Chapter 7 Return from Operations
Chapter seven considers the veteran who returns from operations and, whether
knowingly or unknowingly, is carrying physical or mental scars for which they neither
seek nor receive treatment. This Chapter also addresses the issue of delayed
onset mental health conditions.
The Department of Defence (Defence) advised that all members receive a
Return to Australia medical brief from medical staff prior to leaving an Area
of Operations (AO). Personnel are briefed on the actions required during the
post-deployment period and issued with a post-deployment information card.
A post deployment health screen is conducted by a medical officer and
includes a targeted physical examination guided by a general health questionnaire.
Members are advised on any health eradication regimes at this time (as may be
necessary, for example, for malaria or helminths) and provided with the
appropriate medication. This regime applies to all personnel, including those
injured and undergoing rehabilitation.
A post deployment health assessment is then conducted three months post
deployment to review any health issues that may have arisen since the
deployment and includes testing for blood borne diseases and audiometry
(hearing testing) for those on land based deployments.
Non-reporting of injuries
The Committee heard that it is common for servicemen to not seek
treatment for physical injuries:
You would find that most good soldiers would probably be
carrying injuries of some sort, especially in Afghanistan, or Iraq when we were
there. Everyone gets injured in some form. Most good soldiers will just keep
Professor Sandy McFarlane AO submitted that following every major
conflict of the 20th century, non-specific physical symptoms have been a common
presentation and determining the cause of those symptoms has often led to
controversy, such as with Gulf War Syndrome, or the effects of Agent Orange. Professor
McFarlane submitted that the possibility of post-deployment syndromes need to
be anticipated, and both the question of causation as well as establishing
treatment programs to assess and thoroughly treat those affected need to be
addressed by research. In this regard, current areas of concern include, but
are not necessarily limited to, cancer clusters and mild traumatic brain injury
The Committee shares Professor McFarlane’s concerns and recommends that
post-deployment syndromes be the subject of further study.
The Committee recommends that
the departments of Defence and Veterans’ Affairs sponsor a program of
research examining the development of post-deployment syndromes in the
current veteran cohort, be it relating to mild traumatic brain injury or some
Dr Andrew Khoo, a consultant psychiatrist and the Director of Group
Therapy Day Programs at Toowong Private Hospital (TPH), submitted that the 2010
ADF Mental Health Prevalence and Wellbeing Study carried out on serving ADF
personnel found that over a 12 month period, 20% of the Australian Defence
Force (ADF) population suffered from some form of mental health disorder.
Whilst this is a similar rate to the general community, ADF personnel represent
a younger, more motivated, male dominated and physically more robust cohort. When
the same cohort was asked if they had ever experienced an affective, anxiety or
alcohol use disorder, this number increased to over 50 per cent. Combined with
the United States (US) figures, these findings show rates of 25-30 per cent of
returned soldiers exhibiting significant psychological symptoms (typically a diagnosable
mood, anxiety or substance use disorder), Dr Khoo submitted that it would be a
reasonable assumption to make that overseas deployment and exposure to trauma
increases the incidence of psychological distress and disorder.
The Australian Centre for Post-traumatic Mental Health (ACPMH) submitted
that Defence’s institution of mental health, suicide prevention and traumatic
stress awareness campaigns aimed at improving recognition and reducing
stigmatisation and barriers to accessing care has been a critically important
Professor McFarlane submitted that post-traumatic stress disorder (PTSD)
is only one of the common psychiatric syndromes and that depression and
substance abuse are, in fact, the more common disorders and that they
frequently go undiagnosed.
Rear Admiral (RADM) Robyn Walker AM, Commander Joint Health, acknowledged
that the issue is not just PTSD but alcohol and drug abuse, depression and
broader mental health concerns.
Defence, in its submission, affirmed that the Australian Government is
committed to protecting the lives and welfare of Defence personnel deployed on
operations. A key component of this commitment is the provision of health
support to deployed forces. This support ensures that a force deploys at
optimal fitness with adequate preventive health measures.
All ADF members who deploy on operations must be assessed as being
medically, dentally and particularly psychologically fit for the tasking and
are pre briefed on local health threats and appropriate individual health
precautionary actions. Commodore (CDRE) Peter
Leavy, Director General Navy People told the Committee:
In Navy’s case in particular, we started a program last year
of pre-briefing sailors involved in Operation Resolute, the border protection
operation in the north of Australia, and providing dedicated screening of those
who have been involved in the operations to try and identify early potential
problems where professional help can be brought in early.
It is very early days; it has only been running for about a
year now, but, again, there are positive signs and we are hoping that
throughout their careers we will be able to follow much better those people who
were involved in potentially traumatic events.
Health threats to Defence members may be operational, environmental,
psychological and/or occupational. Operational health threats are those posed
to Defence members by weapons systems, which may include non-conventional
weapons. Environmental health threats include communicable diseases and
environmental hazards. Psychological threats include an assessment of threat
to self, exposure to trauma and operational stress. Occupational health threats
are those posed to Defence members by their own weapon systems, platforms
and/or work environments. Briefs addressing these specific health risks are
developed and where possible appropriate measures to mitigate the threats are
Pre-deployment medical screening
All ADF members’ medical employment classifications (MEC) are reviewed
between four and eight weeks prior to deployment to ensure that they are fit to
deploy and all required vaccinations have been administered. A further check
is undertaken within seven days of departure to ensure no additional medical
conditions have occurred. Associate Professor
Neuhaus CSC told the Committee that she is comfortable that the process is a ‘fairly
comprehensive and robust system of pre-deployment screening’.
That said, soldiers who spoke to the Committee said that it was common
for individuals to deliberately not report injuries, or that prior injuries
were not considered significant:
But it is very broad. There are only limited medical staff
to conduct these pre-deployments and a lot of it is just a check sheet. You
just sort of go through and mark down. … [My prior injuries were] not really
flagged at any of those pre-deployment medicals prior to going back into
‘Soldier L’ told the Committee that, particularly when it comes to deploying
on operations, soldiers will put aside minor medical concerns and ‘just deal
with it’. He told the Committee that soldiers will often push aside injuries
and pain, acknowledging that that is why there are so many medical problems
when units return to Australia because by then, the problem has worsened.
While not critical of in-theatre medical support, he said that it was also not
always immediately available:
A lot of guys do not want to risk getting sent home, either,
because a lot of guys do not want to leave their mates.
Pre-deployment cognitive testing and psychological
For the Middle East Area of Operations baseline cognitive testing
(COGSTATE© Sport) is undertaken and is mandatory for all members of the Special
Operations Task Group and attached elements, all combat engineers and explosive
ordnance device technicians and all mentoring task force personnel engaged in
outside-the-wire duties. Defence submitted that COGSTATE© Sport tests reaction
times, concentration, memory and decision making and it is employed as a tool
to assist clinicians making decisions about when to return a member to duty
after a concussive injury (for example, from an improvised explosive device
(IED) strike). Baseline testing allows comparisons to be made with a repeat
test after a concussive injury. ‘Soldier B’, who
himself had been struck by an improvised explosive device (IED) said:
The whole battle group did the cognitive function tests so
that if they hit an IED later that they could compare the results to see if
there was any decline.
I had a friend that hit an IED in September. It was pretty
down pat for him. … They had all the cognitive tests to compare it and stuff
like that. I think [that the process] has already improved.
Pre-deployment psychological preparation briefs are given and cover
topics such as separation, cultural adaptation, operational tempo, fatigue,
stress management and homecoming. Major General (MAJGEN)
(Retired) John Cantwell AO DSC, the former Commander of Australian troops in
the Middle East, emphasised that:
It is almost impossible to prepare anyone for the horror of
combat, for the loss of losing your mate, of the distress and revulsion of
picking up pieces of another human being. You cannot prepare people for that.
Associate Professor Malcolm Hopwood, the Clinical Director of Austin
Health’s Psychological Trauma Recovery Service (PTRS) told the Committee that it
is possible to identify some general risk factors for the development of
disorders like PTSD. He advised that a prior personal history of depression,
anxiety, psychiatric disorder or a prior personal history of trauma is a risk
factor for the development of a mental health disorder following subsequent
trauma. While not definitive, prior screening for susceptibility to a mental
health disorder could provide a general predictive capacity for individuals to
be employed in a role appropriate to that susceptibility:
There are undoubtedly individuals who possess some of those
risk factors for post-traumatic stress disorder who it may not be desirable to
deploy overseas because of the risk, but who could function very effectively
with other roles that did not involve a high risk of trauma.
Professor David Forbes, the Director of the ACPMH, agreed. He told the Committee
that the evidence on screening for entry and screening for risk is not strong
and the biggest risk factors in terms of PTSD development are the nature of the
trauma, what happens to the individual, and the kind of support they receive in
the aftermath of the event. An individual with a significant psychiatric
history would be a concern, though that would be identified as part of the
existing screening processes.
Professor McFarlane told the Committee that while it is extremely
difficult to do, risk-screening could be done: ‘We have reached a time where
you can actually measure people’s psychophysiology’. He gave evidence that startle
response, brain function and anxiety responses can be measured on currently
accessible systems. In the military context, underreporting would be
anticipated and it would be necessary to lower cut-off thresholds as a first
step in a screening process.
Post-deployment psychological screening
Professor Hopwood gave further evidence that PTRS would be of the view
that screening for mental health disorders prior to overseas deployment is an
appropriate thing to do, but difficult to do effectively. PTRS are aware that
there are relative risk factors for the development of mental health disorders
in the face of trauma such as a prior history of anxiety or depressive
disorder, but these are only relative indicators. Therefore, it is not
possible to completely screen out people who are at risk and PTRS believe that
effective screening for mental health disorders post-deployment is just as
Defence submitted that members returning from operational deployments
receive psychological screening both prior to returning to Australia (return to
Australia psychological screen – RtAPS), and three to six months following
their return (post operation psychological screen - POPS). This applies to all
personnel, including those injured and undergoing rehabilitation.
For those personnel requiring further mental health support and
treatment, comprehensive counselling and treatment programs are available using
a network of Defence mental health providers and external services.
The ACPMH submitted that the implementation of the RtAPS/POPS process is a
critically important initiative. As with pre-deployment
screening, however, in some instances:
We have POP screening currently, but anyone who has ever been
through that — I know; I have been through five of them — laughs it off. It is
Another soldier commented that ‘It’s a joke’!
The Committee received evidence of one instance where PTSD symptoms were
identified during both RtAPS and POPS but very little coping advice and no
treatment was given at that time. In another instance, a
member was able to conceal psychological issues and the POPS interview was conducted
as a mere formality. General Cantwell’s view
was that the POPS process is ‘not greatly effective’ because the interviews are
not generally responded to in an open and honest way. Further:
It would be very difficult to have a genuinely effective,
intrusive, compulsory assessment scheme for all those thousands of troops that
we have rotated through.
That said, Professor Forbes told the Committee that the RtAPS/POPS
process plays an important function in that it communicates a very strong
message that the mental health of every service person is important and will be
followed up on an individual basis.
Defence submitted that ADF personnel are not to redeploy on any further
operation until such time as any outstanding post deployment heath assessments
and POPS screening has been undertaken. Austin Health’s PTRS highlighted
that the risk of exacerbating mental health disorders through further operational
deployments is real and poses operational risk beyond the effected individual.
Professor Hopwood highlighted that there is a tension in the screening process
between the desire of many individuals in the ADF to continue their role within
the forces and a concern that, should they be screened as having a mental
health problem, they may be viewed differently by their peers and their
occupational role may change.
Defence also stated in the 2013 Defence White Paper that they will continue
to enhance their approach to screening, assessment and
treatment of mental health concerns, including PTSD.
Self-awareness and resilience training
Further to RtAPS and POPS arrangements, Dr Khoo submitted that all
returning troops ought to be provided with a psychological first aid (PFA)
session – including psycho-education on human responses to trauma and on basic
signs and symptoms. Defence Families of
Australia (DFA) also submitted that such a post-deployment process needed to be
Dr Glen Edwards warned that when assisting ADF personnel presenting with
emotional or psychological difficulties, the emphasis is often on PTSD. Rather,
what is needed is to determine the ability of the individual to understand and
process aspects of their treatment.
General Cantwell made a similar point. Not only was he ashamed of how
he was feeling, he did not understand what PTSD was when he first started
feeling the symptoms.
General Cantwell felt that it was important to involve senior
non-commissioned ranks in advertising mental health self-awareness because of
their credibility and influence. He advocated for mental health training being
a component of the battery of annual compulsory training Defence members are
required to attend.
ACPMH, however, submitted that Defence has been among the international
leaders in initiatives focused on the development and delivery of training to
enhance psychological resilience, which is in the process of being expanded to
focus on re-iterating these strategies across a range of points in service
life. Director General Navy
People told the Committee:
We have had a fairly robust program of peer group training
sessions. In fact, we have annual awareness training across the department to
try and break down that stigma we spoke about earlier and also to provide our
own people, our peers in particular, the tools to recognise potential mental
health issues with the people they live and work with.
Professor Forbes gave evidence that the potential for building
resilience is a field that has been developing recently but that the clinical
evidence for the worth of resilience building is not yet fully established. He
advised that the program Defence had put in place was probably one of the first
that was introduced internationally and that it is based on building an
individual’s capacity to manage some of the stresses associated with
operational deployment. He noted that such strategies may not prevent the
development of mental health problems but that it will make some difference.
It was also submitted that research needed to be conducted to establish a
means to deprogram (and provide ongoing support to) combat personnel on
returning from operations. Dr Edwards submitted
that for some returned service men and women the war is not over and that for
many it has just began. There is a whole process of readjusting from a life
changing experience and it is not always a smooth process.
‘Soldier E’, a veteran of Afghanistan, told the Committee:
There is no heads up or, ‘Okay, you possibly might experience
this in the future, and when that happens come and see us’, or anything like
Specific to Special Forces (SF), Defence submitted that since mid-2011,
Joint Health Command has worked collaboratively with Special Operations Command
on a performance and wellbeing framework to enhance the physical and mental
health of SF personnel. This framework acknowledges the potential impact of
multiple combat deployments and includes initiatives to build psychological
resilience, monitor health and physical performance and provide early
interventions for emerging issues.
The Defence White Paper states that the current ADF mental health reform
program has developed a range of initiatives to improve mental health awareness
which are in place and will help ensure all members of the ADF are aware of the
risks associated with mental health issues including PTSD and know how to
address this risk.
Alcohol use in the ADF
The Committee heard that one of the major manifestations of traumatic
stress and mental health issues is alcohol and other substance abuse.
Defence submitted that they provide funding support to over 130 bars and clubs
on bases around Australia, and provide bar services as part of mess
facilities. Bars and clubs play an important role in Service culture and
In 2012, Defence agreed to reforms to reduce and standardise bar opening
hours and promote responsible management of bars across Defence. This change
is consistent with initiatives being developed under Defence’s Pathway to
Change Strategy and the complementary ADF Alcohol Management Strategy. Further
phases of bar reform, including consistency in bar management and alcohol
pricing across Defence bars, will be finalised over the coming months for
implementation later in 2013 and in 2014.
Defence submitted that they provide a comprehensive suite of alcohol,
tobacco and other drug services to ADF members. This includes mandatory
awareness briefs, psycho-education workshops and access to a stepped care
approach to appropriate garrison-based interventions in a primary care setting
and referral to external specialist treatment and rehabilitation services as
Additionally, Defence advised that they are working closely with the DVA
in adapting its health promotion initiative, The Right Mix -Your Health
& Alcohol, to the needs of current serving ADF members. This includes
promotion of the recently released smart phone application On Track with The
The Australian Drug Foundation has been contracted to assist Defence with
the development of the alcohol management strategy and formulation of single
Service implementation plans in collaboration with each Service and Joint
Health Command. The strategy is informed by and addresses the recommendations
arising from the Independent Review of Alcohol use in the ADF conducted
by Professor Margaret Hamilton in 2011. Implementation of the strategy is
intended to strengthen the ADF approach to alcohol management by providing
education and information to ADF members about responsible alcohol use; managing
the availability and supply of alcohol; providing support and treatment to
those who require it; and monitoring and responding to alcohol related
To support implementation of the strategy, the ADF will implement four initiatives
developed with the assistance and expert advice of the Australian Drug Foundation
that will enhance the ADF’s existing alcohol, tobacco and other drugs service. These
A review of the Defence alcohol policy aligning Defence policy
with evidence based national alcohol and other drug policy;
An alcohol behaviours expectations statement which outlines the
standards expected for responsible use of alcohol in the ADF;
A leader’s guide to alcohol management which provides guidance to
ADF commanders in relation to all aspects of alcohol use in the ADF with a particular
focus on prevention and early intervention; and
A hospitality management program designed to provide guidelines
for Defence in the planning and conduct of events where alcohol will be available.
Delayed onset mental health issues
There is a concern that there will be a wave of delayed onset PTSD and a
likely increase in mental health prevalence rates relating to contemporary
operations. General Cantwell, in
his compelling appearance before the Committee said:
There is yet to come a very large number of problems
associated with PTSD, … the numbers will grow, and grow exponentially. We have
exposed thousands and thousands of young and old Australians to some pretty
brutal experiences. Even for those who are not directly involved in combat,
there are an ample number of vicarious exposures and experiences. … So there is
a large wave of sadness coming our way, and the system—DVA and Defence—needs to
be ready for it. I wonder whether we are.
Professor Neuhaus told the Committee there is likely to be a significant
lag, potentially of many years, before the full extent of the psychological
injuries alone, are fully appreciated – after every previous conflict there has
been a delay in recognising other injuries or illnesses directly related to
operational service that were not immediately identified.
The Returned and Services League of Australia (RSL) South Australia Branch
submitted that the development of additional support services for veterans who
subsequently develop PTSD is critical and currently lacking. RSL SA submitted
that many will be captured by the general health system, however this is not
appropriate as mental health issues such as PTSD need specialist treatment.
Also, some are not captured until their problems are well entrenched and their
condition has caused additional social and family problems, or not captured at
I have put a lot behind me. I have achieved four tours of
Timor in my 25 years, including 1999-2000 in Balibo. I have seen a lot of
stuff and have managed to put everything behind me. Everything escalated last
year … the anger built up and the dreams became more reoccurring to the point
of having visions of bags of ice — something you take naturally for
granted—around Benny Ranaudo on the 27 hours it took to fly him back to
The Committee heard that PTSD can lie dormant for up to 30 or 40 years.
The Committee heard of several cases of delayed onset of PTSD and other mental
health issues as a result of military operational service:
Forty years after serving as a conscript in Vietnam, I had a
complete breakdown and was diagnosed with delayed onset, chronic PTSD and
severe depression. This war caused injury has completely disrupted our lives
and taken away my ability to work.
Early identification of mental health issues is of primary importance —
Associate Professor Hopwood gave evidence that for disorders like PTSD, once
that disorder has been established for three to five years, but possibly as little
as two years, the chance of remediating the disorder shrinks dramatically.
Concern was raised that there is not a broad understanding of how many
veterans will be affected by their participation in contemporary operations.
Professor Peter Leahy AC gave evidence that Soldier On believes the numbers may
be in the thousands.
Dr Khoo did not believe that there is a great probability that there
will be increased PTSD rates amongst the current veteran cohort. He told the Committee
that PTSD rates of major conflicts stay fairly static, with Vietnam potentially
the only outlier where there were slightly increased rates probably due to the
reception faced by the soldiers when they returned. He highlighted to the Committee
therefore that, noting the lifetime risk following trauma, it can be assumed 15
to 20 per cent of the veterans of recent conflicts may develop PTSD at some
point in their lives.
The Committee heard of soldiers taking their lives. A recent veteran
I have also known soldiers who have taken their own lives. Some
personal friends have taken their own lives because they did not have this kind
The Department of Veterans’ Affairs (DVA), however, do not have precise
information on the number of suicides amongst veterans, though they have had 65
claims between 2003 and 2012 in relation to death by suicide attributed to
service, from the Second World War to the present day.
The Committee heard evidence that there were both similarities and
differences between the experiences of Vietnam veterans and those of the
current cohort of veterans. Associate Professor Hopwood noted that only a
small proportion of younger veterans had ‘reconciled with the old blokes’.
A 25-year ADF veteran whose career includes a tour in Afghanistan and four in
East Timor told the Committee:
I had the misfortune of seeing it all with my father, a
Vietnam vet also in the infantry. I always promised I would never go down that
road, although it is my last year as a result of the injuries and everything
which have brought it all out.
Dr Glen Edwards, in his book Beyond Dark Clouds, documented his longitudinal
record of the psychosocial effects of Vietnam veterans and their families,
detailing the stories of twenty veterans, their spouses and children based on
two separate sets of interviews conducted in 1986 and 2006, spanning two
generations and three countries. All individuals interviewed spoke candidly,
highlighting the struggles they face in trying to understand and make sense of
events that have impacted their lives, often in unexpected and traumatic ways.
He submitted that many continue to suffer emotionally, psychologically and
physically from their service often in silence or behind closed doors.
Professor McFarlane identified the issue:
It is the invisible wounds that are the ones that are most
easily forgotten. This was very clearly the case after Vietnam. I think that
what we have got to do is make sure that we do not make those same mistakes
Pre/Post-deployment support of families
Defence advised that the ADF is committed to ensuring family members of
those ADF personnel wounded or injured on operations are supported through the
period from wounding or injury, acute treatment and rehabilitation to return to
work or transition from the Service. The ADF and Defence Support Group (DSG)
are attuned to the requirements for family-sensitive health care delivery and a
number of supporting systems and programs have been or are being implemented to
further address the needs of the family.
The Returned and Services League of Australia WA Branch (RSL WA) submitted
that families should, like the service member, also receive pre- and/or
post-deployment training, if only to be made aware that the person who returns
to them after deployment may not be the same person that joined the ADF.
DFA also highlighted that this is a common concern with families.
General Cantwell told the Committee that he had not seen anyone brief
families on what could be expected when their serviceman returned from
operations and felt that such information needed to be provided. He was
concerned that spouses and families are vulnerable for a variety of reasons and
that their vulnerability could be ‘exacerbated by ignorance’.
Defence White Paper 2013
The Committee notes that in the Defence White Paper 2013, the Government
announced that it has decided to provide an additional $25.3 million for
enhanced mental health programs including:
Extending the Veterans and Veterans Families Counselling Service (VVCS)
coverage to a number of current and former personnel not currently eligible (that
is, border protection personnel, disaster zone personnel, personnel involved in
training accidents, ADF members medically discharged and submariners); partners
and dependant children up to the age of 26 of these high risk peacetime groups;
and families of veterans killed in operational service;
Extending mental health non-liability health cover to include
access for former ADF members with three years continuous peacetime service
after 1994 and expansion of current conditions of PTSD, depression and other
anxiety disorders to also include alcohol and substance misuse disorders for
Implementing a post discharge GP health assessment, using a
specially developed screening tool, for former ADF members, including regular
and reserve forces;
Additional funding for the Defence resilience platform, LifeSMART
(Stress Management and Resilience Training) for veterans and families. Additional
modules may include anger management, substance misuse, depression, anxiety,
grief and loss;
Developing and maintaining a Peer-to-Peer Support program to
support recovery of veterans with a mental health condition by providing a
non-clinical support network;
Additional funding for improving processing time for compensation
claims by veterans and current serving personnel; and
Additional assistance for veterans and current serving personnel
making claims for injury.
The Committee applauds the additional funds announced in the Defence
White Paper 2013 to enhance mental health programs.
On the balance of evidence, the Committee does not, at this stage,
advocate employment-related pre-screening of individuals for susceptibility to
PTSD but certainly commends current psychological pre-deployment processes and
the adoption of pre-deployment cognitive testing. The Committee is, however,
concerned at the rigour of health checks, both prior to, and post, deployment.
The Committee agrees that returning troops ought to be provided with Psychological
First Aid (PFA) as necessary in order to equip them with the tools to identify
trauma-related mental health issues and seek appropriate assistance.
With respect to mental health and PTSD rates in the current veteran
cohort, the Committee accepts the evidence that it is unlikely that there will
be increased mental illness rates for recent veterans. The Committee notes,
however, the evidence that it can be assumed that up to 20 per cent of the
veterans of recent conflicts may get PTSD at some point in their lives. The
Committee also notes that as many as 50 per cent of servicemen or women can
expect to have some form or mental health disorder in their life. The
Committee therefore highlights to Defence, DVA and the broader health service
provider community that there are at least 45,000 veterans with operational
service from conflicts since 1999.
The Committee notes the Review of Mental Health Care in the ADF and
Transition through Discharge (The Dunt Report) concluded that the
prevalence of suicide in the veteran community was not easy to determine.
The Committee is very concerned, however, at the lack of data and research regarding
suicide rates in the veteran serviceman/ex-serviceman community and recommends
that this be quantified.
The Committee was surprised to hear that not only did some families not
receive pre-deployment briefings, but that there was not a routine process in
place for families to be contacted by the Defence Community Organisation (DCO),
or another similar agency, to check on their wellbeing while a member is
The Committee heard evidence that during pre- and post-deployment health
checks, physical injures to ADF members are not diagnosed due to either the cursory
nature of the check, or the member’s desire to hide the injury in order to
deploy. The Committee is therefore concerned at the thoroughness of these
The Committee recommends that
the Department of Defence review the adequacy and rigour of pre- and post- deployment
The Committee recommends that
the Department of Defence provide all troops returning from operations,
including non-warlike operations, targeted psychological first aid and
post-deployment psycho-education which should include:
on human responses to trauma;
of basic signs and symptoms of mental health conditions; and
on assistance options.
The Committee recommends that
the departments of Defence and Veterans’ Affairs conduct an assessment of
suicide rates in the military/ex-military community as a priority.
The Committee recommends that
the departments of Defence and Veterans’ Affairs establish strategic research
priorities to address suicide attributable to defence service.
The Committee recommends that
the Department of Defence establish formal, Defence-wide pre- and
post-deployment training for service families, and a periodic contact program
for the families of deployed members.