As part of the Government response to the 'Independent Study into Suicide in the Ex-service Community', DVA commissioned the Australian Institute of Suicide Research and Prevention to undertake a review of the Operation Life Suicide Awareness workshops to ensure they were evidenced based. DVA accepted all recommendations made in the final report. 

On 9 September 2013, the Department of Veterans’ Affairs (DVA) commissioned a study into firefighter exposures in response to health concerns voiced by ex-serving Royal Australian Air Force (RAAF) firefighters and a concurrent legislated review of the Fair Protection for Firefighters Act 2011 by the Department of Employment. DVA and the Department of Defence have continued to liaise closely with firefighter representatives over the course of this and other related research into the firefighter occupation and fuel exposure.

The Firefighter Case File and Literature Review were carried out in two parts to address occupational health and compensation matters:

Firefighter Literature Review

Dr Tee Guidotti conducted the Firefighter Literature Review, which was a systematic review of international literature in relation to civilian and military firefighters. Specific consideration was given to occupational exposure of RAAF firefighters to chemical contaminants listed at the Point Cook fire training ground, as provided by Chief of Air Force.

Dr Guidotti is an international expert in the field of occupational health risks for firefighters and has published extensively in this field.

To guide the research, Dr Guidotti worked with Dr Graeme Peel, who undertook a compensation and health file examination of 71 cases of ex-serving or serving Australian Defence Force (ADF) firefighters. Dr Peel is a specialist in occupational and public health.

Dr Guidotti used a benchmark of “weight of evidence” to assess the literature. This is a concept that does not equate easily to the standards of proof in Australian legislation for veterans.

The report has been provided to the Repatriation Medical Authority, which indicated it would undertake routine monitoring of the medical literature to ensure further associations between firefighter employment and conditions can be identified.

In the mean time, firefighter group representatives and DVA are advising individuals to claim diagnosed conditions they believe may have been caused by their Defence service through DVA.

Case File Review

Dr Peel independently reviewed Defence service and medical records and DVA compensation files for 71 serving or ex-serving RAAF-trained firefighters or firefighters who served at Amberley. The reason for the review was to ascertain if there are any claims DVA had rejected that may now be recognised, if there are any decisions on claims that need to be reconsidered, and whether there are any previously unrecognised clusters or trends in conditions.

Firefighters should lodge claims to DVA for diagnosed conditions they believe may be related to their military service.

This literature review was funded under the Department of Veterans' Affairs Applied Research Program and conducted by the Australian Institute for Suicide Research and Prevention.  The review examined Australian and international sources to determine prevalence and risk factors for suicide and non-fatal suicidal behaviour in serving and ex-serving military personnel.  

Fifty-one Australian and international papers and reports were included in the review.  The review indicated that there is no current research that would allow a comparison of suicide mortality rates between Australian ex-serving personnel and the general community.  However, there is some evidence that Australian Vietnam veterans could be at increased risk of non-fatal suicidal behaviour and suicidal ideation.  Other research suggests that veterans might experience veteran-specific risk factors such as difficulty returning to civilian life and a reluctance to seek help for their problems.  International research, from the United States in particular, provides a different spectrum of evidence.  However, international findings have limited generalisability to the Australian context due to differing military sizes, operational tempo, models of health care, and access to firearms.

The limited number of Australian publications available for review points to the need for high-quality studies that analyse the prevalence of and risk factors for suicide among Australian ex-serving personnel. The Department of Veterans’ Affairs, in collaboration with the Department of Defence, is continuing to explore rates of suicidal behaviour and ideation as part of its Transition and Wellbeing Research Programme.

Suicidal behaviour and ideation among military personnel: Australian and international trends:

The purpose of this report is to collate evidence gleaned from the international research literature, as well as the personal experiences of claimants, family members, and the Department of Veterans’ Affairs (DVA) personnel, in order to inform our understanding of the relationship between applying for compensation and adverse mental health outcomes.