Of the 900 recommendations for struggling veterans, there is one that stands out

Veterans and their families fought hard for The Royal Commission into Defence and Veteran Suicide. They’d had enough and knew something needed to change. As a psychiatrist who works with veterans, I shared their frustration and anguish.

Last week, the royal commission handed down 122 recommendations to address the shocking rates of suicide among Australian Defence Force members. While some of the recommendations made are new, many of the issues raised have been with us for decades.

Rates of suicide among military service personnel are shocking. Credit: Getty Images/iStockphoto

Over the past 20 to 30 years, there have been over 57 inquiries and more than 770 recommendations for change. Each report paints a picture of a system that is failing to care for our veterans, and the consequences are dire.

Service life is hard. It’s hard on the individual, and tough on families. Serving members voluntarily surrender some of their independence and many of the freedoms everyday Australians enjoy. They are also put under immense physical, emotional and mental pressure as part of the job.

Current serving personnel are not allowed to take a “sickie”. It takes months to get an appointment to see the medical officer on base, and going to sick parade might mean letting your comrades down.

Moreover, ADF members experience morally challenging dilemmas and situations where it’s harder to distinguish right from wrong, moral and not moral. This kind of “moral injury” can leave people with immense feelings of guilt, inadequacy, shame and disgust.

As a psychiatrist, I see these sorts of injuries regularly, not rarely. Often, in leaving the service and the uniform, there’s a harsh separation from years of duty and defined purpose. This can leave people isolated and adrift.

Veterans needing and wanting help are faced with a system that’s infuriatingly difficult to navigate – at a time when it should be easy. Vulnerable people are falling through the cracks of a system that’s too complex, disjointed and often unsafe.

We know that 66 per cent of service members and veterans who died by suicide weren’t using Department of Veterans’ Affairs’ services. Why? One reason is there aren’t enough services or clinicians who understand military life and its unique challenges. We must expand access to mental health care, but we also need to ensure services are trained in how to provide culturally safe care to this unique group.

What’s also highly concerning is that military personnel face a greater risk of trauma from within the ADF than from combat itself. The commission uncovered disturbing rates of sexual misconduct and assault within the ADF, predominantly perpetrated by male members, and mainly impacting female members.

Sexual violence is linked to increased suicidality. When compared to the general population, suicide rates are 107 per cent higher for ex-serving women in the ADF.

These are hard truths, which have been hard fought for and often reluctantly revealed.

It’s taken immense moral courage from veterans and their families to fight for a royal commission and speak up about their experiences serving in the ADF and as a veteran. There are also champions of truth within the ADF and DVA. They exist, at all levels. I know because I’ve met them.

But we must face the reality that there are deep systemic failures. Many veterans and their loved ones have lost trust in the government and their agencies.

In the final report, the commissioners spoke about their desire to ensure the dynamics of abuse, trauma and neglect experienced by serving and ex-serving ADF members and their loved ones weren’t repeated in their interactions with the royal commission. They worked hard to rebuild some of this trust through prompt, consistent and transparent communication.

People are understandably cynical about the prospect of change. Veterans and their families have the right to ask what will be different about these 122 recommendations on top of the previous 770? Well, there is one that stands out – it’s time for a new independent body to oversee these recommendations.

We have to give the men and women of our navy, army and air force something to trust. This independent body would cut through red tape. It would hold the government and its agencies to account and provide transparency to a community and sector desperate for change.

We need to step up and step together on this. The best thanks we can give our veterans and those who are still serving is accountability and action together.

If you are a current or former ADF member, or a relative, and need counselling or support,
you can contact the Defence All-Hours Support Line on 1800 628 036 or Open Arms on 1800
011 046.

Dr Alex Lim is a consultant psychiatrist specialising in the care of current and former serving uniformed personnel including Defence, veterans, and first responders. He is a spokesperson for the Royal Australian and New Zealand College of Psychiatrists on veteran mental health care.