Impact Report 2021-22

WHY ATLAS?

The Atlas Institute for Veterans and Families was originally established as the Centre of Excellence on PTSD (CoE – PTSD) through the Minister of Veterans Affairs’ 2015 mandate letter. However, it quickly became evident that the community was looking for something different and that would reflect what it was that Veterans, Families, researchers and service providers identified in terms of issues, goals and directions.

Throughout the past year, we undertook an integrated strategic planning and branding process which involved extensive consultation with stakeholders connected to the Centre itself to determine what the evolution would be. With this integrated approach, both the strategic plan and brand were developed to complement each other, and reflect what had been learned through the consultative process.

Based on our engagement with Veterans and Families, several themes emerged: the original name was limiting in scope as it focused on a single condition, it didn’t identify who the organization was intended to serve, and the diagnostic feel of the name could perpetuate stigma, preventing people from coming forward and engaging. We also heard that a neutral name would be more welcoming. While the concept of being a centre of excellence was important as an aspiration, it didn’t need to be part of the name.

The community identified the key characteristics they wanted our organization to embody, and then how to best reflect that in our name and brand. What was identified through the consultative process was that these archetypes or personalities best reflect what we should represent for the people we serve — CAF Veterans, former members of the RCMP and their Families.

Those that were emerged were:

• The Explorer – who will search for ways to help Veterans and their Families become free of the stigma and confines of trauma-related mental health conditions.
• The “Everyman” (or rather the “Everyperson”) – who will ensure that everyone has equitable access to services and supports, and that everyone’s voice and experiences are heard.
• And the Outlaw – who will disrupt the status quo and create a better future.

The next step was to find a name that would embody these characteristics of direction setting, disrupting the norm, and supporting Veterans and Families.

• An atlas — a reference books of maps or charts — provides direction and information.
• In Greek mythology, Atlas led Titans into battle against the Olympians. As punishment, he was compelled to carry the weight of the world on his shoulders.
• In architecture, an atlas is a column of support.

These metaphors combined to give us our new name, to chart the course of our work, and to cement our commitment — and our responsibility — to improve the daily lives of Veterans and Families.

A STRATEGIC PLAN TURNS ASPIRATION INTO REALITY

This past year we came back to connect with the community we were built to serve, to help us co-create the strategic priorities for our 2022–27 strategic plan. This plan would help us find novel ways to ensure that Veterans and their Families have access to evidence-based care that makes a difference for their mental health and well-being. Toward that end, we had the community participate in many different touchpoints, including interviews and mini virtual retreats that brought together Veterans, Family members, service providers and researchers.

We asked questions about what we should focus on to support all Veterans and their Families. This included a deep dive to identify the specific needs of Family members, taking a broad definition of Family to include immediate and extended Family as well as friends. We sought to understand potential (or promising) areas for research, as well as the knowledge needs of Veterans and Families. We wanted to learn how to support service providers by offering resources that build an understanding of the military and RCMP cultures and the unique challenges experienced by those who have served. And, we focused on how to accelerate action in key areas that will translate into tangible improvements in the mental health and well-being of Veterans and Families.

What we heard through this process is that Veterans want a place to tell their stories about where they have been, and that Families need to be involved in every step of the process. We heard that not all military members are the same, their experiences differing by gender, trade, element and other factors. We heard that empowering Veterans in their choices is important. They identified the need for a holistic, multifaceted approach tailored to their specific needs, one that includes non-traditional options. And, we heard that people need to have hope, a sense of belonging, meaning and purpose.

The strongest message coming from these consultations was this: Veterans and Families need to know that we have their backs. They need to trust that we are there to help create access to safe, meaningful resources and supports to improve the mental health and well-being of themselves and their loved ones.

Everything we learned through this process was distilled into four key areas of focus that will provide a foundation for our work, guiding it for the next five years and beyond:

Community helping us to shape priorities and goals: Our reference groups

Atlas’s four reference groups — Veterans, Families, service providers, and researchers, made up of over 50 participants — meet quarterly to provide the strategic advice, expertise, and recommendations we rely on for specific initiatives and priority areas. Their contributions help us to stay connected to what is happening and what is needed in the communities we support. Reference group Chairs form the Atlas Institute’s Advisory Committee.

Some of the topics reference group members raised as key considerations within their respective communities include:

Veterans:

• The need for stigma reduction related to mental illness
• Challenges related to mental health service navigation
• A need for information related to alternative and non-traditional healthcare
• The need for training or resources for service providers related to military culture
• A lack of resources that are specific to RCMP

Veteran Families:

• The need to create a Families resource hub
• Techniques to communicate and de-escalate situations of high intensity with a Veteran loved one, and a general need for information related to PTSD
• A need to for increased mental health service access for Veteran Families

Service providers had conversations about the following topics:

• Improving resources for service providers working with Veterans (military sexual trauma, moral injury, service standards)
• Exploring the impacts of COVID-19
• Training frontline workers in military culture

Researchers:

• Creating more and better Canadian evidence related to mental health treatments and research
• Turning community needs into research projects
• Creating new best practices for researchers pursuing work related to research with Veterans

We collect data related to individual meeting satisfaction and overall engagement following the quarterly meetings. Overall, the majority of reference group members report feeling that their input is valued by the Atlas Institute and report a high level of satisfaction with their engagement.

Community working with us to make real change: Our partnerships

Partnerships are critical for information sharing, strategizing, co-creation, and driving change. At Atlas, our Network of Networks – a constellation of national and international partners – collaborates to build supports tailored for, and responsive to, the needs of Veterans and their Families. We currently have 184 stakeholders participating in our project advisory committees, reference groups and communities of practice across Canada and globally.

International

Although part of multiple international partnerships, a key one which Atlas is proud to participate in is as a member of the Five Eyes Mental Health Research and Innovation Collaboration (MHRIC). Created in 2018 and co-chaired by Phoenix Australia and the Canadian Institute for Military and Veteran Health Research (CIMVHR), the MHRIC convenes thought leaders from the Five Eyes nations (Australia, Canada, New Zealand, United Kingdom and United States) to connect on emerging and current research areas and move forward on common priorities to advance the field of mental health research and treatment for military members, Veterans and their Families across the five nations.

As part of this collaboration, Atlas was pleased to support the following publications:

• Pathways to mental health care in active military populations across the Five-Eyes nations: An integrated perspective: https://www.sciencedirect.com/science/article/pii/S0272735821001434
• Addressing the mental health needs of civilian combatants in Ukraine: https://pubmed.ncbi.nlm.nih.gov/35305300/
• The effect of the withdrawal from Afghanistan on military personnel’s mental health: https://www.sciencedirect.com/science/article/abs/pii/S2215036621003692?via%3Dihu

Atlas looks forward to continuing its participation in the Five Eyes MHRIC, particularly to collaborate on shared research priorities and support knowledge mobilization efforts across the countries.

Across Canada

This past year we signed a Statement of Agreement to partner with the Canadian Institute for Military and Veteran Health Research (CIMVHR) and Chronic Pain Centre of Excellence (CP CoE). Through this agreement we will undertake a systematic review to identify psychometric tools to both measure housing and physical environment and then further the collaboration by broadly mobilizing the knowledge.

This past year we established a formal agreement to partner with the Canadian Institute for Public Safety Research and Treatment (CIPSRT). As part of this official agreement, we worked together to establish a National Collaborative on PTSD and Related Mental Health Conditions. The purpose of the National Collaborative is to enhance our collective understanding of PTSD and related mental health conditions, and leverage the breadth and depth of existing knowledge across Canada. Anticipated outcomes of the collaborative include an enhanced collective understanding of the impact of PTSD and related mental conditions on military members, Veterans and former members of the RCMP, Public Safety Personnel (PSP), and their Families. This collaborative will provide an opportunity to understand the work related to PTSD by peer organizations. Members include representatives from charitable or non-profit organizations, community or family foundations, granting organizations, government departments or agencies, and other intermediary organizations.

In addition, we are working with CIPSRT, McMaster University, Veterans Affairs Canada, the Public Health Agency of Canada, and CIMVHR to update the CIPSRT Glossary of Terms to version 3.0. The purpose of the glossary is to enhance the accessibility of conversations related to PTSD, to facilitate open and transparent discourse. In particular, the Glossary of Terms acknowledges the ever-evolving language of PTSD and related terms, which has resulted in the development of the third version of this document.

We partnered with the Mental Health Commission of Canada (MHCC) to deliver the SPARK Knowledge Translation Training Program. The program helps participants turn ideas that aim to support the mental health and well-being of Veterans and Families into action. Thirteen individuals are currently enrolled in the program, representing various services, including employment services, clinical and non-clinical intervention services, and homelessness support services. Participants began their training through eight workshop sessions in July 2021. They will continue to work on developing their ideas into project plans until July 2022, with the dedicated support of mentors who have previously graduated from the program.

We also have 24 formal partnership agreements in place with leading community and governmental organizations, academic partners and healthcare centres in Canada, the U.S. and Australia.

KNOWING WHAT IS NEEDED: Doing the ground work

We’ve seen you. We’ve heard you.

Here is how we are turning the information, guidance and insights we have received from our stakeholders into activities and products with tangible results for our community.

Finding out what our community wants and needs

Our goal is to achieve real change for Veterans and Families.

To accomplish this, we needed first to know what is missing in research, knowledge sharing, and service provision. Having an in-depth understanding of the landscape will help us to create a work plan that reflects real-world needs and offers tangible solutions. To achieve this, we undertook two major studies:

Research gap and knowledge needs analysis

In spite of increased awareness of the mental health needs of Veterans and their Families, there are still gaps in the evidence base and in knowledge sharing that, in part, make it difficult to develop, deliver, and assess the effectiveness of supports. Gaps in knowledge sharing also limit Veterans’ and Families’ access to important, accessible information they may be seeking. In 2021, the Atlas Institute commissioned a systematic review of research literature and stakeholder consultations to identify research and knowledge needs specific to PTSD and related mental health conditions. Of the more than 5,000 publications that were screened, more than 2,000 articles were relevant and were included in the analysis.

We consulted with stakeholders — Veterans, Families, researchers, service providers and decision makers — through a detailed online survey. And, we also conducted a systematic literature review of English-language research published from 2010 to 2021 in Canada, the United States, the United Kingdom, Australia, New Zealand, and Israel. Finally, we undertook an environmental scan of research and knowledge sharing efforts currently underway around the world, which identified 339 studies and 175 knowledge products and resources.

With respect to research, gaps were identified in each of the areas examined (screening, assessment and treatment; health services research; causes and impacts; prevention, mitigation and early intervention; patterns and groups, such as women, Veteran Families and men; and social services and supports). In terms of knowledge sharing, it was identified that clear-language information that is accessible, reliable, credible and up-to-date is needed along with a central repository, or hub, to facilitate access to resources for a wide range of audiences.

The findings will be used by the Atlas Institute to identify high-impact, high-priority topics that can be addressed as part of its ongoing research and knowledge sharing agendas.

Needs assessment survey for service providers

We also sought a deeper understanding of the knowledge and training needs of service providers who are working with Veterans and Family members and the preferred modalities to best support the delivery of capacity-building initiatives designed to meet those needs.

We distributed a national online survey for healthcare professionals who provide a wide range of mental health services. The most common professions responding were psychologists, psychotherapists, social workers, and counsellors.

We received responses from service providers in every province, and one territory with almost 700 responding to our survey in total. Among the respondents, there were 437 Medavie Blue Cross Federal Administered Program Providers.

We are using the results of the needs assessment to inform the development of educational resources, along with our promotion and delivery of clinical and other trainings for service providers, which began in early 2022.

Highlights

Expand what we know

Having knowledge to share starts with new discoveries and reliable data. Our research team is hard at work applying their experience and expertise to developing lines of inquiry as well as pursing the lines of inquiry identified by our reference groups, our lived experience team, our gap analysis, and by our community at large. This year, the work of our research team and its partners around the world has resulted in:

• 11 research projects
• 3 new research partnerships
• 16 published manuscripts
  • 13 citations
• 4 manuscripts under review
• 10 conference presentations

Improving care and support

Service providers are on the frontline of the care system for Veterans and Families. We must ensure that they have the training and resources they need to provide effective care to those who have served our country. We have seen some immense successes this year in creating training opportunities and resources for service providers:

• We partnered with The Royal Ottawa Mental Health Centre and Operational Stress Injury Centre to offer a four-day workshop in prolonged exposure therapy to 29 eligible clinicians who care for Veterans and their Families. The Atlas Institute covered the expenses for the training so that clinicians working to support this population have access to training in evidence-based care. Eighteen participants also continued their training by participating in 12-weekly group consultation sessions, also coordinated and given free of charge by Atlas.
• We partnered with Drs. Candice Monson and Philippe Shnaider to offer a four-day workshop in cognitive processing therapy to eligible clinicians who care for Veterans and their Families. Ninety-six clinicians participated and 54 have continued on with a 20-week group consultation.
• Five hundred service providers will receive free trauma awareness training for trauma-exposed professionals, including current and former military and RCMP, thanks to a new partnership with Wounded Warriors Canada.
• Two sections of a resource for leaders in healthcare, “Understanding and Addressing Moral Injury: A Toolkit for Leaders,” was published on our website, with three more sections to come.
• We began working with CIPSRT to co-lead and co-chair a National Peer Support Community Network (PSCN) to co-develop minimum guidelines for the delivery of peer support for Veterans, Public Safety Personnel and their Families.

Engaging and Informing

We continue to build the Atlas suite of resources for Veterans, Families, service providers and researchers. To date, we have created over 50 accessible fact sheets and reports, toolkits, guides, videos and web resources on topics including:

• Coping with events in Afghanistan
• Military sexual trauma
• Moral injury
• Therapy options for PTSD
• Intimate partner violence
• Representation of Veterans in the media
• Suicide
• Families living with PTSD
• Veteran and Veteran Family testimonies

In addition, our website continues to be an effective and engaging voice for Atlas, providing a central hub of information, support services, resources and news items. This year culminated in 91,879 page views.

1. Coping with events in Afghanistan – Views: 2,906 | Visits: 2,051
2. PTSD and some options for therapy – Views: 4,416 | Visits: 3,049
3. Military sexual trauma – Views: 5,465 | Visits: 2,028
4. Intimate partner violence – Views: 4,963 | Visits: 2,510
5. For Veteran Families and friends – Views: 4,383 | Visits: 3,253

Responding to Community Need

Military Sexual Trauma Symposium Series

Military sexual trauma impacts thousands of Canadians, and their loved ones supporting them. As part of the Canadian Military Sexual Trauma Community of Practice, along with McMaster University’s Department of Psychiatry and Behavioural Neurosciences, we hosted a three-part virtual symposium on MST.

The symposium began on June 3, 2021 and delivered three sessions through September 2021. Bringing together researchers and policy leads from across universities, government departments and intermediary organizations, as well as individuals representing those with lived personal experience of MST, the symposium offered a cross-section of disciplines and walks of life. More than 1,000 people attended the three virtual events. Of those who responded to the post-event surveys, we learned about two-thirds of attendees were there to inform their work.

Satisfaction rates for the individual events:

The evolving discussion on military sexual misconduct and military sexual trauma: An introduction

• Quality of presenters: 85%
• Quality of presentations: 82%
• Overall symposium: 81%

Services and supports for people affected by MST

• Quality of presenters: 86%
• Quality of presentations: 84%
• Overall symposium: 84%

A path forward

• Quality of presenters: 86%
• Quality of presentations:84%
• Overall symposium: 86%

Words matter: Guidelines for journalists reporting on Veterans

On October 27, 2021, we hosted a webinar to present and discuss a newly developed resource that aims to improve media coverage of Veterans’ mental health conditions and suicide. The resource, titled Media Guidelines for Reporting on Veterans, with a focus on PTSD and suicide, was co-developed with Dr. Rob Whitley of the Douglas Research Centre at McGill University.

Using a case study approach from recent media coverage of an Afghanistan war Veteran, the webinar aimed to provide audience members with the opportunity to learn about the purpose and intended impact of the media guidelines on Canadian journalism. A panel discussion discussed the findings and media guidelines among stakeholders, including those with lived expertise as well as representatives from academia and the journalism industry. The intention of the webinar was to share ways to improve communication between journalists and Veterans during interviews as well as to inform future Canadian journalists who will be covering Veterans’ issues.

Stats

• 94 attendees to the event

In a post-event survey

• 100% of respondents reported that they would be interested in attending future webinars regarding Veterans’ mental health, hosted by the Atlas Institute.
• 78% of respondents reported that the content of the webinar was relevant to them.
• 56% reported that the event improved their understanding of the influence of the media on Veterans’ mental health.
• 78% of respondents reported that they are interested in learning more about issues related to representations of Veterans in the media.

Families matter: Exploring military and Veteran Family involvement in suicide prevention in Canada

There is increasing awareness – in research, practice, and policy – that members of military communities, including Family members, are more likely to experience suicidal thoughts, engage in suicidal behaviours and die by suicide. Families play vital roles in suicide prevention. Suicide has serious and lasting impacts on Family members. These impacts can be physical, emotional, spiritual, and relational.

In November of 2021, in alignment with International Survivors of Suicide Loss Day, we co-hosted a webinar in collaboration with Dr. Heidi Cramm and Dr. Denise DuBois of Queen’s University. Through two presentations and a panel discussion, the webinar was intended to increase understanding of how Families are included or reflected in suicide prevention, intervention, and postvention activities across multiple jurisdictions, to share knowledge from relevant research findings, and bring together a variety of community perspectives to chart next steps. Joined by members of the community from service providers to those Family members sharing their personal stories of loss, what we heard is that the needs of Families are often overlooked or forgotten in research, policy, and practice related to suicide prevention as well as within the wider military institution. These all need to be more “Family engaging.”

We also heard that while Family members can be a crucial source of support for their loved ones, they matter in their own right and need appropriate supports, training, and resources across the suicide prevention pathway, from prevention to postvention. Central to this need is education to help Family members navigate issues related to mental health and suicide.

Stats
Of the 143 individuals who attended the webinar, many responded to a post event survey where we learned that:

• 96% of respondents reported that the content of the webinar was relevant to them.
• 77% of respondents reported that the event improved their understanding of the need for Family-inclusive military and Veteran suicide prevention efforts.
• 92% of respondents reported that they are interested in learning more about suicide prevention within military communities.

Coping with Current Events: Help for Veterans and former RCMP members, their Families, and Friends

Global events have the potential for significant impact on Veterans, particularly when it relates directly to their service. We saw this unfold in August of last year when troops left Afghanistan and the Taliban regained control and then earlier in 2022 with the conflict in Ukraine. Working closely with Canadian Veterans and their Families to more fully understand and appreciate the impact this was having on them, and what they needed for support, we heard that it is important for all Veterans and their Families to hear and to feel that the public has their backs. The best way to do this is by being informed and prepared for the significant support many Canadian Veterans and their Families may require to process the traumatic impacts associated with events such as these.

Knowing it is vital that any Veteran, Family member, friend, or service provider with someone close being triggered by these would have access to resources and advice to support their care and well-being, we developed an online resource section with information, practical ideas and tips for coping among other resources for those impacted by ongoing conflicts around the world. These resources are intended to provide supportive suggestions and information related to common reactions many may be experiencing at the moment, as well as coping tips and available resources for mental health and well-being support.

Social Reach

Concurrently, our social media reach continued to grow throughout the year. By year’s end, we experienced significant growth on all of our social channels:

• Facebook: 832 followers | up 263.3% from 2020–21
• Twitter: 887 followers | up 64% from 2020–21
• LinkedIn: 781 followers | up 205.1% from 2020–21
• Email marketing: 1,326 contacts | up 69% from 2020–21