Friday, October 24, 2014

Canadian Community Health Survey - Mental Health and Well-being - Canadian Forces (CCHS-CF)


I have a graduate student who is looking for datasets related to members of the armed forces, in Canada or the US, including health and mental health.

I noticed that Cycle 1.2 of the Community Health Survey looked at a representative sample of the Canadian Forces population, Canadian Community Health Survey - Mental Health and Well-being - Canadian Forces (CCHS-CF) - <>. When I look at CCHS Cycle 1.2 I could not find variables for Canadian Forces, and it specifically states that members of the Canadian Armed Forces are excluded from the sampling. Does anyone have any idea where or if this data is available? Or suggestions for an alternative dataset?


From the guide found at the bottom of the link you gave: (First paragraph and last paragraph of the Description section) In Cycle 1.2 of the Canadian Community Health Survey (CCHS),
an additional component was administered to a representative sample of the Canadian Forces (CF) population. This is known as the CF Component. 

One of the exclusions of the core CCHS target population is full-time members of the regular Canadian Forces.

As the Department of National Defence (DND) wanted to be able to provide reliable, comparable information for the Canadian Forces, DND contracted Statistics Canada to undertake a special survey component with a representative sample of the Canadian Forces, both regular and reservist members.

Mental Health and Well-being – CF Component has analogous objectives to those of the CCHS, against which results can be compared – to estimate the prevalence of certain mental disorders in the Canadian Forces and record members’ utilization of mental health services.

This information is intended to assist in the determination of mental health care needs in the CF and to allow DND planners the crucial data they need to ensure adequate resources.

Further, do not forget that this came out not to long ago, <>

We had a similar question in the past year. Below, you will find clues to the existence of data found in the secondary literature.


In October 2013, the CAF Surgeon General’s Mental Health Strategy  was released. Based on a number of internal and external studies, the Strategy gives an assessment of the current state of mental health in the CAF, and provides guidance for the delivery of services and the prioritization of resources and research over the next five years. It is important to note that Afghanistan-related OSIs are a minority of the mental health conditions present within the CAF population. According to the Mental Health Commission of Canada, one in every five Canadians will experience a mental health condition in their life time. The Canadian Community Health Survey – Mental Health and Well-being – Canadian Forces (CCHS-CF) conducted by Statistics Canada in 2002 showed that CAF members exhibited double the risk of depression, both related and unrelated to military operations, as compared to the Canadian population.15 Therefore, CAF health services must have the ability to treat “a far greater” mental illness burden that is not related to combat or deployment operations.16 Unfortunately, the Statistics Canada survey did not capture data with respect to determining whether the OSIs suffered by CAF personnel were specifically related to deployments to Rwanda, Bosnia, or other locations. The only mission-specific OSI data the CAF holds is from its report entitled Cumulative Incidence of PTSD and Other Mental Disorders in Canadian Forces Personnel Deployed in Support of the Mission in Afghanistan, 2001–2008. The report, by David Boulos and Dr. Mark Zamorski, indicates that out of about 30,000 CAF personnel deployed to or in support of Canada’s mission in Afghanistan before 31 December 2008, 13.2% were diagnosed with an OSI in the 5 years following that deployment. This included 8% diagnosed with PTSD and more than 5% with other types of deployment-related OSIs, such as depression and anxiety disorders.17 BGen Bernier informed us that once extrapolated to approximately 9 years post-deployment, the
percentages increase to 20% for OSIs and 11.8% for PTSD. In comparison, the lifetime
prevalence of PTSD in the general population is 7% to 9%.18 The report also indicates that
when deployment and non-deployment related mental illnesses within the cohort are taken into account, the figure rises to 18.9% for PTSD. Another report by the same authors
extrapolates that those who deployed to Kandahar specifically have close to a

14 Department of National Defence, Guide to Benefits, Programs, and Services for Serving and Former
Canadian Armed Forces Members and their Families
, November 2013 Edition.
15 BGen Jean-Robert Bernier, NDDN Evidence, 41st Parliament, 2nd Session, Meeting No. 19, 8 April 2014.
16 Ibid.
17 Department of National Defence, Cumulative Incidence of PTSD and Other Mental Disorders in Canadian
Forces Personnel Deployed in Support of the Mission in Afghanistan, 2001–2008, Canadian Forces Health Services , November 2011.
18 BGen Jean-Robert Bernier, NDDN Evidence, 41st Parliament, 2nd Session, Meeting No.19, 8 April 2014.

30% possibility of developing an OSI nine years post-deployment.19 The limitations of these studies include the inability to capture those who have not sought care, who have sought care outside CAF health services, or who were released shortly after their deployment.

The DND/CAF Ombudsman has also been engaged in CAF mental health issuessince 2002. He has released 5 different reports and almost 50 recommendations intended
to improve the care and treatment received by CAF members suffering from OSIs,including PTSD. The 2012 report Fortitude Under Fatigue,concluded that the CAF made considerable progress in implementing previous recommendations with respect to the identification, prevention, and treatment of OSIs. The report also identified a number of broader areas of improvements, including the evolution of the CAF’s mental health capability from an ad hoc system to one that is better structured to deliver integrated care to CAF members suffering from OSIs, including PTSD. The challenges that remain are addressed in this report.

CAF health services are the primary health care provider for all CAF personnel whether their health concerns are duty related or not. If necessary services arenot available within the CAF system, military members are reliant on civilian provincial/territorial health authorities. Every military member is insured by a third-party insurer, currently Blue Cross, which covers the cost of external health care treatments for DND. Since the closure of CAF hospitals, and given that 80% of military members and their families live off military bases, there is an increased dependence on provincial/territorial health care services and support systems than ever before. This is an overarching challenge that touches not only the care of ill and injured CAF personnel, but also the care of their family members and reservists.
<>Caring for Canada’s Ill and Injured Military Personnel p. 5-6

-Unfortunately, a PUMF will not be created for the Canadian Forces Mental Health Survey, access to the masterfile will be available through the Research Data Centers (RDCs).