There is continuing concern within the ADF and the wider Australian community about suicide in current serving and contemporary ex-serving ADF personnel. In particular, contemporary ex-serving ADF personnel may face increased risk of suicide.
Between 2001 and 2017, there were 419 suicides among current serving, reserve and contemporary ex-serving ADF personnel (AIHW 2019a).
After adjusting for age, the rate of suicide compared with Australian men for 2002–2017 was:
- 48% lower for current serving men
- 48% lower for men in the reserves
- 18% higher for contemporary ex-serving men (AIHW 2019a).
The number of women in the ADF is increasing, but historically, numbers have been relatively low (Department of Defence 2019b). Suicide information for contemporary ex-serving women was reported for the first time in 2019, as the number of contemporary ex-serving women was sufficient to have confidence in the results (see AIHW 2019a).
Between 2001 and 2017, there were 21 suicides among contemporary ex-serving women: a rate of 15 per 100,000. This was lower than the rate for contemporary ex-serving men (27 per 100,000), but higher than for Australian women (see AIHW 2019a).
On 5 February, the Federal Government announced the appointment of a National Commissioner for Defence and Veteran Suicide Prevention. The AIHW will be playing a new role in some of the interim work preparing for the new commissioner. This work will align with existing work and will include further analysis of suicides among current, reserve and contemporary ex-serving personnel who have served since 2001.
Open Arms—Veterans and Families Counselling provides support and counselling to current ADF members, veterans and their families and can be contacted 24 hours a day on 1800 011 046.
See Suicide and intentional self-harm.
Disability
A disability or restrictive long-term health condition exists if a limitation, restriction, impairment, disease or disorder has lasted, or is expected to last, for 6 months or more, and restricts everyday activities (ABS 2019a).
According to the 2017–18 NHS, a disability or restrictive long-term condition is classified by whether or not a person has a specific limitation or restriction. The specific limitation or restriction is further classified by whether the limitation or restriction is a limitation in core activities, or a schooling/employment restriction only. There are 5 levels of activity limitation in the 2017–18 NHS:
- profound
- severe
- moderate
- mild
- school/employment restriction only.
These are based on whether a person needs help, has difficulty, or uses aids or equipment with any core activities (mobility, self-care and communication). A person's overall level of core activity limitation is determined by their highest level of limitation in any of these activities.
According to estimates from the 2017–18 NHS, almost 2 in 5 (37%) men who had served in the ADF reported a disability. Age-standardised data found that men who had served in the ADF were more likely to report a disability (28%) than men who had not served (20%) (ABS 2019a).
Veterans’ health is influenced by health behaviours that may relate to ADF service or individual lifestyle. Screening at recruitment and aspects of serving in the ADF—such as the requirement to maintain a high level of physical fitness and regular health assessments—may act as a protective factor for veterans’ health.
Based on estimates from the 2017–18 NHS, men who had ever served in the ADF had similar exposure to health risk factors to men who had not served (after accounting for differences in age structure between the 2 groups). This included smoking, alcohol consumption, overweight and obesity, fruit and vegetable consumption, sweetened drink consumption and physical activity.
The departments of Defence and Veterans’ Affairs provide services to support serving and contemporary ex-serving ADF members during and after ADF service. Veterans may use these services, or those available to all Australians through mainstream providers. DVA funds health-related services and programs where clinically required for eligible veterans and their families (those with a DVA-issued health card). DVA funding of health care for entitled veterans is ‘demand driven and uncapped’—this means that the Australian Government increases health care funding if needed (DVA 2018). In 2017–18, DVA spent $3.0 billion on health-related services (excluding aged care-related services): the majority was for treatment in hospitals (private and public $1.4 billion), and primary care ($1.4 billion) (AIHW 2019b).
The 2014–15 NHS, estimated that 90% of people who had served in the ADF consulted a general practitioner (GP) in the 12 months preceding the survey; the highest rate of GP visits was among those aged 75 and over (95%) (ABS 2017). Rates were similar between men of the same age who had or had not served except those aged 35–44, where 89% of men who had served consulted a GP in the 12 months preceding the survey compared with 74% of men who had not served (ABS 2017).
Medicines
The Australian Government subsidises many medications. All Australian residents who hold a current Medicare card can access medications listed under the PBS, subject to patient entitlement status. The RPBS funded by DVA subsidises medications listed under the PBS and additional medications and items for eligible veterans, war widows/widowers, and their dependents.
See Medicines in the health system for more information.
In 2017–18, more than 1 million medications were dispensed under the PBS/RPBS to around 70,000 contemporary ex-serving ADF personnel with service from 1 January 2001, an average of 16 dispensed per person (AIHW 2019c).
After accounting for age and sex differences, similar proportions of the contemporary ex-serving and Australian populations were dispensed medications in 2017–18 (72% and 71%, respectively) (AIHW 2019c). Among contemporary ex-serving personnel:
- 37% were dispensed at least 1 nervous system medication (including antidepressants and anxiolytics)—compared with 31% for all Australians
- 22% were dispensed a cardiovascular system medication (for example for hypertension or high cholesterol)—compared with 24% for all Australians.
Policies regarding mental health treatment for contemporary ex-serving personnel have undergone change in recent years to facilitate early access to mental health treatment. The full effect of these changes may not be reflected for the contemporary ex-serving personnel captured in this data. Due to these policies, contemporary ex-serving ADF members have different pricing structures for, and access to, medications from the Australian population. These factors may influence the levels of dispensing between contemporary ex-serving members and the Australian population.
Overall, 17% of the contemporary ex-serving ADF population were dispensed at least 1 antidepressant in 2017–18 (AIHW 2019c). Figure 2 shows that after accounting for differences in the age and sex structures of the populations, 20% of all contemporary ex-serving ADF members received at least 1 dispensing for antidepressants, compared with 15% in the Australian population. On average, contemporary ex-serving ADF members who received at least 1 dispensing for antidepressants, received 9 dispensings per person, similar to the Australian population. Antidepressants are most commonly prescribed for mood and anxiety disorders but are also prescribed for other medical conditions, for example, chronic pain and sleep disorders.