The Things They Carry

"All of my pieces have to do with my healing, my journey," says Bruce Cleveland, holding a stone carving of a howling lone wolf. He turns the carving on its side. A limb is missing. "There was a flaw in my rock but I thought, 'That's it, that's life. What looks good on one side might not on the other.' " Cleveland, a former captain with the Canadian Armed Forces, adopted stone carving as therapy for his major depressive disorder and post-traumatic stress disorder.

Cleveland's words will sometimes slip away mid-sentence. His moods can be explosive. He's so hyper-vigilant that at a picnic this summer he nearly attacked a family member who accidentally fired a toy Nerf gun in his direction.

Much of what we know about depression, suicidal thoughts and anxiety in the military is based on self-reporting - asking the person to accurately and honestly detail what they are experiencing physically and mentally. But diagnoses can't rely on self-reporting alone, especially when soldiers know that "being honest" could halt their careers. And because earlier intervention makes for a better outcome, this inability to be forthright leads to a festering that can complicate recovery from mental health issues, says Cleveland.

"We're all great actors," he says, sitting in his Edmonton home not far from the CAF base he was transferred to in 2006. It was there that he began treating the mental health of repatriated Afghan war casualties, all while his own health started declining. "The world could be falling around us and any one of us could sit there stone-faced and tell a happy story."

Though self-reporting is flawed, the CAF's 2013 mental health survey showed the rate of reported post-traumatic stress disorder among its members has nearly doubled since 2002, to 5.3 per cent. Despite what many are calling a mental health crisis, it's rare for the Canadian Armed Forces and academics to collaborate on such matters.

After 25 years in the CAF - first with the artillery, then combat engineers and finally as a uniformed military social worker - Cleveland received a medical discharge three years ago. In 2012, he became founding program manager of the Canadian Military and Veterans' Clinical Rehabilitation Research Chair, a role that allowed him to serve as a link between the military and the researchers at the University of Alberta. (He left the UAlberta clinical rehabilitation program after a year in the position to focus on his own mental health.)

The chair, which is a first for Canada, is dedicated to research that will improve the quality of life for people in the military and for veterans. And it is only one piece of the efforts taking place across UAlberta to address issues affecting these populations, says Elizabeth Taylor, associate dean of Professional Programs & Teaching and a professor in the Faculty of Rehabilitation Medicine.

UAlberta's BLINC Lab - bionic limbs and improved natural control - has imported and improved upon leading-edge bionic limbs, including arms that allow patients to sense touch again through muscle re-innervation surgery. The 15-person team has also invented its own bionic parts at a fraction of the standard $60,000 to $500,000 prices, while prototyping new limbs with 3D printing models. Another dramatic example of research that can benefit members of the military is the much-publicized ReWalk Robotics Exoskeleton, a device that allows people with spinal cord injuries to once again stand upright, walk and even climb stairs.

There are researchers working on smartphone apps to help people with brain injuries manage memory issues. Another app could help people living with PTSD alleviate the stressors wherever or whenever the symptoms hit, rather than having to seek medical support every time. And, of course, existing research on sleep and concussions can also benefit veterans.

And because this is clinical research - where the researchers are working directly with clients - the work brings immediate benefits. This helps veterans in the here and now, says Taylor.

Taylor is passionate about this work. Both her father and her son have served in the military and her uncle, who once served as a bomber pilot, demonstrated the symptoms of PTSD long before it was an issue that society discussed openly. But, mostly, Taylor believes in the potential of research to unlock practical solutions for the issues facing those serving in the military, veterans and first responders. And she sees the need to create a single institute that could co-ordinate the collective efforts of all universities in Western Canada. She believes UAlberta has the capacity to create such an institute.

"We owe our military, veterans and first responders the best research and the best services that we can provide," says Taylor. "When you think of what they do for our community, when you think of what they do to make all of our lives better and safer - we owe it to them."