To survive in combat, soldiers need to be armed, hyper-alert and sometimes secretive. That’s part of their training.

But what happens when they return from Afghan­istan? Do they get the mental health support they need to unlearn these battle skills and reintegrate into everyday life? This is a question to ponder on Remembrance Day tomorrow.

One U.S. post-combat support tool that Canadian clinics are watching closely is Battlemind. It is a program that helps soldiers reintegrate into a regular life with their family.

“In battle, you learn hypervigilance. People are out to get you. Being in war mode is helpful in combat, but maladaptive when you get home,” Dr. Jitender Sareen, an associate professor of psychiatry at the University of Manitoba and director of Deer Lodge operational stress injury clinic in Winnipeg.

A recent study in the U.S. tested Battlemind on 2,000 soldiers returning from Iraq. The soldiers in the study had been through at least 19 combat experiences such as being shot at, handling human remains, being ambushed, or killing.

The study found that soldiers who underwent Battlemind training had fewer sleep problems and less severe post-traumatic stress disorder (PTSD) than those who received no training upon return. Battlemind classes are now mandated in the U.S. military.

It is well known that one of the risk factors for PTSD is not having proper support upon returning from war. Other risk factors are being female, having a previous history of childhood adversity, a family history of mental illness, witnessing a higher number of traumatic events, experiencing more intense trauma and possibly having a genetic predisposition, says Sareen.

In 2002, a study was done that found about 30 per cent of Canadian veterans developed either depression, PTSD or another mental health illness upon returning home.

That was before Canada went to war. “But because of the Afghanistan deployment, the rate of mental health problems would be higher at this time,” says Sareen.

Back in 2002, he notes, there was a big gap between the number of people who needed care and the number who received it. “Veterans Affairs has taken a lot of steps to increase mental health services.”

Canadian physicians are using cognitive behavioural therapy, medication, and education to treat PTSD in returning soldiers.

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