Defence continues to deliver services to support the health and wellbeing of ADF personnel and veterans. The services are planned and delivered as a collaborative effort between Joint Health Command, Defence People Group, Navy, Army, Air Force and the Department of Veterans’ Affairs.

Health services

In 2019–20, the Services continued to maintain health capabilities, primarily to support their exercises and operations.

The Services also contributed to the delivery of health services by providing uniformed health staff for:

• Garrison Health, which delivers and manages health care for ADF personnel in Australia and on non- operational postings overseas
• Combat Health Support, which delivers health care for ADF personnel on military operations, including Operation BUSHFIRE ASSIST 2019–2020, and Operation COVID-19 ASSIST.

Mental health services

Defence has long recognised that the mental health and wellbeing of its workforce is critical to Defence capability. Defence is committed to providing mental health services and support to all ADF members and APS employees, and is focused on making Defence people ‘Fit to Fight, Fit to Work, Fit for Life’.

The Defence Mental Health and Wellbeing Strategy 2018–2023 brings Defence’s mental health and wellbeing actions and priorities together for the first time into one coordinated plan. While there are differences in the types of initiatives and programs available to the ADF and APS workforces, there is a common understanding of the need to ensure a mentally healthy and resilient workforce.

The strategy outlines six strategic objectives for improving the mental health of serving members using evidence- based practice. These objectives are:

• Leadership and shared responsibility
• A thriving culture and healthy workplace
• Responding to the risks of military service
• Person-driven care and recovery
• Building the evidence
• Continually improving.

The Mental Health and Wellbeing Strategy is focused on decreasing stigma, improving the knowledge and skills of all employees and improving the support services available. It includes the delivery of a range of mental health programs and training. During 2019–20 there was an emphasis on the design and development of a continuous improvement framework for mental health support. The implementation phase of the continuous improvement framework will begin in late 2020. It will involve the monitoring and evaluation of mental health initiatives, including suicide prevention and mental health programs and training, and will provide informative data on the impact of the overall strategy.

Mental health screening

Defence applies a mental health screening continuum that supports operational and post-deployment screening, critical incident mental health screening, and the Periodic Mental Health Screen. The continuum provides opportunities for ADF members to undergo screening regardless of whether they have deployed. The Periodic Mental Health Screen was an enhancement to the mental health screening continuum implemented in 2019.

Operation BUSHFIRE ASSIST 2019–2020 presented an opportunity to apply a streamlined risk-indicated mental health screening process, which provided a useful indicator of the health and wellbeing of ADF members force assigned to the operation. As of May 2020, almost 6,000 ADF personnel had participated in mental health screening relating to BUSHFIRE ASSIST 2019–2020.

Joint Health Command mental health and wellbeing mobile application

The mental health screening continuum will be further enhanced in late 2020 with the development of a smart phone application enabling ADF members to self-check their mental health anonymously and access timely guidance and support on their current levels of mental health and wellbeing. It will enable the integration of mental health services by connecting the current range of websites, applications and resources, providing a central point to navigate and direct users through the system and enabling members to track their mood and complete surveys.

The application will be available to all Groups and Services and to families. It will be a tool to access information that supports the prevention of mental health issues and promotes early intervention and maintenance of wellbeing. It is not a replacement for face-to-face clinical intervention.

Project RESTORE

Project RESTORE is a clinical trial of a treatment for post-traumatic stress disorder known as Prolonged Exposure. The trial is being run to determine whether an intensive delivery of Prolonged Exposure therapy will deliver outcomes comparable to the Prolonged Exposure treatment protocol.

Defence has partnered with the Department of Veterans’ Affairs, Open Arms—Veterans and Families Counselling, and Phoenix Australia to run the clinical trial. The COVID-19 pandemic led to the trial being conducted using video- conferencing and extended to the end of July 2020. It will deliver an initial evaluation of outcomes by the end of 2020. It is hoped that the trial will lead to improved access to, and availability of, effective evidence-based care for post-traumatic stress disorder for both current and former ADF members.

Family Sensitive Practice in Health Care

Following a successful trial in 2018, the Family Sensitive Practice in Health Care course for health professionals was developed in the second half of 2019 by The Bouverie Centre at La Trobe University, in partnership with the Department of Defence. The Bouverie Centre trained Defence trainers to deliver the program, enabling Defence trainers to implement the program across all Garrison Health Centres by late 2019. This program facilitates improved opportunities for attendance by families with the member at health appointments and welfare boards, improved exchange of information with families, and improved opportunities for families to convey concerns and information that will support the member’s health management. It assists in validating the important role of the family and in incorporating their preferences and needs, and helps families identify options for additional supports.

Transition from Australian Defence Force

Defence is developing a Health Aspects of Transition policy and working closely with the Department of Veterans’ Affairs and the Commonwealth Superannuation Corporation to ensure that this policy achieves early acceptance of initial liability and provides a streamlined approach and greater security for transitioning ADF members.

Defence continually refines the health processes associated with preparing ADF members for transition from service. A collaborative and comprehensive transfer of a member’s health care to the civilian health system now occurs, especially for those undergoing rehabilitation. This includes arranging appointments with a civilian general practitioner before and immediately after transition for those who are medically transitioning.