‘There’s no club, absolutely nothing’: Experiences of parents of Veterans living with illnesses and injuries in Canada

Abstract

Introduction:

Research and programs for Veteran families often target those with young children, leaving parents overlooked, despite the role some adopt to support adult children following military-acquired illnesses or injuries. The objective of this study was to lay groundwork in studying the experiences of parents of Veterans through an initial exploration of parents of Canadian Armed Forces (CAF) Veterans living with operational stress injuries (OSI).

Methods:

A phenomenological approach was used to create rich, thick narratives focusing on experiences and meanings, collected through in-depth semi-structured interviews conducted with 15 parents of CAF Veterans with OSI. Interpretive phenomenological analysis was done during data collection. Rigour was enhanced through reflexive practices and team debriefing.

Results:

Six themes described parents’ experiences: 1) being exasperated by persistent, dynamic, and unanticipated demands for instrumental support, 2) living in a constant state of worry and guilt about their adult children, 3) feeling at a loss for what to do and where to go for support, 4) dealing with consequences to their own health and well-being, 5) wreaking havoc on relationships, and 6) being left to pick up the pieces alone.

Discussion:

Parents of CAF Veterans living with OSI described feeling forgotten, despite significant costs in supporting their children. This exploration invites several future research directions, including a more in-depth exploration of the caregiving role parents may adopt, implementation of a family-centred circle of care, help navigating the system, connection with other families, psychoeducation, and public awareness.

Lay Summary

Parents of Veterans are often excluded from literature or programs surrounding military and Veteran families. Parents can play an important role in their adult child’s life following an operational stress injury. Little research has been done to look at how supporting an adult child may affect the parents. Parents of Canadian Armed Forces Veterans were interviewed to discuss their experiences supporting an ill or injured adult child. Parents reported taking on many additional responsibilities and often feel worried, guilty, and lost. These demands impacted their own health, well-being, finances, jobs, and relationships. They described feeling forgotten and betrayed by the lack of support and programs available for them. It is important that all parents are given the support and programs required, demonstrating a need for more in-depth explorations of what families of Veterans experience and need in Canada.

Introduction

Families are affected by all aspects of military service, including frequent relocation to different communities, regular absences for training and deployment, and increased and real risk for injury, illness, and death.^1,2 Many military services created programs and supports for military families to counter these effects. In 2008, the Canadian Forces Family Covenant served to further develop the network of Military Family Resource Centres established in 1991 offering “specialized programs and services that promote health, education, and social well-being.”³ Canada’s defence policy, Strong, Secure, Engaged, acknowledges the important role families play in the lives of military members, noting that military families are supported “physically, psychologically, and socially,”^{4(p. 12)} and asserting that military families “must have access to the support and services they deserve, to cope with the unique challenges and stresses of military family life.”^{4(p. 28)}

Despite the pledge to support all military families, existing programs and services typically target families with young children.⁵ Focusing programs and services exclusively on traditional definitions of families (i.e., heterosexual couples with children) ignores the role of parents in the lives of military members and Veterans across the life course.⁵ Exclusion of family members who do not fit into the heteronormative military family subtype is highlighted in a scoping review by Gribble,⁶ who stated that the continual focus on the heteronormative family results in a lack of understanding of other military or Veteran family members, including parents. Veterans with military-acquired injuries or illness may rely, fully or in part, on their parents for help and support. Despite this, there remains a significant gap in literature exploring the experiences of parents of ill and injured Veterans, with parents notably under-represented when exploring both military and Veteran family populations,^7–11 with little programming and support specifically for them.^7–9

Existing literature on parents has primarily focused on experiences while serving children are deployed, underscoring ambivalent and mixed emotions including fear, anxiety, pride, compassion fatigue, and worry.^7–10 The purpose of this qualitative study was to lay the groundwork for studying the experiences of parents of Veterans in other contexts, through an initial exploration of the experiences of parents of Canadian Armed Forces (CAF) Veterans living with illnesses or injuries associated with military service.

Methods

Design

Phenomenological approaches focus on experiences and meanings ascribed by participants to create rich, thick narratives.¹² Grounded in the constructivist/interpretive paradigm that conceptualizes reality as developing through participants and their subjective views,¹³ the study followed an interpretive phenomenological analysis (IPA) approach to explore the experiences of parents who provided support to adult children engaged in the process of releasing from military service who experienced illnesses or injuries attributed to service. IPA is grounded in the detailed exploration of how participants make sense of their personal and social world, with the goal of understanding the meaning these experiences hold for participants.¹³ IPA involves collecting and analyzing participant perspectives for emergent themes to explore the commonalities and divergence across participants’ unique experiences.^12–14 The authors involved in this data analysis acknowledge their positionality as regulated health professionals and researchers with advanced degrees conducting research about military and Veteran families.

Ethical clearance for this research was obtained by the Health Science Research Ethics Board at Queen’s University.

Data collection

Recruitment took place through social media, print, and philanthropic organizations. Following initial difficulties in recruitment, made more difficult by the COVID-19 pandemic and its countermeasures, inclusion criteria were expanded from parents to include parents-in-law. Ads were also placed in Canadian Military Family Magazine, which yielded no additional participants. In-depth qualitative interviews with parents were conducted using a semi-structured interview guide. Conducted by phone (HC), interviews were approximately two hours long and took place between September and December 2020. Transcripts were transcribed verbatim by a professional transcriptionist.

Data analysis

Data analysis, following the IPA approach described by Smith and Osborn,¹⁴ was done concurrent to data collection, with emergent themes identified following initial reading of transcripts. Themes were developed by combining the experiences of participants with the researcher’s interpretation of them to capture the essence of the experience by describing commonalities and differences in the participant’s subjective experience and meaning making that experience.¹⁴ To enhance rigour, reflexive practices and team debriefing were used, including discussions about general thematic observations from interviews and transcript reviews (HC, LTS). Thick descriptions were developed to enhance the transferability of the findings.

Results

Participants

A total of 13 adult children were represented in the sample; 3 participants were parents-in-law and 12 were parents of CAF personnel who released, or were in the process of releasing, because of illnesses and/or injuries acquired during military service. Two sets of spouses opted to participate as separate individuals, agreeing not to discuss their interviews until both were completed. Participants were a mixture of mothers, fathers, and parents-in-law. Ten of the 15 participants were 64–66 years old (mode 65 y), with 3 between the ages of 49 and 61 years and 3 from 69 to 75 years old. Many participants grew up in military families, with a few having served in the military as well. Fourteen participants spoke only English at home and one participant indicated they spoke primarily another language at home. Participants were based in Ontario (n = 11), British Columbia (n = 1), Alberta (n = 1), and Atlantic Canada (n = 2).

As for the children of the participants, three opted for a voluntary release, despite significant ongoing health issues that subsequently resulted in diagnoses. The two women represented among the children both experienced military sexual trauma. According to their parent’s/parent-in-law’s reports, all children struggled with an operational stress injury (OSI) and/or were diagnosed with posttraumatic stress disorder (PTSD). Several also had histories of significant addiction, suicidality, legal issues, and/or homelessness after release. The majority served in the army; the rest served in the air force. No navy personnel were represented in the sample. Five children released before age 30 years, with most releasing between 33 and 40 years of age. Three served for fewer than 5 years, another four between 6 and 14 years, and six between 15 and 21 years. The majority were deployed at some point during service, and the participants directly linked the children’s struggles to those deployments. The period between the event/situation that caused their injury and their release ranged from months to decades. For many of these families, struggles occurred for well over a decade.

Findings

Results primarily reflected the active role parents adopted as caregivers to ill or injured children and were organized into the following themes: 1) being exasperated by persistent, dynamic, and unanticipated demands for instrumental support, 2) living in a constant state of worry and guilt about their adult children, 3) feeling at a loss for what to do and where to go for support, 4) dealing with consequences to their own health and well-being, 5) wreaking havoc on relationships, and 6) being left to pick up the pieces alone.

Being exasperated by persistent, dynamic, and unanticipated demands for instrumental support

Participants reported adopting considerable additional roles and responsibilities to support children beyond their injuries. The nature, intensity, and duration of these roles and responsibilities created “just staggering mental exhaustion” (SD) and included instrumental activities like managing mail, medications, banking, and so forth, for their children. One parent (YJ) shared the strategy around her son who “cannot manage money”:

When he gets his pension, it goes into a bank account with my name on it and not his. … I pay all, all, all the bills … everything is paid out of that money. … And I give him a certain allowance each week.

Several children had financial difficulties because of disruptions in Veterans’ benefits or job/housing loss caused by symptoms of an OSI and were relying on their parents to support them through: “Anything, like, we’re always, whatever he needs” (MB). For other participants, they stepped up to ensure their grandchildren had basic needs met — including access to good nutrition and clothes — at the expense of the grandparent and often to the level expected of a parent. One parent shared:

I’m more of emotional support to my son, emotional support to my daughter-in-law, … emotional support to my grandson, um, my granddaughter is fine, my grandson is not really. Um, I buy most of their clothes, um, I am the go-to babysitter, I have them once a week, I’m the extension of the parent.

— OD

When custody issues emerged, some participants reported facilitating supervised visits to enable relationships between their children and grandchildren. These scenarios played out for most of the participants, some of whom were also managing elder care for aged parents of their own. For those who had a co-parent, they could rely on each other; however, for those parents on their own, they had additional difficulties without any respite.

The resources required to sustain significant levels of support to adult children had financial implications for parents. One parent shared that “for the first year, it was every day all the time, um, our life was spent exclusively helping him through” the period after release (SD). For many, they relocated to be closer to their children or took on regular travel when their child was in distress, using “a considerable amount of financial resources” (AL). For others, impacts on their own career trajectory and/or job security were notable, moving beyond short-term leaves of absence to ongoing reduction in work hours. For one parent, the uncertainty around work endured, and she had to leave her job because of relentless caregiving demands with a suicidal son, wondering, “Will I always have to care for my mentally ill son? … Will my life now be devoted to that … my ability to work after?” (MB). The ages at which many of the parents were intensively dealing with their children’s health and well-being meant they were unable to move into better-paying jobs, with greater responsibility concomitant with end-of-career stages, creating knock-on effects for their pensions going forward.

Living in a constant state of worry and guilt about their adult children

One participant shared, “It’s been a struggle for me, um, to really stay in a positive frame of mind but you know, I have” (CN). While awaiting the next stressful event, participants worked on keeping their children safe, including preventing suicide and self-harm. Participants became central to de-escalation efforts when emotional dysregulation and aggressive behaviours emerged and risked legal responses or suicidal behaviours, even going so far as to act as custodian of weapons. Parents were often turned to by their child’s spouse during distressing events, leading to urgent, episodic pleas for help: “We’d get these calls … saying, you know, he’s dissociated, this is happening, so we’d jump in the car and drive over there and it was a really stressful time” (SD).

Participants described putting their lives on hold, shifting focus to their child and grandchildren, and struggling with efforts that did not result in positive outcomes. One parent shared: “I had to devote my whole life to it. I had to, yeah, stop, my whole life is stopped” (MB). Participants described feelings of guilt because they had not done enough or their children were “ruining our lives” (CR). Some expressed ambiguous loss for their children — “a wasted life … ruined” (IX) — and vision of a specific future for their children and grandchildren.

Feeling at a loss for what to do and where to go for support

All participants emphasized that no one could have prepared them for how to parent an adult child with an OSI acquired through military service. Parents found themselves at a loss for what to do, say, or not say. They reported “walking on eggshells” (CR) and feeling trepidation about to how best to help. Participants felt they did not have the skills or language to speak to their grandchildren about military service and/or trauma and emphasized the need for help with communication and boundary-making skills with their children.

Participants struggled with knowing where to get help and resources for themselves and for their children. Some found support through treatment facilities like Bellwood Health Services; these participants found such services to be incredibly helpful. For the most part, participants were unfamiliar with resources available to them as parents through Veterans Affairs Canada (VAC) and seemed to be better acquainted with supports focused on their children. Participants regularly advocated for their children, as the children were generally unable to do so themselves. Participants had to learn about a range of topics, including operational stress, moral injury, chronic pain, and military sexual trauma, and struggled to identify a central clearinghouse or aid to navigate the system:

There’s no club, absolutely nothing. There, there’s not a thing out there. Not, nothing that we’ve ever found. … I don’t mean to sound crass. Had [my son] lost his life, … I’d be a member of a very special crowd. A very special group. Uh, um, and I know that sounds awful, but I’d have people that I could go talk with and could understand what’s going on. Uh, you know, that type of thing. … Um, but as it was explained to me, it’s over for us.

— AP

Dealing with consequences to their own health and well-being

Participants reported feeling drained of time and energy to do things for themselves. Several shared how they required their own mental health supports to help process the situation, develop healthier boundaries, and deal with compassion fatigue. One participant commented, “He’s the one who was injured, but I’m the one who needs to see a psychiatrist” (WH). Another shared they try not to think about themselves, lest they fall into a depression:

I can’t think of any positive thing that’s come out of this, it’s all been terrible. I, I mean the, my family and, uh, my husband and the kids, they all pulled together. And, and they treat me a little bit like glass because I, I’m to the point now if someone, friends, and stuff, have you heard from [A]? I go it’s not up for discussion, and that’s it. And then everybody’s fine, they just back off. ‘Cause I won’t talk about it with them, I lose it, like I start crying and I don’t wanna cry all the time.

— GV

Parents struggled to balance keeping their children safe with their own mental health, noting it was exhausting to be overinvolved while also setting boundaries when suicide risk was high for their children. Creating healthier boundaries had significant impacts on a participant who shared: “At the beginning, we were actively seeking to be involved in his life all the time so we could help him through the, the difficulties. But over time, partly because we just felt so exhausted, we switched from being fully involved, assertively getting involved in his life to being more passive. … We help whenever he needs any kind of help. But that means we’re not as involved in his life and I found that little bit of withdrawal from his life was good on us mentally” (SD). Despite the negative effects on their own health and well-being, some participants reported increased empathy and, at times, an increased sense of strength through supporting their children.

Wreaking havoc on relationships

For many participants,closely supporting their children came at significant costs to other relationships. Other children and grandchildren were unable to receive the same time, attention, or financial assistance as their Veteran child, potentially wreaking havoc within the family. Experiences with their Veteran child coloured the whole lives of participants, leaving little energy or interest to engage socially. One participant said: “Like, um, relationships that I had with other people, I can’t have.”

— MB

There were also unwelcome issues within their networks, where participants felt they were always complaining and found it hard to share with friends who didn’t “get it” (YJ). Friends would reportedly counsel participants to cut off their Veteran children and move on, and family rifts were fuelled by intergenerational ideas about military service. Sentiments like they “knew what they were signing up for” (KZ) were difficult to respond to. Participants expressed a profound sense of social isolation and loneliness, knowing no one else with similar experiences. These sentiments were intensified when they came from within the family, causing long-term rifts:

We’ve had family people say well didn’t [she], [she]’s having problems well didn’t she know what she’s signing up for? I don’t think you could ask a woman in Canada to say you know something, I expect sexual assault to be part of my work experience. You know I, I’m just gonna accept that, it’s not gonna affect me if you work in an office, or a, or a mine or any place so you shouldn’t be accepting it there.

— KZ

Strains were also evident within parental units. For one participant, after their child attempted suicide for the fourth time, her spouse refused to allow the child back into the parental house, creating a chasm between the parents: “My husband says to her, will you promise not to do that in our house again [attempt suicide], and she says I cannot promise that. And so he says, you cannot come to live with us.”

— AL

Being left to pick up the pieces alone

While some parents retained pride in their children’s military service, others reported a deep sense of disillusionment and disappointment with the CAF and VAC, with no outreach or correspondence from either organization. Parents struggled to reconcile their children’s military service and the heavy impacts that followed without support. Words such as “tired” (AP), “helpless” (IX and YJ), “angry” (IX), and “hopeless” (YJ) were used throughout the interviews.

Parental advocacy came at great personal, financial, and occupational expense, yet families felt “forgotten” (CR) and that “no one would listen” (CR). Participants were clear and forthcoming in their perspective that parents matter to the success of the CAF and to the recovery of their children. Participants repeatedly asserted they should be recognized as caregivers and should have rights to care for their child, rather than being told that, without their child asking for help, there was nothing that could be done. Parents faced frustration being told that, per policy, “hands are tied” (GV) regarding how active a role they could play in their child’s care.

Discussion

This study makes a notable contribution in capturing, for what appears to be the first time, the experiences of Canadian parents of military Veterans with operational stress illnesses and injuries. Additionally, this study explored the ways in which such illnesses and injuries affect broader family systems, as parents attempt to support children transitioning to civilian life and manage the consequences of operational stress illnesses or injuries.

Findings expand the long-held narrative that “family systems” must be limited to traditionally defined nuclear families.⁵ Research about military and Veteran families typically explores experiences from the military member/Veteran and their partner or spouse and, therefore, has resulted in a narrow representation of who constitutes a military or Veteran family.^5,6 Participants of this study, the parents of ill and injured Canadian Veterans, demonstrate clear evidence of how their daily lives were impacted by unexpected, frequently changing demands and responsibilities required of them by their child’s situation and how their own health, well-being, and relationships were affected. Not only do the health and wellness of Veterans affect those of their parents, but efforts to become healthy also have instrumental impacts on everyday life, underscoring an ecological systems perspective on families¹⁵ that understands the interdependence of all members of a Veteran family with one another, as well as with external environments. Families are often represented in this area of research as proxies or representatives of the experience of military personnel or Veterans. Recent work specific to suicide prevention revealed families of military personnel or Veterans are typically relegated to consideration as risk or protective factors, or made responsible to act, with little view on family members themselves in their own right.¹⁶ In turn, families, particularly parents of the ill and injured, do not have services and supports dedicated to addressing their specific struggles.

The narrow definition of family in recent research and the literature reflects views of military institutions that hold certain assumptions, including that caregivers tend to be (women) spouses, further perpetuating exclusion of parents as a special population warranting research and attention. This conceptualization resonates with parents in this study, who were compelled to report experiences and challenges their children faced, along with their own roles in acting to manage those challenges, with little regard for their own personal well-being. Parents of ill and injured Veterans reported caregiving experiences that echo the experiences of parents who are caregivers to civilian adult children with serious mental illnesses or development disabilities, including impacts to their own health, given additional and often unexpected caregiving tasks.^17–18 Parents report feelings of long-term burnout and compassion fatigue when caring for their adult children, along with fear for their child’s future, because of a lack of informal or formal caregiving support for their child beyond them.¹⁸ Parents experience wide-ranging impacts when acting as caregivers. A systematic review by Smith-Osborne and Felderhoff¹⁸ highlights how the caregiving burden of parents can disrupt their relationships, their own health and well-being, and their careers, aligning with the findings of this study, which described impacts on daily life and routines, relationships, and health and well-being.

In addition to adopting an unexpected role as caregiver to their ill or injured adult children, participants were also left to deal with the process of supporting their child’s military-to-civilian transition (MCT). There is a growing body of international work that examines the impact of mental health challenges on MCT and how these may affect families.^19–22 A study examining the needs and current services available to families across Five Eyes nations during MCT by Dodge and colleagues¹⁹ identified four themes of support: mental health, barriers to care, financial needs, and target transition support. Themes of support from this review echo the challenges expressed by parents in the current study. However, these findings do not seem to be universally recognized, as participants still feel at a loss. In another study by Norris,²⁰ findings from a narrative review of military family resiliency literature found, among other factors, the value of external social supports in the face of transition and mental health challenges. The review identified that “resilience processes can be fortified by informal social support and formal policy and social efforts,”^{20(p. 52)} as they provide opportunities for families to develop skills and learn information while also maintaining a sense of well-being — all important to offset the impacts of stress. Formal recognition, through development of policies, and a strong social network not only acknowledge and validate ongoing roles and contributions made by parents in the lives of their ill and injured adult children but also support resiliency.

Repeatedly heard throughout this study were stories parents shared about feeling unrecognized for their roles in supporting/providing care to their adult children, highlighting the lack of dedicated supports for these caregivers. Similar feelings and experiences were found in U.S.-based military research of parents of military members whose children were deployed to active combat zones.^7–9 Crow and Myers-Bowman⁸ explored experiences of parents whose adult children were deployed, which found that parents described the lack of both formal and informal supports during this stressful period. Supports available to families at that time were focused on the needs and experiences of spouses and children, which study participants emphasized were different from their needs as parents. Parents have elsewhere been shown to adopt an active role in supporting their adult children as they transitioned back from deployment, which was often unrecognized or unresourced.⁹ Findings from Crow and Myer-Bowman are corroborated through this current study — the needs of parents are distinct from the needs of their adult children. Moreover, the lack of recognition parents reported in the Crow and Myer-Bowman study resonates with findings of this study in which parents expressed feelings of being left on their own and experiences of being left to pick up the pieces alone.

The sense of abandonment by the military, and feelings of betrayal, can be understood within the context of enduring neo-liberal policies that idealize independence from state support and promote economic self-sufficiency and personal responsibility.^23–25 The experiences expressed by parents of ill and injured Veterans are not unlike parents of children living with long-term and lifelong health challenges. Some mothers of adult children with disabilities have found a way to both “resist and reframe notions of self-sufficiency and independence embedded in the neoliberal cultural narratives.”^{26(p. 111)} For example, they reframed taking personal responsibility to “doing what’s best for my kid,”^{25(p. 126)} which included advocating for their children. This reframing is similar to perspectives of parents of Veterans in the current study who serve as advocates for their adult children through interdependent community support networks.²⁵

Parents in this study described various ways in which their contributions and roles in the recovery and support of their adult children can be recognized by the Department of National Defence, CAF, and VAC, ranging from increasing access to the health information of their adult children to having dedicated programs and resources. This sentiment can be found in the U.S. literature exploring the experiences of parents of military Veterans.⁷ Since 2008, Veterans Affairs (VA) required all VA medical centres (VAMCs) to provide family education or family psychoeducation services to Veterans with PTSD or severe mental illness.²⁶ The Support and Family Education (SAFE) Program,²⁶ a family education program for families of Veterans with a serious mental illness or PTSD, was developed in 1999 at the Oklahoma City VAMC. SAFE is the only family education program developed specifically for the VA system and includes a strong, but not exclusive, focus on PTSD. In addition, the SAFE Program is provided in a variety of non-VA settings in the United States and around the world (e.g., state agencies, community mental health centres, National Alliance on Mental Illness organizations, state hospitals).²⁷ A program such as this, one developed and disseminated through a military-affiliated health service, and one that provides both psychoeducation and supports to parents, fits the needs identified by participants in this current study. Despite this critical gap in programs and services, parents of ill and injured Veterans are doing what they can, with what little support they have, to learn about their adult children’s health needs and advocate for support. The absence of formal supports only adds to the growing betrayal expressed by these parents.

Strengths and limitations

As the first study of its kind conducted in the Canadian context, this study makes an important contribution in beginning to capture the experiences of Canadian parents of military Veterans living with a service-acquired illness or injury, advancing knowledge on how these changes affect broader family systems. However, there are limitations to acknowledge. As with all qualitative research, findings cannot be generalized to all parents of ill and injured Canadian Veterans, and conclusions drawn from this work are only reflective of participants of this study. Challenges with participant recruitment because of the COVID-19 pandemic were noted earlier and thus limited diversity in the sample. Participants included in this study had limited diversity. In future research, participants should better reflect the composition of the CAF, including an examination of intersectional identities (e.g., race, ethnicity, gender, education), military demographics (e.g., rank, service element, years of service), and geographic location(s). Of note, with limited diversity among sample participants, and the small sample size, a sex-disaggregated analysis could not be completed. Identifying participants as mothers or fathers may have increased the risk of identifying participants. Based on this, no differentiation was made between the experiences of mothers and fathers. The traditional narrative of mothers as caregivers may have resulted in significant differences in the experiences of mothers and fathers, and this indicates a key future research direction for a larger-scale study. Future work can also explore parent caregiving dynamics from the perspective of adult child Veterans, providing a more holistic understanding of the experience, as well as exploring the experiences of other adult family members who may provide care, such as siblings. Findings in this study can be a starting point for more focused work to understand impacts of caregiving on parents, to include more in-depth explorations on health, well-being, relationships, roles, and identities.

Conclusion

Parents feel overlooked, despite significant personal, relational, financial, and occupational costs invested for small improvements in their children’s well-being. This initial exploration of experiences of parents of ill and injured Veterans highlights their critical role in acting as informal caregivers. Bearing this role in mind, several future research directions are made possible by this first look at their experiences, including a larger-scale study with sex-disaggregated analysis and an exploration of this experience from the perspective of adult children Veterans. For example, findings indicate future policy development priorities should consider the extension of caregiver benefits to include parents, integrating them into the circle of care. Furthermore, this study demonstrates a lack of available support for parents of ill and injured Veterans, including assistance in navigating the system, psychoeducation, and access to mental health support, including couples and/or family therapy. This study illuminates the experiences of parents and the importance of improving public awareness and recognition of the role parents adopt when supporting an ill or injured Veteran child, and draws attention to the simple fact that families, including parents, matter in their own right and not only as an extension of a serving member or Veteran family member.

Biographies

Linna Tam-Seto, PhD, OTReg(Ont.), is Assistant Professor in Occupational Science and Occupational Therapy at the University of Toronto. She holds a PhD in rehabilitation science and is a registered occupational therapist. Her research interests include understanding the health and well-being of Canada’s military members, Veterans, and public safety personnel, and their families, with a focus on life transitions and changes.

Deborah Norris, PhD, is a professor in the Department of Family Studies and Gerontology at Mount Saint Vincent University. Informed by her background in family studies, critical theory, and qualitative methodology, Norris’s military family research program includes focuses on secondary trauma in military families, the impact of operational stress injuries on the mental health and well-being of families of Veterans, resilience and posttraumatic growth in military families, and the military-to-civilian transition.

Melissa Richardson, BHSc, is a master’s candidate in rehabilitation science at Queen’s University. Her research focuses on the mental health and well-being of military, Veteran, and public safety families, including the provision of psychosocial support following disasters or crises within occupational communities.

Rachael Gribble, PhD, is a lecturer in war and psychiatry at King’s College London. As a member of the King’s Centre for Military Health Research, her research focuses on the health and well-being of military families, including spouses and partners, children and young people, and other family members. Gribble’s research interests include occupational health, family health and well-being, women’s health, and public attitudes toward the military.

Nicola T. Fear, DPhil (OXON), has been the director of the King’s Centre of Military Health Research, alongside Professor Sir Simon Wessely, since 2011. She joined the Academic Department of Military Mental Health at King’s College London in 2004, having trained as an epidemiologist at the London School of Hygiene and Tropical Medicine and the University of Oxford. Fear has also worked as an epidemiologist within the UK Ministry of Defence. In 2014, Fear was awarded a Chair in Epidemiology.

Heidi Cramm, PhD, OTReg(Ont.), is Professor, School of Rehabilitation Therapy, Queen’s University, and the research lead for the Families Matter Research Group. Cramm’s research program is dedicated to the mental health and well-being of defence and public safety families, working in close collaboration with the Garnet Families Network, a research ecosystem for defence and public safety families and those who study, serve, and support them. She is also Head of Family Research Strategy for the Canadian Institute for Military and Veteran Health Research.

Funding Statement

NT Fear’s salary is covered in part by a grant from the United Kingdon Ministry of Defence and the Office for Veterans’ Affairs. She also received financial support from NHS England and the Global Medical Relief Fund for providing specialist advice and support. Fear is also a trustee for Help for Heroes, a charity providing support to the United Kingdom Armed Forces community.