Promoting recovery from trauma
ANNUAL REPORT 2018 - 2019 Improving the wellbeing and quality of life for individuals and communities who experience trauma
B Annual Report 2015 - 2016 Chair’s Welcome 2
Director’s Welcome 4
National Centre of Excellence in Posttraumatic Mental Health 6
Strategic Framework 10
2018-19 Highlights 12
Board of Management 14
Centenary of Anzac Centre 16
Our Research and Evaluation Portfolio 20
Our Policy and Service Development Portfolio 26
Our Practice Improvement and Innovation Portfolio 32
Events in 2018-19 36
Publications, Presentations and Dissemination 40
Our Staff 44
Governance and Management 46
Financial Statement 48 Mrs Janine Kirk AM
I am delighted to have joined Phoenix Australia and Chair’s heartily thank His Honour Michael Strong for his diligent and expert guidance of the Board for more than six years. welcome I thank the Board members - in particular Mr Greg Ridder who acted in the role before I took up the position - and the management team for ensuring a smooth transition from Michael to myself. I was honoured to take on the role of Chair of an organisation so well respected both nationally and internationally for its leadership, and for the quality and excellence of its work to support those suffering trauma. During the year the Board welcomed Mr John Fely, representative for the Department of Veterans’ Affairs and Ms Lesley Podesta (CEO of the Alannah & Madeline Foundation). Major General Mark Kelly retired at the end of the financial year after serving on the Board for nine years. His contribution to the Board was significant and we thank him for his wise counsel. I am pleased to be able to report on a very successful year. Once again, we exceeded expectations and continued to develop our centre of excellence through leadership and collaboration, and our core areas of expertise: research excellence, policy and service
2 Annual Report 2018 - 2019 development, and practice improvement and innovation, Our patron, Air Chief Marshal Sir Angus Houston AK, AFC enabling us to move closer to our vision of improved (Ret’d) and ambassadors, Mr David Mann AM and Wing wellbeing and quality of life for individuals, families and Commander Sharon Bown (Ret’d), enthusiastically assist us communities who experience trauma. in ‘getting the word out’ about the important work we do, With an increasing focus in the community on mental health and raising the profile of posttraumatic mental health in the and traumatic stress recovery, Phoenix Australia has an community. We are most grateful for their support. important role to play in disseminating knowledge and skills We thank our national and international funders, partners in evidence-based, best practice treatments, to ensure the and collaborators for enabling us to conduct our vital work. best possible care is available for those affected by trauma. While we have received a record amount of funding during We continued to grow our research program, with the the year, we invest these funds wisely. increased number of publications reflecting the steady Financially, we continued to ensure the sustainability of our growth in our research capability and outputs. organisation and ensure the impact of our initiatives is far We have consulted for a wide variety of organisations reaching. to develop mental health and wellbeing frameworks, I am excited to advise that our new strategic plan will guidelines, programs, tools and resources, as well as to shortly be finalised - it has been the subject of much careful provide advice on management policy and regulations. consideration and consultation, and we are looking forward We expanded our training program by developing a range to implementing our goals of an expanded and even more of innovative digital initiatives and products, providing effective support for those suffering trauma. tools and resources for frontline workers across a variety of The growth of our work, and of our reputation for quality sectors to support people affected by trauma. and delivery, is the result of the skill and dedication of During this time, we promoted collaboration and our Director, Professor David Forbes, and his leadership knowledge sharing by holding events, information sessions team and all our staff. I thank them for their effort and and interest group meetings, leading international commitment. I also thank my fellow Board members for collaboration initiatives, producing recovery tools and their enthusiasm and support. resources, as well as speaking at conferences and collaborating on projects with a variety of experts and organisations.
Annual Report 2018 - 2019 3 Professor David Forbes
The 2018-19 year has been very successful, with continued significant growth in our work and our Director’s achievements, and I would like to share some of the highlights with you. welcome In July 2018 we held a most successful educational and networking forum for clinicians working in veteran and military mental health. Conducted in partnership with the Departments of Defence and Veterans’ Affairs and Open Arms, the Military and Veteran Mental Health: Innovations in Treatment Practitioner Forum was attended by more than 400 people - testament to the fact that there is a real thirst for information sharing in this area (read more on page 38). In October 2018, Phoenix Australia and the Canadian Institute for Military and Veteran Health Research established the 5-Eyes Mental Health Research and Innovation Collaboration (5-Eyes MHRIC). Bringing together leading centres in military and veteran research and innovation from Australia, Canada, New Zealand, the UK and the US, the inaugural meeting was held in Sydney in parallel with the International Veterans’ Ministers 5-Eyes Conference (read more on page 37). The group will meet annually and assure a focus, at the highest levels, on policy-relevant priorities and actionable outcomes.
4 Annual Report 2018 - 2019 And in June this year, I attended and presented at the This flows from the significant work we have been doing Veteran Mental Health and Wellbeing and Suicide in the area of disaster-related mental health, such as Prevention Summit organised by the Minister for Veterans establishing a mental health advice and consultation service and Defence Personnel. He described the meeting as a for practitioners supporting people affected by the 2019 “chance to help set the veterans’ mental health agenda”, Queensland floods. This rapid-response project was funded and it was an opportunity for an exploration of what is by the Commonwealth Government. working and not working, and what the gaps are – to guide We also continued research into our Skills fOr Life us to improve mental wellbeing. Adjustment and Resilience (SOLAR) intervention for There is a growing awareness in the community of the psychosocial recovery following disaster. This year we importance of workforce mental health, particularly in received funding from the Department of Foreign Affairs industries where there is an inherent risk for exposure and Trade to pilot a culturally adapted version of SOLAR in to potentially traumatic events, such as the emergency the Pacific Islands nation of Tuvalu. services. Our work in this sector continues to expand, with Phoenix Australia has undergone a number of changes this some important work undertaken this year with new clients year. We have a new Chair of the Board, with His Honour across states, including further police jurisdictions and an Michael Strong leaving the position in March, and Mrs office of the director of public prosecutions. We are able Janine Kirk AM commencing in May. While we were very to provide such organisations with expert review of current sorry to farewell Michael, who had been a most valuable policies and strategies, and guidance in implementing guiding hand, we were extremely pleased to welcome best practice systems and procedures to ensure the health, Janine with whom we had collaborated in the past. Janine safety and wellbeing of their workforces. brings her extensive leadership experience to the role, and In March this year, we presented a special event for the I very much look forward to continuing our work together. emergency services sector, Managing Workplace Trauma: Since our earliest days, the scope of Phoenix Australia’s Insights & Learnings. Held at the Melbourne Cricket work has been nation-wide. Now our national footprint is Ground, four excellent speakers discussed their experience growing, with offices open in Canberra, Adelaide, Sydney and insights and engaged in a dialogue with attendees. and Brisbane. This will bring benefits to local communities You can read more about the event on page 36. – increasing our understanding of local needs, improving We are also pleased to have worked with a number of new local relationships, as well as facilitating input from those federal clients this year, including the National Disability communities into our national agenda of work to improve Insurance Agency which engaged us to provide a best outcomes for people affected by trauma. practice approach to promoting and supporting the mental Finally, I would like to thank the members of the Board health and wellbeing of its workforce. for their guidance - in particular I’d like to acknowledge In May, the Victorian government generously committed to Mr Greg Ridder who was our acting Chair for the interval extending and improving our research clinic facilities at the between Michael Strong’s departure and Janine Kirk Royal Park Campus of the Royal Melbourne Hospital. This commencing, and continues to Chair our Finance & Risk will enable us to conduct more vitally important research Committee. I also thank our patron and ambassadors for into clinical treatments. their strong support of this organisation. In June 2019 we were gratified to receive a grant from the And to all our staff – thank you for your dedication to the Federal Department of Health to develop a digital platform mission of Phoenix Australia. I am constantly inspired by in disaster mental health that will provide training and you and grateful for your work. resources to assist primary health providers across Australia to respond to the mental health needs of disaster and trauma-affected communities.
Annual Report 2018 - 2019 5 The National Centre of Excellence in Posttraumatic Mental Health
Phoenix Australia is an international leader and the national centre of excellence in posttraumatic mental health.
We are at the forefront of research, policy and training, working with individuals, organisations and the community to understand, prevent and recover from the potential adverse effects of trauma. With over 20 years of experience, our passion and drive is to improve the wellbeing and quality of life for individuals and communities who experience trauma.
Our acclaimed research and international networks are the foundation of our work. We collaborate, partner with and guide organisations, communities and individuals to reduce the effects of trauma.
6 Annual Report 2018 - 2019 Phoenix Australia
National and international leadership and collaborations
• Board membership and presidency of the International Society for Traumatic Stress Studies • Co-founder of the 5-Eyes Mental Health Research and Innovation Collaboration • Developer of the Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder • Vice-chair of the ISTSS Prevention and Treatment Guidelines Committee
Internationally recognised program of research
• Twenty years of experience in scientific research spanning military and veteran, community, industry, and workplace populations • Traumatic Stress Research Clinic conducting innovative clinical treatment trials • Translation of research knowledge into trauma informed policy and service development for governments, organisations and communities
Independent experts focussed on posttraumatic mental health
• An independent not-for-profit organisation and a registered charity, with an affiliation with the University of Melbourne • Board of Directors include independent members as well as senior representatives from the Departments of Veterans’ Affairs and Defence • Staff include more than 50 researchers and clinical specialists with expertise in posttraumatic mental health • National coverage with offices in Adelaide, Brisbane, Canberra, Melbourne, and Sydney
Committed to improving availability of high quality evidence-based treatment
• Set the standards of best practice for the management of trauma in high-risk organisations • Comprehensive program of training, competency development and supervision in evidence-based treatments and supports • Expert guidance and support for practitioners working with veterans, military personnel and their families
Annual Report 2018 - 2019 7 Phoenix Australia Our expertise
Research and Evaluation Our program of internationally acclaimed research and evaluation aims to advance the knowledge of posttraumatic mental health; create real-world solutions through the application of diverse research methodologies; and translate research findings into practical implications for governments, organisations, and communities.
Policy and Service Development Our policy and service development work aims to establish the standards of best practice for the management of trauma. We translate research into best practice policies and procedures for organisations, and work with organisations to build their capacity to minimise the impact of workplace trauma.
Practice Improvement and Innovation Our aim is to create engaging and evidence-based education and training programs that improve the practice of those working with individuals, organisations, and communities affected by trauma. We provide tailored training, supervision, and consultation services that meet the specific needs of a diverse range of clients.
Phoenix Australia also promotes a greater understanding of posttraumatic mental health through online and print resources, videos, journal articles, presentations at conferences and other forums, and via expert media commentary.
8 Annual Report 2018 - 2019 Phoenix Australia
We integrate knowledge and skills into best practice and tailored implementation, offering clients end-to-end service.
Our clients include:
• Government departments with responsibility for people who are at high risk of being impacted by psychological trauma, including Veterans’ Affairs, Defence, Home Affairs, Foreign Affairs, Health, Human Services, and Education
• Insurers and compensation agencies who fund treatment and support
• Police, ambulance, fire, rescue and other emergency service providers
• Other industries and organisations whose employees are at high risk of being impacted by psychological trauma
• Individual practitioners who treat those impacted by psychological trauma
• Organisations which provide treatment and/or support to individuals, families and communities impacted by trauma, including disaster.
Annual Report 2018 - 2019 9 Phoenix Australia Strategic framework
Our strategic framework defines our mission, vision, strategic goals and values. As a mission and purpose-led organisation, the framework guides our strategic direction and decision-making. Our Strategic Plan for 2016-2018 has provided this direction over the past three years. Our next Strategic Plan is drafted and due for publication in the second half of 2019.
OUR VISION Mission
To be an international leader in Improved building the capability of individuals, wellbeing and organisations and the community to understand, prevent and recover quality of life for from the adverse mental health effects of trauma. To be at the individuals and forefront of world’s best practice in communities veteran and military mental health. who experience trauma.
10 Annual Report 2018 - 2019 Trauma and mental health
Most people will experience a traumatic event during their lives. Whether from natural disasters, transport accidents, sexual assault, early childhood experiences, or exposure through military or emergency services experiences, trauma can have lasting effects and impact people’s mental health, relationships, work, and study.
Values 75% • We are passionate about making of Australians are exposed to a real difference to the wellbeing a traumatic event every year of people impacted by trauma
• We operate with integrity in our words and actions 1m+ • We collaborate with our colleagues More than 1 million and partners to achieve the best Australians suffer from PTSD possible results
• We are responsive to the changing needs of the communities we serve • We strive for excellence 2nd PTSD is the second most • We are guided by scientific common mental health evidence condition nationally 1/3 Only 1/3 of people with PTSD fully recover using current treatments
Annual Report 2018 - 2019 11 Phoenix Australia 2018-19 highlights
21 91 Active research Policies reviewed projects 41 7 Projects delivered New clients 32 6,838 conference PTSD Guidelines presentations downloads 230 124,260 Enquiries received by our Website visitors Professional Advice Line
12 Annual Report 2018 - 2019 Centenary of Anzac Centre • Conducted national forums for practitioners and ex-service organisations to share knowledge, increase collaboration and improve support for veterans • Refined our veteran mental health research framework and established a Veterans Advisory Group to provide 1,180 input into research projects Practitioners attended a veteran mental health information session Research and Evaluation • Conducted innovative research trials, including piloting a culturally appropriate post-disaster intervention in the Pacific Islands, and a trial of a shorter version of prolonged exposure therapy • The large number of journal publications reflects the steady growth in our research capability and outputs 37 • International collaborations included attending NATO intervention Research Task Groups Innovations tested
Policy and Service Development • Consulted for a wide variety of organisations to develop mental health and wellbeing frameworks, guidelines, programs, tools and resources 33 • Deepened our work within the emergency services Peer reviewed publications sector - worked with new clients such as police jurisdictions and an office of the director of public prosecutions, and held a special information event on managing workplace trauma
Practice Improvement and Innovation 1,887 • Developed a range of innovative digital initiatives and products, including an eLearning program for rail PractitionerS Trained industry employees • Worked with new federal clients, including development of a best practice approach to workforce mental health and wellbeing for the National Disability Insurance Agency
Annual Report 2018 - 2019 13 Board of Patron & Management Ambassadors
An independent not-for-profit organisation, Phoenix Australia has a Board of Management which provides oversight in terms of strategic direction, strategic risk management, governance and performance. Our Board of Directors includes independent members as well as senior representatives from the Departments of Veterans’ Affairs and Defence.
Mrs Janine Kirk Professor David Forbes Mr Paul Dolan Patron Air Chief Marshal AM Sir Angus Houston AK, AFC (Ret’d)
Major General Mark Kelly Mr John Fely Professor Malcolm Hopwood Ambassador AO DSC Wing Commander Sharon Bown (Ret’d)
Ms Lesley Podesta Mr Greg Ridder Air Vice-Marshal Tracy Smart Ambassador AO Mr David Mann AM
14 Annual Report 2018 - 2019 Senior Leadership Team
The Senior Leadership Team incorporates the Management Group and other senior staff. It works under the broad direction of the Board. The team is responsible for the day-to-day management of Phoenix Australia as well as leading the continual improvement in the organisation’s performance, through the implementation of our strategic plan, delivery of client work, the development of new business opportunities and the evolution of our internal operations.
Professor David Forbes Associate Professor Andrea Phelps Paul Dolan Professor Meaghan O’Donnell BA (Hons) MA (ClinPsych) PhD BA (Hons) MPsych (Clin) PhD BA (Hons) BAppSci (Nur) BSci (Hons) Director Deputy Director Head of Strategy and Operations MPsych (Clin) PhD Head of Research
Associate Professor Darryl Wade Nicole Sadler Dr John Cooper Jane Nursey BA (Hons) MA (ClinPsych) PhD AM CSC, BA Psych (Hons) MBBS MPM FRANZCP BBSc Grad Dip Child Head of Practice Improvement MPsych (Clin) Consultant Psychiatrist & Adol Psych MPsych (Clin Neuro) and Innovation Head of Policy and Service Director, Centenary of Anzac Development Centre Practitioner Support Service
Dr Mark Hinton Anne-Laure Couineau Alexandra Howard BEd BA (Hons) MPsych (Clin) PhD BA (Psych) MA (Psych) BPsych (Hons) MPsych (Clin) Director, Centenary of Anzac Grad Dip (Psych) Acting Director, Policy and Centre Treatment Research Director, Policy and Service Service Development - Veterans Collaboration Development and Community
Annual Report 2018 - 2019 15 Centenary of Anzac Centre
The Centenary of Anzac Centre aims to ensure better mental health and improved lives for Australia’s veterans and military personnel and their families.
We are achieving this through pioneering research, expert guidance and support for practitioners around Australia, and national leadership by engaging researchers, practitioners, and the veteran community to create collaborative networks.
16 Annual Report 2018 - 2019 Centenary of Anzac Centre
Treatment Research Collaboration
The Treatment Research Collaboration aims to improve mental health outcomes for veterans by conducting and facilitating innovative research into posttraumatic stress disorder and other military mental health issues and to engage with the broader research and clinical community in this endeavour.
2018-2019 overview
Over the past 12 months the Treatment Research Collaboration has been working hard to address a wide range of issues affecting veterans’ mental health. These efforts have been guided by the research framework that was developed through consultation 6 2 with clinicians, researchers, ex-service organisations new systematic and veterans themselves. The research framework collaborative reviews continues to evolve as we continue to seek input partnerships conducted and advice from these groups around which areas of veterans’ mental health are of greatest priority. These areas include, understanding complexity and the phenomenology of signature veteran mental health disorders, the mechanisms underlying disorder and how to target these through treatment, and how and when to best deliver appropriate treatments. 8,784 More recently, in consultation with our key records screened on stakeholders and collaborators, we have expanded title and abstract the priority areas to include the factors that drive wellbeing and positive mental health outcomes. This is particularly relevant through the challenging period of transitioning out of the ADF. There are currently 10 research projects underway, and one project has been completed. A number of 2 10 new collaborations have been established, including new technologies study designs with the Toowong Private Hospital, Tel Aviv University, being trialled Soldier On Australia, the University of New South Wales, and the Centre for Positive Psychology (University of Melbourne). These collaborations aim to enhance the capacity of treatment services and ex-service organisations to undertake research themselves, so that they can innovate and increasingly evaluate their own programs.
Annual Report 2018 - 2019 17 Centenary of Anzac Centre
Practitioner Support Service
The Practitioner Support Service aims to improve the lives of Australian veterans with mental health problems by supporting the practitioners and organisations who work with them. The service provides expert multidisciplinary support and guidance through consultations, and national outreach and engagement.
2018-2019 overview
The Practitioner Support Service was launched in July 2018 by the Minister for Veterans’ Affairs, Darren Chester at the Military and Veteran Mental Health: Innovations in Treatment Practitioner Forum. In the past year the service has had contact with over 129 29 2,300 people working in the area of veteran mental requests for case health. Key activities have included: information or consultations resources • Training in trauma informed care and conducting sensitive conversations provided to a range of Department of Veterans’ Affairs (DVA) staff who work with veterans with mental health problems. • Case consultations provided to Open Arms staff, DVA Complex Care staff, ex-service organisations (ESOs) and private practitioners. 1,180 • A one-day national forum for ESOs. people attended presentations • A one-day conference in Sydney for ESOs, or information sessions practitioners and families - co-hosted with the Veterans Centre Sydney Northern Beaches. • Three seminars conducted as part of the Mental Health Practitioners Network online conference. • Papers presented at two conferences. • Education sessions conducted for ESO and 86 practitioner groups across the country. 93% Net Promoter of participants • Development of a Guide to Working with Veteran Score loyalty satisfied with Mental Health Issues specifically for theE SO measure the quality of community. outreach activity We also provide a monthly e-newsletter which highlights events and activities and provides articles on key areas of interest.
18 Annual Report 2018 - 2019 Outreach activities held in major centres around the country adelaide PERTH Mental Health Professionals Soldier On Network Anglicare RSL Care SA Mental Health Professionals Network Canberra Open Arms Mental Health Professionals Salvation Army Network
South-East QLD Hobart Department of Veterans’ Affairs Rural Alive and Well Royal Australian College of Open Arms General Practitioners conference Pioneering MELBOURNE Sydney Department of Veterans’ Affairs Department of Veterans’ Affairs research and Mental Health Professionals RSL Defence Care Network Veterans Centre Sydney expert support Oakleigh RSL Northern Beaches Melbourne Legacy Ex-service organisations forum for practitioners Dementia Australia Veterans Review Board Employee Assistance Professional Online Association of Australasia Mental Health Professionals Network conference
Annual Report 2018 - 2019 19
TheOur Centenary Research and ofEvaluation Anzac Centre portfolio
Phoenix Australia’s internationally acclaimed We benefit from our extensive national and international program of research and evaluation aims to collaborative research relationships, integrating the findings from our research activities and program evaluation with advances advance the scientific knowledge of trauma from around the world. and posttraumatic mental health. Phoenix Australia is proud of its unparalleled leadership in translating research into practical implications for governments, organisations and communities, thereby promoting the best possible outcomes for people affected by trauma.
Phoenix Australia’s research targets three main populations of trauma survivors:
• Military and veteran • Community • Industry and workplace
Program of research
Treatment Resilience and Knowledge Clinical Systems Level Research Wellbeing Mobilisation Interventions Interventions Collaboration
Longitudinal Treatment Primary Family Synthesis research resistance prevention violence
Functional New Indicated Addictive Phenomenology health methodologies interventions behaviours
Social New Testing Primary Epidemiology connection technology treatments care
Wellbeing Cognitive Testing Novel initiatives emotion innovations interventions
Mental/physical health
20 Annual Report 2018 - 2019
2018-2019 overview
Research at Phoenix Australia continues to grow substantially. Our number of publications in the peer review literature steadily increases each year reflecting the growth in our research outputs. This was an exciting year because we commenced two randomised controlled studies at our Traumatic Stress Research Clinic. The clinic 21 33 is centrally located at the Royal Park campus of Melbourne active research peer review Health and we’re getting a steady stream of referrals of projects publications trauma survivors keen to receive expert PTSD treatment. Our consumer and veteran advisors make an important contribution to our research. Our Veterans Advisory Committee plays an essential role in determining our research priorities and processes. All our clinical trials have consumer advisors so that our research is as relevant as possible. Our international collaborations are very important. This year, Professors David Forbes and Meaghan O’Donnell 63 32 were invited to attend a number of NATO Research Task technical conference Groups. Meaghan attended the Leveraging Technology reports presentations in Military Mental Health panel in Los Angeles, and David attended the Personalized Medicine in Mental Health and Performance: Precision Medicine in Human Performance. We appreciated the Department of Defence nominating Phoenix Australia for these panels, and they were exceedingly useful to participate in. This year we launched our new structure for the Research Portfolio (see page 20). This structure reflects the expertise of our senior research leadership team who are developing 7 7 these programs of research. current NHMRC active national We supported 15 higher degree students who have all grants and international been handpicked because of their expertise and past consortiums experience. We are pleased to be developing the next generation of traumatic stress researchers. Finally, two international researchers received awards from Germany and the Netherlands to conduct research at Phoenix Australia. Congratulations to Dr Annett Lotzin and Jurriaan Jacobs on receiving these prestigious awards. 15 higher degree students
Annual Report 2018 - 2019 21 Research and Evaluation projects
Evaluation of Transport Accident Commission Evaluating if a computer task can help Defence claims management after the Bourke Street Force personnel adjust to civilian life incident Transitioning out of the military can be a vulnerable Vehicle-ramming attacks on civilians have become time for military personnel. Military training incorporates more frequent in recent years. Following an attack attending to cues in the environment that may signal in Bourke Street, Melbourne in January 2017, the threat; in deployment situations this training can Transport Accident Commission (TAC) was responsible be life-saving. Upon return to civilian life, however, for providing compensation to individuals. This constantly feeling alert and attending to cues that was a unique situation due to the high number seem threatening can become a problem, and it can of mental injury claims submitted, and the way in be associated with the development of posttraumatic which they were managed. Phoenix Australia is stress disorder (PTSD). Attention Control Training (ACT) examining the effectiveness of this approach to claims is an intervention designed to modify the fluctuations in management. The findings will be used to inform attention to threat that underpins PTSD. ongoing improvements to the TAC’s standard claims SOAR (Stepping Out Attention Retraining) is a management process as well as provide learning for randomised controlled trial testing whether ACT is future responses to large-scale traumatic events. effective in preventing PTSD from developing following transition. The results will improve our understanding of effective preventions for the development of mental health symptoms after military service. Piloting a brief intervention following disaster in the Pacific Islands Skills fOr Life Adjustment and Resilience (SOLAR) is a brief intervention for psychosocial recovery following Testing a shorter version of prolonged disaster, designed by Phoenix Australia in collaboration exposure therapy with international experts. We piloted a culturally The Rapid Exposure Supporting Trauma Recovery adapted version of SOLAR in the Pacific Islands nation RESTORE) trial aims to identify whether a modified of Tuvalu which was impacted by Tropical Cyclone form of the gold standard treatment for posttraumatic Pam in 2015. The results from the pilot are promising, stress disorder (PTSD) - prolonged exposure (PE) showing reductions in levels of distress, post-trauma therapy - delivered over 10 days in a two-week period symptoms, and impairment. We partnered with the can obtain similar outcomes to standard weekly Australian Red Cross for the pilot, and the Department treatment over 10 weeks. This is the first Australian of Foreign Affairs and Trade provided funding. randomised controlled trial to compare both modalities of PE for the treatment of PTSD, and aims to improve access to effective evidence-based care. Current and ex-serving Australian Defence Force members are Development of a disaster intervention being recruited across mainland Australia. Findings program for young people will directly influence policy and delivery of evidence- based treatment to current and ex-serving defence Skills fOr Life Adjustment and Resilience (SOLAR) force members nationwide. The trial is a partnership programs have been developed for children and between Phoenix Australia, the Departments of adolescents (SOLAR-Kids and SOLAR-Teens). Phoenix Defence and Veterans’ Affairs, and Open Arms. Australia in collaboration with the University of Queensland developed materials and field tested the two programs as part of the disaster response following Tropical Cyclone Debbie. Funding was provided by Queensland Health.
22 Annual Report 2018 - 2019 Rapid evidence assessment of meditational National Health and Medical Research Council practices and mindfulness Program Grant There is increasing interest in treatments such as Our NHMRC Program Grant represents a collaboration meditation, yoga and mindfulness for mental health with internationally renowned experts Professors disorders. These therapies are potentially cost effective, Richard Bryant and Derrick Silove (University of NSW), can have physical benefits, and may appeal to people Alexander McFarlane (University of Adelaide), Gin Malhi who find other types of therapy too confronting (University of Sydney), and Kim Felmingham and Mark or demanding. We conducted a rapid evidence Creamer (University of Melbourne). assessment of scientific evidence to understand the role The SPRITE study of meditational practices and mindfulness in improving mental health. We found that both yoga and This randomised controlled trial tested a group-based mindfulness have a promising level of transdiagnostic treatment for anxiety and depressive evidence for the treatment of depression. Group disorders that develop following severe injury. Through mindfulness was found to have a promising level of our partnerships with the Alfred and Royal Melbourne evidence for the treatment of anxiety. At this time, Hospital trauma units, we recruited patients to test these interventions can be considered as emerging, but whether a transdiagnostic intervention, Unified Protocol not first-line treatments. Funding was provided by the therapy, is effective in reducing symptoms of not only Department of Veterans’ Affairs. posttraumatic stress disorder (PTSD) but other mood and anxiety disorders that often occur following trauma. This study has also received additional funding The IMPACT study Evaluation of a suicide prevention service for This new trial is looking to establish whether Unified the Department of Veterans’ Affairs Protocol is as effective as prolonged exposure (PE) therapy, the current gold standard treatment for PTSD. In 2017, the Department of Veterans’ Affairs (DVA) Evidence suggests that the effectiveness of PE is limited contracted Beyond Blue to adapt and pilot a version by high dropout rates, a reluctance by individuals and of their community suicide prevention support service, therapists to engage in it, and treatment non-response. The Way Back, for the needs of ex-serving Defence The results of this trial could offer evidence for a new personnel. Phoenix Australia has been engaged by effective treatment for PTSD. DVA to independently evaluate the effectiveness of The Way Back at reducing suicidal behaviours in ex- serving members and to collect evidence to inform future policy implementation in this area. This project is ongoing and completion is scheduled for 2021. Evaluating psychological resilience factors in the Australian Defence Force Phoenix Australia has been collaborating with the Australian Defence Force (ADF) since 2010 on the Development of a gold standard measure of LASER-Resilience research project which aims to the impacts of moral injury provide the ADF with valuable information regarding the situational and individual factors that both erode The development of the Moral Injury Outcome Scale and promote psychological resilience in ADF members (MIOS) for ex-serving and current serving Defence during training and their first three years of service. members is a multi-phased project conducted in Phoenix Australia has delivered a total of nine reports. collaboration with an international consortium of The LASER-Resilience research program as a whole has experts from the US, Canada, UK, and the Netherlands. implications for the overall wellbeing and functioning It aims to develop a gold standard measure of the of early-career ADF members, and potentially also psycho-social-spiritual impacts of moral injury. This for retention and for effective transition back into project is funded by the Department of Veterans’ the civilian community for those who voluntarily or Affairs. involuntarily discharge after a short period of service. The findings from this program of research can inform current and future Defence training, policies and procedures, including initiatives outlined in the 2018– 2023 Defence Mental Health and Wellbeing Strategy.
Annual Report 2018 - 2019 23 Investigating the combination of exercise with Gambling problems in the ADF: Analyses of the standard PTSD treatment Middle East Area of Operations Prospective In a collaboration between the Melbourne School Health Study of Psychological Sciences at Melbourne University This study involves analyses of data collected from the and Phoenix Australia, this randomised controlled Middle East Area of Operations (MEAO) Prospective trial is investigating whether combining aerobic Health Study, which was a longitudinal study of Defence exercise with prolonged exposure therapy enhances personnel who deployed to the MEAO after June 2010 treatment response in individuals with posttraumatic and returned by June 2012. This is the first Australian stress disorder (PTSD). Brain derived neurotrophic study which has examined gambling problems factor (BDNF) can improve capacity to regulate fear alongside measures of other commonly recognised responses, and its levels are increased by engaging in mental health problems and addictive behaviours. The aerobic activity. Hence, adding this component into analyses of the data are ongoing and will provide new the gold standard intervention may enhance treatment evidence of the frequency of gambling problems in response for PTSD. This study is funded by the NHMRC. the context and aftermath of deployment, as well as the risk factors and implications of gambling problems for post-deployment adjustment and wellbeing. This study is funded by the Victorian Responsible Gambling Family violence study Foundation. We are conducting a study of Intimate Partner Violence (IPV) in veterans’ mental health and family support services. This mixed-methods study involves surveys and interviews with veteran mental health workers, Traumatic brain injury, PTSD, and the risk of and will explore the existing responses to IPV victims neurodegenerative disease and perpetrators, as well as opportunities to improve This study in collaboration with Professor Chris Rowe identification and responses to IPV in this environment. aims to investigate whether individuals with traumatic The study is a collaboration with the Safer Families brain injury (TBI), including those with repetitive Centre for Research Excellence at the University of concussion, and individuals with posttraumatic stress Melbourne, and is funded by the Defence Health disorder (PTSD) are at increased risk of Alzheimer’s Foundation. disease or chronic traumatic encephalopathy. This will be achieved by comparing the prevalence of amyloid and tau pathology in TBI and PTSD compared to matched controls. This study will provide objective, Review of mental health impacts of quantifiable measures that can help refute or confirm compensation claim assessment processes linkages established largely from self-reported epidemiological studies. This study is funded by This review for the Department of Veterans’ Affairs NHMRC. examined the mental health impacts of compensation claim assessment processes on claimants and their partners and families. We identified key themes from the literature and reviewed relevant documents. The final report provided suggestions for further research and potential improvements to compensation claim processes to mitigate the risk of negative mental health impacts.
24 Annual Report 2018 - 2019 Higher degree research – Supervision
Phoenix Australia is committed to growing the next generation of traumatic stress researchers. We’d like to acknowledge the fantastic work of our higher degree students.
Long-term impact of disaster on schoolchildren – Greg Ireton Moral injury in military veterans – Anne McDonald Pathways to mental health care and self-managed care in the Australian Defence Force – Helen Benassi Mapping trajectories of psychological adjustment across ADF Life Cycle – Martine Cosgrove Social support following natural disaster – Fanhong Shang Biomarkers associated with PTSD diagnosis – Rahul Khanna The role of emotion regulation in promoting recovery after complex trauma – Hope O’Brian The role of alexithymia in response to PTSD treatment – Andrea Putica HCC as a predictor of PTSD development – Mark Donato Healthy ageing in Vietnam veterans – Loretta Watson Investigation of the differences between adaptive dreams and posttraumatic nightmares as featured in posttraumatic stress disorder – Fiona Henrich The use of television documentary to improve men’s resiliency – Kylie King A novel social media evaluation of the Man Up documentary – Marisa Schlichthorst Mental health and wellbeing in firefighters: Risk and protective factors – Heather Bancroft
International research fellow visitors
This year we welcomed two international research fellows to work with us. Dr Annett Lotzin received a German international scholarship to work at Phoenix Australia for six months in the area of refugee mental health. Jurriaan Jacobs is in the final stages of his PhD and received a Dutch international award to visit and work with us in the area of mental health responses to terrorism.
“Phoenix Australia has an international reputation in the field of posttraumatic mental health, particularly in the development, evaluation and implementation of interventions after disasters and other traumatic events. The fellowship provided an excellent opportunity for me to work with highly experienced and recognised researchers in a very supportive and welcoming work environment.”
Dr Annett Lotzin Senior postdoctoral researcher at University Medical Center Hamburg-Eppendorf, Germany (Postdoctoral research fellow at Phoenix Australia)
Annual Report 2018 - 2019 25 Our Policy and Service Development portfolio
The Policy and Service Development portfolio We provide services in three main areas: provides evidence-based services, advice and • Workplace trauma staff support across government, health and Supporting organisations and agencies to minimise community sectors. Our approach is to work the mental health impact of workplace stress and collaboratively and closely with organisations trauma. We develop tailored frameworks, provide to gain an understanding of the risk and advice on trauma management policy and regulations, review current policies and practices, and develop protective factors for their workforces, and the training and tools to build workforce capacity. systems and processes that support employee • Evidence-based support and treatment wellbeing and performance. We consult widely Promoting evidence-based interventions and support with staff at all levels of the organisation in organisations that offer services to people affected through interviews, focus groups and surveys, by trauma, including through the development of guidelines and programs. reviewing policies and procedures, and considering how those align with national and • Resources for trauma-affected communities Developing tools and resources for people and international research findings and evidence- communities affected by trauma, such as web pages informed and best practice guidelines. We and information booklets, and providing advice then work with the organisation to determine to organisations on how to engage effectively and their priorities and the best approaches for ethically with service users affected by trauma. implementing and sustaining any required changes, such as through frameworks, policies, practices, services and training.
26 Annual Report 2018 - 2019 2018-2019 overview
This year we have worked with a broad range of federal and state government organisations across Australia, not-for-profit and community organisations. 91 38 We have continued to build on our long- Mental health Focus groups standing work with military and veteran and human conducted populations, as well as with police and resources emergency services employees, and have policies reviewed expanded our work to assist judiciary, workers’ compensation, and disability support sectors. 9 7 Literature Training reviews packages conducted developed
organisations we have worked with 3,300+ 25% Participants in online surveys 35%
25% 15% 3 Mental health frameworks Government departments and agencies developed
Emergency services and police
Community organisations
Military and veteran
Annual Report 2018 - 2019 27
Policy and Service Development projects
Information booklets about PTSD for Redevelopment of Defence Community Defence family members Organisation’s resilience programs for children and adolescents The Department of Veterans’ Affairs (DVA) engaged Phoenix Australia to develop information booklets for Children in military families face unique challenges, family members of serving, transitioning or ex-serving including periods of separation from parents, concern members of the Australian Defence Force who are for parent safety during deployment, and frequent experiencing mental health difficulties following trauma. relocation. The Defence Community Organisation We developed five booklets: Supporting your partner, (DCO) offers programs to children and teenagers which When your parent is having problems (for adolescents), aim to foster resilience. DCO approached Phoenix What’s happening to my family? (for children aged 9-12 Australia to review the existing programs and develop years), Helping your child (to assist with parenting of new content and produce train-the-trainer materials. children and adolescents), and Supporting your son or Based on best practice resilience programs aimed daughter (for the parents of members and ex-serving at children, we developed workbooks for children members). Each booklet aims to provide engaging, and facilitator manuals for three programs aimed at practical and personalised information on posttraumatic 6-8 year olds, 9-12 year olds, and 13-17 year olds. stress disorder and other trauma-related mental health The workbooks are engaging and developmentally problems. The booklets provide advice about helping appropriate with illustrations and stories used to yourself and others, effective treatments and support, facilitate learning for younger children. Extensive and getting help. instructions and train-the-trainer materials were developed to ensure that non-professionals are The development of the booklets was a joint effort, thoroughly supported in delivering the programs. and we thank DVA, Open Arms, Defence Community Organisation, and Joint Health Command, as well as members of the Defence and veteran communities, for their thoughtful and considered input. Review of Country Fire Authority’s mental health and wellbeing initiatives Victoria’s Country Fire Authority (CFA) engaged Clinical data collection for Department of Phoenix Australia to conduct a review of CFA’s mental health and wellbeing services and initiatives. A series Veterans’ Affairs’ Trauma Recovery Programs of three reports was delivered. The first report made Phoenix Australia continues to monitor and report on recommendations to enhance CFA’s longstanding the treatment outcomes of Department of Veterans’ peer support program. The second and main Affairs (DVA) funded Trauma Recovery Programs for report, CFA Mental Health and Wellbeing Services: current and ex-serving members of the Australian Review of Best Practice, CFA Wellbeing Framework, Defence Force (ADF) which are currently delivered by 12 and Recommendations, provided information and hospitals across Australia. In the 2018-19 year, a total of recommendations that will assist CFA to implement an 40 cohorts commenced, including 193 veterans and 43 integrated approach to mental health and wellbeing ADF members. The data indicates that modest positive and inform the Mental Health and Wellbeing overall clinical treatment outcomes are being achieved, Framework under development. The third report however, there is much variability between hospitals. presented the views of career firefighters on the mental The data indicated small to moderate improvements on health and wellbeing support services available to most primary and secondary outcomes measures from them, gleaned through interviews. Based on the main intake to discharge, and, for veterans, these changes themes that emerged from the consultation process, appeared to be maintained up to nine months after best-practice recommendations were made to improve treatment. The outcome information is fed back to mental health and wellbeing support services available DVA and individual hospitals for their use. for career firefighters.
28 Annual Report 2018 - 2019
Improving access to care and increasing Development of the National Disability resilience in migrant and refugee populations Insurance Agency mental health framework Phoenix Australia in partnership with the Australian The National Disability Insurance Agency (NDIA) Muslim Women’s Centre for Human Rights (AMWCHR) engaged Phoenix Australia to provide tailored is investigating the barriers and facilitators to accessing information regarding a best practice approach for psychological support experienced by migrant and promoting and supporting the mental health and refugee women exposed to family violence or sexual wellbeing of the NDIA workforce. We conducted a assault. A set of practical recommendations based on literature review to establish good practice principles, research will be developed to help increase access to and reviewed relevant NDIA documents, and we trauma informed care and mental health support. This conducted a workforce environment scan through focus project has been funded by the Helen Macpherson groups, interviews and an online survey. Our findings Smith Trust. were synthesised into a final report, which identified In partnership with AMWCHR we have also examined NDIA strengths and gaps and suggested improvements how to best promote resilience in Muslim families. related to each good practice principle. We conducted a literature review to identify existing approaches to fostering family resilience in vulnerable families and migrant and refugee communities, and developed an intervention aimed at increasing Review of New South Wales Police Force resilience and social participation in Muslim families. workforce health, safety and wellbeing This project was funded by the Victorian Department of The New South Wales Police Force is undertaking a Premier and Cabinet. strategic review and strategy development in the area of workforce health, safety and wellbeing. Phoenix Australia was engaged to conduct a comprehensive review of their approach to managing the mental health Ambulance Victoria psychosocial health of their workforce. Current services will be mapped and wellbeing survey against best practice, allowing the identification of Phoenix Australia was commissioned by Ambulance any gaps. Assistance will then be provided in the Victoria to conduct an organisational survey of staff development of a mental health strategy. and volunteers. More than 1300 staff and volunteers completed the online survey. The survey report highlights: the current status of psychosocial health and wellbeing issues reported by the Ambulance Victoria Review of the Office of the Director of workforce in 2019, changes over time in comparison Public Prosecutions mental health-related with a previous survey administered by Phoenix workplace risks Australia in 2016, as well as potential implications and recommendations for Ambulance Victoria based on the Staff at the Office of the Director of Public Prosecutions survey findings. (ODPP) Western Australia, can be exposed to potentially traumatic information, such as manual and digital imagery, communication with victims and witnesses, and the confronting nature of criminal proceedings. Phoenix Australia was engaged to: 1) conduct a review of the emerging risks and workplace issues, 2) assess the current practices surrounding mental health and traumatic stress support, and 3) suggest improvements and a tailored best practice system. The outcome of this review is intended to enhance the ODPP’s capability to provide evidence- informed, best practice support to staff.
Annual Report 2018 - 2019 29 Policy and Service Development projects
Development of new Australian Guidelines for NSW State Insurance Regulatory Authority the Treatment of Acute Stress Disorder and Recovery Framework extension Posttraumatic Stress Disorder The New South Wales Government State Insurance The Australian Guidelines for the Treatment of Acute Regulatory Authority (SIRA) approached Phoenix Stress Disorder and Posttraumatic Stress Disorder Australia to extend their current Recovery Framework (PTSD) were first developed by Phoenix Australia by developing recommendations for the workplace in 2007 and revised in 2013. We have commenced injury compensation sector. The framework aims to development of the next revision - an online ‘living’ support people injured at work or in a motor vehicle guideline which can be updated as new evidence accident as they travel through the claims process and about effective treatments emerges. For the first time, access health, mental health and return to work services. the guidelines will cover complex PTSD. A Guideline The framework is informed by trauma-informed and Development Group consisting of researchers, recovery oriented care approaches and seeks to ensure clinicians, people with lived experience, and a guideline that people accessing services through a compensable methodologist has been formed to consider the scheme have a client-centred and empowering research. interaction with service providers.
Review of Queensland workers’ compensation Open Arms group program redevelopment scheme In 2019 we completed the redevelopment of four Phoenix Australia undertook a review of the current of the Open Arms group programs. Partnering with workers’ compensation arrangements for emergency the Flinders Human Behaviour and Health Research services workers suffering from posttraumatic stress Unit at Flinders University, Phoenix Australia was disorder (PTSD) and other mental health disorders. engaged by Open Arms to redevelop four of its group The review found a range of commendable practices programs - Recovery from Trauma, Managing Your Pain, and resources within the scheme, and identified Understanding Anxiety, and Doing Anger Differently. opportunities to improve the experience of workers Recognising the need to flexibly respond to the with mental health conditions in their dealings with the treatment needs of veterans and their families, as well scheme, making a total of 30 recommendations. This as current serving personnel, we helped Open Arms to project was funded by the Queensland Government deliver and implement an evidence-informed flexible Office of Industrial Relations. group treatment approach that allows delivery of group treatment in different formats, integrated with new digital material, that can be delivered as part of a suite of Open Arms services.
Queensland Police Service mental health screening advice Phoenix Australia provided advice and recommendations to the Queensland Police Service (QPS) on specific aspects of their mental health screening processes. We conducted a desktop review of QPS screening documentation and policies, and consulted with key QPS staff. The findings and recommendations were informed by a review of the available literature and best practice guidelines on mental health assessment and support provision in military and emergency sector organisations.
30 Annual Report 2018 - 2019 Developing an online trauma recovery resource for the Australian community Phoenix Australia has developed an online trauma recovery resource for the Australian community. Recovery Online provides information and support for people who have experienced any form of trauma, and who are experiencing a range of potential impacts. The website provides simple, easily accessible information about recovery, help-seeking and self-care, including a range of audio-visual resources. The website launched in November 2018. This project was supported by Perpetual and a range of public donors. To find out more visit www.recoveryonline.org.au
Early intervention program review Phoenix Australia conducted two projects related to early responses to community disaster for the Victorian Department of Health and Human Services. 1) We developed a best practice framework to guide the evaluation and continual improvement of the provision of psychological first aid (PFA) following natural disaster. 2) Based on a review of current best practice approaches together with advice from international experts, we identified two screening tools to identify primary-school aged children (one for ages seven and above, and one for younger children) who are experiencing elevated levels of distress following exposure to a disaster.
Annual Report 2018 - 2019 31 Our Practice Improvement and Innovation portfolio
At Phoenix Australia, we believe that giving Delivery framework managers, staff, practitioners and other Typically, our training and workforce development providers the skills and knowledge to provide activities are guided by a three-level framework to practical, effective support and treatment will deliver the most appropriate support and mental health care. enhance the quality of life of those affected by psychological trauma. Level 1 refers to advice and simple practical and emotional support that can be provided in the days Key components of our Practice Improvement and weeks following a traumatic event, aimed at and Innovation portfolio include engaging reducing distress and facilitating recovery. and effective training and workforce Level 2 refers to recovery-oriented approaches development programs as well as supervision to assist those with more persistent posttraumatic and consultation services to meet the needs mental health problems. These approaches are of a diverse range of practitioners and well suited to practitioners with basic counselling skills working in primary care, mental health, and organisations. We also develop and deliver community-based settings. digital, face-to-face or blended training and implementation solutions. Level 3 refers to more intensive evidence-based psychological and pharmacological interventions for people with more chronic and severe distress, including those with diagnosable posttraumatic mental health disorders.
Formal mental 3 health interventions
Simple psychological 2 strategies
Early response 1advice and support
32 Annual Report 2018 - 2019 2018-2019 overview
In 2018-2019, Phoenix Australia’s research-informed training and workforce development programs were delivered to an array of organisations and services as well as individual practitioners and supporters. 1,887 34 Highlights of the year included our work teaching post- trauma practical support skills to managers and staff number of number of working in health and education settings, and trauma practitioners organisations informed care skills for those working in legal and justice trained we delivered settings. We also expanded our work in designing and training for developing innovative digital initiatives and products for specific organisations as well as practitioners and supporters working in the wider community.
Our public and private training and workforce development programs were delivered in metropolitan, regional and rural regions around Australia. During the 99% 91 2018-2019 year, we provided 41 public training events of satisfied participants training events and 50 private training events. Taken together, we delivered 91 training and consultation programs to a total of 1,887 of participants.
Our programs, developed and delivered by highly experienced experts, facilitators and developers continue to receive excellent feedback. Participants and where we delivered programs the organisations we partner with consistently rate our programs highly for quality of content and delivery.
Industries we have worked with
Community health and mental health Media
Child protection Justice and legal services
Sexual violence support Homeless Participant numbers
Adelaide 33 Horsham 11 Education, including schools and universities Ballarat 22 Melbourne 843 Bendigo 22 Mt Isa 47 Alcohol and other drug Insurance Veteran Brisbane 290 Perth 36 Cairns 27 Shepparton 42 Emergency and law enforcement services Canberra 95 Sydney 278 Geelong 42 Townsville 77 Community welfare and support Transport Gippsland 22
Annual Report 2018 - 2019 33 Practice Improvement and Innovation programs
Digital programs Tailored training programs
Phoenix Australia continued to design and deliver Phoenix Australia’s tailored training programs meet innovative and high quality digital products. the training and supervision needs of a diverse range • Digital disaster mental health training platform: of organisations around Australia. funded by the Commonwealth government to upskill primary care and other providers in best practice Trauma Informed Care treatment and support for people impacted by Phoenix Australia continues to expand its training disaster. and supervision offerings for a range of organisations, • Coping with trauma: Strengthening resilience services and workforces in the area of Trauma among rail industry employees eLearning program Informed Care. Our program enables participants to and companion manager guidebook for rail understand the biopsychosocial impacts of trauma, industry organisations affiliated with the TrackSAFE and equips them to provide psychoeducation, Foundation to implement to assist employees manage trauma disclosure, and deliver recovery- impacted by psychological trauma. The eLearning oriented brief interventions. program will be disseminated to almost 30 member rail organisations across Australia. Psychological First Aid • Recovery Online: a website that provides information Psychological First Aid (PFA) is a recommended, and support for community members impacted by practical and flexible approach to providing practical psychological trauma of different types. and emotional support in the immediate aftermath of a traumatic event, such as a disaster, workplace accident, or assault. Increasingly, organisations are wanting their staff and volunteers trained in post- Publicly available training programs incident response to potentially traumatic events.
Phoenix Australia’s public training programs were Resilience delivered around Australia, with 37 workshops Our trauma informed resilience workshops assist scheduled in 2018, and 42 in 2019. The programs organisations to better support the mental health are aimed at mental health, health, welfare, and lay and wellbeing of staff. Our programs identify the personnel who treat and support individuals impacted sources of potential harm, what the impacts can be, by psychological trauma. and importantly, what organisations and individuals Our Trauma-Focussed Psychological Therapy and can do to actively support coping and resilience. Cognitive Processing Therapy training programs teach skills in exposure-based and cognitive therapy to effectively treat posttraumatic stress disorder (PTSD) and related conditions. Small-group consultations following the workshops support practitioners to Supervision implement new skills in their practice. Phoenix Australia provides high quality supervision to Our Anger and Trauma training program provides a range of organisations. Of note, we provided Open practitioners with a set of flexible and effective Arms staff across Australia with regular group-based interventions to address problematic anger among supervision to help support their use of evidence- those affected by trauma-related mental health issues. based therapy and interventions for veterans with The Neuropsychological Impact of Trauma workshop posttraumatic stress disorder and related conditions. enables participants to learn about cognitive impairments commonly associated with trauma and PTSD, their neurobiological underpinnings, and how to identify and address these deficits. Trauma Informed Care training provides a framework for understanding, responding to, and aiding recovery from the impact of psychological trauma. Psychological First Aid training is suited to those who provide support in the immediate aftermath of potentially traumatic events.
34 Annual Report 2018 - 2019 Featured projects
Viewing objectionable materials Impacts of institutional abuse In the past year we have continued to provide training Phoenix Australia provided training sessions to for the Australian Border Force (part of the Department Department of Veterans’ Affairs compensation staff of Immigration and Border Protection), to help a and complex case managers on the impact of variety of staff reduce their risk of psychological harm institutional abuse. The training sought to improve from viewing objectionable materials in the course of staff’s understanding of the psychosocial impacts of their work. The two-day training program integrates sexual and physical abuse in the military and to increase skills training in psychological coping strategies with their skills in responding respectfully to ex-serving learning how to record and rate objectionable materials members presenting with distress and challenging to meet prosecutorial requirements; it is delivered behaviours. Staff self-care was also covered. within a supportive and controlled environment, and is built around a graduated viewing paradigm, where participants are gradually exposed to increasingly Vicarious trauma graphic and/or disturbing material. Viewing sessions are interspersed with skills training in coping strategies Phoenix Australia provides resilience and vicarious and discussions on trauma impacts and ways to trauma training in understanding and managing the minimise risk. impacts of trauma, and strengthening resilience to minimise the likelihood of longer-term mental health impacts, including vicarious trauma. This training has been delivered to state government lawyers and other Prolonged exposure therapy implementation public servants including those involved in the National Funded by EML, Phoenix Australia implemented Redress Scheme for adult survivors of institutional child training plus intensive consultation to improve sexual abuse. psychologists’ beliefs about, and uptake of prolonged exposure therapy, for emergency service clients with posttraumatic stress disorder. Program participation Occupational violence and aggression resulted in improvements in psychologists’ beliefs in post-incident support resources their ability to deliver prolonged exposure to patients as well as an increase in their delivery of prolonged The Department of Health and Human Services exposure to patients. engaged Phoenix Australia to develop a suite of evidence-informed resources to support the consistent delivery of best practice post-incident support for Mental health disaster response Victorian healthcare service employees following occupational violence and aggression. We developed Funded by the Commonwealth government, Phoenix a suite of post-incident support resources and tools for Australia established a mental health advice and health service staff, managers and leaders, as well as consultation service for practitioners supporting people a micro website to house resources, tools and training affected by the 2019 Queensland floods. Over a four- for Victorian healthcare services. Finally, we evaluated month period, practitioners and other supporters in the resources and made recommendations for their affected areas received 57 hours of consultation and implementation. 430 hours of training in early and practical support and interventions.
“Phoenix Australia were very responsive during our mental health activation for the monsoon flooding event in North and Western Queensland in January/ February 2019. The Practitioner Advice Line they implemented was able to complement a raft of psychological support services deployed in the field and provided a safety net for front line practitioners during a highly dynamic and stressful period. They were a great partner to have in the response.”
Ben Norris Manager, Mental Health Drought and Disaster Team, Clinical Excellence Queensland, Queensland Health
Annual Report 2018 - 2019 35 Events in 2018-19
Managing Workplace Trauma: Insights & Learnings
On 22 March 2019 Phoenix Australia and Stand Tall for PTS held an event at the Melbourne Cricket Ground to encourage discussion about mental health and trauma in the workplace. The event was attended by more than 100 people from a range of emergency service organisations and other high risk industry organisations, who heard from a highly experienced panel that included Air Chief Marshal Mark Binskin AC, Former Chief of the Defence Force, Nicole Sadler AM CSC, Director of Policy and Service Development, Phoenix Australia, Tony Dell, Founder, Stand Tall for PTS and Tim Peck, Manager Wellbeing Services, The Police Association of Victoria.
36 Annual Report 2018 - 2019 Events in 2018-19
Meeting of 5-Eyes military and veteran mental health experts
A meeting of military and veteran mental health experts from 5-Eyes nations was held in Sydney on 20 and 21 October 2018. The meeting was held in parallel with the International Veterans’ Ministers 5-Eyes Conference, and the collaboration made a presentation to the ministers on military and veteran suicide prevention.
Led by Phoenix Australia and the Canadian Institute for Military and Veteran Health Research (CIMVHR), the 5-Eyes Mental Health Research and Innovation Collaboration (5-Eyes MHRIC) brings together leaders in research and innovation from the following organisations:
Australia Phoenix Australia – Centre for Posttraumatic Mental Health and the Centenary of Anzac Centre
Canada Canadian Institute for Military and Veteran Health Research
United States of America National Center for PTSD; Center for the Study of Traumatic Stress (CSTS), Uniformed Services University; Walter Reed Army Institute of Research
United Kingdom Combat Stress; King’s College
New Zealand Defence Chief of Mental Health
The 5-Eyes nations have highlighted the need for a policy and problem-solving perspective that takes a lifelong approach – from military service to veteran life, and this group will deliver that. The International Veterans’ Ministers, in a media release, encouraged the expert collaboration to continue their important work and “report back with practical outcomes to be progressed by Veterans’ Affairs agencies”.
Annual Report 2018 - 2019 37 Events in 2018-19
Military and Veteran Mental Health: Innovations in Treatment Practitioner Forum
The two-day Practitioner Forum on 27 to 28 July 2018 in Melbourne was attended by over 400 delegates working in military and veteran mental health. It was an engaging, challenging, and inspiring two days with a theme of innovation, and a focus on what is new, exciting, and challenging in research, treatment, and service delivery.
The forum showcased the offerings of the Centenary of Anzac Centre, with the Minister for Veterans’ Affairs, the Hon Darren Chester MP, launching the Practitioner Support Service on the first day. The forum was a partnership between the Centenary of Anzac Centre, the Departments of Defence and Veterans’ Affairs, and Open Arms - Veterans and Families Counselling. Two master classes were presented by internationally renowned US specialists in military and veteran mental health. Professor Barbara Rothbaum of Emory University is a pioneer in prolonged exposure therapy, and her master class guided delegates through the application of this established evidence-based intervention for the treatment of posttraumatic stress disorder (PTSD). Professor Marylène Cloitre from Stanford University and the National Center for PTSD has developed Skills Training in Interpersonal and Affective Regulation (STAIR) therapy, and she presented a practical demonstration of this effective skills-focussed intervention.
38 Annual Report 2018 - 2019 Events in 2018-19
Supporting Veteran Mental Health - A Day for Staff of Ex-Service Organisations
Sixty-five people from a range of ex-service organisations (ESOs) gathered to meet with Anzac Centre staff at the Anzac Memorial in Hyde Park in Sydney on 29 April 2019 for a day of networking, information gathering, and collaboration. Participants heard from a range of presenters including Sir Angus Houston AK AFC, and Professor Peter Butterworth from the Australian National University who spoke about the social influences on mental health.
The day provided the opportunity for the Anzac Centre to collaborate with ESOs on developing practitioner networks, closer links between ESOs and the Anzac Centre, and ensuring our work meets the needs of those who work at the coalface of client delivery.
Annual Report 2018 - 2019 39 Publications, presentations and dissemination
Journal articles published Lau, W., Silove, D., Edwards, B., Forbes, D., Bryant, R., McFarlane, A., Creamer, M., Hadzi-Pavlovic, D., Steel, Z., Nickerson, A., van Baker, F. A., Metcalf, O., Varker, T., & O’Donnell, M. L. (2018). Hooff, M., Felmingham, K., Cowlishaw, S., Alkemade, N., Kartal, D., A systematic review of the efficacy of creative arts therapies in & O’Donnell, M. L. (2018). An ecological approach to investigating the treatment of adults with PTSD. Psychological Trauma: Theory, the adjustment of refugee children and adolescents in Australia: Research, Practice, and Policy, 10(6), 643-651. doi: 10.1037/tra0000353 Outcomes from wave three of the Building a New Life in Australia Barbano, A. C., Van der Mei, W. F., deRoon-Cassini, T. A., Grauer, study. BMC Medicine, 16, 157. doi: 10.1186/s12916-018-1124-5 E., Lowe, S. R., Matsuoka, Y. J., O’Donnell, M. L., Olff, M., Qi, W., Lau, W., Silove, D., Edwards, B., Forbes, D., Bryant, R., McFarlane, Ratanatharathorn, A., Schnyder, U., Seedat, S., Kessler, R. C., Koenen, A., & Felmingham, K. (2018). Adjustment of refugee children and K. C., & Shalev, A. Y. (2019). Differentiating PTSD from anxiety and adolescents in Australia: outcomes from wave three of the Building a depression: Lessons from the ICD-11 PTSD diagnostic criteria. New Life in Australia study. BMC Medicine, 16(1), 157. doi: 10.1186/ Depression and Anxiety, 36(6), 490-498. doi: 10.1002/da.22881 s12916-018-1124-5 Choi Y. J., O’Donnell, M. L., Choi H. B., Jung H. S., & Cowlishaw, S. Nickerson, A., Hadzi-Pavlovic, D., Edwards, B., O’Donnell, M. (2018). Associations among Elder Abuse, Depression and PTSD in L., Creamer, M., Felmingham K. L., Forbes, D., McFarlane, South Korean Older Adults. International Journal of Environmental A. C., Silove, D., Steel, Z., van Hoof, M., & Bryant, R. A. (2019). Research and Public Health, 15(9), 1948. doi: 10.3390/ijerph15091948 Identifying distinctive psychological symptom profiles among a Forbes, D., Pedlar, D., Adler, A. B., Bennett, C., Bryant, R. A., Busuttil, nationally representative sample of refugees resettled in Australia. W., Cooper, J., Creamer, M. C., Fear, N. T., Greenberg, N., Heber, A., Australian & New Zealand Journal of Psychiatry, 53(9), 908-919. doi: Hinton, M., Hopwood, M., Jetly, R., Lawrence-Wood, E., McFarlane, 10.1177/0004867419846403 A. C., Metcalf, O., O’Donnell, M. L., Phelps, A., Richardson, J. D., Nickerson, A., Liddell, B. J., Keegan, D., Edwards, B., Felmingham K. Sadler, N., Schnurr, P. P., Sharp, M. L., Thompson, J. M., Ursano, R. J., L., Forbes, D., Hadzi-Pavlovic, D., McFarlane, A. C., O’Donnell, M. Van Hooff, M., Wade, D., & Wessely, S. (2019). Treatment of military- L., Silove, D., Steel, Z., Van Hoof, M., & Bryant, R. (2018). Longitudinal related posttraumatic stress disorder: Challenges, innovations, and association between trust, psychological symptoms and community the way forward. International Review of Psychiatry, 31(1), 95-110. doi: engagement in resettled refugees. Psychological Medicine, 49(10), 10.1080/09540261.2019.1595545 1661-1669. doi: 10.1017/S003329171800224 Gallagher, C. H., Block, K., Gibbs, L., Forbes, D., Lusher, D., Reifels, L., Mills, K., Dückers, M., & O’Donnell, M. L. (2019). Molyneaux, R., Richardson, J., Pattison, P., MacDougall, C., & Bryant, Psychiatric epidemiology and disaster exposure in Australia. R. B. (2019). The effect of group involvement on post-disaster Epidemiology and Psychiatric Sciences., 28(3), 310-320. doi: 10.1017/ mental health: a longitudinal multilevel analysis. Social Science and S2045796017000531 Medicine, 220, 167-175. doi: 10.1016/j.socscimed.2018.11.006 Roberts, A., Sharman, S., Landon, J., Cowlishaw, S., Murphy, R., Gibson, K., Haslam, N., & Kaplan, I. (2019). Distressing encounters in Meleck, S., & Bowden-Jones, H. (2019). Intimate partner violence in the context of climate change: Idioms of distress, determinants, and treatment seeking problem gamblers. Journal of Family Violence, response to distress in Tuvalu. Transcultural Psychiatry, 56(4), 667-696. 1-8. doi: 10.1007/s10896-019-00045-3 doi: 10.1177/1363461519847057 Schnabel, A., Youssef, G. J., Hallford, D. J., Hartley, E. J., Gibbs, L., Nursey, J., Cook, J., Ireton, G., Alkemade, N., Roberts, McGillivray, J. A., Stewart, M., Forbes, D., & Austin, D. W. (2019). M., Gallagher, C., Bryant, R., Block, K., Molyneaux, R., & Forbes, Psychopathology in Parents of children with autism spectrum D. (2019). Delayed disaster impacts on academic performance of disorder: A systematic review and meta-analysis of prevalence. primary school children. Child Development, 00, 0, 1-11. doi: 10.1111/ Autism. doi: 10.1177/1362361319844636 cdev.13200 Shalev, A., Gevonden, M., Ratanatharathorn, A., Laska, E., van der Harb, G., Cook, J. M., Phelps, A., Gehrman, P. R., Forbes, D., Mei, W. F., Qi, W., Lowe, S., Lai, B. S., Bryant, R. A., Delahanty, D., Localio, R., Harpaz-Rotem, I., Gur, R. C., & Ross, R. J. (2019). Matsuoka, Y. J., Olff, M., Schnyder, U., Seedat, S., deRoon-Cassini, Randomized Controlled Trial of Imaginary Rehearsal for Posttraumatic T. A., Kessler, R. C., Koenen, K. C., & International Consortium to Nightmares in Combat Veterans. Journal of Clinical Sleep Medicine, Predict PTSD. (2019). Estimating the risk of PTSD in recent trauma 15(5), 757-767. doi: 10.5664/jcsm.7770 survivors: results of the International Consortium to Predict PTSD Karen, K., Robyn, M., Gibbs, L., Alkemade, N., Baker, E., (ICPP). World Psychiatry, 18(1), 77-87. doi: 10.1002/wps.20608 MacDougall, C., Ireton, G., & Forbes, D. (2019). The role of the Shang, F., Kaniasty, K., Cowlishaw, S., Wade, D., Ma, H., & Forbes, natural environment in disaster recovery: “We live here because D. (2019). Social support following a natural disaster: A longitudinal we love the bush”. Health and Place, 57, 61-69. doi: 10.1016/j. study of survivors of the 2013 Lushan earthquake in China. Psychiatry healthplace.2019.03.007 Research, Elsevier, 273, 641-646. doi: 10.1016/j.psychres.2019.01.085 Kartal, D., Alkemade, N., Eisenbruch, M., & Kissane, D. (2018). Yeterian, J. D., Berke, D. S., Carney, J. R., McIntyre-Smith, A., St. Cyr, Traumatic exposure, acculturative stress and cultural orientation: K., King, L., Kline, N. K., Phelps, A., Litz, B. T., & Members of the the influence on PTSD, depressive and anxiety symptoms among Moral Injury Outcomes Project Consortium. (2019). Defining and refugees. Social Psychiatry and Psychiatric Epidemiology, 53(9), 931- measuring moral injury: Rationale, design, and preliminary findings 941. doi: 10.1007/s00127-018-1532-z from the Moral Injury Outcome Scale Consortium. Journal Kartal, D., Alkemade, N., & Kiropoulos, L. (2019). Trauma and of Traumatic Stress, 32(3), 363-372. doi: 10.1002/jts.22380 mental health in resettled refugees: Mediating effect of host language acquisition on posttraumatic stress disorder, depressive and anxiety symptoms. Transcultural Psychiatry, 56(1), 3-23. doi: Books 10.1177/1363461518789538 Wong, D., Hsieh, MY. McKay, A., Haines, K., O’Donnell, M., Ponsford, King, K., Schlichthorst, M., Keogh, L., Reifels, L., Spittal, M. J., Phelps, J. (2019) Cognitive Behavior Therapy for anxiety and depression A., & Pirkis, J. (2018). Can watching a television documentary change – Adapted for brain injury (CBT-ABI). A treatment manual. ASSBI the way men view masculinity? . Journal of Men’s Studies, 27(3), 287- Resources, Sydney, Australia. 306. doi: 10.1177/1060826518815909 King, K., Schlichthorst, M., Turnure, J., Phelps, A., Spitall, M. J., Book chapters & Pirkis, J. (2019). Evaluating the effectiveness of a website about masculinity and suicide to prompt help-seeking. Health Promotion Alisic, E. & Kartal, D. (2019). The role of trauma and cultural distance Journal of Australia. doi: 10.1002/hpja.237 in refugee integration. In Kehoe K., Alisic E. & Heilinger J-C. (Eds.), Responsibility for Refugee and Migrant Integration (pp.113-128). De Gruyter, Berlin/Boston.
40 Annual Report 2018 - 2019 Cooper, J., & Sadler, N. (2019). Trauma-informed mental health Heffernan, K., Crozier, T., Nursey, J., Pacella, B., Freijah, I., care for Australian defence force personnel and veterans. In R. Johnson., L., Little, J., Humphries, M., Stone, C., & Sadler., N Benjamin, J. Haliburn & S. King (Eds.) Humanising Mental Health (2019). The Office of the Director of Public Prosecutions, Western Care in Australia: A Guide to Trauma-Informed Approaches. London: Australia: Review of mental health related workplace risks and best Routledge. practice recommendations executive summary. Melbourne: Phoenix Australia Centre for Posttraumatic Mental Health Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, Reports L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Cash, R., Lau, W., Frederickson, J., Howard, A., Chisholm, K., & – Outcome report: Buderim Private Hospital. Report prepared for McGregor, K.. (2019). Open Arms Group Program Redevelopment the Department of Veterans’ Affairs. Melbourne: Phoenix Australia Project: Final Report. Melbourne: Phoenix Australia Centre for Centre for Posttraumatic Mental Health Posttraumatic Mental Health Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, Couineau, A-L., Gibson, K., Nursey, J., & Humphries, M. (2019). L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Helping your children. Coping with trauma in a military family. – Outcome report: The Geelong Clinic. Report prepared for the Consumer booklet prepared for the Department of Veterans’ Affairs. Department of Veterans’ Affairs. Melbourne: Phoenix Australia Melbourne: Phoenix Australia Centre for Posttraumatic Mental Health Centre for Posttraumatic Mental Health Couineau, A-L., Gibson, K., Nursey, J., & Humphries, M. (2019). Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, Supporting your partner. Coping with trauma in a military family. L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD – Consumer booklet prepared for the Department of Veterans’ Affairs. Outcome report: Greenslopes Private Hospital. Report prepared for Melbourne: Phoenix Australia Centre for Posttraumatic Mental Health the Department of Veterans’ Affairs. Melbourne: Phoenix Australia Couineau, A-L., Gibson, K., Nursey, J., & Humphries, M. (2019). Centre for Posttraumatic Mental Health Supporting your son or daughter. Coping with trauma in a military Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, family. Consumer booklet prepared for the Department of Veterans’ L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic – Outcome report: the Hollywood Clinic. Report prepared for the Mental Health Department of Veterans’ Affairs. Melbourne: Phoenix Australia Couineau, A-L., Gibson, K., Nursey, J., & Humphries, M. (2019). Centre for Posttraumatic Mental Health What’s happening to my family? Consumer booklet prepared for Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, the Department of Veterans’ Affairs. Melbourne: Phoenix Australia L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Centre for Posttraumatic Mental Health – Outcome report: Jamie Larcombe Centre. Report prepared for Couineau, A-L., Gibson, K., Nursey, J., & Humphries, M. (2019). the Department of Veterans’ Affairs. Melbourne: Phoenix Australia When your parent is having problems. Coping with trauma in a Centre for Posttraumatic Mental Health military family. Consumer booklet prepared for the Department Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, of Veterans’ Affairs. Melbourne: Phoenix Australia Centre for L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Posttraumatic Mental Health – Outcome report: The Mater Health Services North Queensland Crozier, T., Gibson, K., Howard, A., Pearce, A., Humphries, M., Private Hospital. Report prepared for the Department of Veterans’ & Wade, D. (2019). Coping with trauma: Strengthening resilience Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic among rail industry employees - manager guidebook. A guidebook Mental Health prepared for the TrackSAFE Foundation. Melbourne: Phoenix Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, Australia Centre for Posttraumatic Mental Health L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Crozier, T., Gibson, K., Howard, A., Pearce, A., Stone, C., & – Outcome report: St. John of God Hospital. Report prepared for Wade, D. (2019). Coping with trauma: Strengthening resilience the Department of Veterans’ Affairs. Melbourne: Phoenix Australia among rail industry employees. An eLearning program prepared for Centre for Posttraumatic Mental Health the TrackSAFE Foundation. Melbourne: Phoenix Australia Centre for Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., Johnson, Posttraumatic Mental Health L., Ye, L., & Phelps, A. (2019). Trauma Recovery Programs - PTSD Crozier, T., McGregor, K., Conroy, R., Mech, P., Wade, D., – Outcome report: Townsville Private Hospital. Report prepared for Dennison, M., Johnson, L., & Humphries, M. (2018). Occupational the Department of Veterans’ Affairs. Melbourne: Phoenix Australia violence and aggression post-incident support resources evaluation Centre for Posttraumatic Mental Health report. Report prepared for the Victorian Government Department of Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., & Phelps, A. Health and Human Services. Melbourne: Phoenix Australia Centre for (2019). Trauma Recovery Programs - PTSD – Outcome report: Baringa Posttraumatic Mental Health. Private Hospital. Report prepared for the Department of Veterans’ Dell, L., Fredrickson, J., Sadler, N., Terhaag, S., O’Donnell, M. L., Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Crane, M., Lewis, V., & Forbes, D. (2019) The Longitudinal Australian Mental Health Defence Force Study Evaluating Resilience (LASER): 2009-2019. A Howard, A., Armstrong, R., Cowlishaw, S., Freijah. I., & Phelps, Summary Report of the Research Program. Report prepared for the A. (2019). Trauma Recovery Programs - PTSD – Outcome report: The Australian Government Department of Defence. Melbourne: Phoenix Marian Centre. Report prepared for the Department of Veterans’ Australia Centre for Posttraumatic Mental Health Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Gibson, K., Forbes, D., & O’Donnell, M. L. (2019). A pilot trial Mental Health of the Skills fOr Life Adjustment and Resilience (SOLAR) program Howard, A., Armstrong, R., Cowlishaw, S., Freijah, I., & Phelps, A. in Tuvalu: Final report – project outcomes. Report prepared for (2019). Trauma Recovery Programs - PTSD – Outcome report: Wesley Australian Research Council. Melbourne: Phoenix Australia Centre for Hospital Ashfield. Report prepared for the Department of Veterans’ Posttraumatic Mental Health Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Heffernan, K., Crozier, T., Nursey, J., Pacella, B., Freijah, I., Mental Health Johnson., L., Little, J., Humphries, M., Stone, C., & Sadler., N Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). (2019). The Office of the Director of Public Prosecutions, Western Trauma Recovery Programs - PTSD – Outcome report: Baringa Australia: Report on the review of mental health related workplace Private Hospital. Report prepared for the Department of Veterans’ risks and best practice recommendations. Melbourne: Phoenix Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Australia Centre for Posttraumatic Mental Health Mental Health
Annual Report 2018 - 2019 41 Publications, Presentations and Dissemination
Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). Lethbridge, R., & Sadler, N. (2019). CFA Mental Health and Trauma Recovery Programs - PTSD – Outcome report: Buderim Wellbeing Services Report: Career Firefighters. Melbourne: Phoenix Private Hospital. Report prepared for the Department of Veterans’ Australia Centre for Posttraumatic Mental Health Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Sadler, N. & Varker, T. (2018). Queensland Police Service Mental Mental Health Health Screening Advice. Melbourne: Phoenix Australia Centre for Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). Posttraumatic Mental Health Trauma Recovery Programs - PTSD – Outcome report: Greenslopes Savic, A., Bowd, C., Mech, P., Brisolla, L., Nursey, J., & Wade, D. Private Hospital. Report prepared for the Department of Veterans’ (2019). Queensland Floods Practitioner Advice Line on Mental Health: Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Final Report. Melbourne: Phoenix Australia Centre for Posttraumatic Mental Health Mental Health Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). Varker, T., Fredrickson, J., Gong, J., Khatri, J., Watson, L. & Trauma Recovery Programs - PTSD – Outcome report: Marian Centre. O’Donnell, M. L. (2018). Meditation and mindfulness practices for Report prepared for the Department of Veterans’ Affairs. Melbourne: mental health: A Rapid Evidence Assessment. Report prepared for Phoenix Australia Centre for Posttraumatic Mental Health the Department of Veterans’ Affairs. Melbourne: Phoenix Australia Howard, A., Armstrong, R., Cowlishaw, S. & Phelps, A. (2019). Centre for Posttraumatic Mental Health. Trauma Recovery Programs - PTSD – Outcome report: Toowong Varker, T., Kartal, D., Metcalf, O., Gong, J., Khatri, J., Sadler, N. Private Hospital. Report prepared for the Department of Veterans’ & O’Donnell, M. L. (2019). Current research in suicide prevention: Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic A continuum framework of prevention and treatment for suicidality. Mental Health Report prepared for the Department of Veterans’ Affairs. Melbourne: Howard, A., Armstrong, R., Kartal, D., Cowlishaw, S. & Phelps, A. Phoenix Australia Centre for Posttraumatic Mental Health. (2019). Trauma Recovery Programs (PTSD) – Clinical Data Collection: Varker, T., Khatri, J., Fredrickson, J., Creamer, M. & O’Donnell, M. Final Report. Report prepared for the Department of Veterans’ L. (2018). Mental health impacts of compensation claim assessment Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic processes on claimants and their families. Report prepared for the Mental Health Department of Veterans’ Affairs. Melbourne: Phoenix Australia Howard, A., Armstrong, R., Terhaag, S., & Phelps, A. (2018). Centre for Posttraumatic Mental Health. Trauma Recovery Programs (PTSD) – Clinical Data Collection: Interim Varker, T., Metcalf, O., Pacella, B., Chisholm, K., Forbes, D. & Report. Report prepared for the Department of Veterans’ Affairs. O’Donnell, M. L. (2018). Recent developments in the treatment and Melbourne: Phoenix Australia Centre for Posttraumatic Mental Health understanding of problematic anger in veterans. Report prepared for Howard, A., Bowd, C., & Wade, D. (2019). Development of an the Department of Veterans’ Affairs. Melbourne: Phoenix Australia accredited online training program on veterans’ mental health for Centre for Posttraumatic Mental Health. Australian general practitioners: Eighth progress report. Melbourne: Watson, L., Fredrickson, J., & Dell, L. (2019). Evaluation of The Way Phoenix Australia Centre for Posttraumatic Mental Health Back Support Service for Ex-Serving Defence Members progress Howard, A., McGregor, K., Johnson, L., Savic, A., Bowd, C., report 4. Report prepared for the Department of Veterans’ Affairs. Freijah, I. & Couineau, A-L. (2019). National Disability Insurance Melbourne: Phoenix Australia Centre for Posttraumatic Mental Agency: Mental health in the workplace: Final report. Melbourne: Health. Phoenix Australia Centre for Posttraumatic Mental Health Howard, A., Putica, A., & Nursey, J. (2018). TrackSAFE Train Conference presentations the Trainer workshop evaluation report. Report prepared for the TrackSAFE Foundation. Melbourne: Phoenix Australia Centre for Chisholm, K., Lau, W., & O’Donnell, M. L. (2019). Mental health Posttraumatic Mental Health impacts of traumatic injury. Presentation at the Royal Melbourne Hospital Senior Nurses Research Day, Melbourne: 18th June 2019 Howard, A., Sbisa, A., & Wade, D. (2018). Development of an accredited online training program on veterans’ mental health for Dell, L. (2018). Enhancing Resilience in the Early Careers of Serving Australian general practitioners: Seventh progress report. Melbourne: Members. Presentation at the Warrior Care Symposium, Sydney: Phoenix Australia Centre for Posttraumatic Mental Health October 16th 2018 Kartal, D., Hinton, M., Fredrickson, J., Nursey, J., O’Donnell, M. Forbes, D. (2018). Challenges to Transition - Pathways to Care. L., Wade, D., Forbes, D., Dell, L., Johnson, L., & Phelps, A. (2018). Presentation at the Veterans’ Transition Forum - The Invictus 18 Centenary of Anzac Centre. Activity Report November-December Symposium, Sydney: 19th October 2018 2018. Melbourne: Phoenix Australia Centre for Posttraumatic Mental Forbes, D. (2018). Large Australian data studies, outcomes of the Health. 5 Eyes Centres of Excellence meeting in Sydney and the potential Kartal, D., Hinton, M., Fredrickson, J., Nursey, J., O’Donnell, M. for future research. Presentation at the NATO Human Factors in L., Wade, D., Forbes, D., Dell, L., Johnson, L., & Phelps, A. (2019). Medicine - Leveraging Technology in Military Mental Health - Big Centenary of Anzac Centre. Activity Report November-December Data and Machine Learning Meeting #4, Canadian Embassy, 2018. Melbourne: Phoenix Australia Centre for Posttraumatic Mental Washington DC, USA: 30th November 2018 Health. Forbes, D. (2018). Pathways to care-serving and e-serving Kartal, D., Hinton, M., Nursey, J., Sadler, N., O’Donnell, M. L., populations. Presentation at the Warrior Care Symposium, Sydney: Wade, D., Forbes, D., Lau, W., Dell, L., Johnson, L., Fredrickson, 17th October 2018 J. & Phelps, A. (2018). Centenary of Anzac Centre. Activity Report Forbes, D. (2019). Responding to others, caring for ourselves. First Quarter 2018-19. Melbourne: Phoenix Australia Centre for Presentation at the Queensland Police Chaplaincy Conference, Posttraumatic Mental Health. Brisbane: 15th May 2019 Lethbridge, R., Phelps, A., Pedder, D. J., Varker, T., & Couineau, A-L. Forbes, D. (2019). Updated guidelines for PTSD in emergency (2019). CFA Mental Health and Wellbeing Support Report: Review of service workers – a webinar. Live webinar for the Australian Society of Best Practice, CFA Wellbeing Framework, and Recommendations. Rehabilitation Counsellors, Melbourne: 24th May 2019 Melbourne: Phoenix Australia Centre for Posttraumatic Mental Health Forbes, D., & Cooper, J. (2019). The mental health impacts of natural Lethbridge, R., Phelps, A., Pedder, D. J., Varker, T., & Couineau, disasters. Presentation at the Association of Pacific Rim Universities A-L. (2018). Country Fire Authority: Review of the Traditional (APRU) Symposium, University of Southern California, Los Angeles, Peer Support Program. Melbourne: Phoenix Australia Centre for USA: 1st-2nd April 2019 Posttraumatic Mental Health
42 Annual Report 2018 - 2019 Publications, Presentations and Dissemination
Forbes, D., & Dell, L. (2018). The Longitudinal ADF Study Resilience Phelps, A. (2019). Innovations and dilemmas in the treatment of Project (LASER): Trajectories of mental health and wellbeing in combat related trauma (including moral injury and complex PTSD). early career. Presentation at the 2018 AMMA Annual Conference, Presentation for The Mental Health of Armed Forces Veterans: What’s Canberra, 12th October 2018 the current state of play?, Royal College of Psychiatrists, London, UK: 20th May 2019 Forbes, D., & Sadler, N. (2018). Pathways to Care in Transitioned ADF Members & Regular ADF Members in 2015: Results from Phelps, A. (2018). Innovations in research in the nature and treatment Pathways to Care Report. Presentation at the 2018 AMMA Annual of REM-related parasomnias and sleep disturbance in PTSD. Chair of Conference, Canberra, 12th October 2018. symposium at the Sleep DownUnder Annual Scientific Meeting 2018, Brisbane: 19th October 2018 Gibson, K., Forbes, D., & O’Donnell, M. L. (2019). Skills for Life Adjustment and Resilience (SOLAR) – A pilot study in Tuvalu. Sadler, N. (2019). Developing and delivering graded exposure Presentation at the 7th World Congress of Asian Psychiatry, Sydney: training to enhance resilience. Presentation at the Mental Health 22nd-25th February 2019 Strategies for First Responders Conference, Melbourne: 7th March 2019 Kartal, D. (2019). Integration…What is it really and how do we pursue it? Responsibility for Refugee and Migrant Integration Workshop. Sadler, N. (2019). PTSD in contemporary veterans. Presentation at Workshop at the Melbourne Social Equity Institute, University of the Royal United Services Institute – Victoria (RUSI Vic) meeting, Melbourne, Melbourne: 21st February 2019 Canberra: 27th June 2019 Nursey J. (2019). Military Families in Transition. Presentation at the Sadler, N. (2018). Suicidality: considerations for individuals and NUSC-CIMVHR International Military Research Summit, Los Angeles, organisations. Presentation at the Converge International Annual USA: 11th-13th February 2019 Conference, Melbourne, 3rd December 2018 Nursey, J. (2019). Theta Burst Stimulation as a treatment for PTSD in Sadler, N. (2019). Trauma informed practice (including Posttraumatic veterans. Chair of meeting at the 3rd International Brain Stimulation Stress Disorder – Diagnosis and Guidelines). Presentation at the Conference, Vancouver, Canada: 24th-27th February 2019 Interdepartmental Forum of Workplace Mental Health (IFMH), Canberra: 20th March 2019 Nursey, J. (2018). Navigating the evidence path for Posttraumatic Mental Health interventions. Presentation at the Converge Sadler, N., & Parker, P. (2019). Current, new and innovative evidence- International Staff Conference, Sydney, December 2018 based treatments for veterans. Presentation at the ‘Breaking Down the Barriers’ Veteran Mental Health Symposium, Sydney: 15th March Nursey, J. (2018). Rebuilding communities after a disaster – A 2019 psychosocial perspective. Presentation at the Victorian Emergency Management Institute Community Response Conference, Sadler, N., Parker, P., Heffernan, K., & Lane, D. (2019). Making Melbourne, November 2018 sense of veteran mental health presentations. Live webinar and panel discussion at the Mental Health Professionals Network Online Nursey, J. (2018). Navigating the evidence path for Posttraumatic Conference: 28th May 2019 Mental Health interventions. Presentation at the Employee Assistance Professionals Association of Australia (EAPAA) Conference, Sydney, Shigemura, J., O’Donnell, M. L., Fukuchi, N., & Gibson, K. (2019). August 2018 Disaster, trauma and resilience: findings from Australia and Japan. Presentation at the 7th World Congress of Asian Psychiatry, Sydney: Nursey, J. & Forbes, D., (2018). Evaluating the effectiveness of Theta 22nd February 2019 Burst Stimulation as a treatment for PTSD in an Australian Veteran Population. Presentation at the 2018 AMMA Annual Conference, Wade, D., Couineau, A-L., Cash, R., & Nursey, J. (2018). Canberra: 12th October 2018 Prolonged Exposure Therapy: Training and Support Program for Private Psychologists in Australia. Poster presentation at the 34th Nursey, J., O’Donnell, M. L., Creamer, M., & Hopwood, M. (2019). International Society for Traumatic Stress Studies Conference, Current updates in veteran and military mental health research. Live Washington DC, USA: 7th-10th November 2018 webinar and panel discussion for the Mental Health Professionals Network Online Conference: 28th May 2019 O’Donnell, M. L. (2018). Recalibrating attention processes to achieve better health outcomes – Stepping Out Attention Reset Trial. Presentation at the Warrior Care Symposium, Sydney: 16th October 2018 O’Donnell, M. L., Lau, W., Fredrickson, J., Bryant, R.A., Bisson, J., Burke, S., Busuttil, W., Coghlan, A., Creamer, M., Gray, D., Greenberg, N., McDermott, B, McFarlane, A.C., Monson, C., Phelps, A., Ruzek, J., Schnurr, P.P., Ugsang, J., Watson, P., Whitton, S., Williams, R., Cowlishaw, S., & Forbes, D. (2019). Promoting adjustment following disaster. The Skills for Life Adjustment and Resilience Program. Presentation at the 7th World Congress of Asian Psychiatry, Sydney: 22nd-25th February 2019 Phelps, A. (2018). An ambulatory PSG study of the posttraumatic nightmares of PTSD. Presentation at the Sleep DownUnder Annual Scientific Meeting 2018, Brisbane: 19th October 2018. Phelps, A. (2019). Best Practice approach to managing trauma in high-risk organisations. Presentation at the Melbourne Clinic, Melbourne: 10th April 2019 Phelps, A. (2018) Emerging evidence of the impact of moral injury. Presentation at the Warrior Care Symposium, Sydney: 17th October 2018
Annual Report 2018 - 2019 43 Our staff
Phoenix Australia employees as at 30 June 2019
Management Group Our people
Professor David Forbes Director James Agathos Research Assistant Dr Abdullah Arjmand Research Fellow I Associate Professor Deputy Director Andrea Phelps Dr Renée Armstrong Research Fellow I
Dr John Cooper Consultant Psychiatrist Courtney Bowd Research Assistant Lucia Brisolla Brand and Marketing Manager Head of Strategy and Paul Dolan Operations Dr Katherine Chisholm Research Fellow I Professor Head of Research and Dr Sean Cowlishaw Senior Research Fellow Meaghan O’Donnell Evaluation Tilly Crozier Senior Clinical Specialist Head of Policy and Service Nicole Sadler Dr Carolyn Deans Senior Clinical Specialist Development Dr Lisa Dell Senior Research Fellow Associate Professor Head of Practice Improvement and Professor David Dunt Senior Evaluation Specialist Darryl Wade Innovation Suzie Firth Centre Manager Dr Julia Fredrickson Clinical Research Specialist Isabella Freijah Research Assistant Senior Leadership Team Dr Kari Gibson Research Fellow I Jaiganesh Govinda Swamy Finance Manger Director, Policy and Anne-Laure Couineau Service Development Kristi Heffernan Senior Clinical Specialist Maria Humphries Communications Manager Director, Centenary of Anzac Dr Mark Hinton Centre Treatment Research Lucinda Johnson Research Fellow II Collaboration Dr Kim Jones Research Fellow I Acting Director, Policy and Alexandra Howard Service Development - Dr Dzenana Kartal Research Specialist Veterans and Community Juhi Khatri Research Assistant Director, Centenary of Anzac Jane Nursey Centre Practitioner Support Dr Winnie Lau Senior Clinical Research Specialist Service Dr Ros Lethbridge Clinical Specialist Dr Jonathon Little Research Fellow I Julie Mastrodomenico Senior Clinical Specialist Kari McGregor Research Fellow I Dr Paulina Mech Research Fellow I
44 Annual Report 2018 - 2019 During the 2018-2019 financial year, we welcomed
Lucinda Johnson Research Fellow Director Centenary of Anzac Lee Merzel Executive Assistant Dr Mark Hinton Centre Treatment Research Collaboration Dr Olivia Metcalf Research Fellow II Lucia Brisolla Brand and Marketing Manager Dr Kim Murray Clinical Research Specialist Isabella Freijah Research Assistant Corporate Services Veronica Ong Administrator Anita Savic Senior Clinical Specialist Amanda Pearce Research Assistant Courtney Bowd Research Assistant Dr David Pedder Research Fellow II Caleb Stone Research Assistant Daniel Redman IT Officer Dr Abdullah Arjmand Research Fellow Anita Savic Senior Clinical Specialist Dr Carolyn Deans Senior Clinical Specialist Dr Alyssa Sbisa Research Fellow I Corporate Services Veronica Ong Administrator Rebecca Sheehan Business Services Officer Kristi Heffernan Senior Clinical Specialist Caleb Stone Research Assistant James Agathos Research Assistant Dr Tracey Varker Senior Research Fellow Julie Mastrodomenico Senior Clinical Specialist Loretta Watson Research Assistant Dr Kim Jones Research Fellow
Honorary staff members This year we farewelled Professor Richard Bryant Professorial Fellow
Professor Mark Creamer Professorial Fellow Dr Richard Cash, Director, Education and Training; Dr Rowena Conroy, Senior Clinical Specialist; Dr Peter Elliott Senior Fellow Dr Ellie Brown, Research Fellow; Dr Holly Knight, Clinical Associate Professor Research Specialist; Dr Naomi Ralph, Research Fellow; Principal Fellow Virginia Lewis Belinda Pacella, Research Assistant; Dr Andrea Putica, Professor Reg Nixon Principal Fellow Research Fellow; and Dr Sonia Terhaag, Research Fellow.
We thank them all for their hard work and commitment during their time with Phoenix Australia and wish them well in their future careers.
Annual Report 2018 - 2019 45 Governance and management
The Phoenix Australia Board of Management Board members as at 30 June 2019 is led by an independent chair and includes Mrs Janine Kirk AM representatives from the Department of Veterans’ Mr Paul Dolan Affairs, the Australian Defence Force and the Mr John Fely University of Melbourne. It also includes an Professor David Forbes independent secretary, two further independent Professor Malcolm Hopwood directors and the executive positions of Director Major General Mark Kelly AO DSC of Phoenix Australia and Executive Manager Ms Lesley Podesta Business Planning & Strategy. Mr Greg Ridder Air Vice-Marshal Tracy Smart AO
Board meetings and attendance
AGM 4/7/18 29/8/18 26/9/18 21/11/18 21/11/18 28/2/19 7/5/19 27/6/19
His Honour Michael Strong • • • • • •
Mrs Janine Kirk AM • •
Ms Gayle Anderson •
Mr Paul Dolan • • • • • • • •
Mr John Fely • • • • • •
Professor David Forbes • • • • • • • •
Professor Malcolm Hopwood • • • • • • • •
Major General Mark Kelly • • • • • • • •
Ms Lesley Podesta • • • • •
Mr Greg Ridder • • • • • • •
Air Vice-Marshal Tracy Smart • • • • • •
AGM attendance • Attendance Non-appointment at time of meeting
46 Annual Report 2018 - 2019 Significant events
Board appointments, cessations, resignations and re-appointments
The following movements relating to the Board of Management occurred during the 2018 – 2019 year: • Ms Gayle Anderson resigned from the Board on 13 August 2018. • Mr John Fely was appointed to the Board on 29 August 2018. • Ms Lesley Podesta was appointed to the Board 1 November 2018. • His Honour Michael Strong assumed the role of Honorary Chair effective 7 January 2019 and resigned from the Board on 31 March 2019. • Mr Greg Ridder was appointed Interim Chairperson 1 April - 30 April 2019 • Mrs Janine Kirk AM was appointed to the Board as Chair on 1 May 2019. • Major General Mark Kelly AO DSC resigned from the Board 30 June 2019.
Senior staff appointments Professor David Dunt was appointed as casual Senior Evaluation Specialist, with effect from 7 January 2019.
Annual Report 2018 - 2019 47 Board of Management Report For the year ended 30 June 2019
The Board of Management submit the financial accounts of Phoenix Australia Centre for Posttraumatic Mental Health Inc for the financial year ended 30 June 2019.
Board Members The Board of Management in office at any time during or since the end of the year are: Mrs Janine Kirk AM (Chair) (Appointed 01-05-2019) Major General Mark Kelly AO DSC (Resigned 30-06-2019) His Honour Michael Strong (Chair) (Resigned 31-03-2019) Professor David Forbes Mr John Fely (Appointed 29-08-2018) Mr Greg Ridder (Appointed Interim Chair 01-04-2019 to Ms Lesley Podesta (Appointed 01-11-2018) 30-04-2019) Professor Malcolm Hopwood Mr Paul Dolan Air Vice-Marshal Tracy Smart AO Ms Gayle Anderson (Resigned 13-08-2018)
Board members have been in office since the start of the financial year to the date of this report unless otherwise noted.
Principal Activities The principal activities of the Association during the year were to build the capability of individuals, communities and organisations to prevent, recognise and reduce the adverse mental health effects of trauma. The Association achieves this through world class research, policy and service development, and education and training.
Operating Results The operating result for the year was a surplus of $95,861 (2018: $323,389). The Association is exempt from income tax.
Significant Changes in State of Affairs In the opinion of the Board of Management, there were no significant changes in the state of affairs the Association that occurred during the financial year under review not otherwise disclosed in this report.
After Balance Date Events There has not arisen in the interval between the end of the financial year and the date of the report any item, transaction or event of a material and unusual nature that in the opinion of the Board is likely to substantially affect the operations of the Association, the results of those operations or the Association’s state of affairs in future financial years.
Future Developments The Association will continue to carry on the principal activities noted above. There are no likely developments in the activities in future years which will affect the results and therefore require disclosure.
Indemnification and Insurance of Board During the year, the Association paid insurance premiums to Comcover to indemnify its current Board of Directors and officers for the professional risks associated with their responsibilities and roles as Board of Directors and officers of the Association.
Signed in accordance with a resolution of the Board of Management on 26th September 2019.
Mrs Janine Kirk AM Professor David Forbes Chair Director
48 Annual Report 2018 - 2019 Statement of Profit or Loss and Other Comprehensive Income For the year ended 30 June 2019
Notes 2019 2018 $ $ Income DVA Core Funding 13 1,372,607 1,346,697 Centenary of Anzac Centre 16 (a) & (b) 2,300,158 1,067,904 Policy and Service Improvement and Advice Income 1,423,106 1,473,127 Research Income 2,354,559 1,620,977 Training and Education Income 1,305,090 860,155 Publications and Audio Visual Sales 4,231 8,353 Donations 951 2,642 Income from other activities 14 18,862 44,915
Total income 8,779,564 6,424,770
Expenditure Consultants Fees 12 (a) 73,971 23,707 Contractors Fees 12 (b) & (c) 902,364 546,008 Employment Expense 6,391,962 4,299,205 Depreciation and Amortisation 45,129 50,822 Independent Board Member Fees 33,035 42,000 Printing and Production 85,151 94,368 Travel and Accommodation 370,588 220,573 Phoenix Rent 233,225 207,378 Royal Park Site Establishment Expenses 17 - 206,128 General Expenses 652,003 458,086
Total Expenditure 8,787,426 6,148,274
Operating profit / (loss) (7,862) 276,496
Other Income Interest Received 103,722 46,892
Net surplus for the year 95,861 323,389
STATEMENT OF CHANGES IN EQUITY
Accumulated surplus at the beginning of the financial year 1,575,344 1,251,955
Net surplus for the year 95,861 323,389
Accumulated surplus at the end of the financial year 1,671,204 1,575,344
The Statements should be read in conjunction with the notes to the accounts.
Annual Report 2018 - 2019 49 Statement of Financial Position As at 30 June 2019
Notes 2019 2018 $ $ Current Assets Cash and Cash Equivalents 2 4,513,310 3,132,669 Trade and Other Receivables 3 1,408,401 1,667,969 Other Assets 4 175,230 111,879 Work in Progress / Advance 1 (b) 1,412,028 1,217,066
Total Current Assets 7,508,969 6,129,583
Non-Current Assets Property, Plant & Equipment 5 35,306 49,382 Intangible Assets 6 28,728 54,014
Total Non-Current Assets 64,034 103,396
Total Assets 7,573,003 6,232,979
Current Liabilities Trade and Other Payables 7 3,648,646 1,765,440 Borrowings 8 50,534 30,201 Other Liabilities 9 2,202,619 2,861,995
Total Current Liabilities 5,901,799 4,657,635
Net Assets 1,671,204 1,575,344
Funds Accumulated Surplus 1,671,204 1,575,344
Total Funds 1,671,204 1,575,344
The Statement of Financial Position should be read in conjunction with the notes to the accounts.
50 Annual Report 2018 - 2019 Statement of Cash Flows For the year ended 30 June 2019
Notes 2019 2018 $ $ Cash flows from operating activities Receipts from sales and activities 23,093 53,268 Operating income received 8,356,664 8,103,341 Payments to suppliers and employees (7,097,073) (6,453,021)
Net cash provided / (used in) operating activities 10 (b) 1,282,684 1,703,588
Cash flows from investing activities Interest received 103,722 46,892 Payments for furniture and equipment (5,766) (28,606)
Net cash provided by / (used in) investing activities 97,956 18,286
Net increase / (decrease) in cash held 1,380,641 1,721,874
Cash and cash equivalents at the beginning of the financial year 3,132,669 1,410,795
Cash and cash equivalents at the end of the financial year 10 (a) 4,513,310 3,132,669
The Cash Flow Statement should be read in conjunction with the notes to the accounts.
Annual Report 2018 - 2019 51 Notes to the Financial Statements For the year ended 30 June 2019
Note 1: Statement of Significant Accounting Policies This financial report is a special purpose report prepared for use by the Board of Management to satisfy the financial reporting requirements of the Associations Incorporation Reform Act 2012. The Board of Management have determined that the Association is not a reporting entity. The financial report covers Phoenix Australia Centre for Posttraumatic Mental Health Inc as an individual entity and as an association incorporated in Victoria under the Associations Incorporation Reform Act 2012. The report has been prepared in accordance with the requirements of the Associations Incorporation Reform Act 2012 and the following Australian Accounting Standards: AASB 101: Presentation of Financial Statements AASB 107: Statement of Cash Flows AASB 108: Accounting Policies, Changes in Accounting Estimates and Errors AASB 110: Events after the Reporting Period AASB 116: Property, Plant and Equipment AASB 117: Leases AASB 118: Revenue AASB 138: Intangible Assets
The following Accounting Standards have been issued but are not yet effective: AASB 15 Revenue from Contracts with Customers. AASB 16 Leases Any new, revised or amending Accounting Standards or Interpretations that are not yet mandatory have not been early adopted. The expected impact on the financial statements of the Accounting Standards that have been issued but are not yet effective are yet to be determined. The financial report is prepared on an accrual basis and is based on historical costs and does not take into account changing money values or, except where specifically stated, current valuations of non-current assets. The following is a summary of the material accounting policies adopted by the association in the preparation of the financial report. The accounting policies have been consistently applied, unless otherwise stated.
(a) Property, Plant & Equipment Each class of plant and equipment is carried at cost, less, where applicable, any accumulated depreciation.
Furniture and Office Equipment Furniture and office equipment is measured on a cost basis.
Depreciation All fixed assets are depreciated on a diminishing value basis over their useful lives to the Association.
Intangible Assets Assets related to systems and software are carried out at cost, less accumulated amortisation. Systems and software costs are amortised on a straight line basis over 5 years.
Impairment of Assets Assets are assessed for impairment annually. Any excess of an asset’s carrying amount over its recoverable value is recognised immediately as an expense in profit or loss.
52 Annual Report 2018 - 2019 (b) Unearned Income the liability for unearned income is the unutilised amount of grants received on the condition that specified services are delivered or conditions are fulfilled. Whilst agreed services are usually provided or the conditions usually fulfilled within 12 months of receipt of the grant, where some portion of the agreed services is yet to be provided as at the end of the financial year, a provision is recognised based on the estimated amount of services that will be provided after year end.
Work in Progress / Advance Represents any preliminary work undertaken for a project where the contract is yet to be signed or when work under contract is in progress but not yet billed.
(c) Taxation Income Tax the Association is a tax concession charity for the purposes of Australian taxation legislation and is therefore exempt from income tax. This exemption has been confirmed by the Australian Taxation Office.
Goods and Services Tax (GST) Revenues, expenses and assets are recognised net of the amount of GST except where the amount of GST incurred is not recoverable from the Australian Taxation Office, in which case it is recognised as part of the cost of acquisition of an asset or as part of an item of expense.
(d) Operating Leases lease payments for operating leases, where substantially all the risks and benefits remain with the lessor, are recognised as expenses on a straight-line basis over the lease term.
Note 2: Cash and Cash Equivalents 2019 2018 $ $ Petty Cash 829 297 Cash at Bank - NAB Public Fund Account 5,609 44,683 Cash at Bank - NAB Cheque Account 1,479,302 2,166,222 Term Deposit - NAB (Bank Guarantee) 150,000 90,289 Term Deposit - NAB (Investment I) 851,958 831,178 Term Deposit - NAB (Investment II) 506,645 - Term Deposit - NAB (Investment III) 1,518,968 -
4,513,310 3,132,669
Annual Report 2018 - 2019 53 Note 3: Trade and Other Receivables Notes 2019 2018 $ $ Current Trade Debtors 1,385,341 1,652,628 Security Deposit 23,060 15,341
1,408,401 1,667,969
Note 4: Other Assets Current Interest Accrued 23,032 8,824 Prepayments 100,567 52,976 Other Current Assets 15 51,631 50,079 175,230 111,879
Note 5: Property, Plant and Equipment Furniture & Office Equipment 508,306 539,434 Less: Accumulated Depreciation (473,000) (490,052) 35,306 49,382
Note 6: Intangible Assets Project Management System 59,125 59,125 Less: Accumulated Amortisation (59,125) (59,125) Website Development 111,759 111,759 Less: Accumulated Amortisation (85,477) (63,125) Toolbox Database and Report System 37,501 37,501 Less: Accumulated Amortisation (35,055) (32,120) 28,728 54,014
Note 7: Trade and Other Payables Current Trade Creditors 1,686,644 77,773 Accruals 1,929,155 1,588,601 GST Owing 32,847 99,066 3,648,646 1,765,440
Note 8: Borrowings Current Credit Cards 50,534 30,201 50,534 30,201
54 Annual Report 2018 - 2019 Note 9: Other Liabilities Notes 2019 2018 $ $ Current Unearned Income 2,202,619 2,861,995
2,202,619 2,861,995
Note 10: Notes to the Cash Flow Statement (a) Reconciliation of cash and cash equivalents For the purposes of the Cash Flow Statement, cash and cash equivalents includes cash on hand and in banks and investments in money market instruments, net of outstanding bank overdrafts. Cash and cash equivalents at the end of the financial year as shown in the Cash Flow Statement is reconciled to the related items in the Statement of Financial Position as follows:
Petty Cash 829 297 Cash at Bank - NAB Public Fund Account 5,609 44,683 Cash at Bank - NAB Cheque Account 1,479,302 2,166,222 Term deposit - NAB (Bank Guarantee) 150,000 90,289 Term deposit - NAB (Investment I) 851,958 831,178 Term deposit - NAB (Investment II) 506,645 - Term deposit - NAB (Investment III) 1,518,968 -
4,513,310 3,132,669
(b) Reconciliation of surplus / (deficit) for the year to net cash flows from operating activities Net surplus / (deficit) for the year 95,861 323,389 Depreciation 19,843 25,525 Amortisation of intangibles 25,286 25,299 Net finance income (103,722) (46,892) Changes in assets and liabilities, net of effects from acquisitions and disposals of business: (Increase) / decrease in assets Trade and other receivables 259,568 (545,583) Other assets (258,313) (618,913)
Increase / (decrease) in liabilities Trade and other payables 1,883,206 237,763 Borrowings 20,332 25,579 Provisions (659,375) 2,277,423
Net cash from operating activities 1,282,684 1,703,588
Annual Report 2018 - 2019 55 Note 11: Lease Commitments and Bank Guarantee 2019 2018 $ $ (a) Lease Commitments Current (less than 12 months) 186,149 60,536 Non Current (more than 12 months) 248,192 -
434,341 60,536
The operating lease exists in relation to office rent. The lease extended for a term of 3 years ending on 31 October 2021. Bank guarantees totalling $150,000 are in place at 30 June 2019 in respect of credit card facilities.
Note 12: Contractors and Consultants (a) Consultants Person or company who undertakes a contract to provide specialised advice and/or labour to Phoenix Australia. Consultants usually perform work outside of the skillsets available across Phoenix Australia staff.
(b) Contractors Person or company who undertakes a contract to provide labour and/or materials to perform a service for and/or on behalf of Phoenix Australia. Contractors usually perform overflow work that Phoenix Australia would otherwise be able to perform itself given greater availability of internal resources.
(c) Contractors include Co-partners A Co-partner is a person or company who undertakes a large portion of the work in a particular project, perhaps even a larger portion than that undertaken by Phoenix Australia. Co-partners are hence project-specific. Co-partners usually perform major functions in a project that fall outside of the skillsets of Phoenix Australia staff, although, Phoenix Australia has been determined “lead” partner in these projects.
Note 13: DVA Core Funding DVA provides financial assistance to Phoenix Australia, to provide a national base of expertise in veteran and military mental health to improve and maintain the health care and wellbeing of the veteran and defence force communities and provide support to DVA in respect of mental health policy, program development and service. The funding is acquitted similarly to other Phoenix Australia projects, with its own budget and control measures to demonstrate fulfilment of funding purposes and objectives.
Note 14: Income from Other Activities This includes income from donations, attendance at various meetings and other sundry income.
Note 15: Other Current Assets This includes reimbursable expenses for project related activities and security deposits held in respect of the offices leased in Canberra, Brisbane, Sydney and Adelaide.
Note 16: Centenary of Anzac Centre Represents a Commonwealth grant provided to Phoenix Australia to establish and operate the Centenary of Anzac Centre consisting of a Practitioner Support Service and Treatment Research Collaboration to improve the mental health outcomes of serving and former-serving Australian Defence Force members. The funding is provided as part of the Support to Veterans and Their Families Program.
(a) This Statement of Income and Expenditure has been prepared to meet the requirements of the Commonwealth Grant Agreement to establish and operate the Centenary of Anzac Centre.
56 Annual Report 2018 - 2019 Statement of Income and Expenditure For the year ended 30 June 2019
2019 2018 $ $ Income Grant Funding carried forward 1,929,774 - Grant Funding received during the year 2,000,000 3,000,000
Expenses Salaries acquitted 1,690,730 514,040 Advertisment 28,671 3,544 Contractors and Consultants 364,852 233,950 Design, Printing and Production 15,510 24,453 Travel and Accommodation 80,699 21,031 Venue Hire and Catering 76,733 5,613 Royal Park site establishment - 227,163 General expenses 19,258 9,582 Furniture and equipment at cost - 13,903 Rent 21,595 14,701 Outgoings 2,110 2,245
Total Expenses 2,300,158 1,070,226
Grant Funding to be carried forward 1,629,616 1,929,774
The expenses as reported in the above Statement of Income and Expenditure have been spent in accordance with the grant agreement required to be incurred by Phoenix Australia on the agreed project as detailed in the funding agreement.
( b) For the purposes of Phoenix Australia’s financial statements, Centenary of Anzac Centre income is only brought to account to the extent of expenditure incurred on the project. Any remaining project funding received (that is yet to be spent) is carried as unearned income in accordance with the policy outlined at Note 1(b). Reconciliation from the Centenary of Anzac Centre Statement of Income and Expenditure to the Phoenix Australia Statement of Profit or Loss and Other Comprehensive Income
2019 2018 $ $ Expenditure incurred per the Centenary of Anzac Centre 16 (a) 2,300,158 1,070,226 Statement of Income and Expenditure
Less: Minor timing differences - (2,322)
Income per the Phoenix Australia Statement of Profit or Loss 2,300,158 1,067,904 and Other Comprehensive income
Note 17: Royal Park Site Establishment Expenses This includes the costs for establishing and renovating the leased facility to standard required for the Treatment Research Clinic operations, for the Centenary of Anzac Centre.
Annual Report 2018 - 2019 57 Board of Management Declaration
The Board of Management has determined that the Association is not a reporting entity.
The Board of Management has determined that this special purpose financial report should be prepared in accordance with the accounting policies described in Note 1 to these financial statements.
In the opinion of the Board of Management:
1 the financial statements and notes to the financial statements for the year ended 30 June 2019 present fairly the financial position of the association at 30 June 2019 and the results of its operations for the year then ended in accordance with the accounting policies described in Note 1 to the financial statements. .
2 there are reasonable grounds to believe the Association will be able to pay its debts as and when they become due and payable.
This declaration is made in accordance with a resolution of the Board and is signed for and on behalf of the Board on 26th September 2019.
Mrs Janine Kirk AM Professor David Forbes Chair Director
58 Annual Report 2018 - 2019 Independent Auditor’s Report
To the Members of Phoenix Australia Centre for Posttraumatic Mental Health Inc.
Opinion We have audited the accompanying financial report, being a special purpose financial report, of Phoenix Australia - Centre for Posttraumatic Mental Health Inc. (the Association), which comprises the statement of financial position as at 30 June 2019, statement of profit or loss and other comprehensive income, statement of changes in equity, cash flow statement, a summary of significant accounting policies, other explanatory notes and the statement by the Board of Management. In our opinion, the financial report of Phoenix Australia - Centre for Posttraumatic Mental Health Inc. presents fairly, in all material respects the financial position of the association as of 30 June 2019 and of its financial performance for the year then ended in accordance with the accounting policies described in Note 1 to the financial statements.
Basis of Opinion We conducted our audit in accordance with Australian Auditing Standards. Our responsibilities under thosestandards are further described in the Auditor’s Responsibilities for the Audit of the Financial Report section of our report. We are independent of the association in accordance with the auditor independence requirements of the Corporations Act 2001 and the ethical requirements of the Accounting Professional and Ethical Standards Board’s APES 110 Code of Ethics for Professional Accountants (the Code) that are relevant to our audit of the financial report in Australia. We have also fulfilled our other ethical responsibilities in accordance with the Code. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. We confirm that the independence declaration required by the Corporations Act 2001, which has been given to the Board of Management of the Association, would be in the same terms if given to the Board of Management as at the time of this auditor’s report.
Basis of Accounting and Restriction on Distribution Without modifying our opinion, we draw attention to Note 1 to the financial report, which describes the basis of accounting. The financial report has been prepared to assist Phoenix Australia - Centre for Posttraumatic Mental Health Inc. to meet the requirements of the Associations Incorporation Reform Act 2012. As a result, the financial report may not be suitable for another purpose.
Other Information The Board of Management is responsible for the other information. The other information comprises the information in the Association’s annual report for the year ended 30 June 2019, but does not include the financial report and the auditor’s report thereon. Our opinion on the financial report does not cover the other information and we do not express any form of assurance conclusion thereon. In connection with our audit of the financial report, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial report or our knowledge obtained in the audit or otherwise appears to be materially misstated. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.
Annual Report 2018 - 2019 59 Board of Management’s Responsibility for the Financial Report The Board of Management of the Association is responsible for the preparation and fair presentation of the financial report and have determined that the accounting policies described in Note 1 to the financial statements, which form part of the financial report, are consistent with the financial reporting requirements of the Associations Incorporation Reform Act 2012 and are appropriate to meet the needs of the members. The Board of Management’s responsibilities also include establishing and maintaining internal control relevant to the preparation and fair presentation of the financial report that is free from material misstatement, whether due to fraud or error; selecting and applying appropriate accounting policies; and making accounting estimates that are reasonable in the circumstances.
Auditor’s Responsibility Our objectives are to obtain reasonable assurance about whether the financial report as a whole is free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with the Australian Auditing Standards will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of this financial report. As part of an audit in accordance with the Australian Auditing Standards, we exercise professional judgment and maintain professional scepticism throughout the audit. A further description of our responsibilities for the audit of the financial report is located at the Auditing and Assurance Standards Board website at: www.auasb.gov.au/auditors_responsibilities/ar4.pdf. This description forms part of our auditor’s report. We communicate with the Board of Management of the association regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.
Mazars Melbourne Assurance Pty Ltd
Craig Silvester Director
Dated this 10th day of October 2019 at Melbourne.
60 Annual Report 2018 - 2019 National Centre of Excellence in Posttraumatic Mental Health www.phoenixaustralia.org
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Published by Phoenix Australia Centre for Posttraumatic Mental Health Inc. Phone: +61 3 9035 5599 [email protected] www.phoenixaustralia.org Victoria Level 3, Alan Gilbert Building 161 Barry Street, Carlton VIC 3053 Phone: 03 9035 5599
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