4.0 Where We Are: Investing in the Defence Team

4.1 The Strategic Landscape

Defence Team members provide a unique service to Canadian society. As such, we consider their health and wellness not only a practical duty to enable mission success, but also a moral obligation in recognition of their tireless efforts to defend our nation and promote Canadian values and interests. The Government of Canada’s Defence Policy - Strong, Secure, Engaged - provides unprecedented support to Defence Team members. Its commitment of long-term funding signifies a genuine concern and respect for their quality of life at work and at home. The Defence Team Total Health and Wellness Strategy is aligned with the Defence Team Human Resources Strategy, striving to optimize our workforce, increasing our operational and institutional effectiveness, and positioning the DND/CAF as an employer of choice within Canadian society.

The DND/CAF’s commitment to wellness is reinforced through our continuous investments in health and wellness-related strategies, programs, and services. The Defence Team Total Health and Wellness Strategy is part of a larger continuous improvement effort to ensure people excel in the defence of the nation. Continuous improvement necessitates the alignment of efforts through a comprehensive approach to health and wellness. This, in turn, promotes collaboration, capitalizes on the institution’s expertise, and helps to reduce barriers to wellness.

4.2 The Need: Why Does Health and Wellness Matter?

4.2.1 Work and Performance

Wellness contributes to mission success by providing the Defence Team with the skilled, fit, and motivated personnel they need to meet their professional obligations and maintain operational effectiveness. People who are well are more empowered, productive, and inclined to remain in service—which is critical, given the high operational tempo faced by the DND/CAF.

Workplace factors such as autonomy, role clarity, and a sense of belonging contribute to greater levels of motivation, engagement, job satisfaction and productivity. Work overload, unclear roles, competing or conflicting demands, racism, discrimination, and bias increase the risk of workplace strain and may lead to disengagement and burnout. Our ability to remain effective now and into the future hinges on ensuring our people feel enabled, empowered and supported.

We recognize that crippling stress is not a ‘badge of honour’. It is a burden with inevitable negative health consequences that jeopardizes our success. Despite our efforts, the 2018 Defence Workplace Well-being Survey revealed that one third (34%) of the Defence Team has lower workplace well-being than their peers, including lower morale and job engagement, and higher levels of psychological distress. Low perceived organizational support, low relatedness (sense of belonging), excessive job stress and a lack of meaningful work were identified as the main factors contributing to lower workplace well-being. Similarly, senior public service leaders are also experiencing increased work stress. Lower-level Defence executives, while reporting fewer work hours than senior executives, are experiencing difficulties managing the demands of work, are less satisfied with their job, and are more likely to get burnt out from work (APEX, 2018).

Lower workplace well-being and high levels of psychological distress can have a negative impact on productivity in the workplace and can be linked to increased absence from work (Kelloway et al, 2005). Consequences resulting from absence from work due to issues such as illness, disability, or personal or family responsibility—known as absenteeism—can be far reaching and negatively affect productivity and workplace morale (The Conference Board of Canada, 2020). A more subtle but equally significant problem is presenteeism, whereby unwell individuals show up for work, but are not fully engaged in their jobs because of personal health and life issues (Catano et al, 2016). This is the result of one’s prioritization of work life over personal life and can be attributed to a variety of factors that include excessive workload, workplace culture and feeling compelled to put in long hours (Lowe, 2014).

A fit and resilient Defence Team requires a work environment which supports the pursuit of wellness. Through this strategy, the DND/CAF commits to better understanding the main causes of stress which can have a negative impact on productivity as well as the ways in which health and wellness can be supported by empowering those who have the most influence within the organization. COVID-19 survey results exemplify the importance of having a holistic strategy focused on the well-being of our Defence Team.

4.2.2 A Healthy Work Environment is the Foundation

Elements of the physical work environment, such as air quality, temperature, ergonomics, lighting, access to gyms, bike/running paths, layout/design and physical factors, have a direct relationship to our physical and mental wellbeing and have been the subject of occupational health and safety efforts to date. More recently, the psychosocial work environment is receiving greater attention due to the profound impact it has on employee engagement, job stress, and turnover intentions. This environment consists of the larger interpersonal and social relationships that define the social dimension of work

According to the 2018 Defence Workplace Wellbeing Survey, a majority of the DND/CAF personnel (66%) report positive levels of workplace well-being. Notwithstanding these results, a significant minority of Defence Team members are experiencing a lower level of workplace well-being. Those more likely to fall into the lower well-being category reported low levels of perceived organizational support and relatedness, a lack of meaningful work, and high levels of job stress (DWWS, 2018). These results are consistent with the 2018 results from the Public Service Employee Survey which identifies areas such as workload, job stress and perceptions of organizational support as needing the most improvement (PSES, 2018).

Creating a healthy work environment is essential to improving health and wellness in the DND/CAF population. Addressing stressors is fundamental to improving overall health in the workplace. These stressors include workload, time pressure, and offences like incivility, microaggressions, bullying, harassment, and even violence, sexual assault and racism. A fit and resilient Defence Team requires an inclusive work environment that supports the pursuit of wellness. The DND/CAF is dedicated to increasing its understanding of the effects of a healthy workplace on its workforce in order to set the necessary positive conditions for the health and wellness of Defence Team members.

4.2.3 An Inclusive and Diverse Defence Team

Defence Team members work together in an integrated manner to carry out the Defence mandate. This relationship allows the organization to draw on the specialized expertise of military and civilian personnel to perform the critical work needed to achieve operational effectiveness.

Discrimination, harassment, and violence based on any identity factor is a threat to the health and wellness of the Defence Team and to our ability to work collectively toward shared goals. Various forms of discrimination exist based on a range of identities, such as: gender, sex, race, ethnicity, Indigeneity, religion, disability, etc. Individuals also experience multifaceted layers of discrimination based on the intersectional nature of their identity factors. Harassment in the workplace is linked to increased dissatisfaction, low motivation, lower relatedness, and higher turnover intentions (Hango & Moyser, 2018). This, in turn, can lead to decreased wellness due to increased psychological distress.

In the 2018 Defence Workplace Well-being Survey, Defence Team members of visible minority groups and Indigenous persons were as likely to fall in the lower well-being group as their non-Indigenous, non-visible minority colleagues. At the same time, CAF workplace harassment surveys have consistently shown that CAF members of designated minority groups are more likely to experience abuse of authority and personal harassment. Understanding workplace experiences from the perspective of diverse groups, and at both the individual and organizational levels, is of paramount importance to developing ways to overcome barriers to diversity and inclusion.

Protecting human rights and supporting gender equality and diversity is critical to a healthy DND/CAF. Wellness in the workplace requires the elimination of barriers to an inclusive and equitable workplace as well as introducing supportive programs and services. The Defence Team Total Health and Wellness Strategy calls for all health and wellness policies, programs, and services to conduct gender-based analyses plus (GBA+) in the design, delivery and continuous improvement of these initiatives. The use of GBA+ mitigates systemic barriers to the wellness of the Defence Team. We must consider the needs and interests of our diverse Defence Team members to ensure we are ready to achieve our objectives. Continued success depends on a modernized workforce reflective of Canadian values at their best. A diverse workforce promotes innovative thinking and benefits from having Defence Team members with different experiences and perspectives. We must reflect “Canadian ideals of diversity, respect and inclusion, including striving for gender equality and building a workforce that leverages the diversity of Canadian society” (SSE, 2017).

We embrace and actively promote diversity and inclusion as a core institutional value that goes beyond Employment Equity. We also acknowledge that a diverse Defence Team is better equipped to fully contribute to the execution of missions at home and abroad. As such, we are committed to ensuring the Defence Team Total Health and Wellness Strategy considers impacts and experiences across genders and multiple intersecting identities when determining the needs of Defence Team members.

4.2.4 Prioritizing Women's Health

Sex and gender are important determinants of health which, along with other intersecting cultural, social, economic and environmental factors, can have a profound influence on health and wellness. Any successful approach to health and wellness promotion, prevention and care and support must factor sex and gender and related social determinants into the design of health initiatives from the outset. Historically, when compared to public service employees and Canadians writ large, this fact has not been adequately recognized in the Canadian Armed Forces (CAF), and has been reflected in inequities built into policy, health benefits and health care approaches. From medical and healthcare research, to prescription drug protocols, to treatment options and access to care, a sex and gender-based health gap among CAF personnel has persisted.

As the CAF strives to improve enrolment of women in its ranks, addressing health and wellness needs related to sex and gender is also critical to ensuring we retain those women. Women currently make up 16.3% (15,536) of the Regular Force and Primary Reserve. By comparison, women constitute 42.45% (12,087) of public service employees working in the Department of National Defence. The Employment Equity Plan and stated policy goal in Strong, Secure, Engaged is to increase representation of women in the CAF to 25.1%. The under-representation of women in the CAF has contributed to strategic policy and decision-making that lacks women's perspectives regarding their health needs. Further, under-representation of women has also been linked to the prevalence of discriminatory and harmful conduct in the workplace, impacting the psychosocial and physical well-being of affected women in the CAF (Davis & Squires, 2019).

Current research has shown that CAF females are at a higher risk of musculoskeletal injuries like stress fractures and back pain compared to their male counterparts. Importantly, women CAF members are also more likely to report barriers to accessing health care and health-related accommodations. Qualitative evidence also points to persistent unresolved issues with ill-fitting operational clothing, load-carriage systems and personal protective equipment for females, adding to a general lack of awareness and understanding regarding reproductive health, maternity, postpartum depression, lactation, menopause and the impact of training and exercises on the female body. Although, work-life balance is consistently identified in CAF Research as a retention factor for both men and women in the CAF, population statistics have demonstrated that in families with children, women continue, on average, to spend more time on parental tasks (e.g., child care, dependent education, etc.). Unpaid family work remains a driver of inequality and directly impacts women’s well-being, time spent at work, and job quality (Leclerc, 2020). Similar impacts of unpaid family work are experienced by women in the federal public service, which were further strained by additional home responsibilities, such as home schooling, due to the COVID-19 pandemic. To support employees in need, the Government of Canada introduced a pandemic focused leave provision (i.e., Leave 699) in addition to leave provisions contained in collective agreements. Leaders and managers were also encouraged to support employee accommodation through flexible work schedules.

Understanding that women’s health needs are different than those of men, the Defence Team must institute processes that challenge assumptions and uncover hidden impacts on individuals and social groups. To support women to reach their full potential and goals, and to optimize operational effectiveness, a gender and sex informed approach to health and wellness must also be supported by an inclusive, equitable, trauma and violence-informed, contextually-tailored and culturally-sensitive approach to care in order to reduce health care inequities (Browne et al, 2012).

To create equity in care, additional research, supports and enablers may need to be tailored to the needs of women. The implementation of the Women’s Health Framework will be an important contribution to enhance women’s long-term health and occupational performance. It will be applied to future research and policy development to optimize the health and wellness care provided to women in the CAF.

4.2.5 Work and Life

Balancing the competing demands of work and personal life can be difficult to achieve. Just as work plays a significant part in all of our lives, aspects of our personal lives can also support or hinder our health and wellness at work. Healthy work-life balance reduces stress and helps prevent burnout in the workplace. Not only can it improve productivity and performance, it is also important for physical health and relationships.

While we are already making great strides in promoting increased work-life balance, the Defence Workplace Wellbeing Survey reveals that work-family conflict remains a concern for 31% of the Defence Team (DWWS, 2018). These results are supported by additional research showing Defence Team members identify their lack of worklife balance as a barrier to pursuing learning opportunities, maintaining a healthy diet, spending time with their family, coping with stress, and pursuing recreational activities (Prairie Research, 2016).

Participants of the Defence Team consultations conducted at CAF Bases and Wings across Canada in the Summer of 2018 also expressed that balancing work and family demands along with personal health interests is a continual struggle. Most participants voiced concerns with their ability to meet all of their work and family obligations while maintaining personal care, resulting in the tendency to neglect sleep, exercise, and/or nutrition. Many participants stated they lack the energy or time to fit healthy activities into their schedule and admitted that the stressors associated with work-life conflict have led to maladaptive coping (e.g., drinking alcohol to deal with stress or experiencing feelings of guilt for not meeting others’ expectations).

It is no easy task to achieve work-life balance in today’s unpredictable and fast-paced world. As we grow more connected through technology and social media, it is becoming increasingly difficult to separate work from our personal lives.

Managing the demands of work has only been exacerbated by the extended use of technology which has blurred the lines between work and home life, rather than providing more flexibility. The DND/CAF is committed to facilitating positive work-life balance for Defence Team members and fostering a culture of reasonable accommodation. This includes gaining a clear understanding of workload, time pressures, prioritization, and aligning the necessary tools to allow Defence Team members to better balance their priorities for optimal wellness both at work and at home.

We are committed to an inclusive military and civilian Defence Team that grows in diversity and represents Canadian values at their best.
- Message from the Minister of National Defence in the DND/CAF 2019-2020 Departmental Plan

4.3 Current Efforts

The Defence Team Total Health and Wellness Strategy builds on significant investments across all the dimensions of health by both the DND and the CAF. These investments are reflected in a comprehensive suite of health-related strategies and programs targeted at each of the dimensions. They are currently underway to promote the benefits of healthy living, prevent illness and injury, and improve the supports available to Defence Team members in need.

The strategy is designed to complement and amplify the following efforts. It does so by introducing an evidence-based holistic approach to wellness as the foundation for greater alignment and integration among existing initiatives.

4.3.1 Strategies

	The Federal Public Service Workplace Mental Health Strategy outlines the GC’s efforts to build a healthy, respectful, and supportive work environment that strengthens the public service.		BALANCE – The CAF Physical Performance Strategy is designed to encourage a culture of well-being and improve operational effectiveness through performance behaviours.
	The CAF Diversity Strategy sets goals and objectives to create the conditions for an operationally effective, diverse, respectful and inclusive CAF.		The Spiritual Wellness Strategy offers the full spectrum of moral, spiritual, religious care, advice and support to military members of the military community.
	The Defence Departmental Occupational Health and Safety Strategy outlines the organization’s commitment to foster an environment in which the health, safety, and wellbeing of Defence Team members are foremost in the decisions and actions of everyone in the workplace.		Mission: Ready – The Canadian Army Integrated Performance Strategy promotes the adoption of a performance-oriented and health and fitness-based culture in support of ready and resilient soldiers.
	The Surgeon General’s Mental Health Strategy guides our efforts, and priorities and highlights our role in supporting the mental well-being of military members.		The Comprehensive Military Family Plan aims to enhance the experience of Canadian military members and their families.
	The Surgeon General’s Integrated Health Strategy outlines our commitment to ensuring military members get the care they need when they need it from the right members of the support team		The Path to Dignity and Respect: The CAF Sexual Misconduct Response Strategy will create the conditions to prevent and address sexual misconduct within the CAF and create a work environment that respects the dignity of all Defence Team members.
	The CAF/VAC Suicide Prevention Strategy establishes our ongoing commitment to suicide prevention and presents a comprehensive approach in support and protection of CAF members and veterans.		The AccessibilityStrategy for the Federal Public Service is a roadmap to prepare the Public Service to lead by example and become a model of accessibility for others.

4.3.2 Supporting Programs and Services^{Footnote 1}

Sexual Misconduct Support and Resource Centre (SMSRC)	The SMSRC offers support to individuals affected by sexual misconduct, provides expert advice to the Defence Team, and monitors progress in addressing sexual misconduct within the DND/CAF. Anonymous and confidential 24/7 support is available.
Integrated Conflict and Complaint Management (ICCM)	ICCM provides a trusted and confidential environment available to CAF members to navigate, select and engage in conflict and complaint resolution mechanisms.
Adaptation of the National Standard to improve Psychological Health and Safety in the Workplace	The National Standard for Psychological Health and Safety in the Workplace aims to promote mental health and prevent psychological harms in the workplace through the development of a monitoring framework and supporting guidance, tools and resources (Mental Health Commission of Canada).
Office of Disability Management	The Office of Disability Management (ODM) is a new organization that aims to help DND employees remain in the workplace or return to work as early as medically feasible.
Family Support Program	The Military Family Support Program provides services to support all military families in managing the unique challenges related to military lifestyle.
CAF Transition Group	The CAF Transition Group, in coordination with valued partners, delivers personalized, professional, and standardized casualty support and transition services to CAF members and their families to enable seamless transition and enhanced well-being with special attention provided to ill and injured personnel, their families and the families of the deceased.
Seamless Canada	Seamless Canada aims to enhance dialogue with governments, private sector and non-government organizations to improve the coordination of services across Canada. The aim is to ease the burden of frequent relocation, creating a seamless experience for military families.
Defence Ethics Program (DEP)	The DEP is a comprehensive values-based program aimed at fostering the practice of ethics in the workplace and in operations, such that all Defence Team members perform their duties to the highest ethical standards.

4.3.3 Health and Wellness Systems

Delivering on the DND/CAF’s commitment to supporting the health and wellness of Defence Team members depends on a variety of organizational support systems. A focus on wellness calls for the alignment and integration of these systems to further empower the Defence Team. This approach requires the engagement of a range of activities, including effective governance, ongoing consultation and collaboration across the institution, and supporting policy to address health and wellness issues in the workplace.

Governance

In the Fall of 2019, the Total Health and Wellness Sub-Committee (THW SC) was established under the Defence Team People Management Committee (DT-PMC). This Sub-Committee is responsible for the coordination and oversight of Defence Team health and wellness activities at the national level, and for the provision of total health and wellness advice to the DT-PMC. The Sub-Committee is composed of DND and CAF leadership across environmental commands and includes subject matter experts from all dimensions of health. Its current priorities are the completion and institutionalization of the Defence Team Total Health and Wellness Strategy.

In 2019, a network of health and wellness committees was established through BALANCE – The CAF Physical Performance Strategy. These committees ensure local level support for health and wellness at all Bases and Wings across Canada. The Total Health and Wellness Strategy team consulted with a number of these health and wellness committees to understand the regional needs and the significant efforts already underway. Continuous improvement necessitates a reciprocal bottom-up/top-down approach to understand local-level issues and their impact on national programs. The integration of health and wellness committees into a federated governance model with the THW SC will lead to more responsive national initiatives through sharing of best practices and lessons learned, while empowering Bases and Wings to create local solutions to address local circumstances.

Policy

Well-aligned and integrated total health and wellness related policies are necessary to enable a healthy work environment in support of the health and wellness of the Defence Team. Clear direction and accountability will clarify the roles and responsibilities for health and wellness across the organization. A systematic review of existing DND/CAF health and wellness related policies is required to better understand potential barriers to wellness that currently exist in the policy suite. This review will identify opportunities for alignment to meet the needs of both the organization and Defence Team members. To support greater integration across the institution, efforts will also look to establish an umbrella policy to reinforce the existing suite of policies, communicate the established total health and wellness governance framework, and to clearly communicate the necessary conditions for achieving desired results.