Letter to the Editor - Marie Claire

Dear Editor,

The recent article The unseen enemy in Marie Claire (May 2014) on Post Traumatic Stress Disorder (PTSD) contains a number of discrepancies and misrepresentations which Defence would like to clarify.

Firstly, Defence takes seriously our responsibility to prepare our personnel to meet the unique occupational risks of military service and provide effective treatment and rehabilitation if they become ill or injured.

Defence does not seek to distance itself from the problem of PTSD nor do we fail to acknowledge the causes and impact of PTSD on some of its members. In fact the opposite is true.

Since 2009 Defence has invested almost $95 million on mental health services and support.  We have introduced a range of resilience training programs, increased our mental health workforce, introduced mental health literacy initiatives to improve the understanding of mental health issues and specifically port-traumatic stress disorder, suicide prevention and alcohol misuse.

In 2010, in partnership with independent academic research bodies, Defence undertook world class research, producing the first comprehensive investigation of the mental health of an ADF service population. Australian Defence Force (ADF) personnel were invited to participate anonymously in this research and 52.5 per cent  (26,281) of ADF personnel chose to participate.

In 2011 Defence invited a range of independent mental health experts to form the ADF Mental Health Advisory Group.  This group provides advice on evidence based approaches to mental health policy and program which is assisting the ADF to implement the ADF Mental Health and Wellbeing Strategy.

Most recently through the ADF Theatre Project – The Long Way Home - the Australian community has been able to see and hear the real life experience of ADF personnel who have returned from operations and have faced, with their families, the challenges of recovery from psychological and physical injury.

These examples clearly demonstrate that Defence has actively engaged with mental health issues and specifically acknowledge the impact of disorders such as PTSD.

While Defence agrees ADF members who are repeatedly exposed to traumatic experiences are at greater risk of developing mental disorders, the fact is that some individuals may develop a disorder with exposure to only a single traumatic event. Equally important, is that not all ADF members will be exposed to trauma, either on deployment or in their duties at home and the majority will not present with mental health concerns.

In fact, Defence has found the majority of incidences are the result of lifetime of accumulated trauma in their personal and/or military lives rather than the direct effect of just deployment or military service.

In my interview, I also drew widely on statistics from the 2010 ADF Mental Health Prevalence and Wellbeing Study (MHPWS). This study, when matched with an age, gender and employment sample from the Australian Bureau of Statistics 2007 National Survey of Mental Health and Wellbeing shows that the impact of mental illness in the ADF is very similar to that experienced by the wider community.

Defence also found that the estimated incidence of PTSD amongst Defence members was 8.3 per cent. While this percentage is greater than in the Australian community (5.2 per cent), the study found that ADF members who have never deployed are just as likely to have PTSD (8.8 per cent) as those who have deployed (8 per cent).

Currently one in five (22p per cent) of the ADF population has experienced a mental disorder in the previous 12 months, which is similar to the rate of the Australian community (20.7 per cent). This includes PTSD, but ranges from anxiety to affective (mood) disorders such as depressive episodes, bipolar affective disorder and Dysthymia.

In the ADF, males also report significantly higher rates of PTSD than the general community (8.1 per cent vs. 4.6 per cent), however the findings of the study did find that there was no statistical difference in the rate of PTSD between ADF males (8.1 per cent) and females (10.1 per cent).

In recent years Defence has, in collaboration with the Department of Veterans’ Affairs (DVA) made significant improvements to the provision of mental health care and rehabilitation for defence members and those transitioning to civilian life.

Regardless of whether a Defence member’s illness or injuries are physical or psychological, sustained on operations or as part of their wider military service, Defence provides the full range of health care including clinical treatment and rehabilitation.

Defence also has a comprehensive and multi-layered approach to mental health and wellbeing with a range of support programs available for all personnel, no matter the source or cause of their mental health problems.

ADF personnel are provided with a continuum of mental health support designed to enhance their ability to cope with the challenges of deployment and to assist them to effectively transition from the deployed environment to life back in Australia.

We are committed to promoting good mental health for all Defence members and their families. We are interested in all of our personnel, no matter the source or cause of their mental health problems and remain committed in our efforts along with the Department of Veterans’ Affairs to build resilience and improve awareness of all mental disorders that impact on ADF personnel.

We will continue to reduce stigma and barriers to care thereby improving access to treatment and encouraging ADF personnel and their families to seek help as early as possible.

Defence can assure all Australians that the level of care and services afforded to our service men and women and their families has not been degraded and we will continue to ensure ADF members receive the best health services available, or seamlessly transition them to civilian life under the care of the DVA on their discharge from the ADF.

Yours sincerely,

R.M. WALKER AM

Rear Admiral, RAN
Commander Joint Health and
Surgeon General Australian Defence Force
9 April 2014