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SENATE FOREIGN AFFAIRS AND TRADE COMMITTEE INQUIRY INTO SUICIDE BY VETERANS AND EX-SERVICE PERSONNEL

Submitted by: Name withheld

Terms of reference A The Reasons why Australian Veterans are Committing Suicide at Such High Rates.

This term of reference acknowledges that Australian veterans are committing suicide at high rates, but provides no figures on the actual numbers of suicides. This is because neither the ADF nor DVA record actual suicides of veterans. This is a matter of serious concern for veterans, their families and in fact the Australian nation. If the US can record accurate data on suicides of its veterans, then so too can . Perhaps the ADF and DVA have taken a conscious decision not to record these figures.

I feel the following excerpts from an article by David Ellery in the Sydney Morning Herald, 7 June 2015, titled Alarming' rise in suicide deaths by former military personnel, are very relevant to this Inquiry, Refer: http://www.smh.com.au/national/alarming-rise-in-suicide-deaths-by-former-military- personnel-20150605-ghhfut.html

Despite Defence's multibillion-dollar resources, Vice Chief of Defence Force, Vice said: "What is the suicide rate amongst the ex-serving community? We just don't know ... People get very energetic and say `you should know'. Well, we'd love to know."

The ADF was scrambling to plug the information black hole by working with a wide range of stakeholders, including a grassroots suicide register whose founder said his job was "speaking for the dead".

Admiral Griggs, said “he did not believe claims held up that as many as 200 Afghan war veterans had committed suicide”.

Mr Gray (from the Veterans Suicide Register) said his data indicated "a significant increase in suicide" at the end of ADF conflicts or deployments.

"For Afghanistan you see a sharp increase from 2013 until the present. Numbers increased from an average of seven a year up to 18 in 2013, 19 in 2014 and already 13 to the end of May this year (2015)."

It is notable that Griggs (who is also Vice Chief of the Defence Force) said they do not know the suicide rate amongst veterans, but he then said “he did not believe claims held up that as many as 200 Afghan war veterans had committed suicide”. Vice Admiral Griggs said, “He wants a more sophisticated and mature discussion around mental health issues in ”. These comments are not at all helpful in dealing with this very important matter.

Vice Admiral Griggs has supported views expressed by his Subordinate, the former Chief of Joint Health Services, Robyn Walker, which I address in Terms of Reference B, below.

The Veterans Suicide Register, which is a facebook site, has estimated the number of veteran suicides from reliable sources from its followers on social media to now be at least 250 since the 2 year 2000. The vast majority of these suicides are from contemporary veterans, ie. those who have served in Iraq, and Afghanistan in particular. Given the manner I which the Australian Veterans Suicide Register obtains its data on veteran suicide statistics, I consider it to be a reliable source.

41 Australian soldiers lost their lives in Afghanistan, and 261 were wounded. Therefore, the number of suicides so far among contemporary veterans is at least six times the number of soldiers killed in action by the enemy. It is also a striking feature that the vast majority of suicides are by non- commissioned personnel, ie. veterans who are not officers.

Both the Iraq and Afghanistan conflicts occurred during the period November 2001 to December 2012. Operational engagements with the enemy in Afghanistan finished in December 2012. Some personnel remained in Afghanistan until the end of 2013 to dismantle certain infrastructure in Tarin Kowt, and to return military assets to Australia. There is a small detachment of around 400 troops still there to provide security in Kabul.

From my observations in dealing with veterans for the last five years, there are a number of reasons veterans commit suicide, including:

1. Dreadful experiences during their war time service, such as seeing their mates killed some of whom were literally blown to pieces by IED’s, and others lose their limbs from IED’s; losing their brothers in arms killed by insider attacks whereby Afghan Nation Army soldiers turned on their Australian mentors and shot them; seeing young boys sexually abused by adult men as part of the Afghan culture; seeing small innocent children killed and wounded; seeing women mistreated.

2. Lack of education to enable veterans to integrate into mainstream society after they voluntarily discharge or are discharged from the ADF. This is particularly relevant to non- commissioned personnel, ie. those who are not officers. Officers who have come through ADFA have attained tertiary qualification, free of charge, at the public’s expense while also receiving a salary during their training. ADFA is possibly the only Commonwealth instrumentality which provides such a generous training package. By contrast, training of the non-commissioned ranks during their service is primarily directed towards field skills, first aid and the operation of sophisticated weaponry to enable them to kill the enemy, but they receive no tertiary education credentials as part of their normal training program. The training of non-commissioned personnel is primarily directed at how to kill or capture the enemy. There is no demand in civilian society for this skill set. It should also be noted that those who face enemy fire are primarily personnel in the non-commissioned ranks – the same cohort of veterans who represent the greatest percentage of suicides.

3. Dealings with DVA and Comcare by veterans who have lodged claims. I believe this to be a significant factor leading to suicide of veterans and I will deal with it under other terms of reference below. 3

Terms of Reference B previous reviews of military compensation arrangements and their failings

I am not familiar with previous reviews. However, on the basis of the current performance of DVA, if there have been any previous reviews, no improvement in the performance of DVA has come from the reviews.

This may be an appropriate juncture to mention previous views expressed and the need for reviews of current arrangements, through this Senate Inquiry, regarding the claims assessment procedure and the rising trend in suicide among contemporary veterans.

The former of Joint Health Services, and ADF Surgeon General, was Rear Admiral Robyn Walker. In an ABC article on 22 April 2014, journalist Rachael Brown states Rear Admiral Walker says she has not found a link between operational deployment and suicide. I watched as Ms Walker repeated this view on an SBS Insight program. Ms Walker has been strongly criticised in social and mainstream media for expressing her views but fellow senior officers, including Vice Admiral Griggs (refer preceding hyperlink) rallied to her support. Refer: http://www.abc.net.au/news/2014-04- 22/number-of-soldiers-committing-suicide-triples-afghan-combat-toll/5403122

The same article reports that Dr Stephen Hodson from DVA points out that suicide rates mirror those in the wider Australian Community. However, as with the comments by Rear Admiral Walker, no research findings were quoted to support his statement.

In an interview with Marie Claire magazine on 9 April 2014, Rear Admiral Robyn Walker said, “post- traumatic stress disorder is a result of a “lifetime exposure” to trauma – not military service. http://www.michaelsmithnews.com/2015/03/adfs-chief-medical-officer-admiral-robyn-walker-on- ptsd-its-not-about-the-military.html

In 2015 the Rear Admiral Walker was the subject of an online petition that attracted more than 8,000 signatures and hundreds of pages of comments in social and commercial media demanding her removal over her statements.

If the views of Rear Admiral Robyn Walker, supported by the most senior officers of the ADF, including a media statement from the CDF (http://news.defence.gov.au/2015/03/13/a-message- from-the-australian-defence-force-senior-leadership/) are a true representation of the views of the ADF and DVA, then what hope is there for any change in attitude of either organisation towards the recognition of the extent of veteran suicides, the fact that it is a serious problem brought about by military service, and appropriate measures to deal with this serious problem. These two bodies have already indicated they will not change their views.

The first step in solving a problem is to recognise there is one.

I know from my personal association with veterans that their military service can lead to suicide, as can their frustration in dealings with DVA.

I also commend the following article to the Committee, particularly the comments by General John Cantwell (Retired): http://www.abc.net.au/news/2014-04-23/rising-ptsd-compensation- figures-in-adf-only-the-start/5404778 4

Terms of Reference C & E Claims Administration By DVA

The system involved in lodgement of claims is immensely convoluted and laden with paper work. Most veterans are not used to filling in reams of paperwork. It is a very daunting process for veterans. Furthermore, most claims invariably involve duplication of paperwork with multiple agencies. Claims can take anywhere from a year (if very lucky) to five years to process - if applicants persevere, and stay alive. There appears to have been little change in the modus operandi of DVA over the last 50 years. The following examples illustrate this:

An example of a past refusal by DVA to even consider applications for serious health issues from a service related incident (peace-time) is the collision by Australian Navy destroyer HMAS Voyager with the aircraft carrier HMAS Melbourne in 1964.

HMAS Voyager sank as a result of the collision. 82 men on the Voyager were killed. In 2007, 43 years after the incident, 46 claims for compensation were before the courts and another six on appeal. Victims were still fighting claims through the courts because the Government/DVA refused to accept any liability. Under section 55ZF of the Judiciary Act, the federal Government and its agencies must act "honestly and fairly" in litigation. They are obliged to keep costs to a minimum, not cause undue delays, concede facts known to be true and not raise purely technical points. Lawyers acting for survivors of the Voyager disaster say the commonwealth has done just the opposite: that the Government has dragged its feet, destroyed crucial documents, denied access to information and fought plaintiffs tooth-and-nail for every cent of compensation. However, millions of dollars in compensation have been awarded to claimants by the courts. This proves these people had legitimate claims all along. Their claims should have been dealt with by DVA. Refer: http://www.theaustralian.com.au/business/legal-affairs/long-fight-for-voyager- survivors/story-e6frg97x-1111114571636

An example of an unreasonable time period for investigating health issues as a direct result of military service and assessing applications is the deseal/reseal program for the F-111 aircraft fuel tanks:

The Deseal/Reseal and pick-and-patch programs of F 111 fuel tanks took place for more than 20 years during which maintenance personnel suffered chronic and occasionally acute exposure to the hazardous substances they worked with. It was not until 2009 that a Parliamentary Inquiry was established after persistent lobbying by F-111 deseal/reseal workers and their families to examine the health and compensation issues. On 30th April 2015, Chief of Air Force, Geoff Brown, released the long-awaited Jet Fuel Exposure Syndrome (JFES) Study Report. The F-111 aircraft were retired in 2010.

Given these two matters, coupled with the Rear Admiral Walker fiasco and the current paper-laden bureaucratic assessment process within DVA which generally takes years to complete, it could well be argued that the assessment process is driven more by cost minimisation than by a desire to look after the welfare of veterans. It is well known in the veteran community and their non-government support organisations that DVA’s claims and appeals system is unnecessarily complex and confusing. Many veterans are not accessing the help they need because they simply cannot navigate the 5 system. Claims lodged are invariably returned for innocuous reasons such as a word missing, or a box missed. Many veterans just see the process as too difficult and simply give up. A frequent problem experienced by claimants is that when they follow-up on their claims with DVA, the response is that their file has been lost. This means the veteran has to start the process all over again. Another frequent problem is that DVA case managers assigned to individual veterans frequently change. The affected veterans have to start from scratch all over again with a new case manager, who may also change mid-steam. These factors, individually or collectively, can tip veterans over the edge to suicide.

There appear to be only two possible directions for veterans to take once they connect with DVA and face the daunting assessment process:

1. Persevere with the process which can take years

2. Give up. This can then lead to:

a. homelessness,

b. alcohol and drug abuse,

c. domestic violence and marriage break-ups,

d. suicide.

Once veterans discharge or are discharged from the ADF, their pay ceases after a defined period of time. This is often the turning point for them. What can a veteran do with his/her life when he has no income, and no training other than to seek out and kill or capture the enemy using sophisticated weaponry?

I have noticed that claims from officers are finalised relatively quickly, compared with claims from non-commissioned personnel. This may of course be a reflection of the difference in education and the fact that officers are performing paperwork functions daily during their service careers. DVA case managers should be helping veterans complete their paper work but the reality is the veterans are left to try to work through it themselves, or seek the assistance of advocates outside the system.

I have also noticed that when people with influence (such as a retired senior ) make representations to DVA on behalf of a veteran who is experiencing unreasonable difficulties with DVA, the claims are invariably approved within days. Additionally, when a veteran commits suicide, if he/she has lodged a claim with DVA which has not been finalised, it seems to be finalised within days of the suicide. This would suggest that the claims process is deliberately stalled, or is inefficient.

I have personally seen evidence to support the following article in the Herald Sun by Ruth Lamperd 16 March 2013 ”. Refer: http://www.heraldsun.com.au/news/victoria/at-least-15-ex-servicemen- have-committed-suicide-since-christmas-in-the-terrible-hidden-toll-of-war/story-e6frf7kx- 1226598932503 in which she states, “Queensland psychiatrist Dr Andrew Khoo treats veterans almost daily. He said the process for making a PTSD claim could be a bureaucratic maze that has become more complicated in the past decade. Rather than the onus being on DVA to find out if applicants are not telling the truth, it seems like the onus is on guys to prove they are not lying. This 6 is opposite to how it should be”. “Delays have a direct bearing on the treatment options and mental wellbeing of claims left in limbo”.

In the US, nearly one in every five suicides nationally is a veteran — 18 to 20 percent annually — compared with Census data that shows veterans make up about 10 percent of the U.S. adult population. Refer https://www.publicintegrity.org/2013/08/30/13292/suicide-rate-veterans-far- exceeds-civilian-population

There is no reason to suggest that Australia’s experiences of veteran suicide should not be any different to the US, on a proportionate basis relative to population and numbers of military personnel. Australia and US soldiers fought together in the same wars in Iraq and Afghanistan. They face the same health issues which emanate from their experiences in those wars.

Regrettably, the evidence suggests that DVA is either deliberately abrogating its responsibilities, it terribly inefficient, or is incapable of performing its responsibilities.

Terms of Reference F Other Related Matters

I would like to share the following quote from the widow of her veteran husband who committed suicide: they take them away, they break them, then they give then back.

The primary role of the ADF is to train soldiers, sailors and airmen/airwomen to be able to fight in war if called upon to do so. The ADF must be prepared to go to war 24/7 with personnel in uniform who are properly trained and 100% medically and physically fit to perform the tasks expected of them. However, the service experiences of these ADF personnel can result in physical wounds and injuries, psychological conditions such as PTSD, and in the worst cases, suicide. The question which needs to be addressed is whose responsibility is it to deal with health issues (such as PTSD), and suicide among veterans. Is this a shared role between the ADF and DVA or is it purely the role of DVA.

I suggest the welfare of veterans is clearly the role of DVA once veterans are discharged from the ADF. However, the transition period during discharge is critical. The ADF and DVA need to sort this out. If this period is a shared responsibility, it is likely to encounter problems of overlap, as currently occurs between DVA and Comcare. I have no suggestions or solutions to this matter, only to identify it as a serious matter which clearly needs due attention by both DVA and the ADF.

The prime role of DVA is to look after the welfare of veterans. It does not perform its functions well at all. It appears that the current process is largely driven by cost minimisation. The Government of the day needs to understand that the costs of sending troops to war do not stop when the war is over. There is an on-going need to look after returned veterans who need help. If the Government cannot afford to look after its veterans, then don’t send them to war.

Suggestions to Improve the Welfare of Veterans and Contain Costs

Anecdotally, DVA appears to devote a lot of effort into deciding on whether a veteran in entitled to a white card or a gold health card. This process alone consumes an inordinate period of time and resources. It is likely that a cost-benefit analysis would show the bureaucratic costs of this decision 7 making process would outweigh the funds saved by denying a gold card. The logical solution is to provide all veterans who have qualified for active service medals in war to be given a gold health card – as a condition of service. The gold card would be for veterans only, not their family members. This would cut out at least half the problems which veterans experience with DVA, and correspondingly half the work of DVA in evaluating the claims of each veteran. Initial contact with DVA is usually health related. It would not necessarily follow that every veterans with the gold card will be visiting a doctor every week for the rest of their lives. This would also allow DVA to concentrate on other welfare assistance to the extent required by individual veterans on a case by case basis.

If DVA is concerned about veterans rorting the system, then I suggest it should employ suitable veterans to undertake the assessment process of applications. A veteran will quickly be able to identify another who is faking a claim. This would also provide much needed employment for veterans. Public servants who have never served in the ADF, or never served in combat deployments do not really understand what veterans have been through.

The other main and critical welfare assistance requirement is Training of veterans for civilian jobs in accordance with the aptitude of veterans on a case-by-case basis, regardless of the individual costs. By and large, non-commissioned veterans do not have a skill set which is demanded in the civilian sector of the economy. Post-war costs of vocational training to settle veterans into main stream society will reduce other welfare costs. If some can meet the academic requirements to study medicine or to fly planes, they should be funded accordingly. Such high level vocational training would of course apply to very few so the costs would not skyrocket. Other veterans may be best suited to being school teachers, nurses, accountants, earth moving machinery operators, ambulance officers, and so on.

On the basis of my association with veterans, vocational training is of prime importance – keeping veterans occupied so they do not dwell on their psychological problems. Employment gives them a sense of purpose and value to society which they had when they were serving the country in the ADF. Employment will also dissipate the effects of PTSD on their friends, families, and society at large.

Non-Government Organisations Associated with Veterans

The best known non-government organisation (NGO) associated with veterans is the RSL. However, a plethora of new NGO’s has sprung into existence since the end of the Afghanistan war. Some of these include Mates 4 Mates, Soldier On, Homes for Heroes, Young Diggers, Veterans off the Streets, Hounds for Heroes, Diggers Rest, and many more. Many of these organisations have gained DGR (deduct gift recipient) status through the Australian Charities and Not-for-Profits Commission and the Australian Tax Office which enables them to operate as a charity with tax free status. The main reason these organisations have come into existence is because there is such a void in services provided to veterans by the Government.

Regardless of improvements made within DVA, if any as a result of this Inquiry, we live in an imperfect world so there will probably be a need for some such organisations into the foreseeable future. Many of these organisations have very beneficial effects for veterans because they are generally run by veterans for veterans. Many veterans obtain great benefit from these organisations, 8 particularly through their association with other contemporary veterans. These organisations seem to be able to survive on public donations and their charity status, so Government funding may not be needed. Some of these NGO’s have an association with Branches of the RSL, and receive funds from the RSL.

Whether there is a need for Government funding assistance to an NGO will depend upon the services provided, or to be provided, by the NGO, and the capabilities of the NGO. The Government may wish to channel some services though an appropriate NGO.