Veterans Care: Operational Stress Injury Clinic

Established in 2003, St. Joseph’s Health Care London’s Operational Stress Injury (OSI) Clinic is one of 10 outpatient clinics within the Canadian Operational Stress Injury National Network

Within the St. Joseph's Health Care community, OSI is a part of the Veterans Care program.

Who we serve 

St. Joseph’s OSI Clinic provides specialized mental health services to:

  • Veterans
  • Currently serving members of the Canadian Forces
  • Eligible members of the Royal Canadian Mounted Police who are experiencing mental health challenges as a result of their operational services.

Our sites

St. Joseph’s OSI Clinic is located at Parkwood Institute in London, Ontario and satellite clinics are located in Toronto and Hamilton. The satellite clinics offer a variety of assessment and treatment services.

An access point for assessment has also been established in partnership with the University of Waterloo. St. Joseph’s OSI Clinic provides service across Ontario to those living in:

  • Southwestern Ontario
  • Greater Toronto Area
  • Hamilton and Niagara
  • Northern and Western Ontario

Treatment and services

At St. Joseph’s OSI Clinic we treat operational stress injuries through individual therapy, group therapy, medication, couples and/or family counseling, and education. Treatment methods are based on the latest scientific knowledge (also known as evidence-based) to improve mental health and are tailored to meet the needs of each individual. In partnership with the care team, client's set goals for their treatment and recovery.

An OSI is defined as any persistent psychological difficulty resulting from operational duties performed while serving in the Canadian Armed Forces or Royal Canadian Mounted Police. OSIs include diagnosed mental health conditions such as anxiety disorder, depression and post-traumatic stress disorder, as well as other conditions that may be less severe, but interfere with daily functioning.

When to seek help

It is normal to have stress reactions after a traumatic event. Your emotions and behaviours can change in ways that are upsetting to you. Even though most people experience stress reactions following a trauma, they get better in time. You should seek help if your symptoms:

  • Cause you great distress
  • Disrupt your home or work life

What is an anxiety disorder?

People with anxiety disorders have an excessive degree of anxiety that can sometimes lead to episodes of panic. Symptoms of anxiety can include racing thoughts, excessive worry, racing heart, trouble breathing and more.

What is depression?

Depression is a medical disorder. Symptoms of depression can include persistent low mood, low interest, problems sleeping, changes in appetite and can include thoughts of suicide.

What is post-traumatic stress disorder (PTSD)?

PTSD is a mental health condition that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood.

There are four types of PTSD symptoms:

  1. Reliving the event including nightmares and flashbacks;
  2. Avoiding situations that remind you of the event;
  3. Negative changes in beliefs or feelings; and
  4. Feeling keyed up or irritable including difficulty sleeping, concentrating or being easily startled. 

What is moral injury?

Military service puts people at heightened risk of being exposed to events that disturb or undermine deeply held moral beliefs about how people can be expected to behave. For example, service members may be confronted with experiences in which innocent, vulnerable people have been subjected to violence. These experiences can result in lasting emotional distress. This is referred to as a moral injury.  

Substance misuse and OSIs

Substance misuse is the harmful use of substances (like drugs and alcohol) for non-medical purposes. The term “substance misuse” often refers to illegal drugs. However legal substances can also be misused including alcohol, prescription medications, caffeine, nicotine and volatile substances.

Teaching and Research

Our clinic provides placements and residency opportunities for clinical psychology doctoral students from Western University. Our clinic is directly affiliated with Western University and provides various training opportunities through Schulich School of Medicine and Dentistry.

St. Joseph’s OSI Clinic is committed to research in collaboration with the Western University, Veterans Affairs Canada and the national network of OSI clinics. The mandate of our research is to better understand the effects of operational stress and the benefits of treatment for veterans and military members experiencing operational stress injuries.

Working alongside a number of local and international teams, we have published research on the treatment and progression of mental health diagnoses in current and former Canadian Forces (CF) members. We work in partnership with the Canadian Institute of Military and Veteran Health Research [CIMVHR]. 

Current research projects include:

  • The relationship between combat experiences and clinical diagnoses
  • Sleep and suicidal ideation
  • Somatic symptoms and PTSD
  • Profiles of co-occurring mental health conditions (comorbidity) and social support
  • Neurobiology of PTSD

Exciting future collaborations include predictors of PTSD using machine-learning techniques, and the development of a validated scale to measure moral injury.

St. Joseph’s OSI Clinic has also been integral to the creation of Research Consortium group being led by psychiatrist Dr. Don Richardson.

The consortium includes representation from St. Joseph’s OSI Clinic as well as:

  • Western University
  • McMaster University
  • Centre for Addiction and Mental Health (CAMH)
  • University of Toronto
  • Ryerson University
  • DND/DRDC (Defense Research & Development Canada)


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