Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Foreign Affairs, Defence and Trade References Committee
21/09/2015
Mental health of returned Australian Defence Force personnel

BINSKIN, Air Chief Marshal Mark, AC, Chief of the Defence Force, Department of Defence

CARMODY, Mr Shane, Chief Operating Officer, Department of Veterans' Affairs

GAYNOR, Brigadier James, Acting Inspector-General of the Australian Defence Force, Inspector-General of the Australian Defence Force

GRIGGS, Vice Admiral Ray, AO, CSC, Vice Chief of the Defence Force, Department of Defence

Committee met at 09:03

CHAIR ( Senator Gallacher ): Welcome. Would you like to make a brief opening statement before we go to questions?

Air Chief Marshal Binskin : I think both Shane and I would like to make opening statements.

CHAIR: No problem.

Air Chief Marshal Binskin : Thank you for the opportunity to be here today to address the committee on something that is very serious and something we take very close to heart, and that is our people's mental fitness. It is as important to us as their physical fitness. We acknowledge that military service creates unique stresses and we are committed to ensuring all our personnel have access to the best possible health care. Whilst post-traumatic stress disorder dominates discussion, treating anxiety, depression or alcohol and substance abuse is equally important. When treatment is required, we will provide it regardless of the nature or source of a person's injury or illness.

Since 2009 Defence has invested more than $162½ million in mental health programs. In that time we have upskilled and increased our mental health workforce as well as strengthened our resilience training and prevention strategies, which now begin at recruitment. We have improved the screening programs used to identify problems and we have also undertaken world-class mental health research and surveillance. As a result, we know more now than at any point in our history about the impact military service can have on the mental, physical and social health of current and ex-serving personnel. We have a comprehensive body of data about the causes and prevalence of mental health issues in the Australian Defence Force population.

Our research clearly shows that exposure to trauma increases a person's risk of developing a mental health condition or problem, as you would expect. Some people will be exposed to trauma while on operations. Others may experience traumatic events outside a deployment or military service. Despite reports to the contrary, we fully accept that the risk of experiencing a traumatic event increases during a deployment whether it be to a conflict zone, during a humanitarian or disaster relief mission or in border protection operations.

Our studies show that around eight per cent of ADF personnel have suffered PTSD in a 12-month period. Unfortunately, only half of those people will actually seek help. This points to one of the biggest challenges we continue to face in the Australian Defence Force: how do we break down the stigma and perception of weakness associated with admitting to a mental health illness? This is an issue not just for the ADF but for our police and emergency service colleagues and for the broader Australian community. There is no simple solution, but we continue to talk openly and honestly about the subject to try to give people the confidence and the courage to reach out for help.

I remain concerned about any suicide of an Australian Defence Force member, and it is a concern shared by the Vice Chief of the Defence Force and the service chiefs, which is why they are here today. Any death by suicide is a tragedy, and my primary purpose in responding to the issue is to save lives. Since meeting with Mr Aaron Gray, founder of the Australian Veterans Suicide Register, in April of this year, I have been working on options to examine in greater detail the range of factors which may contribute to a person taking their own life. I have now appointed a one-star officer to conduct a systemic review into suicide and related mental health issues in the Australian Defence Force Unlike previous studies, this review is deliberately designed to have a much broader remit than health alone. I intend that the review will look at all aspects of a military career from the recruitment phase right through until discharge from the Australian Defence Force.

While the ADF has made significant progress in mental health care over the past six years, we continue to see young men and women who are suffering. I want to identify any potential shortcomings in our policies, our programs or our practices and clearly identify those areas we may be able to change in order to prevent future tragedies. Simply put: are we missing something in what we currently do and, if so, how may we need to address it in the future? We already have a number of suicide prevention strategies in place, but the review I am announcing today and have been looking to develop over the last few months is about building on our existing programs and identifying any gaps to further improve our practices and better support our people.

I have also recently engaged with the Commissioner of the Australian Federal Police with a view to sharing the insights and experiences of our respective organisations.

You will not necessarily see it in media reporting, but there are numerous examples where people have successfully undertaken rehabilitation and returned to work. In the 2013-14 financial year more than half of those people diagnosed with a mental health condition such as depression or anxiety orders, including PTSD, successfully returned to work. Our current suite of evidence based treatment, rehabilitation and awareness programs are among the best in the world; however, we are well aware that no one size fits all, so we employ multiple targeted programs to develop a tailored recovery plan to suit each individual person and their family. We have adapted new methods to reach out to the tech-savvy cohort of younger veterans with a range of self-help and information apps that they can access anywhere and anytime on their smart phones.

We also recognise that we need to continue to develop a family-sensitive and inclusive approach to the mental health and rehabilitation programs we offer ADF members. As an example of this, the joint Defence/DVA Transition and Wellbeing Research Program, which is now underway, will not only examine the impact of service on the mental health and wellbeing of serving members and reservists but will, importantly, also include Defence families.

We are looking beyond medical circles and our international counterparts to address mental health. We are working cooperatively with external agencies and ex-service organisations to meet our people's needs. Most importantly, we are listening to those who are suffering in order to understand what works and what does not so that we can better target those areas where we fall short of expectations. I regularly spend time with our Defence personnel on deployment, on base and in their units, including visits to the Melbourne repatriation hospital and recently at Townsville Soldier Recovery Centre. I speak directly to those soldiers, sailors, air men and women who are recovering from mental or physical wounds as a result of their military service. The conversations can be distressing and can be inspiring, but are necessary to understand what these men and women are going through. I am grateful for their frank and fearless opinions—and they do provide me frank and fearless opinions. Their views and experiences do matter. They are vital to ensuring that the service chiefs and I follow through on our pledge to do what we can to support them in their recovery.

Mr Carmody : I wish to say a few opening remarks. Thank you very much for the opportunity to appear today. As you would have seen from our submission, DVA's major focus is on early intervention. This is the critical step in identifying and meeting the mental health needs of the veteran community. DVA has around 320,000 clients—

of whom about 210,000 have the gold or a white card for healthcare treatment. Our client profile reflects the broad range of serving personnel who have served in the ADF in peace and in war. Our largest cohort is the older veterans and war widows group. The needs of people in this cohort are increasingly in aged care and support. Even the Vietnam veterans are now in their 60s and 70s, with many of them in retirement. We are starting to see an increasing number of contemporary veteran clients, given the range of ADF operations since 1999. Of the around 58,000 permanent members of the ADF, about 6,000 leave each year—about 1,000 of these for medical reasons. A key point here is that around 5,000 separating members have no relationship with DVA.

DVA's responsibilities for care and compensation are enshrined in legislation. To ensure that people know about our services and the support that we can provide, the department secretary now writes to all 6,000 or so ADF personnel who separate each year. This letter outlines what DVA can do for them and that we are here to help them if and when required. Even so, around 25 per cent of separating ADF personnel opt out of receiving information from DVA. DVA's on-base advisory service has developed into a very important service, providing advice and support as well as encouraging the early lodgement of claims. DVA now has an on-base presence at over 44 bases around the country. In 2013-14, our on-base service responded to over 13½ thousand inquiries—an increase of over 4½ thousand on the previous year.

There are many ways for veterans and families to access mental health support. They can talk to their GP, who may provide treatment or refer them to a psychologist, a psychiatrist or a social worker. They can go online to DVA's mental health web portal, At Ease, which gives them access to videos, self-help tools, mobile apps on mental health and wellbeing. Or they can call the Veterans and Veterans Families Counselling Service 24 hours a day, seven days a week, to access free and confidential Australia-wide counselling and support. We also provide non-liability health cover for veterans. This is where DVA can pay for certain mental health treatment, whatever the cause; it does not have to be related to service. These arrangements are available for anyone with operational service and for many with more than three years peacetime service. The conditions covered include post-traumatic stress disorder, anxiety, depression, alcohol use disorder and substance use disorder.

In 2013, DVA approved 1,244 non-liability applications for mental health. The government expanded access to these arrangements in July 2014. The number of applications approved by DVA increased to 3,826 the year after. In January 2015, the government further simplified access to non-liability healthcare by permitting diagnosis from a vocationally registered GP, a clinical psychologist or a psychiatrist. Prior to this change, only psychiatrists could diagnose for these arrangements.

Some of the submissions to this inquiry refer to our times taken to process for compensation claims. We have various strategies underway to improve compensation claims processing and to promote early access to support treatment for mental health conditions. Our average time taken to process compensation claims in 2014-15 has improved on the 2013-14 results under all of our acts. Claims under the Military Rehabilitation and Compensation Act are down to 109 days, a reduction of 35 days; under the VEA they are down to 72 days, a reduction of three days; and under the SRCA they are at 140 days, a reduction of 20 days.

It was heartening to see strong support in some of the submissions for the Veterans and Veterans Families Counselling Service. This is an important and very valuable service. Importantly, other submissions also made reference to the need for strong and continuing focus on homelessness and suicide prevention. Both of these matters are high priorities for DVA.

Given the operational environment since 1999 DVA expects an increase in the number of claims related to mental health, but research has shown that even in the absence of operations we should expect a level of mental health claims from our defence community. In anticipation of this, in 2013 the government released the Veteran Mental Health Strategy 2013-2023, a strategic framework to support mental health and wellbeing in the veteran and ex-service community, underpinned by the principles of prevention, recovery and building resilience.

Together with the ADF, DVA has important research underway—as the CDF mentioned—investigating the prevalence of mental health disorders in the contemporary cohort. The Transition and Wellbeing Research Programme is a four-year program in conjunction with Defence. It will include a picture of mental health disorders in the initial years after transition from full-time service and it will investigate how members previously diagnosed with mental health disorders access care, how issues change over time, the mental health status of reservists and the experiences and needs of service families and ex-service personnel and reservists. Data collection started in June 2015, with around 25,000 ex-service personnel, 20,000 serving personnel and 5,000 reservists and their families invited to participate.

Mental health is a priority for DVA and any suicide is a tragedy, so we must do all we can to prevent it. As the committee knows, funding for mental health treatment is demand-driven and is not capped. We spend around $182 million annually on veteran mental health services, but our focus remains on early intervention. If people are worried about how they are feeling or how they are coping we encourage them to seek help early. There are services and there is support ready and waiting to help. Thank you very much.

CHAIR: Thank you, Mr Carmody. Mr Carmody, you would be aware of the submission from Slater and Gordon's Mr Brian Briggs.

Mr Carmody : Yes, I am broadly aware of it.

CHAIR: Broadly aware of it. I want to read a part of his opening submission because I think it really goes to the heart of the matter:

My first suggestion is this simple proposition: tackle the chaotic claims handling by DVA. An Australian Public Service Commission review found that the Department of Veterans’ Affairs has fundamental problems with its culture, leadership and equipment. The department has itself admitted that it cannot deal with the complicated needs of many physically and mentally injured veterans. The APSC review further found that the decision-making process at Veterans’ Affairs was a confusing mess of committees with duplicated membership and overlapping agendas. For example, 200 individual ICT systems operating within a single department cannot be efficient or productive. The structure of small cells of public servants working in isolation and not considering the whole picture has failed. Files are shipped all over the country—one section may deal with liability before another considers incapacity and then another rehabilitation or treatment. Permanent impairment and compensation will be looked at by an entirely separate team. This entire bureaucratic file shuffling and passing on of an injured member's claim causes significant delays. The frustration of my clients at this inefficiency and ineptitude often overwhelms.

That is really hard-hitting. I am not sure whether it is accurate, but it is on the public record and it has been taken as evidence by the committee. The department needs to rebut that evidence either on notice or here today.

Mr Carmody : I assume Mr Briggs is referring to the APSC capability review which was conducted a couple of years ago. There are a range of statements made in the review. Some of the other statements were:

DVA is one of the oldest and most stable of Australian Government agencies and its work is well understood, recognised and acknowledged by its clients.

And:

It is evident to the review team that DVA staff are strongly committed to supporting the Australian veteran community. There is a palpable, sincere and passionate sense of mission among client-facing, administrative and policy staff within DVA; namely, to support those who serve, or have served, and to commemorate their sacrifice.

The review team identified three key areas of focus, and we have discussed those I think more than once during the estimates process. They saw that we needed urgent attention to transforming our operating structure; our governance arrangements and information and communications technology; our approach to clients, culture and staffing; and our efforts to formulate effective strategy, establish priorities and use feedback. All of these issues have been identified, and strategies are in place to deal with them through DVA's strategic plan towards 2020.

In terms of operating structure, as we mentioned during a number of hearings, part of the creation of my position as chief operating officer was to streamline the governance process and take control of a number of key aspects of business. We have programs underway in terms of our clients, culture and staffing, including a strong program such as 'It's why we're here', a very clear program to ensure that our staff have a very good understanding of the client base we are dealing with and the injuries and illnesses they face.

We do have challenges—I will admit those—without a doubt. I mentioned some during a hearing last week. We have antiquated ICT systems. We are doing our best to modernise those systems within the funding that we have available. We are doing our best to digitise our systems to move files off paper and on to digital systems. It will take time. In terms of chaotic claims handling, I refer to my opening statement. We have reduced the times taken to process year on year in the past couple of years. We are improving times taken to process. And we are focused on continually trying to improve our business.

CHAIR: You mentioned 72 days. Is that 72 working days, or is that 72 days?

Mr Carmody : I think it is 72 working days. One of my colleagues might be able to provide—

CHAIR: So, how many weekends were there on top of that?

Ms Foreman : I will confirm that, but my understanding is that it is 72 days including weekends.

Mr Carmody : We will confirm that for you in a few moments, Senator.

Senator BACK: So, it is calendar days.

Mr Carmody : Yes, calendar days, but we will confirm that before the hearing is complete.

Senator XENOPHON: I want to ask both the ADF and the DVA about the report of the Senate inquiry into issues with respect to Defence abuse that was released in October 2014. The Commonwealth government's response to that in May 2015 was either to reject or to simply note a number of the policies. What is the opinion of the ADF and the DVA, particularly the ADF, in relation to some of the key recommendations of that Senate inquiry, which unanimously found on a bipartisan or non-partisan basis that there ought to be, for instance, an extension of the activities of the Defence Abuse Response Taskforce to support victims of abuse, including allowing new complainants to make claims up to 30 June 2015 and issues of resource and the like? In terms of mental health it seems to me that if you have been a victim of Defence abuse and your claim has been cut off because of an arbitrary time limit then that adds to—exacerbates significantly—the mental harm caused.

Air Chief Marshal Binskin : I am not sure what the question was in there.

Senator XENOPHON: I will clarify that. It is a bit awkward over the phone. Does the ADF support the Senate committee's recommendations in 2014 that the activities of the Defence Abuse Response Taskforce to support victims of abuse to allow new complainants to make claims up to 30 June 2015—in other words, an extension of time in which to make a claim?

Air Chief Marshal Binskin : If I can talk more generally from the Defence point of view, the Defence Abuse Response Taskforce was looking at cases of past abuse within the Defence Force. We work very closely with the task force in doing that, and they refer those across to us. In parallel with this we have been going through our Pathways to Change, and we have been also looking at the processes and the pathways within the Defence Force to be able to manage any current accusations of abuse or even the culture that may be there that needs to be addressed. There are a number of means now by which people who do experience abuse can come forward and we can address them without necessarily having to keep the task force open for any longer.

Senator XENOPHON: But if someone has made a complaint—and there was a cut-off of the task force back in 2011; there is a cut-off that the Senate committee unanimously recommended be extended to this year, given that there are a number of victims who have not come forward—do you at least acknowledge the inability of a number of people to put in a claim and have that claim considered, including the restorative mechanisms, and the compensation mechanisms of the data are not available to them? Is that, in your view, problematic in terms of the mental health of existing or former ADF personnel who have been victims of abuse?

Air Chief Marshal Binskin : I think it was well advertised over the past few years that the task force had been there and that people had the ability to put complaints in. I think there are enough mechanisms now, with what people know, that they can bring forward any complaints or allegations that they have and they will be treated very seriously and they will be treated on the information that is provided. I think where we are focusing is more on making the culture within the organisation such that we do not get to that point.

Senator XENOPHON: Yes, but—and perhaps it is a bit circuitous, as I am conscious of time—do you acknowledge that there may be some people who, for whatever reason, such as that they might have been out of the country or might be simply so damaged and traumatised that they are cut off from the world in a sense, were not aware of the DART process? If somebody was not aware of the DART process or did not feel strong enough, if you like, to come forward, then extending the time limit would be a reasonable proposition as recommended by the Senate committee unanimously.

Air Chief Marshal Binskin : I would have to go and have a look at the government response to the committee and look at all the reasons behind their position on that. But you will end up in a circuitous argument here about how long you keep it open. If people have not felt comfortable coming forward up until now, I am not sure necessarily what would make them more comfortable next month or the month after that.

Senator XENOPHON: Although, the argument is that in some senses in criminal law, particularly in relation to abuse, there is no time limit if something occurred. As long as you can meet that threshold or proof, the matter can be dealt with at any time. You understand that in terms of issues of sexual abuse, for instance, there is no time limit in general criminal law.

Air Chief Marshal Binskin : I understand that, and in those areas there are enough areas that you can come forward to with any allegations of abuse where they would be investigated.

Senator XENOPHON: Okay, but at this stage the position of the ADF is not to recommend any extension of time for victims of abuse to bring their claims forward?

Air Chief Marshal Binskin : No. We work for the government, and we work with the government's acceptance or not of the recommendations.

Senator XENOPHON: I know that. My final question is: I know you work with the government, but the ADF must—

Air Chief Marshal Binskin : I work for the government.

Senator XENOPHON: Yes. But do you have a view that the time limits imposed in respect of making a claim in relation to the DART is an arbitrary time limit and that there should be an ability for extensions of time to take place for victims of abuse?

Air Chief Marshal Binskin : I think you would need to ask the head of the task force, because he has spent a lot of time reviewing this in making those recommendations.

Senator XENOPHON: I am not asking the head of the task force; I am asking for your view.

Air Chief Marshal Binskin : My view is not relevant in this.

Senator XENOPHON: I respectfully disagree.

Mr Carmody : Senator Xenophon, you asked a question of the DVA as well. It is always open to anyone to put in a claim. That period is not limited. As you know, working very closely with the DART in the last couple of years, we have set up a special process and a special team to manage and deal with these claims as they come in, and it is very successful. So there is no limit in that space.

Senator XENOPHON: But you do not have a view as to whether the DART process should be extended in terms of time limits?

Mr Carmody : My view is that any extension is a matter for government.

Senator WHISH-WILSON: I just want to apologise for not being there in person this morning. My flight out of Launceston last night was cancelled, so I would have been there. Thank you for the opportunity to ask some questions. I have several questions for both Defence and DVA. I will start by asking the CDF quite a broad question. You rightfully pointed out the evidence that this committee has heard in the last couple of days of hearings around a stigma in the Defence Force about coming forward on issues like PTSD. In your submission, on page 2, you mentioned:

... mental health considerations are increasingly part of our command and leadership training, personnel management and human performance considerations ...

In terms of the cultural issue within Defence on things such as PTSD, do you or the leadership there today, or more broadly, have personal experience in dealing with mental health issues?

Air Chief Marshal Binskin : Do you mean personal experience as in training or personal experience having managed this with our personnel?

Senator WHISH-WILSON: I understand that your submission talked about training. I want to know if you had any personal experience in managing personnel or from yourself in suffering from these kinds of conditions.

Air Chief Marshal Binskin : The answer for myself is yes. I can get each of the service chiefs and the Deputy Chief of Navy to talk about it, but I would think that, at this level of command, we have all had to deal with personnel who have had mental health issues.

Senator WHISH-WILSON: In terms of the data that you provided on page 7 of your submission, you give various numbers about diagnosed mental health disorders. Can you give us an idea of how many service personnel who have been diagnosed with issues such PTSD—and I understand there are much broader conditions apart from PTSD—have gone on to continue their service and have successful careers?

Air Chief Marshal Binskin : The data going back a long way is difficult to get, but what we are seeing in current time is that around 55 per cent of those who present with mental health issues are being rehabilitated, are recovering and are going back to work. How does that compare with physical injuries? Physical injuries are running at about 72 to75 per cent. I think that is the figure that we run with. It is not as good as the physical injuries, but, it is what we are aiming to work towards. We are looking for early recognition of a mental health injury and then looking to get early intervention and early rehabilitation to be able to get people back to work.

Senator WHISH-WILSON: In terms of those getting back to work and rehabilitation—and you have provided various categories of people who have presented—can you give us some examples where personnel have been promoted and had successful careers?

Air Chief Marshal Binskin : I would have to take that on notice because there would be personal issues in mentioning anyone specifically. I will have to look at that and get back to you.

Senator WHISH-WILSON: I will have a question a bit later relating to the Privacy Act and how you share information. I am just trying to get an idea about the culture within ADF. We heard direct evidence from a number of veterans about not wanting to speak out on this issue because of fear over their future careers, both within Defence and outside Defence. We had evidence also, directly, that when it is clear that, for example, soldiers are damaged, they are kicked out as soon as possible.

Air Chief Marshal Binskin : Senator, I think that is a bad word. I do not like you using that word.

Senator WHISH-WILSON: No, that is okay.

Air Chief Marshal Binskin : Sorry, I do not think 'damaged' actually helps the situation.

Senator WHISH-WILSON: Sure.

CHAIR: Senator Whish-Wilson, if I can just—

Senator WHISH-WILSON: Let me rephrase that then; they are discharged as soon as—

CHAIR: Senator Whish-Wilson, I am sure Air Chief Marshal Binskin—were you made aware of the evidence that we received in Brisbane? Very confronting evidence—that is on the public record.

Air Chief Marshal Binskin : In general terms, yes.

CHAIR: Carry on, Senator Whish-Wilson.

Senator WHISH-WILSON: I will make that clear for Hansard that I was quoting the direct evidence that was given to us by Platoon Sergeant McKeever; they were his words. He said he, for example, was involved in medical boards where the culture was very clear that, if someone was injured, mentally or physically, that they were pushed to discharge as soon as possible. I think his terms said there was a culture around malingerers—he called them lingers—that was the lingo that was used within the Defence Force for people who had been injured mentally or physically. Obviously, it is going to be very different across the Defence Force, CDF; I understand it is not a homogenous structure. I think he was in 6 RAR, but he was talking about the culture in his battalion. Do you dispute that kind of evidence?

Air Chief Marshal Binskin : No, I think that we have had issues in the past and I am sure that there are pockets there now, still, that we will have to work on from a cultural point of view for people to understand that this is a command issue in looking to rehabilitate our people. There are times though when—despite all the best efforts on rehabilitation—that people will end up inevitably being discharged. But I think, even in a behavioural sense, even using the word 'damaged' is not the right term and that sets the wrong tone for what we are trying to do here. I am happy, if you would like, for Chief of Army to come and talk a bit more about what is going on in his units, because this is a command and leadership issue. But I will say to you that, within the last couple of weeks, I was up in Townsville at 3 RAR and visited the Soldier Recovery Centre and the soldier rehabilitation recovery platoon. They take a very inclusive approach for both mental and physical injuries up there in looking to do their best to rehabilitate and, if they cannot rehabilitate, they work very closely with their people to be able to transition them.

Senator WHISH-WILSON: That is excellent to hear. I would appreciate the Chief of Army making some comments.

Air Chief Marshal Binskin : He is just coming up to the table now, Senator.

Senator WHISH-WILSON: Thank you.

Lt Gen. Campbell : Senator, do you wish to ask a particular question or would you like me just to make some general comments following on from the CDF's comments?

Senator WHISH-WILSON: If you could just make some general comments, General Campbell, in relation to the evidence that the committee has received.

Lt Gen. Campbell : Sure.

Senator WHISH-WILSON: Some of it has been in confidence, so we cannot share it directly with you, but some of it is on record.

Lt Gen. Campbell : I will just note, Senator, that you raise an interesting point there. Some evidence you have received in confidence; some is public and on the public record. Some people will come forward during their service; some will not. Some will come forward and raise their needs as veterans; and, again, some will not. It is a very diverse group that we are trying to support and respect their choices and the point at which they are ready to engage.

I accept the evidence that has been provided to the committee as well intentioned, and the experience and perceptions of the individuals who have offered that evidence. Also, that evidence indicates a particular experience, and at a particular time, in a period in which the Defence Force's efforts in supporting persons' mental wellbeing, as well as physical wellbeing, has been substantially evolving and improving over the course of this 15-year story since we conducted our first operations in East Timor. But it is also engaging, of course, the considerable number of persons who never deploy but still enter into some form of mental health illness at some point in their service or beyond their service.

So what we are trying to do—and this is a comment that I would offer across the entire Defence Force—is be an organisation that is open to supporting people. We are trying to encourage those who may feel that they need support to advise early. That is when that support can be most effective and when return to the same service that they were offering previously is more likely than when support is offered later, issues have become more complex or persons have left service and are separated from the community that they were comfortable serving in. We are trying, through an education program, to better inform commanders at many levels in our organisations and encourage soldiers and officers in all services to come forward and connect them with not just a joint health command support environment but also a DVA environment that is very attune to the modern needs of our people and their circumstances.

My comment is that the evidence that has been received by the committee reminds us always that there is more to do and that we need to treat people as individuals. Each individual case is one that will have to be managed and dealt with to the needs of that individual. It is a very, very complex space. I know through personal command experience of soldiers and officers that I have worked with—and I think that this is common across the senior echelons of Defence—that unit commanders all over the army are very actively engaging in trying to support their people. I want to reiterate that for people who come forward early, for people who come forward later, for people who do not come forward until they are in the Veterans' Affairs system and for people who never come forward the experience is different and the complexities are different. That is what we are trying to confront and to support.

Senator WHISH-WILSON: Thank you. Could I ask in relation to the Privacy Act and the sharing of information with the army—and it would apply equally, I suppose, to the Navy and the Air Force—are you comfortable with the awareness of ADF commanders of the mental health of their personnel? Is information available from platoon sergeant all the way up to higher levels of command about mental health issues, especially in deployments?

Air Chief Marshal Binskin : There is no doubt that the Privacy Act and the legislation that we work under do make this difficult sometimes. That being said, I would not ask that the legislation suddenly be changed, because there are second- and third-order effects. The privacy legislation means that people can comfortably come forward with any injury or any issue and that that information respected as we work with them. In respect of how we manage our people that have a mental health injury, medical personnel are a part of the welfare boards that are conducted across the three services. So once a mental health injury is known and they work to rehabilitate the particular member then—unless the member specifically does not want it talked about—we do bring command into it. It is when a member specifically does not want the reason that they have an injury discussed that it becomes a little bit difficult.

Senator WHISH-WILSON: Would it be fair to say that the reason that they would not want it discussed is because of this stigma?

Air Chief Marshal Binskin : That is most probably the reason. We need to break down the stigma that is there so that people come forward earlier, we can react to it earlier and we can look to rehabilitate earlier.

Senator WHISH-WILSON: CDF, earlier you mentioned suicide and that you are now doing a systemic review into this issue. We received evidence from organisations like Beyondblue, who have civilian models around suicide. They suggest that it works very well for them to have ambassadors or very high-profile role models who talk openly about issues to do with depression, and that that has been a very successful way of raising awareness of the issue. Have Defence given any consideration to having someone senior and well-respected speaking openly on these issues to Defence personnel?

Air Chief Marshal Binskin : I think that that is a good thing, but I do not force people to come out and talk about their particular medical or health issues. If there are people that want to talk about it, then I am quite happy to be able to facilitate them talking to our members. I do get emails from people within Defence, across the ranks, that talk about their positive experiences here. The interesting thing is that if we try and get that reported it is actually not newsworthy, unfortunately. But there are people there.

So you know where I am coming from on this review: for every death and every suicide, every report on those comes across my desk; so I get to read them all. While we have some world-class practices, processes and programs within Defence, and I know that commanders are working harder than ever before in this particular area to get ourselves across this issue, I want someone I respect—and that is Commodore Paul Kinghorne—to look right across the issue and see if there is something that we are missing or if there is something that we can do better. I do not know if there is, but that is what I brought him in to do. I have asked him already, as he comes on board for this, to talk to a number of people to get a broad view of what we might be able to do better.

Interestingly, though, everyone has an opinion on this. As an example, I can go to one of the very well-known ESOs that are out there at the moment, and I did. Within half an hour in a particular forum, I had one senior member of this ESO come up, take me aside and talk to me very seriously about how we were handling both physical and mental health injuries and the fact that we were keeping people in too long—we were not transitioning them at the right time. Thirty minutes later, a senior person from the same organisation came and tried to tell me why we were transitioning them too early. So, in this space, there are a lot of people's perspectives on what we are doing.

Senator WHISH-WILSON: Do you mean transitioning out of the services or out of rehabilitation?

Air Chief Marshal Binskin : Transitioning out of the service. So if we find that we go through the rehabilitation program for a period, some people hold the view that we hold them for too long before we transition and that a part of what is stopping them from being rehabilitated is the environment that they are in—so we should actually transition them earlier. Some people will say, 'Actually, we need to hold them in longer before we look to transition.' So I just use that as an example: it was one organisation, and, within 30 minutes, I had the two distinct views.

We look at the health aspects of this very, very closely, and we have done a lot of reviews. In this review that is getting done, it is looking right across the Defence organisation, from recruitment through to retirement transition, to see whether there are things in there that we are not doing well. In the recruitment process are there things that we are not doing as well as we could that set people up for mental health injuries or even physical injuries, for that matter? Then, later on, in transition, are there ways that we can improve what we are doing in transitioning people to DVA—noting that we have done a lot over the last couple of years to do that. If someone is going to transition, we do ask the member. Their information is passed to Veterans' Affairs. And Simon Lewis, the secretary of DVA, rights to each individual member. Interestingly, though, 33 per cent of our members do not want DVA to contact them. What is behind that? There are things that we need to do better in that space. So there are a lot of things across this area that I would like to have a broad review into and see if there are things that we can do better. And the high-profile ambassadors are a good idea that has potential.

Senator WHISH-WILSON: I read Exit Wounds by John Cantwell, in which he talks about this kind of thing. I think you might have some interesting people there who could step in and talk with farmers on issues around depression. Beyondblue said it has worked fairly well for them in that community. It might be an interesting one for you to look at. There have been two consistent themes in the evidence that we have heard, one of which goes back to the Privacy Act and the sharing of information. Families of Defence personnel could be a lot more involved, especially in transition and in post-deployment sessions and a whole range of different criteria. Is that something Defence is prepared to look at more closely?

Air Chief Marshal Binskin : Not only are we prepared to do it, we are doing it. I agree. I think families are a very important part of the rehabilitation. It is difficult, though, if the member says they do not want the families to be involved. In that area, we want to make sure we have enough information out there for families to be able to be involved with this. And you are right: there is beyondblue and a number of organisations families can go to for information. But we also have our own information available. At the moment, we work very closely with Defence Families Australia. They have links on their webpage for families to access. What I have asked for is that our own Defence intranet webpage have the same visibility and access—I was not happy that we had that—and that is now in train. If you jump on the Defence internet webpage this will be far more prominent. Families will be able to access the information that they need without having to go deep into subfolders to find it.

Senator FAWCETT: We do not have a concentration of families in married quarters anymore; they are dispersed into the community. One young partner told us about the fact that she received a brochure through the mail. Her partner had just returned, so it was not clearly apparent at that stage that he needed any help. So she thought the brochure did not apply to him and she ripped it up and put it in the bin and moved on. What strikes me is that a number of the websites and a number of the one of mail-outs not actually achieving the effect of informing families. It became very clear that having a social worker or a case manager at each major base who could reach out to families would be a really valuable service. Has that been considered?

Air Chief Marshal Binskin : It has been considered and it is there. If you have not spoken to Defence Families Australia, it would be worthwhile talking to Robyn Ritchie about what they do to engage there as well. We work through the Defence Community Organisation—and we have a representative here to talk in a bit more detail if you would like. There have been a number of changes over the last two years in being able to put information out for families on members' deployment. The biggest issue we have had in getting information out is that the members do not want information going out to their families. We have broken that down over the last few years; it is still an issue, although it is decreasing.

Across the board, there are some units doing a fantastic job and there are other units where we probably need to look at it a bit more and improve what we are doing to support the families of deployed members. So what we are looking at is how they engage the families. The three service chiefs are currently sitting with Defence Families Australia to look at what those needs may be. In a month or so, a letter will go out from each of the service chiefs to their commanders on what they expect their commanders to do and the support that they expect those commanders to provide to families of members who are deployed. So there is a bit there that we are working on right now. That came out of discussions with Defence Families Australia in the last six weeks as a part of their annual forum.

Senator FAWCETT: In other areas where we have been wanting to change awareness and culture within the ADF we are seeing recurrent professional development. Whether it is equity and diversity, fraud awareness or other things, there is a compulsory training session that people have to do every year just like their physical fitness tests. What elements of mental health awareness are included in a similar kind of program so that we destigmatise it and make soldiers, sailors and airmen aware of the importance of early intervention and the important role of families so that we can start breaking down that reluctance to have families involved?

Air Chief Marshal Binskin : I am not convinced that mandatory training in this space is the way to get to it, because it would be taken as mandatory training. What I am trying to do here across the board is get information out to people so that they are comfortable that this is a natural thing that they can bring forward. There is a lot of information. If you jump on our intranet website, there is a lot of information there for members to be able to know where they can go and what they can do. I would think most members are aware of that.

Senator FAWCETT: With all due respect, there is a lot of information there about equity, diversity and fraud awareness, but I would argue that the majority of members would not look at that on an annual basis if it were not mandatory to do so.

Air Chief Marshal Binskin : But this also gets to the leadership and down through the commanders as well. They do that as part of their leadership training. It is in their promotion courses and all that, because that is where it needs to be. Importantly, it is a component of what the senior non-commissioned officers do as well. We had a warrant officers course in the last couple of weeks—which the vice chief and, I am pretty sure, all the service chiefs addressed—and this was a major part of the course. It is to help them understand what they are working with here, what support mechanisms there may be and their importance in this process in being able to identify and help early on their people who may have issues.

Vice Adm. Griggs : The other thing is that we have mandatory annual suicide awareness training, which is a very good package. And we also have ADF Mental Health Day each October, where all units and all personnel in the ADF have a facilitated discussion around a theme. This year the theme is 'Take Action', which is again focused on early intervention. Last year we had a major focus on destigmatisation. In this year's package we have a video from the six three-stars and four-stars with a unified message about taking action. I think that is the first time that has ever been done—in one 2½ minute package. Plus we have a facilitated video which goes through three scenarios, one of which is very heavily family oriented. Everyone will not only see that but have a facilitated discussion around it.

Air Chief Marshal Binskin : I think it is a far better option than a tick and flick training process.

Mr Carmody : Senator Whish-Wilson, in terms of the role models that you referred to earlier, we released a couple of years ago a range of YouTube videos, which are highly visited. They have a range of role models—serving members and former serving members—whom people identify with. They are people who mention their experiences. That has been very successful.

Senator WHISH-WILSON: Excellent. That is good to hear. I wonder whether we could have those kinds of role models come and do presentations. It was pointed out to us in Brisbane that individual commanders on different bases have a lot of flexibility in what they can do with their troops. They often do bring people in for discussions, so this might be an opportunity to get them face to face as well.

Air Chief Marshal Binskin : I think that is a good idea, Senator, and you are right: the commanders on the different bases do have a lot of flexibility and they do have a lot of links into the community in being able to draw on that, and they do.

Mr Carmody : Senator, can I answer a question for you. I just wanted to answer the question that was asked earlier about times taken to process. Times taken to process are calculated on calendar days between lodgement and finalisation, so the improvements that we have achieved through our restructuring over the last 12 months are all on calendar days.

CHAIR: Excellent. Thank you very much. I just wanted to ask a question of the inspector general, Brigadier Gaynor. You are responsible for 'the taking of discipline action under the Defence Force Discipline Act to enforce and maintain Service discipline'. That is in your annual report.

Brig. Gaynor : The inspector general is responsible not for taking action but for monitoring the—

CHAIR: In the preamble to your report, that sentence is there.

Brig. Gaynor : Yes.

CHAIR: Anyway, I want to ask a very simple question. If people have post-traumatic stress disorder or may be having issues in the workforce, quite often that manifests itself in other ways like excessive alcohol consumption, drug taking or whatever. Is it true that, if you get convicted of DUI, you are automatically thrown out of the Army?

Brig. Gaynor : No, it is not true, but it is not for the inspector general to answer that question either. That is a matter for the services. Each of the services has policies.

CHAIR: So the simple conviction for driving under the influence will not result in a soldier being terminated from his organisation?

Air Chief Marshal Binskin : I think the Chief of Army would be best placed to answer that.

CHAIR: Okay.

Lt Gen. Campbell : A conviction for a DUI action may well result in a notice to show cause as to why you might not receive some administrative action, and it might be a formal warning. If you were found either to be a repeat offender or to be of particular concern for some reason, it could be a notice to show cause before termination, or it could simply be a matter of counselling.

CHAIR: So there is no policy in the Army where, if you have a DUI, you are automatically finished?

Lt Gen. Campbell : No.

CHAIR: Thank you.

Vice Adm. Griggs : That applies right across the services, and it would actually be in breach of administrative law to have that sort of policy, because each case has to be treated on its merits.

Senator FAWCETT: In your opening statement, you said you are looking beyond medical circles and approaches. I notice that the head of psychological health in the US Marine Corps, Bill Nash, has not only done a lot of work with PTSD—in treating alcohol and other substance abuse, depression and anxiety—but spearheaded a lot of the work that has been done around the concept of a moral injury. We have had evidence here from Professor Tom Frame as to some of the early work that has been looked at. Could you—or Joint Health Command or whoever—talk about how the ADF is approaching that and whether that is an approach that you are supporting and promoting as an approach to dealing with what appears to be a cohort who are suffering an effect of seeing things that offend their moral code but do not fall neatly into the medical category.

Air Chief Marshal Binskin : I will be quite straight: I have an open mind across the board here, and it is a similar thing with spiritual welfare as well, looking at that. But I will get the vice chief just to take you through where we are at the moment with the moral injury, and I think that will help you understand where we are progressing with this.

Vice Adm. Griggs : Anyone who has commanded on operations, and particularly in some of those more challenging scenarios like Rwanda or border protection, for example, would agree that this is a concept that is very much worth exploring. It is still emerging, as you know, but intuitively we know that there is something to this. At the moment we are working with Professor Frame to commission some work by him and explore this a bit further. We think it is quite important work. Importantly, we are not treating it as a Joint Health Command issue. It will be led out of the Centre for Defence Leadership and Ethics, because that is the sphere where it really belongs. To pigeonhole it as a joint health issue would be the wrong approach. We are in the process of talking with Professor Frame as we speak.

Senator FAWCETT: In terms of learning from what the US Marine Corps is doing?

Vice Adm. Griggs : He has done a lot of work himself and drawn on a lot of other work from overseas. We want to get a project going for the ADF.

Senator FAWCETT: Describe briefly the scope of that. Are we talking about one person doing some study? Are we talking about an active engagement of commanders within the ADF?

Vice Adm. Griggs : To a certain extent we already do that in the work that the Centre for Defence Leadership and Ethics does already. In fact, we recently had a seminar out at the Defence College for the veterans of the two rotations that went to Rwanda, to mark the 20th anniversary of the return of the second contingent. I was there for that. It was an extremely powerful and moving afternoon. The term 'moral injury' was not used, but it was really all about what had happened to these people in some incredibly challenging circumstances.

We are already doing that in a lot of our command courses, particularly in Navy. These sorts of issues are posited for our commanders and their executive officers when they do their designate courses before they take up command. It is not being done under the tag of 'moral injury'. We want to scope out and come to an agreed position on what 'moral injury' means—because part of the problem is that you have got one group of people who think it is all about religion, which it is not; it is about your moral core—and make sure that we understand what we are talking about in using the term and building the programs as we go down that path. The first element of this is a scoping study with Professor Frame and some of his team.

Senator FAWCETT: One of the things that has become very clear through the evidence we have received is that every individual has a different experience. Some individuals' experience with the ADF around physical and mental injury and the support they have been giving is just outstanding. We have had some evidence to show how the system as a whole has moved on. But we still get some people who have dreadful experiences. One of the consistent things—albeit it is a very small sample—is that some of the people who have had dreadful experiences have not been engaged in the Soldier Recovery Centres; they have been isolated from their units and not given that supportive environment. What consideration is being given to increasing the capacity of the Soldier Recovery Centres, so that any serviceman or servicewoman who is physically or mentally injured can be included in that very supportive environment?

Air Chief Marshal Binskin : There is nothing stopping that from happening now. The resources are there. We need to take lessons from the small cohort you are talking about as to why they might have been excluded or might not have had any inclusive rehabilitation program to be able to answer it. The resources are there now to be able to do it. It is not a resource issue per se.

Senator FAWCETT: When the joint standing committee—the defence subcommittee—did its inquiry a year or so back, we were told very clearly by each of the Soldier Recovery Centres that places were limited and that not every soldier who had a physical or mental injury could take part in an SRC. I have heard nothing since to indicate that that is different. The evidence we received up in Brisbane indicated that the current situation is still that there are some people who did not receive that option of going to an SRC.

Air Chief Marshal Binskin : I will take that—actually, not on notice, I will take that and work with the three chiefs to find out what might be happening there, because I think they would be concerned if that was still the case.

Senator FAWCETT: The last thing comes back a bit to the comment about one ESO saying you are moving them on too quickly and others saying you are holding them too long. We have heard a number of people talk about the fact that they would really value the opportunity to continue to contribute to Defence. They have learnt a range of skills and knowledge and—albeit that they are no longer deployable, perhaps in the short term or perhaps for good—they have looked and asked why there is not an option for them to continue in a non-deployable role, perhaps filling some of the roles currently filled by APS or contractors or other people. What consideration has been given to retaining people in a non-deployable role so that we provide that ability for them to continue to contribute to the ADF, as a recognition of what they have learnt and the commitment they have made to the service?

Air Chief Marshal Binskin : I think the answer there—and it sounds but is not vague—is: it depends. We do have limited resources as an organisation. But that does not mean that we move people on quickly. We have shown that we keep people a fairly long time in the rehabilitation process. I think what you are saying is: we get to a point where someone may not be able to be rehabilitated, to be able to deploy again—and again this will be 'It depends': it will depend on whether the environment they are in is actually stopping them from being able to progress, or we have got to a point where that is as well as we can make them and then we look at what other avenues there may be for employment.

I know people in units—because I have visited some of the units recently—where they are not able to deploy but they actually have been kept on, perhaps in a reserve capacity because they have some specialist skills, or they have transferred to the APS and as an APS member they are providing that service. They are limited in parts of the organisation that are out there, but I think we need to look at some of the transition programs that we have for employment outside. We have one within Defence that is being developed; we work with DVA on that. We also work with the Mates4Mates and Soldier On programs, and they have their own. I think what we need to do is to coordinate them a little bit better in being able to transition people to meaningful employment outside. To answer your question: there are some avenues within Defence where we do keep people on; they have got some fantastic skills we cannot afford to lose, and they enjoy continuing to participate. In other areas, it is a bit more difficult.

Senator FAWCETT: This question is for Mr Carmody. We have had a number of calls for reform of your IT systems, and you mentioned before that you are starting to digitise and move down that path. So we would be pleased to receive some updates as you can provide those. We have also had calls, though, for time limits, in terms of processing: that if it is not processed within a given time frame then it defaults in favour of the veteran. Could you just describe what you do, as compared to other jurisdictions, whether within Australia or overseas, and whether that is something you have considered actively previously.

Mr Carmody : I will start, and I think Ms Foreman will probably join me. This is the debate about statutory time frames—so, a statutory completion to a claim. That does exist in a number of jurisdictions, but the way those jurisdictions operate is very, very different from the way the beneficial Veterans Affairs system operates. There would be some quite significant challenges with statutory time frames. I might pass over to Ms Foreman.

Ms Foreman : Last year, we tabled a report in the Senate on the review of statutory time frames which looked at the options that we might be able to adopt in relation to our claims processes, but overall there are two significant issues in relation to compensation claims that we receive compared to compensation claims under states' compensation and private compensation schemes. Firstly, we have no time limit on when a member—a veteran—can lodge a claim. So an injury could have occurred in the forties, the fifties or the sixties, and a veteran is still able to lodge a claim with us; there is no limit. We do not have any directions on the state of the claim that we receive. Essentially, a veteran can put a claim in which just has their name, address and injury, and they sign it. A lot of other compensation schemes actually will not accept a claim until it is fully completed. In our case, that would mean that it has not only the details of the veteran but also reports from their medical specialists or doctors about the nature of the injury and the illness, proof of identity that the veteran has served, and details of where they served and when they served. We do not do that; we allow veterans to come in and immediately give us their claims. We then go away and try and get that additional information. We will contact their specialists and ask them to produce a report. We will contact Defence and ask them to produce details of their medical records and the incident that gave rise to the compensation. I think, overall, we are in a very different position to other compensation schemes in Australia.

Mr Carmody : If I may add something to Ms Foreman's evidence: one of the key points in statutory time frames is what you wish to achieve. For example, do you want to have a deemed acceptance at the end of a particular period? If that were the case, that would encourage everybody to go slow on their claims process, because we have to collect all of the information. If you were to have a deemed acceptance, people would be reluctant to put in their material, because at the end of a particular period of time we are going to accept it anyway. That would be unfair across the whole system. If you decided to have a deemed rejection at the end of a particular period, if somebody gets 95 per cent through their claims process and the time elapses, they have to go back and start again. So there are some real issues in trying to manage this. A great amount of our time that is taken to process is taken up with collecting information which in other jurisdictions would be provided in advance. That is probably the simplest answer.

Senator BACK: CDF, evidence that has been given to us indicates that greater than 50 per cent of cases of PTSD are in people who have never deployed. Does anybody on the panel have any understanding as to, firstly, whether that is accurate and, secondly, why that might be the case?

Air Chief Marshal Binskin : I will get Commander Joint Health to come up and talk in a little bit more detail on that. While a deployment will increase your chance of being exposed to a traumatic event—with PTSD, in some people it might be one traumatic event which they are exposed to; in others it may be a number of traumatic events—you do not have to be deployed on warlike operations to be exposed to a traumatic event. It could be humanitarian assistance or border protection; it could be that on the way to work you witnessed a car accident in which someone was killed. So it is the number of traumatic events, depending on the person, not necessarily where that may have occurred. Also, in some cases, when you are deployed you are in a mind frame where you are actually more resilient—you are prepared for those sorts of events—whereas if you are not deployed you may not be mentally prepared to be exposed to something. But I will get Commander Joint Health to talk you through it a little bit more and give you the reasoning and the evidence behind it.

Rear Adm. Walker : Firstly, as to whether the number is accurate, it was accurate at the time that the study was done. The study that we refer to is the 2010 prevalence study, where we used very detailed, scientific screening and assessment tools to understand the prevalence at that point in time. That is a major body of work, but it gives you very good data that is robust and scientifically defendable and that you can use with confidence. To repeat that, that is why we are now doing the transition and wellbeing study; it is seeing what has happened over time. Again, it is a very significant piece of research to undertake, but it gives you the best data and the best validity.

It is incongruous to people that people who have never deployed on operations into a war-like zone may still have the same burden of mental health as those who have. It is exactly as the CDF says: it is not simple, and everyone is affected differently. For some people, one episode of trauma will be enough to cause PTSD. For others, there is very good evidence that it is a accumulative load of stress. You might have had a car accident, you might have had a sexual assault or you might have been exposed. There is some evidence about the number, but the information about how many traumatic events you should only be exposed to is not quite exact. For some, I then does not occur until 20 years later.

We know that our group of people in the military are exposed to traumas, whether they deploy on operations or serve on operations in Australia, such as border operations, fighting bushfires or are exposed to dead bodies from bushfires and car accidents.

We also know that as a group the people who join the ADF are risk takers. They are the people we want. A lot of people who do not like taking risks do not really want to join the military. So we have people who are risk takers, and that is in a medical sense. It is not meant in a derogatory sense. So they are more likely perhaps to be exposed to events that might cause trauma. Trauma affects people differently. We medical practitioners are used to seeing people bleeding and having trauma. That is what we are there to do, whereas, for someone who does not have that background, seeing someone severely injured is very traumatic.

Senator LAMBIE: Mr Carmody, have you seen the story in this morning's paper in which, apparently, the Department of Veterans' Affairs once again has breached?

Mr Carmody : No, I have not, but I will read it when I get to the office.

Senator LAMBIE: I am sure you will. Just so you know, I see that documents from veterans are still going out to other veterans—their psychology reports. Is this indicative of deep systematic problems within DVA, because if you are making a mess of this issue what else are you making a mess of? This has been going on for many years, and I am quite sure you are aware of that. As a matter of fact, I would like to know the exact number that this has happened to—where one veteran's physical and psychological information has been given to another.

Mr Carmody : As I said, I have not read the article. But there have been occasions where material has been released erroneously. That is very distressing for the veterans concerned. In those cases it is clearly a breach of privacy, and we need to report those breaches of privacy, and we do. So we should be able to find some statistics for you on the number of occasions on which this has occurred. Essentially—without looking at the article—it is an oversight. It is something that should not happen. Someone is photocopying documents, probably from a very large file, and for some reason the documents get confused. I have no explanation for it. It should not occur. As I said, we probably have some numbers so we can tell you how many times it has occurred. But it is serious. It is a breach of someone's privacy, and it is something that should not happen.

Senator LAMBIE: That is great. So after the numerous letters I have sent you about the same issue you could probably write that on a piece of paper for me and send me back a reply. I would appreciate that.

Mr Carmody : Certainly. Also, in terms of the individuals themselves, obviously when we report the breach to the Privacy Commissioner we also go to great lengths to apologise to the person concerned, for the breach of their privacy, because, as I said, that is something that should not occur.

Senator LAMBIE: You claim that in 2012-13 you spent $170 million on health needs for clients. Can you please provide the details of what actions you took and the KPIs that have support for that? I am assuming that you have KPIs on everything you do.

Mr Carmody : Certainly, we have a lot of KPIs. I will ask Ms Campion to talk through our mental health programs. I think the figure for last year was $182 million—for the current year—and that covers all of our mental health programs, including, for example, programs in hospitals around the country, and a range of other treatment activities. I will pass to Ms Campion.

Senator LAMBIE: Ms Campion, we do not have a lot of time, so can I please have on notice the KPIs showing that these have been successful? You do keep KPIs when you are running these, don't you?

Ms Campion : In some cases we do have KPIs—for example, for our hospital contracts. Where we are contracting directly with a provider our contracts will have performance information contained in them. We rely on services through Medicare. So, for GPs and mental health services, for example, we do not have a direct contractual relationship with that provider, so we do not have any sort of clinical performances indicators that we collect in relation to the services they provide.

Senator LAMBIE: You mental health initiatives cover a very broad spectrum. That is also given to some groups that actually assist with mental health. So are you telling me that you do not keep notes, you do not follow through and you do not see whether the millions of dollars of taxpayers money we are spending have been spent successfully and that the outcomes expected are being delivered?

Ms Campion: Where we have a direct contractual relationship with the providers we can prescribe certain performance criteria they are required to comply with, but, where we do not, where we are relying on our general universal access system through Medicare, we cannot possibly impose criteria on them that are applied more broadly through the Medicare arrangements. So, no, we cannot measure the outcomes through those arrangements.

Mr Carmody: We also have some statistics on the treatment in the Veterans and Veterans Families Counselling Service. As you know, I think 80,000 counselling services were conducted last year in that space, and that also falls in under our mental health budget. We have some statistics in that space, too, that I am sure we could provide.

Ms Campion: I should say that will we cannot measure at that end, we do put a lot of effort and resources into developing materials for practitioners, GPs, allied health et cetera on understanding the impact of military service and the unique needs of our client group. So we do put a lot of focus at the front end in terms of their training and continuing professional development to understand the needs of the clients they are servicing.

Senator LAMBIE: Let me get this right, Mr Carmody: in 2012-13 you spent $179 million on the mental health needs of clients. Are you including the costs with VVFCS as well?

Mr Carmody: Yes. As far as I aware the VVFCS costs are included in the overall mental health budget.

Senator LAMBIE: Okay. So it actually does not look as big at $179 million. That is what I wanted to know. Can you tell me how many contract staff are currently employed by DVA and what basic training they are being given before they take up that post?

Mr Carmody: Just to clarify, is this staff in the mental health space or contract staff generally?

Senator LAMBIE: Right across the board in DVA.

Mr Carmody: Because we have ICT contractors—

Senator LAMBIE: I am not talking about ICT. I am talking about case manager and the whole works. Apart from the ICT, how many current contract staff are being employed by DVA and what sort of basic training are you giving them to deal with their clients?

Mr Carmody: I would probably have to take that on notice. In some cases when we have contracted social workers we have a very clear skills set within the people that we contract with to provide the service. But in looking at contractors across the board, I would have to take that on notice.

Senator LAMBIE: Could you also take on notice that I would like to know what areas the contract staff have been deployed in.

Mr Carmody: Certainly.

Ms Campion: We are in the process of renewing our arrangements for the broad range of mental and allied health contractors. The new contracts will commence on 1 October, and we do have an induction program that we will require all of those contractors to go through. That will include some of the material that I referred to earlier around ensuring that those contractors understand the nature of military service and the nature of the needs of our clients. But we can provide you with more detail on notice.

Senator LAMBIE: How many complaints do you get from your DVA workers in relation to anything, right across the board? What do you do with those complaints when you receive them?

Mr Carmody: It depends on the nature of the complaint. They are always investigated, but it actually depends on the nature of the complaint. If it is a complaint about something that occurred in the workplace—a harassment complaint or a complaint about some other staff member—we deal with it through the human resources mechanism. If it is a complaint from a client, we have a complaints and feedback management system, so we review all of those complaints and manage them. It depends a bit on the nature of the complaint.

Senator LAMBIE: On page 3, point 21 says that you have employed a further 91 positions for the mental health workforce. My question to you is: do you employ veterans to help with policy and program development? Don't you think this would be beneficial for everyone involved? After all, they know it firsthand.

Mr Carmody : I may have to be corrected, but I believe that about five per cent of our staff have indicated that they have some ADF background or service.

Senator LAMBIE: That is not what I asked you. Have you had Department of Veterans' Affairs workers that have been on the other side, competing and playing you guys? Do you have any of those serving there? Do you have anyone that has been through the DVA process sitting there?

Mr Carmody : A number of our staff members are also DVA clients, Senator, if that is what you are asking. I am sorry. I am trying to get to the nature of the question.

Senator LAMBIE: What I want you to tell me is: do you have on staff people that have fought against the Department of Veterans' Affairs?

Mr Carmody : I would not know whether we have people who have fought against the Department of Veterans' Affairs. All I can say is that a number of our staff members have served in the ADF and have submitted claims with DVA and are therefore ongoing clients of the Department of Veterans' Affairs. We have to make specific arrangements for them, such as securing their files and those sorts of things, because they are ongoing staff members.

Senator LAMBIE: About the Ex-Service Organisation Round Table: how many service organisations do you have participating in those round tables? Can you name which service organisations they are?

Mr Carmody : The Ex-Service Organisation Round Table is the peak body. I will do my best to name them: the RSL, the VVAA, the VVFA, Legacy, the War Widows' Guild, the RAR Corporation, the SAS Association, the RAAF Association, Partners of Veterans—I am probably losing count, but I would be pretty close. My colleagues might help me if I have missed a couple.

Vice Adm. Griggs : The Naval Association.

Mr Carmody : The Naval Association—I am sorry, Vice Chief—the Peacekeeper and Peacemaker Veterans Association and the TPI Federation. I am just reeling them off without looking.

Senator LAMBIE: How many times a year do you have those round tables?

Mr Carmody : I think the ESO Round Table is at least three times a year. Then there are a number of smaller groups as well—so that is the round table group, but there is also a younger veterans group and a national aged and coordinated care group. That is nationally. In each of the states and territories the deputy commissioners have a forum. They run forums with their state ex-service organisations, and some of those mirror these organisations but some of them do not, because some organisations are not national and they are more strongly represented in the states. So our deputy commissioners run forums and they run them very frequently—probably every month or every two months—and they actually allow us to pass information out to the veteran community and to receive feedback from the community and some of that works its way back to the peak bodies. So it comes to us in two ways: from the committees themselves and from the representative organisations when they meet at the Ex-Service Organisation Round Table. There is also the Prime Ministerial Advisory Council on Veterans' Mental Health. There are a lot of consultative bodies.

Senator LAMBIE: About the overpayments: there seems to be a great deal of overpayment going on under the Department of Veterans' Affairs. I have quite a few of those members on my desk back in my office. It is not their fault; it is actually the fault of the Department of Veterans' Affairs. Is there any way that these overpayments can be cancelled?

Mr Carmody : There are a lot of reasons for overpayment. I acknowledge your point that people would say that some of them are not their fault. A lot of our overpayments are discovered when we find that people have received payments from other sources and have not declared it. They have to declare those changes twice a year. There was a significant amount of overpayment released—I think in a recent answer to a question on notice—but it is a very small percentage of our overall expenditure. There are clients who therefore access superannuation from another source, superannuation from overseas and those sorts of things. There are times when payments are written off. When clients indicate financial hardship, which is assessed and taken on merit, periodic payment regimes are put in place. There are occasions when it is written off, but there are occasions also when it is recovered in full.

Senator LAMBIE: Could I have all the statistics in relation to that over the past five years?

Mr Carmody : Within the bounds of privacy, I will—

Senator LAMBIE: I am not asking for any names. I just want statistics; I just want numbers.

Mr Carmody : Certainly.

Senator LAMBIE: I want to quickly speak about the DART. I am concerned about the DART. I am concerned that they have closed it off and that the transparency required is no longer there—as it has now gone back into Defence's hands. So if you want to make a complaint about abuse, you now have to go through the channels at Defence.

Air Chief Marshal Binskin : No, you do not.

Senator LAMBIE: I have had a lot of inquiries about this. Where else do they go?

Air Chief Marshal Binskin : There are a number of areas. If it is a serving member or a past serving member—

Senator LAMBIE: If it is a serving member.

Air Chief Marshal Binskin : There are a number of avenues open to be able to make those complaints. I understand where you are coming from—from the DART—but the government's position is the DART will be closed, and that is the recommendation of the task force head himself.

Senator LAMBIE: Have you seen the DLA Piper review volume 2? Have you been able to access it yet?

Air Chief Marshal Binskin : No.

Senator LAMBIE: I just want to know how you are going to fix the problem if you cannot get to the core root of the problem and if you cannot see the 33 disgusting volumes that I had to sit through and read?

Air Chief Marshal Binskin : Every DART referral comes across my desk. I am well aware of the issues that we are dealing with.

Senator LAMBIE: So you would have seen the DLA Piper review volume 2?

Air Chief Marshal Binskin : No; I get every DART referral across my desk, not DLA Piper. If it was in DLA Piper—and that particular case went to DART—and it gets referred to us, because the DART does not refer all of them to us, then I see it come across my desk.

Senator LAMBIE: Wouldn't you like to see all the evidence sitting in front of you, so you can see what is going on?

Air Chief Marshal Binskin : I think I do see the evidence that is there. I do not need to read every case to see the evidence.

Senator LAMBIE: So why would you agree that DART should now be closed down? I believe that DART should be left open so that those people have somewhere outside of Defence to go to.

Air Chief Marshal Binskin : The DART decision was not mine.

Senator LAMBIE: Would you like the DART to remain open for transparency reasons and to finally put this to rest, so these guys can be fully heard?

Air Chief Marshal Binskin : That needs to be an issue for government, because DART does not work for Defence. The DART is separate to Defence—even though it has the word 'defence' in it—and reports directly to government. That is a decision for government.

Senator LAMBIE: Thank you. In your submission—page 3, point 19—it says:

Consultations for development of a new ADF Mental Health and Wellbeing Strategy 2016 - 2020 commenced in March 2015.

What will be involved in this new strategy and why is this needed if things are working so well?

Air Chief Marshal Binskin : I will answer the last question first, while the commander of joint health comes to the table. Any good strategy is continually reviewed and adjusted—and with that I will hand over to the commander of joint health.

Rear Adm. Walker : The strategy does need to be reviewed. We have done five years. It came out of the Dunt inquiry, which looked to a whole series of reforms to mental health services within Defence; those 52 recommendations have been implemented. As the CDF said before, we have some very good programs in place. We have got very good services in place that have been evaluated by external authorities; but not all of them are very good services. So what we need to do is consult with, particularly, our command group and with our people to make sure that what we are doing in a health sense is not just health—it is reaching out into the command. It is becoming a strategy for the whole organisation and is not being just seen as something belonging to Joint Health Command. Whilst we have the very good basics of how we treat people from a health perspective, how we get them into accredited programs and how we use evidence-based treatment, it is now about maturing that strategy to make mental health everybody's business—from the recruit to the most senior commanders that we have in the organisation. The consultation undertaken so far is really telling us that. It is giving us more information about what command would like, how we can support them better, how we can improve their mental health literacy and how we can continue to improve on the support to our people.

Senator LAMBIE: I have just one final question. Transition—

Senator WHISH-WILSON: Sorry to interrupt, Senator Lambie. Can I have some direction from the Chair as to the remaining allocation of the last 20 minutes?

Senator BACK: I have not had a chance yet, Senator Whish-Wilson.

CHAIR: We have until 11.15, Senator Whish-Wilson.

Senator BACK: But I will not be taking the entire time to 11.15.

CHAIR: Our next hearing is not scheduled until 11.30, so we should have plenty of time to exhaust everybody's questioning.

Senator WHISH-WILSON: Thank you.

Senator LAMBIE: I want to briefly touch on the transition. I want to know exactly what Defence are doing with their transition. I see a massive hole between what is going on with Defence and DVA. The problems have not gotten any better. I only have to look at the same complaints coming across my desk in my office in Tasmania. It has not gotten any better. I want to know what you are doing to help transition and de-program these men and women who have worn the uniform. It seems to be a really sticky point. I think this is where their psychological injuries are really getting a boot.

Air Chief Marshal Binskin : It is a good point. It is an area that we continue to look more and more closely at. An early answer gives you a part of the problem that we face. In transitioning someone out, the minute they start to transition we have the transition centres on the bases to be able to help them. As you know, it is the paperwork myriad to step through. There are programs there to help them transition. As we start to transition them out, very early on we make sure they are put into contact with DVA. As I said earlier, 33 per cent do not want that. We need to work around why that is the case.

If someone has of recognised medical issue—a physical or mental issue—as they transition, that transition occurs across to DVA. That is handed to DVA. Where we find issues arise is: for people do not have a declared medical condition, their transition out is the point that they realise, 'Oh, now I don't have that whole structure around me—that support network that I needed.' Issues start to come to the fore. Then they need to go into the DVA process after having come out of Defence. What we are trying to do up-front with as many people as we can is to get them to understand that, if they think they have an issue, we need to address it before they come out of Defence. Then we can hand them to DVA. There are a number of programs in place to improve that so that there is no chasm that sits between the two organisations.

Senator WHISH-WILSON: I want to ask a point of clarification on that. Which programs are you referring to? Are you referring to the Stepping Out program, for example?

Air Chief Marshal Binskin : That is one of them.

Mr Carmody : That is the DVA one.

Air Chief Marshal Binskin : That is right; it is one of the DVA ones. That is one of the programs. We can give you a full list on that, if you would like, on notice between the two organisations.

Senator WHISH-WILSON: I would be interested to see a full list and whether these programs are voluntary or mandatory, and the kind of take-up rates you have.

Air Chief Marshal Binskin : We will take that on notice.

Mr Carmody : We are also very focused on transition. Clearly, we work very closely with Defence in trying to identify members and to ensure that members transition as effectively as they can. Continuity of care, particularly for those under treatment, is really important to us. As the CDF, there are people who leave, administratively or for other reasons, who do not make contact with us and need to make contact with us later. That is something that we are working very hard on to see whether we can reduce the number of people who opt out from contact with us when they leave, and to find if any mechanism we can to continue to engage with them to see whether we can meet their needs. It would be good if we could get their claims processed as quickly as we can and try to ensure that their transition is smooth. That is not always the case. But we are working very, very closely together on the Support for Wounded, Injured and Ill Program and various other programs to try to make the transition effective.

Air Chief Marshal Binskin : Even to the point of simplifying single case numbers—all these sorts of things to try to simplify the whole process to make it easier for a person to be able to work with DVA after they have transitioned from defence.

CHAIR: I understand that defence and DVA have circumstances. You might have people who come to you 20 years or 30 years after service. But there are some things that akin to an employer and an insurer. I would like to know whether there is any tension between defence and DVA, when it is very clear that an administrative procedure better handled and better put in place would have had a better compensation outcome. How do you manage that? If you were an insurer and a large corporation, and defence has bad policy, the insurer says, 'Pay more money.' Is there that competitive tension in there with what you are dealing with, Mr Carmody, if there are shortcomings on the defence side in protocol, procedure or management of injuries or illness that are impacting on the bottom line in DVA? How do you handle that?

Mr Carmody : This is one of the matters that we look at and discuss regularly in our defence/DVA links board meeting ,which meets on a number of occasions during the year. It monitors the transition process. As part of that process, we see defence's and workplace health and safety statistics, for example. Defence has a very sophisticated regime of managing its workplace health and safety stats. I would tell you that, for example, the vast majority of the injuries that we see are still not related to combat operations but related to sport and training.

CHAIR: Slips and falls.

Mr Carmody : I cannot speak for the ADF, so I will leave the answer in terms of how they respond to these things to them, but we focus on that very closely.

CHAIR: I did not get a lot out of that. I am going to put you on notice. When was the last time your organisation challenged defence about an injury stream or an injury which, with better management on their side of the fence, would have resulted in less compensation? That is the question on notice.

Mr Carmody : Fine.

CHAIR: Air Chief Marshall Binskin, do you accept what I am saying?

Air Chief Marshal Binskin : Yes. We normally would not be working with DVA on that; it would be on the workplace health and safety side. That would not necessarily be through DVA. But there is no penalty on you if you hand over 1,000 or 100 injured people per year to DVA?

Air Chief Marshal Binskin : No, but we will get taken to task through workplace health and safety if we systematically break people and we are not doing anything to improve it. So it would not necessarily be DVA that would come back to us on that; it would be Comcare.

CHAIR: Okay.

Air Chief Marshal Binskin : But I will raise one thing—and it will probably open Pandora's box, and I am not the expert on it. We are working now with DVA, as we work to words ComSuper, in trying to better simplify that process when people do have claims and making sure that ComSuper do not need different documentation and data to what DVA might have been working through. But that is an area that we do need to work on.

Senator BACK: I want to describe to you a process that was in place a decade or so ago in relation to personnel coming out of combat zones and I want then to know how, if at all, this situation has changed since the middle part of the last decade. Personnel would come out of a combat zone. Whilst they were still in the geographic area, they would participate in an exit interview—these are my words, not military words.

Air Chief Marshal Binskin : Yes. It would be called RtAPS, the Return to Australia Psychological Screening.

Senator BACK: Sure. This is before a psychologist unknown to the person. The person or people involved were likely to be very suspicious of the questions and particularly what effect the responses might have on their subsequent career. At that stage, are they well positioned anyhow to respond to questions? Are they therefore unlikely to give much of a response, based on their concerns about how that might permanently remain? Once back in Australia, they were returned to their unit, often on their own, with nobody at an airport to meet them. They returned physically to their own operations, often with nobody to take much notice of where they had been. If it was the first operation in that combat zone, there was indifference and certainly no prior communication with personnel back at the base so that they might have some understanding as to what activity the person or people had been involved in. There was a subsequent psychological appraisal at some time in the future and very little if any—in fact, no—attempt for that person or those people to have some form of—I will use this term—letting down back to a normal operational life and, indeed, civilian-related life.

That is the experience of a decade ago, and I observed in many instances that that indifference—and, indeed, cases of personnel of similar ranks who had not engaged in that combat zone actually being quite dismissive rather than being supportive—was the cause of a lot of the difficulties that these people faced. That was so for commissioned, non-commissioned and other ranks. I have engaged with your predecessors in this, so I do not particularly want to revisit it, but at some time or another, if you want to have a discussion about that, I am happy to. What I am more interested in knowing is: have there been any changes and, if so, what now are the protocols that take a person from a combat zone or an area of operations back to their own units and, if you like, reorient them to the civilian life as well?

Air Chief Marshal Binskin : The first thing I would say is 'often' is probably not the right term. The reason I say that is that most of our people deploy in formed units, and therefore, when they come back in formed units, they go through that bit of decompression, come back and then are processed in a formed unit. But you are right: it gets harder, especially when we do operations the way we do today, when we take people from various parts of the organisation and deploy them more on rotations. In fact, I will put my hand up: I was one of those. In 2003, I went over on operations. I was not a part of a formed body. I operated on my own, with a little bit of administrative help with Australians. I came back and reintegrated. So I understand the exact issue that happens there.

The processes are the same. The difficulty remains, though: individual commanders being aware of the people that have been deployed coming back into their organisation. But I would say that it would be better now than it was, because there is far more awareness, after doing this for 15 years, that people who come back need to have some management around them as they reintegrate back into the unit. Does that solve the indifference that they might get from some people in the unit? No, it does not, but I think there have now been enough people that have deployed in that period that, when you go to a unit, most people have been in some sort of deployment situation, so they are more aware of the issues around it. But we are still going to have issues out there with individuals that come back in. That is where it is a command and leadership issue for the specific commanders to address. What each individual service does to make those commanders aware of a person that has gone away and come back, I would have to ask the three service chiefs to come and talk to you, but it would probably take a bit more time than we have right now.

But you have hit the issue that makes this more difficult than what it has been—not in the last 15 years but back in major operations—where people went away as formed units all the time. You have hit it on the head.

Senator BACK: Do you direct benchmarking with other forces with whom we operate or have operated—the Americans, the Dutch, the British, the Canadians—are there similarities? Is there anything we do learn and implement as a result of communication with other countries in terms of their post-deployment reorientation? What was the term you used? It was one I was searching for.

Air Chief Marshal Binskin : Integration?

Senator BACK: Yes, thank you.

Air Chief Marshal Binskin : The answer is yes. We are part of a number of forums. The Commander Joint Health or Vice-Chief can take you through those forums. One is TTCP, which is the Technical—'T' used to be 'Tripartite'—Cooperation Program: now there are far more than three, so the 'T' is now 'The Technical Cooperation Program' where we get together across a number of nations. There is one particular working group here that we do work in to look at what is best practice across the world and learn from that. There are a number of forums as well—I can get the Vice-Chief or the Commander Joint Health to take you through those various forums. We do not sit here in isolation; we do talk to other organisations and militaries to find out what they do: what works and what does not.

Senator BACK: Given the time, that really is what I wanted to be satisfied about.

Air Chief Marshal Binskin : Would you like us to give you that on notice? I would like to be able to give you all that.

Senator BACK: Yes, if you could go into detail, I would really appreciate that greatly. My next comment is that you made the observation that you have appointed a one-star to conduct the systemic review—and it probably is an extension of what I am saying—I am quoting from you here:

I intend that the review look at all aspects of a military career from the recruitment phase through until discharge …

My urge would be, if there is a capacity, to take that at least to some cohort beyond discharge, because I do think that there would be a lot to be gained from engaging with not only personnel who have been discharged but also families of discharged personnel.

Air Chief Marshal Binskin : You are right. I state it that way because, legally, that is where I stop. But, morally, I understand my obligation here: once you are a CDF of people, you are always CDF of people. Whether they are a veteran or still serving, I still see it as being morally my obligation to make sure that they have the best care available. One of the first people that Commodore Kinghorne will talk to is Simon Lewis in DVA. Simon knows that I am doing this, and I want Commodore Kinghorne to go across and talk to him and make sure that—you are right, we do not want to have that chasm that sits there in the middle: if there are areas there that we need to improve on, we will improve on it. It is not just bounded by in-service.

Senator BACK: From the commentary, reading submissions and hearing what has been said, I know that you are alert to the families of personnel and veterans, and never overlook siblings and they influence they have. Mr Carmody—you mentioned maintaining contact with personnel after they are discharged—am I right at the moment in my understanding that those leaving military service have got to opt in to communicating and having their details maintained on the DVA file?

Mr Carmody : That is essentially it. What happens is that we have agreement from them to write to them and provide an outline of what DVA services are available to them. One of our programs that we are working on with Defence is an early engagement program where, at a point in time, we might be able to get there with permission from members of the ADF. But at the moment we do not actually have a file on everyone who has ever served. When somebody submits a claim to us, that is when a process begins. We have tried to get a bit further upstream now with writing to them all to say, 'This is what our service is,' but some people do not want to know, so that is part of the challenge as well.

Getting back to your file comment, at the moment you start a file when you submit a claim or a process. In the future we hope that, with agreement from members and agreement from the ADF, we can start developing details of people from enlistment.

Air Chief Marshal Binskin : We would like to make it that it is a condition of employment: as you join, you are joining the continuum. Therefore right at recruitment you have a number, and that number is either your number in Defence or your number in DVA, should you eventually put in a claim. That would be the optimum way to go.

Senator BACK: The line of my question goes exactly to that, because—

Mr Carmody : Yes, and that is exactly where we would like to be.

Senator BACK: when I do speak to veterans—and these are people who have no claim but, nevertheless, they seem to be ignorant of the service. I have heard you say this in different fora.

Air Chief Marshal Binskin : What that would mean is that when someone comes through—the majority of people get out about the eight-year point—they get out, and a couple of years later the discover an injury that was from their Defence service. They can give that number—DVA already have that number—and they can come back in through Joint Health through Defence with the electronic records and the records of their bank.

Senator WHISH-WILSON: I was just going to say a very consistent theme in our submissions was: having a DVA file number, a single identification number for discharge, regardless of acceptance and entitlements. In their submission, the RSL did raise that this has been proposed several times before and they seem frustrated that these kinds of things have not been taken up already. CDF, how far away do you think that idea is?

Air Chief Marshal Binskin : The idea is there. It is the implementation that obviously takes a bit longer, but we are working very closely with DVA to get to that point.

Mr Carmody : We are also trying to work with Defence on this single number but, as I have said, we have 340,000 clients and a large number of our clients do not have ADF service; they are war widows. So 60,000 to 70,000 people do not have a Defence number. We also have the situation where, particularly, our World War II and or Korean veterans had different prefixes on the numbers that they were allocated when they were in service, by state. There were different prefixes by gender. Our history of engagement with the numbering system is a very long one, and there is a range of very different numbers. We are in the process of working with Defence to try and resolve that in looking forward; however, in terms of all of our current client base, we need a very complex system of cross-referencing the various numbers that they might have been given, including DVA numbers. It is not a straightforward matter of just giving everyone a number, because as I said, a large number of our clients will not have one to start with.

Senator WHISH-WILSON: I am talking about going forward as in a transition process. You mention in you submission that one in five vets have lodged claims after 2004. That presumably means four out of five have not and have not been in touch. You also said that you are working with Defence to get in touch with those four out of five. You do not have to provide it now but could you give the committee an update on how that is going.

Mr Carmody : We now write to all the members when they leave the ADF. We have no right to contact people, unless they have provided us with their details to allow us to contact them. We have to do a lot of publicity and have a lot of awareness campaigns and work through the ex-service organisations to have people come to us. But I have no direct ability, unless I have been given their details to actually directly contact them.

Senator WHISH-WILSON: There are a couple of questions that you could probably take on notice, if you do not mind, because I have a few others I have to get through very quickly. In terms of your On Base Advisory Service that you offer, can you give us an idea of what utilisation rates have been for these services—I think that was on page 27 of your submission.

Mr Carmody : Certainly. We can give you that on notice. We have a lot of activity in that space.

Senator WHISH-WILSON: Also, the take-up rate of post-ADF discharged GP assessments—how many ADF personnel voluntarily seek a GP assessment? That would be useful as well.

Mr Carmody : I will just have Ms Campion address that question. I do not know whether it is—

Ms Campion : I can answer that one now. The issue with the GP assessment is that it is actually an assessment open to a range of other groups as well. The same item number can cover an assessment for the post-ADF members and it can also cover assessments for other groups. There is no way of measuring through Medicare statistics to know just how many of those assessments are being provided to former ADF members as opposed to other groups that are eligible for the check, unfortunately.

We have monitored the rates of the assessments across the board and we can compare numbers prior to and post the post-ADF assessment being introduced, so we can see some growth there. How much of that is attributable to the group that we are targeting as opposed to other groups, we cannot be sure but we can see some growth in the utilisation.

Senator WHISH-WILSON: I would have more questions but I have some others I have got to get onto quickly. CDF, in relation to suicide in your systemic review, will you be working with recently developed veterans' groups such as Soldier On and Mates4Mates, who have their own suicide watch network? Ultimately, will you be seeking to make recommendations such as having a register of suicide with the DVA? Who would have responsibility?

Air Chief Marshal Binskin : That is all happening now, in fact.

Senator WHISH-WILSON: At the moment, DVA does not have a register for suicide.

Air Chief Marshal Binskin : No, sorry: working with DVA to develop that register—that work is in process now.

Senator WHISH-WILSON: How far away is that?

Mr Carmody : It is still quite a challenging process to work out the suicide numbers in the ex-service community. As I indicated, we do not have contact—the only time we officially hear of a death by suicide is when we get a claim for compensation. We have worked with the Commonwealth Superannuation Corporation—formerly ComSuper—the Australia Institute of Health and Welfare, and Defence to try and see whether we can get more details on this, but we are still a way away from this journey.

One of the other activities that we undertook was to try and get a veteran-specific item in the Census. But that was refused on the basis that the veteran population is too small a population of the Australian community to warrant a particular question in the Census, because most of the people who respond to the census would answer in the negative.

We have tried a number of tactics and we are still continuing to get a tactic on what the overall veteran number is and then compare that to a database—maybe the National Death Index—to work our way through this, but there is still some time to go on the journey.

Senator WHISH-WILSON: Can you give us an update on what you think that official number is at the moment?

Mr Carmody : I have not got a number I can give you at the moment. The statistics, even on how many people have served in the ADF during the last 10 or 15 years, are not statistically clear.

Senator WHISH-WILSON: Can I ask you about vet homelessness. In their submission, RSL LifeCare assert the numbers of homeless ex-service personnel are much higher than the DVA or the government acknowledge. Have you read that submission and do you dispute that?

Mr Carmody : I have read the submission. Maybe my colleague Ms Campion can answer the question in more detail. There is a definitional issue: it is a question of risk of homelessness versus rooflessness—if I can put it that way—people who do not have anywhere to stay. Our difficulty with the figure that was in the survey of 2009 was that it was extremely broad, including people at risk of homelessness, people who were couchsurfing and quite a range of reasons. We ran our demographic against that number and came up with a smaller figure.

Senator WHISH-WILSON: There were a number of submissions that did suggest expanding the DVA definition of homelessness. You have probably seen those.

Ms Campion : If I could just add to Mr Carmody's answer: it is certainly a difficult area, trying to quantify the number, and it is actually a reflection of just how difficult it is to quantify homelessness more broadly. In relation to what we are trying to do to get a better handle on the numbers, we have got a couple of things in train. One is that we are working with the Australian Institute of Health and Welfare to refine the questions that are in the housing and homelessness data collection that is run periodically so that we get a better definition of what a veteran is and a better understanding from that collection about the number of veterans who are accessing specialist homelessness services.

We also have started to work with Homelessness Australia to see whether we can get information out to homelessness organisations about the services that DVA offers and get them to identify veterans who are accessing their services and refer them to us. But also they periodically do what they call a rough sleepers census, and we are looking at whether we can link in with them when they do those censuses to see whether we can identify veterans—

Senator WHISH-WILSON: There is no database existing at the moment on vet homelessness?

Ms Campion : No, there is no one source of information. So, we are trying to work with a number of different organisations to (a) see whether we can, as I said, get a better handle on the number, and, probably more importantly, (b) make sure that when veterans are identified they are informed about the services we can provide and hopefully refer to us so that we can start to ensure that they are getting their entitlements.

Senator WHISH-WILSON: In relation to those services being provided, obviously groups have sprung up—not just RSL LifeCare but also groups like Homeless To Heroes—to fill what they see as a gap in the provision of those services. Is there any chance of a model like Homeless To Heroes being rolled out nationally on a much bigger scale?

Mr Carmody : That provision of housing is not within our portfolio responsibility. If the RSL or one of the other organisations wanted to roll out such a thing, that would be a different matter. But it actually is not something that is within our portfolio funding responsibility.

Senator WHISH-WILSON: Yes, and I have that as my next question: why are no effective government services provided for homeless vets? Is there a reason it is not included in your portfolio responsibility?

Mr Carmody : Funding for homelessness is provided, if I understand it correctly, under the National Partnership Agreement from the Commonwealth to the states and to a range of other organisations. With regard to RSL LifeCare, they are doing a great job in Narrabeen is providing accommodation for people so that they can live in that community environment, and I applaud that.

Senator WHISH-WILSON: That is good to hear. The RSL certainly indicated that it might be interested in looking at some funding options for something a little bit more holistic. I also want to ask about something that I think Senator Fawcett touched on earlier. For people going through the DVA process, or ex-servicemen and their families going through the process, of having dedicated caseworkers working with them, will there be more funding available in the future for dedicated caseworkers to work with clients?

Mr Carmody : In the last budget the government provided $2½ million a year over four years for improved case coordination. We currently have case coordinators for a certain client group. We have service coordinators for another client group. We have our social worker initiative in Victoria, and we have our client liaison unit. We are looking at how all of these coordination functions work together. A large number of clients who go into the compensation space just go into the space and apply for compensation and it is resolved in a particular way at the end of the process. A small number have difficulty with the process, and they are the ones we really want to look at and see what we can do to assist them.

Senator WHISH-WILSON: I also have a question on the difference between counsellors and other experts that you have. We had evidence from a couple of submissions that talked about the need for more trained counsellors, particularly those with military backgrounds. A number of ex-service people are already volunteering to do this job. Do you believe that they should have a military background? And is there funding to have more counsellors trained?

Mr Carmody : I am not sure where the question is going. Do you mean in the Veterans and Veterans Families Counselling Service space?

Senator WHISH-WILSON: Yes.

Mr Carmody : We have both in-house counsellors and a network of many hundreds of contracted counsellors in that space. We try to ensure that they have a good understanding of the community in which they are working, but they are all professionally qualified either in psychology or social work.

Senator WHISH-WILSON: I had the impression from some of the ones we were talking to up in Brisbane that they were not necessarily professionally qualified.

Mr Carmody : If they are not, I will come back and answer that question, but my understanding is that they are all professionally qualified and all certified.

Senator WHISH-WILSON: I have two big-picture questions just to finish off, one for the CDF. Do you support the initiative by Soldier On to have an extra minute of silence on Remembrance Day to recognise and respect mental health and other issues for the walking wounded? In terms of leadership and raising awareness of these issues that we have been discussing, would you support that initiative?

Air Chief Marshal Binskin : That is the first I have heard of it, so I would need to understand the initiative a little bit more.

Senator WHISH-WILSON: I am happy for you to have a think about it.

Air Chief Marshal Binskin : I will get Peter Leahy to come and talk to me about it next time. I had a coffee with him last week and he did not even raise it, so—

Senator WHISH-WILSON: Last year they contacted us and other people and said that they had an initiative to have an extra minute of silence on Remembrance Day for the walking wounded to raise education and awareness about mental health issues and other issues amongst veterans and those who have come back from service. I will leave that with you. Also, I would like to ask a question on behalf of Platoon Sergeant Matt McKeever, who gave evidence in Brisbane, and I would like to ask the question of General Campbell. It is more a matter of asking you for assurance. Mr McKeever said that his experiences with the Army were that the Army wanted to sweep the issue of mental health under the carpet. Can you reassure the committee that this is not the case?

Lt Gen. Cambell : The Army absolutely does not wish to sweep the issue of mental health under the carpet—quite the reverse.

Senator WHISH-WILSON: Excellent. I have some other questions that I will put on notice.

Senator LAMBIE: I have one other question, because I think it is really important that the inquiry understands how this works. Say an infantry soldier, a digger who has done six to eight years and has probably done multiple tours, when he leaves after that period of time goes through a transition. Apart from him getting a letter saying, 'Thank you for serving your country', what else does he receive to ensure that we are trying to de-program him and re-civilianise him back into civilian life?

Lt Gen. Cambell : First, I want to say that I do not agree with the phrase 'de-program'. The rest of your question: fair enough. What we do look to is how we might see how people transitioning informs or gives them the best chance for a next career in their lives. This year we will be trialling a transition-through-employment program with a number of very large employers, looking for opportunities to help people make a first successful step. But I do not think that we are focusing on 'de-programming'; indeed, I would actually contend that a very considerable amount of military training is extraordinarily attractive to employers and that if we can see people leave with a positive experience and with some sense of where they want to go in life and that they are very successful members of society—as indeed two former serving persons on the other side of this table are—then—

Senator LAMBIE: So, do you believe that maybe we should have something like a GI bill whereby these guys are given a second chance? For two or three years, we could retrain them. We are actually paying them 75 per cent of their wage and saying, 'Thank you for your service and thank you for standing out on the front line prepared to take a round for your country.' That is where I am coming from. I do not believe that we are putting a big enough offer on the table for these guys to give them half a chance of getting on with their lives again out of uniform. That is a problem I have.

Lt Gen. Cambell : I think we are beyond my remit there.

CHAIR: On that point, we will conclude today's public hearing. Thank you to all witnesses who have appeared. The date for answers to questions on notice is Friday 16 October.

Committee adjourned at 11 : 19