Canadian soldiers are fighting in Afghanistan as part of the NATO force
there, and for decades before that, Canadian units served on peacekeeping
missions in places such as Cyprus, Haiti, Rwanda, and the former Yugoslavia.
Regardless of their mission, the Canadians have faced the same stresses that
affect their U.S. counterparts.
And some Canadian soldiers returned with minds disturbed by the experience.
One was Lt. Col. Stéphane Grenier. Grenier is not a doctor. A
self-described tough armored corps officer, Grenier found himself one morning
years after his return from Rwanda sitting in his car for 45 minutes outside
the base clinic wondering how he was going to describe his internal turmoil to
the corporal on duty.
"I was oblivious," he recalled for listeners at a symposium at
Canada's embassy in Washington, D.C., in February. "I had been injured
in Rwanda and didn't know it."
Grenier has helped turn his struggle with the horrors of the Rwandan
genocide into a source of refuge for fellow members of the Canadian forces
similarly affected by the outcomes of their missions. He is now director of
casualty support management at National Defence Headquarters in Ottawa, home
of the Operational Stress Injury Social Support Program (OSISS). The program
was proposed in 2000, and the first peer coordinator came on board in
Most existing support programs depended on social workers or other
providers for coordination, Grenier found in the course of researching the
idea of a support program, but he ultimately decided that only a veteran of
military service would have the needed credibility with soldiers.
To that end, OSISS recruits and trains people who have not only served in
Canada's armed forces but have also been through the same trials by fire as
those they assist: all have been diagnosed with mental health problems at some
point in their careers. They can tell the soldiers they're helping:"
We've experienced it too, but we're in a healthier place
All have to be screened by doctors before they can work in the program."
No one wants to see them fail," said Grenier.
Once accepted, the peer-support coordinators take a two-week training
course, not to become therapists, but rather to "listen, assess, and
refer." They learn to recognize the boundaries between peer support and
counseling. This part of the training is extremely complex and emotionally
charged because it brings up issues the new coordinators have faced
themselves, said Grenier. Additional training covers the nuts and bolts of
services and programs available from the Canadian Forces or Veterans Affairs
The program has about 20 ex-military coordinators, an equal number of
family coordinators, and about a dozen bereavement-support members (all of
whom have lost a family member in the line of duty). They have served about
4,000 service or family members, mostly on or near half a dozen main military
bases. Most cases so far have been soldiers who served in Bosnia or
"We want employees to quickly grasp the issue the soldier has and
know where to get help," Grenier said. "They know how to build
trust to overcome barriers."
One barrier, he believes, is the language of therapy.
"The doctors use words to heal us, and I didn't know what the words
meant," he said of his own experience. His situation was difficult
enough, but he realized it had to be even harder for a combat arms
So when he began planning what has become OSISS, the place of language was
Start with "operational stress injury." What happens in
soldiers' minds after warfare is an injury caused by the stress of military
operations—being under fire, seeing friends killed or wounded, facing
the added horrors of civilian casualties. The U.S. Marine Corps and the Navy
medical service that serves the corps have adopted similar language, and
Grenier has consulted with Marine Corps psychiatrists in developing OSISS.
Along with others, he would like to demedicalize operational stress
"We're not trying to challenge the DSM-IV but to bridge the
gap between the mental health providers and the people they care for,"
The entire organization meets every six months for training. The next
session will concentrate on self-care and time-management skills for the
coordinators. All coordinators must maintain contact with a mental health
provider and run through an annual checklist to minimize burnout.
OSISS also offers services to the families of military personnel. Peer
coordinators who help families must live with a person who has had a stress
injury, said Melissa Bryden, an OSISS family-support peer coordinator from
Bryden is not a war veteran, but she has worked for 13 years, half of them
full time, as a reservist medical technician in Saskatchewan and Alberta. Her
husband, also a medical technician, has served a stint in Afghanistan. Bryden
is part of the second half of OSISS, the family-support side. All the family
peer-support coordinators must have a family member who served in the Canadian
There is other existing support for the families of deploying soldiers.
They are briefed in advance about what they and their service member can
expect while in the war zone. Staff at Military Family Resource Centers
located on 32 bases across the country brief them again before the soldier
returns home and once more six months later. The centers also offer help with
child development, parenting support, crisis intervention, and other services.
Family coordinators like Bryden attend those meetings. Their contact
information is available from the Canadian Forces or Veterans Affairs Canada,
but they do not seek out potential families in need. The families that decide
they need some kind of help must take the first steps in contacting OSISS,
either through using contacts on the base such as the chaplains or via an 800
An initial interview with the family often brings a moment of recognition
as the family members realize for the first time that they are not the only
ones experiencing the problems they have just shared, said Bryden. The
peer-support coordinator's job is to try to figure out what the service member
or family members need, show them where to get it, and often help them through
the inevitable paperwork and bureaucratic maze that veterans and military
families in every country seem to face. They function partly as coaches,
partly as case managers.
"People with mental health problems just can't navigate the
system," said Bryden, so she will go to the family home and help with
the paperwork or make sure someone sees a counselor.
The program also launched a speaker's bureau in January 2008 to increase
awareness of operational stress injury, address the stigma surrounding mental
illness, and urge early intervention.
More information on the Canadian Forces' Operational Stress Injury
and Social Support Program is posted at<www.osiss.ca>.▪