Nicole Brangwin, Foreign Affairs, Defence and Security Section
The prioritisation and implementation of mental health strategies has become a critical issue for the Australian Defence Force (ADF) and the Department of Veterans’ Affairs (DVA).
Attempts to de-stigmatise and appropriately address mental health issues in the military and veteran communities have been given greater priority over the last decade. Concerns surround the ADF’s recent high operational tempo and the number of personnel who have experienced multiple operational deployments. But how critical is the situation? DVA’s Deputy President, Shane Carmody, told the online journal Crikey that he is not sure there will be a ‘tsunami’ effect, but incidents of anxiety, post-trauma stress and alcohol abuse are on the rise, particularly among younger veterans.
Mental health initiatives and studies
A significant focus on mental health issues in the military and veteran communities began in the early 2000s when DVA launched its Towards Better Mental Health for the Veteran Community in 2001 and the ADF launched its Mental Health Strategy (MHS), Work Well, Live Well, Be Well, in 2002. Both strategies were developed from the broader National Mental Health Strategy.
DVA’s approach sought to incorporate a broader understanding of mental health issues, as part of veterans’ overall health care needs, in an effort to provide better services to the veteran community.
The ADF’s MHS predominantly aimed to raise awareness about suicide prevention, alcohol management and post-trauma stress. The MHS was established following a recommendation from the Australian Defence Force Health Status Report (August 2000).
The 2002 MHS was reviewed by Professor David Dunt in January 2009 as part of the Review of Mental Health Care in the ADF and Transition Through Discharge. Dunt noted that while the 2002 MHS was far-sighted and in some respects, more developed than other countries’ military mental health care initiatives, the roll-out of the MHS had been patchy and underfunded in other respects.
Over the last few years, numerous studies have been undertaken and initiatives put in place to provide military members and veterans with appropriate access and tools to assist in improving mental health and wellbeing. Regardless of study outcomes, initiatives and strategies, the greatest challenge still needs to be overcome—the stigma attached to mental disorders.
One of the more recent studies undertaken into mental health in the military, the 2010 ADF Mental Health Prevalence and Wellbeing Study (2010 study), interviewed up to 49% of ADF members and reported that within a 12 month period:
- 17.9% ‘ADF members sought help for stress, emotional, mental health or family problems’
- 27.6% were concerned that reporting a mental disorder might result in being treated differently
- 26.9% feared their career might be harmed and
- 36.9% stated the ‘highest rated barrier to seeking help was concern it would reduce deployability’.
While the key findings showed the prevalence of mental disorders in the ADF is similar to rates encountered in the general Australian population, the ‘profiles of specific disorders’ varied.
Of the 22% of ADF members who ‘experienced a mental disorder’, anxiety disorders rated highest, particularly among female members. Male members reported a higher rate of affective (mood) disorders, such as ‘depressive episodes’, than the general population. Alcohol disorders for both males and females were much lower in the ADF than the general community.
At the time the study was conducted, around 43% of ADF members had been deployed multiple times, 19% deployed on one occasion and 39% had never deployed. Although the study did not find that deployed personnel were any more likely to suffer mental disorders than those who had not deployed, it did find that respondents who had deployed were 10% ‘more likely to seek care for mental health or family problems’. The 2010 study did suggest a trend in ‘greater levels of traumatic symptomatology with each trauma or combat exposure on deployments’, but further studies should be undertaken.
The 2010 study considered the rates of suicidality (instances where suicide is being contemplated and/or a suicide attempt is being planned) in the ADF over a 12-month period and found them to be more than double the general population: 4.0% in the ADF as opposed to 1.8% of the general population. However, the study found that the number of suicide attempts in the ADF was similar to that of the general population: 0.4% in the ADF compared to 0.3% of the general population. The number of actual suicide fatalities in the ADF was also reportedly lower than in the general population, but figures were not provided in this study. The study suggested that the suicide prevention strategies implemented by the ADF may have reduced the number of suicides.
Initiatives for serving members
In October 2011, findings from the 2010 study (previously discussed) led to the release of the ADF Mental Health and Wellbeing Strategy. The strategy seeks to improve a number of priority areas including mental health screening, peer support, service delivery and access to care. The implementation of the strategy is guided by the ADF Mental Health and Wellbeing Action Plan 2012–2015. Defence might be called upon to provide updates to Parliament on the progress of these initiatives, particularly the ADF Suicide Prevention Program.
Initiatives for veterans
In 2001, DVA launched its mental health strategy, Towards Better Mental Health for the Veteran Community. At that time, 22% of DVA’s treatment population of 350,000 (around 73,000 veterans) ‘received some form of mental health treatment within any given year’.
As at March 2013, around 148,700 veterans with service-related disabilities were being supported by DVA and of these, up to 46,400 had ‘an accepted mental health disorder’. Common conditions include anxiety disorder, depression, stress disorder and alcohol dependence.
On 27 May 2013, the Veteran Mental Health Strategy (VMHS) was released by the Labor Government. The strategy pledged to provide ‘a ten year framework for mental health care in support of current and future veterans and their families’. The 2013–14 Budget committed $26 million over four years towards the VMHS, commencing in July 2014. The VMHS includes the ‘families, carers and organisations that support’ veterans in its definition of ‘veteran and ex-service community’.
DVA is developing an action plan to guide the implementation of the VMHS. The plan may be subject to updates over the next ten years.
ADF Mental Health Reform Program website includes links to the 2010 ADF mental health prevalence and wellbeing study and the three Middle East Area of Operations (MEAO) health study reports.
Department of Veterans’ Affairs (DVA), Veteran mental health strategy: a ten year framework 2013–2023, DVA, 27 May 2013.
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