Surgeon General’s Mental Health Strategy: Canadian Forces Health Services Group - An Evolution of Excellence
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Table of Contents
- Introduction
- The State and Impact of Mental Illness in the CAF and Canadian Society
- Need for Care
- Impact of Operations
- Suicide
- Use of Services
- Stigma and Barriers to Care
- Occupational Impact of Mental Illness
- CAF Mental Health Programs and Services — Understand, Educate, Care
- Understand
- Educate
- Care
- Unique Opportunities within the CAF Mental Health System
- Shared Responsibility
- Primary Care/Mental Health Integration
- Performance Measurement and Quality Improvement
- Mental Health Education
- Clinical Competency Training
- Programs versus Services
- Research
- Military Families
- Groups With Different Considerations
- Strategic Priorities
- Optimize Health Outcomes
- Invest In Our People
- Increase Partnerships with Internal and External Agencies
- Optimize Use of Technologies
- Improve the Efficiency of the Mental Health System
- Expand Mental Health Education and Training
- Improve Internal and External Communications
- Conclusion

Foreword
The state of mental health in the Canadian Armed Forces (CAF), its many related factors, and the best approach to addressing them are very complex issues that cannot be easily addressed. I congratulate the Surgeon General and his mental health staff for producing a strategy which does just that. Based on a balance of objective data, extensive lessons learned, clinical experience, and military-specific considerations, it clearly identifies opportunities and priorities for the Canadian Forces Health Services Group (CF H Svcs Gp) to further evolve our superb mental health system to better address CAF needs now and in the future.
This strategy will primarily guide CF H Svcs Gp efforts and priorities, and it highlights the critical role of commanders in supporting the mental well-being of their sailors, soldiers, and air personnel. The World Health Organization’s definition accurately captures the concept that health consists of positive well-being as well as the absence of disease. This is not only associated with better enjoyment of life, but also with such military-significant benefits as better performance and resilience under the routine stresses of daily life and the more difficult stresses of military operations. The CAF must succeed in its missions supporting Canadian interests, and good mental health among its members is a pre-condition of success.
This strategy provides excellent guidance and direction to CF H Svcs Gp personnel. I am confident that its implementation will permit the CAF to effectively address its current and future mental health challenges, and I strongly support it as the CF H Svcs Gp roadmap for the next five years. I expect all leaders to continue supporting the related efforts of our dedicated medical staff, while also leading efforts within their own commands to further enhance mental health education and reduce barriers to early care.
T.J. Lawson
General
Chief of the Defence Staff

The health and well-being of Canadian Armed Forces (CAF) members is of utmost importance to me personally, as it is to all Canadian military leaders. I therefore welcome the Surgeon General’s Mental Health Strategy for Canadian Forces Health Services Group (CF H Svcs Gp) as a clear definition of CAF mental health challenges and enhancement opportunities. CF H Svcs Gp professionals understand better than anyone the critical importance of mental health to both individual well-being and to military operational readiness. By virtue of their exemplary dedication to protecting and restoring health, they play a critical role not only in the welfare of their colleagues, but also in the defence and security of our country.
This strategy provides an excellent summary of the state of mental health in the CAF, our robust mental health system that is widely considered a best-practice model, and the long-term guidance needed to further enhance it. The strategy aims to ensure that CF H Svcs Gp personnel are equipped with the competencies, tools, and support necessary to provide the best possible preventive measures and mental health care. It includes an expansion of our comprehensive mental health training and education system that has consistently proven its value, as well as continued investment in health surveillance and research that are so critical to optimizing policy, programs, protocols, and resource allocation.
The Surgeon General assesses and advises on the CAF’s health needs, while also delivering the necessary health services. The Chain of Command, however, is ultimately responsible for the health and well-being of CAF members, and commanders at all levels can influence the determinants of health outlined in this strategy. The Surgeon General and all CF H Svcs Gp members will have my full support in this regard and in the implementation of this strategy. They can also be assured of my grateful appreciation for their exceptional commitment, sacrifices, and competence in supporting the health of the CAF’s most important asset, its personnel.
D.B. Millar
Major-General
Chief of Military Personnel

Preface
Since the implementation of the Rx2000 Project’s Mental Health Initiative and other program enhancements since Afghanistan combat operations began in 2006, our annual Canadian Forces Health Services Group (CF H Svcs Gp) mental health campaign plan has served to reflect our strategic vision and to guide specific program enhancements. A longer-term and more detailed strategy is now indicated to guide and prioritize our efforts given the coming conclusion of operations in Afghanistan, our major increase in mental health financial resources, clinical-technological developments, and our greater understanding of the current and projected Canadian Armed Forces (CAF) mental health burden through health surveillance and research.
This strategy is necessary to guide optimum use of our resources and data in dealing not only with the CAF’s Afghanistan-related mental health burden, but also with our baseline toll of mental illness arising from the routine stresses of military service and from the stresses that affect Canadians generally. We have received many accolades from national and foreign health authorities for our mental health leadership and for our system as a model of multi-disciplinary, comprehensive, high-quality care, but we must and can continue to improve. Despite the reality that perfection can never be fully achieved by any human organization, the unique sacrifices of our combatant colleagues and of our own personnel in protecting our country demand that we endlessly strive for it.
The strategy is primarily informed by, and applies to, our military and civilian experts in the Directorate of Mental Health and at our mental health clinics and centres across Canada. It also, however, applies to all CF H Svcs Gp members given the interdependencies and indivisibility of physical and mental health. It particularly applies to our primary care clinicians who, as in civilian society, provide the bulk of routine mental health care, either independently or through the application of treatment plans established by mental health specialists.
You have earned your worldwide reputation for military medical excellence as a result of extensive training, innovation, sacrifice, and dedication. The welfare of our colleagues and CAF operational readiness demand that we further apply the factors that gave us such great clinical success in operations to our efforts in preventing and treating mental illness and injury. In concert with CAF casualty support, stigma reduction, chaplaincy, and leadership measures, this strategy provides a robust internal roadmap for our health system to further relieve suffering among those to whom Canada owes so much.
J.J.-R.S. Bernier
Brigadier-General
Surgeon General
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