More must be done to help veterans suffering PTSD

23 Apr 2016

Sydney Morning Herald – 22 April 2016.

This Anzac Day, we salute the contribution and sacrifice of the men and women who have served Australia in the armed forces for the past 100 years.
For some, that sacrifice results in the devastating invisible wounds of poor mental health – posttraumatic stress disorder (PTSD), depression, anxiety, anger, aggression, alcohol and drug abuse, and thoughts of suicide.
This Anzac Day, let us make a commitment to those who are currently suffering, a commitment to improve the availability and effectiveness of interventions to help their recovery.
The majority of service men and women come through their military experiences with little or no long-term psychological problems. However, a substantial minority do develop devastating mental health problems which have a profound impact on the individual and their family.
We know that PTSD, the most common mental health disorder in veterans, is a serious and debilitating disorder. Symptoms include frequent flashbacks, nightmares, panic attacks, being constantly on the alert,and feeling emotionally numb. Other issues often occur alongside it, such as anger, aggression, depression, substance abuse and suicidal thoughts.

Without effective treatment, the person can feel overwhelmed by their problems, isolated, unable to work, unable to find peace in the world, and unable to connect with their families.
In 2016, Australia’s serving personnel and veterans have very good access to mental health care due to the commitment of both the Australian Defence Force (ADF) and the Department of Veterans’ Affairs (DVA) to provide high quality evidence-based care and treatment. But the best treatments that we currently have only work for some, and only a third of PTSD patients fully recover.
We need to close that gap and research new, innovative treatments, and discover how to make existing treatments more effective and how to engage and intervene early. We also need to learn more about adjunctive therapies and activities that can support evidence-based treatment and improve quality of life. As understanding of PTSD grows, and research is undertaken to improve treatments, awareness and understanding is also increasing about the broader scars of war.
“Moral injury” is a term used to describe the potential impact of experiences in battle that challenge or transgress a person’s deeply-held moral beliefs. The consequences of such an experience may extend beyond PTSD into guilt, shame, anger and aggression, and at times, self-destructive thoughts and behaviour.
While research in this area is in its infancy, the notion itself is not a new one. Helping a person who has suffered moral injury is not the domain of mental health researchers and practitioners alone; it requires a multidisciplinary understanding, including of the spiritual dimension.
Experts across Australia and internationally are examining ways to better understand and define moral injury and consider how best to support healing and recovery. It is critical that scarce research efforts and dollars are targeted to answer the most urgent questions and ensure that the research is then used to improve the lives of serving personnel and veterans.
Phoenix Australia – Centre for Posttraumatic Mental Health, in collaboration with key partners around the country, is planning cutting edge research into new and innovative treatments, to help those people who do not benefit from current treatments. Already, in collaboration with DVA and ADF, a trial has commenced to test the effectiveness of delivering one of the most effective therapies for PTSD in a shorter, more efficient manner to make it more accessible to a broader range of veterans and serving personnel.
The rewards of increased research involving a collaboration of specialists and experts in military mental health will be benefits for not only service men and women and their families, but ultimately for all Australians who are affected by trauma, whether it be the result of a serious accident, sexual or physical violence, natural disaster, or war.
Professor David Forbes is the director of Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, the University of Melbourne. Phoenix Australia is a not-for-profit centre promoting recovery from trauma through research, policy and service advice, and education and training.

 

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The rewards of increased research involving a collaboration of specialists and experts in military mental health will be benefits for not only service men and women and their families, but ultimately for all Australians who are affected by trauma, whether it be the result of a serious accident, sexual or physical violence, natural disaster, or war.
Professor David Forbes is the director of Phoenix Australia – Centre for Posttraumatic Mental Health, Department of Psychiatry, the University of Melbourne. Phoenix Australia is a not-for-profit centre promoting recovery from trauma through research, policy and service advice, and education and training.