Chapter 15 - Occupational health, safety and support services
15.1
During the
course of the inquiry, some witnesses, in recounting their experiences of the
military justice system, referred to the adverse effects that these experiences
had had on their health. Others spoke of a work place where safe and
responsible work practices were not always promoted and which, in some
instances, placed the physical or psychological well-being of ADF personnel at
risk. This chapter looks at the links that can be made between the military
justice system and the health and well-being of those who became involved with
it. It also examines the broader issues of the ADF's duty of care, the health
services available to ADF personnel and the support offered to the friends and
families of serving ADF members who have been seriously injured or have died
suddenly.
Features of military service that impact adversely upon mental health
15.2
A number of witnesses to this inquiry attributed the
onset or aggravation of health problems, particularly psychological, to the
difficulties they encountered with the military justice system. A psychologist,
who has worked within the ADF, gave his overall impression of the military
justice system and its potential to adversely affect some ADF members:
One can see that almost every application of the justice system
has a human cost, ranging from stress to humiliation to suicidal thoughts and
behaviour.
...
I have seen cadets with suicidal thinking held to continue
service against their wishes...individuals in utter despair, at risk of
self-harm, with no hope of returning to service...
...
The Army and ADF fail to recognise that everybody is there
voluntarily. The justice system treats them as if they were indentured
servants. To my mind, one of the worst aspects of the application of military
justice and regimentation is an invisible one. Fewer and fewer people are
wishing to volunteer for it. We cannot fill our places in officer training.
Early last century soldiers were being shot for cowardice, as a management tool.
Today, that management tool looks barbaric because it is presumed that those
who did not comply could be forced to obey, and it paid no notice to the real
reasons, to the suffering behind that behaviour. I wonder how our current
techniques of behaviour management will look in 100 years time.[914]
15.3
Other witnesses, such as, Mr Nigel Southam and Mr Keith
Fitzpatrick, made a direct connection between their treatment under the
military justice system and problems they experienced including anxiety, severe
depression, psychological breakdown and suicidal thoughts and actions.[915]
15.4
The following section looks at specific aspects of the
military environment and justice system that may impact upon mental health issues.
They include:
-
the general reluctance of ADF personnel to report
personal health concerns;
-
the failure by senior officers to acknowledge or
accept reports of problems or difficulties,
preventing the commencement of resolution processes;
-
defective inquiry and investigation conduct,
such as poor record keeping and communication, lack of support, conflicts of
interest and breaches of privacy, that may exacerbate or even trigger mental
health problems;
-
lengthy and delayed military justice procedures that
leave individuals feeling isolated, let down or even defeated, and processes
that lead individuals to believe that there is no ‘justice’;
-
failure by the ADF to fulfil its duty of care to
provide a safe working environment; and
-
inadequate mental health reporting and
service-delivery.
15.5
Much of the material presented below draws on evidence
discussed in previous chapters.
The reluctance to report health risks
or concerns
15.6
Evidence presented to this committee suggests that an
environment exists in the ADF which makes it difficult for members to seek
help.[916] One of the major challenges facing the ADF is
to counter the attitude that seeking help is of itself an admission of weakness.
15.7
Other inquiries have noted that the existing military culture
can make individuals reluctant to seek help because they believe that this will
damage their reputation.[917] This fear
of stigma was manifest in written and oral evidence to the current inquiry that
detailed a variety of mostly negative attitudes towards mental health services and
social workers.[918] Colonel
Anthony Cotton,
Director of Mental Health, Department of Defence, spoke authoritatively on this
matter when he stated:
The help-seeking culture in general—the idea that it is okay to
go and get some help—is something that, in my opinion, is foreign to men of our
culture. We have seen that in lots of places. I think the military environment
exacerbates that because the military environment is all about being robust,
being independent and those sorts of things and being able to look out for
yourself.
...
The culture makes it difficult for us to do business. We really
need a sea change or a significant culture change, because we need people to be
prepared to go and seek help. But it is a complex issue, because we need them
to be able to admit that they have a problem and seek some help while not
diminishing their robustness and resilience. This underpins pretty much
everything that we do or is a flavour to what we do. Culture change is a
significant thing.[919]
15.8
An ADF psychologist who appeared before the committee
stated that the situation is particularly difficult in the ADF because
attitudes towards mental health tend to be extreme:
There is no acknowledgement of the fact that difficulties might
be temporary, that it is human to be stressed at certain crisis points in our
lives, and that to have a temporary crisis or to seek mental health is a
positive thing at certain points in time. There is no acknowledgement of that
whatsoever. It is beyond the ability of many of our officers, let alone our
soldiers, to make a differentiation between the people who are not coping
temporarily and the people who would not cope permanently or would not cope on
the battlefield.[920]
15.9
The committee again urges the ADF to acknowledge that
the military culture makes it difficult for members to seek help, and to put in
place services that take account of and compensate for this weakness. Hotlines
and handy 'seek help' cards will not overcome the fear of stigma or ridicule
attached to seeking help, nor will they convince ADF members that their
concerns will be taken up in a professional manner, treated with respect, and handled
in the strictest of confidence.
Failure to treat complaints
seriously
15.10
ADF members must have confidence that their requests
for assistance will be accepted as legitimate and taken seriously. As noted in
previous chapters, this is not always the case. The committee heard accounts of
senior officers refusing to accept a ‘complaint’ or dismissing a complaint as
'vexatious' or 'trivial'; the unwillingness of witnesses to become involved in
the investigation of a complaint; and the lack of commitment by those
responsible for handling a complaint to pursue the matter.
15.11
Refusing to accept complaints in the first instance effectively
limits the operation of resolution processes.[921]
The Defence Force Ombudsman told the committee:
We have received several complaints where it appears Defence has
had considerable difficulty in entertaining the notion of investigating a
complaint in the first instance despite very clear concerns being expressed
both by the individuals involved as well as by other people in relatively
senior positions in the ADF. It is axiomatic that if a complaint is not
accepted as a complaint, it cannot be resolved.[922]
15.12
Failure to accept a complaint can cause on-going
emotional stress and thereby affect an individual’s mental health. One witness
stated:
If some aggrieved military people do seem obsessive and
preoccupied with their complaints, I suggest the reason is mostly because of a
long history of military complaint inertia, lack of feedback, perceived lack of
compassion, and attitudes similar to that expressed by the ADA,
that complainants are cranks. The resultant stress causes many complainants to
drop their complaint in despair, and/or suffer nervous disorders. The matters
then remain unresolved while the complainant’s career evaporates.[923]
15.13
Chief Petty Officer
Hyland asserted that he had medical evidence
of a physical assault and corroborative evidence that some type of assault had
occurred. In spite of this, his case went through several different sets of
authorities, including the State police, only to end up in the ‘no action’
tray. Not only has the assault caused him 'an immense amount of personal
distress' but he also feels disappointed by what he perceives as the military
justice system's failure to redress wrongdoing. He believes that he has been
'stonewalled at every turn': that there is a 'malignancy of buck passing or
serious lack of effective interagency liaison'.[924] He goes on to state:
I am exasperated at the lack of closure and have contacted the
media to try and put more pressure on the Navy to try and gain answers to my
situation. This in hindsight may have not been in the best interests of my
career, however, the emotional turmoil I have undergone may well have clouded
my judgement.[925]
Investigation processes as a
complicating factor in mental health
15.14
Investigation and inquiry conduct has also had an
adverse impact upon many submitters to this inquiry. Both complainants and
those complained about have recounted how they were gradually worn down by the
stresses and frustrations of inquiry processes.[926] Some submissions noted:
-
little information was provided even about the
fact that there was an inquiry;[927]
-
few opportunities were given to provide evidence;[928]
-
absent, incomplete or missing file notes resulted
in all the responsibility being placed on the person who believed he/she was
the victim, rather than on the alleged aggressor/offender; [929]
-
individuals suffered reprisals for complaining
or providing evidence leaving members feeling ostracised and without support;[930] and
-
lack of confidentiality and privacy breaches
during investigations.[931]
15.15
It appears that appeal processes intended to correct
defects have, in some cases, also caused or exacerbated mental health problems.
Members recall having to battle to obtain relevant documentation to defend
their case; non-adherence to procedural fairness; conflicts of interest; intimidation;
lack of support; poorly trained investigators; and delays.[932]
15.16
Evidence before this committee concerning the Westralia BOI
clearly demonstrated how a poorly conducted investigation can contribute to mental
health problems, rather than alleviate personal distress after a major
incident. Many of those affected by the Westralia
incident felt let down by the subsequent BOI process. To this day, a number of
crew members directly involved in the fire—the victims of a terrible accident—are
still trying to come to terms with aspects of the inquiry.[933] Some have unresolved anger about the
way they were required to provide witness statements so soon after the fire:
Potential witness[es] were still suffering from grief and shock.
We can all appreciate the need to get the evidence whilst it is still fresh in
people’s minds but some people just wouldn’t have been up to it.
...
The day of the memorial service I was required to give my
statement, this happened shortly after the service had finished...I was still
suffering from shock and disbelief that this accident had actually happened and
I was understandably still confused, in a state of distress trying to come to
grips with the death of personnel in my charge. The interview lasted about six
hours or so and was very disturbing.[934]
Protracted military justice
procedures
15.17
Delay and unnecessarily complicated processes involved
in the military justice system were identified in several submissions as
causing or aggravating mental health problems.[935] The Ombudsman drew the committee's
attention to the impact of lengthy delays on an individual's psychological
state as an issue progresses through the many stages of complaint resolution,
administrative inquiry and/or disciplinary investigation:
I would note that we do
explicitly consider the issue of the impact psychologically on an individual.
There is a case we have decided recently to expedite because we believe there
is undue psychological pressure on the individual, and we are pressing harder
for a more prompt response. In the legislation, we do have the power to
intervene even before the 28 days, should there be circumstances that we
believe merit that sort of intervention. That really does impose on us the
obligation to look at each case on its own merits, rather than with a blanket
policy.[936]
15.18
Stress and anguish can result from several factors,
including the time taken to convene an inquiry, conduct hearings, consider material,
and reach decisions. It is worthwhile to quote again one witness whose sentiments
about her family's experiences over seven years encapsulate the feelings of
many submitters:
Our family's psychological and emotional abuse suffered at the
hands of the military justice system has been likened to repeated bashings with
a baseball bat perpetuated by multiple unknown assailants on multiple
occasions—never sure if it was the last bashing... Our journey is a horrific
example of the appalling state of the military justice system, highlighting
organisational deficiencies, the system barriers, the lack and/or failure to
adhere to the relevant policies, processes or procedures. A complete abuse of
process that began in 1998 and continued for seven years—a system in total
disarray.[937]
15.19
In addition to delayed proceedings, many submitters
expressed concerns about defective processes that left them with the impression
that justice had not been done. Several witnesses claimed that disciplinary processes
reflected imbalances of power inherent in the Defence Force's rank system and
tended to favour those of superior rank. One witnesses stated:
The rank system makes it difficult as well because anyone with a
superior rank will automatically be given more credibility than a lower ranking
victim.[938]
15.20
Another witness
commented that ‘even though no other officers agreed with this [person] they
all closed ranks and kept their mouth shut’.[939]
The committee has also heard evidence that on occasions individuals have been
charged without prior warning,[940] and
the availability of adequate and competent legal assistance was erratic or
non-existent. One witness stated:
What I believe should be addressed by your committee is the
resources the military throw at investigations, as opposed to the lack of
advice the member receives.[941]
15.21
The problems with the disciplinary process discussed in
this report have important consequences for the mental health and well-being of
service members and their families. The stresses placed on individuals under investigation
in many cases appear to have had longer term effects, including loss of
confidence, loss of employment, suicidal thoughts, attempted and actual suicide.
The SAS soldier's case discussed in chapter 3 stands out as a stark example of
the extreme, relentless, and unnecessary pressure that can be placed on a
member through the conduct of an investigation and pursuit of a prosecution.[942]
15.22
Administrative inquiries have also left families and
individuals with the feeling that justice had not been served. The most glaring
example of this was the Westralia BOI.
Family members felt that obstacles such as obtaining access to information and
the difficulties in attending the BOI suggested that a 'cover up' effort was
underway.[943] Many held the perception
that the inquiry was conducted in the interests of absolving the Navy of any
responsibility or blame for the death of the four sailors:
I have no doubt the Westralia
BOI was nothing more than a navy public
relations exercise.
....
There was a Board of Inquiry rushed into action, before the four
deceased sailors were buried. No time or consideration for the families of
those deceased, and little information of the inquest was given to the families
other than media articles.[944]
15.23
Families also questioned the 'justice' done to the four
service members that lost their lives on the Westralia:
The four deceased personnel were never represented at the BOI.
The Board members and Council Assisting the Board were accountable directly to
the Navy, and that is the way they appear to have run the BOI.
MIDN Megan Pelly, POMT Shaun Smith, LSTM Bradley Meek and ABMT
Phillip Carroll had nobody to investigate their actions. None of the Board
members or Council Assisting the BOI took any steps to get character analysis
or probable action assessments done.
Had anyone been interested in finding out what these brave young
sailors may have been doing during the fire, the Board may have come to a
different conclusion for their actions as the WA Coroner did (see Coroner's
Report, pp. 24-25).
Had the Navy or the BOI panel provided representation for the
deceased sailors, it may have avoided the public embarrassment associated with
a lengthy drawn out inquiry.[945]
15.24
Dissatisfied families and otherwise affected people
pursued the 'justice' they found lacking in the 1998 Westralia BOI for a further five years.[946] Having obtained no satisfaction from the
military justice system, they eventually gained some sense of justice after
successfully lobbying for a coronial inquiry.
Duty of Care
15.25
During the course of the inquiry the committee also became
aware that in some cases there was evidence that the ADF had failed to meet its
duty of care towards ADF members. The following section looks at ADF's duty to
ensure that all personnel are working in an environment that is as safe as it
possibly can be with regard to both physical well-being and mental health. The
committee considers that the ADF should ensure that precautions are taken to avoid
placing service personnel at unnecessary risk of physical or mental harm.
Physical safety
15.26
One factor that became increasingly obvious as this
inquiry progressed was the apparent lack of awareness by those in middle
management of inappropriate or risky behaviour. Their unawareness or inaction
meant that unsafe work practices continued unchecked until an incident
requiring investigation shed light on such practices. Unfortunately, in some
cases, the incident sparking the investigation involved the death of an ADF
member.
15.27
In the case of Private Jeremy
Williams, senior officers had failed to
implement recommendations from an investigating officer's report completed two
years earlier that had exposed improper conduct, including harassment and
bullying.[947] According to the
investigating officer's report into Jeremy's Williams' suicide, the situation
had remained largely unchanged since the first report identified the existence
of harmful practices in the unit—senior members in the chain of command had no
knowledge that denigration and harassment existed.[948]
15.28
The inquiry into the loss of Seaman Gurr
revealed that drinking practices on board his ship, and probably other ships,
put personnel at risk. Vice Admiral Chris
Ritchie told the committee that people in
positions of middle-ranking authority in the ship 'ought to have brought
knowledge of that sort of event to the commanding officer's attention but did
not...that is where the system of leadership in that ship fell down'.[949] He went on to state:
I do not accept that there was a culture of illegal drinking on
board HMAS Darwin.
I would accept that there was a culture of illegal drinking amongst a small
group, a particular trade category, on HMAS Darwin...I
certainly do not contend that it was one-off, but I do contend that it was a
small subgroup. Indeed, the board of inquiry found that it was not a one-off
event and that there had probably been instances before which could have been
brought to a head much earlier and were not.
Certain people in that ship did not take those responsibilities
seriously enough......
I am not convinced it is a problem that is limited to HMAS Darwin.
If it was in HMAS Darwin, there probably were
subcultures in other places.[950]
15.29
The investigation following the death of Corporal
Jason Sturgess
in a vehicle accident also exposed unsafe and dangerous work practices.
Although factors such as poor vehicle maintenance were not found responsible
for the accident, the fact that these practices and such a lax attitude to
safety matters prevailed is of concern. According to Jason's
uncle, Mr Jonathan
Ford, who had some experience in safety investigations
and audits,[951] the report on Jason's
death referred to unserviceable brakes, inadequate record procedures and other
deficiencies. The were also questions about the safety of vehicle seat belts.[952] Jason's
Aunt, Ms Coral Giffen, expressed the view that:
Being in the ADF should not mean that there is an unacceptable
death rate from accidents or failure of equipment. If anything, under peacetime
circumstances, under normal circumstances, because of the very job that we ask
them to do when we ship them overseas, when we deploy them, we should be even
more respectful of the need to keep them safe when they are not at home. How
awful to think that our young people may find that the worst enemy that they
face in their career in the defence forces is actually their own government,
their own command and the people who vote those people in.[953]
15.30
The examples given here are not isolated cases. They
demonstrate that all three services have at times failed to provide a safe work
environment for personnel, and highlight the need for the ADF to have
mechanisms in place that will enable the early detection of unsafe work
practices. The cases discussed so far relate to physical safety concerns. Numerous
witnesses have also related accounts of where they believe the ADF was remiss
in not taking account of emotional and mental health needs.
Mental Health
15.31
Evidence of
people's experiences in the military and encounters with the military justice
system suggest that the ADF may also not adequately meet its duty of care in
relation to mental health.
15.32
The case of Lance Corporal Nicholas
Shiels serves as a stark reminder that the
ADF, on occasion, has not adequately considered the mental health of those
under its charge. Nicholas was involved in a
live firing exercise in which he accidentally shot and killed a fellow soldier.[954] Mr
Paul Sheils, Nicholas'
father maintained that, from this moment on, Army abrogated its duty of care towards
a severely traumatised young man who was in total disbelief and trying
desperately to rationalise the tragic circumstances that had occurred. He told
the committee:
We want to emphasise the major factors in Nicholas’s demise as
being the failure to diagnose PTSD, the abysmal lack of follow-up medical
treatment, poor or flawed man management by superiors and, in particular, the
appalling negligence of Army psychologists, all of which ultimately contributed
to his death.[955]
...
The Army failed to look after Nicholas
in his work environment during peacetime training. Comcare found that the Army
contravened 24 areas of its duty of care under the occupational health and
safety act. No senior officer was court-martialled for this. Why not? In the
initial aftermath of the accident it was crucial that Nicholas
be given support and counselling commensurate with his trauma. Because he did
not receive this, he commenced a downward spiral that resulted in his death.
There is an implicit comparison between the treatment normally available to
civilians and that which was given to our son. It is not up to us to prove that
the Army failed in its duty of care for our son: it is indisputable. The
evidence is clearly outlined in the Comcare report, the coronial inquest
findings and ultimately in his death.[956]
15.33
One of the most disturbing aspects of this case was Nicholas'
participation in another live firing exercise soon after the accident. Mr
Shiels told the committee that, despite his
heavily traumatised state, Nicholas was not
placed on sick leave, nor did he receive proper medical treatment immediately
following the tragedy. Mr Sheils
claims that his son was instead 'instructed to undertake the same "live
firing" exercise two days after the death of his colleague.' [957]
Mr Shiels
told the committee:
In our presence he was told, not asked, to undertake the same
live firing exercise just two days after the accident—the instigator being the
on-scene Army psychologist.
You must remember that here we have a young private—bottom of
the rung—involved in an accident, the consequences of which were that his mate
was killed. Army hierarchy were in damage control. He relived the accident over
and over, with questions and statements from both Army and state police. As a
private you are powerless and subject to the Defence Force Discipline Act. He
was not in a position to refuse an order. We were absolutely staggered.
However, we knew that we had absolutely no say. We expressed our reservations
because of his already fragile state. We saw Nicholas
pressured to undertake the same live firing exercise again. The handling of the
situation emphasised the outmoded idea: if you fall off your horse, get back on
it and get over it.[958]
15.34
He stated further that, before the second live fire
exercise, Nicholas was put in front of the 200
troops who were asked 'who will volunteer to be Private Shiels's
partner?' Not only did the actions or lack of action by the Army add to this
young man's suffering, but the military justice system further contributed to
his distress. Nicholas was discharged from the
Army in February 1995, having served just under three years. He attempted
suicide on 29 December 1996
and died on 31 December 1996.
15.35
The sequence of events after the Westralia accident followed
a similar pattern. Again, those in charge failed to appreciate the severe
trauma suffered by those involved in the accident. Where mental health care was
provided in the immediate aftermath of the Westralia
tragedy, witnesses have told the committee that it was inappropriate.
Personnel who had been on the Westralia at the time of the fire were given
'group therapy' sessions by the critical incident stress management team.
Personnel found these sessions incredibly stressful, traumatic and
unproductive. Mr Gary
Jenkins stated:
At the briefing the psychologists tried to get everybody to talk
about what they did on the ship that day but I couldn't talk about it and
started to get very emotional and annoyed. Some of the crew were starting to
ask questions about the way we did things, and why we had sent the hose team
back in, what was Midshipman Pelly doing in the room and so on. I felt that I
couldn't answer them at this stage and walked out. This major disaster briefing
was a joke. It didn't help in any way, in fact it made things worse for me.[959]
15.36
Aside from the inappropriate mental health care
delivered immediately after the incident, witnesses have also told the
committee that their ongoing mental health care needs were inadequately provided
for. One witness stated that Navy had been advised that she required further
psychiatric treatment. This information, however, was not given to her. She
informed the committee that:
I have proof of gross negligence on [the part of] the Navy, who
received a report from a Psychiatrist stating I had PTSD from the fire and
needed counselling every two weeks, and also anti-depressants but the Navy kept
that letter to themselves and this advice went unknown to me until I found the
letter on my medical file when I was discharged.[960]
15.37
Another victim of the Westralia fire, Able
Seaman Matthew Liddell, received some psychiatric care but it appears to have
been insufficient to deal with his PTSD.[961] His mother, Ms
Dulcie Liddell,
told the committee that Matthew had attempted to
revive a badly burnt crew member. As a direct result of his experiences
following the fire he suffered PTSD, and eventually took his own life. Mrs
Liddell told the committee:
Matthew was hospitalised in St
John of God for a few days, then transferred back to HMAS 'Stirling'
medical facility. After discharge about a week or so later he was then sent
back to HMAS 'Westralia' which was in my opinion very wrong, this did a lot of
damage to his mind—it is a lot like sending someone back into the lion's den
after they're been already attacked and mauled. Matthew
did not want to go back to the 'Westralia'. There were too many traumatic
memories, he couldn't cope with emotionally which resulted in bad nightmares, a
great loss of sleep, which consequently resulted in a high degree of
irritability and anxiety. Even though he'd had counselling on a few occasions,
this did nothing to alleviate his problems, maybe his treatment was not taken
seriously enough.
Just before Xmas of 1998, Matthew was hospitalised with severe
depression, this should have been a warning and to have something constructive
done—The Navy then decided for 'the purposes of maintaining his mental health
he could not stay on the 'Westralia', it only took them months to come to this
obvious conclusion.[962]
15.38
Ms Liddell
explained further:
The assessment team of psychiatrists, social workers and
psychologists who follow the Guidelines of the National Centre for War Related
P.T.S.D. found Matthew qualified for admission
to the P.T.S.D. treatment program. This programme commenced 24-9-99. This is 16–17 months after the
'Westralia' disaster. Why so long?[963]
15.39
The committee notes that Navy has acknowledged that it
lacked a good understanding of PTSD, but has expressed its willingness, and
taken action, to obtain a better insight into the condition.[964]
15.40
Jason
Gutteridge's case is an example where Army
failed to manage a soldier's obvious mental health difficulties. Mrs
Debra Knight,
Jason's mother, told the committee that Jason
had been in a military prison and had attempted suicide twice over a short
period immediately preceding his death. Despite these attempts at suicide, Mrs
Knight was never informed about Jason's
difficulties. The evidence before the committee suggests that Jason's
friends assumed most of the responsibility for Jason's
care.[965] Mrs Knight only discovered, some
months after his death, that he had been experiencing emotional difficulty and
had made two previous attempts at suicide.[966]
15.41
Mr Keith
Showler, a Flight Sergeant with the RAAF,
told the committee that after continued harassment and abuse from an Army
Major, he suffered a 'nervous breakdown'. Mr
Showler received immediate medical attention
but could not continue receiving mental health care because adequate records
detailing the initial treatment were not made.[967] He had to access ongoing psychiatric
care at his own cost. In this instance,
not only did the ADF fail in its duty of care to provide an environment where the
risk of mental health difficulties was reduced, but it further failed to
provide adequately for Mr Showler's mental health needs after the initial
incident.
15.42
These varied experiences—from Navy, Army and Air
Force—all demonstrate that shortcomings in mental health care are not confined
to a particular service. They are common to all three. There seems to be a
broad-based failure within the ADF to adequately meet the duty of care owed to
Service personnel.
Managing mental health reporting and service provision
15.43
In addition to receiving evidence from submitters
concerning their experiences, the committee heard from the ADF regarding its
management of mental health issues, including reporting mechanisms and support
service provision.
Reporting mental ill-health
15.44
Mental health issues seem to be under reported
in the ADF. The problem may actually be much larger than the evidence to this
inquiry, or the records kept by the ADF, suggest. The committee has already
discussed a general reluctance within the ADF to report wrongdoing or lodge
complaints. In para. 15.5 the committee asserted that this reluctance may extend
to and impact upon an individual's ability to identify and seek help for mental
health needs. The committee considers, however, there are also shortcomings in
the way that the ADF records mental health data and assesses the performance of
its mental health programmes.
15.45
The ADF acknowledges that it is operating in
something of a vacuum regarding mental health services because it has no
prevalence data. Colonel Cotton
told the committee:
It is going to be difficult for us to get any real measure of
the effectiveness that we have had in reducing the incidence of mental
ill-health in the ADF because we have no prevalence data. We do not know what the
current rates are
...
We will get a prevalence study up and running probably next
year, which will give us some benchmark data that we can then use for a
subsequent evaluation, probably a couple of years on from that. The simple fact
is that we do not have good data on prevalence rates at the moment to do
comparisons.[968]
15.46
A committee
member asked whether there was any data at all that could be used to benchmark
the state of mental health in the armed forces. Colonel Cotton replied that these things could be done, but the effort involved in
retrieving data from paper records would be enormous. He stated:
Defence Health is starting a
process of routine health studies for every deployment and that has a mental
health component. But the simple fact is that we do not have the electronic
information systems to do that easily.[969]
15.47
The
committee does not accept that an armed force with a budget running into
billions, access to some of the most technologically advanced weapon systems in
the region, and the sophisticated software to manage these, does not have an
electronic information system sufficiently advanced to maintain adequate mental
health records and service provision.
15.48
In the
absence of service-specific data, the ADF expects to monitor the outcomes of its
mental health strategies using information from the federal government's National
Mental Health Strategy.[970] The
ADF would therefore appear to be relying on broad-based, nation-wide 'whole of
government' mental health indicators to assess the success or otherwise of its
own specific programmes.
15.49
The committee questioned Colonel
Cotton regarding suicide rates in the armed
forces. He confirmed that suicide rates have at times exceeded the rates in the
general population. A committee member asked Colonel Cotton
whether it was appropriate to compare the ADF against the general population,
given that the issue did not involve the general community per se, but rather, involved a single employer. Colonel
Cotton replied that the ADF does not
generally tend to examine its statistics against other employers, but
acknowledged 'it would be interesting and useful to do that'.[971]
15.50
The committee considers that the ADF needs to improve
its reporting and management systems. It should not measure its performance
against the general population, but rather, should act swiftly to develop
adequate reporting and mental health management systems that are adapted and
appropriate to its specific circumstance.
Providing mental health services
15.51
Colonel Cotton
informed the committee that the ADF is in the process of upgrading and enhancing
its mental health service provision, and was generally adopting a more
proactive approach:
The ADF mental health
strategy represents a major change in direction for the delivery of mental
health care to the ADF. It is based on the Australian national mental health
policy and uses a public health model of mental health service delivery. This
means that it is focused on health promotion and preventing mental ill health
rather than simply responding to ADF members who become unwell. This does not
mean that we do not provide treatment to individuals who become unwell, but we
are putting a lot more effort into stopping individuals getting to that point.[972]
15.52
In referring to gradual changes that have been
implemented or developed for the provision of mental health care, General
Cosgrove noted:
In the past few years the ADF has significantly improved the
mental health care provided to its members. We have a mental health strategy
that integrates the efforts of personnel in health, psychology, social work and
chaplaincy in the ADF to better meet the needs of our people and commanders.
Considerable efforts have been made to address alcohol and other drug issues,
to enhance our ability to respond to suicide related behaviour and in how we
deal with the potentially traumatising effects of military service. We have put
substantial resources into training ADF health and allied health staff to
provide care to ADF members. In most areas, the level of care substantially
exceeds what is provided in the general community.[973]
15.53
The ADF has a process of information development and
service provision, and also produces and disseminates material to raise
awareness of the services it provides. The
ADF has produced material on PTSD, mental health generally, and on the links
between mental health and substance abuse. While these are very important, help
to increase the awareness of mental health, and recognise that mental health difficulties
are common reactions to a range of issues, there also needs to be an awareness
that the responsibility of the individual and his or her colleagues is limited.
It is vital that the ADF adopts a pro-active stance towards mental health service
delivery and develops the infrastructure required to adequately provide for the
needs of service personnel.
15.54
The ADF informed the committee about a hotline ADF
personnel can access to discuss problems and obtain referrals to services:
The purpose of the all-hours
support line is not to provide a telephone counselling service or anything like
that; it is to provide access for someone in crisis to ADF provided facilities.
What they will do is that if someone calls and they are in crisis now they will
be put onto the 24-hour support that is available in their region but the people
at the end of the line, who are all trained health or allied health
professionals, will make an assessment and if that person can be best dealt
with the next day they will refer them the next day.[974]
15.55
According to Colonel Cotton,
Service personnel are not, however, readily accessing this phone service.[975] Several factors could explain this,
including the fact that, regardless of being able to speak to someone outside
the ADF during times of crisis, individuals are subsequently referred to ADF-provided
services. The committee has previously postulated that individuals may be
unwilling to access ADF-provided services due to cultural factors and fear that
this may adversely impact on career prospects. Personnel's willingness to
access services like mental health hotlines will not improve until a cultural
shift occurs in the ADF, and personnel begin to accept that penalties or stigma
will not and should not occur when mental health services are accessed.[976]
Services to families and support to next of kin
15.56
The committee has received evidence concerning the way
families have been treated while matters have progressed through the military
justice system, and has also considered the provision of support services to
grieving families and families otherwise encountering difficulty.
15.57
The ADF has introduced a number of processes to assist
personnel and families to cope with ordeals such as accidental death and
suicide. A number of these have been operating for some time, and others have
been set up in response to particular reports. They include:
-
the introduction of the 'sudden death protocol';
-
providing assistance for families to provide
input into inquiries; and
-
providing support teams, including chaplains and
social workers to help families when a death has occurred, and liaison officers
who can take care of and co-ordinate services, thus minimising a family’s need
to be involved in details.[977]
15.58
The Service Chiefs have also often had contact with
families during times of tragedy. Much of the ADF's contact with families,
however, is organised through the Defence Community Organisation (DCO):
Members of ADF families can
approach DCO officers directly in order to obtain assistance or any ADF member
can obtain access to the DCO as he or she requires. However, in times of crisis
or tragedy involving a serving member, it is usually the ADF chain of command
which activates the DCO to assist a family.[978]
15.59
Rear Admiral Brian
Adams, head of Defence Personnel Executive, told
the committee that DCO staff partner with medical, psychology and chaplaincy
providers within the ADF to provide critical incident mental health support
services and counselling to people affected by a loss—including deceased
member's colleagues and families. The DCO may also engage independent external professional providers if caseworkers feel
that it is in a family’s interests to do so and the family is agreeable to it.[979] Rear Admiral Adams stated:
The DCO ensures a system of
support is built around the family from within the wider community to support
the longer term recovery and support needs of the family.[980]
15.60
Mr Bernard
Collaery, a lawyer who has assisted many
families through the military justice system, nonetheless advised that the process left some gaps in information and
support which could contribute to long term issues. He told the
committee:
The other people who do not
get the critical incident debriefing and proper treatment are the relatives,
who, sometimes by perception—wrong, right or otherwise—become absolute thorns
in the side of the government and military people, sometimes when issues could
be put down straightaway.[981]
15.61
Responses to ADF support services have varied.
This variability may have been the result of process changes over time, and of
differences in the attitudes of the forces. Mr
Collaery praised the ‘current Chief of Air Force’ whom he described as
‘just an exemplary man in the way he deals with issues. I have great admiration
for him’:
Whilst I am very critical of
the Air Force over the F111, his ability to send notes to the families on the
anniversaries of the deaths of his operational crew just marks the man. That
process has to be led and that man is leading that in that arm.[982]
15.62
Ms Gurr,
mother of the sailor lost at sea in 2002, found the support she received was
excellent. On the other hand, Mrs Liddell
was critical of the DCO:
The DCO from Mitchelton dropped off pamphlets at my daughter Michelle’s house in Keppera. There was no
conversation, no talking about it; nothing was explained.[983]
15.63
Mrs Satatas,
mother of a young man alleged to have committed suicide in 2003, also
considered that the help she received was inadequate.[984] The mother of a pilot killed in 1993
expressed similar concerns, stating that there had been no assistance in
getting to the funeral, and no counselling provided.[985] While there have been improvements
since 1993, other factors still appear to limit the provision, and quality, of
services to some people.
15.64
The Committee notes and
welcomes the initiatives taken by the ADF to improve its health services for
serving ADF members and the support services its provides for families of
serving members who have been injured or died suddenly. Evidence shows that
this is an area that needs the ADF's close attention.
Conclusion
15.65
The report could go on to describe in detail aspects of
the delivery of mental health services in the ADF but this would go further
beyond the terms of reference. The committee concludes this chapter by
emphasising that the military justice system should be a mechanism that not
only deals with wrongdoing but is instrumental in preventing wrongdoing from
occurring. It should be a means of stopping the emergence or continuation of
conduct that puts the well-being of individual members at risk. Its procedures
should not add to the ordeal experienced by people who are caught up in the
process. The military justice system should not be part of the problem, it should
be part of the solution— it should resolve problems, not create them.
15.66
The committee draws attention to the evidence that
highlights the shortcomings in the military justice system and how such
failings have contributed to or caused mental heath problems. This awareness
alone should convince the ADF of the need to put in place the recommendations
made by this Committee to reform the military
justice system.
15.67
The recommendations contained in this report are
intended to remove some of the systemic problems that cause Service members unnecessary
stress and anxiety. The committee hopes that implementation of the suggested
reforms will encourage ADF members to report wrongdoing or make a complaint,
and will promote the attainment of impartial, rigorous and fair outcomes. The committee hopes that a reformed military
justice system will enable those who feel unable to pursue a matter through the
chain of command to seek redress through independent and impartial bodies.
15.68
An independent body created to correct administrative
defects and an independent military court will perform important oversight functions,
ensuring that investigators are better trained, that inquiries and investigations
observe the principles of procedural fairness, and that delays are kept to a
minimum. These bodies will be in a better position to take account of the needs
and well-being of those caught up in the military justice system.
15.69
Furthermore, by expanding the involvement of civilian
police and courts in areas where they have the expertise and structures to
better handle such matters, and creating a court that reflects principles
enshrined in the Commonwealth Constitution, ADF members can expect to enjoy the
same rights and have the same safeguards as all Australians. Overall, the
recommendations are designed to put in place for ADF members a justice system
that will provide impartial, rigorous and fair outcomes and one that is
transparent and accountable.
SENATOR
STEVE HUTCHINS
CHAIRMAN
Navigation: Previous Page | Contents | Next Page