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Govt heeds AMA on veteran health

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The health of returning Australian Defence Force personnel and their families will be the focus of a major Commonwealth research effort following calls at the AMA National Conference for improved understanding of, and provision for, the health needs of returning servicemen and women.

The Federal Government has announced the establishment of a $5 million Transition and Wellbeing Research Programme, which will include a study into the mental health and wellbeing of both active and retired ADF personnel, a project examining the effect of combat experiences on personnel deployed in the Middle East between 2010 and 2012, and an investigation of the effect of military service on the families of current and former ADF personnel.

The research program is seen as timely given the recent wind-down of Australia’s involvement in several overseas conflicts, particularly in Afghanistan.

AMA President Associate Professor Brian Owler said the ADF had, since 1999, been through an extended period of high operational tempo during which more than 45,000 personnel had seen active service overseas including Afghanistan, Iraq, other areas of the Middle East, South Sudan, East Timor, and Papua New Guinea.

At the AMA National Conference late last month, A/Professor Owler chaired a policy discussion on health care for current and former ADF personnel, and said it was clear that while the country was getting many things right in the care it provided to its troops and veterans, there was room for improvement.

“We must do everything we can to support those who return with service-related injuries,” A/Professor Owler said. “The research to be funded by the Government is important because it will allow us to identify emerging health issues and better inform the future delivery of health services.”

In addition to the research program, the Government has announced that, from 1 July, a new Medicare Benefits Schedule item will be provided for GPs who use a screening tool in assessing the health of former ADF members for up to five years after discharge, a move long suggested by the AMA.

ADF personnel are often reluctant to disclose injuries, particularly mental health problems, A/Professor Owler said, and may even keep them hidden for many years after leaving the ranks, often making the condition worse.

The AMA President said the new health assessment item was an important initiative that would help encourage veterans to come forward and access treatment earlier.

“We are pleased the Government has taken up the AMA’s call for an assessment item to make it easier for veterans to access services,” he said. “We need to do as much as we can to look after those who have served. We don’t want to see a repeat of the sort of treatment veterans have received in the past.”

The Conference was told that changes in the nature of conflict and advances in frontline medical care meant many soldiers were surviving injuries that would once have been fatal.

But, as a consequence, many were returning home with much more severe physical injuries, such as amputations, multiple severe wounds, hearing loss, fractures and traumatic brain injuries.

Immediate-past ADF-Reserves Surgeon General Major General Professor Jeffrey Rosenfeld said the prevalence of bomb attacks in modern warfare could inflict particularly severe injuries.

In addition, the Conference heard that many ADF personnel suffered mental health problems as a result of their service, with around 50 per cent of all ADF personnel expected to experience some form of stress disorder.

Navy psychiatrist Commodore Duncan Wallace said research showed that post-traumatic stress disorder, in particular, was much more common among Defence personnel. The 12-month prevalence of PTSD among ADF members was 8.3 per cent, compared with 5.2 per cent in the broader population, and the incidence of obsessive-compulsive disorder among ADF personnel was more than twice that of Australians in general.

Commodore Wallace said the extent of depressive disorders among ADF personnel was particularly marked – a 6.4 per cent it was more than twice that in the general population.

He and former Army chief Lieutenant General Peter Leahy told the Conference that one of the biggest problems was getting returned Defence personnel with mental health issues to admit they had a problem and seek help.

Lieutenant General Leahy said among soldiers there was a stigma attached to admitting they had a mental health problem, and Commodore Wallace cited research showing that almost 37 per cent delayed seeking help because they feared it would prevent them from being redeployed, 27 per cent felt such an admission would harm their career prospects, 27 per cent were concerned others would treat them differently, and 25 per cent thought it would make them seem weak.

He said that despite improvements in recent years, there remained problems for soldiers leaving the ADF to access Department of Veterans’ Affairs services, and there was a lack of support for the families of returned servicemen and women during what could be a difficult transition to civilian life.  

A/Professor Owler said the AMA was keen to work with the ADF, the Department of Veterans’ Affairs and personnel and veterans themselves on ways to improve the delivery and integration of services, so that all get the care they need.”

A resolution passed unanimously by the AMA National Conference called for research to monitor the health of ADF personnel and veterans injured during ADF operations, to identify emerging health issues and better inform the future delivery of health services; the development of seamless health care delivery for ADF personnel and veterans; the development of a unique service/veteran health identifier; and the potential for existing non-liability health care arrangements for veterans to be extended to a broader range of conditions.

Adrian Rollins