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Fit to fight and fit for life

Australian Defence Force personnel and Defence public servants, alongside family and colleagues from ACT and NSW police, fire and ambulance services, the Australian Federal Police and the Australian Border Force, participate in the CDF Mental Health Walk around Lake Burley Griffin, Canberra.
Australian Defence Force personnel and Defence public servants, alongside family and colleagues from ACT and NSW police, fire and ambulance services, the Australian Federal Police and the Australian Border Force, participate in the CDF Mental Health Walk around Lake Burley Griffin, Canberra.

Whether it’s measured in time, dollars, research or dedication, one of Defence’s greatest investments is the protection and enhancement of the mental health and wellbeing of ADF personnel and veterans.

Underpinning the work of Joint Health Command to improve the resilience of servicemen and women are strong partnerships with Commonwealth, state and territory agencies and not-for-profit organisations. Collaboration with the Department of Veterans’ Affairs (DVA) has been especially important and prominent.

David Morton, the Director-General of Mental Health, Psychology and Rehabilitation, explained that since 2010 Defence and DVA had been collaborating strongly in areas of best practice of post-traumatic stress disorder (PTSD) treatment and suicide prevention.

‘Rehabilitation, transition and mental health have become shared responsibilities for both departments,’ Mr Morton said.

‘Strong integration and a team approach now define how we support current and former serving personnel and their families. This is one of the best changes since the early days of establishing mental health programs, because consistent and integrated approaches to support reduce gaps and help people understand how to access care at every stage of their career.

‘In fact, a great deal of Defence’s activity in mental health service delivery now occurs within a framework of collaboration, partnership and/or integration.’

The Commander of the Joint Health Command and Surgeon-General of the ADF, Air Vice-Marshal Tracy Smart, said a major focus for the Joint Health Command over the last 12 months was the work being done on suicide prevention, which also relied on partnerships and collaboration for success.

‘In providing suicide prevention support to veterans and current ADF members and their families, Defence, DVA and the Department of Health work closely together, coordinating programs and exchanging knowledge,’ Air Vice-Marshal Smart said.

In August 2016, the Prime Minister, the Hon Malcolm Turnbull MP, announced that the National Mental Health Commission would review the suicide prevention programs of Defence, DVA and the Department of Health.

‘The commission consulted widely before delivering its independent report, which helped the Government set priorities for suicide prevention support services for current and former ADF personnel and their families,’ Air Vice-Marshal Smart said.

‘Another example of collaboration is with Phoenix Australia – Centre for Posttraumatic Mental Health to design and develop mental health training for defence healthcare providers. Our training helps medical professionals like doctors and nurses to assess a patient’s risk for suicide, self-harm and harm to others and provide early intervention to those who need support.’

Efforts to develop more effective and accessible treatment for mental health conditions such as PTSD require careful clinical research. Collaboration is occurring around how to apply evidence-based treatment for PTSD in ways that are more accessible and timely.

RESTORE is a national clinical trial into treatment for PTSD, bringing together Defence, DVA and Phoenix Australia. The trial involves up to 200 current and former serving ADF personnel and will assess the impacts of intensive PTSD treatment compared to benefits of the standard exposure treatment that is conducted for a longer duration.

‘The RESTORE trial began last year and will conclude in 2018,’ Air Vice-Marshal Smart said.

‘If the evidence shows that participants get the same good results from the shorter intensive treatment, we can begin to make it more widely available and remove the barriers to care that often arise with longer treatment periods.

‘The last 18 months have also seen a real galvanising of our work with civilian first responders and other frontline agencies in how they develop and design mental health support.

‘Defence is helping the emergency services by sharing our knowledge, strategies and programs such as our “Battle Smart” resilience training. We also share our information about mental health awareness resources and peer support programs.

‘With some adaption to their specific needs, Defence mental health experience and expertise is helping civilian emergency servicemen and women, and their families, to benefit from similar benefits ADF members and veterans have enjoyed in recent years.

‘These examples of collaboration and evidence- based contributions demonstrate that we are not just focusing on servicemen, servicewomen and veterans, but finding ways to demonstrate leadership and contribute to the mental health of other Australians,’ Air Vice-Marshal Smart said.

Research on suicide and prevention program design has also been intensified over the last 12 months. While Defence has a strong understanding of factors impacting serving personnel, knowledge about those who have transitioned back to a civilian life has been limited.

David Morton explained that Defence worked closely with DVA to support the Australian Institute of Health and Welfare (AIHW) to undertake research into the incidence of suicide among current and former serving members last year, with results already shedding light on what is a complex matter.

‘The AIHW delivered its first summary report in November last year, and their second “in brief” report was released on 30 June this year. Their final report will be completed by the end of 2017,’ Mr Morton said.

‘We have confirmed the prevalence of suicide in serving ADF and Reserve members is about half that in the general Australian community. This would suggest screening, recruitment and support services that are designed to protect ADF members are effective.

‘While this is good news, of course we always want to improve, so we are closely analysing results to determine how we can continue to boost resilience and support.

‘Sadly, the incidence of suicide for former members is around twice that of the community, so Defence and DVA are committed to building a framework that effectively addresses this.

‘AIHW research shows the most vulnerable group is typically males under 25 who had a short military career before being medically discharged, and left Defence within the last 12 months. Knowing this means we can appropriately target them with the support and dedication they need and deserve,’ Mr Morton said.

The collaboration with the AIHW will continue beyond 2017, with ongoing research—delivered biannually to both departments—expected to continue improving Defence and DVA’s work in suicide prevention for current and former serving personnel.