Feb 27, 2013

Military mental health plan revealed — but problem underestimated

A new Defence Force report outlines how the military plans to deal with mental health issues like alcoholism and post traumatic stress disorder among troops. The problem is being underestimated.

Amber Jamieson — Freelance journalist in New York

Amber Jamieson

Freelance journalist in New York

Nearly six months after it was completed -- and a year after it was due -- the Australian Defence Force has publicly released its action plan for mental health reform in the military. But veteran groups have told Crikey the ADF could be grossly underestimating the extent of the problem. The report reveals how the force plans to break down the stigma around mental health issues such as post traumatic stress disorder and alcoholism, provide mental health care access to troops via apps and websites and engage with army mates and families to identify and treat those suffering psychological stress. The ADF Mental Health and Wellbeing Action Plan 2012-2015 is the latest plank in the ADF's Mental Health Reform Program, introduced after the landmark 2009 Dunt review into mental health in the armed forces. The plan outlines how Dunt's recommendations -- plus the objectives of the 2011 ADF Mental Health and Wellbeing Strategy -- will be implemented (these include promoting and supporting mental fitness, identifying specific mental health risks for those in the military, delivering and improving mental health care and building a body of evidence about the state of mental health in the military). Around 8% of serving ADF personnel who had been deployed suffer from PTSD, according to a 2010 study. The ADF Mental Health Prevalence and Wellbeing Study -- which found nearly 2491 of 51,000 staff deployed between 2002-2009 suffered from PTSD -- is the most recent ADF data available. But that 8% only covers ADF staff with diagnosed PTSD. One in five in the 2010 study had suffered a mental disorder in the previous 12 months and more than half of the ADF had battled anxiety, alcohol or affective disorders at some stage in their life. With Australian combat troops stretched across Iraq, Afghanistan and the Pacific in recent years, veteran organisations put the rate of PTSD and combat stress at closer to 30%. "We get a lot of the blokes who are out of the service and have got out on their own freewill and then find they have issues and come to us,"  said John Jarrett, president of Young Diggers -- a non-government, non-military organisation which provides assistance to serving and ex-ADF personnel. "Defence don't get to hear about them and there's a lot more of them. Our figures show at least 30% [of ADF personnel] suffering with combat stress, PTSD or a mental illness, compared to the Defence's 7-10% figure. And we're both right." That figure could riseto over 50%. "It will grow with time; it did with the Vietnam vets," Jarrett told Crikey. "You can keep switching it off and just keep concentrating on your work or something else until one day you just break down. That's what happens with at least half of them. That's the percentages we're going to be heading towards for the next five, 10, 20 years." Around 5% of the general Australian population is estimated to suffer from PTSD. One of the main issues -- which the action plan acknowledges -- is breaking down the stigma for tough, blokey soldiers to discuss combat stress. "It's very hard to address an issue that not many young people are coming forward with," said Jarrett. "There are still a lot of unit commanders and unit NCOs [non-commissioned officers] that tell the blokes to 'man up'. But Defence is getting much, much better at looking after this issue and trying to get it out there." The action plan commits to building a mental health website and mobile applications this year, recruit regional mental health promotion officers, hold annual Mental Health Day programs and implement the Self Management And Resilience Training (or SMART) and Keep Your Mate Safe programs, which train troops to recognise mental health issues in their colleagues. Better integration of health services is also flagged, so sufferers can access a range of services from a single point. And Defence is building new facilities for its Sydney mental health centre (the government tender was estimated at $2.5-3 million) which will research and implement evidence-based treatment programs for PTSD, suicide risk and other military-specific mental issues. Funding is also an issue, particularly in a department which has seen extensive cuts in the last few years. The action plan acknowledges that Joint Health Command (the ADF health organisation) has received funding to implement the mental health plan but notes the "limited funding and resources available to support the ongoing maintenance and delivery of services by Garrison Health Command and the single Services. Innovative approaches will be required to ensure the best value for money is achieved." A Spiritual Health and Wellbeing Strategy for the ADF -- examining spirituality and how it can assist with mental health -- is also due to be completed this year. The action plan was completed and released to internal stakeholders on the ADF's inaugural Mental Health Day in October. But it wasn't until Crikey questioned the Department of Defence on the status of the plan (as it was due for completion in early 2012) that it made it publicly available. The reason for the delay? No other outside stakeholder had ever asked for it. *Have you or someone who know suffered from mental health issues during or after ADF service? Crikey would love to hear from you (anonymity is assured). For help or information visit beyondblue.org.au, call Lifeline on 131 114 or visit this page for a detailed list of support services.

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5 thoughts on “Military mental health plan revealed — but problem underestimated

  1. Gavin Moodie

    I’m glad this is getting an airing. Military people have clearly been traumatised by their experience of war at least since WWI – yet another cost of war which therefore should be avoided almost at all costs.

  2. Harley Dennett

    In light of crushing funding pressure, it’s easy to see how the ADF may opt for the cheapest path: relying on chaplains and external volunteer groups to prop up “spiritual fitness” of the troops pre & post deployment. That approach, borrowed from the Pentagon, has already started to creep into the Defence leadership lexicon, including CDF speeches last year. I just don’t understand how anyone could read Cantwell’s book or the submissions to the Senate inquiry into wounded diggers and come away thinking theology can solve this. It really needs new funding for mental health support, and get rid of the assistance divide between active duty, reserves and DVA.

  3. Mike Flanagan

    I too am glad to see this issue surface in our political policy development and discourse.
    The evidence that modern warfare is traumatic to the individual is clear and beyond refute.
    If we are to engage in these expeditionary military exploits like Iraq and Afghanistan then we have to accept the consequences and attend to our commitments to the affected individuals.
    What I would like to know is ,how do we compare to other national military establishments. Perhaps we may doing a better job than most of them! It wouldn’t surprise me!
    The contradictions, in training an effective killing machine as against accepted social norms, are enormous and the advance training methods used in Australian military are sophisticated.
    Even so we should devote more energy and resources in this area.
    We witnessed the lost souls that returned from Vietnam and many of the individual’s recovery processes were left to their families and friends while the politicians and others avoiding their responsibilities to our men in uniform.
    Let us not make the same mistake twice, or more

  4. Gerry Hatrick, OAP

    And who these people normally vote for? Good plan guys! Who says they don’t want you for your brains!

  5. Hamis Hill

    Then there is the contrast between service life and “civvy street”.
    The normal business world is more like piracy than national defence, with rewards handed out in almost complete contradiction to honesty, discipline and merit.
    Hard for former defence force personnel to fit in.
    Time to complete the current continuing replication of the evil Empire of Rome and replace the “Dulce Et Decorum Est Pro Patria Mortem” of the early republic with a sub-contracted, privatised and mercenary defence force that allows personnel to transition seamlessly with the commercial world.
    That will remove some of the problems concerning how the general public recognise and reward the extraordinary efforts of defence force personnel.
    Just don’t recognise them at all; that, at least, would be honest.
    It is not sweet and proper to die and be maimed, physically and mentally, for a nation of selfish, money worshipping ingrates.
    See, just like ancient Rome; just before the fall.
    Howard opened the door to all this, didn’t he.

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