Transition has become the catchphrase for the period that a veteran passes through from service life to civilian life. The period is also recognised as one of the most difficult passages for some veterans and their families. Veterans leave a highly organised, hierarchical, and regulated environment, where the group is paramount rather than the individual, and where discipline and mission focus is central. Some veterans have described transitioning as being akin to joining a world where everything is foreign, often leaving them feeling lost and cast adrift.
Prior reference to transition action
Many studies and reviews, including the Royal Commission into Defence and Veteran Suicide (Royal Commission), have highlighted this period as being one of the most significant periods for any veteran. As mentioned in chapter one, this committee in a 2016 report recognised the need for greater services to be made available to veterans during the critical time of transition out of the Australian Defence Force (ADF) by recommending that Defence work with ex-service organisations (ESOs) to develop a transition mentoring program to connect veterans with trained mentors:
The committee recommends that the Department of Defence work with
ex-service organisations [ESO] 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.
This recommendation has been reiterated through a number of subsequent reports, including the committee’s 2016 report recommendation. The Productivity Commission’s (PC) 2019 report also drew attention in its recommendations calling for more work on transition services for ADF personnel. This recommendation included that there needs to be a ‘lifetime approach’ to transition to life after service. The PC recommended the establishment of a Joint Transition Authority to ‘prepare members for other aspects of civilian life, including the social and psychological aspects of transition’.
The Royal Commission and its predecessor, the Independent Review of Past Defence and Veteran Suicides, have both signalled that more work needs to be done to support veterans better transition.
The Royal Commission’s interim report notes in its preliminary observations the ongoing issue of effective transition and draws attention to the – yet to be functioning – Joint Transition Authority:
Transition from service to civilian life is a significant event for ADF members and their families. It can be associated with increased risk of suicide and suicidality. For the approximately 6,000 personnel who leave the ADF each year, transition requires major readjustments. For some, it can be a challenging and traumatic time, particularly if they are left without financial means. While the ADF has taken some promising steps to improve the transition process, we are considering the effectiveness of these changes – and asking what more should be done. We are concerned that the Joint Transition Authority is not scheduled to reach full operating capacity until 31 December 2022, despite being established nearly two years ago. We will continue to focus on contemporary veterans’ experiences of leaving the ADF, and on ensuring that systems are in place so that every veteran has sufficient time and support to make a smooth transition.
The committee notes that the Royal Commission added that ‘although a body with the name ‘Joint Transition Authority’ had been established, the more important part of the recommendation – the list of functions – had not been implemented at all. The significance of this will be a matter for further consideration by this Royal Commission’.
The committee notes evidence that sport is one of the elements of a veterans’ life that can span the period in uniform, transition, and as a civilian with service experience. While sport alone is not a complete answer to rehabilitation and transition, it clearly has potential to have even greater benefit for many veterans with more structured support by Defence, the Joint Transition Authority and DVA in partnership with ex-service organisations and community sporting groups.
Australian Defence Force’s role in adaptive sports
The Department of Defence (Defence) noted in its submission that it has several programs for conventional and adaptive sports.
Sport in general is conducted at all levels across the Australian Defence Forces (ADF) and is an essential part of the team building and wellbeing for all three Services. Commanders at all levels promote physical fitness and team work for all ranks as being essential elements of the operational efficiency of the ADF. Increasingly, veterans who are wounded or injured, or become ill while serving, have been able to continue with their sporting ambitions by remaining involved in ADF Sport through participation in adaptive sporting activities both domestically and overseas.
Responsibility for the coordination and promotion of sport in the ADF is led by the ADF Sports Cell, with coordination through the ADF Sports Advisory Council. The ADF Sports Advisory Council is chaired by the Director General of ADF Sports business unit and is made up of Single Service Sports Council representatives.
The ADF Sports Cell includes three pillars to ‘enhance, connect and sustain’ ADF sports opportunities, in order to improve capability. These pillars are directly connected to the ADF values:
Enhance - Sport enhances the physical and mental wellbeing of veterans through four sports programs. Training and playing sports help to overcome physical and mental barriers and creates an ability to work together in often dynamic and stressful situations. Sport also creates leadership and organisational opportunities at all levels, including participation, coaching and sports administration;
Connect - ADF Sports participants are made up of all ranks, ages, genders and backgrounds representing the diversity of the ADF. Few other avenues within the ADF promote friendships, networks and the exchange of ideas in an environment like sports, that is neither rank nor service specific, and culminates in many inter-service level competitions; and
Sustain - Veterans often work at a high operational tempo, often deployed for long periods on operations or training exercises. Sport offers opportunities for veterans to regroup, refresh and face new challenges of each veterans’ choosing and reaffirming interaction with others through sport. In some cases, the healing and mental health aspects of sport can be a motivator for participation and aids morale.
In addition to the above programs and program architecture, the ADF has a dedicated program for adaptive sports:
The ADF Adaptive Sports Program (ADFASP) focuses on preparing current and former serving wounded, injured and ill veterans for major domestic and international adaptive sporting events such as the Invictus Games, United States Warrior Games, Canadian Winter Trials and the Sydney City to Surf.
The ADFASP, in conjunction with ex-serving organisations (ESOs) such as the Returned and Service League of Australia (RSL) and Invictus Australia (formally Veterans Sports Australia), manages the schedule of activities for current and former serving veterans selected to represent Australia at international adaptive sports events. The ADFASP funds and administers participation of current serving veterans, with ESOs funding and administering participation by former serving veterans.
However, Defence notes that while it has the above programs ‘there is no current formal mechanism or pathway to involve sport as part of the transition plan.’ Defence does note that the Department of Veterans’ Affairs is examining a range of projects to look at ways to help veterans transition better:
Being involved in physical activities for fun, fitness or competitions present opportunities for positive social connections and networking that goes beyond sport. Pursuing regular exercise or a training program can also re-introduce purpose and structure and keep the mind active, which in turn, may build/improve veterans’ skills for self-management of their health conditions and assist with their transition to civilian life.
DVA continues to invest in research projects that are expanding the evidence base. The aim of these research projects are to discover ways DVA can help veterans transition and live well through physical activity, promote the benefits of physical activity and social connection within their local community (i.e. ‘Stepped-down’ Intervention Programs to promote self-managed physical activity in veterans and their dependants research project).
Need for a smoother transition
As mentioned, transition out of service is recognised as a challenging time for some ADF veterans. The Royal Australian and New Zealand College of Psychiatrists report that rates of completed suicide are double for ex-service ADF males when compared to current serving ADF males, with increased risk among those who had recently transitioned out of service. The Royal Commission has recommended that Defence should ‘support ADF members to prepare for their transition from the first day of service, with a particular focus on preparing them for the mental and practical challenge of cultural adjustment.’
Evidence received by the committee supports the idea that mental health and wellbeing support should be the key focus of any adaptive sport program, whether run by the ADF for serving members, in conjunction with community-based clubs, or as part of preparation, selection, and participation at events such as Invictus Games.
For example, the National Rugby League (NRL) provided an account from Mr Josh McFarlane, a veteran discharging after 15 years of service who used the NRL’s Battlefields to Footyfields program to prepare for transition, on how the program linked him with local clubs and gave him the opportunity to talk to other veterans about the stresses of transition from the defence force:
As a member that’s in the defence it’s hard to get into local sport. But the B2F program, eases the stress a lot and connects you with the club. It allows me to talk with other members from other clubs or districts within Australia that share similar stresses … As a member on the way out of defence, this program still is with me by my side.
The need for support following Invictus Games participation and the subsequent re-integration into the community was a point stressed by Dr Jonathan Lane. In support of his call for a more holistic approach (see chapter two), Dr Lane also detailed how a participant in the Invictus Games can appropriately ease back into the community at the conclusion of the event:
[S]election as an athlete has to involve some sort of responsibility to the community that you've come from and to the movement—that is, adaptive sports—that you've been a part of. If we can ensure that, in the follow-up process, competitors, athletes, are going back to their community and raising awareness of adaptive sports and raising awareness of their journey and the mental health challenges and all the other sorts of things, then there's a continual process of feedback into the community, of increasing public awareness of veterans and veterans issues and whatever else but also of how sport empowers an individual and then benefits the community as a result.
Invictus Pathways Program
The Invictus Pathways Program (IPP) was founded by Mr Mark Reidy, a veteran and former participant at the Invictus Games, and is now managed by the University of South Australia (UniSA). UniSA submitted information on their use of adaptive sport and participation in community sports through the IPP to assist serving and veteran personnel to improve their wellbeing. The IPP supports veterans by providing baseline fitness testing; training facilities; and access to student led UniSA Allied Health clinical exercise physiology, physiotherapy, podiatry, and occupational therapy services. The priority throughout the program is to provide opportunities for participants to develop social networks that will aid them in reintegrating into the community.
The IPP is structured around two pillars: the student-led Exercise & Performance Program (EPP), and the Community Adaptive Sports Program (CASP). The EPP is a two-year program utilising UniSA exercise science or clinical exercise physiology students to provide training sessions using UniSA sport facilities. The CASP program has partnered with established community sporting organisations to offer participants access to a range of community adaptive sport opportunities. CASP is geared towards developing social networks that will help participants to reintegrate into the community.
Participants in the program have indicated that it in some ways replicates the ADF environment of providing a sense of comradery, being part of a team, and belonging to something, all of which support the transition from life in the ADF. Participants who have successfully transitioned from the ADF can provide support and mentorship to those who are just beginning, or are still going through, their own transition out of the ADF. Other participants mentioned that programs like IPP should be put in place prior to transitioning from the ADF to act as a support mechanism.
The focus on building networks and reintegrating into the community is an important one. Mrs Vanessa Broughill, a former IPP participant who represented Australia at the 2018 and 2022 Invictus Games, gave evidence to the committee at a public hearing in Canberra detailing the benefits of receiving care before, during, and after the Games:
The way to help people transition from the games would be to help them set up future goals after the games. For me, a program like IPP was perfect because, at the end of the day, I wanted to trial for the next games but I already had something set up at home; there was that consistency. I was doing the program before I went to the games; they helped me to be games ready, to be as fit, fast and strong as I could. Back then, let me tell you, I wasn't that fit, fast and strong; it took a long time to get there. I knew at the end of the day I still had them—even though I might not have acknowledged it at the time, and that's something I can look back and reflect on now—but, in the back of my head, I knew I had that. If there was consistency in the sense that they have another goal, another ambition—you can't come home from the games and have that be the very end.
The University of South Australia currently has a Memorandum of Understanding with the Department of Defence focussed on the provision of allied health, exercise and sports science, and high-performance testing for participants preparing for the Invictus and Warrior Games.
Despite the name, the IPP is not a part of Invictus Australia. It is funded and run by UniSA as a learning tool for students by providing them with an opportunity to engage with a diverse client group with significant physical and mental health issues. Some further financial support for IPP is provided by Military and Emergency Services Health Australia (MESHA) which is part of The Hospital Research Foundation Charity Group.
The IPP indicates that cost is a major factor in limiting expansion of the program. In 2022, the program had up to 60 concurrent participants. However, they currently receive more than 150 expressions of interest per year. Interest mostly comes from the metropolitan Adelaide area, but they have received applications from as far away as Broome, Western Australia, indicating that there is interest in this type of program elsewhere.
UniSA has offered to provide all the information they have in setting up the program to other institutions in regions with military bases and a large population of current and former ADF personnel who might benefit, including the University of Canberra and James Cook University, but these universities have found it difficult to commit due to cost pressures. This is despite these universities having the staffing and facilities available to deliver IPP-style programs.
Professor Roger Eston, Executive Dean, Allied Health and Human Performance at the UniSA, estimated that the current cost for staffing the program is approximately $220,000 per year. The program receives around $200,000 a year from MESHA. While this contribution is helpful, it is not enough to further expand the program. According to the IPP:
A mechanism for providing financial support to universities to deliver programs similar to IPP would provide wide-ranging benefits to ADF personnel, veterans and their families by increasing access to programs that are run by highly qualified staff. Such programs will provide training opportunities for students who will become the practitioners of the future & who will work with ADF personnel and veterans and their families to improve their physical, mental and social wellbeing.
The benefit of adaptive sports to veterans has been well recognised in its use for rehabilitation of injured and disabled veterans. Mostly this has been seen as assisting veterans improve their quality of life, gaining more mobility and staying connected with friends, family, and their community. The committee considers that the optimum benefit is obtained where programs integrate currently serving veterans, those transitioning from service and those in the community.
The committee noted that the IPP model of providing care to serving members, throughout the transition process, and to veterans is highly beneficial. The framework for helping both physical and mental rehabilitation, facilitating participants to connect with local sporting communities, and where relevant, assisting a participant to prepare for selection at the Invictus Games is an exemplar of the longitudinal approach to supporting veteran wellbeing.
The committee notes that in addition to the support from the University, IPP outcomes benefit from the linkages with community-based sporting clubs. Support for veteran participation in these community-based clubs should be part of consideration by ADF and DVA in funding transition pathways.
The committee recommends that the Department of Defence and the Department of Veterans’ Affairs align policies to jointly support the Joint Transition Authority to facilitate veterans’ sports programs that support transition from service into civilian life.
The committee recommends that the Department of Defence and the Department of Veterans’ Affairs assess the benefit of directing some existing funding for rehabilitation programs for veterans (including those still serving) to structured programs such as the Invictus Pathways Program where sport is used as a vehicle to provide physical and mental support to veterans, and making such programs more accessible to veterans across Australia.