Suicide rates are higher compared to the general population in military veterans. In US combat veterans, suicidal behaviour is higher in those who are younger, suffer from Post Traumatic Stress Disorder, depression and anxiety and score lower on measures of general health. Identification and effective treatment of mental health disorders in the veteran population is essential in reducing suicide rates.
Veterans maybe of any age or gender with the number of women in the ADF increasing from 4% in 1973 to 15% in 2015. Women’s roles have expanded significantly including deployment of mothers. There are many traumatic stressors in the military environment that may lead to mental health disorders. These can occur in Australia and on deployment overseas (peacetime and combat).
GPs have a key role to play in the diagnosis and treatment of mental health issues in the veteran population. These issues can occur across a lifespan with increased suicide rates in those under 30. There can be a significant transgenerational impact on a veteran’s family and GPs can assist in breaking down barriers such as stigma and accessing the range of available support.
The Transition and Wellbeing Research Program has been established to investigate these issues. The Mental Health Prevalence and Pathways to Care reports have been released. The study populations are ADF members who transitioned from regular ADF between 2010 and 2014, a random sample of regular ADF members serving in 2015 and those who participated in the 2010 Military Health Outcomes Program (MILHOP).
The estimated prevalence of lifetime mental disorders in transitioned ADF showed anxiety (46.1%) and alcohol disorders (47.5%) as the most common classes of lifetime disorder; 25% are estimated to have met criteria for PTSD.
GPs can address maladaptive strategies that may be used to avoid acceptance of mental health issues, such as alcohol and substance misuse. On diagnosis by a GP, the DVA will fund treatment of PTSD, anxiety, depression, and alcohol or substance misuse disorders for veterans with operational service. These arrangements are known as “non-liability health care” and aim to allow prompt intervention.
The DVA At Ease website provides online mental health information. It includes self-help tools, information, and free mobile apps to help with stress, PTSD, alcohol, resilience and suicide prevention. DVA provides group treatment programs for PTSD in hospitals across Australia. The Veterans and Veterans’ Families Counselling Service (VVCS) provides free confidential mental health services for veterans and their immediate family members. No referral is required, though veterans may need encouragement to check their eligibility and be reassured about the confidentiality of these services.
Treating veterans can be very satisfying with a comprehensive service and support available to assist GPs in providing effective care.
- Veterans have complex mental health needs
- DVA fund treatment on diagnosis by a GP
- VVCS provides psychological treatment
- DVA “At Ease” is a useful online resource
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