ADF MENTAL HEALTH STRATEGY GPCAPT LEONARD LAMBETH BSc(Med) MBBS FRANZCP DAvMed Director, DMH

INTRODUCTORY REMARKS War causes injury, sickness, psychological injury, death The scope of military service in the 21 st century A risk averse society Psychological damage – an inevitable outcome ??

MENTAL HEALTH TODAY 25% attending a GP need psychological treatment 20% will suffer clinical depression Mental health now in an enlightened age – or is it??

THE PROBLEM How can a nation defend itself with a professional armed force at the same time as protecting its servicemen and women from lasting damage?

MORE PROBLEMS Ethical dilemma “Mad” or sane?? Military psychiatry on the border between stress that enhances performance but can cause long term psychological injury

HISTORY OF DMH  Established with launch of ADFMHS 2002  Aimed at co-ordination of ADF MH management  Now within Directorate of Strategic Health Policy and Plans  Responsible to Head, Defence Health Service

DMH – THE MISSION “TO ENHANCE THE OPERATIONAL EFFECTIVENESS OF THE ADF”

CONCEPT OF OPERATIONS “To enhance the effectiveness of ADF units through the provision of best practice, evidence based, mental health support to Commanders and ADF members in order to contribute to the well being and operational effectiveness of the ADF’s key capability – its people”

DMH – Our Obligations  Development of evidence based policy adaptable to military service  Keep abreast of world literature  Keep aware of relevant research  Focus on training  Conduct relevant research

DEALING WITH MH ISSUES Four tiers: 1.Enhancement of mental health 2.Preparation for operational service 3.Identification of MH issues 4.Treatment of MH issues

KEY INITIATIVES 1.Integration and enhancement of mental health services 2.ADF mental health research and surveillance 3.ADF Critical Incident MH support 4.ADF Suicide Prevention Program 5.ADF Alcohol, Tobacco and Other Drugs program 6.Enhanced resilience and well being in the ADF

INTEGRATION AND ENHANCEMENT OF ADF MHS  Liaison with centres of excellence  Liaison with external agencies  International relationships  Liaison with key stakeholders.  Regional Mental Health Teams  Policy – PTSD, Depression, Suicide, CMS  Courses – CHRP, Acute MH on ops  MH literacy

ADF MH RESEARCH AND SURVEILLANCE  MH Surveillance, Research and Advisory Group  ADF MH and Wellbeing Study  ADF Psychological Resilience Study

ADF CMS  Fundamental in response to critical incidents  Framework developed in conjunction with ACPMH  Training manuals developed  T4T courses (76 CMS trainers)  CMS professional/provider courses (460 MH professionals and providers trained)

ADF SUICIDE PREVENTION PROGRAM  Suicide rates within ADF declining  4 levels of training 1.SPP induction training 2.KYMS – SPT (2 hr. for jun. leaders – 54 trainers) 3.ASIST (2 days) – 128 accredited trainers, over 3000 personnel trained 4.Clinical upskilling – for MH professionals

ADF ATODS  Linked to National Alcohol campaign  KYMS – Alcohol – ‘first aid’  ATODS course – 2 day for MH prof. and providers  Motivational Interviewing  9 OAT programs (83 participants Jun 06 – end Apr 07)  RAN program  AREP program

RESILIENCE AND WELL BEING  ADF Wellbeing Forum  Wellbeing Handbook  Chaplaincy and Spirituality Wellbeing  Resilience training

DMH GUIDING PRINCIPLES  Develop policy to promote good mental health and well being aimed at maintaining operational capability  Carry out limited and basic training  A resource for clinical advice and policy  Partnership building ( key stakeholders, ACPMH, CMVH, DVA, VVCS)

THE FUTURE  Development of MH service  E Health  Development of ADF MH Act  ADF MH and Well Being Study  ADF Resilience Study  Policy development

Questions ??