Summary
Australian Defence Force (ADF) members have unique experiences as a result of their service in the military, which can influence their health and wellbeing relative to the rest of the Australian population. In general, ADF members are trained to be physically and mentally fit, receive regular medical assessments, and have access to comprehensive medical and dental treatment. In contrast to the general Australian population, ADF members can be subject to workplace stressors from exposure to combat, periodical geographical relocations, and lengthy separation from family. Military service also increases the likelihood of exposure to life threatening situations, which may result in physical and mental trauma and moral injury (Jones et.al, 2020).
An important message from studies of the health and wellbeing of ADF members has been to understand the risk and protective factors for serving, ex‑serving and reserve members of the ADF who have died by suicide (Baker et.al., 2017; NMHC, 2017; SFADTRC, 2017; Productivity Commission, 2019; Jones et.al., 2020).
Suicide in the Australian community has profound impacts on family, friends and communities. Every life lost to suicide in the veteran population is a tragedy and service men and women in the ADF are a critical part of the Australian community, particularly in their role in the defence of Australia. Suicide prevention of ADF members is of significant public interest and a particular consideration for enabling positive health and welfare outcomes for ADF members. Suicide by ADF members, like suicide in the Australian population is an ongoing, complex, and multifaceted public health problem. Ex-serving ADF members represent a population group that are at increased risk of suicide (AIHW, 2020).
In this report, risk and protective factors for suicide are described in terms of connections to personal circumstances or social processes of ADF members, and their physical and mental health. Risk and protective factors can vary by age, health status, and changes in employment outcomes, such as separation from the ADF. The frequency, type and timing of access to social, health and welfare services can also be risk or protective factors affecting suicide outcomes for ADF members.
In this report a cohort of serving, ex‑serving and reserve ADF members who have died by suicide and had at least 1 day of service since 1 January 2001 was examined. The analysis uses Department of Defence (Defence) and Department of Veterans’ Affairs (DVA) administrative population datasets, and combines these with other data sources through data-linkage to enable investigation of systemic evidence with a high level of applicability to inform policy and prevention programs.
The themes explored include influence of demographic and socioeconomic factors, and ADF service career history including phases of active service and separation from the ADF. Further, the analysis identifies psychosocial and other factors affecting suicide among the study cohort. The report also provides an analysis of use of health services and pharmaceutical dispensing by serving, ex‑serving and reserve ADF members who have died by suicide. For all of these data, comparisons are made between ADF members who died by suicide, the whole ADF population and the general Australian population.
There are notably some challenges and limitations encountered in the analysis of linked administrative data; for example, with respect to bias from linkage errors where records cannot be linked and other examples where the data sources are of varying quality and limited in the time period to which data are available. See the footnotes and Technical notes in this report for further details on caveats in interpreting the analysis.