Navigation: Previous Page | Contents | Next Page
I think there is a question in this for all those politicians
who collectively sent those soldiers to war, particularly those who shared the
spotlight with them when they went. What have you done since, what are you
doing now to help them deal with the price they have paid? (Kerry O’Brien, Four
Corners, 9 March 2015[1])
This program, Bringing the War Home, and the
questions raised by the host, Kerry O’Brien, are a useful starting point for
this monograph. In attempting to hold the politicians to account in this way,
and with the health and wellbeing of our serving personnel in mind, perhaps
more questions might be raised about foreign policy decisions that commit our
military to war. However, the danger exists that this approach will prompt a
defensive response and will continue to perpetuate the circular argument that
pits veterans against the bureaucracy, and continues to parliament only to be
repeated again without any progress having been made. One positive to come from
the stance taken by the media is that this issue is now being discussed more
than ever before. The mental wellbeing of military personnel and veterans now
occupies a prominent place on the media and political landscape. Part of that
is the way in which this program was the catalyst for the ongoing parliamentary
inquiry. Once again however, the adversarial committee setting may not be the
most effective vehicle to break the model of debate circularity described
above.
This monograph employs qualitative methods as well as
ethnographic and phenomenological methodologies in its analysis of the
prevailing views of experts and personal truths of those who have experienced a
military service-related psychological injury. As noted, a useful starting
point for discussion on the health and wellbeing of Defence personnel and
veterans is the lived experiences of these groups themselves. To provide this
context, the stories of 12 veterans are included in an Appendix to this
monograph. While these men and women represent the reason for the interest and
action on this issue, the very small number of veterans interviewed means that
interpreting the findings requires caution. While their stories can be most
usefully seen as an important first step in the creation of evidence-based and
best practice policy solutions to address the issue of the effects of military
service on wellbeing, caution must be exercised when making generalisations
based on the experiences of these case studies. While these stories give much
needed context to discussions around mental health and the military, they do
not, in and of themselves, necessarily lead directly to policy solutions or
treatment models. Neither does having a career background in the military mean
that an individual is uniquely qualified to speak on this issue.
Using these personal stories as a starting point to define
the scope of this problem, this monograph considers the ways in which this
issue has been treated within the bureaucracy. Both Defence and DVA have been
actively considering the mental fitness of their respective client pools, as
part of a larger picture of the wellbeing of these communities. The parliament
has also taken an interest, evidenced by two recent parliamentary inquiries.
While there is currently an unprecedented amount of interest in these issues,
the veterans who agreed to be interviewed for this research described
significant barriers to accessing care and support. They describe a system that
treats them at times with suspicion, in which inadequate treatment options
exist. They describe being frustrated with a process that effectively
exacerbates their existing psychological injuries. If the debate is to move
beyond the current circularity that pits the needs of veterans against the
bureaucracy, the first step is recognising these problems.
While much of the available data used in the preparation of
the following chapters relates to the Army, these issues are not solely an Army
problem. Examples of the impacts of Navy and Air Force service have been used
where available and it should be noted that the issue of mental fitness is not
limited to any single service.
This monograph is divided into three parts. The first part
places the issue of mental fitness and the military within a wider context of
(mental) health and Australian society. It notes, however, aspects of this
issue that are particular to military service. These include a growing
appreciation of the fact that the military exposes its personnel to trauma and
therefore experiences corresponding incidences of psychological injury; and
that service in a totalising institution can significantly disrupt individuals’
lives when that service comes to an end.
The second part maps the changing attitudes towards mental
health and the ADF of a range of stakeholders. These include the federal
parliament and the departments (both Defence and DVA). A growing awareness and
increasingly sophisticated understanding of this issue is evident in the
parliament, the military and the broader community. This corresponds with an
increased level of services and support available to those who require it.
Nevertheless, while the senior leadership of the ADF, Defence and DVA recognise
the serious nature of the issue and are focused on helping those affected,
these attitudes have not sufficiently permeated the low and mid-levels of their
respective organisations. A disconnect has been noted between the attitudes of
senior leadership and the services available, with better outcomes for those
affected. Encouragingly, there exists a tangible appreciation amongst the ADF
hierarchy that attitudinal and cultural change is not a found object,
and there is commitment to continuous improvement and learning by doing
evident from within this group. Another limitation is that while there is some
consensus on what constitutes best practice psychological and medical care,
there is no such thing as best practice macro-level policy models. While
lessons can be learnt from the examples set by our partners in the US, UK,
Canada and New Zealand, global policy settings are thought to be too context
specific to allow for the adoption of an off-the-shelf product to address
detailed policy requirements.
The third part of the paper describes areas of significant
progress and others where progress is required. The persistent issue of stigma
acts as a reminder of the low starting point of knowledge and uninformed
attitudes towards service-related psychological injuries. A hopeful note is
struck by the 2nd Commando Regiment and its approach to dealing with the health
and wellbeing of its workforce. Changing attitudes towards veterans has a
shaping effect on broader attitudes towards service-related non-physical
injuries. This monograph records examples of ESOs that provide an invaluable
range of services and support to veterans. There is, however, a feeling that
some advocacy and support groups appear to remain trapped in an entitlement
mentality that sees DVA as the enemy with whom they must wage battles for
compensation. Finally, the issue of preventative mental fitness will be
introduced, investment in which is seen to have good prospects for improved
outcomes.
The Government has not failed all veterans. The majority of
ADF personnel go on to live productive and happy lives, having enjoyed their
career in military service. Mirroring the attitudes of the broader community,
attitudes in the ADF towards mental health have come a long way from a very low
starting point. However, the results are not yet effective and without
significant investment in this issue now, there is a risk that the mistakes of
the Vietnam War will be replicated, creating another long legacy of
psychological injury from recent and current deployments.
[1]. Australian Broadcasting Corporation (ABC),
‘Bringing the war home’, Four Corners, ABC TV, 9 March 2015.