Lt Gen John Sanderson AC (Retd) Returns to Cambodia as AUSTCARE Ambassador
- Tuesday 20 June 2006

Invisible enemy strikes Australian troops - The Age Newspaper

It's not just bullets and bombs that are threatening our soldiers in Iraq. The troops are battling another foe and it has felled more people than the fighting. Tom Hyland reports.

OVERSEAS operations are taking their toll on an over-stretched Australian Defence Force, with mental illness rather than combat injuries emerging as the leading threat to soldiers.

Figures obtained by The Sunday Age show that mental illness accounts for more than half the casualties suffered by Australian troops in Iraq.

Over the past three years, 23 soldiers have been discharged from the army on mental health grounds due to their Iraq service.

A further 29 who served in Iraq have also been discharged on mental health grounds not directly attributed to Iraq service. Instead, it was put down to other factors, including the possible cumulative impact of other deployments.

Over the same period, 14 Australian soldiers have suffered physical combat injuries in Iraq, mostly from roadside bombs, according to the ADF's figures.

An ADF spokeswoman was unable to give a breakdown on the extent of those injuries, but most are believed not to have been life-threatening or requiring repatriation to Australia.

The ADF is unable to say how many soldiers who have served in Iraq have been treated for mental illnesses, including post-traumatic stress disorder (PTSD).

While the discharges account for only a small percentage of the total number of personnel sent to Iraq 7287 have served there since 2003 the mental health of soldiers and veterans is emerging as an important focus for military health experts.

What the ADF calls the "high tempo" of operations is prompting the focus on mental health, amid fears that regular overseas deployments are having a cumulative effect, leading to PTSD, depression and anxiety disorders.

"Our ADF personnel face an increased tempo of operations and diversity in the nature of operations," Veterans Affairs Minister Bruce Billson said. "This is a new situation of stressors to their emotional health and wellbeing."

Mr Billson said the diverse operations — from combat, post-conflict stabilisation and peacekeeping, to disaster relief — were placing new strains on ADF members.

Unlike older veterans of conventional military service, a new generation of veterans faced different and multiple "stressors", that could affect their psychological wellbeing.

"There are new stressors — quite different from direct combat and battle over territory," Mr Billson told The Sunday Age.

The incidence of mental illness among soldiers is causing alarm in the US, where army research shows that 35 per cent of Iraq veterans sought mental health care during their first year home. The research found that 12 per cent of the more than 222,000 returning soldiers and marines in the study were diagnosed with a mental health problem.

Similar Australian figures are not available. A Department of Defence spokeswoman said the ADF did not have data on how many personnel who had served in Iraq required treatment for mental health conditions.

"This information is not held centrally and currently would only be available by identifying each ADF member who has deployed, and then by referring to each of those people's individual records," she said. "Defence is not prepared to undertake this extensive task."

An important obstacle in assessing the extent of mental illness among soldiers is the stigma involved.

According to US studies, half the soldiers who needed treatment for mental illness were unwilling to admit it for fear of being stigmatised.

Group Captain Len Lambeth, director of mental health in the ADF, said he would be "flabbergasted" if the US figures applied to Australian soldiers.

There were big differences between the US and Australian experience in Iraq, he said. US soldiers had a higher exposure to combat and many were part-time reservists who lacked the training, readiness and unit cohesion of regulars.

Group Captain Lambeth conceded mental illness carried a stigma among soldiers, just as it did among civilians.

He said the ADF was about to begin an important study of mental health problems in the military, and to identify barriers to people seeking medical care.

"I know one barrier to care is a fear of not being promoted," Group Captain Lambeth said.

He said there were similar barriers in other workplaces, and the military had a better record of treating and caring for people than some other employers.

But veterans spokesman Paul Copeland said soldiers were not reporting mental health problems because they feared being discharged.

He said members of one infantry battalion were recently asked to "put their hands in the air" if they felt they had a mental problem after operational service. "A number of them did and, basically, three months later they were medically discharged," said Mr Copeland, who is president of the Australian Peacekeepers and Peacemakers Veterans' Association.

"These people are hiding it and keeping it to themselves because of the risk they're going to lose their jobs."

Mr Copeland said the multiple operations facing the ADF were a burden on service personnel.

"That's certainly a problem," he said. "Speaking to a number of friends of mine who are still in service, there are a lot of tired people. They've gone on operation after operation."

The psychological welfare of soldiers and veterans is emerging as a big concern to the Federal Government and it committed an extra $20 million in the budget to military mental health.

In an attempt to earlier detect mental and other health effects of overseas service, the government-funded Centre for Military and Veterans Health has set up a project called the Deployment Health Surveillance Program, which aims to assess the health impact of operations, with a pilot program looking first at people who served in East Timor, Bougainville and the Solomons.