Introduction
Background
In 2014, the Department of Veterans’ Affairs (DVA) and the Australian Institute of Health and Welfare (AIHW) established a partnership to build a comprehensive profile of the health and welfare of Australia’s veteran population. As part of this partnership, AIHW has worked with the Department of Defence to link information from Defence personnel systems to a variety of health and welfare data sources to better understand the characteristics of all veterans including cause of death, use of health services and pharmaceuticals and use of homelessness services. In 2017, the Australian Government responded to the Senate Inquiry Report, The Constant Battle: Suicide by Veterans, by committing to provide an annual update on the level of suicide of permanent, reserve and ex-serving ADF members. In addition, recent government strategic priorities have highlighted that improvements to data and evidence-based research are essential enablers of effective suicide prevention, with all agencies and levels of government having a role to play in strengthening these (National Suicide Prevention Adviser 2020). This report is the fourth annual update.
The first three reports included ADF members who served from 2001 based on the availability of information at that time from the Defence Personnel Management Key Solution (PMKeyS) which started on 1 January 2001. To build a more comprehensive picture of the ex-serving population, DVA commissioned AIHW to investigate the feasibility of using data from earlier Defence personnel systems and other sources. The Department of Defence supported this research by compiling records from historical systems. After extensive investigation and validation of data sources, a population study cohort based on all ADF members with at least one day of service since 1 January 1985 has been established and is used for the first time in this report. More information about this process is contained in the Technical notes.
AIHW acknowledges that the data presented in this report represents human lives and we acknowledge all of those serving and ex-serving ADF members who have died by suicide. We also acknowledge all of those who have been affected by suicide. We are committed to ensuring our work continues to inform improvements in mental health, and suicide awareness and prevention.
What is included in this report?
This report includes information on suicide deaths among all ADF members who have served at least one day in the ADF since 1 January 1985 and who died by suicide between 1 January 2001 and 31 December 2019.
In this report, the term ‘ADF members’ collectively refers to the three categories of ‘currently serving permanent’, ‘active and inactive reserves’ and ‘ex-serving’ members (Box 1). These three ADF service status groups will be referred to as; permanent, reserve and ex-serving for the remainder of this report. In previous reports, permanent ADF members were referred to as serving – there has however been no methodological change and the term is comparable to previous reports.
As of 31 December 2019, almost 373,500 Australians had served at least one day in the ADF between 1 January 1985 and 31 December 2019. Of these, just over 358,000 were still alive of which 59,000 were permanent, 38,700 reserve and nearly 261,000 ex-serving.
The previous report was based on ADF members with at least one day of service since 1 January 2001 who died by suicide between 1 January 2001 and 31 December 2018. The expansion to the larger population provides results that are more representative of the ex-serving ADF population. The larger study population allows for more detailed analysis of subgroups. Care should be taken in directly comparing data in this report with previous AIHW publications due to the larger study population.
Information in this report is presented by age, sex, rank, length of service, time since separation and reason for separation.
Box 1: Who is included in this report?
Permanent: ADF members serving in a full time capacity in the Royal Australian Navy (Navy), Australian Army (Army) or the Royal Australian Air Force (Air Force) from 1 January 1985, and serving in a permanent capacity on 31 December 2019 or when they died.
Reserve: ADF members in the reserve forces for the Navy, Army or the Air Force from 1 January 1985 and who were in the reserve forces on 31 December 2019 or when they died. Most members leaving full-time service transition to the reserves (for a minimum of five years), unless prevented by medical or other reasons. The service status ‘Reserve’ includes members with a wide range of different experience and relationships to the ADF. For example, it includes personnel who have transitioned from full time service as well as both those who have joined in reserve capacity. Members provide service across a service spectrum that is based on their availability to render service. Some members may not render service in any capacity due to their personal circumstances, however they are liable to be called on by Government.
Ex-serving: ADF members in the fulltime or reserve services between 1 January 1985 and 31 December 2019, but who subsequently transitioned from Defence.
Each annual release updates previously published numbers of suicides to incorporate any updates to the source data. The main reasons for changes to previously published results are:
- use of the expanded population, meaning that deaths by suicide from 2001 to 2019 for those who separated between 1985 and 2001 are included for the first time.
- a lag in cause of death information for more recent years of data, where cause of death is finalised in the following years.
- revisions to cause of death data by the Australian Bureau of Statistics (ABS).
- improvements in information available to the study.
More detail on these reasons for changes to previously published information is provided in the Technical notes.
If you need help or support, please contact:
Open Arms - Veterans and Families Counselling 1800 011 046
Open Arms Suicide Intervention page
Defence All-hours Support Line (ASL) 1800 628 036
Defence Member and Family Helpline 1800 624 608
Defence Chaplaincy Support 1300 333 362
Lifeline 13 11 14
Suicide Call Back Service 1300 659 467
Beyond Blue Support Service 1300 22 4636
For information on support provided by DVA, see:
Notes on measuring death by suicide
Information on suicide is presented in three ways in this report.
- Actual numbers of suicides are presented to give an indication of the total number.
- Suicide rates are reported to compare between groups within the permanent, reserve and ex-serving population to take into account the size of the underlying population.
- Age-adjusted suicide rates or Standardised Mortality Ratios (SMRs) are used to compare rates of suicide between groups with different age structures such as comparing the permanent, reserve and ex-serving populations with the general Australian population.
Confidence intervals (CIs) are used to assess the uncertainty in suicide rates due to fluctuations that may occur in the number of suicides over time. Narrower confidence intervals indicate more certainty in the result, and the difference between two rates is statistically significant when the confidence intervals don’t overlap.
The increased population size in this report means that greater confidence can be attached to consistently observed differences between different groups and therefore confidence intervals are smaller than in previous reports.
More information on these concepts is in the Technical notes.
Box 2: The ADF population with at least one day of service since 1 January 1985 and how it compares with the Australian population
As of 31 December 2019, almost 373,500 Australians had served at least one day in the ADF since 1 January 1985. Of these, just over 358,000 still alive of which 59,000 were permanent, 38,700 reserve and nearly 261,000 ex-serving.
Since 1985, the ex-serving population with at least one day of service since 1 January 1985 has increased each year as permanent and reserve ADF members separate. At the end of 1985, almost 6,100 members of this cohort had separated and by the end of 2019 this had grown to nearly 274,000. Due to the method used to assemble the study population, as members leave the permanent and reserve service, they are counted as members of the ex-serving study population until they die.
The permanent, reserve and ex-serving populations have different demographics to the Australian population. While the Australian population is 50% male, the permanent, reserve and ex-serving populations are 84% male.
The permanent, reserve and ex-serving populations also have different age structures with median ages of 31, 37 and 50 years respectively compared with 38 years for the Australian population.
These age and sex differences are considered when examining differences in suicide levels between these populations.
See the AIHW report Serving and ex-serving Australian Defence Force members who have served since 1985: population characteristics 2019 for more detail on the ADF population.