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 21st 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 2002Aimed at co-ordination of ADF MH managementNow within Directorate of Strategic Health Policy and PlansResponsible 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 serviceKeep abreast of world literatureKeep aware of relevant researchFocus 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 excellenceLiaison with external agenciesInternational relationshipsLiaison with key stakeholders.Regional Mental Health TeamsPolicy – PTSD, Depression, Suicide, CMSCourses – CHRP, Acute MH on opsMH literacy

ADF MH RESEARCH AND SURVEILLANCE

MH Surveillance, Research and Advisory GroupADF MH and Wellbeing StudyADF Psychological Resilience Study

ADF CMS

Fundamental in response to critical incidentsFramework developed in conjunction with ACPMHTraining manuals developedT4T courses (76 CMS trainers)CMS professional/provider courses (460 MH professionals and providers trained)

ADF SUICIDE PREVENTION PROGRAM

Suicide rates within ADF declining4 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 ATODSLinked to National Alcohol campaignKYMS – Alcohol – ‘first aid’ATODS course – 2 day for MH prof. and providersMotivational Interviewing9 OAT programs (83 participants Jun 06 – end Apr 07)RAN programAREP program

RESILIENCE AND WELL BEINGADF Wellbeing ForumWellbeing HandbookChaplaincy and Spirituality WellbeingResilience training

DMH GUIDING PRINCIPLES

Develop policy to promote good mental health and well being aimed at maintaining operational capabilityCarry out limited and basic trainingA resource for clinical advice and policyPartnership building ( key stakeholders, ACPMH, CMVH, DVA, VVCS)

THE FUTURE

Development of MH serviceE HealthDevelopment of ADF MH ActADF MH and Well Being StudyADF Resilience StudyPolicy development

Questions ??