This comprehensive report compares mental health care support in the Australian Defence Force (ADF) with world’s best practice and assessed the extent to which the mental health needs of serving and transitioning ADF members were being met.

Independent studies by Professor David Dunt

In addition to undertaking the Independent Study into Suicide in the Ex-service Community, Prof. Dunt was also appointed by the then Minister for Veterans Affairs’, the Hon Alan Griffin MP, and the Minister for Defence Science and Personnel, the Hon. Warren Snowdon MP, to undertake the Review of Mental Health Care in the ADF and Transition through Discharge.

The review was released on Friday, 1 May, 2009, along with the Government’s response.

Prof. Dunt’s comprehensive report compared mental health care support in the Australian Defence Force (ADF) with world’s best practice and assessed the extent to which the mental health needs of serving and transitioning ADF members were being met.

The review highlighted successes and gaps in the delivery of mental health programs and transition services and made 52 recommendations to improve and extend delivery of those services.

The Government’s response (PDF) to a review of the circumstances surrounding the death of Signaller Geffrey Gregg was published on 30 July 2008. The response outlined 15 outcomes to address systemic problems with transition out of the services.

The review of SIG Gregg’s circumstances involved three parts.

Part 1 was an independent inquiry by the Inspector General Australian Defence Force, Geoff Earley AM, which examined SIG Gregg’s Defence Service, including deployment to Afghanistan, and the ADF’s role in transition management at SIG Gregg’s discharge.

Part 2 was undertaken by Mr Chris Doogan AM (former Registrar of the High Court) and examined DVA’s actions in SIG Gregg’s transition management from the ADF, DVA’s handling of his compensation claims and the actions of the Commissioner for Superannuation in administration of SIG Gregg’s claim for military superannuation benefits.

Part 3 of the review was undertaken by Mr Ron McLeod AM (former deputy Ombudsman) to examine the whole-of-government approach to handling the Gregg case.

The Minister for Veterans’ Affairs, Alan Griffin, and the Minister for Defence Science and Personnel, Warren Snowdon, issued a media release about the Government’s response.

This report was funded by the Department of Veterans’ Affairs to assess available literature on the psychological and vocational outcomes of delivering support services to the families of veterans at times of high family stress. The review considered interventions being provided to veterans in Australia, and other English speaking countries who may have similar veteran experiences.  

The literature review was undertaken in the context of the growing body of research and policy evidence suggesting that veterans can be challenged by transition from the Australian Defence Force (ADF) into civilian life, with a consequential direct negative impact on the wellbeing of the veteran and family members. The aim of this literature review was to examine available peer reviewed research regarding the support available to families of veterans in order to inform the establishment of a policy framework.

• The review yielded 34 results, primarily considering the experiences of veterans and their families in the United States. The absence of peer-reviewed literature from New Zealand, Canada and the United Kingdom highlights that this topic is one that is still in its infancy.
• Overall, studies indicated that family involvement in care was most definitely a contributing factor to veterans achieving positive psychological and interpersonal outcomes. The review noted that younger veterans, in particular, liked the message of family involvement, the use of digital support tools and therapy that accommodated childcare needs.
• While the literature highlights some potential programs which could assist Australian veterans and their families, including online education tools for adults and children, the need for further research in this area is apparent, specifically in the Australian context.

This study investigated the health of Australian veterans of deployments on United Nations sanctioned peacekeeping missions to Rwanda, Somalia, Cambodia, Namibia, Western Sahara and East Timor over the period 1989-2002.

The study examined the long-term effect of peacekeeping on the mental and physical health status, health service use and quality of life of veterans who had transitioned out of full-time service.

The study found that 65% of peacekeepers reported they were in good, very good, or excellent health.  However, 30% of peacekeepers had at least one diagnosable mental health condition.

The research provides a better understanding of the long-term pathways to care and usage of health care services for peacekeepers.

This Comparative Literature Review was the first research project to involve collaboration between the Departments of Veterans’ Affairs of the United States of America (US) and Australia, and was funded by the Australian Department of Veterans’ Affairs.

The review aimed to gain an understanding of the differences and similarities between post-1990 military deployment contexts, health impacts and veterans’ health care systems in Australia and the US.

By reviewing and analysing existing research and publicly available data, the study found that:

The US deployed significantly more personnel to each of the conflicts. US personnel in the Gulf War were more likely to experience direct combat than Australian personnel. The US also maintained a longer presence in Somalia compared to Australia.

Overall rates of posttraumatic stress disorder were similar between Australia and the US.  Prevalence estimates for US veterans of Iraq tended to be higher compared to Australian veterans, and prevalence estimates for Australian Somalia veterans appeared to be higher than in US veterans.

Gulf War veterans from both countries had a reduced risk of suicide compared with respective general populations.  US veterans of Iraq and Afghanistan had high estimated rates of suicidal ideation.  

Estimates of multisymptom illness were lower for Australian Gulf War veterans compared to US Gulf War veterans.

Traumatic brain injury prevalence estimates in Australian Afghanistan/Iraq War veterans were at the low end of those reported in US studies.    

The two countries’ healthcare systems were similar in range of services, focus on mental health, and increasing use of technology. The systems were different in method of service provision and financial structure.

This study was a preliminary overview covering a range of deployments and health and social outcomes.  While it gives an accurate summary of the published literature, it did not test for the statistical significance of differences in health outcomes between different populations.

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.