Research

Research spotlight

• The Athena Project
• Neurofeedback Therapy
• The Minority Mosaic Study
• Mental health and well-being of Afghan-Canadian Language and Cultural Advisors (LCAs) who served with the Canadian Forces abroad
• Public policy portfolio development

The Athena Project

Led by the Applied Research team, the Athena Project is a new initiative dedicated to research and building community in support of women Veterans’ well-being.

There is a lot that remains to be discovered about the lived experiences and health of women Veterans in Canada. Many researchers have done work in this area but there is still a lot to understand so that women Veterans can receive the support and care that they need to flourish and thrive.

While some experiences will be similar regardless of sex or gender, there are some factors that are important for or impact only women. One important area, identified in our recent Women Veterans Dialogue Series, is the need to better understand how experiences from service might relate to mental health outcomes as a woman Veteran. This is the overarching objective of the Athena Project.

The Athena Project takes a community-based approach, which integrates people with lived experience into the research team to ensure that our study is informed by lived experience and is meaningful to women Veterans. The Athena Project Working Group is composed of 14 women who served in the CAF and RCMP and Atlas Institute researchers, all of whom are passionate about advancing research in the field of women Veterans’ well-being.

The working group is a space where researchers and women Veterans are learning from each other to shape new research at the Atlas Institute. The group’s insights and expertise provides context and depth to our work, and ensures that our research reflects the real-world priorities of those it aims to serve. The working group is harnessing the power of shared learning, collaboration, and empathy, and reflects the value the Atlas Institute places in research being genuinely shaped by those most affected by its outcomes.

Neurofeedback therapy

To contribute to the growing body of evidence showing that neurofeedback is a promising treatment for PTSD and other mental health concerns, the Atlas Institute has initiated a program of research focussed on exploring its efficacy .

When people develop PTSD specific regions of their brain can be over-or under-activated, leading to thoughts, emotions, moods, and behaviours that can be unhelpful or distressing. Neurofeedback, a non-invasive therapy that does not involve pain or medication, helps individuals to gain control over their brain activity. By learning how to self-control brain activity, they can respond and think more clearly, balance their emotional responses, and manage triggered behaviours such as avoidance, anxiety, or panic.

There are two primary types of neurofeedback therapy available. One uses electroencephalography (EEG) to recalibrate brainwaves, while the other uses real-time functional magnetic resonance imaging (fMRI) to recalibrate patterns of brain activity and the connections between different brain regions. Both forms of neurofeedback therapy allow clinicians to assess altered brain functioning resulting from trauma and provide feedback that helps individuals learn to self-regulate brain activity that can cause PTSD symptoms.

A collaborative clinical trial between the Atlas Institute for Veterans and Families, the University of Ottawa, Western University, and the University of Geneva has shown the potential of EEG neurofeedback therapy to non-invasively heal trauma-affected brain regions. Two published studies from this trial show the efficacy of neurofeedback training in resetting EEG brainwaves and improving emotion regulation among individuals with PTSD. Participants who underwent neurofeedback therapy had significantly reduced PTSD severity scores following treatment, with a remission rate exceeding 60% at the three-month follow-up, meaning they no longer met diagnostic criteria for PTSD.

The Atlas Institute, in collaboration with Western University, has recently launched a real-time fMRI neurofeedback study in individuals suffering from PTSD symptoms. In this study, we will see whether individuals with PTSD can learn to self-regulate their own brain responses to emotion inducing words. In this study, we will examine the effects of multiple sessions of fMRI-neurofeedback and compare changes in PTSD symptoms and brain activity for two different brain areas that are associated with PTSD (posterior cingulate cortex and amygdala. An additional group of participants receiving a “fake neurofeedback signal” as a control group. Here, our primary goal is to see whether fMRI neurofeedback training over three separate sessions (one per week) will help reduce PTSD symptoms.

The Minority Mosaic Study

Minority stress is the excess stress, discrimination, and prejudice that individuals face due to their minority status/stigmatized identity (i.e., race, sexual orientation, gender, ethnicity, etc.). For instance, sexual minorities experience distinct, chronic, and uncontrollable stressors related to their stigmatized sexual orientation identity (e.g., discrimination, hate crimes, internalized homonegativity, and microaggressions/everyday indignities). Together, these experiences can lead to significant adverse changes in thoughts and behaviours, which can either compromise the mental health of sexual minorities or lead to resilience i.e., “strength through adversity.”

At the Atlas Institute for Veterans and Families, we are conducting research to uncover the effect of minority stress exposure on the brain in order to promote change, foster resiliency, and help those who have been psychologically injured by these experiences. Our research examines both the lived experience, and the adaptations to the brain and body, that are associated with minority stress exposure among sexual minorities with intersecting identities. Therefore, the study consists of two complementary parts: phase 1 involves qualitative interviews to examine lived experiences of individuals exposed to minority stress; and phase 2 examines the neurobiological markers of minority stress exposure. Data collection for phase 1 has been completed and we are currently collecting data for phase 2 at the Brain Imaging Centre (BIC) housed at the Royal Ottawa Hospital. Specifically, we are examining how minority stress exposure (i.e., discrimination) is associated with functional adaptations in the brain using fMRI  data. Taken together, these findings will help to elucidate the neurobiological basis of minority stress and will inform how systemic societal oppression influences risk and protective factors for mental health outcomes.

Mental health and well-being of Afghan-Canadian Language and Cultural Advisors (LCAs) who served with the Canadian Forces abroad

A small group of civilians, known as language and cultural advisors (LCAs for short), were a critical – yet largely unknown – part of Canada’s over decade-long presence in Afghanistan. As recent immigrants to Canada, they were recruited to support our 40,000 soldiers, often going “outside the wire” (or off base) to provide linguistic and cultural advice. At approximately 65 people, they were a small but mighty group.

Despite their critical role in the conflict in Afghanistan, there is little awareness about the existence, role and contributions of LCAs. There is also limited knowledge on their mental health status and support needs after their return home to Canada. In fact, no studies or data specifically on LCAs seem to exist. Instead, much of what we know about them comes from news stories and research on similar groups like contractors. Research on Canadian Armed Forces  members tells us that the post-service transition period is critical and may be when support needs are highest. This may also be the case for LCAs given similarities in their deployment experiences, making this lack of knowledge especially problematic.

As a first step in building knowledge and improving understanding of this particular group, the Atlas Institute for Veterans and Families led a study on the experiences of former LCAs, guided by an advisory group. What emerged was a significant gap between what is available and what is needed, with many describing an absence of appropriate mental health and wellbeing supports despite a preponderance of lasting impacts.

Although Veterans and their families have options available to them when they need support for injuries related to their service, it is less obvious where LCAs and their families can turn. Because LCAs are considered contractors, neither they nor their family members are eligible for mental health services from Veterans Affairs Canada, unlike the soldiers they accompanied. Directed to go through their provincial workplace safety and insurance boards instead, the uniqueness of their situation meant that some experienced significant difficulties accessing services or had their claims denied – a decision currently under review in Ontario.

Notably, in response to the Taliban’s takeover in 2021 and resultant safety risks to the families of those who worked with international forces, the government recently announced a temporary policy change, extending permanent residency to family members of LCAs. This policy is similar to that for local interpreters introduced back in November 2021. Although also described by some as restrictive, this policy change is welcome recognition of the immense contributions, risks and sacrifices made by LCAs and prioritizes the safety of their families.

Nonetheless, there is more to be done to close these described gaps in awareness, knowledge and action. This study represents a starting point. More work is needed to build on these findings and to better understand what LCAs have lived and are still living through.

One potential way forward that emerged through engagement related to this study is to bring the contributions of LCAs into public and political discourse, such as via media stories or education events. Another focused on the provision of dedicated funding for more research on LCAs, which can then inform the design of policies or programs. Over time, this awareness and knowledge can transform into action – namely, the development of appropriate services – to ensure LCAs and their families get much needed access to mental health supports. Baseline awareness and understanding are crucial for meaningful action.

Afghanistan was not the first – and will certainly not be the last – mission where LCAs have played an important role. For example, they also played a role in Bosnia and Iraq. It is important to take the right steps now to create a climate of understanding and respect for their contributions and needs, paving the way forward for LCAs and other civilian contractors sanctioned by the Government of Canada to receive the support they need, let alone deserve.

Public policy portfolio development

Public policies are developed at all levels of government (federal, provincial, territorial and municipal). These policies are developed with input from citizens, government staff and elected officials. Public policies can be guidelines, rules, regulations, laws, principles or directions that specify what should be done, by whom, for whom and how it is to be done. The Atlas Institute initiated three interrelated foundational projects (set to be completed August 2023) to map out existing public policies and associated gaps and to set priorities for impact:

1. A policy scan specific to Veterans and Families mental health and well-being using academic and grey literature.
2. Policy engagement with organizations that serve an intermediary, advocacy and/or knowledge mobilization role.
3. An internal policy framework based on Canadian and international evidence and leading practices.