Recommendations for follow-up care during post-deployment screening of Canadian Armed Forces personnel: how well does self-reported mental health predict referral decisions?

Objective: Canadian Armed Forces (CAF) post-deployment screening aims to facilitate early care for members with mental health issues. The process consists of a questionnaire to screen for mental health problems, followed by an interview with a healthcare provider during which recommendations for follow-up care are provided if needed. In this study, we examined the association of self-reported mental health from the screening questionnaire with recommendation for follow-up care during the interview.

Does recommended mental health follow-up care occur after postdeployment screening in the Canadian Armed Forces? A retrospective cohort study.

Objective: To determine Canadian service members' level of adherence to a recommendation for mental health services follow-up that was assigned by clinicians during postdeployment screening.

Design: Retrospective cohort study.

Setting: Canadian military population.

Does screening shorten delays to care for post-deployment mental disorders in military personnel? A longitudinal retrospective cohort study.

Objective: To determine whether post-deployment screening is associated with a shorter delay to diagnosis and care among individuals identified with a deployment-related mental disorder.

Design: Retrospective cohort study.

Setting: Canadian military population.

Differences between the Canadian military's Regular and Reserve Forces in perceived need for care, mental health services use and perceived sufficiency of care: a cross-sectional survey.

Objective: The primary objective was to explore differences in perceived need for care (PNC), mental health services use (MHSU) and perceived sufficiency of care (PSC) between Canadian Armed Forces Regular Force (RegF) and Reserve Force (ResF) personnel with an objective need for mental health services.

Design: Data came from the 2013 Canadian Armed Forces Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were among those with an Afghanistan deployment and an identified mental disorder (population n=6160; sampled n=868).

Retrospective cohort study of compliance with post-deployment screening in the Canadian Armed Forces.

Objective: Canadian Armed Forces (CAF) personnel who return from certain international deployments are required to complete post-deployment screening (PDS) 90 to 180 days post-deployment; the primary goal of PDS is early detection of mental health problems that aims for reduced delays to care provision. We investigated service members' compliance with the PDS completion requirement and the factors associated with this compliance; a secondary objective was to investigate completion timing.

Design: The study used a retrospective cohort of CAF personnel (n=28 460) who had deployments over 01 January 2009 to 31 December 2014; inferences were based on a probabilistic sample (n=3004).

The Canadian Forces Cancer and Mortality Study II: a longitudinal record-linkage study protocol.

Background: Military service exposes personnel to unusual situations with unclear health-related implications, and to identify both immediate and delayed risks, part of health surveillance includes examination of mortality and cancer rates that extends beyond periods of military service. The main aim of the Canadian Forces Cancer and Mortality Study II (CFCAMS II) is to describe the mortality and cancer experience of Canadian Armed Forces personnel (serving and released; about 230 000 people), with the further aim of informing health promotion and prevention programs for serving personnel and services for veterans after they leave the military.

Methods: This protocol is for a retrospective cohort study of serving and released Canadian Armed Forces personnel who enrolled on or after Jan.

Influence of military component and deployment-related experiences on mental disorders among Canadian military personnel who deployed to Afghanistan: a cross-sectional survey.

Objective: The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder.

Design: Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629).

Child Abuse Experiences and Perceived Need for Care and Mental Health Service Use among Members of the Canadian Armed Forces.

Objective: Child abuse is associated with poor mental health outcomes in adulthood. However, little is known about how a history of child abuse may be related to perceived need for care (PNC) and mental health service use (MHSU) among Canadian military personnel. The objectives of this study were to determine 1) the relationship between child abuse history and PNC and 2) the relationship between child abuse history and MHSU in the Canadian military.

Delay to mental healthcare in a cohort of Canadian Armed Forces personnel with deployment-related mental disorders, 2002-2011: a retrospective cohort study.

Objective: To assess whether the delay to care among Canadian Armed Forces (CAF) personnel who sought care for a mental disorder changed over time and in association with CAF mental health system augmentations.

Design: A stratified, random sample (n=2014) was selected for study from an Afghanistan-deployed cohort (N=30 513) and the 415 (weighted N=4108) individuals diagnosed with an Afghanistan service-related mental disorder were further assessed. Diagnosis-related data were abstracted from medical records (22 June 2010 to 30 May 2011).

Contribution of the Mission in Afghanistan to the Burden of Past-Year Mental Disorders in Canadian Armed Forces Personnel, 2013.

Objective: The purpose of this study was to estimate the contribution of the mission in Afghanistan to the burden of mental health problems in the Canadian Armed Forces (CAF).

Methods: Data were obtained from the 2013 Canadian Forces Mental Health Survey, which assessed mental disorders using the World Health Organization's Composite International Diagnostic Interview. The sample consisted of 6696 Regular Force (RegF) personnel, 3384 of whom had deployed in support of the mission.

Prevalence of Past-Year Mental Disorders in the Canadian Armed Forces, 2002-2013.

Objective: More than 40,000 Canadian Armed Forces (CAF) personnel have deployed in support of the mission in Afghanistan since 2002. Over the same period, the CAF strengthened its mental health system. This article explores the effect of these events on the prevalence of past-year mental disorders over the period 2002-2013.

The 2013 Canadian Forces Mental Health Survey: Background and Methods.

Objective: The 2013 Canadian Forces Mental Health Survey (CFMHS) collected detailed information on mental health problems, their impacts, occupational and nonoccupational determinants of mental health, and the use of mental health services from a random sample of 8200 serving personnel. The objective of this article is to provide a firm scientific foundation for understanding and interpreting the CFMHS findings.

Methods: This narrative review first provides a snapshot of the Canadian Armed Forces (CAF), focusing on 2 key determinants of mental health: the deployment of more than 40,000 personnel in support of the mission in Afghanistan and the extensive renewal of the CAF mental health system.

Military Occupational Outcomes in Canadian Armed Forces Personnel with and without Deployment-Related Mental Disorders.

Objective: Mental disorders are common in military organizations, and these frequently lead to functional impairments that can interfere with duties and lead to costly attrition. In Canada, the military mental health system has received heavy investment to improve occupational outcomes. We investigated military occupational outcomes of diagnosed mental disorders in a cohort of 30,513 personnel who deployed on the Afghanistan mission.

Occupational outcomes following mild traumatic brain injury in Canadian military personnel deployed in support of the mission in Afghanistan: a retrospective cohort study.

Objective: Deployment-related mild traumatic brain injury (MTBI) occurs in a significant number of military personnel but its long-term impacts are unclear. This study explores the impact of deployment-related MTBI on continued fitness-for-duty, with the ultimate intent of identifying potential targets for intervention to attenuate its effects.

Participants: Consisted of 16 193 Canadian Armed Forces (CAF) personnel who deployed in support of the mission in Afghanistan and completed an enhanced postdeployment screening (EPDS) questionnaire over the period January 2009-July 2012.

Do shorter delays to care and mental health system renewal translate into better occupational outcome after mental disorder diagnosis in a cohort of Canadian military personnel who returned from an Afghanistan deployment?

Objective: Mental disorders in military personnel result in high rates of attrition. Military organisations have strengthened their mental health systems and attempted to overcome barriers to care in order to see better outcomes. This study investigated the roles of mental health services renewal and delay to care in Canadian Armed Forces (CAF) personnel diagnosed with mental disorders.

Deployment-related mental disorders among Canadian Forces personnel deployed in support of the mission in Afghanistan, 2001-2008.

Background: The conflict in Afghanistan has exposed more Canadian Forces personnel to a greater degree of adversity than at any time in recent memory. We determined the incidence of Afghanistan deployment-related mental disorders and associated risk factors among personnel previously deployed in support of this mission.

Methods: The study population consisted of 30,513 Canadian Forces personnel who began a deployment in support of the mission in Afghanistan before Jan.

Estimates of the number of prevalent and incident human immunodeficiency virus (HIV) infections in Canada, 2008.

Objective: To estimate the number of prevalent and incident HIV infections in Canada in 2008.

Methods: We applied multiple methods to estimate national HIV prevalence and incidence in Canada, including the workbook method, two statistical modelling methods, and an iterative spreadsheet model.

Results: The estimated number of people living with diagnosed or undiagnosed HIV infection (including AIDS) continues to rise, from an estimated 57,000 in 2005 to 65,000 in 2008.

Behavioural risks for HIV infection among Quebec residents of Haitian origin.

Quebecers of Haitian origin (QHO) have the highest HIV prevalence of all immigrant groups in the province. We conducted a study among QHO to document the behavioural risk factors for HIV transmission. Male respondents were significantly more likely than female respondents to have at least one casual heterosexual partner in the past 12 months (39.

Epidemiology of HIV in the United States and Canada: current status and ongoing challenges.

Purpose: To determine the status of the HIV epidemic in the United States and Canada.

Methods: We used data on AIDS and HIV diagnoses for 1996-2005 reported to the United States and Canadian national surveillance systems to determine trends in AIDS and HIV (33 US states only) diagnoses and to identify population groups most affected by HIV. HIV incidence for Canada was determined using back-calculation methods.

Enhanced surveillance for acute and likely acute hepatitis B in Canada: 1999 to 2002.

Objective: To assess the incidence of clinically identified hepatitis B cases, as well as the demographic and risk behaviour profiles of these cases in a defined Canadian population.

Methods: An enhanced hepatitis surveillance system was established in October 1998 to identify acute hepatitis B and C cases in Canada. Acute and likely acute cases, as determined by laboratory testing, collectively defined incident clinical hepatitis B cases.

Predictive validity of five comorbidity indices in prostate carcinoma patients treated with curative intent.

Background: Comorbidity is important to consider in clinical research on curative prostate carcinoma because of the role of competing risks. Five chart-based comorbidity indices were assessed for their ability to predict survival.

Methods: This was a case-cohort study of prostate carcinoma patient cohort treated with curative intent in Toronto and Southeast Cancer Care Ontario regions between 1990 and 1996; the subcohort was drawn from these men, whereas cases were cohort members who died from causes other than prostate carcinoma.