The DVA Veteran Wellbeing Centre Network can reduce suicide in the Veteran Community

Transition is the central problem

Transition out of the ADF is a very significant stressor that too often leads to poor mental health, resulting in incarceration, drug abuse, homelessness, and suicide among veterans, especially younger veterans. The lack of preparation for transition to civilian life by members of the ADF is the central problem and from which most other issues stem.

I’d like to share some key findings from my last five years as Chair of the Australian Government Department of Health National Suicide Prevention Trial for Veterans and their families (Operation COMPASS). In that role, I have provided a submission to the Royal Commission into Defence and Veteran Suicide which points to the imperative to utilise the network of now eight, soon to be 18, Veteran Wellbeing Centres established by DVA.

The eco-system on the civilian side of transition and the way Defence and DVA work with the various components within it needs to adapt. DVA’s Veteran Wellbeing Centre Network is likely to provide the impetus to reshape the eco-system to focus on improving the lives of our veterans and their families and help them actively contribute to our communities.

My observations of the transition of ADF members to the civilian world in Australia’s biggest garrison town from where 10% of the ADF transitions each year, is that it is one of the most profound, disruptive and complex shifts in life. The change in role, often location, expectations and culture all combine at one time to disrupt the patterns, routines, and relationships in the lives of those transitioning and their families and friends.

In the management of the growing mental health problem, the underpinning philosophy should be that we focus more ‘upstream’ of the suicide problem. While it is easier to find KPIs at the crisis end of the problem, more effort upstream will have the effect of ensuring veterans integrate and thrive and fewer veterans need mental health support later. Although well known, that’s hard to prove in the world of grants. This philosophy is captured nicely in the oft used quote that “everyone needs three things to be happy: someone to love, something to do and something to look forward to”, which appears to have been first used by Immanuel Kant (1724-1804). The challenge is to achieve these three objectives through the transition period, from inside the ADF where suicide is significantly lower than in the general population, to outside where in some demographics suicide is almost four times the national average.

There needs to be a single local coordinating element – one of the newly established veteran wellbeing centres – for members of the veteran community, that supports them on the civilian side of the transition bridge.

Veteran Challenges

Veterans and their families face a very different environment from much of civilian life and the points below highlight the key issues that adversely impact veteran transitions:

• ADF Culture is so different. Life outside the ADF is relatively complex compared to the structure and order of life while serving in the ADF.
• Expectations of the length of service are generally overestimated. Many servicewomen and men believe they signed up to serve their country for a lifetime of service or at least with no consideration for their next job. The reality is most will serve less than seven years. Transition occurs most often sooner than expected.
• Navigation of the complex support eco-system on the civilian side is difficult. The individual’s ability to navigate the many services that might help to transition and settling into life after transition is particularly difficult. While the experience of most is that while serving, personal admin tasks can be completed utilising singular, clear and well-described processes, this is not the case in the civilian world.
• Maintaining ADF identity and adapting that identity to the new reality post-transition can be very challenging. An individual’s identity as a member of the ADF is strong. Many a veteran has made life-long friends even after the rigours of recruit training. Connection with mates, peers and others who have a shared experience of life in the ADF is essential but can be difficult to maintain after transition. Connections to the local civilian community are also essential. Both provide an inoculation against isolation, loneliness, and depression. Many veterans need help to appreciate the need to adapt their ADF identity to accommodate their new civilian and workplace community in order to thrive.
• A poor transition often manifests itself long after two years post-transition. Support provided to a veteran and their family during transition out of the ADF, can be better followed through after transition, especially after two years post-transition (at which time Defence support ceases), by an organisation outside Defence that collaborates with Defence transition agencies and DVA. This is where the ESO community can be of particular benefit if engaged early by a unifying local community veteran wellbeing centre.
• Most organisations in the ESO Community deal with a specific demographic and limited functions.?It is not easy for those transitioning to find and work with an ESO that might be able to help due to the overwhelming number of them and the disparate functions they perform often only for specific demographics.

ADF and Defence Challenges

Those closest to the transitioning individual are not well equipped or focused on transitions.

• The ADF is busy defending the nation and its people. Support for transition from an individual’s unit is often inadequate (confirmed by exit surveys of transitioning veterans), which is understandable given the operations and training focus of units and commanders. Life in the unit goes on at pace while individuals complete the checklist to transition.
• Immediate chain of command generally lacks experience and knowledge regarding transition. Members of an individual’s own unit chain of command feel justifiably unqualified to offer advice on life after transition, especially as most had their last taste of civilian life when they left their parents’ home and joined the ADF as a teenager.

These individual issues are compounded by a lack of organisational support.

• Defence offered transition services are available too late. While attendance at Transition Expos is available to all at any time, real support is generally only available, or at least only taken up, after an ADF member signs an AC853 (a Defence form announcing the intention to transition). By that time, it is typically too late as the serving ADF member has already convinced himself, his family and his friends that it is necessary and that it’s going to happen. The time to prepare has gone and it is now largely a matter of process to separate.
• Transition services offered on a ‘needs-basis’ alienates those who don’t want to send the wrong signals to colleagues. Some secrecy prior to completing the AC853, which announces to the ADF chain of command, posting and promotion authorities the intention to transition, is generally necessary in order not to incur consternation and ribbing from colleagues, for what may only be an attempt to be better prepared for the inevitable transition. Early and mandatory guidance will save lives. The first step is to convince them they need to prepare.

The DVA Veteran Wellbeing Centre Network is emerging as a suitable solution

The solution is to reimagine how support can be provided from the civilian side of transition. DVA’s Veteran Wellbeing Centre Network is likely to be well placed to undertake these tasks:

Enable early appreciation and planning by ADF members. Preparation for life after the ADF that is:

• achieved in the first year of service – perhaps in the first posting after completing recruit and initial employment training,
• executed by an organisation trusted by ADF members to commence early planning for transition without perceived fear of adverse implications for ongoing service,
• executed by an organisation outside Defence working closely with, and complementary to, ADF Transition Centres
• mandatory, not on a ‘needs-basis’, so there is less likelihood of stigma associated with what should be considered best practice for preparation of the inevitable transition,
• executed by an organisation staffed by a paid workforce (not reliant on volunteers) with appropriate lived experience and skills, and
• executed by an organisation funded by the government, not poker machines, alcohol, lotteries and chook raffles.

Support navigating the complex social eco-system. To achieve this, a navigation capability needs to be provided by an organisation that:

• can act as a single point of entry to the wellbeing eco-system,
• has detailed knowledge of appropriate support to members of the local veteran community, including harnessing the capability of the ESO community,
• has staff knowledgeable and with access to civilian support and community connections,
• can suitably refer to the most appropriate services of all types,
• is trusted by ADF members to provide comprehensive guidance in their interests, and
• does not require transitioned veterans to return to an ADF base with the potential indignation and mental health issues that can bring, especially for those who separate.

Facilitate the maintenance of ADF connections and the development of new community and workplace connections. To achieve this, a physical location is needed:

• at which members of the veteran community feel safe and can connect,
• that supports the maintenance of connections with mates from ADF service,
• that supports the integration of veterans and their families into their new local civilian community and new workplace arrangements by being introduced to community groups eager to assimilate members of the veteran community,
• that offers to connect veterans and their families with the local community undertaking activities of common interest,
• that offers access and introductions to civilian clubs and groups and communities which often find that if they don’t have a veteran onboard already don’t know how to attract and integrate members of the veteran community due to limited access to military barracks and serving veterans before they have transitioned,
• that is located near ADF Transition Centres for close cooperation and mutual support, and
• that can maintain a long-term relationship with veterans and their families, well beyond the post-transition period of two years of support provided by Defence.

Every veteran needs their family and friends, ADF mates, connections and work colleagues; they also need a job, and most importantly they need a plan for their future that gives them something to look forward to. The DVA Veteran Wellbeing Centres Network being established now presents an opportunity to reimagine the support that can be focussed on members of the veteran community by being the single coordinating point on the civilian side of the transition bridge.?