Justice Arbour and her team to sit down and review all the Military Women pieces written since March 2019 (vol. 6, no. 2). It is our hope that the more you learn about our world and its culture the more likely your recommendations will receive internal (and external) support and be, this time, successfully implemented. Let’s get it right this time around !