Veterans’ mental health – an overview

Half of people who have served in the ADF have experienced in their lifetime a mental disorder (i.e., anxiety, disorder, affective disorder or substance use disorder). This prevalence is not too dissimilar from that seen in the broader Australian population.

Substantial progress has been made in recent years to overcome the stigma of mental health issues among service personnel. The range of mental health rehabilitation programs means that military personnel are able to be supported to return to full deployable status.

However, many service personnel still fear admitting to a mental health issue in case it should have an impact on their career prospects, including deployability.

Concealment of mental health issues

Many ADF personnel hide their mental health issues, including on admission to the ADF. They often only reveal symptoms much later when they are very ill. Therefore, they may not receive early treatment which can impact their ability to serve. Reasons that have been cited for why ADF personnel might not disclose their mental health issue include:

• concern that reporting a mental disorder might result in being treated differently,

• fear their career might be harmed,

• concern a mental disorder would reduce their deployability.

Prevalence of mental disorders

The prevalence of mental disorders in currently serving ADF members is similar to or less than the rates encountered in the general Australian population.

According to data (meeting diagnostic criteria) analysed from the 2020–21 National Study of Mental Health and Wellbeing (NSMHW), of the 622,000 people aged 16–85 in Australia who have ever served in the ADF:

• approximately 1 in 7 (14%) had a 12-month mental disorder, compared with over 1 in 5 (22%) who had never served.

Of those who had ever served and had a 12-month mental disorder:

• 8.9% had an anxiety disorder (compared with 17% of those who had never served)

• 4.4% had an affective disorder (compared with 7.4% of those who had never served)

• 1.2% had a substance use disorder (compared with 3.3% of those who had never served).

The Transition and Wellbeing Research Programme (TWRP) found the most common reason for accessing care in both the Transitioned and Regular ADF was depression and anxiety, followed by relationship problems and anger.

The burden of military service

The Transition and Wellbeing Research Programme (TWRP), in line with international evidence found:

• Deployment conveys risk for the future development of mental disorder, particularly PTSD and other anxiety disorders.

• The level of exposure to traumatic events while deployed accumulates over time, and it is the cumulative burden of exposure that is most important in risk for disorder emergence. Lifetime trauma exposure adds to this burden and risk.

• Mental disorder morbidity is largely carried by those ADF members who have transitioned from regular service. 

• The effects of deployment and trauma exposure gradually emerge with time.

Mental health risk indicators

From the Transition and Wellbeing Research Programme (examining shifts in mental health status over a 5 year period), indicators of greater risk of poor physical and mental health outcomes including suicide were:

• medical discharge - more likely to report poorer mental and physical health compared with those who were not medically discharged.  

• early service leavers (i.e., leaving before completion of the minimum initial period of 3–4 years' service, especially those who served less than 12 months)

• increasing years since transition and therefore early intervention in the first-year post-transition may be critical times for intervention and building key coping skills.

Suicide

There is some fluctuation in the suicide rates between 2003 and 2021 by age group, though most differences are not statistically significant. According to an AIHW report:

• serving permanent and reserve males are about half as likely to die by suicide as Australian males (49% and 45% lower respectively)

• suicide rates of ex-serving males who separated for voluntary reasons is similar to the general Australian population, but 54% higher for those who separated for other involuntary reasons

• ex-serving females are 107% more likely (or about twice as likely) to die by suicide than Australian females. However, the overall suicide rate for ex-serving females is significantly lower than it is for ex-serving males. 

Mental health support services

You will learn more about access to treatment and the support services available for veterans experiencing mental illness in [link to] Module 2.

DVA has a range of support services available:

• Free mental health care: Non Liability Health Care provides for funded mental health treatment

• Open Arms Drug and Alcohol Support

• Open Arms – Veterans and Families Counselling

• Counselling

• Support for family and domestic violence issues

• Peer support

• Group programs

• DVA can :

• check if they are receiving all DVA payments they are eligible for, such as a crisis payment

• offer case management and services for families experiencing challenging life circumstances

• put them in touch with ex-service organisations in their area

• connect them with homelessness services in their state or territory if needed.

Veterans can call DVA on 1800 VETERAN (1800 838 372) between 8 am and 5 pm, Monday to Friday. Or you can call on their behalf.

Useful resources

Useful contacts for veterans and their families in crisis 

You can print off this sheet and give it to your patient. 

 You may find the following webpages helpful when you have a veteran patient in crisis.

• Get urgent help and support

• Help for alcohol and drug problems

• Mental health support services

• Non-Liability Health Care (mental health) for veterans

• Managing posttraumatic stress disorder

• Psychiatric Assistance Dog program

• Homelessness support