Members of the Canadian Armed Forces and retired Veterans represent a distinct population when it comes to understanding mental health. Researchers in London are working closely with military members to better understand their needs and explore tailored treatment options.
The MacDonald Franklin Operational Stress Injury (OSI) Research Centre, located at Parkwood Institute, part of St. Joseph’s Health Care London, is an international leader in research on military and Veteran mental health. The primary mission of the Centre is to improve the mental health and well-being of this distinct population through clinical and neuroscience research.
Closely connected to the OSI Research Centre, St. Joseph’s OSI Clinic offersspecialized services for Veterans, active military members, RCMP and family members experiencing mental health challenges as a result of military service.
Military members experience trauma and injury in a way that most civilians will never know. In the line of duty, they may perform, witness or fail to prevent acts that conflict with their own deeply held moral standards. This adds another layer of complicated feelings and emotions, known as moral injury, that researchers are just beginning to understand.
Moral injuries are on the rise among members of the Canadian Armed Forces, and research shows that those exposed to these events are at a higher risk of developing post-traumatic stress disorder (PTSD). The OSI Research Centre is investigating patient perceptions of confidentiality around disclosing moral injuries to mental health professionals.
Dr. Don Richardson studies the assessment and treatment outcomes of Veterans and Canadian Armed Forces members with PTSD.
“We have a duty to honour the service of our military personnel and Veterans and take care of them if they’re injured,” says Dr. Don Richardson, Lawson Associate Scientist, Scientific Director of the OSI Research Centre and Lead Physician at the OSI Clinic. “They may not disclose certain details, due to mistrust or a perceived lack of confidentiality, and knowing this helps us serve them better.”
Dr. Richardson’s work also looks at comorbidities of PTSD and how they can be used as predictors of treatment outcomes. It’s common for persons with PTSD to also show symptoms of depression. Research has shown that in military or combat related PTSD, rates of comorbidity are higher than in the general population, and they tend to have more severe symptoms. This can complicate treatment and make recovery more challenging.
The research team has been measuring changes in the brain that occur with PTSD, using fMRI technology. It’s helping researchers and clinicians to identify new subtypes of PTSD and their unique symptoms.
Researchers at the OSI Research Centre are investigating many other areas of mental health, including gender differences in symptom profiles, the impact of sleep on suicidal ideation, sexual health in persons with depression and PTSD, and understanding recovery from the perspective of Veterans and their family members.
As Dr. Richardson explains, “a clinician may determine that a person is recovered because they meet some target on a scale, but when we speak to Veterans and their significant others, they may have a different perspective.”
Much of what we know about treating PTSD has come from the Veteran population, but researchers are learning more about how other types of trauma can lead to PTSD for civilians. What is learned in the context of Veteran’s mental health can improve care for others.
“Military personnel by nature have a desire to help and improve situations. They will often seek help when they need it and want to participate in research. Even if it might not help them directly, they hope it will help future Veterans, and others.”
When patients come through the clinic, they can provide consent for their data to be used for research purposes. Because this research is integrated within the OSI Clinic, there is strong collaboration and results can be translated into care quickly.
The MacDonald Franklin OSI Research Centre’s Advisory Council includes Veterans and spouses of Veterans. “We want to ensure that the OSI Research Centre is meaningful for the individuals we’re trying to help,” says Dr. Richardson. “A Veteran might have a question about their symptoms or treatment, and we can help formulate that into a research question.”
For Dr. Richardson and his colleagues, it is an honour to have so many Veterans participating in research. “We do our best to return the favour by making sure our research is driven by the interests of Veterans.”
Major Ronald Miller, Canadian Armed Forces Veteran and research participant at the MacDonald Franklin OSI Research Centre.