Parliamentary Library Changing attitudes to mental illness in the Australian Defence Force: a long way to go… Dr Edward Scarr 2015 Australian Parliamentary Fellow Changing attitudes to mental illness in the Australian Defence Force: a long way to go… Dr Edward Scarr 2015 Australian Parliamentary Fellow © Commonwealth of Australia Creative Commons With the exception of the Commonwealth Coat of Arms, and to the extent that copyright subsists in a third party, this publication, its logo and front page design are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia licence. In essence, you are free to copy and communicate this work in its current form for all non- commercial purposes, as long as you attribute the work to the author and abide by the other licence terms. The work cannot be adapted or modified in any way. Content from this publication should be attributed in the following way: Author(s), Title of publication, Series Name and No, Publisher, Date. 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Copyright rorem, Shutterstock.com Contents Acknowledgements ........................................................................................................... v List of interviewees ........................................................................................................ vii Executive summary ........................................................................................................... 1 Introduction ....................................................................................................................... 5 Methodology...................................................................................................................... 9 Terminology .................................................................................................................... 11 PART I—THE SCOPE OF THE PROBLEM ............................................................ 13 Defining the problem .................................................................................................. 13 Prevalence rates of mental ill-health in service personnel and veterans ................ 14 Contemporary Australia ......................................................................................... 15 First-hand accounts of personal impacts ................................................................ 18 Transition ............................................................................................................... 20 PART II—CHANGING ATTITUDES........................................................................ 22 The Parliament of Australia ........................................................................................ 22 Floor of parliament................................................................................................. 24 Ministerial statements ............................................................................................ 24 Vietnam veteran influence ..................................................................................... 26 Anecdotal ............................................................................................................... 27 References to the previous Labor Government...................................................... 28 Minor party positions ............................................................................................. 28 The Long Way Home .............................................................................................. 29 Self-fulfilling prophecy .......................................................................................... 30 Independent voices ................................................................................................. 30 Aspirational ............................................................................................................ 31 Previous committee inquiry ................................................................................... 32 Recent Senate committee inquiry .......................................................................... 33 i Parliamentary Friendship Groups .......................................................................... 35 Defence—policy background on mental health ......................................................... 35 Department of Veterans’ Affairs—policy background on mental health .................. 44 Pathways to Care in Veterans Recently Compensated for a Mental Health Condition (ACPMH—now Phoenix Australia)..................................................... 46 Independent Study into Suicide in the Ex-Service Community 2009 (DVA, conducted by Professor David Dunt) .................................................................... 46 Australian National Audit Office Audit Report: Administration of Mental Health Initiatives to Support Younger Veterans (DVA) ....................................... 47 Strategy .................................................................................................................. 48 Australian Public Service Commission Review of DVA 2013 ............................. 48 Department of Veterans’ Affairs Annual Report 2013–14 ................................... 50 Department of Veterans’ Affairs Annual Report 2014–15 ................................... 51 DVA submission to the recent Senate inquiry ...................................................... 51 2014–15 Department of Veterans’ Affairs Budget Fact Sheet .............................. 53 Image problem ....................................................................................................... 53 PART III—MEASURING PROGRESS..................................................................... 55 Stigma ........................................................................................................................ 55 Ex-Service Organisations ........................................................................................... 59 Reported experiences of members of the 2nd Commando Regiment—a case study ........................................................................................................................... 61 Prevention .................................................................................................................. 64 International and Australian approaches to PTSD ..................................................... 68 Conclusion—harnessing the chaos ................................................................................. 70 Opportunity ................................................................................................................ 71 Appendices ...................................................................................................................... 73 Appendix A—veteran testimonials ................................................................................. 73 Appendix B ................................................................................................................... 105 Moral injury ............................................................................................................. 105 ii Problems with PTSD itself ....................................................................................... 105 The need for a realistic narrative on military ‘service’ ............................................. 106 Limitations of the entitlement narrative ................................................................... 106 Appendix C .................................................................................................................... 108 Rural Fire Service model—Paul Patti, veteran advocate .......................................... 108 Appendix D ................................................................................................................... 109 Abbreviations and acronyms ......................................................................................... 110 iii Acknowledgements I am indebted to the Parliamentary Library for providing the Fellowship program and the unique opportunity for research it offers. In particular I would like to thank the Director of the Foreign Affairs, Defence and Security Section, Nigel Brew, Assistant Secretary Research Branch Jonathan Curtis and Dr Dianne Heriot, Parliamentary Librarian who offered enthusiasm and support. I would like to express