1.1
On Wednesday 30 May 2018 the Joint Standing Committee on Foreign Affairs, Defence and Trade resolved to inquire into and report on Transition from the ADF.
1.2
The terms of reference for the Inquiry are:
The Defence Sub-Committee of the Joint Standing Committee on Foreign Affairs, Defence and Trade will inquire into three specific areas relating to the discharge and transition to civilian life of men and women who have served in the ADF having regard to:
1
The barriers that prevent ESOs from effectively engaging with ADF members, the Department of Defence and Department of Veterans’ Affairs to provide more effective support to ADF personnel as they transition out of service;
2
The model of mental health care while in ADF service and through the transition period to the Department of Veterans’ Affairs;
3
The efficacy of whole-of-government support to facilitate the effective transition to employment in civilian life of men and women who have served in the ADF; and
In regard to Point 2, the Committee may consider:
Limitations of the current services being provided by the private and state health systems;
Whether the waiting times and service limitations of the state systems, particularly mental health care, are acceptable for veterans needing treatment;
Documentation of treatment response for PTSD and improvements of treatment outcomes, given the limitations of current evidence-based interventions;
The responsiveness of Defence and DVA to emerging international knowledge in the care of veterans and the advice of health professionals; and
The optimal structure and range of services that could be provided by a national network of clinics for ADF members and veterans, were a different approach adopted.
Conduct of the inquiry
1.3
The Committee announced the commencement of the inquiry by media release on 31 May 2018 and requested submissions from interested members of the public. Submissions were requested by 13 July 2018.
1.4
The Committee received 51 submissions from a range of government agencies, non-government organisations and individuals. Submissions are available on the Committee’s website. A full list of submissions received is included at Appendix A.
1.5
The Committee held five public hearings in Brisbane, Melbourne, Adelaide, Sydney and Canberra. Transcripts from these public hearings are available on the Committee’s website. A full list of public hearings and witnesses is available at Appendix B.
Report structure
1.6
The report is divided into four chapters:
The remainder of this chapter briefly introduces the concept of transition from service in the Australian Defence Force, and discusses the context of the inquiry;
Chapter 2 discusses the provision of effective support to former ADF personnel in their post-service lives (term of reference 1);
Chapter 3 discusses mental health care during and after ADF service (term of reference 2); and
Chapter 4 discusses whole-of government support for the effective transition to employment for women and men post-ADF service (term of reference 3).
Context of the inquiry
1.7
The importance and priority attached to serving members transitioning from the ADF to civilian life have been highlighted in several government reports. The 2016/17 Defence Annual Report (page 116) discusses the critical outcomes determined during the first 12 months of the process of transitioning out of Defence, in the section titled “Fit to fight and fit for life”. The report highlights increased collaboration between the Department of Veterans’ Affairs (DVA) and Defence since 2010 in the area of mental health support. The 2016/17 Department of Veterans’ Affairs Annual Report states that the transition from Defence is a priority for the Department of Veterans’ Affairs in the Secretary’s Review (page 4) and the Chief Operating Officer’s Review (page 7). DVA also reports on various transition programs (pages 36-65) and training for ESOs (page 39).
1.8
Despite increased collaboration and access to care, in the 2017 Senate Inquiry into Veteran Suicide concerns were still being raised about the model via which care is provided. Secondly, the role of Ex-Service Organisations (ESOs) – specifically their role in supporting this transition period – does not appear to be defined despite a new body of work by DVA to lift the standards of claims and pension support by ESO Advocates.
1.9
In response to these concerns, a new parliamentary inquiry was established to examine the support provided to members of the ADF as they transition from active service to civilian life.
1.10
Specifically, the inquiry examined the efficacy of support services available to members of the ADF transitioning out of active service, particularly focussing on mental health care, employment pathways and the role of ESOs. The inquiry also examined whether there is adequate support for reservists and for regular personnel who transition to the reserves following full time service. The inquiry also considered whether the services provided adequately cater to the needs of women transitioning from the ADF to the extent that their experiences may be different from those of men.
1.11
The aim of the inquiry was to identify ways to improve services available to serving members transitioning from the ADF and ensure that they all have appropriate access to mental health care and employment opportunities, including whether there could be a greater role for ESOs in providing ongoing support.
The term ‘transition’
1.12
The term ‘transition’ is used to describe the process of a member of the Australian Defence Force leaving their position with the ADF, and ‘transitioning’ back into civilian society. While this process appears from the outside as if it would be analogous to leaving one job for another, the military framework around the job, and the training and enculturation the individual has undergone during his or her military career, means that the process of leaving the military is more akin to migrating from a land with a language, history, system of leadership and bank of achievements, of which the people among whom they now live, are largely unaware.
1.13
The difficulty for the woman or man going through this process is multi-faceted. On the one hand, she or he could be leaving the service voluntarily, or for medical reasons, or through an administrative separation process, and may have views about the process itself, and the manner of their departure from the ADF, ranging from positive through to negative. The individual may need to move location to a different part of the country; seek employment; find accommodation; locate new health practitioners, and bring their spouse and/or children along on the journey. A reduction in income; difficulties in finding employment; the loss of contact with familiar friends and colleagues, can contribute to the tensions inherent in this time of change. The process of transition itself can be stressful to navigate, and those who have the most promising outcomes often have strong support systems around them in the form of partners, spouses, children, extended families, and friends.
1.14
For many leaving the services, a process of re-assessment of their military career takes place, and this consideration of their achievements, decisions, actions and losses, within the context of the whole of their life, may lead them to utilise counselling or other therapeutic services to ensure they remain engaged in maintaining all aspects of their health. In some cases, moral injury may be a factor, mental health issues including anxiety, depression, post-traumatic stress disorder (PTSD) and substance dependence may arise and require medical attention. These issues may colour how the individual sees their own service, and those associated with the ADF. More successful outcomes for individuals arise when they have some choice over leaving the ADF, and when they have had sufficient time and information to assist them to prepare for their move from the military to the civilian domain.
1.15
Transition is a process which may take years, and be complicated by changes or difficulties in several aspects of life – employment, household income, accommodation, location, sense of identity, personal relationships, family relationships and psychological and physical health. Women have more difficulty finding employment, as do those transitioning for medical reasons.
The term ‘veteran’
1.16
The term ‘veteran’ has traditionally been used to describe those members of the Australian Defence Force who were deployed to serve in areas of operational conflict. The Department of Veterans’ Affairs attributes a particular meaning to the term when assessing claims for support, and includes those ‘who have continuous full time service with the Defence Force (Army, Navy or Air Force) of Australia during WW1 or WW2 or who were allotted for duty in an operational area after WW2’. In 2017 a Roundtable of Australian Veterans’ Ministers agreed that a veteran would be defined as any person who has served at least one day in the Australian Defence Force. A number of Ex Service Organisations (ESOs) indicated that they took the view that any person who had ‘worn the uniform for a day’ would be considered to be a veteran, and would be welcome to access their services.
1.17
It was acknowledged by a number of ESOs that some who have not served in areas of operational conflict, however, do not feel comfortable with applying the term ‘veteran’ to themselves, and do not believe that services and support provided for ‘veterans’ are for their use. This is in part due to the legal definitions applied under legislation by the Department of Veterans’ Affairs. The Committee takes the view that any woman or man who has served in the ADF is a veteran, and uses the term ‘veteran’ in this manner throughout this report. The terms ‘former member of the ADF’ or ‘former member’ are also used in this report.
Outcomes of the report
1.18
This report looks at the support given to those transitioning out of the ADF, and considers two important areas which have shown to be problem areas for some, and into which the government has provided additional input in recent years – employment post-ADF service, and mental health care both during and after ADF service. The recent provision of access to free mental health care for all former members of the ADF, underlines its importance, and is an acknowledgement by the Government that the risks and traumatic incidents that one may be subject to in ADF service place members at a higher risk than do other occupations, of suffering an injury to their mental health.
1.19
The report considers the evidence provided at hearings and in submissions, as well as information from other sources, and makes recommendations on ways of improving outcomes in these areas.
Transition data
1.20
While transition from service is inevitable for most, there are several transition pathways out of the ADF. Between 1 January 2007 and 31 December 2017, a total of 70 675 people separated from the ADF. Voluntary transition, usually initiated by the ADF member, is how the majority of members leave the service, and 56 per cent separated from the ADF voluntarily. Another 13 per cent left for medical reasons, even though for some, they may not have wanted to leave. Nineteen per cent departed due to the end of their Continuous Full Time Service (CFTS) contract. The remainder, 12 per cent, were involuntary separations. These could be for a variety of reasons, including because retention is not in the service interest, that the individual is not suited to service; or for retirement reasons. Eighty two per cent of involuntary transitions occurred within the first five years of service. Of note is that the number of those who transition for medical reasons each year has been generally increasing since 2010 (521) to 2017 (1 144).
1.21
Sixty one per cent of those who transitioned out of the ADF between 2007 and 2017 were from the Army, 23 per cent from the Navy and 16 per cent from the Air Force. Women made up 14 per cent of the total. Thirty seven per cent of those leaving had less than five years of service in the ADF. The Army separates the highest proportion for medical and involuntary reasons, and the Air Force and Navy have a higher proportion of voluntary separations. Currently, between 5 500 and 6 000 members of the ADF leave the Services each year, and approximately 950 of that number are women.
Types of transition
1.22
The process of leaving the ADF is broadly similar but slightly different under the three main types of transition:
1
Medical Transition. May be initiated by a medical officer, a commanding officer, a DVA referral or a self-referral. Can be a difficult process for the person who wishes to continue in the ADF. The process of rehabilitation, attendance at a Transition Planning Session, participation in Transition Coaching, provision of formal advice to DVA, completion of a Transition Health Assessment and Transition Clearance Session can take from three months to three years, with transition from the ADF following completion of other steps such as Rehabilitation Handover from Joint Health Command to DVA. ADF Transitions follow up for 12 months following transition.
2
Administrative Transition. Initiated by the Service. The individual may attend an ADF Transition Seminar at any time prior to transition, may begin Transition Coaching, and access a Career Transition Access Scheme (CTAS) up to 12 months pre- and post- transition. A Transition Health Assessment and a Transition Clearance session take place; DVA are notified; ADF Transitions follow up for 12 months post-transition.
3
Voluntary Transition. Initiated by the ADF member. The rest of the process is the same as for Administrative Transition.
Process of transition
1.23
It should be acknowledged that for a majority of those leaving their ADF service, in particular those leaving voluntarily, transition is a relatively straightforward process:
We believe that many transition well from the military without any problem at all: 80 per cent of them come out of the military, get a new career and live a healthy, happy life.
1.24
There can be a range of reasons that difficulties arise during transition, principally related to locating employment suited to the individual, maintaining a steady source of income, and providing a stable home base for oneself and one’s family. Nonetheless, the majority of the five and a half to six thousand individuals who leave their ADF service each year, do so without significant issues, and enjoy successful transitions back to civilian life. This report focuses on the issues, sometimes unexpected, encountered by the minority during their transition from military to civilian life, and ways that government may alleviate some of these difficulties.