Discharge, transition to civilian life, and veteran homelessness
This chapter considers the effectiveness of training, education, and
transition support services provided to Australian Defence Force (ADF) members
at discharge; the Memorandum of Understanding (MoU) between the ADF and
Department of Veterans' Affairs (DVA) and the effective transfer of
responsibility of care; and veterans experiencing homelessness due to mental
ill-health and other issues related to their service.
A number of submissions highlighted discharge as a critical time for ADF
members, with poor transition experiences linked to poor reintegration and poor
mental health outcomes.
Phoenix Australia noted that 'the process of transition is a critical point in
the military/veteran lifecycle and one which, if not managed well, may be the
beginning of a downward spiral'.
Defence assured the committee that it provides comprehensive health
support for ADF members at discharge, with all members undergoing a
comprehensive Separation Health Examination prior to separation:
All ADF personnel undergo a comprehensive Separation Health
Examination prior to separation which identifies all physical and mental health
issues and ongoing treatment requirements, links them to civilian providers if
applicable, completes paperwork for ComSuper (for medical discharges), assists
with DVA compensation claim submissions and provides them with a medical
summary and supporting documentation to take to their new civilian health care
Defence advised that the Separation Health Examination 'aligns closely
with the DVA assessment to facilitate a smooth transition to the civilian
health care sector for ADF personnel' as well as providing baseline health
information for civilian health care providers.
DVA advised the committee that the Support for Wounded, Injured or Ill
Programme provides support for personnel from the point of injury through
to ongoing support after military service. It is a joint Defence and DVA
undertaking to provide coordinated, transparent, and seamless support to
individuals during their service and after transition from the ADF by:
enhancing support for personnel with complex or serious medical
conditions who are transitioning to civilian life;
improving information sharing between Defence and DVA relating to
injury or illness;
simplifying processes involved in applying for an acceptance of
liability for compensation; and
streamlining and simplifying compensation claims handling.
Transition seminars and services
The Returned & Services League of Australia (RSL) highlighted the
disparity between the intensity and length of training provided to members when
joining the ADF compared to the training provided when they leave. The RSL
noted that positive transition experiences are linked to mentors who can guide
and sometimes 'forcefully encourage' veterans to actively engage in the
A number of veterans have spoken of the intensity and length
of their initial training in Defence compared with the much reduced two-day
transition seminar when leaving. Veterans report transition experiences ranging
from positive and successful to poor. Successful transition appears to often be
linked to a mentor or individual in Defence who is encouraging, helpful and at
times forcefully encourages the veteran to actively engage in the process and
complete the necessary tasks prior to discharge.
The Australian Psychological Society also commented on the importance of
providing adequate time and guidance to transitioning members, noting that the
intensity and volume of the two-day transition seminars provided by Defence can
be overwhelming and make it difficult for transitioning members to retain and
understand the information they are being presented:
These transition seminars take place over two days and
provide a variety of information such as job search strategies, personal wealth
creation, financial planning, private health insurance etc. APS members report
the volume and intensity of the information provided at these seminars is
potentially overwhelming making it difficult for participants to retain and
understand priorities. In addition these seminars do not currently include
representatives from all aspects of the service system - for example, hospital
based services are not invited to present. It is suggested these transition
seminars could be improved by staging the information over a period of time
with additional support such as guidance personnel.
Defence informed the committee that the two-day Transition Seminar aims
'to ensure members and their families are well informed and encouraged to
access educational, financial, rehabilitation, compensation and other
government services to facilitate sound transition planning'. Joint Health Command
have developed the LifeSMART presentation, given during the Transition Seminar,
which aims 'to increase members' psychological resilience and develop awareness
of better ways of coping with the challenges of transition to civilian life'.
Defence noted that members are 'required to finalise their arrangements
well before their date of separation from the ADF' and that administrative
management and support are provided by Regional ADF Transition Centres. Members
can also access the ADF Transition Handbook, which provides transition
information and support online. Furthermore, the Directorate of National
Programs in the Defence Community Organisation provides services to 'ensure
that ADF personnel and their families remain well informed, and are encouraged
to access educational, financial, rehabilitation, compensation and other
government services to facilitate sound transition planning'.
DVA advised that the Veterans and Veterans Families Counselling Service
(VVCS) Transition Program, 'Stepping Out', is available prior to separation and
can be accessed up to twelve months after separation.
Stepping Out is a two-day voluntary program offered to all transitioning ADF
members and their partners and focuses on the 'transition process and what it
means to go from military life to civilian life as an individual and as a
family – in both practical and emotional terms'.
DVA noted that it recently launched the High Res website and mobile application
(replacing the Wellbeing Tool Box), which provides self-help tools and
interactive learning resources for ADF members, veterans, and their families.
On Base Advisory Service
Defence advised that serving and discharging ADF members can seek advice
and information about DVA support services and are encouraged to lodge
compensation claims early at On Base Advisory Services (OBAS), which are
available on over 44 Defence bases across Australia.
DVA told the committee that the OBAS officers are 'selected for their
experience and understanding of DVA entitlements and processes'
and that the uptake of the OBAS has steadily increased since its implementation
in October 2011 (see table 5.1).
Table 6.1 – National Uptake of On
Base Advisory Services
New Client to DVA**
Enquiries relating to medical discharge
*Enquiries relate to face to
face interviews, email and phone contact and are a result of various factors
including but not limited to multiple client visits, client's registering for
qualifying service only, following up post-claim issues.
**A new client to DVA is an
Australian Defence Force member who does not appear on any DVA system.
Department of Veterans'
Affairs, answer to question on notice, 21 September 2015, (received 13 November
Rehabilitation, education and re-skilling
A number of submissions highlighted the importance of providing ADF
members with adequate rehabilitation, education and re-skilling to ensure that
recovery and reintegration into civilian life is successful.
Soldier On stressed the importance of education and re-skilling for veterans'
rehabilitation and positive mental health outcomes, noting that many ADF
members have not engaged with employment in any sector other than the ADF:
Many of our serving and ex-serving men and women will have
joined the services at a young age, and have not engaged with employment in any
sector other than the ADF. Applications, skills requirements, and processes and
procedures are all significantly different. For any veteran the transition is a
challenge, but for those dealing with a mental health issue, it can be near
impossible to tackle alone.
In tooling our ex-serving man and women for the civilian
workforce, we will be able to give them a positive start in their life after
service. Some veterans may not be able to work full time, but giving them the
opportunity to study, to work part time, to keep their minds active and to
contribute to their family and their community will only have positive outcomes
for their rehabilitation.
Soldier On also told the committee that there are inconsistences and
confusion regarding the rehabilitation, education, and re-skilling services
that are available to veterans, recommending that a consistent transition
process be made available to all when they leave the ADF:
It is recommended that a universal transition program is
developed for all those departing from the ADF, so that at the very least these
men and women have the capability to find meaningful work after their service.
For those with mental health issues, current offerings
through DVA don’t allow flexibility to change courses, or for up-skilling once a
course has started. This means there is less chance of meaningful employment as
a result of this study, and more chance of leaving a job and staying unemployed
for a long period of time...there are also issues around awareness, with many
veterans not understanding how much they can study, how long they can work, how
much they can access in study support, and whether or not they are in any way
It is recommended that this process is simplified and made
easier to understand. A simple document should also be developed to highlight
who is eligible to study without affecting their entitlements, how long
ex-serving men and women can work/volunteer each week without an impact on
their entitlements, and who can access what level of study support in order to
up-skill for the civilian workforce.
KCI Lawyers advised the committee that DVA provides 'vertical rehabilitation'
that disadvantages junior-ranked members by only allowing veterans to undertake
rehabilitation based on the level of education, experience and employment they
held prior to their injury or mental ill-health:
DVA will not provide rehabilitation to assist and retrain a
member to a new level of education with the potential to obtain employment with
tertiary or similar type education if they did not exhibit such a potential
prior to their injury. Worse still is DVA terminating a Veteran’s incapacity
payments on the basis that if they undertake tertiary education’ without
permission’ i.e. assessed by DVA and determined to be suitable and appropriate,
then they must have a ‘capacity to earn’ by undertaking further education.
This is in contrast to former ADF Officers/Veterans who,
having undertaken and achieved tertiary education are offered and provided with
additional tertiary education which includes postgraduate degrees like MBAs and
similar type education opportunities. That is, if they have shown a capacity to
undertake tertiary education then they are eligible for additional tertiary
education by DVA to be accepted as a rehabilitation program.
This was also raised by the Australian Peacekeeper & Peacemaker
Veterans' Association, commenting that this this contravenes the whole-person
approach to rehabilitation and thwarts the objectives of psychosocial
We are aware that the [Military Rehabilitation and
Compensation Commission] is rejecting veterans’ applications for vocational or
tertiary education. Accepting that the evidence is anecdotal, two [Commission]
Delegates are alleged to have said: You’re a soldier and don’t have the brains
to go to university, and you don’t need that TAFE course, there’s no job
DVA told the committee that rehabilitation programs are tailored to meet
the individual needs of veterans after discharge, taking medical, vocational,
psychosocial, and educational factors into account. Rehabilitation programs can
include medical; dental; psychiatric; in-patient and out-patient care; physical
exercise and physiotherapy; psychosocial training and counselling; aids and
appliances; and modifications to workplaces, homes and cars. DVA advised that
clients can be referred and assessed for rehabilitation once their liability
claim has been accepted:
The process for receiving rehabilitation begins with the
client submitting a liability claim to DVA. Once a claim is accepted, a needs
assessment is conducted to determine what services are suitable and available
to the client. Where appropriate, the
client is referred for rehabilitation. Following referral, a DVA rehabilitation
coordinator will organise a third-party rehabilitation provider to organise
further assessment and preparation of a rehabilitation plan. Concurrent to the
rehabilitation process, a client may also receive medical treatment and
financial support such as incapacity payments and permanent impairment
DVA advised the committee that there has been an overall growth in
rehabilitation activity in recent years (see table 5.2) and that the 2015-16
budget funded an enhancement of the Veterans' Vocational Rehabilitation Scheme,
providing $200,000 in 2015-16 and a total of $700,000 over the forward
estimates to improve the scheme's operation.
Table 6.2–Rehabilitation activity
by DVA (assessments completed)
Rehabilitation and Compensation Act 1988
Rehabilitation and Compensation Act 2004
Department of Veterans'
Affairs, Submission 35, p. 33.
DVA noted that it has also recently implemented a number of improvements
to ensure continuity of care for ADF members and smooth transition from ADF
rehabilitation services to DVA rehabilitation providers:
...changes have been made to the coordination and communication
between DVA and the ADF Rehabilitation Programme to facilitate the transition
of separating ADF members from this Programme to DVA’s rehabilitation
arrangements. ADF personnel already undertaking a rehabilitation plan with
established goals in place are continued in the DVA environment, including,
where possible, use of ADF rehabilitation providers to ensure an unbroken
provider support environment for clients.
DVA advised the committee that it has recently 'completed a number of ongoing
business improvement activities' to improve quality of support, provider
knowledge, and coordination of its rehabilitation program. This includes a
range of new communication materials and stakeholder education with staff,
rehabilitation providers and clients including:
publishing an online rehabilitation e-learning package for
clients and providers;
publishing rehabilitation success stories to promote
developing a new provider newsletter;
upgrading DVA's rehabilitation website;
launching a new social media campaign;
publishing a rehabilitation online brochure and information pack;
developing an active liaison and communication program with key
stakeholders including defence welfare groups and DVA's On Base Advisory service.
DVA informed the committee that the Veterans Employment Assistance
Initiative was launched in September 2014. The initiative aims to 'help injured
former ADF members reclaim independence, realise their skills and capabilities,
and achieve their vocational rehabilitation goals post-service'. DVA advised
that the initiative focuses on three key areas:
enhanced vocational rehabilitation arrangements;
employer engagement; and
early engagement with clients through the ADF Rehabilitation
The first stage of the initiative was a six-month pilot conducted in
South East Queensland from September 2014 to February 2015. The pilot aimed 'to
monitor and evaluate the enhanced approach to vocational rehabilitation to
ascertain the strengths of the approach and identify any improvements that
could be made, DVA advised that, whilst the evaluation of the pilot is
currently underway, initial indications are that it has been successful.
DVA also informed the committee of the MRCA Rehabilitation Long-Term
Study project. It is a joint DVA and Defence project which will 'examine the
effectiveness of rehabilitation arrangements under MRCA within both the ADF and
DVA, over the long term'. DVA advised that the project is in its early planning
stage and will 'provide Defence and DVA with a clear understanding of the effectiveness
of current rehabilitation programmes and services and an improved understanding
of the client group'.
Continuity of support and transfer of responsibility of care from ADF to
A number of submissions criticised the transfer of responsibility of
care from ADF to DVA.
Phoenix Australia acknowledged that is 'considerable collaboration' between the
ADF and DVA for members who have been identified as physically or
psychologically unwell in the period before discharge, but that 'many mental
health problems may not be obvious while the person is still serving and may
not become apparent until months or years after serving'. Phoenix Australia
noted that these veterans may 'fall through the gap' suffering a steady
deterioration in mental health and functioning to the point of substantial
disability before they eventually seek help.
Memorandum of Understanding
In February 2013, Defence and DVA signed the Memorandum of
Understanding for the Cooperative Delivery of Care and Support to Eligible
The MoU is intended to 'ensure that eligible wounded, injured or ill ADF
members, and their families, are supported and cared for during and after their
Other principles of the MoU include ensuring that:
the framework of care and support, spanning both Defence and DVA
Defence and DVA provide other support and Services as may be
agreed from time to time and as set out in the MoU;
the funding arrangements that support the rehabilitation of
members are defined and understood;
communication with wounded, injured, or ill ADF members, and
supporting agencies, will reflect the joint responsibilities of Defence and
governance arrangements will facilitate collaborative policy and
program development and allow for engagement on emerging issues affecting both
Defence and DVA; and
Defence and DVA's respective, and joint, responsibilities for the
support of wounded, injured, or ill current and former members are measured and
The RSL criticised the MoU, describing it as 'a very prosaic attempt to
outline how two Federal Government Departments should attempt to co-exist when
both are hamstrung by a third organisation, the Department of Finance'. The RSL
emphasised that the MoU 'needs more rigour in relation to transition; it needs
a better system of ensuring that the individual is not discharged from the ADF
prior to their entitlements being satisfied'.
In addition, the RSL asserted that:
the operating principles, as written, are not being adhered to;
too many people are being discharged from the ADF on medical
grounds before DVA has determined their claim;
the effectiveness of the support continuing using agreed metrics
and feedback from current and former ADF members is not being conducted and/or
co-operation 'in real terms' between Defence and the ex-service
community 'has been limited in the extreme';
the schedules outlining the provision of services are
communication management between Defence and DVA 'remains
cosmetic' for those stakeholders not in either Defence or DVA.
Defence assured the committee that 'Defence and DVA maintain a strong,
coordinated and effective relationship' under the MoU. Defence noted that the
MoU provides for oversight of the normal interaction of the two departments as
well as facilitating the development of joint initiatives. Defence noted that
each department is aware of, and can contribute to, key initiatives that are
being progressed independently by each department.
DVA informed the committee that the MoU has 'been effective in ensuring that
both Departments consider and respond to issues impacting upon the care and
support of current and former ADF members'.
Gaps in support
The Australian Psychological Society reported that it 'can often take
from six weeks to six months for some veterans to access income from their
superannuation or pension', noting that 'this creates clear barriers for
veterans in obtaining accommodation, other important capital expenditure
decisions and creates barriers for essential functions like daily living'.
The RSL advised the committee that this can be especially detrimental for
veterans who are not medically discharged, but find themselves unable to work
due to mental or other illness:
Financial difficulty can be even more pronounced for veterans
who are not medically discharged, but subsequently find themselves unable to
work due to mental or other illnesses. Delays in claims processing may drag on
for six months or longer. It can for example, take the DVA many months just to
ascertain that a veteran served in the ADF, let alone process their injuries.
During this time the veteran will receive no income, and may not be able to
access medical services.
The committee received evidence from Miss Alanna Power and her partner,
Mr Ryan Geddes (a veteran combat engineer who served in Afghanistan and who
struggles with PTSD anxiety and depression as a result of his service)
regarding the hardships of transition and the lack of support available. Miss
Powers and Mr Geddes described it as a slow and difficult process which placed
significant personal, financial, and emotional strain on their family:
...when he was finally diagnosed with PTSD, anxiety, depression...That
was when he first contacted DVA. That was when he started going through that
claims process of, you know, are they going to accept liability, are they not?
Obviously he could not work. He had medical certificates saying that he was not
fit for employment in any capacity. But still, we did not get any financial
support whatsoever. Once DVA did finally admit liability, which was nine months
later, they turned around and said, 'We'll pay him minimum wage', which really
is not much, 'until we know if ComSuper is going to recognise his claim and pay
out on that.'
We were told by ComSuper it would take six weeks to sort of
look at all his medical documents and all of that and make a decision...So it was
supposed to take six weeks to get the medical documents. It took nearly five
months. When that finally happened, DVA have said, 'Yes, we will pay you the
correct rate', which only gives 100 per cent of your wage for 52 weeks, and
then after that, with medical documentation, it drops down to 75 per cent. So
you have that side of dealing with DVA, which is, I guess, your incapacity
payments, they are called, which is like your wage, and the other side of
dealing with DVA is also your payout, your compensation. For us, that was
probably the hardest part. It is a lot of paperwork to submit. They lose a lot
of paperwork. They do not help you in any way. You always have to reach out to
them to find out what is happening with your claim, which I think is a bit
unfair. You cannot expect someone who is mentally ill to be following up with
DVA on a weekly basis to make sure that someone is doing their job properly.
The Chief of the Defence Force (CDF), Air Chief Marshal Mark Binskin AC,
assured the committee that there are a number of programs in place to address
gaps so that 'there is no chasm that sits between the two organisations'. However
the CDF noted that, despite this, and despite encouragement from Defence to
contact DVA during transition, members who do not have an identified medical
condition often do not realise that they need assistance until after they have
already left Defence, resulting in the potential for a gap between Defence and
In transitioning someone out, the minute they start to
transition we have the transition centres on the bases to be able to help them.
As you know, it is the paperwork myriad to step through. There are programs
there to help them transition. As we start to transition them out, very early
on we make sure they are put into contact with DVA. As I said earlier, 33 per
cent do not want that. We need to work around why that is the case.
If someone has of recognised medical issue—a physical or
mental issue—as they transition, that transition occurs across to DVA. That is
handed to DVA. Where we find issues arise is: for people do not have a declared
medical condition, their transition out is the point that they realise, 'Oh,
now I don't have that whole structure around me—that support network that I
needed.' Issues start to come to the fore. Then they need to go into the DVA
process after having come out of Defence. What we are trying to do up-front
with as many people as we can is to get them to understand that, if they think
they have an issue, we need to address it before they come out of Defence. Then
we can hand them to DVA. There are a number of programs in place to improve
that so that there is no chasm that sits between the two organisations.
Mr Shane Carmody, Chief Operating Officer of DVA, told the committee
that DVA is working with Defence to engage ADF members during transition and
process their claims as quickly as possible to ensure a smooth and effective
We are also very focused on transition. Clearly, we work very
closely with Defence in trying to identify members and to ensure that members
transition as effectively as they can. Continuity of care, particularly for
those under treatment, is really important to us. As the
CDF, there are people who leave, administratively or for other reasons, who do
not make contact with us and need to make contact with us later. That is
something that we are working very hard on to see whether we can reduce the
number of people who opt out from contact with us when they leave, and to find
if any mechanism we can to continue to engage with them to see whether we can
meet their needs. It would be good if we could get their claims processed as
quickly as we can and try to ensure that their transition is smooth. That is
not always the case. But we are working very, very closely together on the
Support for Wounded, Injured and Ill Program and various other programs to try
to make the transition effective.
The committee received a number of submissions regarding veteran
Phoenix Australia advised the committee that 'veterans with PTSD and other
mental health problems will be at greater risk of becoming homeless.'
DVA noted that homelessness is very difficult to quantify and that it is
working with the Australian Institute of Health and Welfare regarding improving
data collection and working with Homelessness Australia to identify homeless
...we are trying to do to get a better handle on the numbers,
we have got a couple of things in train. One is that we are
working with the Australian Institute of Health and Welfare to refine the
questions that are in the housing and homelessness data collection that is run
periodically so that we get a better definition of what a veteran is and a
better understanding from that collection about the number of veterans who are
accessing specialist homelessness services.
We also have started to work with Homelessness Australia to
see whether we can get information out to homelessness organisations about the
services that DVA offers and get them to identify veterans who are accessing
their services and refer them to us. But also they periodically do what they
call a rough sleepers census, and we are looking at whether we can link in with
them when they do those censuses to see whether we can identify veterans.
DVA advised the committee that 'the current estimate of homeless
veterans is likely to be in the order of 200-300 Australia-wide'.
This number was disputed by the RSL, which criticised DVA, noting that 'already
this year the DVA has cut its own estimates of at least 3,000 homeless veterans
in 2009, to 300 in 2015'.
Mr Carmody explained that the difference in numbers was related to differences
in definition of both veteran and homelessness:
There is a definitional issue: it is a question of risk of
homelessness versus rooflessness—if I can put it that way—people who do not
have anywhere to stay. Our difficulty with the figure that was in the survey of
2009 was that it was extremely broad, including people at risk of homelessness,
people who were couchsurfing and quite a range of reasons. We ran our
demographic against that number and came up with a smaller figure.
DVA also advised the committee that the provision of housing 'is not
within our portfolio responsibility'.
DVA noted that, when it receives a report of a homeless veteran, it can provide
the following assistance:
referral to local homelessness agencies to assist with an
immediate accommodation solution;
referral to the VVCS, which can offer support to connect with
local ex-service organisations offering long term assistance;
investigation by a senior DVA staff member to ensure that the
veteran is receiving all benefits and entitlements to which they are entitled;
referral to Centrelink to assess potential for benefits or for
further support; and
arranging for changes in income support payments if this would assist
a client in need.
Homes for Heroes
The RSL told the committee that the Homes for Heroes Program, originally
established by RSL Lifecare in March 2014, is a comprehensive rehabilitation
service that is available to 'veterans of any conflict, ex-servicemen and women
and the families of those cohorts; providing they are genuinely
The RSL noted that the Homes for Heroes Program is only in its early stages and
has only just begun to publicise the program. Nonetheless, it has housed over
71 veterans. Mr Geoff Evans, the Ambassador and Founder of Homes for Heroes,
explained that homelessness is not limited to veterans living on the streets:
When we talk about homeless veterans, we are not talking
about people who are living rough on the streets. Of the 71 veterans that we
have housed, only a fraction of them had been living rough—perhaps
half-a-dozen. I cannot remember the exact number. But many of them are living
in cars, couch-surfing and things like that. So 'homeless' implies that they
are without a home, not without a house. Our experience is that veterans will
not access mainstream homelessness services, particularly when they are young,
because in the main it is too much of an admission of how far they have fallen.
The committee spoke to a number of homeless veterans who were receiving
assistance from Homes for Heroes. One submitter told the committee that Homes
for Heroes saved their life:
Since being here, I hear the term sleeping rough to describe
someone who is homeless. But that doesn’t do it justice. You’re not camping. I
was in a very dark place. I had very little money, I’d ostracized myself from
all my family and friends, I had no one to turn to. I’d hit rock bottom. I
literally went bush and went through the worst period of my life. I hated
everyone and I hated myself and I was just on my own having nightmarish
conversations with myself. I was broke, any claim outcome was at least 3 more
months away but it didn’t matter. I wasn’t going to make it.
Having just gone through the darkest, lowest point in my life
I can’t express the feeling I had having a shower and going to bed on that
first night. So aside from the fact that Homes for Heroes saved my life, I want
to bring to the attention of the committee why the structure of this organization
provides an excellent model for other similar organizations to facilitate the
recovery of ex-servicemen and women suffering mental illness.
Mr Gray Norman, a former infantry solider, told the committee that he
was injured during service, which resulted in a 'permanently damaged
degenerative spine with a lot of nerve damage'. Mr Norman told the committee
that 'they wanted to medically discharge me while I was still in the battalion'
but that he sought legal advice and was treated very poorly as a result. Mr
Norman said that he left Defence and transitioned into work and was eventually
granted a Gold Card but that by this stage he was already on the path to
By that time, my marriage had disintegrated completely. I had
to leave the married home because I was not going to put my wife and my
daughter through the torment. I knew my injuries were getting worse, because by
that time I was consumed by pain medication. I was taking a lot of OxyContin
and Tramadol. I was a dribbling mess and I became an isolated alcoholic in a
unit. At the time—this is going back 11 years ago—I would go along to DVA or
sub-branch meetings. Most of the guys were 30 or 40 years my senior, and at the
end they would have cucumber sandwiches with the crusts cut off. There was
nothing for me; there was nothing for a person my age. As I said, it
degenerated to where I just went to hospital and got pumped up with as much
medication as I could, just to take the pain away. Family was a distant memory.
I went down the housing pathway. I couch-surfed for 2½ years
because supposedly I was on the top of the list. I was quite excited when I was
called in. But all they called me in for was to say, 'Your pension is now above
the monetary threshold, so you're no longer on our books.' Being on the gold
card, I can apply for housing assistance, but they take dollar for dollar, so
there is no point in me actually asking for any assistance when it comes to housing.
It came to the point that last year I went back into hospitals again, basically
because I was homeless. I had nowhere to go, so I went to hospital for
accommodation. I had long stopped taking pain medication for my injuries, but I
never put the drink down and I was a dribbling alcoholic. Upon
discharge I was living in the back of my car, at the back of a pub. I cannot
recall exactly how I got to know about Homes for Heroes; I just know that there
were a couple of phone calls made. I arrived there and within about three or
four days I was sent to St John of God. I thought that was a chance to actually
turn my life around, so I took that with both hands. Upon my return I started
volunteering within the office and that is where I have been ever since.
Homes for Heroes advised the committee that 'one hundred percent' of its
residents suffer from mental illness and that 'substance abuse and addiction
problems are prevalent, most are wounded or injured and most arrive with no
possessions at all'.
Mr Evans told the committee that family breakdown is 'ubiquitous' and some
homeless veterans are simply without an income while they wait for DVA to
process their claims:
Family break down is ubiquitous. We take a lot of calls from
wives and mothers who will have had a loved one go to war and come back a
totally different person. They will say things like, 'I love them; I want them
to stay here, but they become violent or abusive and they just cannot stay. Can
you take them?' Those calls, in particular, are the most horrendous. The
partners did not sign up to go to war, but nobody is supporting them. Even with
the Department of Veterans' Affairs, remember, the client is the veteran—not
the family member.
Others experience financial problems. We have had incidents
where people have been discharged from Defence, medically, and the Department
of Veterans' Affairs have only paid four weeks post discharge but it has taken
many months to process their pension claims. So they end up, for a long period
of time, without an income.
Mr Evans noted that many veterans who have been receiving in-patient
mental health treatment, provided by DVA, are frequently discharged after
treatment without a follow-up plan, 'discharged into the ether':
...one of the most common pathways into homelessness is when a
veteran goes into a private clinic, under the Department of Veterans'
Affairs—and some of these clinics can charge up to $1,000 a day—when they
discharge there is no follow-up plan. They go in acutely symptomatic and get a
sustained period of treatment. They become well again whilst they are in that
structured environment. Then they are discharged into the ether. It is only a
matter of time when they completely fall over—again—and go back into hospital.
One of our residents, here, has been through that cycle 18
times—possibly 16, but I think it is 18 times that he has been in and out of
clinics—for a four-week stay each time at the cost of around $1,000 a day. The
average number of admissions to private mental-health service providers is four
times each. But when they are discharged there is no screening tool to ask
them, 'Where are you going? What is the follow-up support you are going to
get?' And it becomes a revolving door. That should be fairly easily fixed with
the contracts that are provided by the Department of Veterans' Affairs, because
DVA purchases these services from the health providers. The terms of the
contract should stipulate that follow-up care needs to be provided, but they
are currently not.
Mr Lee Sarich, a veteran at Homes for Heroes, told the committee of his
experiences being discharged into homelessness:
As a result of the PTSD I ended up homeless. It was a very
difficult time. I almost killed myself a year and a half ago. It is hard to
briefly explain what that was like and how that ended. About 18 months ago I
came across this program and started getting some PTSD treatment. Whilst
getting treatment for PTSD I heard about the Homes are Heroes program. I was
one of those guys that went into a hospital on the Gold Coast and as a veteran
got treated anxiety and depression and then left the hospital homeless—it just
seems a little bit absurd. Sometime later I came down to Sydney and went into
the St John of God Hospital and got treated for PTSD. I would have left their homeless
as well, and effectively did, other than at the time the informal kind of
arrangement of the Homes for Heroes program. I moved out here just over 12
months ago. I have been here as a resident for 12 months. I have been
undergoing treatment and rehabilitation for PTSD since I have been here.
Homes for Heroes asserted that there are 'two crucial and mutually
reinforcing aspects' to ending homeless (1) the provision of safe, secure, and
stable housing; and (2) ongoing case management.
Homes for Heroes takes the 'housing first' approach, which asserts that, for a
person experiencing homelessness, the primary need is to obtain stable housing,
and that other issues, such as mental ill-health and substance abuse and that
may affect them can and should be addressed once housing has been obtained. Mr
Evans explained that:
What we do is look at the individual and start wrapping the
services they need around them—psychological support, social support,
employment support or anything they need. The Department of Veterans' Affairs
could do that if they allocated a proper caseworker to the individual and then
assisted them once they were discharged. Ideally, the caseworker would know
when they went into hospital and when they went out. They would follow their
progress, and whatever support they needed the department would provide, along
the same lines as what a social worker would do.
Mr Evans noted that whilst support services for veterans exist, 'by the
time they become homeless they are too unwell to access them', explaining that
veterans struggling with mental ill-health, or otherwise at risk of
homelessness, need someone to coordinate and manage their care:
The support services that the veterans need exist, but by the
time they become homeless they are too unwell to access them. They cannot ring
a doctor and make an appointment and then get to the appointment and see them.
If you are suffering from severe depression, you cannot even get out of bed.
They just cannot tie it all together. They need someone to do that for them
until they are back on their feet—and then manage them along and, if they have
a little slip along the way, be there for them to plug them into the
appropriate services provided. It just does not happen. If you had someone
there to provide that service and tie it all together, very few veterans would
end up homeless, because the key to being homeless is poor mental health.
The RSL advised that 'it is forecast that RSL Lifecare will spend over
$2 million of its own funds over the next three years to provide accommodation,
support and reintegration services to homeless veterans'. Mr Evans informed the
committee that the estimated cost to house and provide psychosocial services to
a veteran at Homes for Heroes is approximately $20,000 per annum. Mr Evans
acknowledged that the provision of housing is outside of DVA's portfolio
responsibilities but asserted that 'what they should be providing is complex
psychosocial care management' services similar to those provided by Homes for
Discharge is a critical time for ADF members, with the committee
receiving considerable evidence that poor transition experiences are linked to
poor reintegration, poor mental health outcomes, and, if left unchecked, can
lead to homelessness and even suicide. The committee acknowledges the support
provided during medical discharge and commends Defence and DVA for its Support
for Wounded, Injured or Ill Programme, which provides support for personnel
from the point of injury through to ongoing support after military service. The
committee also commends Defence and DVA for its On Base Advisory Service and
notes the steady increase in uptake.
Transition seminars and services
However, the committee is concerned about the level of transition
support and services offered to ADF members who are not medically discharged.
The committee notes the comments made by submitters regarding the
intensity and length of training provided to members when they join the ADF
compared to the training provided when they leave. The two-day transition
seminars provided by Defence may be comprehensive; however, the committee is
concerned by evidence that this process can be overwhelming and the information
difficult to retain and understand. The committee does not believe that Defence
has discharged its duty to guide and inform its members through the transition process
after providing a two-day transition seminar.
The committee notes the evidence that positive transition experiences
are linked to mentors who can guide and 'forcefully encourage' veterans to
actively engage in the transition process. The committee believes that Defence
should work together with ex-service organisations to develop a transition
mentoring program. The program would provide volunteers from within the
ex-service community with baseline training regarding transition, services
available to veterans, and common problems with reintegration. During the
transition process, every veteran should be connected to a trained mentor to
assist and guide them through the transition process as well as providing an
ongoing point of contact for any questions or concerns they may have.
The committee recommends that the Department of Defence work with
ex-service organisations to develop a transition mentoring program, which will
connect every veteran with a trained mentor from the ex-service community to
assist and guide them through the transition process.
It is essential that ADF members and veterans are provided adequate
rehabilitation, education and re-skilling to ensure that recovery and
reintegration into civilian life is successful. The committee acknowledges that
rehabilitation programs are tailored to meet the individual needs of veterans
after discharge, taking medical, vocational, psychosocial, and educational
factors into account. However, the committee is concerned by evidence of
inconsistencies and confusion regarding rehabilitation and evidence of policies
that disadvantage junior-ranked members by only allowing veterans to undertake
rehabilitation based on the level of education, experience and employment they
held prior to their injury or mental ill-health. The committee believes that
all ADF members should be given the opportunity to access rehabilitation,
education and re-skilling to ensure that recovery and reintegration into
civilian life is successful, regardless of rank.
The committee recommends that the Department of Veterans' Affairs review
its rehabilitation assessment policy to ensure that junior-ranked members are
not disadvantaged and all veterans are able to access rehabilitation,
education, and re-skilling based on their individual needs and abilities and regardless
Continuity of support
The committee is concerned by evidence of gaps in support for veterans
who are not medically discharged but find themselves unable to work due to
mental or other illness. The committee notes Defence and DVA's assurances that
there are a number of programs in place to address gaps so that 'there is no chasm
that sits between the two organisations' and acknowledges the challenge of
assisting veterans, who, despite encouragement from Defence to contact DVA
during transition, may not need or realise that they need assistance until
after they have already left Defence, resulting in the potential for a gap
between Defence and DVA support. Nonetheless, the committee believes that more
must be done to bridge these gaps and provide support and assistance to
veterans whilst claims are being processed.
The committee acknowledges that the provision of housing is not within
DVA's portfolio responsibility; however, this does not discharge DVA of its
obligation to support veterans and assist them to access one of the most basic
human needs, stable housing. Furthermore, the committee recognises the
challenges of accurately quantifying the number of veterans who are homeless;
however, the committee is troubled by the narrow definition of homeless that
DVA has recently employed, which may inadvertently downplay the seriousness of
the issue. The introduction of a universal identification number and
identification card for veterans should assist in the identification of
veterans who are homeless. This would also assist homeless support services to
identify veterans and connect them to DVA and other appropriate veteran support
The committee is very concerned by evidence that veterans who are
receiving in-patient services for mental ill-health are being discharged into
homelessness and often on more than one occasion. This is a significant
dereliction of duty of care for both the mental healthcare provider and DVA, as
the purchaser of the services. Veterans whose mental health has deteriorated to
the point of receiving in-patient care should be identified by DVA as at risk
of homelessness and be provided with ongoing psychosocial management. This
should include the provision of an ongoing psychosocial case manager to actively
manage a veteran's care program until their mental health and living situation
The committee recommends that the Department of Veterans' Affairs
identify veterans who are receiving in-patient mental health care as at risk of
homelessness and provide an ongoing psychosocial case manager to actively
manage an 'at risk' veteran's care program until their mental health and living
situation is stable.
The committee commends RSL Lifecare for its Homes for Heroes Program and
the work of its founder, Mr Evans. Despite being in its early stages, the
program's 'housing first approach' and focus on ongoing psychosocial support
for veterans appears to be achieving excellent results at minimum cost. The
committee agrees that the key elements for addressing veteran homelessness is
the provision of safe, secure, and stable housing and the provision of ongoing
The committee recommends that the Department of Veterans' Affairs work
together with the Department of Human Services and RSL Lifecare to develop a
program to address veteran homelessness based on the Homes for Heroes 'housing
first approach' and focus on ongoing psychosocial support.
Senator Alex Gallacher
Senator Chris Back
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