Serving and ex-serving Australian Defence Force members who have served since 1985: suicide monitoring 1997 to 2021

Background

In 2014 the Australian Department of Veterans’ Affairs (DVA) and Australian Institute of Health and Welfare (AIHW) established a partnership to build a comprehensive profile of the health and welfare of Australia’s veteran population. AIHW has worked with the Department of Defence (Defence) to link information from Defence personnel systems to a variety of health and welfare data to better understand the veteran population. This includes analyses on cause of death, use of health services and pharmaceuticals, and use of homelessness services. In 2017, the Australian Government responded to the Senate Inquiry Report, The Constant Battle: Suicide by Veterans by committing to provide an annual update on the levels of suicide among permanent, reserve, and ex-serving ADF members. Additionally, the National Mental Health Commission has highlighted the necessity of evidence-based policy advice to suicide prevention across all levels of Government (NMHC 2022). This AIHW report is the sixth annual update reporting the levels of suicide among ADF members.

The first 3 reports included ADF members who served from 2001 based on the availability of information at that time from the Defence Personnel Management Key Solution (PMKeyS), which was launched on 1 January 2001. For the fourth report, published in 2021, DVA commissioned AIHW to investigate the feasibility of using data from earlier Defence personnel systems to build a more comprehensive picture of the ex-serving population. The Department of Defence supported this research by compiling records from historical systems. After extensive investigation and validation of data sources, a population study cohort based on all ADF members with at least one day of service since 1 January 1985 was established and included for subsequent analyses. More information about this process is contained in the Technical notes.

AIHW acknowledges that the data presented in this report represent human lives and we acknowledge all of those serving and ex-serving ADF members who have died by suicide. We also acknowledge all of those who have been affected by suicide. We are committed to ensuring our work continues to inform improvements in mental health, and suicide awareness and prevention.

What is included in this report?

This report includes information on suicide deaths among ADF members who have served at least one day since 1 January 1985 and have died by suicide between 1 January 1997 and 31 December 2021.

In this report, the term ‘ADF members’ collectively refers to the 3 categories of: ‘currently serving permanent’, ‘currently serving active and standby reserves’, and ‘ex-serving’ members (see Box 1). These 3 ADF service status groups will be referred to as permanent, reserve, and ex-serving for the remainder of this report.

As of 31 December 2021, around 385,000 Australians had served at least one day in the ADF between 1 January 1985 and 31 December 2021. Of these, approximately 368,000 were alive, comprising 60,000 permanent, 38,700 reserve, and 269,000 ex-serving members. Box 2 below gives more information on the ADF population used in this report and how it compares to the Australian population. 

Information in this report is presented by service status, age, sex, service, rank, length of service, time since separation and reason for separation. Other factors were investigated for inclusion (namely operational experience, unit, location and occupation) but were excluded from reporting due to data limitations, low frequency of occurrence, and high frequency of movement by personnel. Further details can be found in the Technical notes section.

It should be noted that the female ADF cohort is smaller than the male cohort and, in general, suicide rates for females in the Australian population are lower than that of males¹. As such the confidence intervals (CIs) for statistics relating to female ADF members in this report are wide, meaning that there is less certainty in the accuracy of the calculated values. This affects our ability to detect statistically significant differences between the female ADF cohorts, and the overall Australian female cohort. As a result, caution should be taken in interpreting these data. 

This year, the monitoring report includes a special in-focus chapter on DVA clients. This in-focus chapter presents information about interactions with DVA from 2002 to 2021 by Australian Defence Force (ADF) members who have served since 1985. The chapter provides a profile of DVA clients and deaths by suicide are reported.

A separate web article further examining suicide and select causes of death among ADF members who have served since 1985 is available on request and with approval by AIHW.

Each release updates previously published numbers of suicides to reflect updates to the source data. The main reasons for changes to previously published results are:

• Updating the data to include the most recent year’s population and deaths.
• A lag in cause of death information for more recent years of data, where cause of death is finalised in following years.
• Revisions to cause of death data by the Australian Bureau of Statistics (ABS).
• Improvements in information available to the study.

More detail on these reasons for changes to previously published information is provided in the Technical notes.

What is not included in this report?

This report does not include data on several areas that may be of relevance to a study of suicide in the ADF member population and could further build the evidence base. For example, data are not included on living ADF members who have experiences with suicidal ideation, attempted suicide, or intentional self-harm.

More detailed information on ADF members who separated involuntarily for medical reasons, including detail on related medical conditions, could enable a better understanding of how separating for medical reasons may affect suicide deaths for this cohort.  An additional complex challenge that would require further investigation is the feasibility of comparing rates of suicide between the involuntary medical separation cohort and other appropriate populations, such as people with similar medical conditions.

For some of the above areas of study there are currently no readily available complete data sources for analysis, for example relating to living ADF members who have experiences with suicidal ideation, attempted suicide, or intentional self-harm. Investigation of these areas by AIHW or other researchers would require data development or linkage before information could be reported.

Notes on measuring death by suicide

Information on suicide is presented in 3 ways in this report.

1. Overall counts of suicides are presented to give an indication of the total occurrences.
2. Suicide rates are reported to compare across groups within the permanent, reserve, and ex-serving cohorts to take into account the size of the underlying population.
3. Standardised Mortality Ratios (SMRs) are used to compare rates of suicide between groups with different age structures, such as when comparing the permanent, reserve, and ex-serving populations with the general Australian population.

Confidence Intervals (Cis) of 95% are used to assess uncertainty in suicide rates. CIs give some indication of how close the true rate lies to the calculated rate. Narrower CIs indicate more certainty in the result, and wider intervals means less certainty in the result.

More information on these concepts is in the Technical notes.