The Office of the Prime Minister’s National Suicide Prevention Adviser’s Final Advice identifies veterans specifically as a priority population for suicide prevention.
The information shared here refers to serving and former serving members of the Australian Defence Force (ADF), although it may also be relevant for those who are veterans of military service in other countries.
What we know about suicide amongst veterans and serving Australian Defence Force personnel
There is ongoing concern within the ADF and the wider Australian community about suicide risk in ex-serving ADF personnel.
The Australian Institute of Health and Welfare (AIHW) publishes a yearly update of veteran suicide statistics. The AIHW study focuses on contemporary veterans, reporting on deaths by suicide in the serving, ex-serving and reserve ADF populations who have served at least one day of ADF service since 1 January 2001.
In 2020, the AIHW found that the suicide rate for ex-serving males between 2002 and 2018 was 28 per 100,000, which was higher than the rates for serving (11 per 100,000) and reserve males (12 per 100,000).
The AIHW found that over the three-year period from 2016 to 2018, compared with Australian men:
- The age-adjusted rate of suicide in serving males was 37% lower
- The age-adjusted rate of suicide in reserve males was 47% lower.
However, over the period from 2007 and 2018, compared with Australian men the same age range:
- Ex-serving males who discharged voluntarily from service had similar rates of suicide
- Ex-serving males who discharged from service on medical grounds had consistently higher rates of suicide.1
The following service-related characteristics of ex-serving ADF personnel are associated with higher suicide risk:
- Medical discharge 1-2
- Discharge in all ranks other than commissioned officers.2
While the number of women in the ADF is increasing, it has historically been low. In 2018, women made up only 17% of the serving and reserve population. Thus, for privacy and statistical reasons relating to the small number of women in studies, data on rates of suicide for serving and ex-serving women is limited.
In the period 2001-2018, there were 36 deaths by suicide among females, with 25 of these among ex-serving females. Over the period from 2002-2018:
The causes of suicide are complex and multifaceted. It is important to acknowledge that a person who has ceased ADF service may never experience suicidal behaviours or thoughts. The presence of protective factors may reduce the risk of suicide.
There are many protective factors that have been identified for those who have served in the ADF that can help to reduce the risk of suicide. While not all of these will be relevant to each individual, some will be relevant to most people:
- Staying connected to community – being regularly involved with friends, family and community groups brings the benefit of unconditional support from these connections.
- Significant others (having someone to share concerns with, and to care for) – having a relationship with another person (spouse or partner, a parent or child, a close mate or an old friend) can be a powerful protective factor for suicide by reducing isolation. Having someone to share concerns with, talk with and to care for (and be cared for), all contribute to a meaningful and valuable life.
- Physical and mental health – being mentally and physically healthy are important to help people to participate in a meaningful way in life, to work and to engage in significant relationships.
- Personal factors - such as a strong sense of self-worth and hope for the future; a sense of personal control; and resilience.
- Environmental factors – such as safe/ stable housing; being responsible for others; and opportunities to participate meaningfully in work, leisure or community groups.
- Financial security – being able to pay for basic necessities like food and housing costs reduces stress on a person and their family.
- Spirituality and belief – a belief system is not necessarily about religion. It is a set of beliefs that sustains you and gives you a reason to go on. Belief is personal and can take on many forms.
- Getting timely help and information can avoid a crisis and lead to improved, sustainable levels of wellbeing. 4
Royal Commission into Defence and Veteran Suicide
On 19 April 2021, Prime Minister Scott Morrison announced a Royal Commission into Defence and Veteran Suicide would be established.
The Royal Commission has been set up after community calls for a national inquiry focussing on the systemic issues faced by Australian Defence Force members and veterans that too often result in loss of life to suicide.
The Royal Commission will be independent of government, Department of Veterans Affairs (DVA) and Defence. 5
On 8 July 2021, the Governor-General of the Commonwealth of Australia, His Excellency General the Honourable David Hurley AC DSC (Retd), established the Royal Commission into Defence and Veteran Suicide. Former NSW Deputy Police Commissioner Nick Kaldas, former Queensland Supreme Court Judge James Douglas QC and psychiatrist Dr Peggy Brown AO have been appointed as commissioners. They will produce an interim report by 11 August 2022 and a final report by 15 June 2023. 6
Information about the Royal Commission, including the Terms of Reference and available supports, is available on theRoyal Commission website.
Mental Health and Suicide Prevention Training
All members of the veteran community have access to free mental health and suicide prevention training through Open Arms in order to enhance their capability to recognise veterans ‘at risk’ and provide intervention and support.
The Government is committed to supporting the mental health of veterans and their families, and this access to mental health training will ensure there are caring and trained people to provide that initial support when and where it is needed by veterans.
This training has been expanded to include online delivery. The Suicide Prevention Start online training module provides a brief overview of key knowledge to assist with community suicide awareness and prevention. It has been designed as a flexibly-delivered introduction to the topic of suicide prevention and takes approximately 60-90 minutes to complete. All training is accessible via the Open Arms website.
Open Arms Community and Peer Workforce
The Open Arms Community and Peer workforce utilise their lived experience of ADF service or military family life, and mental health recovery to work in collaboration with clinicians to support clients and engage with external health and community services and ex-service organisations.
Initially piloted to support Operation Compass 7, the National Suicide Prevention trial in Townsville, Queensland (focussed exclusively on veterans of the Australian Defence Force and their families), Community Engagement Teams have now been established to deliver services in 21 locations across Australia to provide support to at-risk veterans and families nationwide.
Through the Community and Peer Program and as part of Community Engagement Teams, Open Arms Peers:
- Utilise their lived experience to work with clinical staff, clients and external organisations;
- Work with veterans and their families to promote hope and offer a positive model of recovery, to de-stigmatise mental health issues and to build help seeking behaviours;
- Work with veterans and their families to equip them with skills and tools to work toward holistic wellness;
- Support clients to access information about available services and supports, and walking alongside veterans and their families to increase their connectedness and belonging, assisting them to connect with activities that promote meaning and purpose;
- Connect with veterans and their families to promote early engagement and provide a bridge to clinical services for those who are hard to reach;
- Engage with Defence, Ex-Service Organisations, hospitals, health and community services and community networks to break down barriers to care, supporting clients to access and transition between services;
- Support care coordination in areas such as post-discharge support, homelessness, bereavement, family violence, alcohol and other drug abuse, family breakdown and gambling;
- Establish and maintain a presence at Defence establishments and bases, developing referral pathways for current serving members and their families, including those transitioning from service, sharing lived experience recovery stories to break down stigma and increase awareness of Open Arms services.
Support for Veterans and Australian Defence Force Personnel
DVA provides access to comprehensive mental health care services for veterans, including services from general practitioners, psychiatrists, allied mental health providers, inpatient and outpatient hospital treatment, pharmaceuticals, as well as specific Trauma Recovery Programs for PTSD and access to alcohol and other drugs community-based programs.
Through DVA, veterans have access to free mental health care for life, with DVA able to pay for treatment for any mental health condition without the need to be accepted as related to service. This support is needs-based, uncapped and available to any veteran who has served a single day in the ADF and certain reservists. This is known as Non-Liability Health Care.
On 11 May 2021, the Australian Government released the Prevention Compassion Care: National Mental Health and Suicide Prevention Plan (the Plan). The Plan supports the announced $2.3 billion 2021-22 budget package for mental health and suicide prevention that will benefit all Australians, including veterans.
Budget initiatives referenced within the Plan specifically targeting veterans include the:
- Extension of the National Suicide Prevention Trial for one year to continue the delivery of local suicide prevention initiatives across Australia, including the Operation Compass trial in Townsville which focusses on ex-serving ADF personnel and is supported by Open Arms.
- Extension of the Provisional Access to Medical Treatment trial to ensure veterans can access treatment for 20 of the most common service-related conditions whilst their claim is being processed.
- Continuation of the Wellbeing and Support Program pilot as an ongoing program. The measure provides case management support for veterans who are either transitioning into civilian life or who have complex needs. This includes veterans with drug and alcohol disorders, complex mental health issues, including clients at risk of suicide or self-harm, multiple comorbid physical health conditions, traumatic brain injury or other complex psychosocial needs.
- Expansion of the eligibility and flexibility of the Family Support Package which provides services to support veterans and their families in crisis including child care, child psychology and home help services.
Open Arms is available 24/7 to provide counselling and support services to Australia's military community. Open Arms assists anyone who has served at least one day in the ADF, and the veteran community.
To learn more about Open Arms' free, confidential 24-hour counselling service, including your eligibility, call 1800 011 046.
Australia Institute of Health and Welfare (2020). National suicide monitoring of serving and ex-serving Australian Defence Force personnel https://www.aihw.gov.au/getmedia/64a2cab8-19ff-49aa-9390-197a1ec0b81c/aihw-phe-277.pdf.aspx?inline=true
Australian Institute of Health and Welfare (2017). Incidence of suicide in serving and ex-serving Australian Defence Force personnel: detailed analysis 2001–2015. Retrieved 23 August 2019 from https://www.aihw.gov.au/getmedia/f8bacce8-e12b-4c14-a789-ed2b292b7678/aihw-phe-218.pdf.aspx?inline=true
Australia Institute of Health and Welfare (2018). National suicide monitoring of serving and ex-serving Australian Defence Force personnel: 2018 update. Retrieved 23 August 2019 from https://www.aihw.gov.au/getmedia/99c20935-ac59-4a78-88d7-e37b6cd3b969/aihw-phe-222.pdf.aspx?inline=true
Department of Veterans' Affairs (2019). Protective factors against suicide.
Department of Veterans' Affairs (2021). Royal Commission into Defence and Veteran Suicide. Retrieved 18 June 2021 from https://www.dva.gov.au/about-us/overview/reporting/reviews-and-reports/royal-commission-defence-and-veteran-suicide
Royal Commission into Defence and Veteran Suicide (2021). Royal Commission into Defence and Veteran Suicide. Retrieved 26 July 20201 from https://defenceveteransuicide.royalcommission.gov.au/
Australian Government Department of Health, & Northern Australia Primary HealthCare Network (2019) A strategic approach. Prevention through connection. Retrieved 2 September 2019 from http://www.opcompass.org.au/strategic-approach